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OS II Final > UE various treatments > Flashcards

UE various treatments Flashcards

1
Q

Range of motion for shoulder

A 
Flexion: 180°
Extension: 60°
Abduction: 180°
Horizontal Adduction: 130-140°
Horizontal Abduction: 40-55
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2
Q

What tx is indicated with subdeltoid bursitis or frozen shoulder?

A

lateral recumbent, dr behind pt

pt bends elbow of sd, dr stabilizes shoulder and elbow

put the GH joint in its INDIRECT position (abduction/adduction, flexion/extension, compression/traction, IR/ER)

hold until release

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3
Q

What scapular motion leads to what inferior movement of sc joint? superior movement?

A

Scapular Elevation leads to inferior movement of SC joint
-SC ABduction

Shoulder Depression leads to superior motion of SC Joint
-SC ADduction

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4
Q

In 90 degrees Shoulder Flexion, what movement leads to posterior glide of the clavicle? anterior glide?

A

Protraction of the scapula = posterior glide of the clavicle at the SC Joint
-SC Flexion

Retraction of the scapula = anterior glide of the clavicle at the SC joint
-SC Extension

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5
Q

How to dx for SC Joint ABduction/ADduction?

A

pt supine, dr at head of bed w finger on both clavicular heads

shrugs shoulders up (ABduction)
inferior/caudal felt at SC join

pulls shoulders down (ADduction)
- superior/cephalad felt at SC joint

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6
Q

How to dx for SC Joint flextion and extention?

A

dr hands on head of clavicle

pt flexes arm to 90 degrees by reaching to ceiling
- posterior clavicle movement felt

lowers pt arm toward the table (extension)
-anterior movement felt

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7
Q

What would you use to prep the SC joint?

A

SC elevated/adducted sd ART/MET
SC joint ART
SC horizontal extension SD MET

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8
Q

how do you perform sc elevated/adducted sd with still’s?

A

pt seated w/dr behind holding sc joint w one hand, elbow w the other

elbow adducted/ extended

compress toward SC joint

move shoulder into superior glide and abduction w posterior circumduction motion

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9
Q

SC Depressed/ABducted SD Still Technique

A

pt seated w/dr behind holding sc joint w one hand, elbow w the other

elbow abducted and slightly flexed

elbow adducted/ extended

move shoulder into adduction with anterior circumduction motion

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10
Q

Sternoclavicular SD HVLA

A

pt supine, dr at head of table

thenar eminence of monitoring hand over restricted SC joint

Apply cephalad traction on arm w/ dysfunction

Apply thrust on SC joint while simultaneously inducing a rapid traction force through the patient’s arm

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11
Q

what type of thrust do you do for Adduction SD hvla?

Extension SD hvla?

A

Adduction SD

  • Elevated SC
  • inferior thrust

Extension SD

  • Anterior SC
  • posterior thrust
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12
Q

what type of test do you do to diagnosis AC joint?

A

look and feel for step off

cross arm adduction test
-Positive test = pain or increased tissue texture abnormalities

Spring inferiorly on distal clavicle (compare bilaterally)
•Resistant to springing inferiorly (Clavicle Superior)
•Presence of springing inferiorly (Clavicle Inferior)

Spring anterior to posterior (compare bilaterally)

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13
Q

AC Joint Separated SD Still Technique

A
  1. Patient seated, physician in front of patient
  2. Affected side is abducted, with slight extension to open the AC joint
  3. Traction is applied
  4. The arm is moved into adduction/flexion
  5. Traction is removed and arm is returned to neutral
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14
Q

what tx do you do for R clavicle superior glide?

A

AC Joint –Direct –seated ART

  1. Grasp elbow or forearm of SD
  2. Grasp clavicle w/ SD b/w thumb and fingers of free hand. (Thumb on posterior/superior surface of distal clavicle & Not on scapula)
  3. Apply anterior/inferior pressure with thumb on lateral (or posterior) aspect of clavicle while flexing patients elbow, extending and adducting humerus (to gap AC joint)
  4. move shoulder in circular motion (posterior, superior, then anteromedial while maintaining adduction and capsular tension)
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15
Q

Counterstrain for Supraspinatus: F Abd ER

A

Location: midsupraspinatus muscle just superior to spine of scapulae

Pt supine

Dr Ipsi to TP

patient’s arm is flexed 45 degrees, abducted 45 degrees, and externally rotated

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16
Q

Counterstrain for Levator Scapulae: IR Abd traction

A

Location: in levator at the superior angle of the scapula

Pt prone, head rotated away

Dr Ipsi to TP

IR pt’s shoulder, add mild-mod traction with minimal abduction

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17
Q

Counterstrain for Subscapularis: E IR

A

Location: anterolateral border of the scapula on the subscapularis muscle (press posterior and medially)

Pt supine

Dr seated ipsi

pt’s shoulder extended and IR, traction can help

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18
Q

Counterstrain for Biceps Brachii (Long Head): F Abd IR

A

Location: over long head of biceps tendon in bicipital groove

Pt supine

Dr ipsi

Positioning: elbow and shoulder flexed, arm is minimally abducted and IR

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19
Q

Counterstrain for Biceps Brachii (Short Head) Coracobrachialis: F Add IR

A

Location: inferolateral aspect of the coracoid process on short head tendon of biceps or coracobrachialis

Pt supine

Dr ipsi

elbow and shoulder flexed, arm is minimally adducted and IR

20
Q

Elbow ROM

A

Flexion: 140-150°
Extension: 0 to -5°

21
Q

When evaluating abduct/adduct of the ulna, what moves in what direction?

A

Ulnar adduction (varus testing): coupled with wrist abduction (radial deviation)

Ulnar abduction (valgus testing): coupled with wrist adduction (ulnar deviation)

22
Q

What is elbow prep techinques?

A

elbow MFR

Ulnar abduction/adduction MET

23
Q

Ulnar Abduction SD HVLA

A

Pt seated

Supinate and extend elbow to 5°. Grasp elbow with fingers of monitoring hand on either side of elbow. Other hand grasps distal radius/ulnar

Move elbow into ulnar adduction. Apply a medial to lateral thrust over the medial olecranon

24
Q

Ulnar Adduction SD HVLA

A

Patient seated

Supinate and extend elbow to 5°. Grasp elbow with fingers of monitoring hand on either side of olecranon. Other hand grasps distal radius/ulnar

Move elbow into ulnar abduction. Apply a lateral to medial thrust over the lateral olecranon

25
Q

how does the radial head move in relation to the wrist?

A

Radial head anterior glide: coupled with supination

Radial head posterior glide: coupled with pronation

26
Q

radial head prep techinques?

A

RH MET, anterior = supination

RH MET, posterior = pronation

27
Q

Anterior Radial Head SD HVLA

A

Pt seated, dr standing facing the pt

Put thumb of one hand into the crease of the patient’s elbow on the anterior radial head. The other hand flexes elbow and pronates forearm

Exert a rapid hyperflexion force while simultaneously thrusting the radial head posteriorly

28
Q

Posterior Radial Head SD HVLA

A

Pt seated, dr standing facing the pt

Extend and supinate elbow. Place thumb over posterior aspect of radial head.

Exert a rapid hyperextension force while simultaneously thrusting the radial head anteriorly

29
Q

how do you tart exam of the interosseous membrane

A

use your thumbs to feel dorsal and volar aspects of the forearm bw radius and ulna

30
Q

Interosseous Membrane MFR

A

Palpate for tension along the ventral interosseous membrane

Place thumbs over tense areas and fingers on the dorsal forearm

Compress thumbs firmly toward fingers, adding compression (pushing thumbs together) or traction (pulling thumbs apart) until a release is felt

31
Q

Interosseous Membrane BLT

A

Dr holds the pt’s hand/wrist with one hand. With the other hand, place index finger on the patient’s radius for monitoring. Use thumbs to monitor interosseous membrane

Perform indirect positioning of the wrist and elbow to attain point of BLT at the interosseous membrane

Add respiratory phases and make minor adjustments to maintain BLT.

Repeat until the best motion is obtained

32
Q

counterstrain for Radial Head–Lateral (Supinator): E SUP Val

A

anterolateral aspect of the radial head at supinator attachment

Pt supine or seated

Dr ipsi

Positioning: pt’s elbow in full Extension, forearm markedly supinated, fine tune with vaLgus force

33
Q

counterstrain for Medial Epicondyle (Pronator Teres): F PRO Add

A

near medial epicondyle of humerus associated with common flexor tendon and pronator teres

Pt supine or seated

Dr ipsi

pt’s elbow Flexed, marked pronation, forearm slightly aDducted

34
Q

ROM for wrist

A

Flexion: 80-90°
Extension: 70°
Adduction/Ulnar Deviation: 30-40°
Abduction/Radial Deviation: 20-30°

35
Q

Wrist Flexor Retinaculum MFR

A

dr thumb on the medial and lateral attachments of the transverse carpal ligament, fingers around dorsal wrist

massage palm of hand outward and hold for 20-60 sec

36
Q

radiocarpal prep techniques?

A

flexor retinacular met (clinch fist as dr holds wrist)

wrist isotonic met

radiocarpal flexion SD MET

radiocarpal extension SD MET

37
Q

Radiocarpal Joint SD Articulatory with Traction

A

dr interlocks fingers around pt wrist, w grooves parallel to joint line

dr squeeze and traction when articulating the wrist in CC and then CCW

38
Q

Wrist Extension/Ventral Carpal SD HVLA

A

Pt seated, dr standing facing the pt

Pronate elbow. Grasp pt’s hand, thumbs contacting dorsally at the proximal carpal bones (radiocarpal joint)

Deliver a thrust moving from extension to flexion through the carpal dysfunction

39
Q

Wrist Flexion/Dorsal Carpal SD HVLA

A

Pt seated. Dr standing facing the pt

Pronate elbow. Grasp patient’s hand, thumbs contacting dorsally at the proximal carpal bones (radiocarpal joint)

Deliver a whip-like thrust moving from flexion to extension through the carpal dysfunction

40
Q

counterstrain for Dorsal Wrist (Extensor Carpi Radialis): E Abd/rd

A

dorsal surface of second metacarpal associated with extensor carpi radialis muscle (may also be in any extensor muscle)
Pt supine or seated

dr ipsilateral

pt’s wrist passively Extended and aBducted

41
Q

counterstrain for Dorsal Wrist (Extensor Carpi Ulnaris):E ADD

A

dorsal surface of fifth metacarpal associated with extensor carpi ulnaris muscle (may also be in any extensor muscle)

Pt supine or seated

dr ipsilateral

pt’s wrist passively Extended and aDducted

42
Q

counterstrain for Palmar Wrist (Flexor Carpi Radialis): F Abd

A

palmar base of second or third metacarpal in the flexor carpi radialismuscle (may also be found in any flexor muscle)

Pt supine or seated

dr ipsilateral

pt’s wrist passively Flexed and aBducted

43
Q

counterstrain for Palmar Wrist (Flexor Carpi Ulnaris): F Add

A

palmar base of fifth metacarpal in the flexor carpi ulnaris muscle (may also be found in any flexor muscle)

Pt supine or seated

dr ipsilateral

pt’s wrist passively Flexed and aDducted

44
Q

counterstrain for First CMP (Abductor Pollicis Brevis): F (wrist) Abd (thumb)

A

palmar base (radial aspect) of first metacarpal in the abductor pollicis brevis muscle

Pt supine or seated•

Dr ipsilateral

pt’s wrist passively Flexed, thumb is aBducted

45
Q

ROM MCP/PIP/DIP

A

MCP Abduction: spread fingers out

MCP Adduction: move fingers back together

Thumb abduction: moves only thumb in to make the # 4

Individual motion testing of MCP, PIP, and DIP joints (abduction, adduction)

46
Q

finger art

A
  1. Lock the dysfunctional metacarpal between the thumb and index finger of one hand
  2. With other hand, place thumb and index finger on the dorsal and volar aspects of the dysfunctional phalanx

3.Apply long-axis extension (straight-line traction) or rotation oranteroposterior glide
aka pull finger out

47
Q

Phalangeal SD HVLA

A

Pt seated, dr standing facing the patient
Isolate dysfunctional joint.
While stabilizing the wrist, exert traction and a hyperflexion thrust through the SD

OS II Final (5 decks)

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