Upper Extremity Testing (OP) Flashcards
What is the Shoulder Girdle made up of?
Sternum, Clavicle, Scapula, & Humerus
Where is the weakest point of the clavicle?
2/3 along the shaft (common site for fractures)
Where is the Coracoid process?
inferior & anterior to Acromion (palpate)
Palpate the bicipital groove, and lesser/greater tuberosity
Bicipital groove- superior, where the long head of the Bicep tendon passes
Lesser tuberosity- medial border of the groove
Greater tuberosity- lateral border of the groove
Deltoid tuberosity- mid shaft where deltoid inserts
What kind of joint is the Sternoclavicular joint?
Gliding joint
What is the purpose of the Acromioclavicular ligament?
prevents clavicle from riding up & over the Acromion process
What landmarks/bones are included in the Glenohumeral joint?
Head of the humerus & the glenoid fossa
What kind of joint is the Glenohumeral joint?
ball and socket
Where is the Latissimus Dorsi?
lumbar spine, through the armpit, inserting at the biceps
Where is the Trapezius?
cervical/thoracic spine to shoulder
Where is the Rhomboid Major & Minor?
c7 - t5 in a rhombus shape
Where is the Levator Scapulae?
under trapezius (c1- c4)
Where is the triceps brachii?
posterior arm
Where is the Pecoralis major/minor?
chest
Where is the bicep brachii?
find it
Where is the Deltoid?
Shoulder
What are the muscles of the Rotator Cuff?
Infraspinatus, Supraspinatus, Subscapularis, Teres Minor
Where is the Acromion Process?
tip of shoulder
Where is the Coracoid Process?
Medial to the acromion process and 1 inch below the clavicle
How do you perform the Apleys Scratch Test?
Have the athlete reach behind their head and touch the opposite scapula
How do you perform the Traction Test? What does it test for?
downward force is applied to the humerus, acromioclavicular ligament tear
What is a Sulcus Sign?
Indentation appears beneath the acromion process, glenohumeral ligament and glenoid labrum tear
How do you perform an AC Compression test? What does it test for?
Hands are cupped over the anterior & posterior joint, examiner squeezes the hands together compresses the AC joint, Positive test = pain, damage to coracoclavicular ligament or acromioclavicular lig
What is the Apprehension test? What does it test for?
Shoulder is Abducted to 90°, the elbow is flexed to 90° while supporting the humerus passively, externally rotate the GH joint by applying pressure to the forearm. Positive = pain, chronic subluxations or dislocations of the GH joint
What is the Anterior Drawer test?
The examiner uses his right hand to grasp the patient’s relaxed upper arm and draws it anteriorly with a force
What is the Posterior Drawer test?
The examiner uses his right hand to grasp the patient’s relaxed upper arm and draws it posteriorly with a force
How do you perform the Impingement test?
The shoulder is passively moved into flexion with the humerus internally rotated
What is the Hawkins/Kennedy test? What does it test for?
Shoulder is placed in 90° of forward flexion and then forcibly internally rotating the shoulder, Positive for Impingement
What is the Drop Arm test? What does it test for?
Hold the shoulder at 90° of abduction then apply a downward tap, positive tests would result in the arm falling to their side, indicates injury to the rotator cuff, especially the supraspinatus
What is the Empty Can test? What does it test for?
With the elbow extended the shoulder is abducted to 90°, IR , horizontally flexed to 30°, the athlete resists abduction, positive test results in pain, indicating supraspinatus inflammation, impingement, or tear
What is Yergason’s test? What does it test for?
Elbow is flexed to 90°, the forearm is in a neutral position with the thumb up, resist supination of the forearm and ER of the shoulder, positive tests results in pain and snapping of the bicep tendon
What is Speeds test? What does it test for?
Resist shoulder flexion while palpating tenderness over the bicipital groove, positive tests results in pain along the tendon especially in the groove, indicates tendinitis or inflammation
What is Cranks test? What does it test for?
shoulder is abducted 90° and slowly internally rotated while a gentle axial load is applied through the glenohumeral joint, positive SLAP lesion
What is O’Brien test? What does it test for?
shoulder is held in 90 degrees of forward flexion, 30 to 45 degrees of horizontal adduction and maximal internal rotation. The examiner grabs the patient’s wrist and resists the patient’s attempt to horizontally adduct and forward flex the shoulder, Positive SLAP lesion
What is Adson’s Test? What does it test for?
Shoulder is abducted to 30°, elbow is extended the thumb is pointing up, head is looking toward the involved side, one hand is positioned to feel the radial pulse, examiner ER and extends the shoulder while the athlete extends the neck, the athlete then inhales deeply and holds their breath, positive test the radial pulse diminishes or disappears
How many bones are in the hand?
27
What are the bones of the elbow?
Humerus, radius, ulna
Where is the Olecranon fossa?
pointy apex of the elbow
Which is most medial, the Capitulum or Trochlea?
Trochlea
Where is the Olecranon process?
fits into the olecranon fossa during complete extension
Where is the Coronoid process?
fits into the fossa during flexion
What are the joint(s) of the elbow?
Humeroulnar, Humeroradial, Proximal Radioulnar
During supination the____ rotates & crosses over the ___
radius, ulna
Radial Collateral Lig resists what kind of force?
Varus force
Ulnar Collateral Lig resists what kind of force?
Valgus force
Name the muscles that flex the elbow.
Biceps Brachii, Pronator teres, Brachialis, Brachioradialis, Palmaris Longus
Name the muscles that extend the elbow.
Triceps Brachii
What nerve passes through the carpal tunnel?
Median nerve
Where does the ulnar nerve pass through?
medial epicondyle
What does the valgus stress test for?
Sprain to Ulnar Collateral Ligament
What does the varus stress test for?
Sprains to Radial Collateral Ligament
What is “Tennis Elbow”?
Inflammation of the Lateral Epicondyle (Lateral Epicondylitis)
What is “Golfer’s Elbow”?
Inflammation of the Medial Epicondyle (Medial Epicondylitis)
What is Volkmann’s Contracture?
Humeral supracondylar fracture
Dislocation of elbow is caused by ___
Fallen on an outstretched hand
Where is the Distal Radioulnar joint?
Wrist
What does MCP stand for?
Metacarpophalangeal
What does DIP/PIP stand for?
Distal/proximal interphalangeal
Name the muscles that extend the wrist.
Extensor Carpi Radialis Longus & Brevis, Extensor Carpi Ulnaris, Extensor Digitorum, Extensor Pollicus Longus & Brevis (thumb)
Name the muscles that flex the wrist.
Flexor Carpi Radialis, Flexor Carpi Ulnaris, Palmaris Longus, Flexor Digitorum Superficialis, Flexor Digitorum Profundus, Flexor Pollicis Longus
What does “Thenar” mean?
thumb (radial/lateral side)
What does “Hypothenar” mean?
pinky (ulnar/medial side)
What is the roof of the carpal tunnel?
Transverse Carpal Ligament
Name everything that travels through the carpal tunnel. (4 things)
Median nerve, Flexor Pollicis Longus Tendon, Flexor Digitorum Superficialis Tendon, Flexor Digitorium Profundus Tendon
What is Insidious pain?
Not recalling when the pain initially started
What is a Ganglion Cyst?
collection of fluid
What is Ape Hand?
Disruption of the Median nerve causing atrophy of the thumb muscles. The ability to flex or oppose the thumb is lost
What is Bishop’s Deformity?
Disruption of the Ulnar nerve causing atrophy of the 3rd-5th finger muscles. Fingers flex at the PIP & DIP joints
What is Swan Neck Deformity?
Flexion of the MCP & DIP, Hyperextension of the PIP. Caused by fractures or Rheumatioid arthritis.
What is Jersey Finger?
Avulsion of the Flexor Digitorium Profundus. Inability to Actively flex the DIP joint
How do you test grip strength?
Squeeze a Dynamometer or examiner’s hand
How do you do the varus Stress test on the wrist? What ligament does it test for?
ulnar deviation testing for Radial Collateral Ligament tear
How do you test the Valgus Stress test on the wrist? What ligament does it test for?
Radial deviation testing for Ulnar Collateral Ligament tear
How do you perfrom the Wrist Glide Test, and what does it test for?
Grip forearm & Proximal carpal row- Force is applied up & down, forward & backwards, Injury to the carpal collateral ligaments
How do you perform the Long Bone Compression Test?
flick the tip of the finger (testing for finger fracture)
How do you perform Phalen’s Test? What does it test for?
Overpressure with wrist flexion. Hold the position for 1 minute. Tingling sensation of the median nerve, positive for Carpal Tunnel
How do you perform Finkelstein’s Test? What does it test for?
Tuck the thumb under the fingers and make a fist. Actively Ulnar deviate the wrist, Positive for deQuervain’s Syndrome
How do you perform Tinel’s test? What does it test for?
Tapping over the median nerve over the carpal tunnel
What is Handlebar Palsy?
pressure on the ulnar nerve