Week 1 Flashcards
Neuropraxia
CLASS 1: FOOT FALLS ASLEEP :REVERSABLE - nerve injury that causes temporary and localized loss of function (sensory or motor)
Axonotmesis
CLASS 2: AXON DAMAGE: RECOVERS 1 MM/DAY- localized damage to axon and myelin and varying degree of peripheral nerve connective tissue
Neurotmesis
: CLASS 3 COMPLEATE LASSERATION : SURGERY-severing of axon and myelin and all connective tissue structures
T or F axons that undergo regeneration remyelinate to pre-injury level
False they DO NOT remylinate to pre injury level
Collateral sprouting
Collateral sprouting can be defined as the growth of intact axons into neighboring denervated territory.
Mononeuropathy
peripheral nerve injury
one nerve injured
ex: carpal tunnel syndrome (median nerve)
Mononeuropathy multiplex
peripheral nerve injury to 2 or more nerves and areas
Radiculopathy
peripheral nerve injury
caused by nerve roots
Plexopathy
a disorder of the network of nerves in the brachial or lumbosacral plexus
Peripheral nerve disease risk factors and examples
risk factors: DM, renal failure, alcohol abuse, autoimmune, nutritional, hereditary infection, medication, toxins idiopathic / spontaneous
examples: Sjogren’s syndrome, lupus, rheumatoid arthritis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and vasculitis.
Peripheral nerve disease symptoms and exam items
Symptoms: weakness, numbness, burning pain, distal to proximal symptoms
exam: treat and address early, neuroplacicity and axonal regeneration /collateral sprouting is possible
screen: autonomic dysfunction(: vasodilation, loss of vasomotor tone (dryness, warmth, edema, orthostatic hypotension ) balance and fall risk, end feel, sensoriomotor (hair loss and vascular changes )
Open vs closed packed
closed: max stability and joint surface area
do not mobilize
good for WB
open: minimal surface area in this position
perform mobilizations
great rom
Grades of mobilization with speed, amplitude an range
All slow
Grade 1: small beginning of range
Grade 2: big within range
Grade 3: big middle to end range
Grade 4L baby available range / tissue resistance
Grade 5: fast/ high velocity small amplitude
End feels
Soft : tissue /muscle
Hard : bone cartilage
Firm: ligament/ tendon, capsular
Empty : pain
Boggy: edema /swelling
Isometric vs isotonic vs isokinetic
Isometric: no change in muscle length
Isotonic: change in muscle length with force staying the same
Isokinetic: constant velocity of muscle action (requires special equipment)
Osteokinimatics vs arthrokinimatics
osteo = bone motion
arthro= joint motion
ULNT 1
Median nerve (tension all fingers)
shoulder: depression abduction to 110
elbow: extension
forearm: supination
wrist: extension
fingers and thumb: extension
ULNT2
Median nerve
everything is the same as ULNT 1 but the shoulder is only abducted to 10
ULNT3
Radial
shoulder IR , abduction 40 and extended to 25
forarm pronated
elbow extension
wrist flexion and UD
thumb flexion
ULNT 4
ulnar nerve
shoulder depression and
abducted to 90
forearm pronation
elbow flexed
wrist extension and RD
thumbb in extension
Adhesive capsulitis Characteristics Presentations Treatment
C: restricted AROM/PROM dense adhesive fibrosis and scarring in capsule. chronic inflammation
P: age 45-65 females associated with DM and thyroid disease. capsular pattern loss
T: increase ROM with mobilization. may need manip under anesthesia
Shoulder impingement Characteristics Presentations Treatment
C: pain with overhead movement /sports RTC tendons becoming impinged under acromion and coracoacromial arch
P:painful arc of motion 60-120
T: RTC strengthening, scapular stability ,improve biomechanics
RTC tear Characteristics Presentations Treatment
C: impaired blood supply to tendon, micro trauma , degeneration
P: resting/night pain, limited abduction and lateral rotation
T: ROM, isometrics, avoid slow eccentrics for 6 months after surgical repair
Lateral epicondylitis / medial epi Characteristics Presentations Treatment
C: Lateral : extensor muscle overuse condition (tennis)
medial: flexor tendon overuse (golf )
P: ages 30-50 pain over lat. epi, painfull gripping
T:ROM, strength of extensors
Colles Fracture Characteristics Presentations Treatment
C: fracture of distal radius due to FOOSH or blow to palmar side of wrist fragment often
displaced in the dorsal and POSTERIOR
direction, can lead to “dinner fork”deformity
P: wrist pain, swelling, deformity, limited ROM
Smith fracture Characteristics Presentations Treatment
C: reverse colles distal radius fracture
anterior displacment : “garden spade” deformity
P: Wrist pain, swelling, and deformity; limited
ROM; tenderness over distal radius
Achilles tendinitisCharacteristics Presentations Treatment
C: repetitive /overuse seen in pt. with limited flexibility, weakness, foot pronation, weakness, runners, gymnastics, dancers, basketball players
P: Aching or burning in heel, tenderness of Achilles tendon, morning stiffness; can
lead to rupture
T: heel lift; cross-training; heel cord stretching; eccentric strengthening of
gastrocnemius and soleus
Plantar faciitis condition, presentation , treatment
C: Inflammation of plantar fascia at calcaneus; acute injury from excessive
loading of foot or excessive pronation
P: Heel pain, heel spur, morning pain, post activity pain, pain when walking barefoot
Phase 1 of ACL protocol
Max protection weeks 1-4
gait training with cutches
edema control
week 1 WBAT/ROM as tolerated
biofeedback
SLR
ROM 0-110
weeks 2-4
FWB: if active knee ext and pain free
good quad strength
CKC and OKC exercises, trunk and pelvis stabilization
aerobic conditioning
Phase 2
moderate protection:
weeks 5-6 multiangle isometrics
balance
band walks
pain free ROM 0-125
normalize gait
7-10
advanced strength
walking/jogging
Phase 3
minimum protection phase
weeks 11-24
advanced PRE CKE strengthening , emphasize eccentric
plyometrics ,agility, sport training , running and cutting
Pronation movements
Eversion , DF, ABduction
Eversion movements
inversion, PF, ADDuction
Max vs mod vs minimal protection timeline
max protection : 6 weeks
Moderate protection: 12 weeks
minimal protection: 6 months
According to Jandas crossed syndromes: if the deep neck flexors are inhibited what is facilitated?
tight upper trap/levator scapula
According to Jandas crossed syndromes: if lower trap/ serratus anterior is inhibited what is facilitated?
tight SCM and pecs
According to Jandas crossed syndromes: abdominals are inhibited what is facilitated?
tight thoracolumbar extensors
According to Jandas crossed syndromes: gluteus are inhibited what is facilitated?
tight rectus femoris / illipsoas
Active insufficiency
The inability of a two joint muscle to shorten simultaneously at
both joints(contracted position)
Passive insufficiency
The inability of a two joint muscle to lengthen simultaneously at
both joints(lengthened position)
Femoral anteversion (pigion toed )
hip internal rotation
tibial internal torsion
subtalar pronation
toe in
squinting pallae
Femoral retroversion
hip external rotation
tibial external torsion
subtalar supination
frog eyed patellae
