Clinical Implications for Shoulder/Wrist/Elbow/Forearm/Hand

What happens in trigger finger

finger becomes lodged in a flexed position

what causes trigger finger

high repetition activities

Interventions for trigger finger

surgical release, activity modification, preventing prolonged flexion

Buotonnie deformed involves the injuries of what joints

PIP flexion and DIP hyperextension

what is the damage of the Buotonniere Deformity

damage of central slip

Intervention for Buotonniere deformity

orthoses, splints

Swan Neck Deformity is the hyper extension and flexion of what joints

PIP hyper extension and DIP flexion

what causes swan neck deformity

laceration volar plate or damage to terminal tendon

Intervention for swan neck deformity

orthoses and splints

Dupuytren’s contracture is the abnormal thickening of what

palmar aponeurosis

Dupurtren’s Contracture is the contracture of what two finger

ring and all finger

Interventions for Dupuytren’s contracture

surgical release, injection, postoperative rehabilitation and scar management and splinting

Tenodesis affect on fingers

fingers relaxed and wrist extended causes fingers to flex

Tenodesis is when a fist is created by

passive tension on finger flexor muscles

Tenodesis provides functional grasp for what type of persons

with SCIs at C6

Dequervain’s Tenosynovitis is also known as

texting thumb

Dequervains Tenosynvitis is

CTD of the tendons of the first dorsal compartment

Dequervain’s Tenosynovitis occurs from

extended ulnar deviation and rapid thumb movement

True or false: surgery is the first intervention for carpal tunnel syndrome

FALSE

FOOSH

falling on out stretched hand

Where is there a common place for OA to develop

CMC of thumb

Intervention for CMC OA of Thumb

Activity modifications,

adaptive grips, orthoses, surgical

intervention

What is the most common cause ofe for flexor tendon injuries

laceration from a sharp object

how are Flexor tendon Injuries categorized

zones of injury

Interventions for Flexor Tendon Injuries

surgical repair,

dorsal blocking orthosis, early

motion to promote tendon

gliding, one handed techniques

Which are more common: extensor tendon injuries or flexor tendon injuries

flexor tendon injuries

interventions for extensor tendon injuries

one handed techniques, orthoses

Carpal Tunnel contains

9 tendons and median nerve

what causes carpal tunnel syndrome

increased pressure caused by repetitive motion

Carpal tunnel syndrome reduces blood flow to what

the arteries that supply the median nerve

interventions for carpal tunnel syndrome

surgical intervention, orthosis, task modification, education

Distal Radius fracture makes up what percentage of all pediatric fractures

25%

Distal Radius Fractures make up what percentage of fractures in older adults

18%

Complications from Distal Radius Fracture

edema, swelling, scar tissue, nerve compression, joint stiffness

Post Op interventions

scar management, edema management, adjacent joint mobility, ADL modifications, balance/fall assessment

Stereognosis

ability to identify an object using hands alone

Somatosenation

ability to determine temperature and pain

Ulnar nerve injuries may present with ___ AND ____ deficits

sensory AND motor

Claw Hand is associated with what nerve injury

Ulnar Nerve injury

Ulnar Nerve injury may lead to

hyperextension of MCPs and Loss of IP extension

Median Nerve Injury is also called

Hand of Benediction

if a patient has a Median Nerve Injury, they are unable to

flex thumb, pointer, and middle finger, with loss of webspace of thumb

Radial Nerve Injury key characteristic

Wrist drop

Wrist Drop is the loss of

wrist and digit extension

Scapular rhythm

patterns of movement between scapula and humerus

what causes scapular winging

neurological conditions

what Is the intervention for scapular winging

strengthening

posture is important for

maintaining purposeful movement of shoulder

what may lead to postural compromise

sitting for long periods of time

Postural compromise can lead to

subacromial impingement, thoracic outlet syndrome

interventions for postural compromise

postural education, workplace

modifications, exercises to counteract

postural difficulties

Glenohumeral Subluxation is

partial dislocation of the GHJ due to

elongating of ligaments of the joint

capsule

possible cause of GH subluxation

hemiparesis after CVA

interventions for GH Subluxation

supportive

tray/positioning or GivMor Sling

Bicipital Tendinitis

Weakness of the rotator cuff that

causes the long head of the biceps

to become inflamed

what causes bicipital tendinitis

repetitive shoulder flexion

interventions for bicipital tenditis

activity mod., rest, pain management

Rotator cuff tear

tear of SITS

what increases incidence occurrence for Rotator cuff tear

age

Joint dislocation is most common for

glenohumeral

what can joint dislocation of GHJ cause damage to

labrum

what are conservative interventions of joint dislocation

strengthening of rotator cuff to promote dynamic stability

What causes osteoarthritis

repetitive use over time

why might osteoarthritis require activity modification

functional limitations and pain

interventions for osteoarthritis

surgery, adaptive equipment

(e.g.) of close packed joint position

full extension with forearm supination

(e.g.) open packed joint position

70 degrees flexion, 10 degrees supination

Subacromial Impingement

compression of the soft tissue between the acromion and humeral head

Thoracic outlet Syndrome

compression of the structures beneath the clavicle and pectoralis muscles 

Cubital Tunnel syndrome

causes numbness and tingling in ring and small fingers

what causes cubital tunnel syndrome

increased pressure/tension on ulnar nerve in the cubital tunnel when the elbow is flexed

what can persistent symptoms of cubital tunnel syndrome lead to

atrophy and chronic symptoms

interventions for cubital tunnel syndrome

activity and environmental

modification, minimizing elbow flexion in

periods of rest and sleep, wraps/orthosis that

discourage elbow flexion

what is the purpose of ulnar collateral ligaments

stabilized the elbow

UCL is vital for what sport

baseball

what can a UCL injury lead to

deformation resulting in a loss of velocity with pitching

intervention for UCL injury

Tommy John surgery

Flexion Contracture may be caused by

the immobilization of the elbow after injury leading to shortening of soft tissues around joint

what do flexion contractures limit

AROM and PROM

Interventions for flexion contracture

Low prolonged stress to

restore tissue length and joint mobility -

static progressive orthoses

What are the two common types of Cumulative Trauma Disorders

medial and lateral epicondylitis

what causes medial and lateral epicondylitis

repetitive musculoskeletal forces of digital flexion and extension

interventions for CTD

modification of workspace, activity mod., ergonomic evaluation, supportive bracing

Lateral epicondylitis is also called

tennis elbow

Mediial epicondylitis is also called

golfers elbow

Medial epicondylitis is related to wrist ____

flexion

Lateral epicondylitis is related to wrist ______

extension