Upper Quarter Screen Flashcards
What does ART stand for
Asymmetries
ROM
Tissue texture changes
True or false:
You always screen the joint above and below the joint in question
True
UQS
Upper quarter screening
Observing posture what do you look at
Alignment of head and shoulders
What do you do during the skin assessment
Observe areas of inflammation, bruising, redness, temperature
To observe temperature which part of the hand is used
The back side
Posture examination requirements (8)
- Sitting or standing
- Cervical and thoracic alignment
- Upper extremity B symmetry
- Muscular/soft tissue imbalances
- Iliac crest height
- Nose over sternum
- Tragus aligned with acromion
- Umbilicus centered
ROM of cervical spine requirements (4)
- Flexion
- Extension
- Sidebending
- Rotation
What do you do if the patient is pain free
Apply gentle overpressure and hold for a few seconds
What should you screen if there is any numbness or tingling in limbs
Spine
ROM of shoulder requirements (6)
- Flexion
- Extension (elbow flexed and extended)
- Scaption
- Abduction
- FIR
- FER
Is over pressure applied for the FIR and FER
NO MA’AM
ROM of the Elbow, Wrist, and Hang requirements (8)
- Elbow flexion
- Elbow extension
- Forearm supination
- Forearm pronation
- Wrist flexion
- Wrist extension
- Finger ABD/ADD/opposition
- Radial/ulnar deviation
What is a myotome
A single nerve root that innervates a muscle
What should be said to the patient before myotomal testing
I want you to… Match my resistance, best effort, and don’t let me move you
Do you examine strength one side at a time
NO, bilaterally
Do you want to reproduce symptoms
YES YES YES
What are the grades for strength (4)
- Strong painless
- Strong painful
- Weak painless
- Weak painful
How should force be applied
A bell curve
What are the requirements of myotomal testing (10)
- Cervical spine (flexion, extension, sidebending) (C1 - 3)
- Shoulder elevation (C5)
- Shoulder abduction (C5)
- Shoulder IR/ER (no specific myotome)
- Elbow flexion (C6)
- Elbow extension (C7)
- Wrist flexion (C7)
- Wrist extension (C6)
- Thumb extension (C8)
- Finger abduction (T1)
Do you have to ask for consent
YES, ALWAYS
True or False:
You should always ask if the patient has resting pain
True
Risks of these tests include what
Recreating symptoms, may be uncomfortable
If there is pain what should you ask
What type, location, the same as your symptoms, was the pain with active movement or overpressure
C1 and C2 dermatome
Base of skull
C3 dermatome
Lateral neck
C4 dermatome
Acromion
C5 dermatome
Lateral elbow
C6 dermatome
Thumb
C7 dermatom
middle finger
C8 dermatome
Pinky medial hand
T1 dermatome
Medial forearm
What are things to ask during light touch test
Does it feel the same on both sides, if they don’t feel it how is it different
What are the 5 aspects of cutaneous sensory testing
- Light touch
- Sharp vs. dull
- Hot vs. cold
- Two point discrimination
- Vibration sensation
What is the normal two point discrimination range for the finger tip
2 - 4 mm
What is the normal two point discrimination range for the palm
4 - 8 mm
What does proprioception/kinesthetic awareness assess
Skin, joints, muscle spindles, dorsal column, and medial lemniscus tracts
What is the static test for proprioception
Move patients arm passively at elbow joint and ask them whether the arm is oriented up or down. PATIENT MUST HAVE EYES CLOSED
What do deficits during static position sense represent damage to
Thalamus
What is dynamic passive motion sense mirroring
Passively move patients arm (eyes closed) and ask patient to mirror where the arm is with the opposite arm. Can be done with position or while moving
What is dynamic passive motion sense following
Passively move patients arm (eyes closed) and ask patient to follow the motion of the arm with the opposite arm
What does an upper motor neuron (UMN) lesion or brain and spine lesion indicated by
Hyperreflexive
What does lower motor neuron (LMN) lesion or nerve root/peripheral nerve lesion indicated by
Hyporeflexive
What is damaged in an UMN lesion
Nerve cells in spinal cord
What is damaged in a LMN lesion
Alpha motor neuron
What is MSR
Muscle stretch reflexes
What is the grading scale for MSR from
0 - 4
What is a 0 on the MSR scale
Areflexive
What is a 1 on the MSR scale
Hyporeflexive
What is a 2 on the MSR scale
Average/normal
What is a 3 on the MSR scale
Hyperreflexive
What is a 4 on the MSR scale
Spastic
What helps when reflex is weak
Jendrassik Maneuver
Cranial nerve V (5) test
Mandibular and corneal reflex
C5 and C6 test
Biceps brachii (C5) Brachioradialis (C6)
C7 and C8 test
Triceps (C7)
