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1
Q

Dorsal Compartment I

A

APL

EPB

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2
Q

Dorsal Compartment II

A

ECRL

ECRB

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3
Q

Dorsal Compartment III

A

EPL

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4
Q

Dorsal Compartment IV

A

ED

EI

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5
Q

Dorsal Compartment V

A

EDM

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6
Q

Dorsal Compartment VI

A

ECU

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7
Q

TAM

A

(MP+PIP+DIP flex) - (MP+PIP+DIP ext loss)

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8
Q

grip tests (3)

A

standard
5 level
rapid exchange

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9
Q

pinch tests (3)

A

lateral
3 point
2 point

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10
Q

Wound Assessment (6)

A

SCOTDD

size color odor temp depth drainage

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11
Q

Lateral Epicondylosis

A 
ERCB most common (EDC 2nd)
night ache morning stiffness
pain w/ grip
decreased grip w/ elbow ext
tightness in extrinsic extensors
orthoses: 35 deg ext
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12
Q

Cozen’s Test

A 
for lateral epicodylosis
examiner's thumb on lat epicondyle
forearm pronated, fist, wrist ext, radial deviation
apply resistance
\+ w/ pain
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13
Q

Mill’s Elbow Test

A

for lateral epicondylosis
palpate most tender aspect
pronate, wrist full flex while moving elbow to flex/ext
+ w/ pain

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14
Q

Middle Finger Test

A

for lateral epicondylosis
extend elbow and hand and apply resistance to tip of the middle finger
+ = Radial Tunnel instead of Lat Epicondylosis

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15
Q

Medial Epicondylosis

A

PT, FCR, PL (FCU/FDS)
less common than lat
pain over medial epicondyle
orthoses: wrist neutral

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16
Q

DeQuervain’s

A

APL/EPB
pain over radial styloid w/ resistive thumb ext/abd
4x more common in women

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17
Q

Finkelstein’s Test

A

for DeQuervain’s
fist over thumb, press to ulnar deviation
+ w/ pain

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18
Q

Treatment: Lateral Epicondylosis

A

Non Operative
ACUTE: orthoses 35 deg wrist ext, heat, ice, friction massage, AROM, gentle isometrics, short arc movements ECRB, prox distal strengthening
RESTORATIVE: flexibility, strength, endurance, graded conditioning, ergonomics, increased isometrics, add eccentric

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19
Q

Treatment: Medial Epicondylosis

A

Non Operative
ACUTE: orthoses wrist neutral, heat, ice, friction massage, AROM, gentle isometrics, short arc movements PT/FCR/PL, prox distal strengthening
RESTORATIVE: flexibility, strength, endurance, graded conditioning, ergonomics, increased isometrics, add eccentric

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20
Q

Treatment: DeQuervain’s

A

Non Operative
thumb spica - IP free
isometrics of ADL and EPB, short arc AROM, isolated wrist flex/ext, isolated thumb IP flex/ext
add strengthening, eccentric ex w/ caution

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21
Q

Digital Stenosisning Tenosynovitis

A

Trigger Finger

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22
Q

Trigger Finger

A

thickening of flexor tendon preventing gliding through a pulley
A1 pulley most common (volar to MP joint)
ring and thumb most common

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23
Q

Treatment: Trigger Finger

A 
Non Operative
refrain from aggravating activities
orthosis
modalities
tissue massage (ASTYM,SASTM)
taping
Operative: surgical release of pulley
most do not need therapy
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24
Q

Cervical Screen

A

ROM Testing
Repeated Motion Testing
Cervical Radiculopathy Test Cluster

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25
Cervical Radiculopathy Test Cluster (4)
Spurling's Cervical Distraction Cervical Rotation ROM Upper Limb Neurodynamic Test
26
Spurling's Test
for cervical radiculopathy lateral cervical flexion to end range and apply 7 kg axial compression + w/ pain
27
Cervical Distraction Test
for cervical radiculopathy patient supine head neutral place hand under chin and base of skull and distract C - spine + w/ relief/decrease symptoms
28
Cervical Rotation ROM
for cervical radiculopathy measure with goni + w/ 60> deg ROM toward involved side
29
Upper Limb Neurodynamic Test
for cervical radiculopathy
30
Thoracic Outlet Syndrome Regions (4)
sternocostovertebral space scalene triangle costoclavicular space pectoralis minor space
31
Proximal Humerus Fx
most common fx of the humerus | may involve articular surface, greater tubercle, lesser tuberosity, or surgical neck
32
Precautions: Proximal Humerus Fx
RC injuries often overlooked high risk for adhesive capsulitis many have concurrent axillary nerve or brachial plexus injury so screen at eval
33
Adhesive Capsulitis
frozen shoulder | primary: idiopathic secondary: precipitates event
34
Freezing Phase
shoulder pain interrupting sleep pain w/ ADLs pain at rest ROM close to full with pain before end range nonspecific tenderness at ant, lat, and post aspects over 2-9 months pain subsides and turns to typical FS pain at end range
35
Frozen Phase
may last up to 1 year distinct movement patterns as client attempts to substitute ST motion to compensate for lack of GH mobility pain with stretching joint capsule at end range
36
Thawing Phase
gradual return of motion | last up to 26 months
37
Precautions: Adhesive Capsulitis
don't push ROM during freezing phase to point that lasts beyond a few minutes--will enhance inflammatory/fibrosing process self-imposed immobilization by client
38
Glenohumeral Instability - TUBS
``` "torn loose" T raumatic etiology U nidirectional instability B ankhart lesion S urgery required ```
39
Glenohumeral Instability - AMBRII
``` "born loose" A traumatic or microtrauma M ulitdirectional instabilty B ilateral symptoms R ehab is treatment of choice I nferior capsular shift I nterval between supraspinatus and subscapularis closed surgically if conservative measures fail ```
40
SLAP Lesion
Superior Labrum Anterior to Posterior
41
Treatment: GH Instability NonOP
strengthen RC and subscap stabilization
42
Treatment: GH Instability Op
in AMBRII - only after 3 month rehab failed most common: Open Inferior Capsular Shift or Arthroscopic Capsular Plication less common: Thermal Capsulorrhaphy
43
Precautions: GH Instability
do not perform end range or grade IV joint mobs/stretches on client with MDI clients w/ anterior instability need posterior capsule stretched - avoid anterior stretch pay close attention to ROM restrictions for postop patients
44
Rotator Cuff Disease
70% shoulder disorders related to RC disease | structures involved: muscles of RC, long head of biceps tendon, subdeltoid-subacromial bursa, and CA arch
45
Extrinsic RC Lesions
result from repeated impingement of RC tendon against different structures of GH joint
46
Intrinsic RC Lesions
result from age-related degeneration of RC tendon | related to vascularization of RC cuff and are on articular side of tendon
47
Neer's Three-Stage Classification of Impingement Syndrome
Stage I: 40 years old, bone spurs and tears of RC and long head of biceps tendon
48
Precautions: Rotator Cuff Disease
watch for tight posterior capsule if showing impingement signs, take care to avoid impinging shoulder during overhead motions monitor for excessive scapular elevation discourage clients from sleeping on involved side
49
Elbow Fx (3)
radial head olecranon distal humeral
50
Radial Head Fx
FOOSH | most common in adults
51
Olecranon Fx
relatively common in adults result from fall onto bent elbow or direct blow majority are displaced most require operative care
52
Distal Humeral Fx
relatively uncommon (2%) most frequent in young males or females over 80 associated with higher velocity injuries in younger individuals can occur from simple fall in older individuals with poor bone stock
53
Heterotrophic Ossicifcation
bone in nonosseous tissues | may develoop following fx to distal humerus
54
Precautions: Elbow Dislocation
avoid combining end range elbow extension and supination for first 6 weeks
55
Varus Elbow Instability
lateral collateral ligament insufficiency | usually results from elbow dislocation
56
Valgus Elbow Instability
medial collateral ligament insufficiency | usually chronic resulting from repetitive stresses such as overhead throwing
57
Precautions: Elbow Instability
avoid elbow ext with sup for at least 8 weeks avoid shoulder abd with IR for at least 12 weeks following varus LCL repair be alert for nerve symptoms
58
Stiff Elbow
frequent complication of elbow dislocation, fraction, head injury, and burns multiple contributing factors
59
Seddon's Classification - PN (3)
neuropraxia axonotmesis neurotmesis
60
Neruopraxia
injury - mild | recovery
61
Axonotmesis
injury - severe regeneration - 1mm/day recovery
62
Neurotmesis
injury degeneration neuroma formation
63
Sunderland's Classification PN - Degree 1
structures remain intact | local conduction block and dymyelination
64
Sunderland's Classification PN - Degree 2
axonal disruption with distal (Wallerian) degeneration
65
Sunderland's Classification PN - Degree 3
disruption of axons and endoneurial tubes | fascicles remain intact
66
Sunderland's Classification PN - Degree 4
disruption of axons, endoneurial tubes | only epineurium intact
67
Sunderland's Classification PN - Degree 5
complete nerve transection
68
Radial Nerve Palsy
most commonly injured peripheral nerve fx of humerus (1:10 have radial nerve complications) elbow dislocation Monteggia fx-dislocation
69
High Radial Nerve (4)
triceps anconeus brachioradialis ECRL
70
Low Radial Nerve (9)
``` ECRB supination EDC EDM ECU APL EPL EPB EIP ```
71
High Median Nerve (7)
``` PT FCR PL FDS FDP (index and long) FPL PQ ```
72
Low Median Nerve (4)
OP FPB (superficial head) APB Lumbricals (index and long)
73
High Ulnar Nerve (2)
FCU | FDP (ring and small)
74
Low Ulnar Nerve (8)
``` ADM ODM FDM Lumbricals (4 and 3) 3 palmar interossei 4 dorsal interossei FPB (deep head) Add Pol ```

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