Hand
Causes of Passive Restriction to Extension
volar plate adhesion
volar skin contracture
bony block
flexor tendon adhesion
C7: palmar middle finger
T4: nipple line
S1: lateral heel
for which cranial nerve test would you utilize sharp/dull?
trigeminal sensory, cranial nerve V - 3 distributions
height of ipsilateral hip and shoulder relative to each other in a C curve scoliosis
opposite
example: L C curve, R hip hike, R shoulder drop
categories of mckenzie assessment
derangement (reducible or irreducible)
dysfunction
posture
wrist held together in flexion for 1 min
for carpal tunnel
positive if patient reports paresthesias
C5: shoulder abduction
L4: ankle dorsiflexion
T1: finger abduction
Nerve V: trigeminal
jaw reflex
hypersensitive: teeth snap shut
What would you see on convex side of scoliosis curve?
rib hump, waist "fuller," prominent rib cage, shoulder/scapular elevation
What would radial nerve damage look like at rest?
drop hand
what would you see with oblique retinacular tightness? intrinstic tightness?
oblique: decreased/limited DIP motion when PIP extended vs flexed
intrinsic: decreased PIP flexion range when MCP extended vs flexed
main difference between Norton and Braden scale? what do they both screen for?
screen for risk of developing pressure ulcer
difference is time of distribution (norton 2-3 min, braden 20 mins)
Describe palate away, tongue toward concept
Palate away from side of damage for IX and X
Tongue toward if XII is damaged
perfect alignment relative to plumb line
lateral: slight anterior to lateral malleolus and axis of knee joint; slightly posterior to axis of hip joint; through shoulder, bodies of vertebrae, and external auditory meatus
posterior: midway between pelvis/heels, follow vertebral column
Describe MMT for combined extension (cervical and capital)
fair and above: prone with head over edge of table
resistance: pt extends head, look at ceiling
below fair: partial range
palpation: difficult bc of carotid arteries
Limited Composite active flexion with normal passive composite flexion
flexor tendon adhesion or rupture
components of a neuro screen
motor, sensory, coordination
examples: DTRs, dermatomes, proprioception, noneq tests
which nerve is involved in your gag reflex?
IX and X
which muscles are shortened in military posture? lengthened?
shortened: erector spinae, hip flexors
lengthened: hamstrings, abdominals
Wrist capsular pattern
equally limited in flexion and extension
Froment's Sign
adductor pollicis weakness vs ulnar nerve paralysis
positive if terminal phalanx flexes or MCP hyperextends
components of upper quarter screen, potential questions, and what you would consider for PT exam
prom/arom, posture, myotomes, overpressure, dermatomes, DTRs, special tests
questions: OLDCARTS, injury history, medical history, specifics of injury..etc
PT exam: UE ROM, strength, functional exam for activities that are difficult
muscle screening for facial nerve - list muscles and how you would test
frontalis: wrinkle forehead, raise and lower eyebrow
zygomaticus: smile and show teeth
obicularis oris: puff cheeks
obicularis oculi: close eyes
platysma: stiffen neck
early signs of osteoporosis
posture changes, protruding abdomen
height loss
back pain
loss of teeth/periodontal disease
transparent skin
Describe flexion/extension ROM of lumbar spine (with tape measure)
position: standing
stationary: line connecting PSIS
moving: 15 cm above stationary
document change in distance and subtract from initial measure
modified schober: 6-7 cm