Lecture 1: UQ Scan Flashcards
flattened deltoid + history of GH dislocation
makes you think… increased concern for ____
axillary nerve palsy
What is regional interdependence?
happens more in UQ than LQ
seemingly unrelated impairments are associated w/ patient’s pain, maybe mediated due to central mechanisms
Impairment/Regional Interdependence model
MSK impairments (pain, ROM
neurophysiologic
biopsychosocial
somatovisceral: referred/radicular pain
lateral elbow pain is associated with
cervical
shoulder
wrist/hand impairments
LBP is associated with ___ impairments
PFPS is associated with _____ impairments
LBP: hip
PFPS: LBP, hip, foot, ankle
T-spine manips (HVLAT) are shown to
___
____
____ outcomes in patients with RC tendinopathy, adhesive capsulitis
decrease c-spine pain
increase Lower trap strength
improve RC, frozen shoulder outcomes
What is impacted with chronic neck pain?
neck
ST
shoulder
hip
trunk (abs, erectors)
EVERYTHING
Why do scanning exams?
Refer, refer and Rx, Rx
narrow source of symptoms
examine neuro
identify primary impairments
improve rehab outcomes
3 reasons to scan or not
- no obvious MOI
- proximal cause for distal symptoms
- sounds MSK or not
components of the UQ scanning exam
- observation
- history (systems review, medical screen)
- c-spine AROM + overpressure
- UE ROM
- myotomes
- dermatomes
- compression/distraction
- ULTT1
- DTRs
- pathological reflexes
- palpation
difference between review of systems and systems review
ROS: collect info about each body system, does it need an exam?
systems review: hands on component
causes for nausea, vomiting
metabolic, CV, liver
pregnancy
meds
increased ICP, HA, Hemmorhage
causes for paresthesias, numb, weak
renal, endocrine
adverse drug reactions***
progressive neuro loss
negative coping skills, anxiety, depression, kinesiophobia, dizziness, abnormal sensory patterns, progressive weakness, fainting, circulatory or skin changes
what flag is this?
yellow
In 1 LBP research study, __% pf pts w/ LBP had 1 red flag, but <1% actually had a serious disease/pathology
80%
myotome screen:
shoulder abduction
mm tested:
root level:
peripheral nerve:
mm tested: DELTOID
root level: C5
peripheral nerve: AXILLARY
myotome screen:
elbow flexion
mm tested:
root level:
peripheral nerve:
mm tested: BICEPS
root level: C6
peripheral nerve: MCN
myotome screen:
elbow extension
mm tested:
root level:
peripheral nerve:
mm tested: TRICEPS
root level: C7
peripheral nerve: RADIAL
myotome screen:
wrist extension
mm tested:
root level:
peripheral nerve:
mm tested: ECRL, ECRB, ECU
root level: C6
peripheral nerve: RADIAL
myotome screen:
wrist flexion
mm tested:
root level:
peripheral nerve:
mm tested: FCR, FCU
root level: C7
peripheral nerve: MEDIAN-FCR, ULNAR-FCU
myotome screen:
finger flexion
mm tested:
root level:
peripheral nerve:
mm tested: FDS, FDP, lumbricals
root level: C8
peripheral nerve: median FDS, median+ ulnar FDP, lumbricals
myotome screen:
finger abduction
mm tested:
root level:
peripheral nerve:
mm tested: DABs (dorsal interossei)
root level: T1
peripheral nerve: ulnar
median nerve is responsible for…what mm actions?
wrist flexion
finger flexion
radial nerve is responsible for…
elbow extension
wrist extension
