Level II Upper quadrant
Terms
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C-Spine Osteokinematics SF/Rot
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ipsilateral SF and rotation
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AA arthokinematics flexion / extension
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flexion: posterior glide
extension: anterior glide
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AA Arthrokin lateral translation
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opposite to side of rotation
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AA Arthrokin rotation contralateral
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anterior / inferior glide
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AA Arthrokin rotation ipsilateral
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posterior / inferior glide
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AA Joint Classification
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Sellar
Biconvex
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AA muscles producing ext (4)
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rectus capitus post. min
inferior oblique
splenius
semispinalis capitus all working together
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AA muscles producing flex (2)
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longus capitus, rectus capitus ant maj
- AA Osteokinematics flexion / extension axis
- odontoid C2
- AA Osteokinematics flexion / extension total ROM
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10-30 degrees
- AA Osteokinematics flexion / extension
- rocking
- AA Osteokinematics rotation
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coupled sideflexion
contralateral?
ipsilateral?
- AA Osteokinematics rotation axis
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vertical axis through dens
- AA Osteokinematics rotation ROM
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40-45 degrees
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AA rotation muscles
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obliqus capitus inferior
- AC joint capsular pattern
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pain at extremes or range
- AC joint close pack position
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30 or 90 degrees abd or full elevation
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AC joint resting position
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arm at side supported
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AC joint Osteokin abd / add
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abd / add
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AC Osteokin flex / ext
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elevation depression
- AC Osteokin med / lat rotation
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protraction / retraction
- Accessory Movements abduction
- initial superior, small amount of inf translation
- Accessory Movements ext rotation
- posterior translation
- Accessory Movements extension >35
- posterior translation
- Accessory Movements flexion >55
- anterior translation
- Accessory Movements int rotation
- anterior translation
- Accessory Movements Mid range flex / ext
- No translation
- Acromioclavicular joint classification
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synovial
complex
simple if disc is not there
unmodified ovoid
- Action Latissimus Dorsi (4)
- IR, Add, ext, depression
- Action Lev Scapulae (2)
- elevation, downward rotation
- Action lower trapezius (3)
- depression, upward rotation, retraction
- Action Pec Major (5)
- add, IR, flex, horizontal flex, depression
- Action Rhomboid min / maj (3)
- Retraction, elevation, downward rot.
- Action Serratus anterior (4)
- protraction, upward rotation, depression, elevation
- Action upper trapezius (3)
- elevation, upward rotation, retraction
- Atlanto-Occipital Joint Osteokin Side-flexion
- Swing with contralateral conjunct rotation Axis through the nose
- Atlanto-Occipital Joint Osteokin flexion/extension
- 10 degrees flex 20 degrees ext Axis through earlobe
- Axillary nerve (2)
- Teres minor Deltoid
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C-spine Capsular pattern
- SF>Rot>ext>flex
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C-Spine flexion muscles(3)
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Longus colli, scaleni, SCM Bilat.
- C-spine joint
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z-joint: synovial
uncovertebral joint: fibrous
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C-Spine muscles extension (3)
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trapezius, splenius capitis, semispinalis capitis
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C-Spine muscles side flexion (4) / rotation
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splenius, levator scapulae, longissimus capitis, ipsilateral scalenes
- Cardinal Signs (6)
- Diplopia Drop attacks dysarthria dysphagia cord signs and symptoms cranial nerve signs and symptoms
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CV locking
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sidebend, rotate away
- Dorsal Scapular nerve (2)
- Rhomboid min and maj
- Eliminating the middle ear
- hold head still, rotate the spine beneath it.
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glenohumeral capsular pattern
- external rotation>abd>med rotation
- glenohumeral close pack
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90 abd
lat rotation
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Glenohumeral jt classification
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simple, unmodified ovoid, triaxial
- Glenohumeral neurology peripheral anterior and inferior capsule
- axillary nerve C5, C6
- Glenohumeral neurology peripheral inferior capsule
- Posterior cord of the brachial plexus: C5,C6,C7,(C8)
- Glenohumeral neurology peripheral post and superior capsule
- suprascapular nerve branches:(C4), C5, C6
- Glenohumeral neurology peripheral anterior and superior capsule
- lat pectoral nerve C5,C6,C7
- Glenohumeral neurology segmental
- (C4), C5, C6, (C7,C8)
- glenohumeral resting position
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30 flex
30 abd
30 medial rotation
- Hautard's test
- sit with both arms at 90 degrees flex. Eyes open and closed. check arms. add rotation and or ext.
- Humeroradial close pack position
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90 flex forearm sup 5
90 flex mid pronation
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Humeroradial joint classification
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synovial
compoind
modified ovoid
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Humeroradial resting position
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70 flex
ext with supination
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Humerordial capsular pattern
- flex>ext
- Key muscles
- C1/2-short neck flexors C3/4-shoulder elevation C5-shoulder abduction C6-elbow flex/wrist ext C7-elbow ext./wrist flex C8-thumb ext T1-5th digit abd
- Lateral pectoral nerve (1)
- pec major upper
- Long Thoracic nerve (1)
- Serratus anterior
- Lower subscapular nerve (2)
- subscapularis Teres major
- medial pectoral nerve (2)
- pec major lower pec minor
- Musclucutaneous nerve (3)
- coracobrachilalis Biceps Brachialis
- OA Athrokinematics extension
- anterior glide of Occiput
- OA Athrokinematics Flexion
- Posterior glide of Occiput
- OA athrokinematics sideflexion
- contralateral translation RSF-R ant. L post. LSF-L ant. R post.
- OA muscles causing extension
- rectus capitis post minor superior oblique splenius, semispinalis capitis
- OA muscles causing flexion
- longus capitis rectus capitis ant
- Radial nerve elbow (4)
- Triceps Anconeus Brachialis brachioradialis
- Radial nerve hand (6)
- ext digitorum ext digiti minimi abd pollicis longus ext pillicis brevis ext pollicis longus ext indicis
- Radial nerve wrist (3)
- ext carpi radialis longus ext carpi radialis brevis ext carpi ulnaris
- Reflexes
- C4-lev scap C5-deltoid C5/6-biceps C6-brachioradialis C7-triceps
- Rhomberg's test
- both feet together arms held by side and close eyes
- Rib joint classification
- costovertebral-synovial costotransverse-synovial costochondral-synchondrosis
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SC ant clavicle rotation
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humeral add, ext, lat rot
scapular elevation, protraction, downward rot
sternal exp
head contralateral rot, sf, f
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SC joint capsular pattern
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pain at extreme range
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SC joint classification
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unmodified sellar
complex
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SC joint close pack
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full elevation and protraction
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SC joint resting position
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arm at side supported
- SC post clavicle rotation
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humeral flex 0-60 clavicle elevates
>60 clavicle posteriorly rotates
humeral abd, int rot
sternal isp.
scapular depression,retraction,upward rot
head ips rot,sf,ext.
- Scapular Anterior tilt (1)
- pec min
- Scapular depression (2)
- lower traps lower Serratus ant
- Scapular elevation (5)
- upper traps lev scaps rhomboid min rhomboid maj upper Serratus ant
- Scapular lateral (upward) rotation (3)
- Serratus ant lower fibres of traps upper fibres of traps
- Scapular medial (downward) rotation (4)
- Rhomboids maj rhomboids min middle fibres of traps lev scap
- Scapular Post tilt (1)
- lower fibres of traps
- Scapular protraction (2)
- Serratus ant pec minor
- Scapular retraction (3)
- middle traps rhomboid min rhomboid maj
- Shoulder Abduction (5)
- Deltoids Supraspinatus Infraspinatus Teres Minor Subscapularis
- Shoulder Adduction (6)
- Pec Major Teres Major Coracobrachialis Latissimus Dorsi Triceps Biceps
- Shoulder Extension (4)
- Deltoids (post) Triceps Latissimus Dorsi Teres Major
- Shoulder External Rotation (3)
- Deltoid Teres Minor Infraspinatus
- Shoulder Flexors (4)
- Biceps (long head) Coracobrachialis Deltoids (ant) Pec major
- Shoulder Internal Rotation (4)
- Latissimus Dorsi Pec Major Subscapularis Teres Major
- Stability Testing AA joint
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anterior shear
lateral shear
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Stability Testing OA joint
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anterior shear
posterior shear
lateral shear
compression, traction
- Subclavian nerve (1)
- subclavius
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sup radioulnar joint resting position
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mid position
- superior radioulnar joint classification
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synovial
compound
modified ovoid
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superior radioulnar joint close pack position
- full sup or pronation
- Suprascapular nerve (2)
- supraspinatus infraspinatus
- T-spine classification
- synovial, ovoid and planar
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Ulnohumeral arthrokin extension glide
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post med glide of ulna
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Ulnohumeral arthrokin flexion glide
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ant lat glide of ulna
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Ulnohumeral close pack
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ext with supination
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Ulnohumeral joint capsular pattern
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flex>ext
pronation = supination
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Ulnohumeral joint classification
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compound synovial
modified sellar
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ulnohumeral resting position
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70 flex
10 supination
- Upper subscapular nerve (1)
- subscapularis
- Vertebral artery dissection
- head and neck P unilateral sub occipital sharp and severe Pain acute trauma related stiffness 14 day delay
- Vertebral Artery Testing
- Rotation as far as possible hold 10 sec back to start, hold 10 sec rotate to other side, hold 10 sec Ext. then rotation + extension
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Vertebral Body Landmarks
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C1: mastoid process and angle of mandible
C2:angle of mandible
C3:lateral to hyoid
C4:superior thyroid cartilage
C5:inferior thyroid cartilage
C6:cricoid cartilage
C7:thyroid isthmmus
- vertebrochondral flexion arthrokin costotransverse
- PMS (planar)
- Vertebrosternal extension arthrokin costotransverse
- inferior glide
- Vertebrosternal extension arthrokin vertebrochondral
- ALI
- Vertebrosternal extension arthrokin z-jts
- inferior posterior
- vertebrosternal flexion arthrokin costotransverse t3-7
- superior glide (concavoconvex) spin with ant roll
- vertebrosternal flexion arthrokin z-jts
- superoanterior
- Vestibular testing
- collar or stabilize head and neck, move from ly to sit. If positive, then head and neck not responsible for dizziness
- superior radioulnar jt degrees of freedom
- one
- superior radioulnar jt close pack position
- full pro or sup
- superior radioulnar jt resting position
- 35 supination with elbow flexed to 70
- superior radio ulnar jt capsular pattern
- equal limitation of pronation and supination
- superior radioulnar jt arthrokin
- sup: Aant med glide of radial head pro: PL glide of radial head
- Ulnar (med) collateral lig bands
- ant: taut in ext. post: taut in flex oblique transverse band: not as well developed
- ulnohumeral joint neurology segmental
- C5-T1
- ulnarhumeral joint peripheral
- median: ant capsule ulnar nerve: MCL,postmed capsule Musculocutaneuous: ant capsule radial nerve: post and anterolat capsule
- Ulnohumeral joint Vascular supply
- collalateral branches of brachial wiht radial and ulnar arteries
- Elbow Flexors (7)
- Biceps Brachialis Brachioradialis Pronator teres Flexor carpi radialis Palmaris longus Flexor carpi ulnaris
- Elbow Extension (2)
- Triceps Anconeus
- Elbow Pronation (4)
- Brachioradialis Pronator teres Flexor carpi radialis Pronator quadratus
- Elbow Supination (3)
- Biceps Brachioradialis Supinator
- Humeroradial joints, ligaments
- Radial collateral ligament, lateral ulnar collateral, accessory lateral collateral