Term
|
Definition
| inspect, palpate, adduct the arm across the chest (crossover test) |
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Term
| overall shoulder rotation |
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Definition
| abduction and external rotation (above head), adduction and internal rotation (behind back) |
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Term
| rotator cuff-Neer's impingement sign |
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Definition
| press on scapula to prevent scapular motion and raise arm-compresses greater tuberosity against acromion-->positive for rotator cuff tear |
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Term
| rotator cuff-Hawkins impingement test |
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Definition
| flex shoulder and elbow at 90 degrees with palm facing down; one hand on forearm and one on arm rotate arm internally-compressed greater tuberosity against the coracoacromial ligament-->positive rotator cuff tear |
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Term
| supraspinatus strength (empty can test) |
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Definition
| elevate arms to 90 degrees and internally rotate so thumbs point down, add downward pressure with resistance-->positive for rotator cuff tear |
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Term
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Definition
| arms at side with elbows flexed at 90 degrees with thumbs pointed up-external rotation of forearm with resistance-->positive for rotator cuff tear or bicipital tendinitis |
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Term
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Definition
| flex elbow at 90 degrees and pronate the wrist-provide resistance while supinating-->positive indicates inflammation of long head of biceps and possible rotator cuff |
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Term
|
Definition
| fully abduct arm to shoulder level and have drop slowly-->positive indicates rotator cuff (90 to 120 degrees isolates deltoid) |
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Term
| onset of carpel tunnel syndrome |
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Definition
| repetitive motion (keyboard use, mail-sorting), pregnancy, rheumatoid arthritis, diabetes, hypothyroidism |
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Term
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Definition
| positive test for weakness of the finger flexors and/or extrinsic muscles of the hand; wrist pain and grip weakness in de Quervain's tenosynovitis, decreased grip in arthritis, carpal tunnel, epicondylitis, and cervical radiculopathy |
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Term
| thumb movement (Finkelstein's test) |
|
Definition
| de Quervain's tenosynovitis |
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Term
|
Definition
| resistance-->positive for carpel tunnel (median nerve) |
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Term
|
Definition
| tap lightly over the course of the median nerve-->aching and numbness + for carpel tunnel |
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Term
|
Definition
| hold wrists in flexion back-to-back-->numbness and tingling within 60 s + for carpel tunnel (median nerve compression) |
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Term
|
Definition
| if click is felt or heard during flex/extend of knee, patient is supine grasp heel and flex knee with other hand grasp knee-with heel hand externally and internally rotate lower leg while applying valgus stress on medial side of the joint; at the same time rotate the leg externally and extend-->click or pop long medial joint + for tear of the posterior portion of the medial meniscus |
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|
Term
| Abduction (valgus) stress test |
|
Definition
| provide valgus (lateral)stress at knee and abduct lower leg-->pain or gap in medial joint + for MCL laxity or tear |
|
|
Term
| Adduction (varus) stress test |
|
Definition
| varus pressure and adduction of lower leg to open up LCL-->pain or gap + for LCL laxity or tear |
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Term
|
Definition
| supine, hip and knee flexed with feet flat on the table; place thumbs on medial and lateral joint line with fingers on the insertions of the hamstrings-draw the tibia forward (compare with contra side)-->contours of tibia + for ACL tear |
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Term
|
Definition
| Knee at 15 degree flexion and externally rotate, grab distal femur with one had and prox. tibia with the other, with thumb of tibia hand on joint line move tibia forward and femur backward-->forward excursion + for ACL tear |
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Term
|
Definition
| hip and knee flexed with feet flat on table, push the tibia posterior and observe degree of posterior excursion (rare)-->positive for PCL tear |
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|
Term
|
Definition
| lumbosacral, may radiate to lateral or posterior leg, usually acute, idiopathic, benign, and self-limiting; risk heavy lifting, poor conditioning, obesity; paraspinal muscle or facet tenderness, pain with back movement , loss of normal lumbar lordosis, no motor or reflex abnormalities; osteoporosis |
|
|
Term
| sciatica (radicular low back pain) |
|
Definition
| shooting pain below the knee, commonly into lateral leg or posterior calf; typically accompanies low back pain; assoc. with paresthesias and weakness; exacerbated by bending, sneezing, coughing, and straining; usually disc herniation; calf wasting |
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Term
|
Definition
| pseudoclaudication pain in the back or legs with walking that improves with rest, lumbar flexion or both; pain vague but usually bilateral with paresthesia; hypertrophic degenerative dx of one or more vertebra; more common after 60; posture may be flexed forward |
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Term
|
Definition
| ankylosing spondylitis (inflammatory polyarthritis); loss of normal lumbar lordosis, muscle spasm, limited anterior and lateral flexion |
|
|
Term
| nocturnal back pain, unrelieved by rest |
|
Definition
| metastatic malignancy from cancer of the prostate, breast, lung, thyroid, and kidney; local vertebral tenderness may be present |
|
|
Term
| pain referred from the abdomen or pelvis |
|
Definition
| deep aching pain; peptic ulcer, pancreatitis, pancreatic cancer, etc; spinal movements are not painful and ROM not affected |
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Term
|
Definition
| aching of paraspinal muscles and ligaments with assoc. muscle spasm, stiffness, and tightness in the upper back and shoulder, no radiation, paresthesia or weakness; may be HA; local muscle tenderness, pain on movement, no neurological deficits; torticollis |
|
|
Term
| mechanical neck pain-whiplash |
|
Definition
| aching paracervical pain and stiffnes, day after injury; occipital HA, dizziness, malaise, and fatigue; musculoligamental sprain or strain from forced hyperflexion; parcervical tenderness, decreased neck range of motion, perceived wekness of upper extremities |
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|
Term
| cervical radiculopathy from nerve root compression |
|
Definition
| sharp burning or tingling pain in the neck and one arm with assoc. paresthesia and weakness, myotomal (deep in muscle), dysfunction of cervical spinal nerve, nerve root, or both from foraminal encroachment of spinal nerve or herniated cervical disk, C7 nerve root most common with weakness in triceps, C6 with weakness in biceps, brachioradialis, wrist extensors |
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|
Term
| cervical myelopathy from cervical cord compression |
|
Definition
| neck pain with bilateral weakness and paresthesias in both upper and lower extremities, often with urinary frequency; hand clumsiness, palmar paresthesias, and gait changes may be subtle; neck flexion often exacerbates; often from cervical spondylosis; clonus at the wrist, knee, or ankle; positive Babinski and gait disturbances; requires neurosurgical eval. |
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Term
|
Definition
| inflammation or synovial membranes with 2nd erosion of adjacent cartilage and bones; Hands: PIP and MCP; Feet: MTP; wrists, knees, elbows; symmetrically additive, insidious onset, often chronic with remissions and exacerbations; frequent swellings of synovial tissue in joints or tendon sheaths; subcutaneous nodules; tender often warm but seldom red; prominent stiffness often in the morning or after inactivity; limitation of motion ofter develops; weakness, fatigue, weight loss, and low fever are common; boutonniere deformity, swan neck deformity |
|
|
Term
|
Definition
| degeneration and progressive loss of cartilage within the joints, damage to underlying bone; knees, hips, hands (DIP), cervical/lumbar spine, wrists (first carpometacarpal joint), previously injured and diseased joints; additive-but only one joint may be involved, usually insidious onset; slowly progressive with temporary exacerbations after periods of overuse; small effusions in the joints (knees) and bony enlargements; possibly tender, seldom warm, and rarely red; frequent but brief stiffness in morning and after inactivity; limitation of motion often develops; general symptoms usually absent; Herberden's nodes (DIP), Bouchard's nodes (PIP, rare) |
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|
Term
|
Definition
| gouty arthritis (acute gout), chronic tophaceous gout, polymyalgia rheumatica, fibromyalgia syndrome |
|
|
Term
|
Definition
| swelling and inflammation of the olecranon bursa from trauma, rheumatoid arthritis or gouty arthritis; superficial to olecranon process |
|
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Term
|
Definition
| synovial inflammation or fluid is felt best in the groove between the olecranon process and the epicondyles |
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Term
|
Definition
| subcutaneous nodules develop at pressure points along extensor surface of ulna; firm, nontender, and not attached to the overlying skin; may or may not be attached to underlying periosteum |
|
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Term
|
Definition
| lateral epicondylitis (tennis elbow): repetitive extension or sup/pro of forearm; medial epicondylitis (pitcher's, golfer's, or Little League elbow): repetitive wrist flexion, as in throwing |
|
|
Term
| acute rheumatoid arthritis of hands |
|
Definition
| tender, painful, stiff joints, usually with symmetrical involvement; PIP, MCP,and wrist joints; spindle-shaped swelling of PIP |
|
|
Term
| chronic rheumatoid of hands |
|
Definition
| swelling and thickening of MCP and PIP; ROM limited; fingers may ulnar deviate; boutonniere deformity (persistent flexion of PIP), swan neck deformity (hyperextension of PIP and fixed flexion of DIP); rheumatoid nodules |
|
|
Term
|
Definition
| Herberden's nodes of DIP; bouchard's nodes of PIP |
|
|
Term
|
Definition
| not as symmetric as rheumatoid; acute inflammation can by present; knobby swellings around the joints ulcerated and discharge white urates |
|
|
Term
|
Definition
| thickened plaque overlying ring finger at distal palmar crease; followed by skin puckering and thickened fibrotic cord development b/w palm and finger; flexion contractures of fingers may ensue |
|
|
Term
|
Definition
| caused by painless nodule in flexor tendon in palm near head of metacarpal; w/ extra effort, finger extends and flexes w/ a palpable and audible snap as nodule pops into tendon sheath (too big to enter easily) |
|
|
Term
|
Definition
| disorder of median nerve or its components (ex. carpal tunnel) |
|
|
Term
|
Definition
| cystic, round, usually nontender swelling along tendon sheath or joint capsules, frequently at the dorsum of wrist |
|
|
Term
|
Definition
| infection of flexor tendon sheaths; may follow trauma; tenderness and swelling along course of tendon sheath (not in joint); finger held in slight flexion; finger extension very painful |
|
|
Term
| acute tenosynovitis and thenar space involvement |
|
Definition
| i. If infx progresses, - may extend from tendon sheath into fascial spaces → tender & SWOLLEN |
|
|
Term
|
Definition
| infection in enclosed fascial spaces of finger pad (after injury to fingertip); severe pain, localized tenderness, swelling, dusky redness |
|
|
Term
| acute gouty arthritis of feet |
|
Definition
| MTP joint of great toe mya be the first joint involved; very painful and tenter, hot, dusky red swelling; mistaken for cellutitis; many involve dorsum of foot |
|
|
Term
|
Definition
| longitudinal arch flattens, sole touches floor, medial border becomes convex; may be only on standing or permanent; medial-plantar tenderness, swelling anterior to malleolus |
|
|
Term
|
Definition
| great toe abnormally abducted in relation to 1st metatarsal, which is also deviated medially; head of 1st metatarsal may enlarge on its medial side and bursa may form at the pressure point |
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|
Term
|
Definition
tenderness over plantar surface, 3rd & 4th metatarsal heads, from entrapment of medial and lateral plantar nerves
i. Sx include numbness, burning & aching distal to metatarsal heads in third & fourth toes
ii. squeeze metatarsal heads - usually b/e 3rd and 4th metatarsal heads |
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