PM&R and Ortho. Test 2
Osteopathic Manipulative Medicine 511 with Prokop at Michigan State University
About this deck
By: Anonymous
Created: 2012-07-19
Size: 26 flashcards
Views: 16
Created: 2012-07-19
Size: 26 flashcards
Views: 16
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Spurling's Test
-Pt.: Ext, SB, Rot. neck to painful side
-Stn: put axial pressure on top of head.
-Result: (+) pain radiates down arm
(-) pain ONLY in neck
-Test for: cervical radiculopathy
Manual Muscle Testing
1-Each muscle- fully contracted.
2-Stn. break or attempt to "break" the contraction (they mean it)
Deltoid mm.
-Pt.: full shoulder ABduction (reach for the sky)
-Stn.: Break contraction by ADduction (pull down arms)
-Test for: C5 & axillary n.
Extensor Carpi Radialis (Longus & Brevis) mm.
-Pt.: Forearm on table & extend wrist.
-Stn.: Break contraction by forcing wrist into flexion (press down)
-Test for: C6 & Radial n.
Triceps mm.
-Pt.: standing/seated- shoulder forwd flx. w/ extended elbow.
-Stn.: Break contraction by forcing elbow into flexion (may NOT work)
-Test for: C7 & Radial n.
ABductor Pollicis Brevis mm.
-Pt.: palmar ABduction of thumb
-Stn.: Put pressure over MCP jt. & force thumb into ADduction.
-Test for: C8 T1 & Median n.
First Dorsal Interosseous mm.
-Pt.: Digits fully ABducted
-Stn.: use your ABducted finger to ADduct pt.'s finger.
-Test for: C8 T1 & Ulnar n.
ROM- Scapula
-On Pt.: passively perform six scapular motions: Elevation, Depression, Protraction, Retraction, Upwd rot., Downwd rot. (use glenoid).
-Test for: a) Serratus ant. weakness- protraction & upward rot. limitation (scapula winging)
*Shoulder flexed + elbow extended while pushing against wall
ROM- Glenohumeral jt.
-Stn.: ABduction, ADduction, Internal & External rotation, Forwd flexion & Extension.
-Test for: Adhesive Capsulitis (frozen shoulder)- limited motions w/ pain.
ROM- Elbow
-Stn.: Flexion, Extension, Pronation & Supination (elbow MUST be flexed)
ROM- Wrist
-Stn.: Flexion, Extension, Radial & Ulnar deviation.
ROM- Hand
-Stn.: 1) Flx. & Ext. MCP & IP jts; 2) ABduct & ADduct MCP jt. (1st dorsal interosseous m.- on dorsal indicis); 3) Lumbricals (4 of them)- flx. MCP jt.; 4) Interos. mm. (4 dorsal & palmar)- flx. MCP & ext. IP jts.
*DAB- Dorsal ABduct
*PAD- Palmar ADduct
*Lumbricals & Interos. mm. work simultaneously
Reflex- Biceps
-Threshold: force needed to elicit minimal reflex.
-Amplitude: elicited jt. movement w/ ↑ force.
-Pt.: flx. elbow @ 90º
-Stn.: place finger on biceps tendon @ elbow then strike it w/ hammer
-Test for: C5 root
Reflex- Brachioradialis
-Pt.: Elbow flx. @ 90º
-Stn.: strike Brachioradialis tendon as it inserts on radius (1/3 distance from wrist)
-Test for: C6
Reflex- Triceps
-Pt.: shoulder ABduct @ 90º & elbow partially flx. to ~90º
-Stn.: strike Triceps tendon @ elbow
-Test for: C7 Root (arm form # 7)
Finkelstein's Test
-Stn.: a) flx. pt.'s MCP & IP thumb jt. w/ ulnar deviation of wrist; b) palpate ABductor pollicis longus & Extensor pollicis brevis tendons over Snuff Box area.
-Result: (+) pain over palpation
-Test for: a) De Quervain's tenosynovitis ( 2 tendons above); b) Wrist pain test for 6 dorsal wrist compartments.
Apprehension for Shoulder Test
-Stn.: ABduct & externally rot. pt.'s arm while stabilizing scapula.
-Result: (+) Apprehension look on pt.'s face & will resist further motion.
-Test for: shoulder dislocation or ant. shoulder instability.
-Follow up test: Jobes Relocation- apply post. pressure on pt.'s humeral head.
Empty Can Test
-Pt.: a) shoulder ABduction to 60 & forwd flx @ 90 w/ thumb pointing down; b) pt. abducts while you force ADduction of shoulder.
-Result: (+) pain in shoulder
-Test for: tear/tendonitis/tendenosis of Supraspinatus mm.
Tennis Elbow Test
-Pt.: make a fist & ext. wrist.
-Stn.: stabilize pt.'s forearm & force wrist into flexion w/ pressure on fist dorsum.
-Result: (+) pain @ lateral epicondyle
-Test for: Lateral Epicondylitis
Allen's Test
-Tasks: 1) Pt. opens & closes fist; 2) You apply pressure on Radial & Ulnar aa. while fist is closed; 3) Pt. opens fist & you release pressure from one of the aa.
-Result: (+) Hand flushes slowly
-Test for: a) Completely/Partially occluded artery; b) Incomplete anastomosis from congenital anomaly.
Impingement Sign Test
-Pt.: Internal rot. of humeral hand in glenoid to bring Greater Tuberosity superior
-Stn.: passively flx shoulder w/ thumb down in front of body.
-Result: (+) ant. shoulder pain
-Test for: Subacromial bursa + Supraspinatus impingement b/t greater tuberosity of humeral head & acromion→ subacromial space pathology
*Greater tuberosity: S. I. T.
*Lesser tuberosity: Subscapularis m.
Tinel's Test
-Stn.: tap over median n. in carpal tunnel area of wrist.
-Result: "+" pain/tingling of median n. of hand
-Test for: a) Carpal Tunnel Syndrome;
*Median n. sensory area: volar aspect of hand including radial 3.5 digits and overlaps over fingertips to dorsal DIP jt.
*Know 10 structures in carpal tunnel: 4 flexor profundus, 4 flexor superficialis, 1 flexor pollicis longus, and 1 median n.
Phalen's Test
-Pt.: shoulder ABducted, elbow flexed, & flx. both wrists by opposing dorsal surface of each hand
*Reverse Phalen w/ volar surface of hand opposing
-Result: (+) pain radiating into 1, 2, 3, 4 digits
-Test for: a) Carpal Tunnel Syndrome- thenar m. atrophy, dropping objects, night pain of median n., buttoning difficulty
Lift Off Test
-Pt.: Hand dorsum in back pocket→ try to lift hand off their back (internal rotation).
-Result: (+) failure at task
-Test for: Subscapularis injury
*Medial border winging of scapula→ Rhomboids injury
Cross over Test
-Pt.: forwd flex & ADduct arm
-Stn.: keep ADduction of arm while pt. tries to ABduct arm.
-Result: (+) pain @ AC jt.
-Test for: AC jt. pathology (injury, osteolysis, degeneration).
O'Brien Test
-Pt.: forwd flx. arm ~ 90 & ADduct ~ 15-30
-Stn.: Push arm upward when pt.'s thumb down and vice versa.
-Result: (+) deep ant. shoulder pain w/ thumbs down & improves w/ thumbs up
-Test for: a) SLAP (Sup. Labrum Ant. Post.); b) ant. labral tears (Bankart).
*Do NOT exacerbate pain from AC jt./ Rotator cuff disease
About this deck
By: Anonymous
Created: 2012-07-19
Size: 26 flashcards
Views: 16
Created: 2012-07-19
Size: 26 flashcards
Views: 16
About StudyBlue
STUDYBLUE makes things that make you better at school.
Things like online flashcards with photos and audio.
Things like personalized quizzes and friendly reminders about when (and what) to study next.
Think of it as a digital backpack™: access to all of your study materials online and on your phone.
STUDYBLUE exists to make studying efficient and effective for every student, for free. Join us.
“I have been getting MUCH better grades on all my tests for school. Flash cards, notes, and quizzes are great on here. Thanks!”
Kathy
Kathy