UE Evaluation, UE orthoses, UE Anatomy

Keyline Eval

Evaluate physical and functional with your NEW SPORC

NEW SPORC

Nerves

Edema

Wounds

Strength

Pain

Occupation

ROM

Coordination

Nerves

Sensation

Nerves responsible for many bodily function: vascular functions, sweating, goosebumps, wrinkling when wet, skin texture, hair and nail growth

Edema

Size

Classification

Wound color

Red is good

Yellow and black bad

Wound inflammation

Red and hot to the touch

Strength testing

Grip and pinch

MMT

Pain scales

Numeric scale

Consider with and without movement

Occupation Assessment

Functional assessment

DASH/QuickDASH

DASH

Disabilities of the Arm, Shoulder, and Hand

Finger AROM < PROM

weakness or adhesion

Finger AROM = PROM, wrist position doesn't change ROM

Joint stiffness

Finger AROM = PROM, wrist position does change ROM

extrinsic issues (tightness, adhesion, etc)

Finger AROM = PROM, MP position does change ROM

intrinsic issues

Coordination Assessment

9 hole peg

Moberg pick up test

Purpose of orthoses

Immobilize early to protect, mobilize later to correct

Static splint

Generic splint, immobilizes and protects

Serial static splint

A "series" of static splints, that is reheated and adjusted to the clients new available ROM to improve it

Static progressive splint

Adjustable, non elastic splint, holding into 90 degrees

Dynamic splints

Elastic splint, 90 degrees, assists with movement

5 Ps of purpose of splints

Pain

Paresthesia

Protection

Positioning

Prevention

3 stages of healing

Inflammation

Proliferation

Maturation

Immobilization purpose

Pain relief

Protection

Positioning

Functional

Preventative

Prevent/manage contractures

Manage muscle force

Purpose of mobilization

Remodel scar tissue

Address contractures

Increase ROM

Facilitate movement

Resistance exercises

Decrease joint fracture

TERT

Total end range time

Resting hand splint

Parrot rests on your shoulder

General comfort

After stroke

Anti deformity splint

Alligator "picky about what he eats, he's anti deformity"

Positioning after trauma or edema

Short Thumb Spica (Short Opponens)

Unicorn

Thumb in opposition

Arthritis

Long Thumb Spica (Long Opponens)

"Kevin" the unicorn

DeQuervain's

Dorsal blocking splint

Dorothy the elephant

" she's so big she blocks the door"

Flexor tendon repair "flexible trunk"

Wrist cock up splint

Cocky surfer bro squid "radical dude" best friend is a carp

Use: radial nerve injury, radial tunnel syndrome, carpal tunnel syndrome

Posterior elbow splint

Holds elbow into flexion

Uses: MCL/LCL injury, elbow injury recovery

Mallet splint

Use: injury to exterior tendon of DIP, immobilize 6-8 weeks

Boutonnière splint (oval 8)

Buttons the inchworm

Arthritis

Swan neck splint

Solutions and problem both look like a bird

Arthritis

Carpi

Wrist

Digitorum/digit

Finger/digit

Policis

Thumb

Indices

Index finger

Minimi

Little finger

Longus

Long

Brevis

Short

Flexor digitorum profundus vs. flexor digitorum superficialis

FDS splits and stops (PIP), FDP passes through (DIP)

Intrinsic vs. extrinsic

Intrinsic muscles are completely within the hand, extrinsic muscles are in the forearm with tendons leading into the hand. They both move the fingers.

Function of the lumbricals

IP extension, MP flexion

Function of interossei

Finger ABD and ADD

Glenohumeral rhythm

In ABD the humerus is most of the movement up to 90 degrees, and scapular rotation is most after 90 degrees

Collateral ligaments injury

Common cause of IP flexion contractures post surgery or edema/trauma

Natural tension

Many muscles span several joints and are put on stretch by movements further down the chain

Functional position of the hand

Slight extension of the wrist

Zero position

Resting orientation of the hand as opposed to anatomical position

DR CUMA

Drop Wrist- radial nerve

(Ulnar) claw- ulnar nerve

Median nerve- ape hand