Download Chapter 16

Chapter 16
Injuries to the Upper Extremities
Upper Extremity Injuries
• Upper extremities are vulnerable to a
variety of injuries depending on the
sport, including:
– Sprains
– Strains
– Dislocations
– Fractures
2
Upper Extremity Injuries
• Upper extremities are vulnerable to a
variety of injuries depending on the
sport, including:
– Separations to the thoracic cage, shoulder,
arm, and hand
– Repetitive motion injuries such as arthritis,
bursitis, tendonitis
3
Shoulder Complex Physiology
•
•
•
•
•
Bones
Muscles
Ligaments
Tendons
Articulations
4
Assessing Shoulder Injuries
• ROM test for external rotation of the
shoulder
• ROM test for internal rotation of the
shoulder
5
Assessing Shoulder Injuries
• Specific ROM tests for the shoulder
including abduction, flexion, extension,
horizontal adduction
• External muscle tests for the shoulder
6
Assessing Shoulder Injuries
• Internal rotation strength test for the
shoulder
• Extension strength test for the shoulder
• Flexion strength test for the shoulder
• Abduction and adduction strength tests
for the shoulder
• Empty can test
7
Types of Shoulder Injuries
• Fractures
– Perform percussion test, compression test
• Dislocations and subluxations
• Contusions
8
Types of Shoulder Injuries
• Sprains
– Sulcus test, apprehension test for sprain of
the anterior capsule
– Acromioclavicular (AC) sprain test
– Sternoclavicular (SC) sprain test
9
Types of Shoulder Injuries
• Strains
– Drop arm test
• Impingement
– Hawkins-Kennedy test, winged scapula
test
10
Types of Shoulder Injuries
• Tendonitis
– Speed’s test
• Synovitis and bursitis
11
Assessing Elbow
and Forearm Injuries
• Methods to assess elbow and forearm
injuries include:
– ROM test for elbow flexion
– ROM test for elbow extension
– ROM test for elbow supination
– ROM test for elbow pronation
12
Manual Muscle
Tests for the Elbow
•
•
•
•
Flexion strength test
Extension strength test
Supination strength test
Pronation strength test
13
Injuries to the Elbow and Arm
•
•
•
•
Fractures
Dislocations and subluxations
Contusions
Sprains
– Valgus stress test for the elbow
– Varus stress test for the elbow
14
Injuries to the Elbow and Arm
• Impingement
– Tinel’s sign
•
•
•
•
Synovitis and bursitis
Biceps brachii rupture
Epicondylitis
Volkmann’s contracture
15
Physiology of
the Wrist and Hand
• Made up of eight bones
– Carpals, arranged in two transverse rows
• Five metacarpals and digits make up
the hand
16
Assessing
Wrist and Hand Injuries
• ROM test for wrist flexion
• ROM test for wrist extension
• ROM test for finger flexion
17
Assessing
Wrist and Hand Injuries
• ROM test for finger extension manual
muscle tests:
– Extension strength test
– Flexion strength test for the wrist
– Radial deviation strength test for the wrist
– Ulnar deviation strength test for the wrist
– Extension strength test for the fingers
18
Assessing
Wrist and Hand Injuries
• ROM test for finger extension manual
muscle tests:
– Flexion strength test for the fingers
– Abduction strength test for the fingers
– Adduction strength test for the fingers
19
Injuries to the Wrist and Hand
•
•
•
•
Fractures
Dislocations and subluxations
Contusions
Sprains
– Gamekeeper’s thumb test
• Impingement
20
Injuries to the Wrist and Hand
•
•
•
•
Tendonitis
Ganglion cyst of the wrist
Mallet finger
Buttonhold deformity
21