Upper Quarter CPR's Flashcards
1
Q
How do you manually stretch the upper traps
A
- Contralateral side bend away
- Ipsilateral rotation toward
- Slight neck flexion
2
Q
How do you manually stretch the elevator scapula
A
- Contralateral side bend away
- Contralateral rotation away
- Slight neck flexion
3
Q
How do you manually stretch the SCM (sternocleidomastoid)
A
- Contralateral side bend away
- Ipsilateral rotation toward
- Slight neck extension
4
Q
Describe the Alar Ligament Stress Test
A
- Palpate C2 spinous process
- Use a key pinch grip on the C2 spinous process or a wider grip to pinch both C2 transverse processes (find C1 transverse processes and fall off onto C2)
- Method #1: rotate patient’s head and you should feel the spinous process rotate into the opposite finger
- Method #2: hold fast on the C2 spinous process while rotating the patient’s head and you should feel a capsular end feel & no more than 21º rotation of the head
- Positive test is if the patient has more than 21º of rotation when held in place (method #2)
- Test in neutral first then flexion and extension for a full test
5
Q
What are the special tests included in the cluster/CPR for partial rotator cuff tear
A
- Painful arc: typically expect pain b/w 60-120º that goes away as arm reaches above head
- Hawkin’s Kennedy: ABD arm to 90º and horizontally ADD across chest then internally rotate looking for reproduction of pain
- Infraspinatus test: arm at side of patient with elbow bent to 90º and perform a MMT of the infraspinatus by asking the patient to externally rotate looking for reproduction of pain
6
Q
What does DAN’s stand for
A
- Ds: Diplopia, dizziness, dysphagia, dysarthria, drop attacks
- As: ataxia of gait, anxiety
- Ns: numbness (ipsilateral face and/or contralateral body), nystagmus
7
Q
Cervical radiculopathy CPR
A
- Positive Spurling’s
- Positive relief of symptoms in neck distraction
- Cervical rotation <60º on ipsilateral side
- Positive ULTTA
8
Q
Cervical myelopathy CPR
A
- Gait deviation
- Hoffman’s test (positive)
- Inverted supinator sign (positive)
- Babinski test (positive = toes extend)
- Age >45 years
9
Q
C-spine manipulation intervention criteria
A
- Symptoms <38 days
- Side to side cervical rotation difference >10º
- Pain with PA spring testing mid C-spine (C3-C7)
- Positive expectation manipulation would help
10
Q
Cluster/CPR for full thickness rotator cuff tear
A
- Positive drop arm test (supraspinatus specifically): ABD pt arm to 90º in a neutral rotation; Positive = unable to hold position
- Positive painful arc
- Positive infraspinatus muscle test
11
Q
Describe drop sign test
A
- Test for rotator cuff tear (infraspinatus specifically)
- Place pt’s arm in 90º ABD and 90º elbow flexion
- Get pt into end range while holding their wrist
- Let go of wrist and patient should be able to sustain the position
- Positive if patient’s arm falls forward/is unable to hold the position
12
Q
Describe external rotation lag sign
A
- Test for rotator cuff tear (supraspinatus and infraspinatus specifically)
- Place pt’s arm in about 70º abduction with 90º elbow flexion
- Place patient into max external rotation with fingers tips wrapped around their wrist
- Let go of their wrist and patient should be able to hold the position
- Positive if patient’s arm falls forward/is unable to hold the position
13
Q
Describe horn blowers test
A
- Test for rotator cuff tear (teres minor and infraspinatus specifically)
- Place the pt’s arm in 90º abduction and 90º elbow flexion
- Have the patient resist internal rotation in this position and they should be able to sustain this
- Positive if patient is unable to sustain against the resistance
14
Q
Shoulder pain intervention with crevice-thoracic OMPT (manipulations/mobilizations at CT junction) CPR
A
- Pain frère shoulder flexion <127º
- Shoulder IR <53º at 90º abduction
- Negative Neer’s impingement: depress the scapula and maximally internally rotate the pt’s arm and lift into full forward shoulder flexion; positive = pain reproduction
- Not taking pain medications for the shoulder
- Duration of symptoms ≤90 days
15
Q
Illness script for shoulder adhesive capsulitis diagnosis
A
- Capsular pattern of limitation ER>ABD>IR
- Think 50 year old shoulder
- Females > males
- Those with Endocrine disorders (DM, Thyroid) more susceptible
