liveonearth: (moon)

Loved this video showing all my friends getting beat down. Everybody takes a turn at this level of whitewater. If you aren't willing to take a beating, you shouldn't be out there.
liveonearth: (Default)
Natural Medicine Options for Chronic Pain
and Musculoskeletal Injuries
notes )
liveonearth: (Default)
Thoracic Outlet Syndrome Tests have poor validity, as there is a false positive rate of 53-92%. So if someone does this test on you and you have a positive result (usually a + is elicited pain/numbness/tingling or loss of a pulse), it doesn't mean anything for sure. Positive tests should be "assessed cautiously".
more )
liveonearth: (Default)
1) Observe pt, posture (standing)
2) Palpate c-spine (sitting)
3) Test ROM: (sitting) active (AROM), resisted (RROM)
4) MRS: muscle testing
5) MRS: reflex: DTR: deep tendon reflexes
6) MRS: sensory: sharp/dull and light touch to dermatomes
7) Spinal Percussion (still sitting)
8) Valsalva maneuver (to confirm suspicion of herniated disc or SOL in spinal cord or IVF)
9) Special orthopedic tests (cervical compression test & variations, cervical distraction test, shoulder depression test)
10) Passive ROM (PROM) (supine)
11) Soto Hall Test
12) Vertebral basilar artery insufficiency tests
notes )
liveonearth: (Default)
Because so many of the tests that we must perform have the names of individuals, instead of names that are descriptive of the procedures, I just went through the list and named them such that I can remind myself the content of the exam by the words that I link together. If you know the tests well enough, the word or two that I have attached to the name may help trigger your memory of the test.
ortho exams in alphabetical order--only the ones named for people )
liveonearth: (Default)
--CTS-->median nerve compression neuropathy (pinkie & 1/2 ring finger not involved)
--swelling, inflam, pressure in tunnel
--ETIO: trauma, overuse (flex, ext, gripping, keyboard), constriction (tenosynovitis of flexor tendons, RA, osteoarthritis, ganglion or neuroma) systemic conditions (diabetes, pregnancy, obesity, hypothyroid, renal dz)
--S/Sx: pain in wrist and hand, burning, numnbness and tingling in fingers, weak thumb abduction (thenar atrophy), usu worse at night, mb retrograde pain to elbow/shoulder), "flick sign"=relief by flicking wrist as if shaking down thermometer, often bilateral but greater on one side
--Tx: avoid aggrav, ice/heat, ultrasound, laser, brace, anti-inflam, local injx
--Dx: nerve conduction velocity test 84% true positive, 95% true negative
--Tx: surgical release 80% success
--Dx: Phalen's test, Tinel's sign, weak thumb abduction, thenar atrophy
more )
liveonearth: (Default)
--most common overuse injury of elbow (90% of elbow tendonitis)
--inflam, microscopic tears, fibrosis of the extensor carpi radialis brevis tendon
--"tennis elbow" -- from backhand, mind you
--S/Sx: PAIN: lateral elbow, w/ gripping, resisted wrist ext, forearm supination, ext of mid finger
--pain: gradual onset, intermittent
--pt may report weakness, tenderness
--dt degeneration, tendonosis, periostitis
--at jct of common extensor and lateral epicondyle of humerus
--usu no visible swelling or inflam
--AROM and PROM usu normal
--trigger points in extensors of wrist
--PROGnosis: good with conservative care (3 months or less to good as new)
--Tx: pain control, anti-inflam, rest, avoid aggrav, exercise as tolerated, ice, ultrasound, laser, splint, manip, forearm soft tissue tx, ergonomic changes
more )
liveonearth: (Default)

I'm not going to rewrite the whole case, but I will summarize it here, then answer the questions. 38 yo male moves heavy stuff and wakes up one morning with a kink in his neck. It gets worse, with cramping, burning pain in his neck and shoulders. He can't sleep, and goes everywhere with his arm over his head (Bakody's sign) because that's the only position in which he gets relief from the pain. A day later he goes to the urgent care center and they prescribe narcotic pain meds and muscle relaxers, but the pt won't take them because he's a recovering addict. They don't take any xrays.
notes on the case and answers to the homework )


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