WRIST ORTHO TEST

S/S:

• PAIN (P)


• NUMBNESS (N)


• TINGLING (T) (PINS & NEEDLES)


• WEAKNESS (W)

CAUSES:

• REPETITIVE STRESS


• FALLING ON OUTSTRETCHED HAND


• CERVICAL SUBLUXATION

MECHANISM OF INJURY:

• TENDONITIS


• COLLAPSE CARPAL TUNNEL


• DISLOCATED LUNATE
  *** LUNATE IS MOST COMMONONLY DISLOCATED BONE IN BODY
  ***SCAPHOID IS MOST COMMONONLY FRACTURED BONE IN BODY

1. PHALEN'S TEST: MEDIAN NERVE ENTRAPMENT, COLLAPSE CARPAL TUNNEL

• PT SEATED


• DEMONSTRATE FOR TO TO PLACE THE DORSUM OF BOTH HANDS TOGETHER


• WITH FINGERS POINTING DOWNWARD + FOREARMS PARALLEL TO THE FLOOR.


• HOLD FOR 60 SECONDS ( OR UNTIL THE SYMPTOMS ARE REPRODUCED.


• (+) PAIN, NUMBNESS, TINGLING


• Dx: CTS (CARPAL TUNNEL SYNDROME)

2. REVERSE PHALENS TEST: MEDIAN NERVE STRETCH, TENDINITIS PROBLEM

• SAME AS PHALEN'S TEST EXCEPT PALMS TOGETHER + POINTING UPWARD


• SAME AS PHALEN'S TEST AND Dx SAME AS PHALENS TEST

3.TINEL TEST

• PT SEATED


• HOLD PT'S HAND IN SUPINATION


• TAP THE WRIST OVER THE MEDIAN NERVE 3X


• ASK THE PT IF THEY HAVE ANY PAIN, NUMBNESS, TINGLING AFTER EACH TIME YOU STRIKE


• (+) P,N,T


• Dx: CTS

4.CARPAL TUNNEL COMPRESSION TEST

• PT SEATED


• PT HAND SUPINATED COMPRESS MEDIAN NERVE WITH BOTH THUMBS


• HOLD FOR 1 MINUTE, UNTIL THE SYMPTOMS HAVE BEEN REPRODUCED


• (+) PAIN, NUMBNESS, OR TINGLING


• Dx: CARPAL TUNNEL SYNDROME (CTS)

Diagnostic & Disease III

Week 4
Dian (Withdrawal)/Kuang(Mania)
Dian (-)

• Excessive stillness
• Doesn't speak much
• Non-expressive & appears depressed
• Blank countenance & withdrawn
• Possibley Inhibited thinking or blocked sense orifices (Coma extreme case)

Kuang (+)

ORTHO ELBOW TEST

LATERAL EPICONDYLITIS TESTS
A. COZEN'S TEST
-PT SEATED
-INSTRUCT PT. TO PLACE THEIR ELBOW IN FLEXION & WRIST IN EXTENSION.
-PLACE ONE HAND ON PT'S SHOULDER (STABILIZE) & GRAB PT;S FIST WITH OTHER HAND.
-INSRUCT PT TO RESIST AS YOU PULL ON FIST.
-(+) PAIN IN LATERAL EPICONDYLE
-Dx: LATERAL EPICONDYLITIS aka TENNIS ELBOW
-MNEMONIC: PULL UP COVERS AND GET COZY

B. MILLS TEST
-PT SEATED
-INSTRUT PT. TO PLACE ELVOW IN EXTNESION & WRIST IN EXTENSION.
-PLACE ONE HAND ON PT'S HOULDERS & OTHER HAND GRABS PT'S FIST.
-HAVE PT RESIST AS YOU PULL ON FIST.
-(+) PAIN IN LATERAL EPICONDYLE
-Dx: LATERAL EPICONDYLITIS aka TENNIS ELBOW.
-MNEMONIC: TAKE COVERS OFF TO GOT WORK AT THE MILLS
C.MEDIAL EPICONDYLITIS TEST
-PT SEATED
-INSTRUCT PT TO EXTEND ELBOW & FLEX WRIST.
-PLACE 1 HAND ON PT'S SHOULDER & GRAB PT'S FIST WITH OTHER HAND.
-HAVE PT RESIST AS YOU PULL ON FIST.
-(+) PAIN IN MEDIAL EPICONDYLITIS.
-Dx: MEDIAL EPICONDYLITIS aka GOLFER'S ELBOW.

D.LIGAMENT STABILITY TEST (aka LIGAMENT INSTABILITY,AB/ABDUCTIN STRESS, OF VALGUS/VARUS STRESS TEST)
-PT SEATED
-PLACE PT'S ELBOW IN EXTENSION
-GRAB PT'S WRIST WITH 1 HAND
-THEN CONTACT PT'S LATERAL ELBOW WITH OTHER HAND.
-PUSH MEDIALLY ON THE ELBOW.
-THEN SWITCH HANDS & REPEAT, THEN PUSH LATERALLY.
-(+) MEDIAL OR LATERAL DEVIATION OF THE ELBOW.
-Dx: TORN/WEAK LATERAL COLLATERAL LIGAMENT





E. WARTENBURG SIGN
-PT SEATED
-INSTRUCT PT TO PLACE PALM FLAT ON TABLE.
-YOU PASSIVELY SPREAD THEIR FINGERS.
-(+) INABILITY TO ADDUCT PINKY.
-Dx: ULNAR NERVE NEURITIS.