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
