Upper Quadrant

Question 1

Initial Observation

Answer 1

body type. head and neck, shoulder levels, spasm, asymmetry, contours, facial expression, postural alignment

Question 2

Hx

Answer 2

SPecial Q’s: sleep, pillow, position, dizziness, diff. swallowing, B/L umbness/ tingling in hands/ feet, gait disturbances, overt weakness, systems scan, imaging: static vs mobility, IS PT APPROPRIATE FOR PT? Red flags (Fx), Yellow flags (psychosocial?)

Question 3

Quick Tests

Answer 3

SF/ SABD + overpressure, apley scratch + overpressure, clear rotator cuff (empty/ full can), elbow flex/ext, wrist flex/ext/uln dev/ rad dev), cross body

Question 4

AROM C/S

Answer 4

Flex, ext, lat flex, rotate… does overpressure elicit distal reactions (no overpressure on ext)?, segmental motion? range? strategy of movement? symmetry? excursion? compensation?

Question 5

PROM C/S

Answer 5

if loss of motion present, repeat cervical PROM and check for end feel

Question 6

Deep Tendon Reflexes

Answer 6

Biceps C5 C6, Brachioradialis C6, Tricepts C7

Question 7

Vertebral Artery Test

Answer 7

Slowly bring into ext, then flex and rotate (30s at each), look for nausea, dizziness, nystagmus

Question 8

Thoracic Outlet Syndrome Tests

Answer 8

Roos: shoulders abd and elbow flexed to 90, have pt open/close hands for 3 min; Adson: Passively extend, abduct and externally rotate affected arm while palpating the radial pulse, extend neck towards hand; Hallstead: adson’s with head the other way; Allen: radial and ulnar arteries occluded at wrist, open/ close and then remove occlusion to see if refills; Wright: Full ABD and ER hold for 1min with neck turned other way palpating radial pulse, repeat and look for changes

Question 9

Spurling’s Test

Answer 9

combines BB, SB, and rot, if pain-free add compression (+) pain for stenosis, facet pathology