Musculoskeletal System Review Session 1 (via Scorebuilders) Flashcards Preview

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Flashcards in Musculoskeletal System Review Session 1 (via Scorebuilders) Deck (97):
1

What are the 3 energy systems in the human body?

1. ATP-PC/ Phosphagen Energy System
2. Anaerobic Glycolysis/ Lactic Acid System
3. Aerobic/ Oxygen System

2

This type of energy system is utilized during high intensity, short duration bursts (i.e. 100 m sprint). This system provides energy for muscle contraction up to 15s. It does not depend on transporting oxygen for energy.

ATP-PC/ Phosphagen Energy System

3

This system only uses carbohydrates and is utilized during high intensity, short duration activities (i.e. 400m or 800m sprint). This process allows 30 to 40s of a muscular contraction. It does not require the presence of oxygen.

Anaerobic Glycolysis/ Lactic Acid System

4

This type of energy system is used in low intensity, long duration exercise such as running a marathon. This system yields the most ATP, but requires a complex series of chemical reactions. This system provides energy through the oxidation of food.

Aerobic/ Oxygen System

5

Describe the classes of levers (fulcrum [axis of rotation], load [resistance], and effort [force]) and provide an anatomical example for each.

1. Class 1: Fulcrum is between the load and the effort. Ex: Triceps brachii and Atlanto-occipital joint

2. Class 2: Load is between the fulcrum and the effort (think wheelbarrow) Ex: Plantarflexion, push-up

3. Class 3: Effort is between the load and the fulcrum. Ex: biceps brachii, biceps femoris

6

What are the types of joint classifications? Be able to provide examples for each.

1. Fibrous Joints (Synarthroses). 3 types: Sutures (skull), Syndesmosis (interosseous membrane of tib-fib), and gomphoses (tooth in socket). No movement.

2. Cartilaginous Joints (Amphiarthroses). 2 types: Synchondrosis (sternum) and Symphysis (pubic symphysis). Slight movement.

3. Synovial Joints (Diarthroses). 3 types: Uniaxial (hinge [elbow], pivot [AA]), Biaxial (condyloid [MCP], saddle [CMC], and Multiaxial (plane [carpal joints], ball and socket [hip])

7

Name the common Joint Receptors and briefly describe their functions.

1. Free Nerve Endings - mechanical stress and noxious stimuli

2. Pacinian Corpuscles - vibration, acceleration, and high velocity changes

3. Golgi Ligament Endings - tension or stretch on ligaments

4. Ruffini Endings - stretching of joint capsule; amplitude and velocity of joint position

5. Golgi - Mazzoni Corpuscles - compression of joint capsule

8

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Glenohumeral Joint

Convex humeral head on concave glenoid fossa.

LPP: 55° ABD, 30° horizontal ADD

CPP: ABD and ER

Capsular Pattern: ER, ABD, and IR

9

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Sternoclavicular Joint

Saddle Joint (with the articular disc)

LPP: Arm resting at side

CPP: Maximum shoulder elevation

Capsular Pattern: pain at extremes of range of motion

10

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Acromioclavicular Joint

Planar Joint (Kaltenborne), but anatomically concave acromion on convex clavicle

LPP: Arm resting at side

CPP: 90° ABD

Capsular Pattern: pain at extremes of range of motion

11

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Radiohumeral Joint

Concave radial head on convex capitulum

LPP: Full extension and supination

CPP: 90° flexion. 5° supination

Capsular Pattern: flexion, extension, supination, pronation

12

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Ulnohumeral Joint

Saddle (Concave trochlear notch moves on trochlea of humerus only though)

LPP: 70° flexion. 10° supination

CPP: extension

Capsular Pattern: flexion, extension

13

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Proximal Radioulnar Joint

Convex radial head of radius moves on concave radial notch of ulna

LPP: 70° flexion. 35° supination

CPP: 5° supination

Capsular Pattern: supination, pronation

14

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Distal Radioulnar Joint

Concave radius moves on convex ulna

LPP: 10° supination

CPP: maximum pronation or supination (Kaltenborne)

Capsular Pattern: supination, pronation (equal)

15

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Radiocarpal Joint

Convex carpus on concave radius and articular disc

LPP: neutral with slight ulnar deviation

CPP: extension and radial deviation

Capsular Pattern: flexion and extension equally limited

16

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Iliofemoral Joint

Ball and Socket (Convex femoral head on concave acetabulum)

LPP: 30° flexion, 30° ABD, slight ER

CPP: Full extenxion and IR

Capsular Pattern: flexion, ABD, and IR (sometimes IR is most limited)

17

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Tibiofemoral Joint

Concave medial and lateral tibial plateus on convex medial and lateral condyles of femur

LPP: 25° flexion

CPP: Full extenxion and ER of tibia

Capsular Pattern: flexion, extension

18

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Patellofemoral

Convex patella on concave trochlear groove (Kaltenborne actually has contradicting information ... choose wisely)

LPP: 25° flexion

CPP: Full extenxion and ER of tibia

Capsular Pattern: flexion, extension

19

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Proximal AND Distal Tibiofibular Joints

Concave fibular head on convex tibial condyle

LPP: 10° plantarflexion

CPP: maximum dorsiflexion

Capsular Pattern: (not mentioned in either Scorebuilders or Kaltenborne)

20

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Carpometacarpal Joints II-V

Concave metacarapal on convex carpus

LPP & CPP: unknown

Capsular Pattern: equal in all directions

21

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Carpometacarpal Joint I

Saddle (flexion/ extension = concave on convex; ABD/ ADD = convex on concave)

LPP: midway between flexion, extension, ABD, and ADD (Kaltenborne)

CPP: maximum opposition

Capsular Pattern: ABD and extension

22

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Finger Joints

Concave on Convex rule for DIPs and PIPs

LPP: slight flexion

CPP: maximum extension

Capsular Pattern: restriction in all directions with slightly more limitation in flexion

23

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Metacarpophalangeal

Only difference is LPP and CPP:

LPP: slight flexion and ulnar flexion

CPP: Maximal flexion

24

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Talocrural Joint

Convex talus on concave mortis

LPP: 10° plantarflexion, midway between inversion and eversion

CPP: maximum dorsiflexion

Capsular Pattern: plantarflexion, dorsiflexion

25

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Subtalar Joint (talocalcaneal Joint)

Concave inferior talus, convex calcaneus

LPP: midway between extremes of motion

CPP: supination

Capsular Pattern: limitation of varus

26

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Midtarsal Joint



LPP: midway between extremes of motion

CPP: supination

Capsular Pattern: dorsiflexion, plantarflexion, ADD, IR

27

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Toe Joints

Concave on convex

LPP: slight flexion

CPP: maximal extension

Capsular Pattern: restricted in all directions, slightly more limited extension

28

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Metatarsal Phalangeal Joints

Concave on convex

LPP: 10° extension

CPP: MTP I: maximal extension; MTP II-V: maximal flexion

Capsular Pattern: restricted in all directions, slightly more limited flexion

29

Musculocutaneous Nerve innervates which muscle with its associated cord segment?

Biceps Brachii (C5-C6)

Coracobrachialis (C6-C7)

Brachialis (C5-C6)

30

Axillary Nerve innervates which muscle with its associated cord segment?

Deltoid (C5-C6)

Teres Minor (C4-C5)

31

Spinal Accessory Nerve innervates which muscle with its associated cord segment?

Traps (C1-C4)

32

Which nerve innervates Pec minor?

Medial pectoral (C8-T1)

33

Which nerve innervates Pec major?

Medial and lateral pectoral (C5-C8, T1)

34

Which nerve innervates Serratus Anterior and its associated cord segment?

Long Thoracic Nerve (C5-C7)

35

Dorsal Scapular Nerve innervates which muscle?

Levator Scapula (C5)

Rhomboids (C4-C5)

36

Suprascapular Nerve innervates which muscle with its associated cord segment?

Infraspinatus (C4-C6)

Supraspinatus (C4-C6)

37

Subscapular Nerve innervates which muscle with its associated cord segment?

Lower Subscapular (C5-C6)= Teres Major

Thoracodorsal C5-C8 (Middle Subscap)= Latissimus dorsi

Subscapularis

38

Ulnar Nerve innervates which muscle with its associated cord segment?

Flexar carpi ulnaris (C7-T1)
Flexor Digiti quinti (C8-T1)
Flexor Digitorium Prof. III & IV (C7-C8)
Adductor Pollicis C8-T1
Abductor digiti C8-T1
Opponens digiti C8-T1
interossei C8-T1
Lumbracals III & IV (C8-T1)

39

Median Nerve innervates which muscle?

Pronator Teres
Pronator Quad
Flex Carpi rad
Palm longus
Flex digit superfic
Flex pollicis longus
Flex digitorum
Abd pollicis brevis
flex pollicis brevis
Opponens pollicis
lumbracals

40

The Radial Nerve innervates which muscle?

Brachioradialis (C5-C6)
Triceps (C6-C8)
Ext Carpi radialis
Ext digitorum
Ext carpi ulnaris
Supinator
Abd pollicis longus
Ext pollicis long/brev
Extensor indicis proprius

41

Femoral Nerve innervates which muscle with cord segment?

Iliopsoas (L1-L3)

Sartorius (L2-L3)

Quad femoris (L2-L4)

Pectineus (sometimes Obturator nerve)

Iliacus

42

Superior gluteal nerve innervates which muscle?

Glute Med (L4-S1)

Glute Min (L4-S1)

TFL (L4-L5)

43

Inferior gluteal nerve innervates which muscle?

Glute Max (L4-S2)

44

Differentiate between muscle spindles and golgi tendon organs

Muscle Spindles - located in belly of the muscle; detects muscle length and/ or rate of change in its length. It is important for postural control and involuntary movements

GTO - located near tendons, GTOs are very sensitive to tension changes/ rate of tension changes in muscles.

45

What is the difference between isotonic and isokinetic exercise?

Isotonic - muscle length changes through contract and relax and the resistance stays the same

Isokinetic - the muscle length still changes, but the resistance adjusts so the speed of the contraction and relaxation remains constant

46

Differentiate between DeLorme and Oxford exercise programs

DeLorme
- 1st set: (10 reps) x (50% of 10 rep max)
- 2nd set: (10 reps) x (75% of 10 rep max)
- 3rd set: (10 reps) x (100% of 10 rep max)
Oxford
- Reverse (100%, 75%, 50%)

47

Resistive Testing and Innervation Level of the Upper Quadrant ... (aka Myotomes)

C1 - cervical flexion
C2 - cervical extension/ rotation
C3 - cervical lateral flexion
C4 - shoulder elevation
C5 - shoulder ABD/ ER
C6 - elbow flexion/ wrist extension
C7 - elbox extension/ wrist flexion
C8 - thumb extension/ ulnar deviation
T1 - finger ABD/ ADD

48

Resistive Testing and Innervation Level of the LowerQuadrant ... (aka Myotomes)

L1 - hip flexion
L2 - hip flexion (ADD and IR)
L3 - knee extension
L4 - dorsiflexion, ankle inversion
L5 - great toe extension
S1 - ankle plantarflexion, knee flexion, ankle eversion
S2 - ankle plantarflexion, knee flexion
S3 -S5 - perianal area ;)

49

Reflex Testing (Common sites throughout entire body)

C5 - Biceps
C6 - Brachioradialis
C7 - Triceps
L4 - Patella
S1 - Achilles

50

Upper Quadrant Dermatomes

C2 - Posterior Head
C3 - Lateral Neck
C4 - Acromioclavicular Joint
C5 - Lateral Arm
C6 - Lateral forearm and thumb
C7 - Middle finger
C8 - ular border of hand and little finger
T1 - medial forearm

51

Lower Quadrant Dermatomes

L2 - Anterior Thigh
L3 - Middle third of Anterior thigh
L4 - Patella and medial malleolus
L5 - Fibular Head and Dorsum of Foot
S1 - Lateral aspect and plantar aspect of foot
S2 - Medial aspect of posterior thigh
S3 -S5 - perianal area ;)

52

Pudendeal nerve innervates which muscles?

Thats right! S2-S4

53

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Cervical Spine

Superior segment on inferior segment

LPP: between flexion and extension

CPP: extension

Capsular Pattern: lateral flexion and rotation equally limited, extension

54

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Thoracolumbar Spine

Superior segment on inferior segment

LPP: between flexion and extension

CPP: extension

Capsular Pattern: lateral flexion and rotation equally limited, extension

55

Differentiate between Type I and Type II muscle fibers

Type I: aerobic, red, tonic, slow twitch, and slow-oxidative
Type II: anaerobic, white, phasic, fast twitch, fast glycolytic

56

Differentiate between muscle spindles and golgi tendon organs

Muscle Spindles - located in belly of the muscle; detects muscle length and/ or rate of change in its length. It is important for postural control and involuntary movements

GTO - located near tendons, GTOs are very sensitive to tension changes/ rate of tension changes in muscles.

57

What is the difference between isotonic and isokinetic exercise?

Isotonic - muscle length changes through contract and relax and the resistance stays the same

Isokinetic - the muscle length still changes, but the resistance adjusts so the speed of the contraction and relaxation remains constant

58

Differentiate between DeLorme and Oxford exercise programs

DeLorme

59

Resistive Testing and Innervation Level of the Upper Quadrant ... (aka Myotomes)

C1 - cervical flexion
C2 - cervical extension/ rotation
C3 - cervical lateral flexion
C4 - shoulder elevation
C5 - shoulder ABD/ ER
C6 - elbow flexion/ wrist extension
C7 - elbox extension/ wrist flexion
C8 - thumb extension/ ulnar deviation
T1 - finger ABD/ ADD

60

How is the Apprehension test for anterior shoulder dislocation Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt supine > UE 90 degrees ABD > PT Lat. rot shoulder.

R: + = Look of apprehension/facial grimace before end point

I: Ant Shoulder Disloc.

61

How is the Apprehension test for posterior shoulder dislocation Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt supine > UE 90 deg flex & med rot > PT applies POST force through long axis of humerus

R: + = Look of apprehension/facial grimace before end point

I: Post. Shoulder Disloc

62

How is Adson's maneuver Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated/standing > PT takes radial pulse > pt ROTATES head Ipsilaterally > active cervical EXT with PT laterally rotating and extending pt's shoulder.

R: + = Absent/Diminished radial pulse

I: TOS

63

How is Speed's Test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated/standing > UE @ 90 deg, Elbow Ext, Forearm Sup > PT palpate bicipital groove other on volar surface pt forearm > PT resists active shoulder flex.

R: + = Pain/tenderness in bicipital groove.

I: BICIPITAL TENDONITIS

64

How Is Yergason's Test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated > 90 deg Elbow flex, forearm pronated > humerus stabilized against patients thorax > PT 1 hand on pt's forearm, 1 on bicipital groove > pt actively supinates and lat rotate against resistance.

R: + = Pain/tenderness in bicipital groove

I: Bicipital tenonitis

65

How is the Drop Arm Test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated/standing > UE 90 deg ABD > Pt slowly lowers arm to side.

R: + = Can't lower slow OR severe pain.

I: Rotator Cuff Tear

66

How is Hawkins-Kennedy Impingement Test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt sitting/standing > PT flex's pt's shoulder to 90 deg with medial rot.

R: + = Pain

I: Shoulder impingement of Supraspinatus tendon

67

How is Neer impingement test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated/standing > PT 1 hand on post aspect of scapula, other stabilize elbow > PT elevates pt's UE through Flex.

R: + = Facial grimace/ pain

I: Shoulder impingement of Supraspinatus tendon

68

How is the Supraspinatus Test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt standing > UE 90 deg ABD > 30 deg horizontal ADD with thumb pointing down > PT resists pt attempt to ABD.

R: += Weakness or pain

I: Tear supraspin. impingement or suprascapular nerve involvement

69

How is Adson maneuver Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated/standing > PT takes radial pulse > pt ROTATES head Ipsilaterally > active cervical EXT with PT laterally rotating and extending pt's shoulder.

R: + = Absent/Diminished radial pulse

I: TOS

70

Resistive Testing and Innervation Level of the Upper Quadrant ... (aka Myotomes)

L1 - hip flexion
L2 - hip flexion (ADD and IR)
L3 - knee extension
L4 - dorsiflexion
L5 - great toe extension
S1 - ankle plantarflexion, knee flexion, ankle eversion
S2 - ankle plantarflexion, knee flexion
S3 -S5 - perianal area

71

Reflex Testing (Common sites throughout entire body)

C5 - Biceps
C6 - Brachioradialis
C7 - Triceps
L4 - Patella
S1 - Achilles

72

Upper Quadrant Dermatomes

C2 - Posterior Head
C3 - Lateral Neck
C4 - Acromioclavicular Joint
C5 - Lateral Arm
C6 - Lateral forearm and thumb
C7 - Middle finger
C8 - ular border of hand and little finger
T1 - medial forearm

73

How is Allen's Test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated/standing > UE 90 deg ABD, ER, and elbow FLEX > Pt rotate contralaterally while PT takes radial pulse

R: + = Absent or diminished pulse

I: TOS

74

How is Costoclavicular Syndrome Test (military brace) Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated > PT find radial pulse> move shoulder down and back.

R: + = Absent/Diminished radial pulse

I: TOS, , via compression of subclavian artery between first rib and clavicle

75

How is Roos test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Seated/standing > B UE @ 90 deg abd, ER, elbow Flex > Pt open and close hands for 3 minutes.

R: Cant hold position, weakness, sensory loss, ischemic pain

I: TOS

76

Lower Quadrant Dermatomes

L2 - Anterior Thigh
L3 - Middle third of Anterior thigh
L4 - Patella and medial malleolus
L5 - Fibular Head and Dorsum of Foot
S1 - Lateral aspect and plantar aspect of foot
S2 - Medial aspect of posterior thigh
S3 -S5 - perianal area

77

How is Wright test (Hyperabduction test) Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated/stand > PT takes radial pulse > UE passively into max ABD and ER > Pt takes deep breath and cervical rot to contralateral side

R: + = Absent/Diminished pulse

I: TOS

78

How is the Glenoid labrum Test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt supine > PT 1 hand post. aspect of humerus, other stabilize humerus proximal to elbow > PT passively ABD + ER UE over pt's head > PT apply ANT directed force to humerus.

R: + = Clunk or grinding sound

I: Glenoid labrum tear

79

How is ULTT1 Performed, identify a positive Result, and what a positive test is Indicative of?

P: Shoulder Depressed > Shoulder ABD 110 deg > Elbow ext > Forearm Supination > Wrist Ext > FInger/Thumb ext > Cervical contralateral lat flexion

R: + = Reproduction of symptoms

I: Median Nerve + Anterior interosseous nerve

80

How is ULTT2 Performed, identify a positive Result, and what a positive test is Indicative of?

P: Shoulder Depressed > Shoulder ABD 10 deg > Elbow ext > Forearm Supination > Wrist Ext > FInger/Thumb ext > SHOULDER ER > Cervical contralateral lat flexion

R: + = Reproduction of symptoms

I: Median, Axillary, and Musculocutaneous Nerve

81

How is ULTT3 Performed, identify a positive Result, and what a positive test is Indicative of?

P: Shoulder Depressed > Shoulder ABD 10 deg > Elbow EXT > Forearm PRONATION > Wrist FLEX+ ULNAR DEV > FInger/Thumb FLEX > SHOULDER IR > Cervical contralateral lat flexion

R: + = Reproduction of symptoms

I: Radial Nerve

82

How is ULTT4 Performed, identify a positive Result, and what a positive test is Indicative of?

P: Shoulder Depressed > Shoulder ABD 10-90 deg with hand to ear > Elbow FLEX > Forearm Supination > Wrist EXT AND RADIAL DEV > FInger/Thumb EXT > Shoulder ER > Cervical contralateral lat flexion

R: + = Reproduction of symptoms

I: Ulnar Nerve

83

How is the Elbow Varus Stress test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated > Elbow 20-30 deg Flex > PT 1 hand on elbow, other prox to pt's wrist > PT applies varus force while palpating lateral joint line

R: + = Inc. laxity in lateral collateral lig, apprehension or pain

I: Lateral collateral lig sprain

84

How is the Elbow Valgus stress test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated > Elbow 20-30 deg Flex > PT 1 hand on elbow, other prox to pt's wrist > PT applies valgus force while palpating medial joint line.

R: + = Inc. laxity in medial collateral lig, apprehension or pain

I: Medial collateral lig sprain

85

How is Cozen's Test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated > Elbow slight Flex > PT thumb on Lateral epicondyle with stabilization of elbow joint > Pt makes fist, pronates forearm, radially deviates, and extends wrist against resistance.

R: + Pain in lateral epicondyle or muscle weakness

I: Lateral epicondylitis

86

How is Lateral epicondylitis test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated> PT stabilize elbow, other hand on dorsal surface of 3rd PIP > Pt actively EXT 3rd PIP against resistance.

R: + Pain in lateral epi. or muscle weakness

I: Lateral epicondylitis

87

How is Medial epicondylitis test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated > PT palpates medial epicondyle > supinates pt's forearm > Ext wrist > Ext elbow.

R: + = pain in medial epicondyle.

I: Medial epicondylitis

88

How is Mill's Test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated > PT palpates lateral epicondyle > passively pronates forearm, wrist flex, elbow ext.

R: + = Pain in latearl epi

I: Lateral epicondylitis

89

How is Tinel's sign Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated slight elbow flex > PT taps between olecranon process & medial epi.

R: + = Tingling sensation in ulnar nerve distribution

I: Ulnar nerve compression

90

How is the Ulnar Collateral ligament instability test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated > PT holds pt's thumb in Ext > applies valgus force to MCP joint of thumb

R: + = Excessive valgus movement

I: Gamekeeper's or skiers Thumb. Tear of ulnar collateral and accessory collateral ligaments.

91

How is Allen Test (Vascular insufficiency) Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated > pt asked to open and close hand several times and then maintain hand in closed position > PT compresses radial and ulnar arteries > pt asked to relax hand > PT releases pressure on one artery & observes color of hand and fingers.

R: + = Delayed or absent flushing of radial or ulnar half of hand

I: Occlusion of radial or ulnar artery.

92

How is the Bunnel-Littler Test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated > MCP held in slight Ext > PT attempts to move PIP into Flex.

R:
PIP does not Flex with MCP joint extended = tight intrinsic muscle or capsular restriction

PIP fully Flex with MCP in slight flex = intrinsic muscle tightness NO capsular restriction

93

How is Froments sign Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated/standing > Hold piece of paper between thumb and index > PT attempts to pull paper away from pt.

R:

Pt flexing distal phalanx of thumb = adductor pollicis paralysis. If at the same time, pt hyperextends MCP joint of thumb = Jeanne's sign

I: Ulnar nerve involvement


https://www.youtube.com/watch?v=1_I_djZaX9M

94

How is Phalens Test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated/standing > PT flexes pt's wrist maximally > pt hold position for 60 sec.

R: + = Parasthesia in thumb, index, middle, and lateral half or ring finger

I: Carpal tunnel syndrom (Median Nerve involvement)

95

How is Finkelstein's Test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated/standing > Pt makes fist with thumb tucked inside fingers > PT stabilizes pt's forearm and ulnarly deviates wrist.

R: + = pain over ABD pollicis longus and Ext pollicis brevis.

I: DeQuervain's Disease

96

How is the Grind Test Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated/standing > PT stabilizes pt's hand and grasps pt's thumb on the metacarpal > PT applies compression & rotation through metacarpal

R: + = Pain

I: Degenerative joint disease in the CMC joint.

97

How is Murphy's sign Performed, identify a positive Result, and what a positive test is Indicative of?

P: Pt seated/standing > Pt asked to make fist

R : + = pt's 3rd metacarpal remaining level with 2nd and 4th metacarpal.

I: Dislocated lunate