Upper Extremity Competency Flashcards
1
Q
a. Perform the evaluation of the glenohumeral joint for somatic dysfunction and document appropriately.
A
- Student contacts the olecranon while blocking linkage at the shoulder region.
- Student evaluates passive flexion, noting normal to be 180 degrees.
- Student evaluates passive extension, noting normal to be 60 degrees.
- Student evaluates passive abduction, noting normal to be 180 degrees.
- Student evaluates passive adduction, noting normal to be 40‐50 degrees.
- Student evaluates passive internal & external rotation, noting normal to be 90 degrees for
both. - Student contacts proximal humerus to assess anterior/inferior glide and posterior/superior
glide passively - Student performs evaluation bilaterally in order to assess for asymmetries
- Student names somatic dysfunction found in glenohumeral joint
- Student states they would document a glenohumeral somatic dysfunction in the objective
portion of the SOAP note
2
Q
b. Perform the evaluation of the acromioclavicular joint for somatic dysfunction and document appropriately.
A
- Student contacts over the AC joint and palpates for tenderness and tissue texture changes.
- Student brings glenohumeral joint into 60° coronal abduction and 60° horizontal abduction
to maximize AC joint motion - While maintain the position, student assesses rotational aspect of AC joint by internally and
externally rotating the glenohumeral joint - Student performs evaluation bilaterally in order to assess for asymmetries
- Student names an internal or external rotation dysfunction of the AC joint
- Student states they would document an acromioclavicular joint somatic dysfunction in the
objective portion of the SOAP note
3
Q
c. Perform the evaluation of the sternoclavicular joint for somatic dysfunction and document appropriately.
A
Describes horizontal flexion and extension assessment as follows:
- Have patient lie supine, place fingers bilaterally anteriorly on the clavicular head next to the
sternum to monitor motion
- Have the patient flex shoulders to 90 then reach towards the ceiling, evaluating the motion
of both clavicles beneath your fingers - States proximal end of clavicle moves posterior as the patient reaches towards the ceiling
(horizontal flexion) as the distal clavicle moves anterior - As the patient returns shoulders back to neutral (horizontal extension), states proximal
clavicle moves anterior and distal clavicle moves posterior - Student states that by performing bilaterally, they can assess for asymmetries
- Student states a horizontal extension dysfunction with restriction to horizontal flexion is
most common
Describes abduction and adduction assessment as follows:
- Student now places the index fingers of both hands on the superior aspect of the head of
both clavicles, and has patient shrug their shoulders
- States proximal end of clavicle moves inferiorly and distal end of clavicle move superiorly as
the patient shrugs shoulders superiorly (abduction) - As patient lowers shoulders to neutral (adduction), states proximal end of clavicle moves
superiorly and distal end of clavicle moves inferiorly - Student states that by performing bilaterally, they can assess for asymmetries
- Student states an adduction dysfunction with restriction to abduction is most common
- Student states they would document a sternoclavicular somatic dysfunction in the objective
portion of the SOAP note
4
Q
d. Perform the evaluation of the scapulothoracic joint for somatic dysfunction and document appropriately.
A
- Patient in lateral recumbent position with student facing the patient’s anterior aspect contacting the inferior angle of the scapula with their caudad hand the acromion with their cephalic hand
- Student performs scapular elevation (cephalad and -parallel to spine) and states the upper trapezius and levator scapulae are responsible for the motion
- Student performs scapular depression (return from elevation) and states the lower trapezius and lower rhomboids are responsible for motion
- Student performs scapular protraction (away from/perpendicular to the spine) and states the serratus anterior is responsible for the motion
- Student performs scapular retraction (moving closer to the spine) and states the rhomboids and middle trapezius are responsible for the motion
- Student performs upward rotation (forward tilt) and states the serratus anterior and upper trapezius muscles are responsible for the motion
- Student performs downward rotation (Backward tilt) and states the levator scapulae, rhomboid major and minor, and latissimus dorsi muscles are responsible for the motion
- Student performs evaluation bilaterally in order to assess for asymmetries
- Student names somatic dysfunction found in the scapulothoracic joint
- Student states they would document a scapulothoracic somatic dysfunction in the objective
portion of the SOAP note
5
Q
e. Perform the evaluation of Ulnar Abduction (valgus testing) coupled with wrist adduction for elbow somatic dysfunction and document appropriately.
A
- Student has patient in seated position with arms in anatomical position.
- Student contacts the wrist with one hand and the lateral elbow with the other.
- Student takes the elbow into extension and a valgus force is applied to the ulnohumeral
joint. - Student notes hard or soft end feel.
- Student describes dysfunction as the ease of motion prefers abduction at the ulnohumeral
joint. - Student states they would document an ulnar abduction somatic dysfunction in the
objective portion of the SOAP note.
6
Q
f. Perform the evaluation of Ulnar Adduction (varus testing) coupled with wrist abduction for elbow somatic dysfunction and document appropriately.
A
- Student has patient in seated position with arms in anatomical position.
- Student contacts the wrist with one hand and the medial elbow with the other.
- Student takes the elbow into extension and a varus force is applied to the ulnohumeral
joint. - Student notes hard or soft end feel.
- Student describes dysfunction as the ease of motion prefers adduction at the ulnohumeral
joint. - Student states they would document an ulnar adduction somatic dysfunction in the
objective portion of the SOAP note.
7
Q
g. Perform the evaluation of Radial Head Motion ‐ Posterior Glide coupled with pronation for elbow somatic dysfunction and document appropriately.
A
- Student has patient in seated position and faces them
- Student contacts the wrist with one hand and the radial head with the other.
- Student provides a posterior glide force to the radial head noting end feel
- Student assesses forearm pronation and notes if there is ease of motion or restriction to full
pronation - Student states a posterior radial head dysfunction will have ease of motion to posterior glide
and forearm pronation with restriction to anterior glide and forearm supination - Student states they would document a posterior radial head somatic dysfunction in the
objective portion of the SOAP note.
8
Q
h. Perform the evaluation of Radial Head Motion ‐ Anterior Glide coupled with supination for elbow somatic dysfunction and document appropriately.
A
- Student has patient in seated position and faces them.
- Student contacts the wrist with one hand and the radial head with the other.
- Student provides an anterior glide force to the radial head noting end feel.
- Student assesses forearm supination and notes if there is ease of motion or restriction to
full supination. - Student states an anterior radial head dysfunction will have ease of motion to anterior glide
and forearm supination with restriction to posterior glide and forearm pronation. - Student states they would document an anterior radial head somatic dysfunction in the
objective portion of the SOAP note.
9
Q
i. Perform the evaluation of Wrist Flexion with coupled Dorsal/Posterior Carpal Glide for wrist somatic dysfunction and document appropriately.
A
- Student has patient in seated position and contacts the hand with one hand and the distal radius/ulna with the other
- Student places wrist into flexion and extension and notes freedom of motion is in flexion with restriction to extension
- Student states the carpal bones will have coupled freedom of motion in dorsal/posterior glide with restriction to ventral/anterior glide
- Student states they would document a wrist flexion/posterior carpal glide somatic dysfunction in the objective portion of the SOAP note.
10
Q
j. Perform the evaluation of Wrist Extension with coupled Ventral/Anterior Carpal Glide for wrist somatic dysfunction and document appropriately.
A
- Student has patient in seated position and contacts the hand with one hand and the distal radius/ulna with the other
- Student places wrist into flexion and extension and notes freedom of motion is in extension with restriction to flexion
- Student states the carpal bones will have coupled freedom of motion in ventral/anterior glide with restriction to dorsal/posterior glide
- Student states they would document wrist extension/anterior carpal glide somatic dysfunction in the objective portion of the SOAP note.
11
Q
k. Perform the evaluation of Abduction of the Wrist (deviation toward the radial side in the anatomical position) for wrist somatic dysfunction and document appropriately.
A
- Student has patient in seated position and contacts the hand with one hand and the distal radius/ulna with the other.
- Student places forearm in full supination.
- Student places wrist into abduction (radial deviation) and adduction (ulnar deviation) and
notes freedom of motion is in abduction (radial deviation) with restriction to adduction
(ulnar deviation) - Student states they would document wrist abduction somatic dysfunction in the objective
portion of the SOAP note.
12
Q
l. Perform the evaluation of Adduction of the Wrist (deviation toward the ulnar side in the anatomical position) for wrist somatic dysfunction and document appropriately.
A
- Student has patient in seated position and contacts the hand with one hand and the distal radius/ulna with the other.
- Student places forearm in full supination.
- Student places wrist into adduction (ulnar deviation) and abduction (radial deviation) notes
freedom of motion is in adduction (ulnar deviation) with restriction to abduction (radial
deviation) - Student states they would document wrist adduction somatic dysfunction in the objective
portion of the SOAP note.
13
Q
m. Perform the evaluation of Finger Abduction (index, long, ring and little fingers) for finger somatic dysfunction and document appropriately.
A
- Student has patient in seated position and contacts the distal metacarpal with one hand and the proximal phalanx of the metacarpal joint in question with the other.
- Student has hand/wrist in full supination for anatomical position.
- Student provides a force to move the joint away from the midline and towards midline.
- Student states the ease of motion is into abduction and restriction is to adduction.
- Student states they would document the specifically named joint plus abduction somatic
dysfunction (e.g. right 3rd metacarpal abduction somatic dysfunction) in the objective portion of the SOAP note.
14
Q
n. Perform the evaluation of Finger Adduction (index, long, ring and little fingers) for finger somatic dysfunction and document appropriately.
A
- Student has patient in seated position and contacts the distal metacarpal with one hand and the proximal phalanx of the metacarpal joint in question with the other.
- Student has hand/wrist in full supination for anatomical position.
- Student provides a force to move the joint toward the midline and away from midline.
- Student states the ease of motion is into adduction and restriction is to abduction.
- Student states they would document the specifically named joint plus adduction somatic
dysfunction (e.g. right 3rd metacarpal adduction somatic dysfunction) in the objective portion of the SOAP note.
15
Q
o. Perform the evaluation of Abduction of Thumb for finger somatic dysfunction and document appropriately.
A
- Student has patient in seated position and contacts the distal first metacarpal with one hand and the proximal phalanx of the thumb with the other.
- Student has hand/wrist in full supination for anatomical position.
- Student provides a force to move the joint in an anterior direction.
- Student states the ease of motion is to abduction of the joint and restricted to adduction.
- Student states they would document thumb abduction somatic dysfunction in the objective
portion of the SOAP note.
