Upper Quadrant Movement Impairment

Question 1

What is difference between cause and source with movement impairments?

Answer 1

Cause: mechanical factor that results in tissue irritation
Source: tissue or patho-anatomical structure that is symptomatic

Question 2

What is the language of MSI?

Answer 2

Repeated movements and sustained postures: alter tissue characteristics
Direction susceptible to movement: accessory motion hypermobility
Relative flexibility: path of least resistance

Question 3

What are factors to consider for cervical spine for MSI?

Answer 3

Cervical pain and degeneration: precipitated by deviations in alignment and movement patterns, accessory motion hypermobility
T-spine
Weight of UE
Effects of hearing loss/vision loss
"Head talker"

Question 4

What are intrinsic cervical flexors?

Answer 4

Close to axis of rotation providing precise control.
UCS: rectus capitis anterior, rectus capitis lateralis
LCS: longus capitis, longus colli
Roll…?

Question 5

What are extrinsic cervical flexors?

Answer 5

power without precision
span multiple segments
Sternocleidomastoid, anterior scalene, middle scalene
anterior translation…?

Question 6

What are the intrinsic cervical extensors?

Answer 6

UCS: rectus capitis posterior, oblique capitis inf/sup, semispinalis capitis, splenius capitis, longissimus capitis
LCS: semispinalis cervicis, splenius cervicis, longissimus cervicis

Question 7

What are extrinsic cervical extensors?

Answer 7

Upper trap

Levator

Question 8

What should be alignment of shoulder girdle?

Answer 8

Vertical or slight upward rotation
Elevation vs. depression (T2-T7)
Scapular abduction (3-4 inches)
Internal rotation: 30-40 degrees
Anterior tilt: 10 degrees

Question 9

What are MSI classification of cervical spine?

Answer 9

Ext with rot
Ext
Flex with rot
Flex

Consider scapular diagnosis: depression, abduction, insufficient upward rotation

Question 10

What are syndromes for MSI classification for ext+rot?

Answer 10

Cervical radiculopathy, DDD, herniated disc, facet syndrome, spondylosis

forward head with asymmetrical findings, pain with rotation

Question 11

What are syndromes for MSI classification for flex+rot?

Answer 11

Cervical radiculopathy, DDD, herniated disc, facet syndrome, spondylosis

decreased lordosis, flat T-spine, excessive recruitment of extrinsic cervical rotators

Question 12

What are parts of MSI exam (sitting, standing, etc)?

Answer 12

Standing: alignment, movement testing on shoulder
Sitting: movement testing c-spine
Supine: positioning effects, movement testing/muscle length of shoulder, cervical motions, MMT intrinsic neck flexors
Sidelying: positioning, muscle performance- traps
Prone: movement testing, MMT traps, GH rotation
Quadruped: preferred position, rocking back
Functional tasks: workstation, sports activities, TV

Question 13

What are interventions for CS MSI findings?

Answer 13

exercises to correct alignment

Specificity of exercise program: address daily activites