Chapter 7 - Upper Extremity Flashcards Preview

Boards OMM > Chapter 7 - Upper Extremity > Flashcards

Flashcards in Chapter 7 - Upper Extremity Deck (45):
1

Rotator cuff muscles (w/ function)

Supraspinatus (abduction)
Infraspinatus (ER)
Teres minor (ER)
Subscapularis (IR)

2

Primary flexor of arm
Primary abductor of arm
Primary extensors of arm (3)
Primary adductors of arm (2)

Deltoid (anterior)
Deltoid (middle)
Latissimus, Teres major, Deltoid (posterior)
Pec major, Latissimus

3

Subclavian artery vs. vein - anatomy in neck

Artery = between anterior and middle scalene
Vein = anterior to anterior scalene

4

When does the subclavian artery become the axillary artery?

When does the axillary artery become the brachial artery?

Lateral border of 1st rib

Inferior border of teres minor

5

What artery runs with the radial nerve in the radial groove?

Profunda brachii artery

6

Where does the brachial artery bifurcate into the radial and ulnar?

Bicipital aponeurosis (under it)

7

Deep palmar arch - via what artery?
Superficial palmar arch - via what artery?

Radial artery
Ulnar artery

8

Order of treatments to relieve lymph in UE (3)

1. Thoracic inlet
2. Re-dome diaphragm
3. Posterior axillary fold technique

9

Abduction of the arm - what joints contribute?

2/3 = glenohumeral (2 of every 3 degrees)
1/3 = scapulothoracic (1 of every 3 degrees)

10

MC shoulder dysfunction

Restriction to IR and ER

11

IR and ER of the shoulder...clavicle movement?

Rotation around a transverse axis

12

MC SC joint dysfunction
Restrictions?

Anterior and superior clavicle on the sternum
- Restricted to shoulder elevation and protraction

13

MC AC joint dysfunction
Restrictions?
Findings?

Superior and lateral clavicle on acromion
- Inferior glide at the AC joint
- Step-off at AC joint, tenderness at AC joint

14

3 places for thoracic outlet syndrome

1. Between anterior and middle scalenes
2. Between clavicle and first rib
3. Between the pec minor and upper ribs

15

Positive Adson's test = ?
Positive Military posture test = ?
Positive Hyperextension test = ?

Between scalenes
Between clavicle and rib 1
Under pec minor

16

Pain at acromion, exaggerated by abduction (60-120)

What is this painful range called?

Cause?

Danger?

Supraspinatus tendonitis

"Painful arc"

Impingement of greater tuberosity on acromion w/ arm flexion and internal rotation

Calcification of tendon (chronic)

17

Acute supraspinatus tendonitis - treatment

Severe cases?

OMT? Goal?

Rest, ice, NSAIDs

Sling, steroid injection

Shoulder complex, upper thoracics, ribs -- free up motion and loosen fascia of shoulder girdle to EXPEDITE HEALING PROCESS

18

Bicipital tenosynovitis - tendon?

Result?

Pain?

Aggravation?

Treatments?

Long head of biceps

Adhesions or subluxation

Anterior aspect of humerus at bicipital groove

Resisted flexion and/or supination

Rest, Ice, injection, OMT to glenohumoral, MFR

19

Tenderness just below tip of acromion
Sharp pain followed by dull ache for days
Weak abduction

Positive tests?
Common sign?
Pain especially when?

Rotator cuff (esp. supraspinatus) tear

Positive drop-arm test, empty can test

Atrophy is common

Pain especially at night

20

Pain and restriction of shoulder, gets worse over a year
Decreased ROM, especially ABD, IR, and ER
Pain at end of ROM

Cause?
Pain location?
Treatment?

Adhesive capsulitis (Frozen shoulder syndrome)

Prolonged immobility of shoulder

Anterior portion of shoulder

PREVENTION, Spencer techniques, GH and thoracic Tx's

21

MC location of shoulder dislocation

Injury risk?

Anterior and inferior

Axillary nerve

22

Winging of scapula - issue?

Long thoracic nerve

23

MC brachial plexus injury during childbirth

Erb-Duchenne palsy (C5-C6)

24

MC nerve injury in UE via direct trauma

2 causes?

Radial n

1. Crutch palsy (axilla)
2. Middle humerus fracture

25

Carpal bones

Scaphoid, Lunate, Triquetral, Pisiform
Hamate, Capitate, Trapezoid, Trapezium

26

Only wrist flexor NOT innervated by median nerve

Flexor carpi ulnaris (ulnar nerve)

27

Supination (2 mm) - nerve?
Pronation (2 mm) - nerve?

Radial n.
Median n.

28

Only thenar eminence muscle NOT innervated by median nerve

Adductor pollicis (ulnar nerve)

29

PIP flexion - muscle?
DIP flexion - muscle?

Flexor digitorum superficialis
Flexor digitorum profundus

30

Carrying angle - how to measure?

Normal values?

Line along Humerus
Line along Radius/Ulna

Men = 5 degrees
Women = 10-12 degrees

31

Carrying angle > 15 degrees

Carrying angle under 3 degrees

Cubitus valgus (abduction SD of ulna)

Cubitus varus (adduction SD of ulna)

32

Increased carrying angle = ___ of the wrist

Decreased carrying angle = ___ of the wrist

Adduction

Abduction

33

Abduction dysfunction of ulna --> issue w/ radial head?

Compression against lateral humeral condyle

34

Adduction dysfunction of ulna --> issue w/ radial head?

Distraction from lateral humeral condyle

35

Falling forward on pronated forearm --> ___ radial head

Restrictions? (2)

Posterior

Supination of forearm
Anterior glide of radial head

36

Falling backward on supinated forearm --> ___ radial head

Restrictions? (2)

Anterior

Pronation of forearm
Posterior glide of radial head

37

Gold standard for diagnosis of carpal tunnel

Nerve conduction/electromyography

38

OMT for carpal tunnel (3) (w/ goals)

1. Rib and upper thoracic (decrease SNS in UE)
2. Cervical and MFR (increase brachial plexus fxn)
3. Direct release to flexor retinaculum (increase space)

39

OMT for lateral or medial epicondylitis (3) (w/ goals)

1. Cervical or upper thoracics (SNS, brachial plexus)
2. Counterstrain to muscles (relaxation)
3. MFR (decreased restrictions)

40

Flexion of MCP and DIP
Extension of PIP

Cause?

Swan-neck deformity

RA - contracture of intrinsic hand muscles

41

Extension of MCP and DIP
Flexion of PIP

Cause?

Boutonniere deformity

RA - rupture of hood of tendon at PIP

42

Extension of MCP
Flexion of PIP and DIP

Cause?

Claw hand

Median and ulnar nerve injury

43

Extension of MCP
Flexion of PIP and DIP
Atrophy of thenar eminence
Adduction of thumb

Cause?

Ape hand

Median nerve damage

44

Contracture of fingers 4-5
Atrophy of hypothenar eminence

Cause?

Bishops deformity (Pope's blessing)

Ulnar nerve damage

45

Permanent contracture of MCP and PIP of fingers 4-5

Cause?

Dupuytren's contracture

Contracture of palmar fascia