Upper Extremity Treatment Protocols Flashcards

In ART for trigger finger (stenosing tenosynovitis), the primary target is the A1 pulley at the:

Answer: Metacarpophalangeal joint

The A1 pulley overlies the MCP joint and is the most common site of triggering where the flexor tendon catches.

When applying ART to the extensor carpi ulnaris (ECU) for ulnar-sided wrist pain, the motion used to lengthen the tendon is:

Answer: Wrist flexion and radial deviation with forearm pronation

Wrist flexion and radial deviation with pronation lengthens the ECU from its origin to insertion against the ART contact.

Which clinical sign, when positive, best directs the ART practitioner to treat the median nerve at the pronator teres rather than at the carpal tunnel?

Answer: Relief of symptoms with forearm in supination and elbow extended

Symptoms improving with supination and elbow extension reduces pronator teres compression, indicating proximal entrapment rather than carpal tunnel.

In ART, the 'nerve mobilization' technique for the radial nerve at the lateral elbow requires the patient to perform which combination of movements?

Answer: Shoulder internal rotation, elbow extension, wrist flexion, and ulnar deviation

Radial nerve neurodynamic mobilization uses shoulder internal rotation, elbow extension, forearm pronation, wrist flexion, and ulnar deviation to tension the nerve.

When treating the supinator with ART for posterior interosseous nerve entrapment, the forearm is moved from supination to pronation with the elbow in what position to maximally stretch the muscle?

Answer: Fully extended

Elbow extension with forearm pronation maximally stretches the supinator as elbow flexion allows the biceps to assist and reduces supinator elongation.

Which ART treatment sequence is recommended for a patient presenting with combined carpal tunnel syndrome and pronator teres entrapment of the median nerve?

Answer: Treat pronator teres first to restore proximal mobility before distal release

ART principles recommend treating the most proximal entrapment first to restore nerve mobility before addressing distal entrapment sites.

In ART treatment of the wrist extensor tendons, which hand position during pin-and-stretch most effectively isolates the ECRL from the ECRB?

Answer: Full wrist extension with index finger extension

The ECRL primarily extends and radially deviates the wrist and is most active with index finger extension, helping isolate it from the ECRB.