Term
| muscles needed for pronation |
|
Definition
| pronator teres and quadratus |
|
|
Term
|
Definition
|
|
Term
| muscles needed for wrist flexion |
|
Definition
flexor carpi radialis
flexor carpi ulnaris
palmaris longus |
|
|
Term
| Muscles required for wrist extension |
|
Definition
extensor carpi radialis longus
extensor carpi radialis brevis
extensor carpi ulnaris |
|
|
Term
|
Definition
flexor digitorum profundus (
flexor digitorum superficialis
Flexor digitorum minimi
extensor digitorums
Extensor indicis |
|
|
Term
|
Definition
|
|
Term
| nerve innervating wrist extensors |
|
Definition
|
|
Term
| nerve innervating wrist flexors |
|
Definition
median (FCR & PL)
and
ulnar (FCU) |
|
|
Term
|
Definition
median nerve
(pronator teres and quadratus) |
|
|
Term
|
Definition
musculocutaneous (biceps)
radial (supinator) |
|
|
Term
|
Definition
on volar aspect
median (FDP 1&2, FDS)
ulnar (FDP 3&4, FDM) |
|
|
Term
| nerve for finger extension |
|
Definition
|
|
Term
| radial palsy results in... |
|
Definition
high radial nerve injury
lose extension of wrist/fingers and supination |
|
|
Term
|
Definition
|
|
Term
|
Definition
wasting of thenar muscles
median nerve innervates opponens, flexors of index/middle fingers, and lumbricals |
|
|
Term
| nerve for thumb extension & abduction |
|
Definition
|
|
Term
| nerve for intrinsics of hand |
|
Definition
|
|
Term
high median nerve injury results in
(at elbow) |
|
Definition
denervation of flexor digitorum profundus to index and long fingers
lose flexor digitorum superficialis to all digits
lose innervation to pronator muscles
loss of sensation in median nerve dermatome |
|
|
Term
|
Definition
| flexors and lumbricals to 4th & 5th digits all interossei adductor of thumb creates "claw" hand posture |
|
|
Term
| intrinsic minus hand results in.. |
|
Definition
no ulnar or medial nerve innervation
common with C7 SCI
lose intrinsics
MCP hyperextension occurs |
|
|
Term
| main concerns of OT in acute phase |
|
Definition
relieve pain
decrease swelling and inflammation
maintain joint/limb alignment
restore function at injury site
assist in wound care |
|
|
Term
| contraindications for ROM |
|
Definition
joint inflammation or infection
myositis ossificans
pain meds/muscle relaxants
osteoporosis, subluxation
newly united fracture
recent surgery
skin graph |
|
|
Term
| contraindications for MMT |
|
Definition
inflammation or pain
dislocation or unhealed fracture
recent surgery
myositis ossifications
bone carcinoma
not usually used in acute settings except maybe with impingement |
|
|
Term
|
Definition
requires surgical reduction, bones brought closer together and stabilized with internal fixation device
direct healing occurs, no external callus forms |
|
|
Term
|
Definition
early consolidation, 6 wks
bones are stable
measure AROM (if shoulder fracture AAPROM)
assess edema, sensibility, pain
shoulder: begin progressive exercises for flexion, extension, abduction, rotation |
|
|
Term
| shoulder complex composed of .. |
|
Definition
glenohumeral joint
scapulothoracic joint
sternoclavicular joint
acromioclavicular joint
stabilizes for distal hand use
immobilization of shoulder results in stiffness and pain
PROM considered contraindicated by some
resume non-resistive functional activities ASAP (when acute pain diminishes) |
|
|
Term
| exercises for post-surgery/injury |
|
Definition
when acute pain diminishes...
isometric for external rotation and shoulder abduction across repair site to facilitate stability
3-4 wks later - isotonic
with internal fixation, AROM can begin 7-10 days post-surgery
fist 6-8 wks, use isometric(push body against each other) (stimulant for fracture healing, callus formation, wall-climbing, non-resistive exercises, pendulum) |
|
|
Term
|
Definition
compression of structures found in subacromial space (subacromial bursa, supraspinatus, joint capsule, long head of biceps)
caused by repetitive or sustained elevatino of shoulder above 90*
can become a rotator cuff tear if untreated
stage 1: edema, inflammation,hemorrhage; focus on activity modification
stage 2: bursa, tendons become thick/fibrotic - conservative Tx
stage 3: bone spurs, partial or full thickness tears result |
|
|
Term
|
Definition
pain during humeral mvt above 90*
independent in ADLs, but experiences pain
caused by repeated overhead use, curved/hooked acromion, weakness of shoulder or scapula musculature, capsular tightness
Tx: conservative w/ pain modalities, activity modification, strengthening exercise, occ specific training |
|
|
Term
|
Definition
inflammation of subacromial bursa
if pain during passive shoulder elevation and pain free during AROM, MMT
hurts at rest
cause:repetitive or sustained elevation of shoulder above 90* |
|
|
Term
| causes of shoulder impingement |
|
Definition
| repetitive or sustained elevation of the shoulder above 90* |
|
|
Term
|
Definition
compression of structures found in subacromial space
(subacromial bursa, supraspinatus, joint capsule, long head of biceps)
can result in rotator cuff tear if untreated
stage 1: edema inflammation and hemorrhage (activity mod)
stage 2: bursa and tendons become thick (conservative)
stage 3: bone spurs and partial/full thickness tears |
|
|
Term
| evaluation for shoulder impingement |
|
Definition
DASH
Neer Test (aka shoulder impingement test)
Hawkins & kennedy |
|
|
Term
|
Definition
inflammation of tendons
main complaint is pain over 90*
hurts WHEN MOVING.
sharp pain
tenderness at tendons of supraspinatus or infraspinatus |
|
|
Term
| causes of rotator cuff tendinitis |
|
Definition
repetitive overhead use
curved or hooked acromion
weakness of shoulder/scapula and capsular tightness |
|
|
Term
| intervention for rotator cuff tendinitis |
|
Definition
treat conservatively with pain modalities
activity mod
strengthen
occ-specific training |
|
|
Term
|
Definition
inflammation of subacromial bursa
unlike tendonitis, bursitis has no specific point of pain and hurts when at rest or passively moving, not AROM
usually coexists with shoulder impingement
throbbing/aching pain |
|
|
Term
| rotator cuff bursitis causes |
|
Definition
coexists with shoulder impingement (same cause)
repetitive or sustained elevation of shoulder above 90* |
|
|
Term
| intervention for rotator cuff bursitis |
|
Definition
focus on activity mod, conservative treatment
rest
ice
shoulder exercises to strengthen rotator cuff muscles and make more efficient |
|
|
Term
|
Definition
partial or full thickness tear of SITS muscles
present with difficulties performing activities above the shoulder
rotational movements can also be limited
see substitution of scapula when attempting arm elevation |
|
|
Term
| causes of rotator cuff tears |
|
Definition
trauma
progression of impingement syndrome
degenerative changes of tendon |
|
|
Term
| evaluation/assess of rotator cuff tear |
|
Definition
DASH
Drop Arm Test (non surgical pt)
physical assessment: functional mvt such as reaching small of back, touch other arm, touch top of head
Neer's impingement
sensory testing C4-T1 (eliminate cervical involvement)
biceps speed test |
|
|
Term
| adhesive capsulitis "frozen shoulder" |
|
Definition
capsule becomes inflamed so shoulder bones are unable to move freely in joint
starts with pain -> prevents you moving arm -> stiffness -> less motion
most pain in abduction
most pronounced loss in external rotation |
|
|
Term
| adhesive capsulitis intervention |
|
Definition
use joint mobilization, not ROM
prevent adhesive capsulitis with pendulum exercises
-passively circulates and gets rid of phagocytes |
|
|
Term
|
Definition
shoulder muscles not strong enough to hold collar bone in place, which slips down and forward putting pressure on nerves/blood vessels that lie underneath
symptoms: aching & tingling from pressure on nerves, swelling and redness from pressure on blood vessels, nonspecific parasthesias or heaviness with sustained positioning/activity above shoulder level/behind plane of body |
|
|
Term
| cause of thoracic outlet syndrome |
|
Definition
repetitive movements
birth defect
trauma |
|
|
Term
| eval/assessment for thoracic outlet syndrome |
|
Definition
|
|
Term
|
Definition
brachial plexus injury
lesions to upper trunk of brachial plexus (c5,c6)
muscles of shoulder & elbow affected
hand mvt retained
paralysis and atrophy in deltoid, brachialis, biceps, brachioradialis muscles
arm hangs limp in internal rotation
adduction of shoulder
elbow extended
forearm pronated
wrist flexed |
|
|
Term
| Erb's palsy eval/assessments |
|
Definition
DASH
upper limb tension test |
|
|
Term
|
Definition
compression or traction of LOWER TRUNK of the brachial plexus (c8-t1)
muscles for wrist and finger flexion and abduction, adduction of fingers is affected
effects are more distal
claw hand deformity |
|
|
Term
| causes of Klumpke's palsy |
|
Definition
childbirth
crutch walking
dragged by arm |
|
|
Term
| klumpke's palsy assessments |
|
Definition
DASH
upper limb tension test |
|
|
Term
| intervention for klumpke's palsy |
|
Definition
short opponens hand splint - thumb in opposition
-atrial immobilization and positioning
PROM critical to maintain joint flexibility
-tactile and proprioception sensory input to increase sensory awareness |
|
|
Term
|
Definition
maintain joint flexibility
prevent contracture, adhesions, deformities
stay within pain-free range
helps little with circulation
rotator cuff - 4-6 wks post repair |
|
|
Term
|
Definition
maintain joint motion, flexibility, strength
muscle contraction help circulation, speed healing, facilitate lymphatic function
don't do when unstable or have pain
rotator cuff - 4-6 wks post surgery |
|
|
Term
|
Definition
increase strength and maintain ROM
show Px they can move
7-10 days following internal fixation
4-6 wks following rotator cuff repair |
|
|
Term
|
Definition
when joint is injured (shoulder fracture), in a cast, bedrest
no motion occurs
max contraction
stabilization - use for muscles you KNOW are INTENDED to stabilize
stimulant for fracture bone healing - use electric stimulation to prevent from becoming weak |
|
|
Term
|
Definition
joint moves and muscle changes length
used to practice functional activities after injury once allowed to move joint |
|
|
Term
|
Definition
joint moves and muscle shortens
used to practice functional activities after injury once allowed to move |
|
|
Term
|
Definition
muscle lengthens
allows for controlled lowering
builds more muscle than concentric
work against gravity |
|
|
Term
|
Definition
may be good for bursitis or tendinitis inflammation
vasoconstriction: relieves spasms and pain
decreased local metabolism, slowed nerve conduction velocity, diminished muscle spasms, decreased edema, lessened tissue damage
elevates pain threshold - decrease pain |
|
|
Term
|
Definition
increase motion, decrease joint stiffness, relieves muscle spasms, increases blood flow, decreases pain, aids in reabsorption of exudates and edema
apply before prolonged stretch to allow permanent elongation of fibers
vasodilation: cleans out junk that's been delivered in trauma, loosens muscle
start therapy with heat to relax, increase blood flow, take Px to therapy and do joint mobilization, PROM, AROM, then ice |
|
|
Term
|
Definition
occurs secondary to supracondylar fracture
a compartment syndrome
increased pressure due to swelling from the fracture leads to a lack of blood flow to the forearm
ischemia can be caused by edema within a fascia-surrounded compartment or by acute elbow flexion that compresses an artery against bone
IMMEDIATE ACTION: peripheral nerves can withstand 2-4 hours without blood flow - still regenerate
muscles can withstand 6 hours but can't regenerate
don't cast until 3-4 days to reduce swelling |
|
|
Term
|
Definition
happens with FOOSH
radial head fracture
pronation is a comfort position, need them to supinate
most common and MOST SERIOUS elbow fracture
high risk of malunion
after 1 wk, remove splint for daily gravity-eliminated mvt
advocate for active over passive, flexion over extension
full mvt 6-12 months post injury |
|
|
Term
|
Definition
from FOOSH
pain / swelling around elbow
may require radial head excision if severe, otherwise closed reduction with sling for immobilization
pronation/supination exercise encouraged early
6x daily w/ 2-10 reps
regain SUPINATION |
|
|
Term
|
Definition
tennis elbow
inflammation of tendons on outside of elbow - lateral epicondyle & extensor wad
affects extensor carpi radialis brevis
tender over distal radial tuberosity
exercise proximal conditioning
scapular stabilization
use built up handles
support wrist in splint |
|
|
Term
|
Definition
golfer's elbow
pain inside of elbow at medial epicondylitis & flexor wad, spread to forearm and wrist
affects flexor carpi radialis
condition proximally
don't use force at end of range
neutral wrist
built up handles
use RICE |
|
|
Term
|
Definition
R = rest affected tendons
I = ice inflammation
C = compress
E = elevate inflamed area |
|
|
Term
|
Definition
2nd most common nerve compression injury
of ULNAR nerve at elbow b/w medial epicondyle & olecranon |
|
|
Term
| signs of cubital tunnel syndrome |
|
Definition
ulnar nerve compression at elbow
sensory symptoms: affect pinky finger and ulnar half of ring finger
flexor carpi ulnaris, flexor digitorum profundus of ring/pinky fingers, adductor pollicus, interossei
pain is proximal and medial forearm, aching/sharp
grip/pinch strength is decreased
symptoms worsen when elbow flexed repeatedly or left in flexion |
|
|
Term
causes of cubital tunnel syndrome
intervention |
|
Definition
trauma, dislocation, chronic mild pressure on elbow
associated with arthritis and diabetes
will elicit positive tinel's sign
intervention: edema control, splinting/padding elbow, avoid flex elbow position, lean on elbow, or elbow intensive activities |
|
|
Term
|
Definition
inability to adduct small finger
associated with cubital tunnel syndrome of ulnar nerve |
|
|
Term
|
Definition
| effort at lateral pinch elicits thumb IP flexion due to weakness of Adductor pollicus |
|
|
Term
|
Definition
common among elderly with osteoporosis
complication: traumatic arthritis from poor articular congruency
-decreased ROM, decreased grip strength, alteration of carpal alignment, instability
therapy during immobilization important: normalize edema, achieve normal AROM of uncasted areas, frequent exercises every 2 hours, 5-10 reps, hold end position 3-5 sec.
after cast: volar wrist splint, retrain wrist extensors, use progressive grasp and release to reinforce tenodesis training, dexterity exercise
cast above elbow, begin AROM when in short arm cast
monitor for cast tightness that can cause CRPS |
|
|
Term
|
Definition
60% of fractures affect scaphoid bone
FOOSH
symptoms: tenderness at snuffbox, depression at base of thumb b/w EPL and EPB tendons
may present after 3 weeks not not be visible immediately on x ray
cast includes thumb with IP free
avascular necrosis possible |
|
|
Term
|
Definition
median nerve compression of the wrist
typically bilateral and in women 40-60 yrs old
tunnel =
floor (carpal bones), ceiling (transverse carpal ligament) & 9 flexor tendons that run through it with the superficial median nerve
swelling or thickening of tendons leads to pressure of nerve causing sensory symptoms
hand numbness, pain/paresthesias, clumsiness, weakness
repetitive use or flexor tenosynovitis (friction b/w tendon and nerve)
eval: cervical screening, MMT, Tinel's, Phalen's, monofilament, 2 point discrimination |
|
|
Term
| carpal tunnel intervention |
|
Definition
conservative:
steroid injection, night splinting with neutral wrist, exercises for median nerve gliding, aerobic exercise, prox conditioning, ergonomic modification, postural training, avoid extreme forearm rotation and sustained pinch or forceful grip
surgical - carpal tunnel release (top 10 surgery), edema control, scar management, desensitization, nerve and tendon gliding exercise, eventually strengthen |
|
|
Term
| stiff hand signs/symptoms |
|
Definition
UE injury causes hand or digits to become stiff with decreased ROM
EDEMA is culprit - balance rest and mvt |
|
|
Term
| boutonniere change signs/symptoms |
|
Definition
extensor injuries in zone 3 and 4
imbalanced digital position of PIP flexion and DIP hyperextension
due to volar displacement of lateral bands secondary to involvement of central slip |
|
|
Term
| swan neck change signs/symptoms |
|
Definition
can be caused by RA
MP flexion, PIP hyperextension, DIP flexion |
|
|
Term
| DeQuervain's disease signs/symptoms |
|
Definition
tendinitis involving APL and EPB tendons at first dorsal compartment
exquisite pain with passive wrist ulnar deviation while flexing thumb |
|
|
Term
| Dupuytren's contracture signs/symptoms |
|
Definition
painless thickening and contracture of tissue beneath skin on palm of hand and fingers
nodules develop in tissue and make difficult to move fingers |
|
|
Term
| tendinitis signs/symptoms |
|
Definition
| pain with AROM, resistance, passive stretch of involved structures |
|
|
Term
| flexor tenosynovitis signs/symptoms |
|
Definition
"trigger finger"
tenderness over A1 pulley of digital flexor along with pain during resisted grip and painful catching/locking of fingers in composite flexion |
|
|
Term
low median nerve injury (wrist)
signs and symptoms |
|
Definition
low median nerve palsy (denervation of OP and abductor pollicis brevis, lumbricals to index and long fingers)
loss of radial sensation of radial side of hand
thumb will rest in adduction (fxn loss of manipulation and sensibility of thumb, index, long fingers) |
|
|
Term
high ulnar nerve injury
signs and symptoms |
|
Definition
at elbow
inolves muscles from low ulnar lesion
denervation of flexor digitorum profundus of ring and small fingers and FCU
lose flexion DIPs of ring/pinky & all pinky flexion |
|
|
Term
low ulnar nerve injury
signs and symptoms |
|
Definition
at wrist
lose most of hand intrinsics
denervation results in flattening of hand with loss of ulnar transverse metacarpal arch
lose thumb adduction and MP support
find manipulation skills compromised
sensory loss involves ulnar digits |
|
|
Term
high radial nerve injury
signs and symptoms |
|
Definition
lose wrist and finger extension
lose sensation on dorsal-radial part of hand
triceps function remains
supination lost
tenodesis lost |
|
|
Term
low radial nerve injury
signs and symptoms |
|
Definition
posterior interosseous palsy - damage to deep motor branch
efforts to extend wrist yield strong radial deviation
MP extension affected
brachioradialis and extensor carpi radialis longus function present |
|
|
Term
flexor tendon injury
signs and symptoms |
|
Definition
zone 1: insertion of FDS to insertion of FDP
zone 2: no man's land: FDS and FDP both lie in flexor sheath
Zone 3: distal edge of carpal tunnel to A1 pulley of flexor sheath, includes lumbricals
zone 4: flexor tendons lie under transverse carpal ligament
median and ulnar nerve entrapment can occur here
zone 5: forearm flexor musculotendinous junction to border of transverse carpal ligament |
|
|
Term
| flexor tendon injury treatment |
|
Definition
education of pt and subtle, but significant changes in splinting and exercise
minimize adhesion formation and prevent gap of repaired tendon
use kleinert protocol or chow protocol
edema control and scar management
tendon gliding exercises and place and hold exercises |
|
|
Term
| high radial nerve injury treatment |
|
Definition
splinting restores tenodesis
various static and dynamic splints
maintain joint suppleness while awaiting reinnervation or reconstructive surgery |
|
|
Term
| low radial nerve injury treatment |
|
Definition
emphasis on maintaining PROM for wrist, thumb, digital extension
splinting to promote tenodesis for functional pinch, grip, release |
|
|
Term
| high and low ulnar nerve injury treatment |
|
Definition
splint to prevent overstretching of denervated ring and pinky finger
MP locking splint (slight MP flexion)
teach compensation for sensory loss and maintain PROM, mPS in flexion and IPs in extension
prevent PIP flexion contracture!!! |
|
|
Term
| low median nerve injury treatment |
|
Definition
hand-based thumb abduction splint to maintain balance
substitute for lost thumb opposition
prevent overstretch of denervated muscles
teach compensatory strategies to avoid injury while sensiblity impaired
instruct in PROM |
|
|
Term
| high median nerve injury treatment |
|
Definition
prepare pt for probable tendon transfers by preventing deformity with splinting and maintaining PROM of pronation, MPs in flexion, IPs in extension, thumb CMC abduction
visual cues, AD, modified handles may help compensate for functional loss |
|
|
Term
| flexor tenosynovitis - trigger finger treatment |
|
Definition
steroid and local anesthetic injection into flexor sheath
splint MP in neutral to prevent composite digital flexion while promoting tendon gliding and place and hold fisting that avoids triggering; built-up handles, padded gloves, pacing strategies may help
instruct pt to avoid triggering |
|
|
Term
|
Definition
new evidence suggests cause is disorganized and degenerated collagen and atypical vascular granulation tissue so...
tx emphasizes interventions that restore nourishment to collagen
early tx -> better prognosis |
|
|
Term
| dupuytren's contracture treatment |
|
Definition
exercise
warm water bath
splints
sugery may be required |
|
|
Term
| DeQuervain's disease treatment |
|
Definition
teach to avoid wrist deviation, esp. with pinching
provide built up handles
if splinting, use forearm-based thumb spica, leaving IP free |
|
|
Term
|
Definition
| hand based thumb spica splint |
|
|
Term
| swan neck change treatment |
|
Definition
fabricate digital dorsal splint in slight PIP flexion to minimize deforming forces and enhance FDS function
at level of MP joint, deformity usually manifests as MP ulnar drift and palmar subluxation |
|
|
Term
| boutonniere change treatment |
|
Definition
splint the PIP in full extension for 6 wks
promote DIP active/passive flexion to prevent stiffness of oblique retinacular ligament
after surgery & medically cleared to begin PIP exercise, watch for PIP extensor lag and modify therapy and splinting accordingly |
|
|
Term
|
Definition
pt achieve gentle full arcs of available motion w/ functional use or exercise instead of quick, incomplete arcs of motion (less effective)
decrease amount of exercise if pt hand is swollen or painful after treatment
avoid aggressive PROM
during acute inflammatory stage, static splinting most appropriate |
|
|
Term
|
Definition
inflammation
fibroplasia
maturation or remodeling |
|
|
Term
| inflammation stage of healing |
|
Definition
1st stage
lasts several days
vasoconstriction followed by vasodilation (white blood cell migration to promote phagocytic removal of foreign bodies and dead tissue
immobilization often recommended |
|
|
Term
| fibroplasia stage of healing |
|
Definition
2nd
starts day 4 and continues for 2-6 wks
fibroblasts synthesize scar tissue
wound tensile strength increases gradually
use AROM and splints |
|
|
Term
| maturation or remodeling stage of healing |
|
Definition
3rd (last)
may last for years
reflects changing architecture and improved organization of collagen fibers and associated increased tensile strength
gentle resistive activity appropriate if not generating inflammatory responses
gentle app of corrective dynamic or static splinting |
|
|
Term
| Complex regional pain syndrome |
|
Definition
previously called reflex sympathetic disorder RSD
disorders that involve pain/dysfunction of severity or duration out of proportion to those expected from initiating event
must have spontaneous pain beyond territory of single peripheral nerve
3 types of CRPS |
|
|
Term
|
Definition
triggered by cycle vasospasm and vasodilation after an injury
caused by excessive edema or constrictive dressing/casts
if circulation is decreased, extremity becomes cool and pale
follows noxious event and results in pain not limited to territory of single peripheral nerve
occurs spontaneously
edema present with skin abnormalities (sudomotor - sweat/dry) color or change in blood flow |
|
|
Term
|
Definition
same as type 1 but develops after nerve injury
corresponds to causalgia
severe burning pain that is alleviated by interruption of sympathetic nerve pathway |
|
|
Term
|
Definition
pain, edema, swelling, stiffness, discoloration (blotchy, shiny)
secondary sympt: osseous demineralization, sudomotor changes, temp, trophic, vasomotor instability (temp), palmar fascilitis, pilomotor activity (goose bumps)
constant attn to pain levels and autonomic responses can lead to early medical mgmt and possible prevention |
|
|
Term
| cumulative trauma disorder CTD |
|
Definition
force applied to same muscle or group, causing inflammatory response in tendon or muscle (tendinitis, nerve compression, myofascial pain)
functional grades 1-5 describe associated symptoms
helps in eval and monitoring improvement |
|
|
Term
CTD Grade 1
cumulative trauma disorder |
|
Definition
| pain after activity is resolved quickly no decrease in amount or speed of work objective findings absent |
|
|
Term
CTD grade 2
cumulative trauma disorder |
|
Definition
| consistent pain in one site while working, goes away when activity stops productivity mildly affected objective findings possible |
|
|
Term
CTD grade 3
cumulative trauma disorder |
|
Definition
| pain in at least 1 site pain persists after stop working multiple breaks may be required during task weakness, loss of control, dexterity, tingling, numbness, other objective findings seen may have latent or active trigger points |
|
|
Term
CTD grade 4
cumulative trauma disorder |
|
Definition
| all common uses of hand/UE result in pain pain 50-75% of time unable to work or limited capacity weakness, loss of control, dexterity, tingling, numbness, trigger points found |
|
|
Term
CTD grade 5
cumulative trauma disorder |
|
Definition
| loss of capacity to use UE from chronic, unrelenting pain unable to work symptoms indefinite duration |
|
|
Term
|
Definition
| synovial joint at risk for RA maintains relationship b/w clavicle and scapula in early elevation pressure causes separation of clavicle over the acromion downward pressure can cause dislocation.. lose stability when stretched |
|
|
Term
|
Definition
synovial joint - frequent site of RA
only bony connection of UE to trunk
may need to perform mobilization treatment to clavicle to prevent impingement
dislocation is common due to joint incongruency |
|
|
Term
|
Definition
not a real joint
purpose: contact scapula with thoracic
hypermobile scapula results from people with stiff shoulders trying to move arms and scapula gives
still scapula: person has not moved for a while -> cause impingement |
|
|
Term
|
Definition
synovial
true fxn: follow arm to allow us to place hand anywhere
muscles more for mobility than stability
at rest - taut superiorly to hold in place, lax inferiorly
sacrifices congruency for mvt
joint capsule: like accordion under arm, stretches as arm reaches up, gets taught when you don't lift it |
|
|
Term
|
Definition
attaches coracoid to acromion
coracoacromial ligament prevents superior dislocation of humerus
compression may cause pain underlying structures - supraspinatus and bursae
in FOOSH, tear/stretch acromion ligament
supraspinatus is under acromion
with shoulder sublux, time can stretch this ligament and bursa) |
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Term
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Definition
lie superior to supraspinatus, underneat deltoid and acromion
provide smooth gliding motion b/w muscle |
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Term
| coracohumeral ligament and supraspinatus |
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Definition
| coracohumeral ligament holds arem in place when at rest, supraspinatus stabilizes when outside forces are applied |
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Term
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Definition
steering muscle
rotates and forces humeral head into fossa
offsets deltoid's upward pull |
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Term
| musculotendinous cuff - rotator cuff muscles |
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Definition
S- subscapularis
I - infraspinatus
T - teres minor
S - supraspinatus |
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Term
| shoulder rotation movement |
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Definition
| deltoid, infraspinatus, teres minor, subscapularis |
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Term
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Definition
0-60* scap:gh = 1:3
60-130* scap:gh = 1:1
140-180* scap:gh = 1-3.5
beginning of flexion (60*) and abduction (30*) the scapula stabilizes while gh joint provides the movement
if scapula is moving at same rate as gh in first 60*, unstable
after 60*, scapula should move more & slow down again at 140* |
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Term
| sternoclavicular nand acromioclavicular contribution to flexion |
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Definition
SC joint complete at 90-100* of humeral flex/abduction
clavicle begins to rotate forward around 90* flexion allowing mvt at AC end, adding 30*more motion |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| roots -> trunks -> cords -> branches |
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Definition
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Term
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Definition
fluid filled
usually not drained
treated with compression
treat inflammation |
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Term
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Definition
| extrinsic and intrinsic of hand needed (spherical or cylindrical) |
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Term
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Definition
engage long flexors and extensors
no thumb |
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Term
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Definition
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Term
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Definition
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Term
| standardized dexterity assessments |
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Definition
perdue pegboard
nine hole peg test
minnesota rate of manipulation
crawford small parts dexterity test
box and blocks
jebsen-taylor hand function test |
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Term
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Definition
MMT
sensory testing
grip/pinch strength |
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Term
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Definition
flex of DIP secondary to avulsed EDC
tender to touch
lacks full extension
can surgically reattach
caused by depression at DIP, tear or twist |
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Term
nerve injury Sedon's classification
neuropraxia |
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Definition
conduction block
lose sensation, periodic numbness, annoys person, not too bad |
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Term
nerve injury Sedon's classification
axonotmesis (2nd) |
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Definition
disruption of axons and myelin sheath
continuous loss of sensation |
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Term
nerve injury Sedon's classification
neurotmesis (3rd) |
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Definition
| comlpete severance or serious disorganization |
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Term
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Definition
1-3 months
severe burning pain
muscle spasm
joint stiffness
rapid hair growth
alterations in blood vessels that cause skin to change color and temperature
keep mobilization! |
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Term
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Definition
3-6 months
intensifying pain
swelling
decreased hair growth
cracked, brittle, grooved, spotted nails
stiff joints |
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Term
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Definition
syndrome progresses
changes in skin/bone no longer reversible
pain unyielding and may involve entire limb
marked by muscle loss
severe limited mobility
involuntary contractions of muscles and tendons that flex the joint
is evidence of modalities and nerve blocks helpping |
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Term
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Definition
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Term
| assessment used to detect median and ulnar nerve injury |
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Definition
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