Lab #1 and #2 Notes - Goniometry and Upper Quarter Screen PDF

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Goniometry and Upper Quarter Screen...

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Lab #1 and #2 – Goniometry and Upper Quarter Screen: Goniometry –  the measurement of angles created at human joints by the bones of the body  may be used to determine both a particular joint position and the total amount of joint motion available  anatomy of the goniometer: o moving arm o stationary arm o fulcrum  uses: o post-operative ROM assessment o immobilization o tight musculature  common mistakes: o fulcrum moves during ROM o inconsistent alignment o reading the goniometer incorrectly o sloppy measurements o not documenting the results Range of Motion (ROM) –  arc of motion that occurs at a joint or series of joints  the starting position is usually in the anatomical position  the anatomical position is usually termed as 0 degrees o if 0 degrees cannot be reached, not the new starting position and reasoning Positioning –  start with anatomical position when necessary  use the same starting position every time you test that joint or person  the test must be done bilaterally and in both AROM and PROM Alignment –  use body anatomical landmarks to align the arm of the goniometer both proximal and distal o few exceptions  the landmarks are universal and should be used whenever possible Upper Quarter Neurologic Screening –  roots  trunks  divisions  cords

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terminal nerves/branches neuro assessment o nerves do:  motor  sensory  reflex o assess:  myotomes  break tests of: o C4 = shoulder shrug o C5 = GH abduction o C6 = elbow flexion o C7 = elbow extension o C8 = thumb/pinky opposition o T1 = finger abduction/adduction  dermatomes  an area of skin innervated by one spinal cord segment  there is overlap between adjacent dermatomes  follow established nerve root patterns: o general senses  touch  light/superficial  deep pressure  vibration  sharp/dull  heat/cold  thermo/cryo  2-point discrimination o normal is 4-5 mm o can feel two distinct points  reflexes  C5 = biceps brachii o at distal bicep tendon  C6 = brachioradialis o at distal tendon or belly of muscle  C7 = triceps brachii o at distal tendon (just proximal to olecranon)  deep tendon reflex (DTR) o 0 = no response o 1 = hyporeflexia o 2 = normal o 3 = hyperreflexia o 4 = hyperactive clonus

Injury to the Brachial Plexus –  commonly referred to as a stinger or burner  differentials: o cervical sprain/strain and fracture  worsened by spinal stenosis  MOI: o #1 = traction o #2 = compression o tackle with head forced to the side and shoulder depressed o most likely to injure?  lateral and posterior cord (C5 and C6)  signs and symptoms: o body posture o burning o numbness o shooting pain o “feels like someone poured hot water down my arm”  circulatory exam: o brachial pulse (medial elbow under bicep tendon) o radial pulse (medial to radius) o capillary refill (1-2 seconds)...