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23 Cards in this Set

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Townsend Article- 4 Most Challenging Exercises
Scaption w/thumb down
Flexion
Horiz ABD w/arm ER
Press-up
Prime Movers (Townsend Article)
Deltoid
Clavicular head of Pec Major

(largest mechanical advantage)
Steering Muscles (Townsend Article)
Supraspinatus
Infraspinatus
Subscapularis
Depressors (Townsend Article)
Lats
Teres Major
Teres Minor
Sternal Pec Major
Referred Pain (p. 323 Kisner)
C4 to: Traps, tip of shoulder
C5 to: delt & lateral arm
Diaphragm: upper trap
Heart: axilla, Left region Pec
Gallbladder: post scap, tip of shoulder
Muscle Imbalances: Stretching
PIP & DIP tend to lose EXT
MCP tends to lose FLX
Selective Stretching
Leave some muscles tight for fxn
EX: Tenodesis grip
Common FX sites associated with Osteoporosis
wrist
hip
lumbar spine
Colle's FX
FX distal end of radius
FOOSH
Dinner Fork Deformity
More often in elderly women
Colle's FX Complications
Sprain UCL
Malalignment (dec AROM, bony block EF w/Acc PROM)
RSD/CRPS
CTS (from malalign./edema)
EPL rupture from Lister's
Colle's FX - ACUTE

(we rarely see bc immobilized)
Impairments: pain, dec mobility/strength, swelling

Limit/No exercise- allow bone to heal
Codman's
Consider acute goals
Colle's FX - SUBACUTE

(usually when we see)
Swing arm w/gait, codman's, reaching activities- if ok by MD
I.C.E.
AAROM -> AROM Sh/E/fingers
ACC.PROM: GR 1-3, end range
Light MRE, T-band
May have CTS Sx
Colle's FX - SETTLED
AROM to end range (collagen mature now)
Passive stretching in HEP
GR 3-4 mobs
Progress MRE & isotonics
Use fxnl activity to motivate
Guttering
Intrinsic loss in hand
Makes metacarpal bones very prominent on dorsal side
Looks like gutters inbtwn
RSD Characteristics
Pain/hyperesthesia
Limited motion
Edema
Vasomotor Instability- sweat, cold, discoloration
RSD Major Impairments
Pain & inflammation
Swelling & stiffness
Vasomotor disturbances
Trophic change (taut shiny skin)
Bone demineralization (prone to osteopenia/fx/osteoporosis)
Dystonia
RSD Progression
Inc scarring
Motion limitation persists
Atrophy of intrinsics
Trophic skin change

Sympathetic nerve block to try and stop pain
RSD 5 TX Areas
Pain
Circulatory & Temp Regulation
Movt
Strengthening
Desensitization
RSD TX
Control pain
Circ/Temp-contrast bath, massage, biofeedback
Movt-AROM, carpal mobs, check thoracic spine
Strength-isometrics, MRE, isotonics, WB, CKC
Desensitization- progress stimulus
Rheumatoid Arthritis vs. Osteoarthritis
RA- systemic autoimmune disorder, all over body, periods of exacerbation/remission

OA- degenerative, usually related to trauma, presents unilaterally
Rheumatoid Arthritis
Common in bilateral wrists
Exacerbation & remission phases
Jt swelling, warmth, jt instability
Muscle imbalances in length/strength
Sublux/dislocations
RA Tx - Active Phase
PROM/AROM- pain as guide
GR I & II mobs
Muscle setting

*Stretching, thrust & vigorous exercise are contraindicated
RA TX - Remission
AAROM -> AROM
Gentle stretching to maintain normal
GR III if needed
Light to mod resistance, HEP
Aquatics- buoyant, dec pain/compression on jts, warm water dec muscle guarding