Week 1 Readings important info

what are some signs and symptoms of bells palsy?

sensation is intact

unable to wrinkle forhead

3 W’s are out= wink, wrinkle, whistle

drooping of the corner of mouth

acute onset that usually recovers in full from several weeks to months

define: neuropraxia

loss of function of the nerve due to compression or other transient ( can be sensory or motor)

ex. carpal tunnel

define: axonotmesis

focal damage to the axon and mylein affecting either the epineurium, perineurium or endoneurioum

define: neurotmesis

severing of an axon and myelin, complete loss of function, requries surgery

what is important to note about axonal regneration?

axons that undergo regeneration do not remyelinate to preinjury level

what are some risk factors for polyneuropathy?

DM, autoimmune diseases, cancers, toxins, hereditary

signs and symptoms of neuropraxia

pain, no or minimal muscle wasting

muscle weakness

numbness

proprioception affected

recovery time: minutes to days

signs and symptoms of axonotmesis

pain

muscle wasting evident

complete motor and sensory loss

sensation is restored before motor

recovery time takes months

signs and symptoms of neruotmesis

no pain

muscle wasting

complete loss of sensory and motor and sympathetic loss

recovery time: months and only with surgery

thumb rolls and glide for flexion/extension

also known as radial adduction and radial abduction

radial adduction= concave on convex= ulnar roll and glide

thumb rolls and glides for abduction and adduction

convex on concave

abudction: volar roll and dorsal glide

adduction: dorsal roll and volar glide

what does a hard or boggy end feel mean?

hard= bony obstruction

boggy=edema, joint swelling

what does springy and rubbery end feels mean?

springy=mensical displacmenet

rubbery= muscle spasm

what does empty and firm with decreased elasticity mean?

empty= muscle guarding or pain

firm= fibrosis of soft tissues

what conditions could a hard capsular or soft capsular end feel mean?

hard capsular- frozen shoulder

soft- synovitis, soft tissue edema

how to stretch upper traps?

rotate towards the tight side, SB away and then flex neck

how to stretch levator scapulae?

opposide side flexion and rotation

how to stretch the scalenes?

extension, side bend of neck to opposite side and rotation to same side

how to stretch the SCM?

opposite side bend and same side rotation of neck

how does adhesive capsulitis occur?

often insidious onset, most common in those aged 40-60, could be secondary to OA, RA, trauma or immobilization

what are some defining features of the 4 different stages of adhesive capsulitis?

Initial onset- gradual onset of pain and increases with movement, present at night, less than 3 months

Freezing- persistent and intense pain even at rest, motion is limited in all directions, cannot be fully restored without injection lasts 3-9 months

Frozen- charactereized by pain only with movement, significant adhesions and limited GH motions, atophy of biceps, rotator cuff and triceps, 9-15 months

Thawing- minimal pain and no synovitis but significant capsualr restrictions and adhesions, 15-24 months, some patients will never regain normal ROM

what is the joint movements for proximal and distal radioulnar and radioulnar motions

proximal radioulnar: convex on concave

distral radioulnar: concave on convex