UE abnormal Flashcards

(48 cards)

1
Q

what are you assessing for when palpating a nodule

A
  • tenderness
  • mobile/fixed
  • soft/hard
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2
Q

Loss of contour of normally rounded shoulder. What condition do you suspect

A

dislocation of shoulder

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3
Q

Examination reveals this. What do you suspect

A
  • paralysis of serratus anterior
  • injury to long thoracic nerve
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4
Q

what test is this?

A

sulcus sign: indicates glenohumeral instability of the shoulder

  • arm in neutral relaxed position, provider will pull the arm downward
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5
Q

what percentage of shoulder dislocations are anterior vs posterior

A
  • 95% anterior (pictured
  • 5% posterior
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6
Q

If there is injury to rotator cuff muscles, what is the likely order in which the muscles will be torn

A

SITS

  1. Supraspinatous
  2. Infraspinatus
  3. Teres Minor
  4. Subscapularis
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7
Q

What rotator cuff muscle is responsible for abduction of shoulder

A

supraspinatous

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8
Q

Which rotator cuff muscle is responsible for internal rotation of shoulder

A

subscapularis

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9
Q

Which muscles are responsible for external rotation of shoulder

A
  • 80% infraspinatus
  • 20% teres minor
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10
Q

What test goes with the maneuver: patient touches superior and inferior aspects of opposite scapula? What diagnosis is suggested by a positive result?

A
  • apley scratch test
  • loss of range of motion: rotator cuff problem
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11
Q

How can you test for a supraspinatous injury/tear

A
  • empty can test
  • resistance against forward flexion in hyperpronation (thumbs down), elbow extension, and abduction
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12
Q

How would test for a subscapularis injury/tear

A
  • Lift off test
  • place hand on the back with shoulder internally rotated
  • push against resistance
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13
Q

How would you test for a rotator cuff injury

A
  • Drop arm test
  • poriver passively abduct arm to 120 degrees and asks the patient to slowly lower his/her arm
  • positive test: inability to complete this secondary to pain
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14
Q

what is impingement syndrome

A

impingement of tendons or bursa in the shoulder from bones of the shoulder

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15
Q

How can you test for impingement sydrome

A

have patient raise arms laterally to side

  • patient will not feel pain for the first 70 degrees
  • patient will feel pain from 70 to 120 degrees
  • if you guide patient’s arm above 120 degrees, patient will not feel pain above 120 degrees
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16
Q

How would you test for supraspinatous tendon impingement

A
  • Hawkin’s test
  • passive flexion to 90 degrees and forceful internal rotatation of the shoulder
  • look for pain
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17
Q

How would you test for subacromial impingment

A
  • neer’s sign
  • passive flexion with arm pronated and scapula is stabilized
  • look for pain
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18
Q

How would you test for biceps tendon instability or tendonitis

A
  • Yergason test
  • flex elbow at 90 degress with forarm pronated
  • supinate forearm and externally rotate humerus against resistance
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19
Q

What is another method, other than Yergason test, to test for Biceps tendonitis

A
  • Speed’s test
  • arm extended in full supination with shoulder flexed. Elevate arm against resistance
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20
Q

How would you test for anterior glenohumeral instability

A
  • apprehension and relocation test
  • elbow flexed at 90 degress, arm abducted at 90 degress
  • apply external rotation at the shoulder and note apprehension
  • Notice if there is pain and apprehension with ROM testing and if pain is relieved with relaxation/relocation
21
Q

how would you test for acromioclavicular joint arthritis

A
  • cross body adduction test
  • forward elevation to 90 degress and active adduction
22
Q

clinical symptoms

  • diffuse, dull, aching pain
  • usually no localized tenderness
  • progressive restriction of ROM
  • usually unilateral
A

adhesive capsulitis (frozen shoulder)

23
Q

clinical symptoms

  • localized pain and swelling to medial aspect of elbow
  • reproducible pain with wrist flexion against resistance
A

medial epicondylitis: golfer’s elbow

  • flexor pronator muscle group
24
Q

clinical symptoms

  • localized pain and swelling to lateral aspect of elbow
  • reproducible pain with wrist extension against resistance
A

lateral epicondylitis: tennis elbow

  • extensor supinator muscle group
25
identify
olecranon bursitis * inflammation of the bursa with fluid accumulation * may be due to local irritation, trauma, or infection
26
What is nursemaid's elbow? Cause?
* subluxation/dislocation of radial head * common cause is sudden pull of pronated arm * pediatrics 1-4 yrs
27
identify
gouty tophi
28
identify
* Colles' fracture: distal radius * "dinner fork deformity"
29
how would you check patency of ulnar artery
* allen test 1. make fist 2. occlude radial and ulnar arteries 3. release pressure over ulnar artery 4. palm should flush within 3-5 seconds
30
clinical symptom * compression neuropathy with pain, paresthesias in hand (lateral 3 and 1/2 digits) * thenar atrophy
Carpal tunnel syndrome * median nerve becomes compressed by inflammation of synovium
31
Tinel's sign
* percuss over median nerve * positive: tingling sensation in the distribution of the median nerve * evaluate: carpal tunnel syndrome
32
phalen test
* flex wrists x 30-60 seconds * positive: paresthesia in the distribution of median nerve * tests for carpal tunnel syndrome
33
what is de Quervain's Tenosynovitis
* inflammation of the 1st dorsal compartment involving the sheath of the abductor pollicis longus and extensor pollicus longus * causes: overuse/repetitive gripping
34
how would you test for Quervain's Tenosynovitis
finkelstein test * fist over thumb and ulnar devation * positive: pain
35
Clinical presentation * inspection: commonly seen on dorsal radial and volar aspects of wrist * palpation: soft mobile mass * ROM: may restrict motion or become painful with repetitive activity
ganglion cyst: collection of synovial fluid within a joint or tendon sheath
36
clinical presentation: * tenderness to palpation in "anatomical snuffbox"
scaphoid fracture
37
what muscles border the snuffbox
Lateral border * extensor pollicis brevis * abductor pollicis longus medial border * extensor pollicis longus
38
what is the boutonniere deformity
* flexion of PIP joint * hyperextension at the DIP * ruptured cental slip extensor tendon mechanism
39
what is the swan neck deformity
* hyperextension of PIP joint * flexion of DIP joint * volar plate attenuation of PIP joint
40
A sign of this disease is ulnar deviation at the MCP and PIP joints
rheumatoid arthritis
41
These nodules are characteristic of osteoarthritis (OA): seen on **dorsolateral aspects of DIP joints**; they usually hard and painless
Heberden's nodes
42
These Nodules are seen in either OA and/or RA (but more typically associated with RA). Nodes are at **PIP joints**
Bouchard's nodes
43
where are rheumatoid nodules commonly located
on the dorsum of the hand
44
what causes trigger thumb/finger? Clinical presentation: * nodule at volar aspect of MCP * digit catches or locks with passive/active flexion of IP/PIP
* flexor tendon becomes irritated and inflamted forming nodule * nodule unable to pass through A1 pulley freely
45
clinical presentation * painless masses that develop into cords along palm * unable to flatten hand on table
Dupuytren's contracture * connective tissue disorder affecting palmar fascia
46
clincal presntation * usually occurs after puncture wound * swelling, tenderness * ROM reduced
septic tenosynovitis * infection in space between the two layers of synovium which cover the flexor tendons of the fingers and thumb
47
what is the name for a fracture to the base of 1st metacarpal
Bennett's fracture
48
Where would you test for radial, median, and ulnar deviation in hand
* radial: dorsum of hand near digits 1-3 * median: palm of hand on first 3 and 1/2 digits * ulnar: palm of hand on pinkie