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A 50 yr. old Patricia-the-pianist, comes in complaining about instability in
her wrist while playing her piano lately. Ironically, the therapist chooses
the __________ test & performs it at the ___joint.
What would this test confirm?
"Piano Keys" Test
- Pt. seated with both FAs pronated
- Therapist stabilizes Pt's arm with 1 hand so that therapist’s index finger
can push down on distal ulna while other hand supports the hand
· Positive Test = results in a difference in mobility & pain/tenderness (vs.
CL side)
· Indicates: instability of distal radioulnar joint
What is the most frequently fractured carpal bone?
Scaphoid FX
,Jamie, a retired desk worker tripped rushing up the concrete stairs on his
way to his appointment to come see you, he managed to catch himself
with his hands on the stairs ahead of him but he nows complains of
severe wrist pain & is very apprehensive to move the joint.
- The massage therapist has to utilizes a tool that they don't use on a
daily basis in order to perform a special test... what tool does the
Therapist need?
- What carpal bone is most vulnerable to osteonecrosis?
- Why would this Pt. have an increased risk of this occurring?
- Tuning Fork (helps determine FX)
- Scaphoid = most FX'd carpal
- Type 2 Diabetes = microangiopathy (decrease healing ability with distal
extremities being affected first)
What ligament does the "Skier's Thumb" Test stress?
MCL - ulnar collateral lig. of thumb
What is the other name for Skier's Thumb?
Gamekeeper's thumb
,Finkelstein's Test is used when what pathology is present?
De-Quervain's
- Paratenonitis in the thumb
or Hoffman Disease
- degeneration of nerves (motor nuclei) w-in lower brainstem) & some
motor neurons in SPC (anterior horn cells) leading to mm weakness of
truncal, & extremity mm
Sweater Finger Sign indicates a _________________
Ruptured FDP
Name that test:
- Pt. seated w- FA supinated
- Therapist holds wrist in both hands & applies direct, even pressure over
the ____________ nerve in the carpal tunnel for up to 30 seconds
Carpal Compression Test
- Median Nerve
Positive Test = production of SX indicative of Carpal Tunnel Syndrome
, What nerve is suspected to be paralyzed if a Pt. presents with a positive
Froment's Sign? What mm are affected?
Ulnar Nerve Wrist Palsy
- Hypothenar mm (primarily adductor pollicis)
Are the Pt's palms facing away or toward one another while performing
the Phalen's Test?
What nerve is being compressed?
Palms facing away from each other
- wrist flexion (dorsal surfaces touch)
Median Nerve
What nerve is potentially compressed if a Pt's presents with a positive
Reverse Phalen's Test?
Are the wrists flexed or extended in this test?
Median Nerve
- wrist extension (prayer position)