Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
41 Cards in this Set
- Front
- Back
Stinger S / Sx
|
Acute shooting, electrical pain down arm following tackle in football, weakness, usually c5-c6 that may last from a few secs to many months
|
|
Stinger mech of inj
|
shldr dep or direct comp to brachial plexus from poorly fittin pads
|
|
Stinger tx
|
Rest & Ice, str ex, check fitting of shldr pad, return to football when overhead Str is 5/5, str deficit may persist fo mos
|
|
Intermediate Nerve Entrapment / Inj: Dorsal Scap N. - S/Sx
|
Unilateral rhomboid pain, may rad into arm, ipsilateral rot and / or contralateral side bending painful
|
|
Intermediate Nerve Entrapment / Inj: Suprascap n. - S/Sx
|
Similar to rot cuff - atrophy in supra or infraspinatus fossa - diff dx: injection into notch for pain relief and EMG
|
|
Intermediate Nerve Entrapment / Inj: Long thoracic n. - S/Sx
|
Pain and weakness w/ shldr flex, Scapular winging, may be excessive, weak / absent protraction
|
|
Distal Nerve Entrapment / Inj: Median n: pronator syndrome - S/Sx
|
Pain reproduced on res pron and elbow flex and sometimes passive supination; + pinch sign; electrodiagnostics not helpful;
|
|
Distal Nerve Entrapment / Inj: Median n: pronator syndrome - Tx
|
Splinting and rest
|
|
Distal Nerve Entrapment / Inj: Median n: Carpal Tunnel syndrome - S/Sx
|
+ Tinels; + Phalens, thenar atrophy, Confirmed by electrodiagnostics
|
|
Distal Nerve Entrapment / Inj: Median n: Carpal Tunnel syndrome - Tx:
|
cock-up splint, NSAID's, correction of posture, positioning, possible surg
|
|
Distal Nerve Entrapment / Inj: Ulnar n: elbow - S/Sx
|
Elbow pain and paresthesia radiating into ring and little fingers; Sx should be reproduced by simultaneous contraction of elbow ext, pronation and flexor carpi ulnaris which narrows the cubital tunnel; + Sustained elbow flex, + Tinnels
|
|
Distal Nerve Entrapment / Inj: Ulnar n: wrist - S/Sx
|
Weakness of abductor digiti minimi and abd pollicis
|
|
Distal Nerve Entrapment / Inj: Radial n: Radial tunnel syndrome - S/Sx
|
Mimics tennis elbow. Main tenderness is over the radial tunnel 4 finger widths distal to the lateral epicondyle; pain on resisted supination; + middle finger sign; pain and weakness on resisted extension of the middle finger. ?ULTT (rad) +
|
|
Distal Nerve Entrapment / Inj: Radial n: Sup branch compression (Wartenberg's syndrome) - S/Sx
|
N. lies beneath brachioradialis near radial styloid; can occur b/c of tight bracelet or band at the wrist. Sensory changes only
|
|
4 concepts in the eval of N. injury
|
1. The mechanical interface
2. Nerves are elastic. 3. Tension on a nerve inc intraneural compression. 4. Tension in the nervous system by movement is not uniform. |
|
Tx principles of nerve injury (4)
|
1. Tx any related jt hypomobility or hypermob that may be present 1st
2. Very careful with irritable patients 3. Start gently with stretching techniques that you used to eval. 4. Jt shoul not be stressed during the tx |
|
Risk factors for osteoporosis
|
Early menopause, caucasian, thin, low Ca intake, excessive use of caffeine / alcohol, smoking, liver / thyroid / renal dz.
|
|
W/ osteoporosis, X-ray will show bone loss but only if greater than _______ %
|
30-50%
|
|
PT options for Osteoporosis
|
1. Rigid orthosis if tol. in acute stage.
2. Ext exercises as tol 3. Str paraspinals (avoid loading in flex) 4. Walking program 5. Balance ex 6. postural correction 7. Breathing ex. 8. education |
|
Postural changes lead to a ___% dec in FVC
|
9%
|
|
*** When should PT's recommend that a patient be screened for osteoporosis? (5)
|
1. Risk factors present
2. >65 yo 3. Pt reports loss of ht, inc kyphosis or protuberant abdomen 4. Hx of chronic low back pain 5. Hx of wrist fx |
|
Scoliosis: __% convexity to the R
|
90
|
|
T1 & T2 disc lesions are rare but some highlights are:
|
1. UE pain
2. pain reproduced by scapular retraction and cervical flex 3. placing hand behind head w/ elbow flex will be painful 4. serious dz if neuro signs are present |
|
Herpes Zoster S/Sx
|
Rash and pain in dermatomal distribution; rash ceases to keep forming after 5 days and pt is nml w/i 2 weeks
|
|
Postherpetic neuralgia s/sx
|
Pain and hyperesthesia that persist for over a month after rash has cleared; freq inc w/ age; 30-50 yrs: 4%, >80 years: 34%
|
|
Mondors Disease: what is it?
|
Thrombophlebitis of the subcutaneous veins in the chest - often involves the thoracoepigastric vein; x3 more common in women
|
|
Mondors Disease: S/sx
|
Insidious onset of lateral chest wall pain. Pain is localized over thromb osed vein and the skin may show localized protrusion; minimal inflammatory changes and there are no associated fevers or chills; sx resolve in 1-10 wks w/o specific tx.
|
|
Intercostal Neuralgia: origin?
|
Development of an intercostal neuroma secondary to a prior thoracotomy, mastectomy, or fractured rib.
|
|
Intercostal Neuralgia: S/Sx
|
Trigger point or tenderness located at the neuroma w/ burning pain regerring into thorax or abdomen
|
|
Posterior Primary Rami innervation:
|
med 2/3 back: can affect rhomboids, traps, paraspinal mm. - post rami close to facet jts.
|
|
How does T4 Syndrom get its name?
|
Despite possible involvement from T2-T6, Hypomobility is usually reported at T4
|
|
Sympathetic trunk supply
|
UE; trauma to this area or irritation of the sympathetic trunk by osteophytes from the costotransverse or costovertebral ts may result in sx of vague UE pain and sensory changes
|
|
***CPR for Manip of thoracic spine to tx neck pain (6)
|
1. Sx <30 days
2. No sx distal to shldr 3. Looking up does not aggravate sx 4. FABQ-PA <12 5. Dec Upper thoracic spine kyphosis 6. cervical ext <30 degrees |
|
Common features of spondyloarthropathies (7)
|
1. Predilection for inflammatory lesions of the axial skeleton.
2. Oligoarticular peripheral joint arthritis 3. Enthesitis or enthesopathy 4. Frequent extra-articular inflammation (uveitis, aortitis) plus skin and mucous membranes 5. affects mainly young men 6. Strong association w/ HLA-B27 7. Negative rheumatoid factor |
|
AS Etiology
|
Individuals with HLA-B27 are predisposed, familial link: 20% have 1st deg rel; onset b/t 20-35; rare over 40
|
|
AS Pathology
|
Pathological changes in synovial and fibrous jts in the form of chronic synovitis --> cartilage destruction, erosions, sclerosis of underlying bone.
SI affected 100%; Cervical: 75%; Lumbar 50%; Hips / shldrs: 30%; heels: 30% Fusion of cervical spine can put more stress on C1-C2 segment and result in sublux |
|
AS Clinical Features
|
Predominant AM stiffness; insidious onset of LBP with exacerbations and remissions; may present like a rupture disc or an SI strain; earlier onset more associated w/ per. jt involvement; earlier onset more severe sx
|
|
AS Physical Findings
|
1. Limitation in all planes - this should make you suspicious
2. loss of chest expansion 3. + SI testing (Gaenslens & SL Compression) 4. Tenderness over bony prominences such as greater trochanters, spinous processes 5. Kyphotic thoracic spine (which result in dec pulmonary function) |
|
AS prognosis
|
Severity of sx in first decade predicts long term disability; severe dz is usually marked by peripheral joint and extra-articular manifestations; osteoporotic fx, AA sublux and spinal stenosis
|
|
AS PT Eval
|
Respiratory - chest expansion, FVC / FEV over 1 sec, posture, trunk flexibility, extremity flexibility, blood pressure, BMI dec
|
|
AS PT intervention
|
1. Aerobic exercise to avoid wt gain
2. Cessation of smoking 3. Ext exercises 4. diaphragmatic breathing ex. 5. Strengthening of spine extensors 6. Correct posture / strengthen scapular retractors 7. cease exercises during exacerbations 8. Abd strengthening (for better posture) 9. Flexibility of ext as needed |