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barbostick
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Active free ROM for cervical region- flexion
- 45-50 degrees
- Chin to chest
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Active free ROM for cervical region- extension
- 75-85 degrees
- Chin to ceiling
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Active free ROM for cervical region- lateral flexion
- 40-45 degrees
- Ear to shoulder
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Active free ROM for cervical region- rotation
- 90 degrees (80 more realistic)
- Chin over clavicle
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Spurling's Test
- Compression test
- Stage 1: Compression top of head in neutral
- Stage 2: Compression top of head in partial extension and rotation to affected side
- Stage 3: Compression in lateral flexion
- Test if sharp local pain in neck and/or nerve pain, with possible numbness/ingling in neck radiating in arm/hand
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Distraction Test
- Crasp client's head at occiput and temporal areas. Return head to a neutral position. Apply slow traction superiorly.
- Positive test if it reduces the client's pain
- Tests for SOL, facet joint irritation, nerve root impingement
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Scalene Cramp Test
- Tests for active trigger points in scalenes
- Have client actively and fully rotate their head to the affected side and forcefully hold for up to one minute.
- Positive if reproduces signs and symptoms
- Use test for anterionr/lateral neck pain (cull/achy), pain following scalene trigger pt referral pattern (upper back, chest, arm, hand), cramping in neck.
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Adson's Test
- Tests for TOS with anterior scalene involvement (Adson's = Anterior scalene)
- Palpate pulse; abduct and extend client's arm; instruct client to look at therapist (ipsi rotation and extension to stretch anterior scalene); instruct client to hold breath and therapist should count down to zero.
- Positive test if diminished or absent pulse; recreation of symptoms.
- Test if pain in the neck/shoulder (if achy muscle pain and nerve pain present radiating down arm; vascular symptoms in hands
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Adson's Test with Halstead Manuever
- Tests for TOS with middle scalene involvement (Halstead is a middle road)
- Palpate client's radial pulse; abduct and extend client's arm; instruct client to look at therapist (contralateral rotation and extension to stretch middle scalene); instruct client to hold breath and therapist counts down to zero.
- Positive test if palpable diminished or absent pulse; recreation of symptoms.
- Test if pain in the neck/shoulder (if achy muscle pain and nerve pain) present down arm; vascular symptoms in hands.
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Costoclavicular/Military Brace Test
- Tests for TOS with clavicle and first rib involvement.
- Palpate client's radial pulse bilaterally; extend both arms and instruct client to slump, retract and dpress shoulders- maintain posture for about 60 seconds.
- Positive test if palpable diminished or absent pulse, recreation of symptoms at any point during test.
- Test if pain in the neck/shoulder (if achy muscle pain and nerve pain) present down arm; vascular symptoms in hands.
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Wright's Hyperabduction Test
- Tests for TOS with pec minor involvement.
- Palpate client's radial pulse; client slowly abducts and extends arm to 90 degrees or greater (hand up = Wright answer)
- Positive test if palpable or absent pulse, recreation of symptoms at any point during test.
- Test if pain in the neck/shoulder (if achy muscle pain and nerve pain) present down arm; vascular symptoms in hands.
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What tests would you use for someone who complains about shoulder pain and cold hands?
- AROM
- PROM (then Spurling's if joint problem)
- Manual Resisted
- Adson's
- Adson's with Halstead
- Costoclavicular/Military Brace
- Wright's
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Contractile tissue
- Tissue that is actively engaged to create movement
- Muscles and tendons
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Non-Contractile Tissue
- Tissue that lacks the ability to produce movement
- Joint capsule, ligament, bursa, cartilage, fascia, dura mater and nerves
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What is the primary reason to use resisted manual testing?
To test the strength of contractile tissue
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What type of mechanical disruption occurs when structures are pressed together?
Compression
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What type of mechanical disruption occurs when a pulling force is applied to one or more tissues?
Tension
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What type of mechanical disruption occurs when a sliding force is applied between two tissues that generates excess friction?
- Shear
- One part is stuck and the other can't go where it wants.
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What type of mechanical disruption occurs when a rotary (twisting) force is applied to tissue?
Torsion
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What type of mechanical disruption occurs when a combination of compression on one side while the other side is stretched?
Bending
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What type of disruption occurs when errors in signal processing within the CNS and PNS occur?
Neurological
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What is the ideal end feel for PROM in the cervical region?
Tissue stretch (soft)
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Name this end feel: a sudden stop end-feel- can indicate osteophytes with DJD
Bony
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Name this end feel: when motion is stopped by the compression of muscle tissue between opposing limb segments
Soft
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Name this end feel: leathery feel, can indicate capsular fibrosis when inflammation is not present
Tissue stretch
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Name this end feel: sudden stop end feel prior to where the end range should be with sudden rebound and pain. Limited ROM
- Muscle spasm
- It prevents you from getting to the end range.
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Name this end feel: pathological caused by a loos body within the joint
- Springy block
- Can mean cartilage is floating around; similar to bony but springy
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Name this end feel: pain is felt before true end feel is attained.
- Empty
- Too much pain; can't test without torturing client (moo ah ah ha)
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Limitations of movement at a joint is called the...
capsular pattern
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What does MRT test?
Contractile tissue only
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