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Details

Musculoskeletal
DPT course
78
Biology
Graduate
09/27/2012
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Term
What is the purpose of an Upper Quarter Screen
 Definition
  • To quickly rule out any regions outside the area of complaint
  • SHould Take no more than 10 minutes
  • positive results include: Malalignment, asymmetrical or limited ROM, pain, symptom production/reproduction ( comparable sign)

 

 
Term
What are the components of an UQS
 Definition
  • Hx (age, occupation, Past medical historry, med, prior level of function and signs and sx they presently
  • Vital Signs:BP 85-140/40-90, HR 60-100, 12-20
  • Observe: Willingness to move, posture (head positioning, cervical, thoracic)
  • Fucntion: Spine (cervical AROM with OP)
  • Shoulder (AROM with OP), Special tests (combine movementsm hands behind head, HBB(hand behind back, hand behind head, apley's scratch test 
  • Reveiw UPS lecture
Term
What is the importance of Combined movements in an UQS
 Definition
Show S/S that might not have been present in single plane mvoements
Term
What position do phalen's and reverse phalen's test occur in
 Definition

Phalens: hands point down

 

Reverse Phalens: Hands point up

 

FOr both want to hold for about 1 minute and see if N/T then occurs
Term
Neurological screening MMT in a UQS
 Definition

C1/C2 Capital Flx

C3 Cervical Lat Flx

C4 Shoulder Shrug

C5 Shoulder ABD

C6 Elbow FL or wrist extension

C7 elbow ext

C8 Wrist ulnar deviation, Thumb IP ext

T1 Finger ABD, finger ADD
Term
Area of teh Neuro Screen for Sensation for UQS
 Definition
  • C1/C2: Top of head
  • C3 Lateral neck
  • C4 Top of shoulder, Upper arm
  • C5 Lateral Arm
  • C6 Antlateral arm, thumb, index finger
  • C7 Posterior Arm to middle finger
  • C8 meidal arm to last 2 fingers
  • T1 anteromeidal forearm

Term
Peripheral Nerves points of isolated sensation UQS neuro
 Definition
  • Axillary: over lateral Deltoid near the deltoid tuberosity
  • Radial: Dorsum of hand into web space of thumb
  • Median: Palmar tip of index finger
  • Ulnar: Plamer tip of the little finger
Term
UMN lesion test for the UQS
 Definition

Clonus: Rapid DF force of foot, min of four beats to be clonus

Babinski's Sign: Up the meidal side of the foot and then across the metatrasal heads, + if toes flare and the big toe extends

Hoffman's Sign: flick the middle finger, + if the index and thumb go tip to tip
Term
UQS includes AROM of which joints
 Definition
Cervical Spine, shoulder, elbow, Wrist, hand
Term
  • What are the levels of the Transtheoretical Model of Change
 Definition
  1. Pre-contemplation: no thought of change, denial of problem(unaware), failure of change
  2. Contemplation: aware of problem, thinking about change (not yet ready to move)
  3. Preperation: making plans to change (time to get a time frame in here), small attempts to/toward changes
  4. Action: < 6 month complience, commitment to change, visible efforts to carry out change
  5. Maintenance: > 6 month complience, change is a part of daily life, relapse prevention (working to sustain changes)
  6. Relapse: will be included sometimes, is common at any point in the progression, return pt often to contemplation stage

 
Term
WHat is the benifit of being aware of the transtherhetical model of change
 Definition
By getting the patient involved in their care they will take more ownship of it. Also as a pratitioner helps you to understand where the pt is at
Term
Name two stratigies to help influence your patient to help them make decisions to change
 Definition
  • Identify beliefs that motivate (pt needs to help decide what to do)
  • Persuasion/Education/Support: credible sources, significant others, challenge beliefs that do not support change
Term
If the patient is in the precontemplation stage how might you help them move along
 Definition

Educate: Raise awarenes of the problem (i.e. knee pain will decrease if weight is losted)

 

Support: Involve family, care givers, friedns (these people can be really helpfull in this stage
Term
If pt is in the contemplation stage how would you progress them
 Definition

Education: Guide individual toward positive consequences

 

Support: fam, friends etc

 

Self-Evaluation: Reflection on change the benifits, barriers, conflicts
Term
If pt is in the preperatino stage how woudl you help them change
 Definition

Supprot: social and physical environmets (do have $ to go to the gym)

 

Reflection and self-evaluation: Removing barriers, resolve conflicts

 

Self-Efficacy: Ability to change ( have to believe they can and they are the ones that will have to do this), responsibility for change
Term
If pt is in the action phase how to you help them to progress in the TTM as well as maintence phase to stay there
 Definition

They are responsible for the change now!

 

Support: possible rewards (can be that there is now no knee pain)

 

New Behavior is incorporated into daily life

 

Address Temptations to replase: reduce or remove them, stimulus control

 

Reinforce + and discourage -

 

Will use same strategies in the maintence phase
Term
what do you gain by negotiating with the patient using the transtherorhetical model?
 Definition
  • By negotiating with the pt it is possible to move them up in the TTM closure to where you want them to be
  • Family can be a part of this process
Term
If you see a single pathological reflex in a child what should be done
 Definition

If it is just one then they should be monitured but not something to get worried about. If there are clusters of them then this is something that needs your attention
Term
  • The elbow consists of what joints? Is this a synovial joint
 Definition
  • Ulnohumeral: Trochlear joint, uniaxial hindge joint
  • Radiohumeral: Uniaxial hindge joint
  • Prox Radioulnar: Uniaxial piviot joint
  • yes it is a synovial joint which will always have: articular cartilage, synovial fluid, articular capsule( synovial membrane, fibrous capsule, ligaments), blood vessels and nerves(do not penetrate the inside of the joint but pass from the fiberous part to the vessels), synovium ( not innervated but capsual is).  Elements that are sometime associated with synovial joints are: intrarticular discs, peripherial labrum, fat pads( help to fill in the space inserting itself into space between synovium ans capsule space), synovial folds or plicae)

 
Term
What makes the Ulnohummeral joint so stable?
 Definition
  • Capsule
  • Collateral Ligaments (ulna and radial)
  • Biceps and Triceps Tendon
  • All these are strong in and of themselve and make for a very strong joint
Term
Carry angle is the angle between?
 Definition

Ulna and distal hummers versus the straight line down the shaft of the hummerus

 

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
Term
Movements and Capsular Pattern of the Elbow
 Definition

Movements: Flx and Ext

Capusular Pattern: Flx>Ext
Term

MCL(Ulnar) sprain

MOI

Ways to Dx

Mangagement of Injury

 Definition

Sprain of the Ulnar collateral ligament

 

MOI: Valgus Stress

 

Way to Dx: Valgus stress test and palpation over the ligament

 

Management: Restrict the ROM 20-90 degrees with gradual progression. Ice, anti-inflammatory modalities, isometrics
Term
WIth a Unlar collateral ligament sprain would friction massage be approperiate?
 Definition
No, the ulnar nerve is located right under the UCL. Do not want to irratate it.
Term
In what direction does the distal hummerus run(capitulum/trochlea)? What is the purpose of this?
 Definition

The distal hummerus runs Medially and inferiorly

 

Allow the hand to come up to the mouth w/o having to lift the elbow
Term
When is the carrying angle the greatest? What are the normal ranges for M/F? What are the ranges for pathologic angles?
 Definition
  • The carrying angle is greatest in extesion
  • M: 5-10 degrees
  • F: 10-15 degrees
  • Cubitus Valgus: 15 degrees
  • Cubitus Varus: <5 degrees (ABD 5 degrees still)  

The important thing is to check side to side bc even if at 20 degree might be just how they were made
Term

What is Little Leaguer's Elbow?

MOI?

Ways to Dx?

How to mangage?

Definition

When there is a strain of the MCL of the elbow or even a avulsion fx of the medial epicondyle( at this point in development childern and adolescents the ligaments can often be stronger than the bones)

 

MOI: Forceful pitching placing a Valgus stress on the MCL

 

Ways to Dx: Point tenderness on the elbow or a mobile epicondyle

 

Management: Rest, Ice, limit contraction of wrist flexors(attach at teh medial epicondyle), progressive ROM and strengthening
Term

Olecranon Bursitis (Minors Elbow):

Location?

MOI?
Ways to DX?

Management?

 Definition

Loc: Subcutaneous bursae over ticeps tendon

 

MOI: Repeated pressure placed on the elbows or deposit of uric acid cyrastals (gout)

 

Ways to Dx: Pain with pressure (rule out other things), is a soft fluid filled pouch

 

Management: Modalities, behavior management, aspiration(suck out extra fluid), Compression (making sure it does not fill back up)
Term

Gun Stock Deformity:

AKA?

Cause?

Dx's?

management?

 Definition

AKA: Cubitus Varus

Cause: malalignment or union of a superacondylar fx

Dx's: Varus deforminty

Management: None or osteotomy (oche)

 

Will be able to see this very plainly. As long as the valgus angle is <5 degree it is a varus deformity even though ABD some
Term

What is a loose body?

Cause?

Ways to Dx?

Management?

 Definition

A loose body is a peice of cartilage or bone that it in the joint

 

Cause: Osteochondroitis dessecans( when a peice of caratilage and bone chip off, most common in young men and in the knee), acute trauma, OA (osteophyte that breaks off)

 

Management: High velocity low amplitude thrust (start in flx and them move to extension rotating as you do so) or surgical excision

 

 
Term

Radiohumeral joint is made stable by what ligaments?

Movement?

Capsular Pattern?

Common Problem with the RH joint?

 

 Definition

The Lateral Collateral Ligaments stabilize the radiohumeral joint

Movement: Flx Ext

Capsular Pattern: Flx>Ext

Common Prm: Impaction of the radial head covered in Fx lec

Not a whole lot goes wrong with this joint
Term

PRoxiaml Radioulnar Joint

Stability?

Movements?

Capsular Pattern?

 Definition

Stability: Anular Lig

Movement: Pronation Supination

Capsular Pattern: PRon/Sup are = limited
Term

Radioulnar joint can experience what problems?

MOI

Ways to Dx

Management

 Definition

Sprain of the Annular and Lateral Collateral Ligament

(Bc the LCL attaches to the annular ligament)

 

MOI: Excessive Varus Force

 

Ways to Dx: Varus Stres test or tenderness will palpation

 

Management: ice, friction massage, modalities
Term
What are some common contractile issues with at the elbow?
 Definition

Biceps tendonitis

 

Distal Biceps Rupture

 

Brachialis Tear

 

Medial/lateral epicondylosis
Term

Biceps tendinitis occurs distally or proximally more often?

 

MOI?

 

Ways to Dx?

 

Managemet?

 Definition

Most commonly occurs at the distal attachment of the biceps to the radial tuberosity less common than long and short head proximally

 

MOI: Strong repetitive elbow flexion (w/ supination or shoulder hyperextension)

 

Ways to Dx: Resisted static contraction

 

Management: Modalities, frct massage, ice, gradual strengthening (typical treatment of a -itis)
Term

Distal Biceps Tendon Ruture:

MOI

Ways to Dx

MAnagement

 Definition

MOI: Forcefull eccentric contraction

 

Ways to Dx: Weak and painless flx (often will see a lump in their middle to upper arm that is fairly plain to see)

 

Management: Usually not addressed bc the functional strenthe of elbow flexion remains (coracobrachialis(attaches to the anterior hummers and the coracoid process of the scapula) and bracialis( attaches to the anterior forearm and the unlar tuberosity not the radial like the biceps brachii)

Surgical repair is possible though
Term
Is a brachialis tear managed the same way as a distal BB rupture?
 Definition

yes:

Dx: weak and painless

MOI: Forceful Eccentric Contraction

Management: None usually

Surgical repair is possible
Term

What is the condition most commonly seen at the elbow?

MOI

Ways to Dx

Mangement

 Definition

Lateral Epicondylosis

 

MOI: Overuse or single forceful contraction

 

Dx: Resisted static contraction, tenderness

 

Management: Modalities, friction, ice, stretching, modify activity (this is important), gradual strengthening, bracing cuff

 
Term

For lateral epicondylosis what do you do after friction massage? How is this done?

 

 Definition

Stretch

 

Elbow ext, wrist flx, and pronation
Term
How is a cuff place around the upper forearm helpful in lateral epicondylosis?
 Definition
WHen placed tight enough it will prevent pulling on the extensor muscles that are attached to the lateral epicondyle and will pull at where the band is placed instead. Not to tight as to cut off circulation or N/T
Term

Medial Epicondylosis

AKA

Tendinosis or itis of what muscles

MOI

Ways to Dx

Management

 Definition

AKA: Golfers elbow

 

Wrist Flexors

 

MOI: Overuse or singe forceful contraction

 

Way to Dx: Resisted static contraction/ tenderness

 

Management: Modalities, friction, ice, stretching, modifiy activity(importnat), gradual strengthening, cuff

 
Term
Where is the brachial artery located? what does it divide into?
 Definition

On the anterior forearm, continueation of the subclavian and the axillary.

 

Divides into the radial and the ulnar(following their respective bones
Term

How does Volmann's ischemic Contracture occur?

 

What can it cause?

 

 

 Definition

Occurs via a tramatic injury that disrupts the briachial arteries blood flow.

 

This disruption of blood flow can cause a contracture of the elbow ( post-traumatic ischimic contracture) can also cause actue compartment syndrome (swelling of the muscles in fascia so that everything becomes compressed most common in lower leg and forearm)
Term

What are the levels of Volkmann's ischemic contracture? How is this managed?

 

Where is this most clearly seen at flexion of the hand or swelling of the forearm?

 Definition
  1. Mild: Flexion contracture of 2-3 fingers
  2. Moderate: All fingers and thumb, some decreased sensation is present
  3. Severe: involves all muscles of the forearm

 

Management: Splinting in functional hand position

 

In the hand(mine)

 

 
Term
Cubital Tunnel Syndrome is what?
 Definition
Cubital tunnel syndrome is when the ulnar nerve is entrapped between the olecronon process and the medial epicondyle
Term

Cubital Tunnel Syndrome:

 

Causes

S/S

Management

 Definition

Causes: Entrapment of Ulnar nerve in cubital tunnel, prolonged pressure, fracture/dislocation, overuse in flexion

 

S/S: Numbness and/or weakness in ring and middle fingers

 

Management: Decreased pressure via behavior modification or surgical release will move the nerve from the epicondyle to the front of the epicondyle
Term

Radial Nerve Palsy:

AKA

Causes

S/S

Management

 Definition

AKA: Saturday Night Palsy

 

Causes: Dislocations of the radial head, entrapement in supinator( if supinator contracts over and over again), repetitive twisting, pressure

 

S/S: No active extension of fingers and wrists (exstensor digitorum, indicis, and digiti minimi, ECU, ECRB, ECRB)

 

Management: Relocation of raidal head or release, decrease pressure, splinting ( hoping nerve will grow back)
Term

Median Nerve Palsy

Causes

S/S

Management

 Definition

Causes: entrapment in the Pronator Teres

S/S: Forearm pain, decreased ability to pintch

Management: Release
Term
How are loose bodies dx?
 Definition
Pain, locking/catching (suddenly)
Term
What are the regions that refer pain to the elbow?
 Definition
Shoulder, C-spine, and Wrist
Term
What is a fx named for?
 Definition
For how the distal fragment is displaced!
Term

Supracondylar Fx:

Most often occurs in?

Where and what?

What commonly happens to the distal portion?

MOI: for posterior and anterior displacements

 Definition

Most often occurs in childern

 

Fx transversely across the hummerus superior to the condyles

 

The distal potion is commonly displaced posteriorly

 

MOI:Posterior displacement: FOOSH, can injury the neurovascular tissue (Radial, Ulnar)

Anterior Displacement: Fall onto flexed elbow
Term

Supracondylar Fx:

S/S?

Management?

 

 Definition

S/S: pain, swelling, S-shaped deformity(see radiography slide). Fragments maybe seen on the radiographs (non-displaced are difficult to see. Positioning painful, may require sedation)

 

Management: Non-displaced: immobilization, gradual return to activity

 

Displaced: Closed reduction or ORIF, immbolization, progressive ROM and strengthening
Term

Transcondylar Fx:

What population is this likely to affect?

What type of fx is this?

MOI

Management

Is there a high likely hood that it will have to be ORIF?

 Definition

Pop: Elderly/Osteoprotic

 

Transverse Fx through both condyles

 

MOI: FOOSH or Falling with the elbow flexed

 

Management: Non-displaced immbolization w/ gradual return to activity. Displaced closed or open reduction IF, immobilization, progressive ROM, and Strengthening

 

Distal Fragment is small and difficult to reduce (may requrie ORIF)

 
Term

intracondylar, bicondylar, T-Fx, Y-Fx

 

What is this?

MOI?

What effect does this have on the appearanc of the arm if displaced

S/S

Management?

 Definition

what: Vertical Fx between the condyles

MOI: Excessive force through olecranon (fall onto the point of the elbow, splits condyles apart)

 

Appearance: Elbow with look wider and the arm will look a little shorter

 

S/S: Short Arm, wide elbow, mobile condyles, fragments on the radiographs (difficult to see non-displaced)

 

Management: ORIF, gentle ROM, isometrics, progress to isotonic

 
Term

With a intrcondylar fx what movement is slow to return?

 

Is a intracondylar fx always a complex fx, why or why not?

 

 

 Definition

Extension

 

Always complex bc the fx goes through the articular surface

 

(Make sure to look at radiographs and diagrams in lecture)
Term

Medial Condylar Epiphysis Fracture?

 

What condition is this similar to?

MOI?

S/S?

Management?

 Definition

Similar to little leaguers elbow

 

MOI: FOOSH w/ wrist hyperextended

 

S/S: edema, tenderness, pissible N/T in ulnar fingers ( pinky half of ring)

 

Management: Non-displaced: immobilize, ROM, Strengthening

 

Displaced: ORIF, immobilize, ROM etc
Term

lateral Epicondylar Epiphysis Fx:

What age group will this happen in?

MOI?

S/S?

Management?

 Definition

Childern > 16yoa (epiphysis)

MOI: FOOSH w/ supination and varus stress. Stretches LCL and cuases an avulsion fx of lateral epiphysis

 

S/S: Edema, tenderness, painful passive wrist flexion

 

Management: Non-displaced: immobilize, ROM, Strengthening

Displaced: ORIF, Immobilization etc
Term

Olecronon Fx:

 

MOI?

S/S?

Mangament?

 

 Definition

MOI: Direct Trauma

 

s/S: edema/effusion(swelling within the joint), pain, decreased ROM. If the triceps is torn an inability to extend the elbow

 

Management: Non-displaced- immbolization, ROM, strengthening

Displaced: ORIF, immobilization, etc
Term

Avulsion Fx of Olecronon:

 

MOI?
S/S

Management?

 Definition

MOI: Pull of triceps (common in javelin throwers)

 

S/S: Unable to extend elbow against gravity

 

Management: ORIF or fragment excision, reattachement of tricepts
Term

Radial head Fracture:

 

Type of Fx

Common in what population

MOI

management

S/S

 Definition

Type: Impaction Fx

Pop: Adults

MOI: FOOSH

s/s: painful pronation supinaation. Radiograph shows vertical split, latearl displacement or shattering

 

Management: Immobilization or ORIF and immobilization, ROM, strengthening. Possivle radial head excision. Possible radial head implant!

NEED TO LOOK AT RADIOGRAPHS ON SLIDE
Term
Dislocatioins of the elbow are either simple or complex: define each
 Definition

simple: no fx involved

 

Complex: fx involved
Term

ulnar dislocation:

most consistent Direction of dislocation

WHat other bone often dislocate along with the Ulna?

Med or lat shift

MOI

S/S

Management

 

 Definition

Dislocates posteriorly most common

 

Radius often dislocates as well

There is commonly a lateral shift of both the radius and the ulna

S/S: Deformity, pain, swelling

MOI: FOOSH with elbow ext or hyperext

Management: Closed redction under anesthesia. Sugical repair of soft tissues (if needed). Immobilization, ROM etc
Term
What are the complications that can occur with an Ulnar dislocation?
 Definition
Extensive soft tissue damage: Tearing of the anterior capsule and brachialis. Overstretch of the medial collateral ligament, nerve, blood vessels
Term

Radial dislocation:

AKA

MOI

S/S

Management

 Definition

AKA: Nurse Maids elbow

MOI: Pulling on the arm distally

S/S: pain w/supination

Management: RElocation w/ distraction, supination and flx

 
Term

monteggia's Fx

Location?

MOI?

S/S?

Tissue that might be injuryed?

Management?

 Definition

Location: Prox 1/3 of the ulna

MOI: Force pronation (falling and twisting)

S/S: Anterior angulation and shortening of the forearm. Radial head palpable in antecubital fossa.

 

possible injury of raidal? nerve (slide said radial but..) see radiographs makes a little more sense

management: CR or ORIF, immobilization, ROM, Strengthening

 

 
Term
Name all of the arthities you can get at the elbow?
 Definition
OA, RA, Osteochondritis desicans, sepic arthritis, neuropathic arthritis
Term

OA of the elbow:

 

 Definition
Look at slide
Term

What kind of diseas is RA?

What are some general characteristic of RA?

 Definition

disease: System inflammatory disease (affects all soft tisse in the body, inflammation process case destruction of the joint themselves)

 

Inflammation of the tendons and ligaments (decreased stability of the joints)

 

Autoimmunie disease (body attacks itself)
Term

Osteochondritis Dissecans:

 

Cause? Can lead to?

Likely bones involed at the elbow

Age group of common occurance?

Management?

 

 Definition

Cause: inflammation of bone and cartilage---> Avascular necrosis

 

Often involved the capitulum of humerus (prolonged stress of radial head)

 

Pop: adolescents and young adults

 

Management: manipulation and excision

S/S: same as loose body (catching locking (can be sudden)

 

Make sure to look at the radiograph on the slides
Term

Septic Arthritis:

Common in which joints?

Causes?

S/S?

Management?

 Definition

More often seen in the shoulder and the wrist

Cause: Bacterial infection (gets into the blood stream and then to the joints)

S/S: acute: increase in temp, swelling, stiffness, pain at rest

ChronicL muscle wasting, osteoporosis, bony erosion

Management: Antibiotic, joint prtection
Term

Neuropathic Arthritis:

What is it?

Syringomyelia: Definition?

S/S?

Flail elbow?

 Definition

It is: something in the NS that is  causing pain in the joints, can occur any where that a lesion is

 

Syringomyelia: progressive denervation fo 2 deg SC lesion

 

S/S: progressive weakness and instability. Loss of pain and temperature sensation (skin becomes more fragil)

 

Flail elbow: not protected at all by ligaments
Term
What are the types of elbow arthroplasty?
 Definition

Constrained: fully hindged joint (no joint play)

 

Semi-constrained: Allows more movement

 

Unconstrained: Works most like a natural joint. Relies on soft tissue integrity for stability
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