Patterns make perfect
Ulnohumeral joint capsular pattern
What is flexion loss greater than extension loss?
When damaged causes weakness in deltoid and teres minor
What is the axillary nerve? What is posterior cord? What is C5-6?
The plan if a PT is unable to reproduce a patient's symptoms with a mechanical examination
What is refer to the physician?
Assess limited jaw opening
What is the anterior glide? (Or jaw distraction)
Patient with right-sided neck pain, limited right rotation and sidebending, negative neurovascular exam. Name 3 possible interventions.
What is R cervical downglide, R sideglide, L upglide, CPA, L UPA, Lower cervical rotation MET, PROM stretching, self-snag R rotation, AROM R rotation and sidebending, L upper trap stretch? What is thoracic thrust manipulation?
C3-7 capsular pattern
What are loss of extension and EQUAL loss of lateral bending (sidebending) AND rotation?
If injured in a specific location, causes weakness in the medial flexors, hypothenar eminence, and hand intrinsic muscles - provide nerve and location of injury
What is the ulnar nerve and the cubital tunnel? (Medial cord; C8, T1)
Name 2 of the most common sites of breast, lung and prostate cancer
What are the spine, brain, liver, and lungs?
BONUS INFO: Pelvic floor dysfunction affects those with neurological conditions, urogenital/prostate cancers, and childbirth - Pathophysiology for PTs has sections on urinary incontinence and PFD.
A positive O'Brien's test suggests these conditions. Name a likely MOI for each condition.
What is a SLAP lesion or an AC injury? What are a FOOSH or repetitive overhead motions for SLAP? What are a FOOSH, hard impact to shoulder (including a fall), or lifting heavy weights?
Name 4 interventions to improve wrist extension.
What are Volar glide of the radiocarpal or midcarpal joints, ulnar glide of radiocarpal joint to improve radial deviation (paired with wrist extension), Cephalic glide of the radius, PROM/AAROM/AROM of the wrist flexors to increase muscle length, strengthening of the wrist extensors, strengthening various grip positions?
BONUS INFO: Full PIP extension is created by lumbricals, palmar AND dorsal interossei, and extensor digitorum.
CMC capsular pattern
What is loss of retroposition?
The elbow and wrist can flex, but the digits 1 and 2 are unable to flex when this nerve is injured in this location
What is the median nerve and the carpal tunnel? (Medial and lateral cords; C5-T1)
Name 2 visceral structures that refer to the thoracic spine/flank region
What are kidneys, large intestine, stomach, small intestine, gallbladder, liver, common bile duct?
Describe 5 tests used to assess for cervical radiculopathy
What are ipsilateral cervical rotation < 60, distraction test, ULTT A, Spurling test, myotome, dermatome, DTRs? (Possibly abduction test)
Describe the effects of manipulation in these 3 categories: Psychological, mechanical, and neurophysiological
What is psychological: affecting the patient's expectations, placebo affects, influence of therapist interactions?
What is mechanical: correcting positional faults, increasing ROM, releasing entrapped menisci?
What is neurophysiological: inhibiting pain and influence on muscle activation? OLSON p93
Radiocarpal capsular pattern
What is the equal loss of flexion and extension?
If a person cannot lift their hand or turn their palm up, this nerve is likely injured in this location
Provide 4 screening questions/observations for cervical myelopathy.
What is ataxia, balance impairment, neck pain or stiffness, decreased fine motor skills, weakness or paresthesia in the hands, hyperreflexia, upper motor neuron signs, Lhermitte's sign?
Name the glides to assess thumb CMC abduction and extension and describe the arthrokinematics of the motions
What is posterior (abduction) and lateral (extension) glides? Arthrokinematics: Abduction is convex on concave and extension is concave on convex.
Describe the position to palpate the supraspinatus and provide 1 example of intervention to address supraspinatus tendinopathy in the following stages: acute, subacute, and chronic.
What is the palpation position of humeral internal rotation and adduction? What are modalities and protected ROM in the acute phase; progressive loading, rhythmic stabilization, cross-friction/transverse friction, scapulothoracic control in subacute phase; and continued progressive loading, plyometrics, and return to activity in the chronic phase?
Glenohumeral joint capsular pattern
What is loss of external rotation, abduction, internal rotation?
Damage to this nerve causes torticollis and a downward rotated scapula occur?
High risk factors requiring imaging in cervical trauma to rule out fracture
What are age > 65 years, dangerous mechanism, or paresthesia in extremities?
Dangerous mechanism = fall from >3ft or 5 stairs, axial load to the head, MVC at high speed, rollover, or ejection.
DESCRIBE 2 tests used to assess the medial structures of the elbow
What is valgus stress test? (With the elbow in 0 extension and 30 extension, apply a lateral to medial force at the elbow.) What is the moving valgus stress test? (With shoulder abd/ER to 90, elbow flexed to 120, apply valgus stress lateral to medial while quickly extending the elbow to 30 degrees)
Patient with WAD II C and NP with movement coordination impairments. Describe 1 intervention to treat WAD II C and 2 interventions to address NP with movement coordination impairments.
What is Graded motor imagery: Pain science education, Laterality, watch others move, imagine oneself moving (explicit imagery), sensory discrimination, mirror therapy?
What is graded movement exposure: determine the provocative movement/activity, use dosing and pacing to gradually increase activity tolerance?
What are relative rest, physical modalities, DNF strengthening, cervical submax isometrics, scapular muscle strengthening, coordination training, and thoracic thrust manipulation?