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PTRS 745 Exam 1 > Clinical Syndromes > Flashcards

Clinical Syndromes Flashcards

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1
Q

Defn: Rupture of biceps brachii long head

A

Complete tear of the tendon of the biceps brachii long head

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2
Q

Q: What are the 2 most common sites of a biceps brachii long head tear?

A
  1. Supraglenoid tubercle
  2. Proximal intertubercular groove
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3
Q

Content: 4 MOI for biceps brachii long head tear

A
  1. Wear and tear
  2. Sudden, forceful contraction
  3. Repetition, overhead movements
  4. Preexisting shoulder problems
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4
Q

Q: For biceps brachii long head tear’s MOI, what falls under “preexisitng shoulder problems?” (4)

A
  1. Chronic impingement
  2. Tendinitis
  3. SLAP tears
  4. Rotator cuff tears
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5
Q

Content: Signs & Symptoms for biceps brachii long head tear (4)

A
  1. “Popping”
  2. Tenderness w/palpation over anterior shoulder
  3. Popeye sign
  4. Positive Speed’s Test
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6
Q

Q: What is the typical treatment plan for young/athletic pts. (who need max supination strength) after a biceps brachii long head tear?

A

Surgery

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7
Q

Q: What is the typical treatment plan for older pts. after a biceps brachii long head tear?

A

Avoid operation

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8
Q

Q: Describe debridment (sx option for rupture of biceps brachii - long head)

A

Treatment for fraying of small amounts of the tendon

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9
Q

Q: Who typically undergoes debridment with tenodesis?

A

Young pt./athlete who has 50% or greater fraying of the tendon

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10
Q

Q: Describe debridment with subacromial decompression (sx option for rupture of biceps brachii - long head)

A

Treatment for fraying of the tendon along with associated rotator cuff and biceps tendon impingement

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11
Q

Content: Modalities for biceps brachii long head rupture (2)

A
  1. Ice
  2. E-stim
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12
Q

Content: Immobilization (1-2 wks) > gentle PROM/AROM > RC resistive strengthening (2-4 wks) > throwing program (after 6-8 wks) > Return to all overhead motions (3-4 mo)

A

TherEx progression for biceps brachii long head rupture

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13
Q

Defn: Snapping scapula

A

Abnormal articulation of the scapulothoracic joint causing a grinding or snapping sensation of the scapula

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14
Q

Content: 3 MOI for snapping scapula

A
  1. Repetitive overhead use
  2. Muscular imbalance
  3. Bony abnormalities
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15
Q

Q: What muscular imbalances can cause snapping scapula?

A

Serratus anterior or subscapularis

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16
Q

Content: Signs & symptoms of snapping scapula (3)

A
  1. Crepitus of the scapula
  2. Reproduction of symptoms with shoulder abduction
  3. Alleviation of symptoms with adduction (HAC)
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17
Q

Content: TherEx for Snapping Scapula (2)

A
  1. Muscle Training (strength/endurance/stretch)
  2. Postural training (min kyphosis)
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18
Q

Q: What muscles should you focus on stretching for postural training of snapping scapula?

A
  1. Upper trap
  2. Pectoralis
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19
Q

Content: Modalities for snapping scapula (3)

A
  1. Ice
  2. Heat
  3. Ultrasound
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20
Q

Defn: AC joint separation

A

An injury that occurs to the ligaments involved in the AC joint that causes separation of the acromion and clavicle

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21
Q

Q: How many types of AC joint separation classifications are there?

A

6

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22
Q

Term: Sprain of AC ligaments

A

AC separation type 1

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23
Q

Term:

  1. AC ligament disrupted
  2. Sprained coracoclavicular
A

AC separation type 2

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24
Q

Term:

  1. AC ligament disrupted
  2. Dislocated w/shoulder complex displaced inferiorly,
  3. Coracoclavicular ligament disrupted with increased interspace
  4. Deltoid and trapezoid usually detached from distal end of clavicle
A

AC separation type 3

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25
Term: 1. AC and coracoclavicular ligaments completely disrupted 2. AC joint dislocated 3. Clavicle displaced posteriorly into or through the trap 4. Deltoid and trap detached
AC separation type 4
26
Term: 1. AC and coracoclavicular ligaments completely disrupted 2. AC joint dislocated w/gross disparity between the clavicle and scapula 3. Deltoid and trap detached
AC separation type 5
27
Term: 1. AC and coracoclavicular ligaments completely disrupted 2. AC joint dislocated 3. Clavicle displaced inferiorly to the coracoid process
AC separation type 6
28
Content: What are the signs and symptoms of a type 1 AC joint separation? (3)
1. Tenderness with mild pain at joint 2. Pain with resisted adduction 3. Normal x-ray
29
Q: What is the MOI for AC separation?
Fall on shoulder with arm ADD is most common
30
Content: TherEx for type 1 and 2 AC joint separation in the 1) acute 2) subacute and 3) Chronic
1. Rest, gentle ROM 2. Isometric, CC exercises 3. Isotonic, OC exercises, task specific
31
Q: What TherEx plan would you follow if you are going the conservative route for a Type 3 AC joint separation?
Follow the Type 1 and 2 exercise progression
32
Q: What TherEx plan would you follow if you are going the surgical route for a Type 3 AC joint separation?
Follow the Type 4 and 5 exercise progression
33
Content: TherEx for type 4 and 5 AC joint separation in the 1) acute 2) subacute and 3) Chronic
1. Immobilization; no shld exercise 2. Gain pain free ROM 3. Progress to strength
34
Content: Modalities for AC joint separation in 1) acute 2) subacute and 3) chronic phases
1. Ice, NSAIDs, analgesics 2. Ice and ultrasound 3. Ice and/or head as needed
35
Defn: Scapulocostal syndrome
Adhesive myocapsulitis (formation of adhesions) that restrict motion and cause pain
36
Q: What is the MOI for scpaulocostal syndrome? (4)
1. Trauma 2. Poor posture 3. Prolonged immobilization 4. Repetitive Activites
37
Q: What activities can increase your risk for scapulocostal syndrome? (3)
1. Desk jobs 2. Prolonged sitting 3. Overhead activities
38
Q: What muscles are most commonly involved in scapulocostal syndrome? (3)
1. Levator scapula 2. Serratus anterior and posterior 3. Rhomboids
39
Content: Signs and symptoms of scapulocostal syndrome (3)
1. Pain of medial border of scap and underliying rib cage 2. Radiating pain 3. Scapula and thoracic cage move together
40
Q: What is the 3rd most common fracture in the elderly?
Humeral head fracture (1 = hip; 2 = distal radius)
41
Q: How are humeral head fractures classified according to Neer?
There are 4 types based on how many pieces the humerus is broken into (1, 2, 3, and 4 part)
42
Q: What is the MOI for a humeral head fractures in young individuals?
High energy trauma i.e. MVA or sports injuries
43
Q: What is the MOI for a humeral head fracture in older individuals?
Low energy trauma - FOOSH
44
Q: What factors are considered when determining the treatment of a humeral head fracture? (4)
1. Age 2. Type and location of fracture 3. # of fragments displaced 4. Amount of displacement
45
Q: \_\_\_% of humeral head fractures are treated conservatively while \_\_\_% of humeral head fractures are treated non-conservatively/surgically.
80, 20
46
Content: Qualification for non-conservative treatment of humeral head fractures in young and old (2)
1. Used in young pts. with \> 0.5 cm or 20 degrees of fracture displacement 2. Used in older pts. with \> 1 cm or 45 degrees of fracture displacement
47
Q: What is the key education point for humeral head fractures?
No movement above 90 degrees
48
T/F: Radial head fractures are more common in men than women
False: flip it
49
Q: What is the age range of most radial head fractures?
30-40 yo
50
Q: What is the MOI for radial head fracture (3)
1. FOOSH 2. Elbow dislocation 3. Direct blow to radial head
51
Term: Small crack in the radial head, bone pieces remain fitted together
Type 1 radial head fracture
52
Term: Involve larger piece of bone, all slightly displaced
Type 2 radial head fracture
53
Term: Comminuted and siplaced, requires surgery to be reduced
Type 3 radial head fracture
54
Term: Dislocation and radial head fracture
Type 4 radial head fracture
55
Defn: Triceps tendinosis (2)
1. Chronic inflammation of the triceps tendon OR 2. Degeneration of tricpes tendon insertion
56
Q: What is the MOI for triceps tendinosis?
Overuse/strain or repetitive sudden elbow extension
57
Q: What does the treatment plan consist of for triceps tendinosis? (3)
1. Rest 2. Stretch 3. Strengthen
58
Content: TherEx for triceps tendinosis
Stretch and strengthen
59
Q: What is olecranon bursitis?
Inflammatin of the flat bursa located posterior to the olecranon
60
Q: What is the MOI of olecranon bursitis? (4)
1. Traumatic event 2. Pressure/Occupational 3. Infection 4. Other medical history
61
Q: What are the signs and symptoms of olecranon bursitis? (3)
1. Swelling and pain 2. Restricted motion (flexion) 3. Infection
62
Q: What are the treatment options for olecranon bursitis? (4)
1. Anti-inflammatories 2. Aspiration 3. Steroid injection 4. Surgery
63
Content: Modalities for olecranon bursitis (3)
1. Ice 2. Phonophoresis 3. E-stim
64
Defn: Pulled elbow
subluxation of the radial head
65
Q: What are the symptoms of pulled elbow? (3)
1. Arm stuck in extension and pronation 2. Pain with moving elbow 3. Unableto flex and supinate arm`
66
Q: What is the MOI for pulled elbow?
Sudden pull of an extended and pronated arm
67
Q: Who is pulled elbow most common in?
Children
68
Q: What manual therapy would you perform for a pulled elbow?
reduction maneuver
69
Defn: Osteochondritis dissecans
A joint condition in which a piece of cartilage along with a thing layer of the bone beneath it comes loose from the end of a bone
70
Q: What are the symptoms of osteochondritis dissecans? (3)
1. Pain/swelling lateral and anterior 2. Limited ROM 3. Clicking and locking
71
Q: What is the MOI for osteochondritis dissecans? (2)
1. Repetitive trauma 2. Radiohumeral lateral compression forces
72
Defn: Elbow instability
General laxity with in the elbow joint capsule that makes the joint susceptible to subluxation and dislocation
73
Q: What is the MOI for valgus elbow instability?
1. FOOSH 2. Repetitive overhead movements
74
Q: What is the MOI for varus elbow instability?
1. Chronic instability due to LCL instability
75
T/F: Elbow instability can be due to trauma but not congenital.
False: can also be congenital
76
Q: What is the MOI for anterior elbow instability?
blow to flexed elbow
77
Q: What is the MOI for posterior elbow instability?
excess stretching or rupture of ligaments
78
Q: What type of elbow instabiltiy is most common?
Posterior-lateral
79
Q: What are the signs and symtpoms of elbow dislocation? (4)
1. Valgus - flexion limited 2. Varus - no symptoms except when WB 3. Anterior - arm held in extension 4. Posterior - arm held in flexion
80
Q: What is the triple triad of elbow instability?
1. Elbow dislocation 2. Radial head fracture 3. Cornoid fracture
81
Defn: Raynaud's Phenomenon
disorder marked by brief episodes of vasospasm causing narrowing of the blood vessels
82
T/F: Raynaud's increases blood flow to the fingers and toes.
False, reduces
83
Q: What triggers Raynaud's?
Cold temperatures and emotional stress
84
Q: What are the symptoms of Raynaud's? (3)
1. Throbbing 2. Tingling 3. BF returns in \< 15 min
85
Q: What are the stages in Raynaud's?
Digital pallor \> cyanosis \> rubor
86
Q: How is Raynaud's treated? (4)
1. Drugs (Ca blockers, Angiotensin converting enzyme inhibitors) 2. Lifestyle changes (exercise, diet, clothing, stop smoking) 3. Modalities: biofeedback, heat pack, paraffin 4. Manual therapy: massage
87
Q: What is the most frequent of all thumb fractures?
Bennett's fracture
88
Defn: Bennet's fracture
Oblique intra-articular fractures of the 1st metacarpal
89
Q: What is the MOI for Bennett's fracture? (2)
1. Axial force down a partial flexed metacarpal 2. Forced ABD of thumb
90
Q: What are the symptoms of Bennett's fracture?(3)
1. Defect - radial dorsal bulge 2. Unable to grab/pinch 3. Numbness and tingling in thumb/wrist
91
Q: What is the treatment plan for Bennett's fracture?
Immobilization
92
Defn: Dupuytren's Contracture
Knots in the fascia of the palm that force your fingers to stay flexed
93
Q: What digits are most commonly affected by Dupuytren's Contracture?
4th and 5th
94
Q: What population is commonly affected by Dupuytren's Contracture?
Older men
95
Q: What should you look for with Dupuytren's Contracture?
Nodules, bands of tissue, curled fingers
96
Q: What modalities can be used for Dupuytren's Contracture? (2)
1. Heat 2. Paraffin bath
97
Q: What is the TherEx approach to Dupuytren's Contracture? (2)
1. Intensive stretching program (for maintenance not prevention) 2. Exercises (finger lifts, spreads, grip strength, pronation/supination)
98
Defn: Triangular fibrocartilage disc (TFCC)
Stabilizes the distal radoulnar joint and helps improve ROM allowing the wrist to move in 6 different directions
99
Q: Where is the TFCC located?
Between the medial proximal and distal ulna, also includes fibrocartilage disc
100
Q: What is the funciton of the TFCC? (3)
1. Enhance joint congruity 2. Cushion against compressive forces 3. Ligaments attachment
101
Q: What is the MOI for a TFCC injury? (4)
1. Trauma 2. FOOSH 3. Power drill injuries (wrist moves instead of drill) 4. Degenerative changes
102
Q: What modalities would you use for TFCC? (3)
1. Ultrasound 2. E-stim 3. Ice
103
Defn: DeQuervain's Syndrome
painful stenosing tenosynovitis of the first dorsal compartment of the hand
104
Q: What are other names for DeQuervain's Syndrome?
Trigger thumb, Gamers thumb, texting thumb
105
Q: What is the MOI for DeQuervain's Syndrome? (3)
1. Over use 2. Shear force on APL/EPB 3. Forceful gripping with UD
106
Q: What are the signs and symptoms for DeQuervain's Syndrome?
Radial wrist pain with thumb movements, tenderness over dorsal compartment
107
Q: What test will be positive for DeQuervain's Syndrome?
Finkelstein's test

PTRS 745 Exam 1 (9 decks)

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