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91 Cards in this Set
- Front
- Back
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How is finger ROM measured
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TAM = total active motion
TPM = total passive motion -measures tendon excursion Add extension deficits and subtract flexion deficits ex. digit 2 MCP = 10 - 50* PIP = 15 - 75* DIP = 0-10* TAM 110* |
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guidelines for recording ROM measurements
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1. Record as a range- start position/end position (0-150*)
2. Do not use negatives 3. WFL = functional ROM 4. WNL = normal ROM |
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shoulder flexion
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0-170*
associated girdle motion: abduction, lateral tilt, slight elevation, slight upward rotation |
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shoulder extension
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0-60*
associated movements: depression, adduction, upward tilt |
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shoulder abduction
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0-170*
associated movements: upward rotation, elevation |
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shoulder adduction
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0*
associated movements: depression, adduction, downward rotation |
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shoulder horizontal abduction
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0 to 40*
associated movements: adduction, reduction of lateral tilt |
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shoulder horizontal adduction
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0 to 130
associate movements: abduction, lateral tilt |
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Internal rotation
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arm in abduction = 0-70
arm in adduction = 0-60 associated movements: abductionm lateral tilt |
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External rotation
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arm in abduction = 0-90
arm in adduction = 0 - 80 |
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elbow flexion
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0 to 135-150*
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elbow extension
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0*
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forearm pronation
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0 to 80-90*
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supination
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0 to 80-90 *
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wrist flexion
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0 - 80*
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wrist extension
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0 - 70*
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ulnar deviation
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0 - 30*
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radial deviation
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0 to 20*
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thumb DIP flexion
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0 to 80-90*
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thumb MP flexion
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0 to 50*
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thumb adduction
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0*
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thumb abduction, radial
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0 to 50*
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thumb abduction, palmar
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0 to 50*
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thumb opposition
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composite motion of thumb
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finger MP flexion
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0 to 90
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finger MP hyperextension
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0 to 15-45*
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finger PIP flexion
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0 - 110*
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finger DIP flexion
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0 to 80 *
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finger abduction
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0 to 25*
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grade 5 strength
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normal
moves through full range against max resistance |
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grade 4 strength
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good
moves through full ROM against gravity, takes moderate resistance |
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4-
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good minus
moves through full ROM againsst gravity takes less than moderate resistance |
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3+
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fair plus
moves through full ROM against gravity, takes min resistance |
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3
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fair
moves through full ROM against gravity cannot take resistance |
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3-
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fair minus
less than full ROM against gravity |
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2
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poor
moves through full ROM in a gravity eliminated plane with no added resistance |
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2-
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poor minus
part moves less than full ROM in gravity eliminated plane |
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1
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trace
tension palpated in muscle or tendon, no motion occurs at joint |
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0
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zero
no tension palpated at muscle or tendon |
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2+
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part moves through full ROM in gravity eliminated plane with minimal resistance, then breaks
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stabilization during MMT
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proximal to the joint the muscle crosses over
Do not hold over muscle belly being tested |
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resistance during MMT
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apply in opposite direction of movement
should be gradual |
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what tool measures grip strength
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dynamometer
vigorometer or sphygmomanometer for arthritis |
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position for testing grip
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arm adducted to side, elbow flexed to 90,"", forearm in neutral
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types of grip strength tests
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place handle in position #2, take mean of 3 trials
or one trial in all 5 positions, forms bell curve |
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how is pinch strength measured
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pinch meter
can measure: lateral pinch 3 jaw chuck tip to tip obtain 3 trails on each hand and take means |
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How to measure endurance
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1. count # of repitions
2. determine percent of maximum heart rate 3. measure time until fatigue 4. use METs |
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what is edema? what are 2 types?
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body's initial response to injury in which exudate moves from blood stream to tissue
can be local or diffuse types: pitting = acute brawny = chronic |
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how is edema measured?
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1. figure of 8
measures circumference record in cm 2. volumeter measures hand & arm mass significant change = more than 10 ml only true objective tool |
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Sensation testing
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1. demonstrate with vision before occluding
2. test uninvolved side first, applying stim to volar and dorsal surfaces Neurological disorders- assess for dermatome pattern Peripheral nerve injuries: assess for peripheral nerve involvement |
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How should SCI sensory testing be completed?
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proximal to distal
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how should peripheral N. damage testing be completed
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distal to proximal, following dermatomes
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order of return for sensation
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pain
moving touch static light touch touch localization |
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Types of sensory testing
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1. light touch (cotton swab)
2. localization (cotton swab) 3. pain (paper clip) 4. temperature (test tubes or thermal kit) 5. stereognosis |
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how to test light touch
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touch with cotton swab. person responds "yes" when touched
score: + = intact - = impaired 0 = absent |
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how to test touch localization
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cotton swab
responds "yes" when touched and points to area score +, -, or 0 |
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how to test pain
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paperclip
person responds "sharp" or "dull" scoring: S+, D+, S, D, S-, D- |
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how to test temperature
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test tubes or thermal kit
person responds "hot" or "cold" scoring = +, -, 0 |
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how to test stereognosis
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recognition by touch of common objects
score by counting # of objects if expressive apashia, use 2nd set of objects for identifying |
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how is moving 2-point discrimination tested
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disk-criminator or caliper
1. begin with points 5-8 mm apart 2. apply proximal to distal on fingertips in horizontal orientation 3. person responds with the number of points he feels 4. 7/10 responses must be correct before deceasing distance 5. norm score = 2 mm |
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how many responses must be correct before decreasing distance on 2 pt. discrimination test?
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7/10
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what is the starting position for 2 pt discrimination?
what is the norm? |
start = 5-8 mm apart
norm = 2 mm |
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how is static 2-point discrimination tested?
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disk-criminator or caliper
1. Begin at 5mm 2. apply to fingertips in longitudinal orientation 3. person states "1" or "2" 4. distance increased until 7/10 responses are correct 5. stop test at 15mm |
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scoring static 2-point discrimination
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normal = 5mm
fair = 6-10mm poor = 11-15mm protective = 1 point perceived anesthetic = no points perceived |
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how to test proprioception
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position involved extremity
person imitates with uninvolved extremity |
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how to test kinesthesia
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movement sense
therapist moves segment person responds up or down |
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CN V
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dermatome location: anterior face
muscles: mastication function: ingestion |
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C3
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dermatome: neck region
muscles: sternocleidomastoid, upper traps function: head control |
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C4
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dermatomes: upper shoulders
muscles: trapezius (diaphragm) function: head control has diaphragm. will not need vent |
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C5
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dermatome: lateral shoulder
muscles: deltoid, biceps, rhomboids function: elbow flexion can use universal cuff |
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C6
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dermatome: thumb, radial forearm
muscles: wrist extensors, biceps function: Sh. abduction, ECR - wrist extension tenodesis splint appropriate |
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C7
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dermatome: middle finger
muscles: triceps, wrist/finger extensors function: wrist flexion, finger extension tenodesis splint appropriate |
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C8
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dermatome: little finger, ulnar forearm
muscles: flexors of wrist and fingers function: finger flexion |
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T1
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dermatome: axilla, proximal medial arm
muscles: hand intrinsics function: abduction/adduction of fingers |
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T2-T12
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dermatome: thorax
muscles: intercostals function: respiration greater endurance |
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T4-T6
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dermatome: nipple line
muscles: intercostals function: respiration |
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T11
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dermatome: mid chest region, lower rib
muscles: abdominal wall function: T5-7 superficial abdominal reflex |
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T10
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dermatome: umbilicus
muscles: psoas, iliacus function: leg flexion |
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L1-L2
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dermatome: inner thigh
muscles: accessory muscles function: elevation of scrotum |
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L2
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dermatome: proximal anterior thigh
muscles: iliopsas, thigh adductors function: reflex voiding |
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L3-4
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dermatome: anterior knee
muscles: quadriceps, tibialis anterior, detrusor urinae function: hip flexion, knee extensors,abductors of thigh |
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L5
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dermatome: great toe
muscles: lateral hamstrings function: flexor withdrawal, urinary retnetion |
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S2
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dermatome: narrow band of posterior thigh
muscles: small muscels of the foot function: bladder retention |
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What is the "neurological level" when describing SCI? How does it differ from "functional level"?
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neuro level: lowest level with grade 3/5, with all above muscles in tact
functional level: similar, only muscles must be grade 3+ or above at this level |
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What level of SCI would benefit from a wrsit stabilizing orthosis and universal cuff? why?
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C5
have elbow flexion for self feeding etc. but no wrist extension (no tenodesis) |
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what SCI levels are likely to use tenodesis?
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C6/C7
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what orthotics can enhance tenodesis?
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wrist-hand orthosis (or
flexor hinge splint) with tenodesis splint increases pinch in absence of finger flexion (T8) |
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What is the presentation of C8 SCI?
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claw hand, or intrinsic minus grasp
no intrinsics (these are L1) |
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What SCI level can breath independently?
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C4, although weak (diaphragm only)
need practice to strengthen breath |
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at what SCI level will reflexive voiding occur?
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L2
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at what SCI level will a person have voluntary control of bladder?
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L5-S1 = urinary retention
S2 = bladder retention |
