Bates Chapter 16 Usf 2014

Front 1

Depression

Back 1

Moving a body part downward

Front 2

Opposition

Back 2

Moving thumb to touch little finger

Front 3

Flexion

Back 3

Bending the limb at the joint, decrease angle between bones, bring bones together

Front 4

Extension

Back 4

Increases angle to straight line. Zero degrees

Front 5

Supination

Back 5

Turning forearm so palm is face up

Front 6

Inversion

Back 6

Moving sole of foot inward

Hint 6

Eversion -moving sole of foot outward

Front 7

Pronation

Back 7

Turning forearm so palm is facedown

Front 8

Elevation

Back 8

Moving a body part upward ie. shrugging shoulders. You get Bonus points if you name cranial nerve.

Hint 8

Spinal accessory XI 😉

Front 9

Circumduction

Back 9

Circular motion that combines flexion, extension, abduction, and adduction. ie. moving arm in a circle around shoulder

Front 10

Protraction

Back 10

Moving body part forward and parallel to the ground

Front 11

Retraction

Back 11

Moving body part backward and parallel to the ground

Front 12

Rotation

Back 12

Turning of the joint around axis

Front 13

Strength testing of joints
"0"

Back 13

No muscle contraction when resistance applied

Front 14

Strength testing of joints "1"

Back 14

A slight muscle contraction but insufficient for joint movement

Front 15

Strength testing of joints "2"

Back 15

Weak contraction -full passive range of motion.

Front 16

Strength testing of joints "3"

Back 16

Contraction weak but full active movement against resistance

Front 17

Strength testing of joints "4"

Back 17

Some muscle strength against resistance

Front 18

Strength testing of joints. "5"

Back 18

Normal strength with resistance

Front 19

Pregnant women

Back 19

Increased joint mobility d/t hormones, increased mobility of pelvic joints = changes in posture. Lordosis compensates for enlarging uterus

Front 20

Infants and children

Back 20

Fetus forms cartilaginous skeleton by 3 months. All muscle fibers present at birth but lengthen with growth. Growth hormone, adrenal androgens, and testosterone contribute to growth spurts in boys

Front 21

Adolescents

Back 21

Rapid growth, complete approx. age 20, closure of epiphysis of long bones

Front 22

Older adults

Back 22

Decreased bone density, increased bony prominence, cartilage degeneration, joint stiffness, muscle atrophy, kyphosis, PTH levels increase=bone re absorption reduces bone density

Front 23

Hypotonicity

Back 23

Flaccidity, decreased muscle tone

Front 24

Spasticity

Back 24

Increased muscle tone, often noted with extreme flexion or extension

Front 25

Simian crease

Back 25

Single crease across entire palm. Associated with Down's syndrome

Front 26

Syndactyly

Back 26

Webbed digits

Front 27

Genu varum

Back 27

Bow leg. Measure distance between knees when ankles together 2.5 cm =genu varum

Front 28

Genu valgum

Back 28

Knock knee. Measure distance between ankles when knees together. 2.5 cm = genu valgum

Front 29

Articular disease

Back 29

Typically involves swelling and tenderness of the entire joint and limits both active and passive ROM due to either stiffness or pain.

Front 30

Extra-articular disease

Back 30

Typically involves selected regions of the joint and types of movement

Front 31

Tendins

Back 31

Collagen fibers connect muscle to bone

Front 32

Tendins

Back 32

Collagen fibers connect muscle to bone

Front 33

Ligaments

Back 33

Rope like bundles of collagen fibrils that connect bone to bone

Front 34

Tendons

Back 34

Collagen fibers connect muscle to bone

Front 35

Ligaments

Back 35

Rope like bundles of collagen fibrils that connect bone to bone

Front 36

Bursae

Back 36

Pouches of synovial fluid that cushion the movement of tendons and muscles over bone or other joint structures c

Front 37

Condylar joints

Back 37

ie. knee the articulating surfaces are convex or concave. Allow for flexion, extension , rotation and motion in a coronal plane

Front 38

Low back pain

Back 38

85% idiopathic usually from musculoligamentous injuries and age related degenerative processes of the intervertebral discs and facet joints

Front 39

Common or concerning symptoms

Back 39

Low back pain, neck pain, monoarticular or polyarticular joint pain, inflammatory or infectious joint pain, joint pain with systemic features-fever, chills, rash, anorexia. Joint pain with symptoms from other organ systems.

Front 40

Assessment tips for assessing joint pain

Back 40

Ask pt to point to pain. When and mechanism of injury esp. If hx of trauma. ? If pain is localized or diffuse, acute or chronic, inflammatory or non-inflammatory.

Front 41

Midline back pain

Back 41

Assess for musculoligamentous injury, disc herniation, vertebral collapse, spinal cord metastases, and rarely epidural abscess.

Front 42

Midline back pain

Back 42

Assess for musculoligamentous injury, disc herniation, vertebral collapse, spinal cord metastases, and rarely epidural abscess.

Front 43

Pain off midline

Back 43

Assess for muscle strain, sacroiliitis, trochanteric bursitis, sciatica, and hip arthritis . Also pyelonephritis or stones.

Front 44

Sciatica

Back 44

Radicular gluteal and posterior leg pain in the S1 distribution that increases w/ cough or valsalva

Front 45

Spinal stenos

Back 45

Leg pain resolves w/ rest and/or forward flexion

Front 46

Cauda equina syndrome

Back 46

S2-4 midline disc or tumor if there is bowel or bladder dysfunction esp. With saddle anesthesia or perineal numbness.

Front 47

Cauda equina syndrome

Back 47

S2-4 midline disc or tumor if there is bowel or bladder dysfunction esp. With saddle anesthesia or perineal numbness.

Front 48

In cases of low back pain plus another indicator

Back 48

10% probability of serious systemic disease

Front 49

Radicular pain

Back 49

Arises from spinal nerve compression most commonly C7 followed by C6. Usually caused by foraminal impingement from degenerative joint changes (70-75%) rather than disc herniation (20-25%).

Front 50

Pain in one joint

Back 50

Injury, monoarticular arthritis, possible tendinitis or bursitis. Lateral hip pain near the greater trochanter suggests trochanteric bursitis.

Front 51

Acute septic arthritis or gout

Back 51

Severe pain of rapid onset in a red swollen joint.

Front 52

Fever, chills, warmth, redness seen in...

Back 52

Septic arthritis also consider gout or possible rheumatic fever

Front 53

Gelling

Back 53

Stiffness and limited motion after inactivity occurs I'm degenerative joint disease but only lasts a few minutes .

Front 54

Gelling

Back 54

Stiffness and limited motion after inactivity occurs I'm degenerative joint disease but only lasts a few minutes .

Front 55

TMJ syndrome

Back 55

Unilateral chronic pain w/ chewing, jaw clenching, or teeth grinding. Associated w/ stress; may also present w/ headache. Pain and tenderness on palpating.

Front 56

Pain with chewing

Back 56

Trigonal neuralgia or temporal arteritis

Front 57

Rheumatoid arthritis

Back 57

Chronic inflammation of synovial membranes. Hands-MIP & PIP, feet metatarsphalangeal joints, wrists, knees, ankles. Onset 20-40 years of age. Systemic autoimmune disorder. Bilateral and symmetrical. Subcutaneous nodules, morning stiffness x 1 hr. onset insidious w/ exacerbation and remission. Joint Tenderness often warm but seldom red. Weakness, fatigue, wt. loss, and low fever are common. In chronic disease, swelling and thickening of metacarpophalangeal and proxim interphalangeal joints. Rom limited. Ulnar deviation. Fingers may show swan neck deformities. Less common boutonnière deformity. Rheumatoid nodules in acute or chronic stage. Interosseous muscles atrophy.

Front 58

Osteoarthritis

Back 58

Deterioration of joint cartilage and new bone. Onset older than 50 in women, 40-50 in men. Localized, progressive, non-inflammatory. Stiffness later in the day. Rest relieves pain. Heberden's nodes on the dorsolateral aspects of distal interphalangeal joints, hard and painless. Flexion and deviation deformities at develop. Bouchard's nodes on proximal interphalangeal joints less common. Metacarpophalangeal joints are spared.

Front 59

Empty can test

Back 59

Superspinatus/rotator cuff
Arms extended and elevated to 90 degrees. Rotate arm to have thumbs pointing down. Examiner places downward pressure on arm while pt resists. Pain=positive test.
Full can test- thumbs point up for infraspinatus strength.

Front 60

Joint dislocation

Back 60

Ends of bones slip out of joint. Usually sports related. Severe dislocation can cause tearing of muscles, ligaments, and tendons. Pain, swelling, and immobility of affected joint. Requires medical attention.

Front 61

Bursitis

Back 61

Inflammation of bursa. Swelling, tenderness and increased pain w/ movement. Can follow injury, infection, or rheumatic condition. More common in shoulders, elbows, and hips

Front 62

Red flags

Back 62

Pain with neurologic deficits, pain in a child, pain w/ fever and/or stiff neck, pain worse at night, urinary incontinence or loss of bowel function.

Front 63

Carpal tunnel syndrome

Back 63

Compression of medial or ulnar nerve. Subjective: numbness and tingling in the hands worse at night, pain may radiate to arms. Objective: weakness of the hand. + Tinel sign. Phalens sign.

Front 64

Tinel's sign

Back 64

Strike the median nerve-tingling or pricking sensation radiating from wrist to. The hand especially the thumb, index and middle fingers. Positive sign associated w/carpal tunnel syndrome

Front 65

Phelan's sign

Back 65

Wrists in flexion x 1 minute. Positive tingling in thumb, index finger, and middle/lateral half of ring finger

Front 66

Spurling's Test

Back 66

Evaluates for cervical root impingement. With head extended and rotated toward the painful shoulder, apply an axial load to the cervical spine. Place hand on top of head apply pressure. Pain with this maneuver is a positive test.

Front 67

Apprehension test

Back 67

Patient holds arm in neutral position elevated 90 degrees. Examiner places mild pressure on anterior aspect of arm while rotating externally. Positive=pain. Suggests glenohumeral joint instability, found in young, active, healthy.

Front 68

Sulcus test

Back 68

Shoulder instability. Pt. arm relaxed at their side. Examiner grasps pts elbow and pulls down on it. Positive test=sulcus appears in subacromial area. Measured in centimeters.

Front 69

Neer's impingement

Back 69

Press on scapula to prevent scapula motion with one hand and raise the patients arm with other. This compresses the tuberosity of the humerus against the acromion. Pain=+ test. Inflammation or rotator cuff tear.

Front 70

Hawkins impingement sign

Back 70

Flex pts shoulder and elbow to 90 degrees with palm facing down. With one hand on forearm and one on the arm, rotate the arm internally. This compresses the greater tuberosity against the acromial ligament. Pain is positive test indicating possible inflammation or rotator cuff tear.

Front 71

Test for medial epicondylitis

Back 71

Pt arm flexed 90 at elbow with palm supination. Examiner holds elbow and palm. Pt to flex wrist and forearm pronation while resisting the motion. Pain may be indicative of medial epicondylitis.

Front 72

Gouty arthritis

Back 72

Inflammatory reaction to micro crystals of urate. Base of big toe, instep or dorsa of feet, ankles, knees, and elbows. Early attacks to one joint. Sudden onset , often at night, after injury, surgery, fasting, or excessive food or etoh. Occ. isolated attacks lasting days - wks. Swelling within and around joint. Very tender, hot, and red. Motion limited by pain. Poss. Fever. Consider also septic arthritis.

Front 73

Chronic tophaceous gout

Back 73

Mult. Local accumulations of urate in joints and other tissues (tophi) w/ or w/o inflammation. Feet, ankles, wrists, fingers, and elbows. Spread not symmetrical. Gradual onset of chronicity w/ repeated attacks. Present as tophi in joints, Bursae, and subcutaneous tissue. Check ears and extensor surfaces for trophi. Stiffness and decreased rom.

Front 74

Hallux valgus

Back 74

Lateral deviation of great toe and enlargement of the head of the first metatarsal on its medial side forming a bunion or bursa. The bursa may become inflamed. Women 10x more likely than men to be affected .