Hypermobility and Joint Instability Quiz
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Questions and Answers

Which symptom is NOT typically associated with joint instability?

  • Chronic joint pain
  • Poor proprioception
  • Neuropathic symptoms
  • Uterine prolapse (correct)

What complication is related to the influence of progesterone?

  • Enhanced proprioception
  • Reduced menstrual pain
  • Worsening musculoskeletal symptoms (correct)
  • Improved joint stability

Which factor is linked to the chronic pain syndrome due to hypermobility?

  • Strong proprioception
  • Stable connective tissue
  • Multiple fractures (correct)
  • Increased joint stability

Which of the following is a potential consequence of pelvic floor weakness?

<p>Chronic bladder inflammation (D)</p> Signup and view all the answers

What is a common characteristic of symptoms linked to chronic fatigue in this context?

<p>Poor response to local anaesthetic (C)</p> Signup and view all the answers

What is a characteristic of constitutional hypermobility?

<p>It can be asymmetrical and affects the whole body. (C)</p> Signup and view all the answers

Which of the following groups is most likely to be hypermobile?

<p>Individuals involved in physical disciplines like dance and gymnastics. (B)</p> Signup and view all the answers

Which condition is classified under symptomatic hypermobility?

<p>Ehlers-Danlos syndrome. (A)</p> Signup and view all the answers

What is a common characteristic of asymptomatic hypermobility?

<p>Many individuals may not experience significant symptoms. (C)</p> Signup and view all the answers

What triggers compensational hypermobility?

<p>Injury or mechanical decrease in range of motion in one segment. (A)</p> Signup and view all the answers

What indicates hypermobility in the neck rotation test?

<p>Range of motion greater than 90° (B)</p> Signup and view all the answers

During the scarf test, what is the positioning of the elbow?

<p>Elbow in a vertical axis (C)</p> Signup and view all the answers

What signifies hypermobility in the Apley’s Scratch Test?

<p>Palms crossing each other (B)</p> Signup and view all the answers

What is the expected range of motion for the neck rotation test in a normal individual?

<p>Around 80° (C)</p> Signup and view all the answers

What should be tested on both sides during the Apley’s Scratch Test?

<p>Shoulder flexibility (B)</p> Signup and view all the answers

What is the minimum angle at which hypermobility is indicated for the extended elbows test?

<p>110° (D)</p> Signup and view all the answers

During the Facing Hands test, what is the requirement for hypermobility?

<p>Palms must fully touch at 90° DFL (B)</p> Signup and view all the answers

What position of the fingers is required during the Facing Fingers test for hypermobility assessment?

<p>Fingers must be in one axis with touching (D)</p> Signup and view all the answers

What should be the condition of the pelvis in the Heel Sitting test to indicate hypermobility?

<p>Pelvis significantly lower than ankle line (C)</p> Signup and view all the answers

In the Lateroflexion test, what is a crucial aspect to observe apart from the reach of the fingers?

<p>Presence of lateral pelvic shift (C)</p> Signup and view all the answers

What is the maximum score achievable on the Beighton scale?

<p>9 points (A)</p> Signup and view all the answers

Which joint movement is NOT assessed in the Beighton score?

<p>Shoulder abduction beyond 90° (B)</p> Signup and view all the answers

What does a Beighton score of 5/9 indicate?

<p>Significant hypermobility concerns (C)</p> Signup and view all the answers

Which condition is associated with excess stretch marks and scarring?

<p>Cardiovascular dysautonomia (A)</p> Signup and view all the answers

What additional health issue can stem from mechanical and neuropathic bowel dysfunction?

<p>Spontaneous rupture of viscera (C)</p> Signup and view all the answers

Which of the following statements about the Beighton score is true?

<p>It assesses a limited number of joints. (B)</p> Signup and view all the answers

What cardiovascular symptoms are associated with dysautonomia?

<p>Hypotension and tachycardia (B)</p> Signup and view all the answers

Which is a test maneuver included in the Beighton scale for scoring?

<p>Passive dorsiflexion of the little fingers (B)</p> Signup and view all the answers

Flashcards

Hypermobility

A condition where joints can move beyond their typical range of motion.

Constitutional Hypermobility

A type of hypermobility affecting the entire body, but not necessarily equally on the upper and lower parts. Often uneven.

General Pathological Hypermobility

Hypermobility caused by neurological disorders, like tabes dorsales, Down syndrome, or central nervous system issues.

Posttrauma and Compensational Hypermobility

Hypermobility that happens as a result of injury to a joint or compensation for reduced range of motion in another joint.

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Asymptomatic Hypermobility

People with hypermobility who experience no significant symptoms.

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Recurrent Joint Injuries

Repeated injuries to joints, ligaments, tendons, and surrounding tissues that can lead to widespread pain, instability, and limitations in daily activities.

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Joint Hypermobility

The condition where joints are abnormally flexible and can move beyond their normal range. This can lead to joint instability, pain, and an increased risk of injury.

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Chronic Pain Syndrome

A chronic condition characterized by persistent pain, fatigue, and other symptoms often associated with joint hypermobility. It may require special treatments for management.

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Joint Subluxation/Dislocation

The condition where a joint pops out of its socket, often due to joint hypermobility and instability. It can cause severe pain and limit movement.

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Neuropathic Pain

A type of pain caused by damage to nerves, often associated with joint hypermobility and increased risk of injury. It can cause tingling, numbness, or burning sensations.

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Beighton Score

A system used to assess joint hypermobility by measuring specific ranges of motion.

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Hypermobility Score

A Beighton score of 5/9, 6/9, or a modified score of 3/9 suggests generalized hypermobility.

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Hypermobility Spectrum

Conditions accompanying hypermobility, such as cardiovascular symptoms, bowel issues, and skin changes.

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Cardiovascular Symptoms in Hypermobility

Heart-related issues like rapid heartbeat, low blood pressure, and fainting, often seen in hypermobility.

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Mechanical and Neuropathic Bowel Dysfunction in Hypermobility

Digestive problems like hernias, reflux, constipation, and inflammation, often associated with hypermobility.

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Skin Issues in Hypermobility

Skin issues like scarring and stretch marks, commonly seen in individuals with hypermobility.

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Eye Problems in Hypermobility

Eye conditions like cataracts and retinal detachment, sometimes found in people with hypermobility.

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Neck Rotation Test

A test assessing joint mobility by measuring the range of motion of the neck. Normal range is 80 degrees. Hypermobility is indicated by a range greater than 90 degrees, with potential for further passive extension.

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Palm-to-Scapula Test

A test evaluating shoulder joint flexibility by reaching across the body with the elbow extended, attempting to touch the opposite shoulder blade. It assesses the internal and external rotation of the shoulder.

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Apley's Scratch Test

A test assessing shoulder mobility by measuring the ability to reach the opposite shoulder with the fingertips. Normal range allows fingertips to touch. Hypermobility allows the hand to cover the shoulder blade.

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Flexion Test (Thomayer Test)

A test evaluating joint mobility by measuring the ability to bend forward and touch the floor with the fingers. Hypermobility allows the palms to reach beyond the feet.

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Heel Sitting Test

A test assessing joint mobility by measuring the ability to sit with crossed legs, with the heels touching the buttocks. Hypermobility allows the person to sit with the feet flat on the ground.

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Extended Elbows Test

A test assessing elbow extension. A healthy individual can extend their elbows to at least 110 degrees from fully flexed. Hypermobility is indicated if they can exceed this amount, even beyond 110 degrees.

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Facing Hands Test

A test assessing wrist dorsiflexion, where individuals should be able to achieve a 90 degree angle. Hypermobility is identified if they exceed this angle.

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Facing Fingers Test

A test for hypermobility in the fingers, using an 80 degree MCP joint (metacarpophalangeal) angle as the benchmark. Hypermobility is indicated if they can exceed this angle.

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Thomayer Test

A test for hypermobility in the spine involving a 'bend-and-reach' movement. It assesses whether the individual can touch their toes with bent knees. Hypermobility is identified if the bend is not happening in all segments of the spine.

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Lateroflexion Test

Assess flexibility of the spine by checking if the line between the axilla (armpit) and the intergluteal gap (between the buttocks) is straight. Any lateral pelvic shift, rotation, or excessive flexion that deviates from a straight line is a sign of hypermobility.

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Study Notes

Hypermobility Overview

  • Hypermobility is a condition where the range of motion (ROM) in a joint exceeds the typical range.
  • It affects approximately 1 in 10 people.
  • It's more common in women and children, and individuals of Afro-Caribbean and Asian descent.
  • Hypermobility can be asymptomatic (no noticeable symptoms) or symptomatic.
  • Gymnasts, athletes, dancers, and musicians are more susceptible due to repetitive movements and training.

Hypermobility Types

Constitutional Hypermobility

  • Involves the whole body, but deficits aren't necessarily equal in upper and lower halves.
  • Asymmetry is common.
  • Crucial to assess the extent and choose the correct approach to treatment.
  • Neurological disorders (e.g., tabes dorsales, Down syndrome) sometimes cause hypermobility.

Post-traumatic/Pathological/Compensational Hypermobility

  • Hypermobility in a specific joint might lead to adjustments in surrounding joints for compensation.
  • Mechanical restrictions in one area (decreased ROM) necessitates compensatory adjustments in others.

Symptomatic Hypermobility

  • Involves specific heritable connective tissue disorders, e.g., Ehlers-Danlos syndromes, Marfan syndrome, Stickler syndrome, osteogenesis imperfecta, plus other conditions
  • Other causes include joint shape, loose ligaments, or muscle tone deficiencies (without connective tissue disorders) and conditions like Down syndrome and cerebral palsy.
  • Injury or repetitive stretching/training (yogis, gymnasts, and dancers) can contribute to symptomatic hypermobility

Hypermobility Symptoms & Concerns

  • Musculoskeletal symptoms (acute and chronic pain, joint instability, injury). Joint pain is an important symptom
  • Chronic pain syndromes and chronic fatigue syndrome.
  • Cardiovascular symptoms, dysautonomia (tachycardia, hypotension, syncope).
  • Mechanical and neuropathic bowel dysfunction (hernia, reflux, poor bowel movements, constipation, chronic inflammation, mast cell activation)
  • Poor wound healing, thin or atrophic scarring, excessive stretch marks, eye problems like cataracts or retinal detachment.
  • Possible complications of pregnancy on musculoskeletal and pelvic systems, as well as psychological anxiety.
  • Hypermobility itself can explain poor response to local anesthetic
  • Possible pelvic floor weakness/prolapse and chronic bladder inflammation
  • Additional concerns include muscle weakness, poor posture and general aches and pains.

Janda's Hypermobility Tests

  • Neck rotation: Normal range is 80 degrees; hypermobility is greater than 90 degrees, possibly affecting the entire cervical spine.
  • "Scarf" test: Elbow positioning and finger contact to assess hypermobility, possible scapular elevation during the test.
  • Internal-External Rotation (Apley's Scratch Test): Evaluates shoulder and rotator cuff flexibility.
  • Palm-to-Scapula Test: Hand contact with opposite shoulder girdle to assess shoulder flexibility.
  • Extended Elbow Test: Extends elbows beyond 110 degrees.
  • Facing Hands Test: Wrist and potential hypermobility beyond 90 degrees.
  • Facing Fingers Test: MCP joint tests possible hypermobility.
  • Thomayer Test: Determines the degree of flexion across the segments. Look for bending issues if abnormal
  • Lateroflexion Test: assesses posture based on the positioning of the axilla and intergluteal area. Important to look for lateral shifts of the pelvis during testing
  • Heel Sitting Test: Evaluates pelvis position relative to the ankle line; possible trunk flexion or issues.
  • Additional tests: Specific joint motions, like Apley's scratch test for the shoulder, assessing various joint motions, were also described.

Beighton Score

  • A scoring system used to assess joint hypermobility.
  • Involves 5 maneuvers (finger, thumb, elbow, knee, spine) and evaluates the degree of hypermobility (range of motion beyond the norm).

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Hypermobility Testing PDF

Description

Test your knowledge on hypermobility and its related symptoms, complications, and consequences. This quiz covers various aspects of joint instability and chronic pain syndromes associated with hypermobility conditions. Challenge yourself to identify characteristics and factors influencing this complex topic.

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