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Flashcards in Midterm Deck (73)
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1

Isometric motor test for elbow flexion (biceps) tests

C6

2

Isometric motor test for finger ab/adduction tests

T1

3

Isometric motor test for finger extension tests

C7

4

Isometric motor test for finger flexion tests

C8

5

Isometric motor test for shoulder abduction (deltoid) tests

C5

6

Isometric motor test for wrist extension tests

C6

7

Isometric motor test for wrist flexion tests

C7

8

Isometric motor test for elbow extension (triceps) tests

C7

9

Pain scale

+1/4: tenderness with no physical response
+2/4: tenderness with grimace/flinch
+3/4: tenderness with withdrawal (+ "jump sign")
+4/4: withdrawal to sup palpation or gentle percussion

10

Motor testing grading scale

5/5 muscle completes ROM against gravity with full resistance
4/5 muscle completes ROM against gravity with some resistance
3/5 muscle completes ROM against gravity but wo resistance
2/5 muscle completes ROM with gravity eliminated
1/5 slight contractility, no jt motion
0/5 no evidence of muscle contraction

11

Biceps reflex nerve root

C5

12

Brachioradialis reflex nerve root

C6

13

Triceps reflex nerve root

C7

14

Hypperreflexia, Babinksi is

Present (abnormal)

15

Cauda equine syndrome sxs

Saddle paresthesia, bladder incontinence/retention, bowel incontinence, reduced DTRs, lower extremity weakness, radicular sxs covering nerve roots

**emergent!

16

Most dominant movements at C0/C1 joint

Flexion, extension

17

Ligaments that stabilize C1/C2 joint

Transverse ligament, alar ligament

18

What grade DTR is normoreflexive?

2+

19

If pt experiences pain with active and resisted neck movements but not passive ones, which tissues types affected?

Tendon, muscle

20

Allodynia upon palpation= grade...

4/4

21

Compression of nerve roots causes

Hyporeflexia

22

These help elicit DTRs

Lengthen muscle being tested
Add Jendrassik maneuver

23

Grimace or wince upon palpation = grade...

2/4

24

What movement differentiates upper div of trapezius from lavatory scapulae?

Rotation

25

Which movement likely to injure vertebral artery by over stretching?

Rotation

26

Three origins of pain

Nociceptive
Peripheral sensitization
Central sensitization

27

What is the one active PE that is performed on all pts with NMS complaint
(No matter the region, MOA, severity)

Active ROM

28

What 3 motions, in combo, maximally stress the vertebrobasilar vascular complex?

Rotation, extension, lateral flexion

29

Rust's sign

Not a sign! An observation: Pt holds their neck still as they move around the office. Suggests instability

30

Bakody's sign

Hx finding. Indicates nerve root irritation if pt reports relief from peripheral sxs with arm overhead

31

Positive valsalva maneuver...

Creates radicular sxs down the arm if the problem in the neck

32

Positive cervical compression test

Creates radicular sxs

(Compressed cervical spine and increased axial load)

Indicates: cervical disc herniation, spinal stenosis, nerve root irritation

33

Spurling's test

Pt actively laterally flex, doc compresses cervical spine

Positive --> radicular sxs

34

Maximal cervical/formaminal compression test

Rotation, extension, lateral flexion

(Done all at once!!)
If positive --> radicular sxs

35

Cervical distraction test

Lift pts head superiorly

Positive if radicular sxs go away with maneuver (100% specific)
Positive if pain worsens with maneuver

36

Shoulder depression test

Pt head in lateral flexion, push down on shoulde

Positive--> radicular sxs, pain in brachial plexus area

37

Soto Hall test

Pt supine, practitioner hand on sternum, max flex the patient's neck

Used to confirm suspicion of: vertebral fracture,joint/lig injury, cervicothoracic strain, facet syndrome, disc derangement

(Positive--> + Brudzinski sign, pain)

38

Vertebrobasilar artery insufficiency

Insufficient blood flow through vertebral and basilar arteries to midbrain, cerebellum, cerebrum

39

Dx cluster for cervical radiculopathy

+ULTT of median n
Active cervical rotation
+ Distraction
+Spurling's

40

Canadian C spine rules for X-rays: any positive of the following..

Cognitive awareness or neuro sxs
65+ yrs
Fearful of moving head when asked
Substantial mechanism of injury and/or axial load injury
Midline palpatory pain

41

Resisted ROM

Muscles contracting...

Gives no information about the joints

42

Passive ROM

Gives information about the joints, some about ligaments.

43

Is the upper limb tension test a thoracic outlet test?

No.
Tests sensitivity of the median n to stretching. May or may not have anything to do with TOS

44

Is scoliosis always clinically relevant?

no! You can have "severe" scoliosis with no pain. Usu not relevant.

45

What is the best way to detect vasculogenic TOS?

Specifically look at vasculature! (Cap refill, etc) Best way..

but do these name tests:
Adson's, reverse adson's, Eden's, Roos' test, Wright's test

46

Scoliosis

Lateral curvature of the spine. Idiopathic--probably genetic.

Name by side of convexity.

47

TOS

Cluster of symptoms that can usu be better diagnosed. Dx of exclusion.

Most common= neurogenic

48

TOS tests..

Poor validity, high false positive rate

Best tests for involvement of scalenes: Reverse Adson's, Adson's

49

ULTT

Positive: pain along course of peripheral n

Suggests excessive nerve tension/impingement

50

Adson's test

Take a breath, rotate head towards arm
Positive:'pulse goes away, paresthesia

51

Median n ULTT very sensitive for..

Cervical radiculitis

52

Each rib attaches to thoracic vertebra at which articulations?

Costovertebral joint, transverse costal jt

53

What movement most dominant at atlantoaxial joint (C1/C2)

Rotation

54

Grade 1 sprain

25-50% of ligament's fibers are torn

55

Adhesive capsulitis/ frozen shoulder syndrome assoc w

Thyroid problems, diabetes

Shoulder injury/surgery, cervical disk dz, open heart surgery

56

Capsular pattern of the shoulder

External rotation, abduction, flexion, internal rotation

57

Bicipital tendonosis

Degenerative changes on histo

58

Failure to perform Gerber Lift may indicate..

Weak or torn subscapularis

59

Positive Neer's test with shoulder in external rotation

Impingement of biceps brachii tendon

60

Normal ROM for shoulder adduction

175-185

61

Ligament attaches scapula to scapula

Coracoacromial

62

Shoulder girdle comprises...

Glenohumeral joint, acromioclavicular jt, scapulothoracic jt, sternoclavicular jt

63

Biceps brachii attaches to

Glenoid labrum

64

Attachment and action of supraspinatus

Greater tuberosity of humerus; abduction of glenohumeral jt

65

Codman drop arm test and Empty can test

Assess tear of supraspinatus

66

Hypertonicity of which muscles can compress brachial plexus

Scalenes

67

Olecranon Manubrium Percussion Test

Tap on olecranon process as listen to Manubrium, check for fracture (if different L vs R)

68

Bicipital subluxation

Bicipital tendon slips out of groove when transverse ligament is lax or ruptured

Sxs:'pain in glenohumeral region, audible snap, swelling, ecchymosis

69

Diagnostic cluster for subacromial impingement

+Hawkin-Kennedy
+ painful arc
+ infraspinatus

70

Diagnostic cluster for acromioclavicular pathology

AC Cross body adduction + AC resisted extension test + AC compression test

71

Most common injury for wrist and hand?

FOOSH, fall on outstretched hand

72

What is pt position necessary for elbow fracture screen

Supine

73

If you suspect elbow fracture, also X-ray/look at...

Wrist and hand