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Comps- MSK 2 UE

Special tests for biceps tendinitis Speed's (palm up, sh flexed), Yergason's (resist ER + supination)
S/S of bicipital tendonitis ant/lat sh pain, overhead pain, overuse/trauma, painful AROM flexion > abduction, possible pain w/ elbow flexion and sh flexion, pain on palpation of biceps tendon
S/S of AC joint sprain local AC pain, pain at >120 ROM, "step deformity"
S/S of ant sh instability clicking, positive apprehension test, impingement (pain post)
S/S of post sh instability pain ant/post, impingement, loss of IR
S/S of multidirectional sh instability sulcus sign, inferior laxity, sx w/ ant/post
S/S of ant dislocation of sh sh appears "square" (prominent acromion), arm held in abduction, all motions painful
Rotator cuff tendinitis (practice pattern) inpaired joint mobility, ROM, decreased muscle performance
S/S of rotator cuff tendinitis anterior/lateral shoulder pain, pain w/ overhead activity, history of trauma/overuse, pain when sleeping on affected side
Painful arc for rotator cuff/glenohumeral pathology 60-120 degrees
Painful arc for AC joint pathology 170-180 degrees
Palpating supraspinatus ant. and inferior to acromion w/ arm behind back
Palpating infraspinatus posterior to acromion (pt prone on elbows w/ shoulders add + ER)
Palpating subscap under pec minor
Common postural observations for pts w/ RC tendinitis upper cross, shoulder hiking, scap winging
Name the dermatome (trapezius) C4
Name the dermatome (lateral arm) C5
Name the dermatome (thumb/lateral forearm) C6
Name the dermatome (middle finger) C7
Name the dermatome (ring + pinky finger) C8
Name the dermatome (medial arm) T1
Organs that can refer pain to sh gall bladder, spleen, diaphram, aorta, heart
Exam findings for AC jt sprain (sub, ob, AROM, PROM, MMT, mobility, palpation) sub: trauma, ob: deformity, AROM: painful horizontal add, PROM: pain at end range, MMT: painful if delt/trap hurt, palpation: spot tenderness over AC
Special tests for AC sprain horizontal add, AC shear test, resisted extension, active compression (empty/full can w/ pain at AC)
Rx for AC sprain ice for pain, immobilize for initial healing (sling), limit pressure on sh, sleep on other sh, isometrics, THEN general strength + ROM
Rx for AC instability sling OR surgery
Instability exam findings (sub, ob, AROM, PROM) Hx of trauma/loose jts, scap winging, apprehensive w/ ab/ER, increased PROM
Exam findings for pt w/ instability (MMT, mobility, palpation) MMT: normal, mobility: hypomobile (in direction of instability), palpation: tenderness over jt
Special tests for instability apprehension/relocation test, load and shift, sulcus sign
Treatment for ant GH instability reduce, immobilize (3-6 wks), rehab
PT for instability <40 = 3-6 wks sling, >40 = 1-2 wks sling, isometrics (strengthen for stability)
Causes of multidirectional instability recurrent dislocation/sublux, congenital hypermobility, muscle imbalance
PT treatment for multidirectional instability strengthen RC, treat pain, proprioceptive training, pt ed
Exam findings for labral tear (sub, ob, AROM, PROM,MMT, mobility, palpation) sub: Hx of overuse/trauma -> instability/clicking; AROM: "click"; PROM: "click"; MMT: normal; hypermobile, unable to palpate pain
PT for labral tear treat instability (strengthen) - treat pain (RICE, 1-2 jt mobes)
S/S of clavicular fracture pt supports arm (head tilted to injured side, chin turned away), deformity, local pain
S/S of neural compression pain/weakness/paraesthesia (above sh, clavicle, and neck - affects C8-T1 dermatomes)
Special tests for thoracic outlet syndrome Roos, Adson's, hyperabduction, costoclavicular test
PT interventions for thoracic outlet syndrome postural correction, stretch scalenes/pec minor -> "sit w/ abducted + elevated shoulders" "sleep on good side"
Ex for thoracic outlet syndrome sh shrugs, roll sh, stretch scalenes, stretch pec minor
Sh adhesive capsulitis impaired joint mobility from CT dysfunction + poor muscle performance
S/S of adhesive capsulitis gradual onset, pain near deltoid insertion, unable to sleep on bad side, restricted ROM
PT treatment for adhesive cap pain relief (mobes/RICE), ROM, strengthen
Exercises for adhesive cap pendulums, pulleys, wands, towel stretch
Primary muscle involved in lateral epicondylalgia extensor carpi radialis brevis (ECRB)
Special tests for lateral epicondylalgia cozen's, mill's
Signs/symptoms of cubital tunnel syndrome Atrophy of ulnar distribution muscles, clawing of ring/pinky, weakness, sensory loss
Special tests for cubital tunnel syndrome Tinel's sign at elbow
PT treatment for cubital tunnel syndrome modalities for pain, splints (for clawing), elbow pads, ulnar nerve glides, strengthening
Signs and symptoms of pronator syndrome pain along median nerve distribution, muscle weakness, tenderness over pronator teres
Special tests for pronator syndrome Phalen's test
PT treatments for pronator syndrome Splint in neutral, modalities, massage, stretching, median nerve glides
Nerve associated with pronator syndrome median nerve
Location of anterior interosseous nerve syndrome (impingement) B/w heads of pronator teres
Signs/symptoms of AIN syndrome pain/weakness in FPL, FDP, pronator quadratus
Special tests for AIN syndrome AIN pinch grip
Signs/symptoms of high radial nerve compression loss of wrist, finger, and thumb extension (WRIST DROP), sensory deficits
Site of radial tunnel syndrome B/w heads of supinator
Signs/symptoms of radial tunnel syndrome tight supinator, neuro signs (sometimes), tender over supinator
PT treatment for radial tunnel syndrome splint, radial nerve glides, stretch supinator (?)
Signs and symptoms of olecranon bursitis inflammation, palpation -> pain
PT treatment for olecranon bursitis splint/pad, ROM, strengthen
Dupuytren's contracture is a flexion conracture of ____ MCP joint of ring and/or pinky (4th/5th)
Describe Boutonniere deformity (flex/ext of what joints?) Extension of MCP and DIP, flexion of PIP
Describe swan neck deformity (flex/ext of what joints?) Flexion of MCP and DIP, extension of PIP
Describe mallet finger deformity (flex/ext of what joints?) flexion of DIP
Trigger finger/thumb flexor tendon sheath + tendon THICKEN -> pain in thumb MCP or finger PIP + tendon "STICKS" during movement
Signs and symptoms of De Quervain's tenosynovitis overuse, pain in radial aspect of wrist
De Quervain's tenosynovitis affects the tendon sheaths of ___ EPB (extensor pollicis brevis), APL (abductor pollicis longus)
PT interventions for DeQuervain's splint, modalities, ROM, tendon glides, strengthening, manual therapy
PT treatment for skier's thumb immobilize/splint
Carpal tunnel syndrome ischemic compression of median nerve
Findings of joint play assessment for elbow sprain Laxity + pain
Pediatric dislocations commonly affect the __ ligament annular
Sign/symptoms of pediatric dislocation arm hangs limply (elbow ext, wrist pronated)
Night splint pts with cubital tunnel syndrome in _ degrees of ___ (flexion/extension) 40-60 degrees flexion
Pronator syndrome -> pain with what motions?(passive and active) pronation + wrist flexion (active), supination, wrist ext (passive)
Most commonly injured nerve w/ forearm fractures radial nerve (fractured radius)
Volkman's ischemic contracture results from... irritation/damage to brachial artery
Volkman's ischemic contracture signs/symptoms severe pain, loss of radial pulse, discoloration, cold hands, flexion contracture
Created by: cbaweiss



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