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Upper Extremity > Final > Flashcards

Final Flashcards

1
Q

Essential hydrodynamics occur during which of teh following

A

Running

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2
Q

Lack of joint play will cause dysfunction within the joint and may cause

A

Pain

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3
Q

Correct proprioception is essential for proper position of ___ in the joint where stability is sacrificed for mtion

A

Gleno-humeral

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4
Q

Over time the scapula tends to migrate which way in the shoulder complex

A

Superior and lateral, making the gelnoid cavirty more shallow

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5
Q

Tennis elbow is usually considered which one of the following subluxations

A

Posterio-lateral radius

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6
Q

Which of the following subluxations can mimic angina or neuritis symptoms

A

Costo-transverse subluxations

Posterior rib angles

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7
Q

The structure within the TMJ that is the source for pain and synovial effusion is called

A

Retrodiscal tissue

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8
Q

When using an AP thoracic x-ray, measuring from teh inferior tips of the scapula and comparing one to teh other a different of greater than ___ indicates an unstable shoulder complex

A

15mm

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9
Q

A patient is muscle tested using opponens pollicis while pronating the forearm, which one of the following conditions is being tested

A

Pronator teres syndrome

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10
Q

Normal opening of the jaw could be measured as 3 fingers wide, whic his equivalent to

A

50-65mm

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11
Q

Initial motion in teh wrist during flexion occurs at which joint

A

Radius and scaphoid

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12
Q

A great exercise used to attempt to re-establish scapulo-humeral rhythm adn strengthen the shoulder, focusing on scapular retractors is which of the following

A

Wall angels

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13
Q

Loose packed posiiton can involve positions of travel away from the closed packed position and extreme movement in that direciton usualy results in which of teh following

A

Sprain

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14
Q

Which of the following structures is a postural sign of upper cross syndrome

A

Anterior head carriage

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15
Q

Which of the following muscles is a primary muscle responsible for protrusion of the mandible

A

Lateral pterygoid

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16
Q

When vertical height of the tetth is lost, this can lead to which mal-position of the condyle

A

Superior/posterior

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17
Q

The alleged part 4 NBCE extremity move that is known as the palmar-distal contact pull move requires which of the following SCP

A

Distal radius and ulna

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18
Q

In a close lock of the mandible, the pt will complain of what

A

Inability to open mouth fully

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19
Q

A measurement between the coracoid and the clavicle of more than ___ on an x-ray could indicate a coracoclavicular ligamentous disruption

A

1.3

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20
Q

Which one of the following is not a dynamic stabilizer of teh scapulae

A

Biceps tendon

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21
Q

The alleged part 4 extremity move that is known as the ulnohumeral extension move requires which one of the following SCP

A

Cubital fossa

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22
Q

The GH joint is in flexion, adduction, and external rotation, the elbow is in extension; this describes the starting position for the RMT for what

A

Costo-angle

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23
Q

after adjusting a PL radius, if the triceps muscle test with wrist extension does not lock out (weakr); which of the following subluxations is then corrected

A

AM radius

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24
Q

The pec major inferior branch muscle test is useful to find which one fo teh following subluxations

A

Costo-chondral

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25
Q

The trigger point type pain between the scapula and upper trapezius/levator scap are evidence of which

A

Dysfunction and symptomatic referred pain

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26
Q

Biomechanically when the scapula drops inferior to give the appearance of a raised scapula this is called

A

Horizon sign

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27
Q

The segmental contact point for a posterior superior costovertebral rib is

A

Just lateral to the transverse process of the vertebrae on the involved rib

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28
Q

Loose packed position for the elbow is what position

A

Flexion and supination of the forearm

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29
Q

The 10th intercostal rib junction is found approx where

A

Lateral aspect of the abdomen

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30
Q

Which muscles listed are primarily responsible for retraction of the mandible

A

Temporalis, masseter, geniohyoid, dygastric

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31
Q

When a patient complains of biting the inside cheek of their mouth which subluxation listing is this complaint most ocmmonly associated with

A

Superior/posterior condyle

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32
Q

Pathologies, pain tolerance and dislocation are classified under which management criteria category

A

Safety

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33
Q

According to the lecture assessment notes of the wrist and hand. When there is decreased motion and pain in full wirst extenstion, your initial assessment is to

A

Check posterior to anterior restriction of the radio-lunate joint

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34
Q

A measurement between the SC joints of more than ____ mm on a AP thoracic x-ray could indicate an unstable shoulder

A

5

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35
Q

Which structure is compensatory stabilizer of the scapulae

A

Supraspinatus

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36
Q

Essential hydrodynamics in a joint occur during

A

Running

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37
Q

The goal for the GH distraction adjusting move is

A

To open up the joint stimulating the mechanoreceptors and improvign proprioception

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38
Q

The injured GH joint is complicated due to the anatomical configuration of the joint. When the joint swells it can contain a tremendous amount of fluid within the joint and still display very little evidence of joint effusion. What is the maximum amount of fluid the joint can containt

A

30cc

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39
Q

Scapular stabilizer exercises will help the scapulae with which way

A

Posterior and medial, making the glenoid cavity deeper

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40
Q

Secondary rotator cuff tears are differentiated from primary tears by

A

The tear is found extracapsular

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41
Q

Which subluxation can mimic angina or neuritis symptoms

A

Posterior rib angles

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42
Q

Within the TMJ a pt that has problems where they are unable to close the mouth is known as a

A

Open lock

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43
Q

When a patient under the age of 25 years has a previous GH joint dislocation, the chance of having another dislocation is greater than

A

96%

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44
Q

Pronating teh forearm while testing opponens pollicis RMT, could uncover a pronator teres syndrome, which subluxation should you check or recheck on your pt

A

PM ulna

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45
Q

Normal opening of the jaw could be measure as ___ fingers wide, which is equivalent to

A

3; 50-65mm

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46
Q

Full recovery in a tendinitis issue is how long

A

4 weeks

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47
Q

The GH joint is in 90d shoulder flexion, 90 horizontal adduction and full radio-ulnar pronation, the elbow is in extenstion, this describes the starting position for the muscle test for which misalignment

A

Costo-sternal

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48
Q

Cervicobrachial compression syndrome, represents a scapula that is ___ which contributes to shoulder instaiblity

A

High on the side of involvement measured at the inferior angle

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49
Q

In lecture we had Emily show us an excellent exercise called the ____ used to help weakness of which muscle

A

Pushup plus

Serratus anterior

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50
Q

Which description is correct for the order of the evaluation procedure, when addressing carpal issues

A 
Motion
Pinch/distract/shear
Opponens pollicis RMT
Palpation to compare bilaterally
Adjust
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51
Q

Which RMT is used to test for the costal chondral rib subluxation

A

Pec major sternal division

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52
Q

After adjusting a costosternal, chondrosternal rib subluxation, how long may the pt continue to feel pain upon palpation

A

48 hours

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53
Q

When assessing extremity injuries in the chiro office, most injuries will require a medical referral at which minimum ghrade

A

2

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54
Q

If on assessment you find a posterior SC joint what is your initial management step

A

Call 911

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55
Q

Following the adjusting protocals improve the neurolgocail and biomechanical components of the VSC and associated extra spinal articular misalignments

A

Yes

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56
Q

Normally the GH capsule contains .5-1.5cc of fluid. How much fluid can it contain before seeig it

A

30 cc

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57
Q

What move is contraindicated for someone who has subacromial bursisits

A

AI humerus

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58
Q

Recruitment

A

1st

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59
Q

Abandonment

A

2nd

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60
Q

What are the dynamic stabilizers

A

Pec minor

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61
Q

Lack of joint play will cause dysfunction and

A

Pain

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62
Q

After clearing the SC joint, AC joint, GH joint and biceps, next chekc

A

Scapulothoracic articulation

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63
Q

The most common reason for re-injury is a

A

Failure to properly condition the healed tissues

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64
Q

The concept of extraspinal management within the chiro paradigm must include integration of extraspinal areas to the spine. First one must consider the ___ connection, then the ___

A

Neurological

Muscles

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65
Q

If multiple extermities are subluxated, how do you determine which one to adjust

A

Use the pain scale - adjust extremity with hgihest pain level

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66
Q

What are benefits of bracing vs. using tape

A

Brace can be washed

No dermatitis from the brace - tape can cause this

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67
Q

Forces of injury, position of joint, and time of episode fall under which category

A

Safety

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68
Q

A sprain with no separation

A

Grade 1

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69
Q

The end of travel in a joint whereby the surfaces are at maximal congruency, the ligaments are taut, and no further movement in that direction of travel may result in

A

Dislocation/fracture

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70
Q

The most common sublux for SC joint is

A

Inferior, anterior, medial

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71
Q

Ligamentous disruption of ___ mm is a SC separation and the direciton is most commonly separates is __ and ___

A

5

Anterior and superior

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72
Q

Theory that states amsucel functioning across a misaligned joint will be inhibited by a reflex signal originating from ___ surrounding that joint

A

Mechanoreceptors

73
Q

Trauma, if acute, check for

A

Patient safety
Joint stability
Then subluxation

74
Q

The most common injuries seen in the office are

A

Grade 1 or mild grade 2

75
Q

Over time the scapulars tend to migrate

A

Superior and lateral

76
Q

SC joint is probably responsible for most of the ___ info for the upper extremity

A

Proprioception

77
Q

Elbow in closed pack position

A

Full extension - taut ligaments at max confruency dislocation or fracture

78
Q

Medial epicondylitis - golfers elbow is typically from a

A

PM ulna

79
Q

Can mimic carpal tunnel syndrome

Pt is tested by pronation against resistance; symptoms follow a median nerve distribution

A

Pronator teres syndrome

80
Q

Compensatory stabilizers for scapula

A

Biceps and supraspinatus

81
Q

Shoulder sulcus sign is ___ instaiblity of GH joint

A

Inferior and anterior

82
Q

TMJ intra-articular involvement = syovitis and capsulitis with the focus on the disc which is considered displaced or degenerated. Studies show that ___% of individuals will show some TMJ related sypmtom in their lifetime

A

85-90

83
Q

Upper cross syndrome signs

A 
Anterior head carriage
Elevated rounded shoulders
Winging scapulae
Shortened pectoralis
Dyphotic upper T spine
Shortened upper trap/levator
Weak serratus anterior
Low/middle trap weakness
84
Q

Lack of ___ will cause dysfunciton within the joint and may cause pain

A

Joint play

85
Q

Hydrodynamics = essential for proper lubrication, transport of nutrients, and removal fo waste materal from the articular surfaces. Proper hydrodynamic occur during

A

Weight bearing, intermittenet muscle activity, full ROM

Running, sleeping, sitting, grade 2 muscle

86
Q

Over time, scapulas tend to migrate ___ making a shallow glenoid cavity more shallow leading to more shoulder complaints

A

Superior

Lateral

87
Q

GH joint is most often affected by ____ or the tendon of the ___ of biceps

A

Rotator cuff dysfunction (supraspinatus)
Long head
Stability sacrificed for meovment

88
Q

Lateral epicondylitis = tennis elvboy. Most common listing is

A

PL radius

89
Q

A ___ muscle test is a good indicator of median nerve involvement

A

Opponens pollicis

90
Q

Weakness of this muslce with arm in ___ usually indicates median nerve pressure at the wrist (carpal tunnel)

A

Supination

91
Q

Weakness with arm in pronation usually indicates median nerve irritation at the elbow or

A

Pronator teres syndrome

92
Q

Exercise for retraction of the scapula/GH joint

A

Wall walks with hands oriented so fingers pointing upward

Wall angels

93
Q

Initial motion upon ____ occurs at the radiocarpal joint and secondary motion at the mid carpal and carpal metacarpal joint

A

Flexion

94
Q

Based on the above, if there is pain at the beginning of ROM, check the

A

Radiocarpal joint

95
Q

Which rib subluxations can cause intercostal neurtisi

A

Costo-vertebral
Costo-transverse
Costal angle
Anterior dorsals

96
Q

The 2 muscles involved in jaw protrusion

A

Lateral pterygoid muscle

Assisted by medial pterygoid

97
Q

4 muscles involved in jaw retraction

A

Posterior fibers of temporalis
Deep part of masseter
Geniohyoid
Digastric

98
Q

3 muscles involved in jaw elevation

A

Medial pterygoid
Masseter
Temporalis

99
Q

3 muscles invovled in jaw depression

A

Digastric
Geniohyoid
Mylohyoid - assisted by gravity

100
Q

Most common SC joint separation

A

Superior and anterior

101
Q

On x-ray a space of more than ____ between the coracoid and clavicle indicates coracoclavicular ligamentous disruption

A

1.3cm or 13mm

102
Q

With cross over maneuver, presence of superior pain or discomfort in the shoulder indicates

A

Pathology of the AC joint

103
Q

On an AP thoracic x-ray a height difference of ___ between the inferior tips of the scapula indicates an unstable shoulder

A

More than 15mm

104
Q

Most common reason for re-injury of a dislocated shoulder is

A

Failure to properly condition the healed tissues

105
Q

Overuse is ___ in tenditis but ___ in tendinosis

A

Rare

Common

106
Q

Tennis elbow can have a long healing time lasting up to as much as __ weeks

A

72

107
Q

Rate of irritation is greater than rate of recovery is the description of the

A

Specific adaptation to imposed demand principle (SAID)

108
Q

___ tears are intercapsular, whereas ___ tears are extracapsular

A

Primary

Secondary

109
Q

Which joint is likely the most responsible for the majority of the proprioceptive information for the upper extremity

A

SC

110
Q

The SC articulation is the most overlooked region of the upper extremity. What is the second most

A

Scapulothoracic articulation

111
Q

Medial epicondylitis or golfers elbow typically produces a ___ ulna

A

PM

112
Q

Medial epicondylitis is observed when there is weakness of the

A

Flexor carpi ulnaris muscle

113
Q

Lateral epicondylitis or tennis elbow is observed when there is weakness of the

A

Extensor carpi radialis brevis muscle

114
Q

If wrist pain is reduced or ROM enhanced by applying mild pressure approximating distal ulna and radius - a ____ may have occurred via hyperextension or hyperflexion insult to the wrist

A

Spreading injury

115
Q

To test this, you would perform this part 4 orho test

A

Bracelets test

116
Q

The sphenoid bone articulates with ___ other cranial bones

A

12

117
Q

The TMJ is unique because it is a synovial joint, but the surfaces are covered by this type of cartilage

A

Fibrocartilage

118
Q

This source for pain and synovial effusion in a TMJ related issue consists of a venous plexus covered with a synovial membrane

A

Retrodiscal tissue

119
Q

If a pt complains of locking, he can’t open his mouth fully, this is called a closed lock. In this case the disc is __ to the condyle

A

Anterior

120
Q

Which direciton of movement is more common in a costal angle subluxation

A

Superior

121
Q

At the 5 rib, the costo-chondral junction is approx

A

Mid-clavicular line

122
Q

Costo-sternal or chondro-sternal sublux apply to whcih ribs

A

The upper 6 ribs

123
Q

Another name for anterior dorsals

A

Pottinger saucer

124
Q

What else has a biconcave disc besides the SC joint

A

TMJ

125
Q

What is the condition regarding grinding of the teeth at night

A

Bruxism

126
Q

Ribs typically articulate with the disc and bodies of vertebrae above and below except

A

1,10,11,12

127
Q

Do alll the middle eastern 7-11s have americnas working in them

A

Noone really knows

128
Q

Musculature that suspends the scapula are innervated by

A

Lower cervic als

129
Q

Trigger point type pain betwen the scapula and upper trapexius/levator scapula is evidence of

A

Dysfunction and symptomatic referred pain

130
Q

What is the primary function of the shoulder

A

To place the upper extermity in space

131
Q

List the dynamic stabilizers

A 
Levator scap
Pec minor
Rhomboids
Serratus anterior
Trapezius
132
Q

Most dynamic stabilizers are

A

Underused

133
Q

Dynamic stabilizers attach

A

Shoulder to spine

134
Q

What are the compensatory stabilizers

A

Biceps and supraspinatus

135
Q

Compensatory stabilizers are often

A

Overused

136
Q

What to ligaments do

A

Connect the chain - DO NOT Create stability

137
Q

What is the osseous pivot of the upper extremity

A

SC joint

138
Q

The AC joint is ___ mobile than the SC joint. However, it is often ___ due to restrictions and fixations of the ___

A

Less
Hypermobile
SC joint

139
Q

What is the sulcus sign

A

Inferior and anterior instability of GH joint

140
Q

When doing apley’s scracth inferior to check ST articulation what is the measurement to demonstrate an unstable shoulder

A

Greater than 1.5cm or 15mm

141
Q

The most commonly overlooked subluxation

A
  1. SC joint

2. Scapulothoracic

142
Q

How should one place their arms for scaption

A

Roos/allens position

143
Q

The 3rd way to check for scapulothoracic subluxation is

A

Internal rotation of at least 70 deg supine

144
Q

When adjusting the inferior scapula, the goal is to break up adhesions of the

A

Subscpularis, bursae and serratus anterior

145
Q

What is the ratio to determine GH efficacy

A

2deg of GH movement vs 1 deg of scapula movement

146
Q

Which joint is the intersection of forces with little force dissipation option

A

Elbow

147
Q

The biomechnical responder is the

A

Wrist

148
Q

Positive ortho tests provide what info

A

Stability

149
Q

Muscle tests are used to check for

A

Subluxation

150
Q

What is hilton’s law

A

The same trunks of nerves whose branches supply the groups of muscles moving a joint furnish a distribution of nerves to the skin over the insertion of the same muscles, and the interior of the joint receives its nerves from the same source

151
Q

The ortho test for any joint in the body is

A

O’donoghue

152
Q

Serious grade 2-3 require

A

Medical referral

153
Q

Except in teh case of ___ the spine is always considered first

A

Direct trauma

154
Q

What is the CP for GH distrcation

A

Interlocking fingers

155
Q

As we age, the scapula migrate _____ and the ____ flal forward with ____

A

Superior and lateral
Shoulders
Anterior head carriage

156
Q

Where is joint play found

A

At the end of passive ROM

157
Q

Based on the mechanoreceptor theory, muscles functioning across a misaligned joint are ___ due to ___ originating from mechanoreceptors surrounding a joint.

A

Inhibited

Reflex signals

158
Q

What is the most common subluxation of the GH jiont

A

AI 95% of the time

159
Q

What is the challenge for the aC joint

A

Dugas

160
Q

What is the SCP for biceps tendon

A

2 inches inferior to the bicipital tubercle

161
Q

If chornic injury, chekc for

A

Instability then subluxation

162
Q

What is the msot common ulnar subluxation

A

PM 80% of teh time

163
Q

What is the SCP for PM ulna

A

Medial ridge of ulna 1” distal to the joint

164
Q

Which ulna sublux occurs 20% of the time

A

PL ulna

165
Q

The more common radius sublux is

A

PL radius

166
Q

SCP for PL radius

A

Lateral rige of radius 1/4” distal to joint

167
Q

How do you adjust a carpal bone

A

With reinforced thumbas - PA glide push

168
Q

What is tennis elbow and what is the sublux commonly associated with it

A

Lateral epicondylitis

PL radius

169
Q

What is golfer’s elbow and what is the sublux associated with it

A

Medial epicondylitis

PM ulna

170
Q

PM ulna and PL radius both commonly occur after a __ injury. This may be the underlying problem in ___ which may mimic ____

A

Hyperextension
Pronator teres syndrome
Carpal tunnel syndrome

171
Q

Pronator teres syndrome affects the ___ nerve distribution and is tested by ____

A

Meidan

Pronation against resistance

172
Q

Retraction of the scapula is called

A

Winging

173
Q

Winging of scap is due to

A

Weak serratus anterior

174
Q

Exercises used to strengthen serratus anterior are

A

Wall walks, wall angles, push-ups on all fours or full pushups

175
Q

We tend to overuse

A

Flexor muscels

176
Q

We tend to underuse

A

Extensor muscles

177
Q

Upon extention of the wrist, carpals move

A

Diagonal and anterior

178
Q

Upon flexion of the wrist carpals move

A

Posterior

Upper Extremity (2 decks)

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