Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
UE Diff Dx
Clin Med UE Diff Diagnosis
| Question | Answer |
|---|---|
| Sign of the Buttock | Limited/painful SLR; Limited/painful passive hip flexion with knee bent; Non-capsular pattern |
| Pancoast Tumor | Men >50 with hx of smoking; Nagging pain in shoulder/vertebral scapular border; Pain progression nagging->burning & extends down arm in ulnar distribution |
| After how many visits should you refer if no improvement? | 3-4 treatments |
| S/sx of neurommskeletal impairments typically related to what? | Changes in posture or movement |
| Stoddard #1 | Back ache, having hx of malignancy during previous 2 yrs, must be assumed to have 2ndary malignant deposits in spine |
| Stoddard #2 | Onset of back pain late in life w/o any previous hx of back s/sx, it is more than likely osteoporosis or 2ndary deposits |
| Stoddard #3 | Serious loss of spinal fxn or shock or vomiting after trivial spinal injury/strain, pt likely to have pathological fx of spine |
| Stoddard #4 | Intense pain requiring morphine >48 hrs may indicate serious disease |
| Stoddard #5 | Severe pain, derofmity & mm spasm in areas of spine other than lower cervical/lower lumbar, should arouse suspicion of disease |
| Stoddard #6 | Constitutional signs like fever, loss of wt, malaise & excessive wkness suggest disease |
| Stoddard #7 | Loss of power too widespread to be accountable by single nerve root lesion suggests neurological disease |
| Stoddard #8 | Loss of sphincter control is never due to simple mechanical causes |
| Stoddard #9 | Continuous pain unrelated to posture is unlikely to be mechanical in origin |
| Stoddard #10 | Normal ESR doesn't exclude disease entirely |
| Cyriax Normal End Feels | Capsular; Bone-on-bone; Tissue approximation |
| Cyriax Abnormal End Feels | Empty; Springy Block; Spasm |
| MMT Strong & Painful | Minor Lesion |
| MMT Weak & Painless | Neurological/Rupture |
| MMT Weak & Painful | Gross Lesion |
| MMT All Painful | Psychogenic/Highly irritable |
| MMT Painful on repetition | Vascular |
| MMT Strong & Pain-free | Normal |
| DTR Biceps; Brachioradialis; Triceps | Biceps/Brachioradialis = C5-6; Triceps = C6-7 |
| S/sx Cervical Radiculopathy | Neck pain, radicular pain with numbness/paresthesia in UE; Mm spasms/fasciculations; Occipital HA; Radiating pain; Wkness, lack of coordination, decreased grip strength |
| Presentation of Cervical Radiculopathy | Decreased ROM (extension/rotation reproduce radicular s/sx); Myotomes, Dermatomes, DTRs; UMN (rule out cord compression) |
| Study with ULTT, Spurling, Distraction Tests; Rotation <60 degrees | 2 s/sx = 21% have cervical radiculopathy; 3 s/sx = 65%; 4 s/sx = 90% |
| Diff Dx of Cervical Radiculopathy | Adhesive capsulitis (AROM/PROM); Demyelinating condiiton (s/sx vary); Myocardial ischemia (ECG/stress tests); Peripheral n entrapment (+ Tinel/Phalen's test); RTC (impingement/RTC s/sx); TOS (decreased radial pulse) |
| Cervical Spondylosis s/sx | Decreased ROM; Chronic neck pain; HA; Radicular s/sx; Irritability, fatigue, sleep disturbances, decreased work tolerance |
| Presentation of Cervical Spondylosis | Diffuse non-sepcific neck pain exacerbated by neck mvmts |
| Presence of joint dysfunction with cervical spondylosis | Limited ROM; Palpable tenderness; dermatomes; myotomes; reflexes |
| Diff Dx of Cervical Spondylosis | Metastatic tumor (night pain); Cervical HNP (younger population); SC tumor (diagnostic studies); Syringomyelia (loss of superficial b reflexes/insensitivity to pain); Vertebral subluxation (advanced spondylosis; RA; trauma) |
| Cervical Myelopathy s/sx | Palmar paresthesia; Decreased UE dexterity; Subtle gait disturbances; abnormal urinary fxn; Loss of vibration/position sense; UE radiculopathy; May not experience pain |
| Key Findings with Cervical Myelopathy | Long tract signs (Hoffman's; Babinski; Clonus); Gait disturbances; Decreased UE dexterity |
| RTC Tear S/sx | Recurrent shoulder pain triggered by specific injury; Night pain; Weakness; Catching; Grating |
| Presentation of RTC Tear | Supra/infra atrophy; Limited AROM; Drop arm; Tenderness over greater tuberosity |
| Diff Dx of RTC Tear | AC jt arthritis (localized pain/tenderness, normal ROM); C-spondylosis (neck stiff, myo/dermatomes/DTRs); GH jt arthritis (radiographs); Adh Caps (AROM/PROM); Impingement; Pancoast tumor; TOS (ulnar n distribution; worse with TOS testing) |
| What is TOS? | Compression of brachial plexus &/or subclavian vessels as they exit b/t shoulder girdle & 1st rib; may be due to congenital anomalies; Fibromuscular bands in thoracic outlet; Post-traumatic fibrosis of scalenes |
| TOS s/sx | Vague & variable; Aching pain/paresthesias from neck to shoulder, arm, medial forearm, fingers; Intermittent swelling/discoloration of arm, decreased radial pulse, coldness; Aching, fatigue & wkness exacerbated by overhead activity |
| Presentation of TOS | Female, late teens to 40s; Must reproduce neuro/vascular s/sx; Fwd head, rounded shoulders; (+) ANTT; Motor/sensory intact |
| TOS Diff Dx | Brachial neuritis (sudden onset, pain, prox wkness); CTS (radial s/sx; Phalen); HNP (neck involvement; radicular pattern); Impingement (+ tests with localized pain); Pancoast tumor (venous congestion; radiographs); Ulnar n entrapment (Tinel, no prox s/sx) |
| Medial/Lateral Epicondylitis S/sx | 35-50 yo; gradual onset in lateral elbow/forearm during wrist ext; medial presents with medial pain exacerbated with wrist flexion/pronation |
| Presentation of Med/Lat Epicondylitis | Local tenderness 1 cm distal to lat epicondyle (common extensor origin); Medial epicondylitis tender just distal to med epicondyle |
| Diff Dx of Med/Lat Epicondylitis | Cubital tunnel sx (ulnar n compression with parasthesias in 4th/5th fingers); Radial tunnel sx (PIN compression; tender 5 cm distal to lat epicondyle) |
| What nerve compression is the 2nd most common nerve entrapment? | Ulnar nerve compression |
| Where is ulnar n usually compressed? | Cubital Tunnel |
| PIN Compression | No sensory, innervates wrist, thumb, fingers extensors |
| Which nerve is compressed in pronator syndrome? | Median Nerve |
| S/sx of ulnar n compression | Medial elbow aches w/ N/T in 4th/5th fingers; Rdiate proximal into shoulder/neck; Mm wasting in late stages |
| S/sx of Radial n compression | Pain 4-5 cm distal to lateral epicondyle; No N/T; Mm weakness in late stages |
| S/sx of Median n compression | Forearm pain that can radiate proximally into arm; Numbness may affect all/part of median n distribution |
| Diff Dx of elbow compression syndromes | CTS (numb thumb, index, middle fingers; thenar wasting); HNP; Med/Lat epicondylitis; TOS; Ulnar n entrapment at wrist |
| Ulnar Nerve supply | FCU; FDP; Superficial sensory; Deep motor; Ulnar lumbricals; IO; Adductor pollicis; FPB |
| What is the most common compression neuropathy in the UE? | CTS |
| What occurs most in middle-aged/pregnant females? | CTS |
| CTS S/Sx | Vague aching radiating into thenar area; Presthesia/numbness in median distribution; Worse at night; Dropping objects/wkness; Need to shake/rub hands |
| Presentation of CTS | Thenar atrophy; decreased sensory; Phalen test; Tinel sign; Carpal compression; ULTT; Opposition strength |
| Diff Dx of CTS | CMC arthritis (pain w/ motion); Cervical radiculopathy of C6 (neck pain; C6 dist); Diabetes; Hypothyroid; Median n compression at elbow; Ulnar neuropathy |
| Median N. supply | FCR; PT; PL; FDS; AI branch = FPL; Radial 1/2 of FDP; PQ; Superficial sensory; Terminal = APB; OP; FPB; Radial lumbricals; Sensory |
| DeQuervain Tenosynovitis is what? | Swelling/stenosis of sheath surrounding APL & EPB |
| DeQuervain's is common in what population? | Middle-aged women |
| S/sx of DeQuervain's | Pain, swelling, triggering resulting in locking/sticking of tendon with thumb motion; Swelling over radial styloid & pain aggravated by moving thumb/making fist |
| DeQuervain's Presentation | Swelling/tenderness over tendons of 1st dorsal compartment; Crepitus with thumb flex/ext; (+) Finkelstein |
| Diff Dx of DeQuervain's | CMC arthritis (painful compression); Dorsal wrist ganglion (palpable mass); Scaphoid fx (snuffbox tender); Superficial radial n (cheralgia paresthetic; dog handler's sx) |
Created by:
1190550002
Popular Physical Therapy sets