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Flashcards in Upper Extremity Anatomy Tests Deck (42)
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1

4 Greek terms for upper extremity inspection

Rumor =. Redness

Tumor = mass

Dollar = pain

Calor =. Heat

2

4 joints of the shoulder

Acromioclavicular

Scapulothoracic

Glenohumeral

Sternoclavicular

3

Acromion

Long flat curved process of scapula that forms the AC joint and is the site of the middle deltoid attachment

4

Coracoid process

Deep scapular projection that serves as the origin of the short head of biceps and insertion of pectoralis minor and coracobrachialis

5

3 acromion types

Flat (least likely to cause impingement)

Curved

Beaked (most likely to cause impingement)

Impingement is the supraspinatus muscle w/ overhead activities

6

3 heads of deltoid origins

Clavicle

AC joint

Scapular spine

* pain along the insertion of the deltoid (lateral humerus) is most indicative of a rotator cuff tear*

7

Neutral shoulder ROM

Flexion = 150-170

Extension = 60

External rotation = 60

Internal rotation (in front of body) = 70

Internal rotation (behind back) = 95

8

Horizontal internal rotation vs horizontal external rotation degrees

Internal = 70 degrees

External = 90 degrees

* horizontal implies arms are abducted 90 degrees*

9

Abduction vs adduction degrees

Abduction = 180

Adduction = 20-40

10

Scapulohumeral motion

For every 30 degrees of shoulder abduction

20 degrees = humeral abduction

10 degrees = scapular rotation

11

Specific names of scapular rotation

“Up and down” =. A-P axis movement through AC joint

“Scapular winging” =. Vertical axis movement through AC joint

“Scapular tipping” = horizontal axis through the AC joint

(AC joint does abduction and both internal/external rotation)

12

Neutral plane of the scapula

30-45 degrees forward in coronal plane

13

Movements of the clavicle

Anterior/posterior

Superior/inferior

External/internal rotation

14

Boa’s sign

Pain in right shoulder/upper back is refereed pain from right abdominal organs (liver/gallbladder/ duodenum/ etc.)

15

Kehr’s sign

Pain in left shoulder/upper back is indicative of referred pain from the left abdominal organs
(Spleen, stomach and possibly renal damage)

16

Joints of the elbow

Humero-ulnar
(Flexion/extension)

Humero-radial
(Pronation/supination)

Proximal radio-ulnar
(Pronation/supination)

17

Elbow ROM from neutral position

Flexion = 145

Extension =. 0

Supination and pronation = 90

18

Carrying angle

Angle created from two lines at rest

From the proximal humerus to the elbow

From proximal forearm to tips of fingers

Males =. 5-10

Females =. 10-15

19

Abnormal carrying angles

Cubits valgus (> 15)

Cubits varus ( <5-10)

20

Supination and pronation with movement radius

Pronation = radius moves over the ulna posteriorly

Supination = radius moves over the ulna anteriorly

The ulna remains motionless

21

Wrist general ROM

Flexion = 80-90

Extension = 70

Adduction/ulnar deviation = 30

Abduction/radial deviation = 20

22

Reflexes of the arm with respect to their nerveroot

Biceps = C5

Brachioradials = C6

Triceps = C7

23

Reflex scale

0 = no reflex

1/4 =. Decreased present

2/4 = normal

3/4 = brisk with unsustained clonus

4/4 = brisk with sustained clonus

24

Motor strength scale

0 - absent

1/5 = slight contraction with no joint motion

2/5 = complete ROM without gravity

3/5 = complete ROM against gravity

4/5 = Complete ROM against gravity w/ light resistance

5/5 = complete ROM against gravity w/ full resistance

25

Difference between physiologic, restrictive and anatomical barrier

Physiological = farthest a patient Can actively move a joint

Restrictive barrier = farthest a joint can be moves just short of the physiological barrier

Anatomical barrier = farthest a patient can passively move a joint

26

Apley scratch test

Upper test over the shoulder to touch contralateral superior angle of the scapula: tests for external rotation and abduction of the arm

Lower test behind the shoulder to touch contralateral inferior angle of scapula: tests for internal rotation adduction

27

AC joint dysfunction

Cross arm over contralateral shoulder by adduction and raise elbow to 90 degrees

- push down on patient elbow and have them resist you

(+) = pain which indicates strain or tear at AC joint

28

Drop arm test

Patient abducts arms fully to 160-180 degrees

Patient is to slowly lower arms to each side

(+) If patient starts to unevenly drop one side at roughly 90 degrees, indicative of RCT specifically supraspinatus.

29

Empty can/jobe test

Patient abducts arm to 90 degrees, internally rotates 45 degrees and horizontally flexes 30 degrees (thumbs down)

(+) slight pressure downward on arm causes pain or inability for patient to resist, indicative of supraspinatus weakness

30

Infraspinatus/teres minor

Two tests:

1) patient flexes elbow 90 degrees and tries to rotate against physician resistance
(+) = cant do it and may cause pain, indicative of Infra and teres minor tears

2) patient flexes elbow to 90 degrees and externally rotates to max point passively
(+) = arm lags back to neutral, indicative of infra and teres minor tears

*if patient shoulder shrugs when lifting arm, usually indicative of a tear*

31

Subscapularis liftoff test

Place patient hand behind them with dorsum of hand on lumbar spine. Patient attempts to internally rotate against physcian resistance

(+) = cant do it and maybe slight pain = indicative for subscapularis tear

32

Neer’s and Hawkins tests

Both test sub acromion impingement of rotator cuff and biceps brachi

1) Hawkins: Patient elbow and shoulder flexed at 90 degrees and shoulder/arm forcefully internally rotated
(+) = pain

Neers: patient arm is internally rotated as close to 180 as possible (so that dorsum of hand is near the ear). Arm is then passively flexed up to 180
(+) pain is usually seen around 90 degrees

STABILIZE SCAPULA DURING BOTH PROCEDURES

33

Difference between dislocated and sublaxed shoulder

Dislocated = is dislocated and does not spontaneously fix itself

Sublaxed =. Dislocated and will spontaneously fix itself

34

Yergasons test

Tests stability of long head of biceps tendon and/or bicep tendonitis

Physcian stabilizes patients elbow and wrist and has patient make arm curl motion, with increases resistance each consecutive curl’

Physician eventually externally rotates the arm quickly

(+) popping sound (indicates sublaxed tendon) and pain (indicates bicep tendonitis)

35

Speeds test

Tests for bicep tendonitis

Patient with arm flexed at 90 degrees and supinate forearm

Physcian resists forward flexion of the arm arm at the wrist

(+) = pain

36

O’Brien’s test

Tests for GH Labrum tear

Patient has arm flexed to 90, adducted medial as far possible and internally rotated as far as possible

Physician then places a downward force on patient arm at forearm

(+) = pain

37

Wrights and adsons test

Test for impingement of the radial artery/nerve at both the pecterolis minor and Scalenes respectively

Physician finds patients radial pulse and then places them in the respective positions. (+)Weakened pulse or numbness

38

Roos test

Tests for thoracic outlet syndrome

(+) = numbness

39

Lateral epicondylitis

Pain at lateral epicondyle specifically at the extensor carpi radials brevis attachment

*also known as tennis elbow*

Maudsley and miles test (+) = pain with resisted extension

Also can experience pain with resisted supination

40

Medial epicondylitis

Pain at the medial epicondyle at the point of flexor carpi radialis attachment

*also known as golfers elbow*

Wrist flexion and resisted pronation elicits pain = (+)

41

Phalens and reverse phalens tests tests

Tests for carpal tunnel

Remain in position for 30-60 seconds (+) - numbness in the lateral hand

42

Finkelstein test

Tests for De Querviuan tenosynovits

*specifically tendonitis in the extensor pollicis brevis and abductor pollicis longus

(+) = pain over area and possible swelling