upper limb and neck Flashcards
What are common cervical symptoms
hoarseness, enlarged lymph nodes, enlarged thyroid
What are the borders of the anterior neck triangle
superior is the mandible
medial is the midline of the neck
lateral is the sternocleidomastoid m
What are the borders of the posterior neck triangle
inferior- clavicle
posterior- trapezius
anterior- sternocleidomastoid
Where do most of the cervical lymph nodes drain
deep to sternocleidomastoid
If the thyroglossal duct into the neck does not close before birth what may happen
a thyroglossal duct cyst may form
What is the first step of the structural neck exam
palpation
what are the normal ROM for flex/extend rotation and side bending of the neck
flexion- 45
extension- 85
rotation- 90
side bending- 40
what muscles are used in rotation of the neck
trapezius, scalene, sternocleidomastoid, splenius, longissimus, semispinalis, and olbliqus capitis
what muscles are used in side bending of the neck
trapezius, scalene, Sternocleidomastoid, splenius longissimus, semispinalis, obliqus, longus and rectus capitis
What is spurlings maneuver checking for
cervical foraminal compression test, side bending to affected time
What is the distraction test
used to alleviate radicular symptoms to support Dx radiculopathy
pain in the neck and numbness in the last 3 fingers and forearm are symptoms of what
thoracic outlet syndrome
What is Roos test
tests for thoracic outlet syndrome and what you do is abduct and flex to 90 degrees and open close hands for 3 minutes, if weakness or numbness- positive test
What is the Adson’s test
thoracic outlet syndrome
palpate radial pulse then move arm into external rotation and abduction and turn head away if pulse diminishes- positive test
What are the rotator cuffs
supraspinatus
infraspinatus
teres minor
subscapularis
what is a winged scapula indicative of
long thoracic nerve injury
What are the ROM for the shoulder
Abduction- 180 ADduction- 75 Felxion- 180 Extension- 60 External rotation- 90 Internal rotation- 100
What is the apley scratch test
touch fingers behind back
Action of trapezius
superior-elevation
middle- retraction
inferior- depression
Action of levator scapula
elevation
action of rhomboids
retraction
action of pectoralis
depression
action of biceps
flexes humerus
action of coracobrachialis
flexes and ADducts the humerus
action of latissimus dorsi
extends and medially rotates humerus
action of deltoid
anterior- flexes
middle- ABducts after 90
posterior- extends
action of supraspinatus
ABducts up to 90
action of infraspinatus
externally rotates
action of subscapularis
internally rotates
action of teres minor
externally rotates
action of teres major
internally rotates
What side do you test first when patient has pain on one side for strength testing
the unaffected side first
What is the strength testing scale
0/5 nothing 1/5 twitch without joint movement 2/5 can move without gravity 3/5 can move against gravity 4/5 against gravity and some resistance 5/5 good
How do you test supraspinatus
patient ABducts against resistance
How do you test subscapularis
patient rotates forearm medially against resistance
how do you test infraspinatus and teres minor
patien rotates forearm laterally against resistance
how do you isolate infraspinatus
hold resistance medially while patient tries to rotate forearm laterally
What is the empty can test for
supraspinatus, abduct arms to 90, forward flex to 45 internally rotate to point downward ans add resistance
how do you isolate subscapularis
lift off test off back
how do you test for AC joint disruption
Crossover test
pain inferior to the anterior border of the acromion and referred pain to anterior deltoid insertion on the humerus are symptoms of what
rotator cuff injuries
pathology of rotator cuff injuries
acromial spurring, subacromial impingement and bursitis, microtears of supraspinatus or complete tear
What is the drop arm test
abduct arm to 90 and ask patient to lower arm, supraspinatus
apprehension test
abducted to 90 and externally rotated and have them add resistance and look for pain
O’Briens test
flex arm and adduct across chest, internally rotate and push down arm- pain is positive for labral tear
Speed’s test
flex straight arm to 90 with palm facing upward. resist student pushing down, pain occurs in bicipital groove- biceps tendonitis
Hawkin’s impingement sign
passively externally rotate shoulder and see if pain is reproduced
elbow ROM
extension- 0 degrees
flexion- 150 degrees
pronation 70 degrees
supination- 90 degrees
what is nursemaids elbow
radial head dislocation
what is posterior elbow
ulnar dislocation
What are the nodes called in someone with osteoarthritis of the distal interphalangeal
heberdens
what are the nodes called in someone with osteoarthritis of the proximal interphalangeal
bouchards
What is tinnel’s sign
tap over median n in carpal tunnel using reflex hammer and see if pain is reproduced for carpal tunnel syndrome
What is a colles fracture
when you fracture distal radius usually by falling on outstreched hand and broken piece moves posteriorly
What is dupuytren’s contracture
inflammation, thickening and contracture of the palmar fascia most commonly in 4th and 5th digits
what is a trigger finger
inflammation of the flexor digitorum tendon sheath which becomes trapped under retinaculum
What is a good test for carpometacarpal osteoarthritis
grind test
how do you test for tenosynovitis of the externesor pollicis brevis and Abductor pollicis longus
put patients thumb in fist and gently ulnar deviate, finkelsteins test
