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Upper Extremity Introduction and Somatic Dysfunction Diagnosis - pt 2

Terms in this set (33)

GH Joint PROM
Sagittal Plane -
F/E
For PROM evaluation, GH joint MUST be ?
This is done by ? to limit any motion other than that of ?
L hand -
? on clavicle and scapula
R hand -
Controls forearm
Induces ?
isolated
stabilizing scapula and clavicle
GH joint
maintains inferior force
F/E
GH Joint PROM:
Sagittal Plane
IR/ER
GH joint MUST be isolated
L hand - inferior F on clavicle + scapula
R hand - Controls forearm; induces IR/ER
AC Joint
•? joint

Motions:
•?/?
•?/?
*(AKA ?/? glide)

Testing Positions
•Requires starting position of ?(scaption) before abduction or IR/ER
•Arm will be used as a ? to test AC joint
•When doing so, do not carry humerus ? into coronal plane as it will then ? scapula (out of scaption).
•Humerus will be maintained in ?, in line with the ?
Synovial
•Adduction / Abduction
•Internal / External Rotation
aka Anterior/Posterior

30-45° forward of coronal plane
lever
posteriorly
retract
scaption
scapula
Scapula Orientation
•"Scaption"
30-45° forward from coronal plane
- Ensure AC joint ?
- If arm/scapula moved into coronal plane,
o ? on AC ligament
o Limits ? at AC joint

Hand Placement
- 1 finger on ? process
- Other finger on ?
- Alternatively, finger on ?
mobile
Tension
Motion

acromion
distal clavicle
joint line
Abduction
- aBduct scapula at AC joint
- Slight ? of clavicle and acromion.
o Fingers ?
o "?"
approximation
closer together
End feel
Adduction
- Slight ? of clavicle and acromion
- Fingers ?
separation/gapping
further apart
Internal Rotation
- Arm abduction
- Scapula in scaption (30-45° forward to coronal plane)
o ? position
- Acromion glides ? relative to clavicle
- Finger on acromion move ? to finger on clavicle
Neutral
anteriorly
anterior
External Rotation
- Acromion glides ? relative to clavicle
- Finger on acromion moves ? relative to the finger on clavicle
posteriorly
posterior
SC Joint
- ? joint
- Cartilaginous ?

Motion
o ?/ ?
o ?/ ?
o ?/?
(But limited and difficult to assess)
Complex synovial
meniscus

o Anterior/ posterior
o Inferior/ superior
o IR/ER
SC Joint: AROM
Posterior/Anterior Glide
- Index fingers on ?/? surface of ? clavicle

Observe for static asymmetry
o If one is more ?/?

Test for posterior glide
o Pt shrugs shoulders ?

Test for anterior glide
o Pt shrugs shoulders ?
anterior/medial
proximal

anterior/posterior

anteriorly

posteriorly
- When pt shrug shoulders anteriorly, proximal clavicle will seem to angle more ?
- If motion is restricted on one side compared, it is called:
o "? Motion Restriction at ?"
- When pt shrug shoulders posteriorly, proximal clavicle will seem to angle more ?
- If motion is restricted on one side compared, it is called:
o "? Motion Restriction at ?"
posteriorly
Posterior
Right/Left SC Joint

anteriorly
Anterior
Right/Left SC Joint
Inferior/Posterior Glide
-Inferior glide
o Shrug shoulders ?
o If this motion is restricted on one side, it is called:
?
- Superior glide
o Return shoulders ?
o If motion is restricted on one side, it is called:
?
superiorly
"Inferior Motion Restriction at the Right/Left SC Joint.

inferiorly
"Superior Motion Restriction at the Right/Left SC Joint."
Elbow
3 Joints:
- Humero-radial,
o ?
- Proximal radio-ulnar
o ?
- Humero-ulnar,
o ?


Elbow movements:
?
?
?
Pronation, supination
Flexion, extension
Pronation, supination

- Flexion, Extension
- Pronation, Supination
- Abduction, Adduction (little)
Carrying Angle
- Anatomical configuration of ? joint cause:
o forearm ?
o wrist ?
- Oblique configuration of trochlea and spiral groove (of trochlear notch) causes:
o Ulnar ?
o At ? joint
o Allows for:
Slight forearm ?
Slight wrist ?
In ? position
humero-ulnar
ABDuction
aDDuction

ulnar deviation
humero-ulnar

ABduction
ADduction
anatomical
"Carrying Angle"
- Formed by Angle of ? from ? axis of humerus
o Measured grossly by ?

Normal
o Males
o Females

Abnormal
o >15, cubitus ?
o <5-10, cubitus ?
deviation
long axis
visual inspection

5-15°
10-15°

valgus
varus
Interosseous membrane
- Fibers from ? to ? joints
- Share ? forces & mvmts
- ? and ? fibers
o Different fiber ?
o Reciprocal F

In regard to perception of pain
- Dysfunction at wrist -> pain in ?
- Dysfunction in elbow -> pain in ?
elbow to wrist
compressive
Anterior, posterior
directions
elbow
wrist
Pronation
- ? radius crosses over ulna
- Moves ? & ?
- ? radial head glides ?
Distal radius
Anterior & medial

Proximal radius
Posterior
Supination
- Distal radius
Moves ? & ?
- Proximal radial head
Glides (moves) ?

Supination and pronation
? actions on radius
posterior & lateral
Anterior

reciprocal
Forearm Pronation/Supination Screening Exam
- Elbow flexed 90 degrees, then:
- Test for L then R Pronation restrictions, then
- Test for L then R Supination restrictions
- Compare ? and ? of motion (end feel) bilaterally

Hand Placement:
For Pronation restrictions:
o Thumb onto ? side of distal radius
For Supination restrictions:
o Thumb onto ? side of distal radius

Radial Head SD Evaluation
- Supination:
o Radial head moves ?
o (away from ? finger
o toward ?)
- Pronation:
o Radial head moves ?
o (away from ?
o toward ? )
quantity and quality
dorsal
palmar

anteriorly
index
thumb

Posteriorly
thumb
index finger
Posterior radial head SD
-Results from:
o Fall ? onto palm
o Outstretched hand
- Distal radius moves ?
- ? accentuated
- Radial head moves ?
forward
anterior
Pronation
posteriorly
Anterior radial head SD
Results from:
o Fall ? onto palm
o Outstretched hand
o Distal radius moved ?
- ? accentuated
- Radial head moves ?
backward
posterior
Supination
anteriorly
Wrist/Forearm Parallelogram Effect
Wrist ?
- When WRIST ABDUCTS, ULNA ?
- When WRIST ADDUCTS, ULNA ?
Abduction
ADDUCTS
ABDUCTS
Hand/wrist abducted
Radius glides ? toward ?
Ulna = relatively ? in articulation with humerus
Thus, it cannot glide ?
As a result, distal ulna deviates ?
THIS IS ULNAR ?
proximally
Humerus
fixed
distally
medially
ADDUCTION
Hand/wrist adducted
Radius glides ? toward ?
Ulna = relatively ? in articulation with humerus
Thus, it cannot glide ?
As a result, distal ulna deviates ?
THIS IS ULNAR ?
distally away from the humerus
proximally
laterally
ABDUCTION
Shoulder - Special Test
Apprehension Test
Tests for ?
glenohumeral instability
Neer Impingement Sign
Tests for
supraspinatus impingement
Drop Arm Test
Empty Can Test
Tests for ?
rotator cuff tear (supraspinatus)
Hawkin Impingement Sign
Tests for ? syndrome
subacromial impingement syndrome
Infraspinatus Test
Tests for ?
infraspinatus tear
Yergason Test
Tests for ?
biceps tendinopathy
Elbow/Wrist Special Tests
Ulnar Tinel Test
- Tests for ?

Finkelstein Test
- Tests for ?
Of AbPL and EPB

Phalen , Tinel Test
- Tests for ?
ulnar nerve compression

DeQuervain Tenosynovitis
AbPL and EPB

carpal tunnel syndrome
Autonomic Nervous System
- ? innervation to UE
- Controls UE ?
- T2-T8
- Actual origins of cell bodies from ?
- Sympathetic trunk courses ?
Sympathetic
vasculature
T5 to T7
anterior to rib heads
Origins of "Shoulder Pain": Viscerosomatic vs. Somatic

Visceral dysfunction
o Must considered when patient presents with "?" pain.

Referred pain
o ? manifestation of visceral disease
- ? reflex
"shoulder"

Somatic
Viscerosomatic
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