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MSK > UQ Intro & Review > Flashcards

UQ Intro & Review Flashcards

1
Q

Regional Interdependence

A

-impairment model
-unrelated impairments in a remote region
-if pt presentation is unclear and treatment isn’t working

-pain, ROM, neuro, psychosocial, referred pain

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2
Q

UQ Scan

A
  1. Vitals (HR and BP)
  2. CNs (optional)
  3. Observation: posture, plumb line, head, face, neck, mouth
  4. Gait: look for gross abnormalities
  5. Clear the spine
  6. UE ROM: All 6 w/ overpressure
  7. Dermatomes (C4-T2)
  8. Myotomes (C5-T1)
  9. DTR: bicep, brachioradialis, tricep
  10. UMN Testing: Hoffman’s, Babinski, Lhermitte
  11. Upper Limb Tension Testing (Median)
  12. Pulses (carotid, axillary, brachial, radial, ulnar) (optional)
  13. Thyroid (optional)
  14. Lymph Nodes (neck, and axilla) (optional)
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3
Q

When to Scan

A
  1. No obvious MOI
  2. Proximal Cause for Distal S/s
  3. Non-mechanical sounding Sx
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4
Q

Observations from Behind

A

Even: ears, scapula, ribs, arm gaps

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5
Q

Observations from Side

A

-spinal curves
-ears even with acromion

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6
Q

Observations from Front

A

Face: pupil dif, CN, scars, eye tracking/bulging
Even: ears, clavicles, nipples, arm gaps

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7
Q

Gait Observations

A

-decreased WB
-hip, ankle, foot
-BOS
-flat food
-shuffling

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8
Q

Myotome Testing

A

-fatiguable weakness=nerve root
-constant weakness=MMT

-C5-T1

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9
Q

Dermatome Testing

A

-test face first
1. “When do you feel it”
2. “Where do you feel it”
3. “Does it feel the same as your face”

-C4-T1

Impaired or intact

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10
Q

Reflex Testing (& grade)

A

0: no response
1: low
2: normal
3: brisk
4: very brisk
5: sustained/clonus

C5: biceps
C6: brachiorad
C7-C8: Triceps

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11
Q

UMN Signs

A

Hoffman’s
Babinski
Lhermitte (demyelination of SC)

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12
Q

Clearing the Spine

A

Normal: flx/ext, LSB, rot
Provocation: compression and distraction, 5-8s

Pain Reproduced w/ Compression:
-herniationn
-end plate/fx
-arthritis
-nerve root

Pain Reproduced w/ Distraction
-spinal lig tear
-tear of annulus fibrosis
-spasm
-dural irritability
-cervical instability

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13
Q

ROM

A

-Cervical
-Shoulder, elbow, wrist, and hand

  1. AROM –> reproduction of local s/s
  2. AROM –> reproduction of remote s/s
  3. AROM –> no impact on s/s
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14
Q

Slump Test

A

-test neuromobility

  1. Hands behind back
  2. Head and neck flexed
  3. Lumbar flx
  4. Straighten knee
  5. overpressure
  6. DF of ankle
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15
Q

Pulses (& grade)

A

-Carotid, axilla, brachial, radial, ulnar
-femoral, popliteal, post tib, dorsalis pedis

0: absent
1: reduced
2: slightly reduced
3: normal
4: bounding

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16
Q

Palpation

A

-inguinal area, axilla, neck (behind ears and jaw)
-check for swelling, pain
-check thyroid

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17
Q

Median Nerve Upper Limb Tension Testing

A
  1. Use elbow to depress scap
  2. Abduct
  3. Extend wrist and fingers
  4. ER
  5. Elbow extension
  6. Lat sidebending of head

+ Findings: differences btw sides, different elbow ROM, reproduction of s/s

18
Q

Neurodynamics

A

-Dynamic mechanical and physiological properties of NS
-inter and intra neural communication
-neural tissue responds to moving by: gliding, lengthening, compression

19
Q

Adverse Neural Tension

A

-abnormal physiological or mechanical response from NS
-limits range/stretch
-neuro s/s

20
Q

Mechanisms of Neural Adverse Tension

A

-dura tethered to bony canal and adhesions increase tension
-C6, T6, L4

21
Q

Site of Vulnurability: Tunnel

A

-tunnels increase probability of spatial compromise
-friction or trauma

ex: carpal tunnel

22
Q

Site of Vulnurability: Branches

A

-where a nerve branches
-harder to move from forces here

ex: radial n at elbow

23
Q

Site of Vulnurability: Hard Interfaces

A

-nerve lying on bone or passing throuhg fascia
-easier to compress

24
Q

Site of Vulnurability: Proximity to Surface

A

-superficial nerves are more vulnerable to compression

25
Q

Site of Vulnurability: Adherence to interfacing structures

A

-nerve more adherent in some places

ex: common fib at head of fibula

26
Q

Nerve Mechanisms of Injury

A

-Posture: adaptive shortening
-Trauma: fracture, dislocation
-Extremes of Motion: traction
-Electrical injury
-Compression

27
Q

3 Signs of a Positive NTPT

A
  1. Reproduces Pt s/s
  2. Movement of distant body part causes responses
  3. Test differences from L to R
28
Q

Slump Test (Trunk)

A

-test neuromobility

  1. Hands behind back
  2. Head and neck flexed
  3. Lumbar flx
  4. Straighten knee
  5. overpressure
  6. DF of ankle
  7. Pt moves head
29
Q

Median Nerve ULTT 1

A
  1. Use elbow to depress scap
  2. Abduct
  3. Extend wrist and fingers
  4. ER
  5. Elbow extension
  6. Lat sidebending

+ Findings: differences btw sides, distant component, reproduction of s/s

30
Q

Ulnar Nerve ULTT 3

A
  1. Use hand to depress scap
  2. Abduct
  3. GH ER
  4. Forearm pronation
  5. Extend wrist and fingers
  6. Elbow flexion
  7. Lat sidebending

+ Findings: differences btw sides, distant component, reproduction of s/s

31
Q

Radial Nerve ULTT 2

A
  1. Use hand to depress scap
  2. GH IR
  3. Flexion wrist and fingers
  4. Forearm pronation
  5. Elbow extension
  6. GH ABD
  7. Lat sidebending

+ Findings: differences btw sides, distant component, reproduction of s/s

32
Q

Contraindications for Neurodynamic Mobilizations

A

-Recent repair
-Malignancy
-Active Inflammatory Disorders
-Acute Inflammatory Demyelinating Disorders

33
Q

Neurodynamic Mobilization Techniques: Tension

A

-load opposite ends of nerve
-both “on” or “off”
-when glides no longer help

ex: head flx and ankle DF, the head ext and ankle PF

34
Q

Neurodynamic Mobilization Techniques: Gliding

A

-load one end of nerve while relieving stress on opposite end
- 1 “on” and 1 “off” then switch

ex: head flx and ankle PF, the head ext and ankle DF

35
Q

Neurodynamic Mobilization Techniques: Stretching

A

-load opposite ends of nerve and hold
-7-30s
-both “on” or “off”
-most aggressive

ex: head flx and ankle DF (hold), the head ext and ankle PF (hold)

36
Q

Double Crush Injuries

A

-multiple sites of compression injury
-common in UE
-Proximal and distal s/s

treat proximal first

37
Q

MUST CLEAR

A
  1. Vertebral Basilar
  2. Alar Ligs
  3. Transverse ligs
38
Q

Radial Nerve Mobilization

A

-pt in standing
Glide:
-Waiter tip
-Head toward and add sensitizer
-On and off

Tension:
-Waiter tip
-Head away and add sensitizer
-On and on, off and off

Stretch:
-Waiter tip
-Head away and add sensitizer
-On and on, off and off, hold

39
Q

Ulnar Nerve Mobilization

A

Glide:
-Waiter tip with batman
-Head toward and add sensitizer
-On and off

Tension:
-Waiter tip
-Head away and add sensitizer
-On and on, off and off

Stretch:
-Waiter tip
-Head away and add sensitizer
-On and on, off and off, hold

40
Q

CN Testing

A
  1. Olfactory: smell
  2. Optic: Vision
  3. Oculomotor: H Test (up down)
  4. Trochlear: H Test, (down and out)
  5. Trigeminal: Facial Sensation and Masseter and temporalis
    6: Abducens: H Test (lateral)
    7: Facial: Taste and Smile
    8: Vestibulocochlear: Hear
  6. Glossopharyngeal: Swallow
    10: Vagus: Cough
    11: Spinal Accessory: Resisted shoulder
    12: Hypoglossal: stick toung out
41
Q

Median Nerve Mobilization

A

Cleopatra, find sensitizer and stop at that
Glide:
-Waiter tray
-Head toward and Arm extended
-On and off

Tension:
-Waiter tray
-Head away and Arm extended
-On and on, off and off

Stretch:
-Waiter tray
-Head away and Arm extended
-On and on, off and off, hold

42
Q

Slump Nerve Mobilizations

A

Glide:
-Slump
-Head back and sensitizer extended
-On and off

Tension:
-Slump
-Head down and sensitizer extended
-On and on, off and off

Stretch:
-Slump
-Head down and sensitizer extended
-On and on, off and off, hold

MSK (37 decks)

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