Quiz: Upper Extremity and Shoulder Girdle

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Question 1 of 23

1. Question
Scar tissue management may be necessary post-surgically, even if the surgery was successful to repair the involved structure.
- True
- False
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Question 2 of 23

2. Question
The edge of the instrument must be the first part of the instrument to contact the patient’s skin.
- True
- False
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Question 3 of 23

3. Question
Dysfunctional tissue has an altered texture, which will be felt through the instruments if the edge of the instrument is applied at the correct angle.
- True
- False
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Question 4 of 23

4. Question
The ideal treatment angle for the instruments is 45o or less, to allow the instrument to glide smoothly over the skin.
- True
- False
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Question 5 of 23

5. Question
During the first Astym treatment, you should increase the number of strokes and the duration of treatment if your patient is tolerating the treatment well.
- True
- False
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Question 6 of 23

6. Question
Dysfunctional tissue is common at areas of interface or intersection, where two or more muscles come together or cross.
- True
- False
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Question 7 of 23

7. Question
With Astym, every evaluation is a treatment and every treatment should be an evaluation (or reevaluation).
- True
- False
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Question 8 of 23

8. Question
If fibrosis is found in the muscle belly, it will commonly be found at the proximal and distal insertions of the muscle as well.
- True
- False
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Question 9 of 23

9. Question
Scar tissue management may be necessary post-surgically, even if the surgery was successful to repair the involved structure.
- Too slow or too firm: extreme discomfort for patient or excessive bruising
- Too fast or too light: missed detection and insufficient stimulation of dysfunctional tissue
- Abrupt initiation and stopping of strokes: patient discomfort and bruising
- All of the above
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Question 10 of 23

10. Question
The middle digit test is a lateral epicondylopathy test based on the distal insertion and action of which muscle?
- ECRB
- ECRL
- FCU
- LMNOP
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Question 11 of 23

11. Question
The dorsal wrist will often have fibrosis in which of the following diagnosis(es)?
- DeQuervain’s
- Lateral epicondylitis
- Wrist fractures, sprains, or crush injuries
- All of the above
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Question 12 of 23

12. Question
Which of the following structures are included in the Astym kinetic chain treatment for carpal tunnel syndrome? (mark all that apply)
- Upper arm (biceps/triceps, etc)
- Flexor tendons
- Flexor retinaculum
- Thenar eminence
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Question 13 of 23

13. Question
If an Astym therapy patient is not responding during the course of treatment, which of the following may be appropriate? (mark all that apply)
- Check for trigger points
- Check entire kinetic chain, including proximal structures
- Dig deeply into site of pain with instruments, even if fibrosis is resolved
- Refer to physician if symptoms still persist after reassessment
- Anti-inflammatory modality or injection at most tender point
- Give them a week to 10 days without Astym treatment to heal
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Question 14 of 23

14. Question
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Question 15 of 23

15. Question
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Question 16 of 23

16. Question
Which stretches would be most appropriate?
- Biceps
- Wrist flexor
- Wrist extensor
- Pronator (into supination)
- All of the above
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Question 17 of 23

17. Question
Astym treatment of this patient in the second treatment should cover:
- Areas of dysfunctional tissue only
- Flexor side only
- Extensor side only
- Entire upper extremity
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Question 18 of 23

18. Question
At the end of the first treatment, grip strength improves 10 pounds. This can probably be attributed to:
- The instruments stimulate enhanced myofibril cross-linkage and ATP utilization.
- Neuromotor stimulation and decreased pain-inhibition.
- Immediate mechanical breakdown of scar tissue, and new collagen synthesis.
- An increase in the cross-sectional area of the involved muscles resulting from the exercises.
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Question 19 of 23

19. Question
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Question 20 of 23

20. Question
Where would you expect the primary dysfunctional tissue to be?
- Anatomical snuffbox and APL/EPB tendons
- Thenar eminence
- ECRB proximal and distal
- Dorsal wrist/extensor retinaculum
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Question 21 of 23

21. Question
If it is up to you to decide his work status with regards to his symptoms, which of the following would be your recommendation as you treat him with Astym therapy?
- Off work completely until he is symptom free
- Light duty no matter what his symptoms are until he is symptom free
- Full duty if he is only experiencing soreness during work or light duty if he has sharp pain during required regular work activities
- Full duty no matter what his symptoms are
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Question 22 of 23

22. Question
If he is now pain-free and you are ready to discharge him, which of the following is the best choice regarding his stretching program?
- He can discontinue all stretching since he is pain-free
- He should stretch only if he starts to feel symptoms
- He should continue to stretch regularly as long as he is performing the same job activities that initiated the problem
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Question 23 of 23

23. Question
Great toe extension of 60-70 degrees is needed to allow normal tibial advancement at heel off.
- True
- False
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Quiz: Upper Extremity and Shoulder Girdle

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