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dpt 516 > Exam 2 > Flashcards

Exam 2 Flashcards

Soft Tissue Disorders to Shoulder Complex (Quiz 4 to present)

1
Q

what nerves are most at risk for entrapment?

A

long thoracic

axillary

spinal accessory

suprascapular

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2
Q

what muscle does the long thoracic nerve innervate?

A

serratus anterior

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3
Q

what muscles do the axillary nerve innervate?

A

deltoid

teres minor

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4
Q

what muscles do the spinal accessory nerve innervate?

A

trapezius

infraspinatus

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5
Q

what would you see with long thoracic nerve palsy?

A

scapular winging

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6
Q

does scapular winging occur more in the frontal plane with abduction or with flexion?

A

with flexion

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7
Q

what weakness is indicated by the flip sign?

A

serratus anterior

scapular weakness

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8
Q

what would you see with axillary nerve palsy?

A

deltoid atrophy

weak abduction and flexion

may see compensatory motions

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9
Q

what would you see in spinal accessory nerve palsy?

A

trapezius atrophy and weakness

may have a flip sign

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10
Q

what is scapular dumping?

A

scap doesn’t come down from abduction smooth and slow, but rather quickly releases at the end of the motion

form of scapular dyskinesia

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11
Q

which capsule of the elbow is more loose, posterior or anterior?

A

posterior capsule

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12
Q

does the lateral collateral lig resist valgus or varus forces?

A

varus forces

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13
Q

are varus or valgus forces more common

A

valgus forces

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14
Q

do the posterior or anterior fibers of the lateral collateral lig resist varus forces more in extension?

A

the anterior fibers

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15
Q

do the posterior or anterior fibers of the lateral collateral lig resist varus forces more in flexion?

A

the posterior fibers

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16
Q

does the medial collateral lig resist varus or valgus forces?

A

valgus forces

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17
Q

do the posterior or anterior fibers of the medial collateral lig resist valgus forces more in extension?

A

the anterior fibers

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18
Q

do the posterior or anterior fibers of the medial collateral lig resist valgus forces more in flexion?

A

the posterior fibers

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19
Q

what is the carrying angle of the elbow?

A

allows elbows to be at the side without hitting the pelvis

normal is about 15 deg

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20
Q

what is epicondylalgia?

A

pain of the epicondyles

21
Q

what is alteral epicondylalgia?

A

tennis elbow

tendinopathy of the extensors and radial deviators

primarily involves ECRB, 1/3 ext dig communis

usually from overuse but cna be traumatic

overhand lifting (pronated)

22
Q

what is stage 1 of lateral epicondylalgia?

A

inflammatory

often resolves

epicondylitis

23
Q

what is stage 2 of epicondylalgia?

A

fibroblastic and vascular response w/in tendon

24
Q

what is stage 3 lateral epicondylalgia?

A

pathologic changes (tendinosis) or rupture

more chronic

25
Q

what is stage 4 lateral epicondylalgia?

A

fibrosis

calcification

26
Q

what is the primary management of lateral epicondylalgia in stages 1 and 2?

A

ice

US

compression

e-stim

ionophoresis (drives meds into the area)

27
Q

what is the primary management of lateral epicondylalgia in stages 3 and 4?

A

friction massage to break up adhesions and reorganize collagen fibers

eccentrics!!!

28
Q

t/f: chronic conditions can have an acute overlay

A

true

29
Q

when are symptoms of lateral epicondylalgia elicited?

A

with active wrist extension or grasping

30
Q

t/f: pts with lateral epicondylalgia may frequently drop items

A

true

31
Q

what tests would indicate lateral epicondylalgia?

A

(+) Cozens
(+) Mills

32
Q

what is a counterforce brace?

A

pad puts pressure on the affected muscle and provides some relief bc the muscle thinks it’s pulling more distally

spreads the area of forces to decrease pain

33
Q

what is a (+) Cozens sign?

A

resist wrist extension in sitting or standing

(+)=painful at the lateral epicondyle

34
Q

what is a (+) Mills test?

A

put pt in full pronation, elbow extension, and wrist flexion

(+)=painful at the lateral epicondyle

35
Q

what is the 1st sign of improvement of lateral epicondylalgia?

A

pt can hold elbow at their side without pain

36
Q

what is the 2nd sign of improvement of lateral epicondylalgia?

A

decreased pain with the Mills test (elbow flexion will feel better first)

37
Q

what is medial epicondylalgia?

A

golfer’s elbow

tendinopathy of the common flexor tendons, primarily FCR, and pronator teres

overuse due to: repeated stress to flexor-pronator tendons, increased valgus stress, failure of the ulnar collateral ligament

38
Q

which is more painful with resisting wrist flexion: MCL injury or med epicondylalgia?

A

medial epicondylalgia

39
Q

which becomes chronic more: lateral or medial epicondylalgia?

A

lateral epicondylalgia

40
Q

t/f: pain with med epicondylalgia increases with resisted wrist flexion, pronation and passive wrist extension, supination

A

true

41
Q

what is the intervention for medial epicondylalgia?

A

RICE, modalities, avoid immobilization, stretching, PRE’s (conc and ecc), bracing (counterforce bracing on medial side)

42
Q

what is little league elbow?

A

ulnar collateral sprain

chronic valgus and external rotation forces (ie. tennis serve, throwing)

may occur from FOOSH, chronic med epicondylalgia

+valgus stress testing

43
Q

what is the intervention for medial collateral sprains?

A

RICE 2-4 wks, modalities, PRE’s for FCU, pronator teres, FDS, and shoulder

surgical repair in athletes only involving palmaris longus graft w/wo ulnar n transposition

44
Q

what are the common surgical procedures for medial collateral sprains?

A

Tommy John and docking to reduce valgus stress

45
Q

what is the docking technique?

A

cinch up MCL

preserves the ulnar nerve

nerve transpostion-take ulnar nerve and move it in front of medial epicondyle to reduce friction

insutu ulnar nerve transposition-free up the nerve so it slides better due to possible scarring around it

46
Q

what is the valgus stress test?

A

move elbow into flexion and extension with valgus stress applied

47
Q

what is a radial collateral sprain?

A

posterolateral rotary instability

combination of compression, external rotation and varus forces or secondary to chronic lateral epicondylalgia

48
Q

is UCL or RCL more common?

A

UCL

dpt 516 (14 decks)

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