2.) Upper Extremities Flashcards Preview

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Flashcards in 2.) Upper Extremities Deck (64):
1

_____ manipulation should occur as an adjunct to the _____ adjustment

Extraspinal, Spinal

2

What is essential for proper management of an extremity injury & appreciating its affect on the spine?

Understanding of the kinetics of the upper and lower extremity

3

What are 2 general rules of extremity adjusting?

1.) Get a history of the area & do a visual & palpatory inspection of the area

2.) Analyze for misalignment/subluxation with pre- and post- criteria

4

What 5 questions should be answered when getting a history & doing a visual & palpatory inspection of the extremity?

1.) Is this a chronic or acute condition?

2.) What tissues are injured?

3.) How severe are the injuries?

4.) Is motion restricted of hypermobile/unstable?

5.) Is this a pre- of post-surgical joint?

5

What is found at the end of passive ROM?

Joint play

6

What is joint play?

The extra "give or spring" that is felt within the joint

7

What limits joint play?

The integrity of the stabilizing ligaments

8

What will lack of joint play cause within the joint?

Dysfunction and may cause pain

9

Joint play is a _____ movement and requires _____ to become adept at determining its presence or absence.

Small, Practice

10

What are 5 methods discussed in class for upper extremity evaluation?

1.) Motion

2.) Relative Muscle Testing

3.) MOI - Mechanism of Injury

4.) Symptoms

5.) X-Rays

11

What is motion palpation?

When the joint is tested for proper motion & joint play

12

What should be done if there is an absence of proper motion or joint play?

A thrust or impulse is applied to restore proper motion

13

Extremity muscle testing is based on which theory?

Mechanoreceptor Theory

14

What is the mechanoreceptor theory?

A muscle functioning across a misaligned joint will be inhibited by a reflex signal originating from mechanoreceptors surrounding that joint

15

What are 3 ways to accomplish the extremity adustment?

1.) Hands only

2.) Instruments

3.) Mechanically Assisted (drop)

16

What must be included in the concept of extraspinal management within the chiropractic paradigm?

Integration of the extraspinal area to the spine

17

What must be considered first when integrating the extremity management to the spine?

The neurological connection

i.e. nerve root levels of innervation

18

What is considered after the neurological connection when integrating the extremity management to the the spine?

Musculature which crosses the area

19

Musculature which crosses the injured area must be differetiated into what 2 groups?

1.) Prime movers

2.) Stabilizers

20

What were the last 2 states to put extremity adjusting in the chiropractic scope of practice?

1.) New Jersey

2.) Michigan

21

What is the criteria for acute trauma to an extremity?

1.) Check for patient safety

2.) Check for joint stability

3.) Check for subluxation

 

22

What does the body innately do for an injury?

Compensate

23

Will compensation always have an outward expression?

No

The more subtle the problem the longer the compensation is present prior to outward expression

24

The _____ traumatic the injury, the _____ the body will be forced to compensate & the _____ the patient is compensation expressiev

More, Quicker, Quicker

25

What are 3 reasons for the body to compensate?

1.) Abnormal stress on a normal structure

2.) Normal stress on an abnoral structure

3.) Normal stress on a normal structure that is not at the time prepared to receive the stress

26

What is one example from class of abnormal stress on a normal structure

Sitting for extended periods of time

27

What are 3 examples from class of normal stress on an abnormal structure?

1.) Falling arch

2.) Scoliosis

3.) Carpal Tunnel

28

What are 2 examples from class of normal stress on a normal structure that is not, at that time prepared to recieve the stress

(Pre-) Disc Herniation

Baby-Jumpers

29

What are the characteristics of a Grade 1: Ligament Sprain?

7-10 days

No residual laxity

30

What are the characteristics of a Grade 2: Ligament Sprain?

Plastic deformation

Residual laxity

31

What are the characteristics of a Grade 3: Ligament Sprain?

Complete rupture of the structure

32

What is the characteristic of a Grade 1: Muscle/tendon Strain?

No residual weakness

33

What is the characteristic of a Grade 2: Muscle/tendon Strain?

Partial muscle tear

34

What is the characteristic of a Grade 3: Muscle/tendon Strain?

Complete tear

35

What are the most common injuries seen in the office?

Grade 1 or mild Grade 2

36

True/False

Grade 3 injuries will heal without reconstruction

True

37

Grade 3 injuries will almost never return to normal _____ and/or _____.

Stability and/or Function

38

What do serious grade 2 and grade 3 injuries leagally require?

Medical Referral

39

What 2 steps need to be taken is the patient refuses the medical referral?

1.) Document

2.) Have the patient Sign It

40

What are the 3 factors to be considered in the mechanism of injury?

1.) Joint Position

2.) Forces Involved

3.) Time of Episode

41

According to the notes, The MOI will often lead to the what 2 things being better?

1.) Understanding of the tissues injured

2.) Potential concerns

42

What is the only case in which the spine is not considered first?

Direct trauma

43

What is the closed pack position?

The end of travel in a joint where:

- The surfaces are at maximum congruency

- The ligaments are taut

44

Injuries in the closed pack position causing further movement in that direct of travel will result in what type of injury?

Dislocation and/or Fracture

45

What is the open packed position?

The position of travel of a joint away from the closed pack position where the capsule and ligaments are not taut

46

Injuries in the open packed position causing extreme movement in that direct of travel will result in what type of injury?

Sprain/Strain

47

What is the cause of degenerative changes?

Loss of normal joint mechanics

48

Degenerative changes lead to what 2 responses?

1.) Inflammation

2.) Fibrotic Response

49

What is the result of the healing processes involved in degenerative changes?

Altered joint mechanics

50

Trauma will lead to the occurance of what 5 steps?

1.) Hyperemia/Inflammation

2.) Passive Congestion

3.) Consolidation of protein exudate

4.) Reorganization via fibrotic activity/Secretion of collagen

5.) Healing by 1st or 2nd intent

51

What tissue is involved in healing by 1st intent?

Similar tissue

52

What tissue is involved in healing by 2nd intent?

Connective Tissue/Fibrosis

53

What are the 10 steps of fibrosis which ultimately result in chronic pain and disability?

1.) Fibrosis

2.) Ischemia

3.) Weaker repair

4.) Less elastic

5.) Hypersensitive

6.) Exacerbations

7.) Altered functional capacity

8.) Further fibrosis

9.) Trophy

10.) Chronic pain and disability

54

How long is the initial healing time?

3-10 days

 

55

How long is the regeneration healing time?

6-8 weeks

56

How long is the remodeling healing time?

6 months - 2+ years

57

What are the 4 questions that need to be answered when planning rehabilitation?

1.) What was the pre-injury status of the patient?

2.) What are the specific goals of the patient and doctor?

3.) What rehabilitation equipment or facilities are available?

4.) What is the likelihood of patient compliance?

58

Joint play is what type of motion in a joint?

Accessory

59

How is joint play detected?

Passive stress to the joint

60

What is joint play essential for?

Proper joint function

61

What are the 3 functions of hydrodynamics?

1.) Proper lubrication

2.) Transport of nutrients

3.) Removal of waste material from the articular surfaces

62

Proper hydrodynamics occur during what 3 activities?

1.) Weight bearing

2.) Intermittent muscle activity

3.) Full ROM of joint and capsule

63

When can radiographic studies be conducted?

Anytime the doctor chooses

64

What are 5 reasons from the medical model to conduct x-rays?

1.) Trauma

2.) History

3.) Age

4.) Muscle strength loss

5.) Litigation