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46 Cards in this Set
- Front
- Back
Describe motion of scapula |
** there is a 2:1 ratio of motion during abduction of the arm between the glenohumeral joint and the scapulothoracic joint - For every three degrees of abuduction --> 2 degrees happen in glenohumeral joint --> 1 degree happens at scapulothoracic articulation
Protraction/abduction retraction/ adduction elevation depression downward rotation/upward rotation motion combinations
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Describe motion of clavicle in sternoclavicular joint |
-Flexion/extension horizontal plane -abduction/adduction frontal plane -rotation around longitudinal axis -true synovial joint with meniscus |
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Describe motion of glenohumeral joint |
-abduction/adduction in frontal plane -forward flexion/extension in horizontal plane -internal/ external rotation in plane of scapula |
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Describe motion of ulnohumeral joint |
- carrrying angle 5-15 degrees,normal angulation, exceeding 15 degree called cubital valgus- excess of abduction in joint glide
- normal joint glide allows for abduction and adduction at elbow
-Flexion-150-160 Extension 0 10 degrees of hyperextension may be normal in some individuals |
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Describe motion of radioulnar joint |
--interosseous membrane-usually retains strain pattern long after a fracture or dislocation is healed -- allows freedom of rotational motion between radius and ulna -distal radioulnar joint- alows lateral/medial gliding motion at wrist at ulnar knotch -Paralellogram mechanics- when elbow moves into abduction, the wrist compensates by moving iinto opposite direction (ulnar deviation) and vice versa
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Describe motion of radiocarpal joint |
-radius is primarily a wrist bone -composed of radius , three carpal bones and attached cartilage 2 major axis of rotation- Transverse- flexion and extension Anteroposterior axis- allows abduction and addcution |
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Describe motion of intercarpal joints |
- concave and saddle shaped joints that allow circumduction |
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Restriction in scapular rotation |
shoulder girdle problem
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Restriction in humeral abduction |
glenohumeral problem |
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Scapular rotation defined by motion of |
acromion process |
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Describe the motion of the clavicle in the acromioclavicular joint |
-elevation with shoulder abduction -depression with shoulder adduction -posterior glide with shoulder flexion -anterior glide with shoulder extension -rotation around longitudinal axis -true synovial joint |
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Radiohumeral joint |
-radius glides anterior with elbow flexion and posterior with elbow extension -proximal radius glides anterior, externally rotates during supination and glides posteriorly, internally rotates during pronation. -Radial head in anchored by annular ligament that allows rotation
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Extreme elbow entension induces |
anterior radial head somatic dysfunction |
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Extreme elbow flexion induces |
posterior radial head somatic dysfunction |
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Elbow abduction and adduction are ______ motions |
gliding |
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The carrying angle of the elbow is |
5-15 degrees and usually does not change during flexion and extension |
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Ulnohumeral Abduction: |
increases carrying angle |
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Ulnohumeral adduction: |
decreases carrying angle |
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What type of dysfunction is often caused by fall onto an outstretched hand |
posterior radial head somatic dysfunction - restricts supination -radial head does not generally glide anteriorly - present with wrist pain or elbow pain especially with supination |
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What type of dysfunction is often caused by a fall when the patient extends arm behind himself with hand facing away from him on landing? |
anterior radial head somatic dysfucntion - radial head does not glide posteriorly - restricts pronation - patient presents with wrist pain in pronation |
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Common somatic dysfunction of ulnohumeral joint
--> Ulnar abduction --> Ulnar adduction |
-restricted adduction (lateral glide) -patient may present with pain or restriction at endpoint of flexion -increases the carrying angle
-restricted adduction -patient may present with pain or restriction at endpoint extension -decrease carrying angle
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Radial head somatic dysfunction |
-posterior head somatic dysfunction -when radius is pronated the radial head will be posterior |
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A sprain, strain, or fracture of the forearm, wrist, or elbow can also strain |
interosseous membrane
--> this can persist long after injury heals --> palpation of interosseous membrane will reveal increased tension or tenderness |
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Wrist in extension |
normal motion that widens the carpal tunnel |
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Wrist in flexion |
normal motion narrows the carpal tunnel |
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Flexion somatic dysfunction in wrist |
repetitive use in flexed position -causes persistent narrowing of carpal tunnel and increased tone of flexor retinaculum -Planlens and Tinels test for median nerve damage |
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Active range of motion of radiocarpal joint |
Flexion 80-90 Extension 70 Abduction( radial deviation) 20 Adduction ( ulnar deviation) 30-50 circumduction- all of above |
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Somatic dysfucntion of the wristmay not be related to gross motions but to the slight gliding motion of |
carpal bones on radius |
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What do the carpal bones do during extension |
anteriorly |
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What do the carpal boones do during flexion |
glide posteriorly |
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If a wrist extends but is restricted in its full flexion than it is and |
extension somatic dysfunction of wrist |
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If a wrist abducts but is restricted in addcution |
then it is and abduction somatic dysfucntion of the wrist |
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The most common somatic dysfunction of the wrist is |
extension wrist |
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Counterstrain tender points in the wrist may be found in the |
muscle bellies or tendons |
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The carpal bones have no |
voluntary motion -involuntary glide between bones with active hand movement -somatic dysfunction occurs with compressive injury |
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Carpometacarpal joints |
-Main somatic dysfunction is dorsal glide with restrcition ventral glide - |
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Thumb |
- has saddle joint that permits angular movements in almost any plane with the excepetion of limited axial rotation -more likely to have strain or sprain |
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metacarpophalangeal joints interphalangeal joints |
6 gliding motions anteroposterior mediolateral internal-external rotational |
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Lateral epicondylitis |
--> pain over common extensor origin about 1cm distal to lateral epicondyle --> maximal pain on tendon --> tissue degeneration --> pain is reprodcued with resisted extension at the wrist |
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De Quervian tenosynovitis |
swelling of sheath that surrounds the abductor pollicis longus and extensor pollicis brevis at the wrist - inflammation thickens the tendon sheath and constricts tendon causing a triggering phenomena as the patient moves thumb -crepitus revealed |
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Compression of nerves of forearm |
ulnar nerve(cubital tunnel syndrome) medial nerve compression at elbow posterior interosseous nerve compression pronator syndrome- musclular compressionof median nerve in forearm Radial tunnel syndrome |
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Somatic dysfunction may be secondary to |
viscerosomatic reflex |
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Diaphragm |
trapezius area |
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myocardial pathology |
left axilla and inside left arm |
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gallbladder irritation can refer to pain in |
acromioclavicluar and scapular |
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Radial head counterstrain tenderpoint |
most important for elbow |