Flashcards in Midterm Deck (73)
Isometric motor test for elbow flexion (biceps) tests
Isometric motor test for finger ab/adduction tests
Isometric motor test for finger extension tests
Isometric motor test for finger flexion tests
Isometric motor test for shoulder abduction (deltoid) tests
Isometric motor test for wrist extension tests
Isometric motor test for wrist flexion tests
Isometric motor test for elbow extension (triceps) tests
+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
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
Biceps reflex nerve root
Brachioradialis reflex nerve root
Triceps reflex nerve root
Hypperreflexia, Babinksi is
Cauda equine syndrome sxs
Saddle paresthesia, bladder incontinence/retention, bowel incontinence, reduced DTRs, lower extremity weakness, radicular sxs covering nerve roots
Most dominant movements at C0/C1 joint
Ligaments that stabilize C1/C2 joint
Transverse ligament, alar ligament
What grade DTR is normoreflexive?
If pt experiences pain with active and resisted neck movements but not passive ones, which tissues types affected?
Allodynia upon palpation= grade...
Compression of nerve roots causes
These help elicit DTRs
Lengthen muscle being tested
Add Jendrassik maneuver
Grimace or wince upon palpation = grade...
What movement differentiates upper div of trapezius from lavatory scapulae?
Which movement likely to injure vertebral artery by over stretching?
Three origins of pain
What is the one active PE that is performed on all pts with NMS complaint
(No matter the region, MOA, severity)
What 3 motions, in combo, maximally stress the vertebrobasilar vascular complex?
Rotation, extension, lateral flexion
Not a sign! An observation: Pt holds their neck still as they move around the office. Suggests instability
Hx finding. Indicates nerve root irritation if pt reports relief from peripheral sxs with arm overhead
Positive valsalva maneuver...
Creates radicular sxs down the arm if the problem in the neck
Positive cervical compression test
Creates radicular sxs
(Compressed cervical spine and increased axial load)
Indicates: cervical disc herniation, spinal stenosis, nerve root irritation
Pt actively laterally flex, doc compresses cervical spine
Positive --> radicular sxs
Maximal cervical/formaminal compression test
Rotation, extension, lateral flexion
(Done all at once!!)
If positive --> radicular sxs
Cervical distraction test
Lift pts head superiorly
Positive if radicular sxs go away with maneuver (100% specific)
Positive if pain worsens with maneuver
Shoulder depression test
Pt head in lateral flexion, push down on shoulde
Positive--> radicular sxs, pain in brachial plexus area
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)
Vertebrobasilar artery insufficiency
Insufficient blood flow through vertebral and basilar arteries to midbrain, cerebellum, cerebrum
Dx cluster for cervical radiculopathy
+ULTT of median n
Active cervical rotation
Canadian C spine rules for X-rays: any positive of the following..
Cognitive awareness or neuro sxs
Fearful of moving head when asked
Substantial mechanism of injury and/or axial load injury
Midline palpatory pain
Gives no information about the joints
Gives information about the joints, some about ligaments.
Is the upper limb tension test a thoracic outlet test?
Tests sensitivity of the median n to stretching. May or may not have anything to do with TOS
Is scoliosis always clinically relevant?
no! You can have "severe" scoliosis with no pain. Usu not relevant.
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
Lateral curvature of the spine. Idiopathic--probably genetic.
Name by side of convexity.
Cluster of symptoms that can usu be better diagnosed. Dx of exclusion.
Most common= neurogenic
Poor validity, high false positive rate
Best tests for involvement of scalenes: Reverse Adson's, Adson's
Positive: pain along course of peripheral n
Suggests excessive nerve tension/impingement
Take a breath, rotate head towards arm
Positive:'pulse goes away, paresthesia
Median n ULTT very sensitive for..
Each rib attaches to thoracic vertebra at which articulations?
Costovertebral joint, transverse costal jt
What movement most dominant at atlantoaxial joint (C1/C2)
Grade 1 sprain
25-50% of ligament's fibers are torn
Adhesive capsulitis/ frozen shoulder syndrome assoc w
Thyroid problems, diabetes
Shoulder injury/surgery, cervical disk dz, open heart surgery
Capsular pattern of the shoulder
External rotation, abduction, flexion, internal rotation
Degenerative changes on histo
Failure to perform Gerber Lift may indicate..
Weak or torn subscapularis
Positive Neer's test with shoulder in external rotation
Impingement of biceps brachii tendon
Normal ROM for shoulder adduction
Ligament attaches scapula to scapula
Shoulder girdle comprises...
Glenohumeral joint, acromioclavicular jt, scapulothoracic jt, sternoclavicular jt
Biceps brachii attaches to
Attachment and action of supraspinatus
Greater tuberosity of humerus; abduction of glenohumeral jt
Codman drop arm test and Empty can test
Assess tear of supraspinatus
Hypertonicity of which muscles can compress brachial plexus
Olecranon Manubrium Percussion Test
Tap on olecranon process as listen to Manubrium, check for fracture (if different L vs R)
Bicipital tendon slips out of groove when transverse ligament is lax or ruptured
Sxs:'pain in glenohumeral region, audible snap, swelling, ecchymosis
Diagnostic cluster for subacromial impingement
+ painful arc
Diagnostic cluster for acromioclavicular pathology
AC Cross body adduction + AC resisted extension test + AC compression test
Most common injury for wrist and hand?
FOOSH, fall on outstretched hand
What is pt position necessary for elbow fracture screen