Term
| List the three compression syndromes? |
|
Definition
1. Thoraic Outlet Syndrome
2. Carpal Tunnel Syndrome
3. Piriformis Syndrome |
|
|
Term
| What are the three compression sites that lead to Thoracic Outlet Syndrome? |
|
Definition
1. Anterior Scalene syndrome- anterior/middle compression
2. Pectorlis Minor syndrome- pec minor, coracoid, first rib
3. Costocavicular syndrome- clavicle, first rib |
|
|
Term
| Compression of the neuromuscular bundle is called? |
|
Definition
|
|
Term
| Neuromuscular bundle is made up of? |
|
Definition
1. Subclavian artery
2. Subclavian vein
3. Brachial plexus (C5-T1)
4. Subclavian Lymph Trunk |
|
|
Term
| Subclaivian Lympth Trunk affects all thoracic compression sites except for? |
|
Definition
|
|
Term
| What makes up the Intrascalene Triangle? |
|
Definition
Anterior Scalene (anteriorly)
Middle Scalene (Posteriorly)
first Rib (Inferiorly) |
|
|
Term
| This is narrowing of triangle compresses of the bracial plexus and subclavian artery? |
|
Definition
| Anterior Scalene syndrome |
|
|
Term
| This is the most vulunerable to be compressed since it lies inferior passing through the triangle |
|
Definition
| Medial Cord, causes ulnar symptoms because C8-T1 make up this cord |
|
|
Term
| These cause pain in lower lateral neck radiating to lateral shoulder and arm (bicep and tricep), over upper chest, medial border of scapula |
|
Definition
|
|
Term
| These trigger points can be activiated by heavy lifting, over use of respiratory muscles (bronchitis, asthma etc.) |
|
Definition
|
|
Term
| These are specific causes of anterior scalene syndrome? |
|
Definition
hypertonicity (anterior,middle scalene)
Trigger points
Anomalies (Cervical rib)
Wide C7 TVP
Extra wide insertion of anterior scalene |
|
|
Term
| This neuromuscular bundles includes both axillary subclavian artery and vein? |
|
Definition
|
|
Term
| Costoclavicular compression is located here? |
|
Definition
| Between clavicle and first rib |
|
|
Term
| When the subclavian lymph trunk is compressed it leads to this? |
|
Definition
|
|
Term
| Narrowing of the subclaivan space is caused by? |
|
Definition
Abduction of the arm
Retraction of scapula
Elevation of First Rib
Hypertonic Subclavius muscle |
|
|
Term
| Boney Calluses on first rib or clavicle, osteoarthritis, hypertrophy or trigger points in subclavis muscle are all common with this syndrome? |
|
Definition
|
|
Term
| This is requently referred to as hyperabduction syndrome? |
|
Definition
| Pectoralis Minor Syndrome |
|
|
Term
| This syndrome produces vascular symptoms when subclavian vein, subclavian lymph trunk, brachial plexus and subclavian artery are compressed? |
|
Definition
| Pectoralis Minor Syndrome |
|
|
Term
| Acy pain, abnormal sensation, neurological weakness are all signs of? |
|
Definition
|
|
Term
| Dull, Achy, Numbness, Tingling are all signs of? |
|
Definition
|
|
Term
| Swollen, Discoloured Limbs are a sign of this type of compression? |
|
Definition
| Venous and Lymphatic Compression |
|
|
Term
| Treatment goals of compression are to? |
|
Definition
Normalize range of motion
Decrease compression on neuromuscular bundle
Reduce Pain
Reduce Trigger points and hypertonicity
Improve Tissue health
Circulation |
|
|
Term
T or F
If edema is present bilaterally you should avoid postioning the client in side lying? |
|
Definition
|
|
Term
| Fascial release for compression syndromes to which areas? |
|
Definition
| Upper back, shoulders, neck, anterior chest |
|
|
Term
| If a client presents with internal rotation while in prone where should towels be placed? |
|
Definition
| Towel rolls to shoulder for support |
|
|
Term
| A compression of the sciatic nerve by this muscle? |
|
Definition
|
|
Term
| Sciatic nerves are composed of what nerve roots? |
|
Definition
| L4-S3, 2 peripheral nerves fibularis and tibial |
|
|
Term
| In most people the sciatic nerve travels here? |
|
Definition
| Under the piriformis muscle |
|
|
Term
| What are the actions of the piriformis muscle? |
|
Definition
Externally rotates the hip
horizontally abducts the hip when flexed to 90 degrees
Internally rotates (very rare- hip fully flexed to 90) |
|
|
Term
| Sciatic nerve innervates this area of skin and muscles? |
|
Definition
| Skin and muscles of posterior thigh, leg and most of the foot |
|
|
Term
| List some things that can cause pirimformis syndrome? |
|
Definition
Anomalies in course of nerve
Trauma
Inflammation
Overuse
Shortening of the muscle through trigger points |
|
|
Term
| Is piriformis syndrome most commonly a bi-lateral or uni-lateral condition? |
|
Definition
|
|
Term
| Symptoms associated with piriformis syndrome are? |
|
Definition
pain/paresthis posterior thigh,calf, sole of foot
loss of propricoception or muscle strength
pain inguinal region & greater trochanter
pain in buttocks
pain with hip flexion, adduction, medial rotation |
|
|
Term
| If this nerver is compressed men have impotence, women painful intercourse? |
|
Definition
|
|
Term
| Trigger points in piriformis refers pain to this areas? |
|
Definition
| low back, buttock, hip, posterior thigh |
|
|
Term
| Treatment goals for piriformis syndrome is? |
|
Definition
Increase range of motion
decrease pain
reduce trigger points and compression of nerve |
|
|
Term
| Self care for piriformis should be? |
|
Definition
Stretching to piriformis
modified sleeping to avoid adduction of hip |
|
|
Term
| This is the compression of the median nerve as it passes through the capal tunnel? |
|
Definition
|
|
Term
| The carpal tunnel is formed by these structures? |
|
Definition
| Flexor retinaculum which attaches to hook of hamate, pisiform on ulnar side and scaphoid and trapezium on radial side of wrist. |
|
|
Term
| List the 4 structures that pass under the carpal tunnel? |
|
Definition
1. Median nerve
2. Flexor digitorum superficials
3. Flexor digitorum profundas
4. Flexor pollicus longus |
|
|
Term
| Who many branches does the median nerve have? |
|
Definition
|
|
Term
| Median branch has two branches, one that travels through the carpal tunnel, the second one travels through? |
|
Definition
|
|
Term
| Palmer cutaneous branch supplies skin over this area? |
|
Definition
|
|
Term
| Median nerve compression affects these fingers? |
|
Definition
|
|
Term
| Common causes of carpal tunnel syndrome? |
|
Definition
Repetitive flexion/extension
thickening flexor retinaculum due to scar tissue
edema or fluid retention
trigger points
sleep pattern
trauma
congenitally smaller compartment |
|
|
Term
| Common signs of carpal tunnel syndrome? |
|
Definition
pain distal to carpal tunnel
pain, numbness, tingling, weakness median nerve distrubtion
|
|
|
Term
| If carpal tunnel is uni-lateral which hand does it typically effect? |
|
Definition
|
|
Term
| Treatment goals for carpal tunnel? |
|
Definition
normalize range of motion
reduce pain
reduce median nerve symptoms
reduce trigger points |
|
|
Term
| If carpal tunnel is in the acute stage you should avoid this? |
|
Definition
| fascial work and distal work to the wrist |
|
|
Term
List three medical treatments for carpal tunnel syndrome?
|
|
Definition
1. Splinting of the wrist
2. Steroid injections
3. Surgery (moderate to serve cases) |
|
|
Term
| Self care prescribed for carpal tunnel? |
|
Definition
Stretch to forearms- not to reproduce pain
appropriate hydrotherapy (wax)
wrists held in neutral while typing |
|
|
Term
| This tunnel is made up of the hook of the hamate and pisiform? |
|
Definition
|
|
Term
| Compression of the ulnar nerve through the guyon canal affects these digits? |
|
Definition
| 4th & 5th (caused by pressure on the wrist) |
|
|
Term
| This condition is an abnormal positioning of the head and neck relative to the body? |
|
Definition
|
|
Term
| This is the typical presentation of torticollis? |
|
Definition
| Ipsilateral flexion, contralateral rotation, and extension |
|
|
Term
| What are the 3 types of torticollis? |
|
Definition
1. Acute Acquired
2. Congenital
3. Spasmodic |
|
|
Term
| This is the most common type of tortocllis, has painful unilateral spasm or shortening of neck muscles? |
|
Definition
| Acute Acquired Tortocollis |
|
|
Term
| Common causes of acute acquired torticollis? |
|
Definition
Trigger points from shortened position (sleep etc.)
Cold breeze blowing on neck
Subluxation of C1-C2
Facet joint irritation
Whip lash |
|
|
Term
| Treatment goals for acute acquired torticollis are? |
|
Definition
decrease pain
decrease spasm
lengthen muscle
30 minute treatment |
|
|
Term
| This should be avoided if client has acute torticollis? |
|
Definition
| passive range of motion of the neck (avoid shortening) |
|
|
Term
| Self Care for Acute Torticollis? |
|
Definition
| Stretches to affected muscles following passive ranges of the neck |
|
|
Term
| This is a contracture of one SCM resulting in abnormal head positioning, and is present at birth? |
|
Definition
|
|
Term
| This form of torticollis is not typically painful? |
|
Definition
|
|
Term
| The treatment goal of congenital torticollis is to do this? |
|
Definition
Lengthen the structure
Increase range of motion
reducing positioning |
|
|
Term
| Length of treatment for congenital torticollis would be? |
|
Definition
| 5-10 minutes with very light touch |
|
|
Term
This condition is intermittent or sustained spasm of cervical muscles and abnormal head positioning (spontaneously or persist indiffiantly)
|
|
Definition
|
|
Term
| Common symptoms of spasmotic torticollis? |
|
Definition
Servere pain
associated with stress adn emotion
tremor assocated with the condition |
|
|
Term
| Treatment goals for spasmodic torticollis? |
|
Definition
Reduce pain
reposition head
reduce spasm
increase range of motion
*** avoid direct contact with affected muscles*** |
|
|
Term
| Contraindications for three types of torticollis are? |
|
Definition
Acute acquired- do not passively stretch muscles
Congential- deep or heavy pressure
spasmodic- painful techniques, joint play, local massage |
|
|
Term
| An accleration- deceleration injury to the head and neck is? |
|
Definition
|
|
Term
| This whiplash typically has longest rehabilitation? |
|
Definition
| Rear Impact (stretch injury to front and back of the neck) |
|
|
Term
| During a this whiplash this impact typically causes nerve damage? |
|
Definition
|
|
Term
| Some complicating factors of whiplash? |
|
Definition
head rotation
improper positioned head rest
improper use seatbelt
airbags (if don't go off there is more flexion) |
|
|
Term
| Whiplash treatment is focused on? |
|
Definition
| Head, neck, shoulders, and couple of structures |
|
|
Term
| Whiplast recovery time for contractile muscles is? |
|
Definition
|
|
Term
| Recovery time for non-contractile ligaments? |
|
Definition
|
|
Term
|
Definition
| pain, stiffness, no loss range of motion |
|
|
Term
|
Definition
| Stiffness, pain, loss of range of motion |
|
|
Term
|
Definition
| Pain, stiffnessm neuroligical signs and symptoms |
|
|
Term
|
Definition
|
|
Term
| This is a condition resulting from damage to the facial nerve (cranial nerve 7)? |
|
Definition
|
|
Term
| Cranial nerve has two branches, they are? |
|
Definition
1. Supplies motor funciton
2. Supplies sensation to muscles of facial expression |
|
|
Term
| Sensory branch of cranial nerve 7 has 5 branches? |
|
Definition
1. Buccal branch- buccinator and upper lip muscle
2. Temporal branch- eye adn forehead muscle (open eye)
3. Zygomatic branch
4. Mandibular branch-lower lip and chin muscles
5. Cervical branch-playtsma, diagastric muscles |
|
|
Term
| Common causes of Bell's Paralysis is? |
|
Definition
Compression, trauma, serve TMJ dsyfunction
50-70% caused by herpes simplex, bacterial infection, lyme disease or familiar tendency |
|
|
Term
| Three lesion sites of Bell's Paralysis? |
|
Definition
1. Stylomastoid foramen
2. Proximal to stylomastoid foramen
3. Distal to stylomastoid foramen |
|
|
Term
| Inablility to close one eye, wrinkle forehead, smile, pucker lip, flare nostril is? |
|
Definition
|
|
Term
| If the lesion for Bell's Palsy is in the face the symptoms would be? |
|
Definition
Same as Classic Bell's Palsy as well as-
reduced salvation
impaired taste 2/3 of tongue
impaired hearing or heighten hearing |
|
|
Term
| If lesion of Bell's Palsy is in the face the symptoms would be? |
|
Definition
| Distal- motor symptoms only and varies depending on the nerve branch involved. |
|
|
Term
T or F
Pain is not usually a symptom, be could be predictor of a permanent condition? |
|
Definition
|
|
Term
| This should be avoided when treating Bell's Palsy? |
|
Definition
Avoid prone- compresses flaccid tissue
Avoid compression of stylomastoid foramen (towel between neck and hand) |
|
|
Term
| Bell's Palsy- techniques on the affected side should be directed this way_____, technique on unaffected side should be directed this way________? |
|
Definition
Affected side- towards the lateral side
Unaffected side- towards the mid line |
|
|
Term
| Passive movements the therapist should make to clients face when treating Bell's Palsy? |
|
Definition
| Wrinkle forehead, Closing eye, flaring nostrils, smiling with teeth, making O shape with mouth |
|
|
Term
| Self care for client's with Bell's Palsy? |
|
Definition
| Passively wrinkles forehead, close eye etc. |
|
|
Term
| List the three peripheral nerves? |
|
Definition
1. Radial
2. Ulnar
3. Median |
|
|
Term
| Damage to this nerve presents with drop wrist? |
|
Definition
|
|
Term
| Radial nerve stems from posterior cord of brachial plexus? |
|
Definition
|
|
Term
T or F
Radial nerve divides early in its course into sensory and motor |
|
Definition
|
|
Term
| Sole distribution for sensory of radial nerve is? |
|
Definition
|
|
Term
| Radial nerve-Primary responsible for? |
|
Definition
| majority of posterlateral arm and forearm, lateral two thirds of the dorsal hand |
|
|
Term
T or F
Radial nerve has no significant autonomic responsiblities? |
|
Definition
|
|
Term
| This is referred to as the Tool Utilization nerve? |
|
Definition
|
|
Term
| Which nerve is involved in fine motor skills? |
|
Definition
|
|
Term
| Which nerve originates from the brachial plexus C5-T1? |
|
Definition
|
|
Term
| flaccid paralysis to median nerve results in? |
|
Definition
| Ape hand deformity (loss of opposition) |
|
|
Term
| Median nerve is soley responsible for? |
|
Definition
| Sensation distal ends 2nd & 3rd digit |
|
|
Term
| Median nerve is primarily responsible for? |
|
Definition
Anterior- 2/3 palmer hand to midline 4th digit
Posterior- middle 2nd & 3rd digit |
|
|
Term
| Injuries to this nerve present in holding position called Claw hand? |
|
Definition
|
|
Term
| Sole responsiblity for sensation to skin of little finger, ulnar border of hand is? |
|
Definition
| Sensation to skin of little finger, ulnar border of hand |
|
|
Term
| This nerve exists from the lowest position of brachial plexus C8-T1? |
|
Definition
|
|
Term
| Primarily responsible for medial half of ring finger and from palm to wrist? |
|
Definition
|
|
Term
| Is the ulnar nerve typically injured from dislocation? |
|
Definition
| No, because it it located at the lowest positon of brachial plexus |
|
|
Term
| Ulnar is susceptible to injury at? |
|
Definition
Elbow because it is so superficial
Hand because of all types of hand and finger injuries |
|
|
Term
| When the myelin sheath around the nerve distal to the lesion degenerates? |
|
Definition
|
|
Term
| Severance to the endoneurial tube and axon, factors that affect regeneration are, size of the gap, speed of axonal regeneration, amount of scar tissue encountered and possible presence of neuroma? |
|
Definition
|
|
Term
| Regeneration is deemed successful if? |
|
Definition
| Resulting in return of function and sensation for the client |
|
|
Term
| What is a combination lesion? |
|
Definition
| Where an injury to a single nerve, effects another nerve that is running near it resulting in two nerves being damaged. |
|
|
Term
| What is Klumpie paralysis? |
|
Definition
| traction injury to lower brachial plexus resulting in combination of median and ulnar lesions. |
|
|
Term
| What does Erb's paralysis effects what nerves? |
|
Definition
| Involves upper brachial plexus mainly C5-C6 |
|
|
Term
| Position of Erb's paraylsis find themselves in? |
|
Definition
| Trauma violently separates neck and shoulder, called waiter's tip |
|
|
Term
| Trophic changes present with these? |
|
Definition
| Permanent lesion where regeneration does not occur and muscle wasting over time. |
|
|
Term
| This results in damage to all the fibers within the nerve? |
|
Definition
|
|
Term
| Results in damage to some fibers within the nerve? |
|
Definition
|
|
Term
| Symptoms of regenerating lesion that are most likey present? |
|
Definition
| functional losses can be noted, altered gait, facial expression or posture, edema may be present. decrease muscle bulk, edema may be present, tropic changes to skin, hair, nails, inflammation, burising |
|
|
Term
| Edema present initially, edema will remain until fibres regenerate and vasomotor functions returns? |
|
Definition
| Edema- complete nerve lesion |
|
|
Term
| Edema present initially, edema will reain until full regeneration however will be less then complete nerve lesion? |
|
Definition
|
|
Term
| Flaccid paralysis and muscle wasting can occur within three weeks? |
|
Definition
| Complete nerve lesion- motor function |
|
|
Term
| Variable symptoms, fibrillation is present, often diminshed deep tendon reflexes? |
|
Definition
| Parital nerve lesion- motor function |
|
|
Term
| Typical holding pattern may be present such as drop wrist (radial nerve lesion), drop foot (sciatic nerve lesion)? |
|
Definition
| Complete nerve lesion- holding pattern |
|
|
Term
| Holding pattern less apparent with parital lesions some muscles still functionm finger drop instead of full wrist drop or a paritial ulnar nerve lesion at the elbow may cause intrinsic hand muscles adn a less obvious claw hand? |
|
Definition
| Paritial nerve lesion- holding pattern |
|
|
Term
| Affected flaccid muscles are unable to exert force on the joint they cross, draw into a shortened position? |
|
Definition
| Complete nerve lesion- contracture |
|
|
Term
| Contractures develop in the unopposed antagonist, less severe then with complete lesion because opposition to the antagonists is present from the unaffected agonists. |
|
Definition
| Paritial nerve lesion- contracture |
|
|
Term
| An area of anesthesia of the cutaneous division of the nerve, can be variable, maybe a decreased or altered sensation that may or may not be interpreted by the client as painful? |
|
Definition
| Complete nerve lesion- pain |
|
|
Term
| Likely to be areas of hyperesthesia and possibly dysesthis which are perceibed by the client as painful, causalgia, and RSD may be present? |
|
Definition
| paritial nerve lesion- pain |
|
|
Term
| Presents as lesion site of complete or paritial, may interfere with nerve regeneration of the nerve? |
|
Definition
| Complete or Paritial nerve lesion |
|
|
Term
| Trophic changes after nerve lesion may consist of? |
|
Definition
| Changes to hair, skin, nails, thickening of skin, whitish tone on nails, skin can become dry, scaly, course, nails pitted |
|
|
Term
| What are palpation concerns of early stages of healing? |
|
Definition
| Fragility of skin, healing process of the nerve |
|
|
Term
| Can tractioning affect the regenerating process? |
|
Definition
| Yes, tractioning or excessive movement introduced once regeneration process unitl function of muscle clearly returned. |
|
|
Term
| How long until on site work for a limb that has been immobilized following surgery? |
|
Definition
| Approximately 3 weeks until regeneration is beyond that point |
|
|
Term
| This is a condition where demyelination of the nerves cause spasticity, altered posture and paresthesia? |
|
Definition
|
|
Term
T or F
MS is an abnormal immune reaction that attacts the myelin once myelin is stripped away axon is unable to transmit signals? |
|
Definition
|
|
Term
| This is the difference between MS and Parkinson? |
|
Definition
|
|
Term
| What is to be avoided during MS treatment? |
|
Definition
Avoid cold hydrotherapy
Avoid large areas of heat
Avoid areas of altered sensation
*** shortened treatment*** |
|
|
Term
| Degenerative disorder of the CNS, specifically basal ganglia results in death of dopamine, resting tremors and rigidity? |
|
Definition
|
|
Term
| When does the symptoms of parkinson appear? |
|
Definition
| After 80% decline of dopamine |
|
|
Term
| who does Parkinson affect? |
|
Definition
| Equally both men and women after age 50 |
|
|
Term
| People affected with Parkinson have a sensitivity to which areas of the body? |
|
Definition
|
|
Term
| What disorder has a dysfunction of sweating and salivation? |
|
Definition
|
|
Term
| What technique if most/least affective treatments of Parkinson Disorder? |
|
Definition
Most- GTO
Least- agonist/anatogonist relationship (both muscles are already affected) |
|
|
Term
| This condition has a societal fear massage can spread because of abiltiy to increase circulation of blood and lymph? |
|
Definition
|
|
Term
| What determines whether cancer spreads? |
|
Definition
|
|
Term
| Scar tissue forms within this many days? |
|
Definition
|
|
Term
| How long until Frictions can be incorporated into a treatment? |
|
Definition
| approximately 4-6 weeks post surgery/injury |
|
|
Term
| Ionizing raditation aimed at several angles to intersect tumor? |
|
Definition
|
|
Term
| How to determine the radiation zone? |
|
Definition
|
|
Term
| this is a drug combination to kill cells? |
|
Definition
|
|
Term
| Local burns from cancer treatment typically will appear? |
|
Definition
| Week 4 of a 5-7 week process |
|
|
Term
| When can treament start following post surgery? |
|
Definition
| typically 2-3 weeks post surgery (stay 4 inches away from surgical site) |
|
|
Term
| This can be placed on radiation site, only if it's 100% pure? |
|
Definition
|
|
Term
T or F
massage may help speed distribution of chemicals used in chemoptherapy? |
|
Definition
|
|
Term
| Chemotherapy can have this affect on the body? |
|
Definition
Thins body tissue
Alters hormones
Damages joint tissue |
|
|
Term
| This is elevated levels of glucose in the blood? |
|
Definition
|
|
Term
| This in response to high levels of blood glucose, converts glucose to glyocen |
|
Definition
|
|
Term
| Released in response to low levels of blood glucose? |
|
Definition
|
|
Term
| Norepinephrine and epinephrine help to maintain glucose levels by releasing stores of glyocgen in liver? |
|
Definition
|
|
Term
| This is dangerous to body, cells without glucose begin to starve? |
|
Definition
|
|
Term
| More dangerous then too much glucose in blood, too little glucose leads to death of tissue. Too much insulin not enough food? |
|
Definition
|
|
Term
| this type of diabetes is insulin dependent? |
|
Definition
|
|
Term
| Cardiovascular complications of diabetes are? |
|
Definition
Capillaries/arteries harden
Inadequate perfusion
Cerebral vascular |
|
|
Term
| Nervous system complication of diabetes? |
|
Definition
| High blood sugar destroys nerve fibers |
|
|
Term
| Symptoms decreased skin integrity in regards to diabetes? |
|
Definition
Delayed healing, decrease tissue perfusion
kidney damage, vision problems |
|
|
Term
| You should check clients ______ for potential ulcers? |
|
Definition
|
|
Term
| What techniques are to be avoided when treated a client with diabetes? |
|
Definition
| If sensory loss this compromises tissue avoid deep stripping, frictions, extremes hydrotherapy |
|
|
Term
| ______ amputations are preceeded by ulceration? |
|
Definition
|
|
