3. Back & Hip Tests & Disorders Flashcards Preview

Physical Assessment > 3. Back & Hip Tests & Disorders > Flashcards

Flashcards in 3. Back & Hip Tests & Disorders Deck (119):
1

Straight Leg Raise Test

Assesses for sciatica; passively flex hip w/ knee straight; lower leg slightly; dorsiflex (+) finding is pain in sciatic n. at any point

2

Opposite Straight Leg Test

Assesses for sciatica in opposite leg; passively flex unaffected hip with straight knee

3

Hoover Test

Tests for fakers; should feel pressure from opposite foot when asking patient to raise a leg

4

Patrick's Test

Tests SI joint, Adductor muscle tightness; Ligament tightness

5

Pelvic Rock Test

Tests for pelvic fracture; Providers hands on ASIS bilat; press inward then down & out; (+) = pain with minimal pressure

6

Beevor's Sign

Tests abdominal muscle weakness; observe umbilicus during crunch. (+) = umbilicus moves to stronger, uninvolved side

7

Trendelenburg Test

Tests for weak glut medius; Patient stands on one leg; (+) on weight-bearing leg if opposite hip drops

8

Ober Test

Test for IT band tightness; Pt in lat decub on unaffected side, passively flex knee to 90, abduct hip, release leg; (+) = leg does not drop

9

Modified Ober Test

Test for IT band tightness; Pt in lat decub on unaffected side, passively flex knee to 90, abduct & extend hip, release leg; (+) = leg does not drop

10

Piriformis Test

Test for piriformis strain or tightness; Pt in lat decub on unaffected side; knee flexed; passively adduct hip & press medially; (+) pain at location of piriformis

11

Femoral Nerve Test

Pt in lat decub on unaffected side; passively extend hip and flex knee to 90 to stretch femoral n. (+) = pain or paresthesias along femoral n.

12

Thomas Test

Test for tight hip flexors; pt supine, actively flex one hip & knee to chest & hold; (+) = extended leg flexes off table

13

Kendell Test

Test for tight rectus femoris; pt supine with one glut off table, actively hug both knees to chest, drop one leg off table; (+) = hanging leg straight at knee

14

Nobel's Test

Test for IT band syndrome; pt supine with knee flexed, apply pressure lat to knee while extending; (+) = pain experienced at IT band at 30 flexion

15

Renne's Test

Test for IT band syndrome; pt stands on affected leg, actively flexes to 30-40; (+) = pain experienced at IT band at 30 flexion

16

Low Back Muscle Strain – Mechanism

Mechanism = forceful contraction or overstretch

17

Low Back Muscle Strain – S/Sx

S/Sx = Pain, edema, muscle spasm, RoM affected depends on muscle

18

Low Back Ligament Sprain – Mechanism

Mechanism = Sudden hyperextension w/ trunk rotation; faulty posture

19

Lumbar Disc Herniation

Intervertebral disc bulges or ruptures; places pressure on spinal nerves exiting intervertebral foramen

20

Lumbar Disc Herniation – Protrusion

Disc bulges posteriorly or laterally; no rupture

21

Lumbar Disc Herniation – Prolapsed

Outermost fibers of Anulus contain nucleus pulposis

22

Lumbar Disc Herniation – Extrusion

Anulus perforated, portion of nucleus moves into epidural space

23

Lumbar Disc Herniation – Sequestrated

Nucleus pulposis outside of disc

24

Spina Bifida

Birth defect; lack of fusion of neural arch of one or more vertebrae; weakness in region; Possible loss of stability due to muscle and ligament attachment; spinal cord may protrude

25

Sacroiliitis

Inflammation of SI joint; excessive movement of joint; common in pregnancy; point tender at SI joint; pain with sitting on hard surface; pain with lying on supine on hard surface; pain-free when standing

26

Spondylosis

Degeneration of intervertebral disc

27

Spondylolysis

Scottie Dog Fracture/Stress fracture; Defect in articular processes of vertebra (fx); Repeated hyperextension & hyperflexion; L5-S1; L4-L5; possibly asymptomatic; Unilateral LBP, radiates to opposite side; increased pain with lat rot, limited ext

28

Spondylolisthesis

Scottie Dog Decapitated; Forward slippage of superior vertebra on inferior one; Radiating LBP; Limited hip flexion, trunk ext

29

Ankylosing Spondylitis

Fusion of cervical vertebrae & SI joint; Males 20-40 yrs; Genetic; Achilles tenosynovitis; Uveitis

30

Cauda Equina Syndrome

Saddle anesthesia; buttocks, posterior upper & lower legs; paralysis; bladder & bowel incontinence

31

Hip dislocation

Joint very stable; occurs when knee is flexed; posterior (90%)

32

Anterior hip dislocation

10% of hip dislocations; Leg shortened; ABD; flex; ER; Medical emergency due to potential FEMORAL NERVE damage

33

Posterior hip dislocation

90% of hip dislocations; MVA most common mechanism; HIP & KNEE FLEXED WITH IR & ADD; SCIATIC NERVE DAMAGE POSSIBLE

34

Congenital Hip Dislocation

Born with dislocation; Galeazzi's Sign

35

Galeazzi's Sign

Knee lower on dislocated side when placed on firm surface with hips and knees flexed; indicative of congenital hip dislocation

36

Ortolani's Sign

Passively abd hip; (+) = click palpable or audible due to reduction; sign of congenital hip dislocation

37

Hip fracture – Location

1) femoral neck; 2) Intertrochanteric line

38

Hip fracture – Mechanism

Mechanism = Trauma, twisting

39

Hip fracture – S/Sx

Pain in groin, anterior thigh; Loss of IR; Hip held in ER; Shock likely

40

Slipped Capital Femoral Epiphysis

BOYS 10-17 YRS.; slipping of epiphyseal line due to prolonged stress; Limping in ER; Affected limb is shorter; Limited ABD, FLEX, IR; No Hx of injury; pain in groin, ant thigh, and referred to knee

41

Slipped Capital Femoral Epiphysis – Complication

Avascular necrosis; cell death due to lack of O2

42

Legg-Hipp-Perthes Disease

BOYS 3-12 YRS; blood supply to femoral head is interrupted & avascular necrosis develops; flattening of articular cartilage; necrosis of tissue; UNEXPLAINED LIMP; SHORTENED LIMB; DECREASED HIP ROM; pain in groin and ant thigh; Pain referred to abdomen or knee

43

Ischial bursitis – Mechanism

Overuse; direct trauma; SITTING ON HARD SURFACE FOR EXTENDED PERIOD OF TIME; falling on butt

44

Ischial bursitis – S/Sx

Point tender; pain with extension

45

Trochanteric Bursitis – Mechanism

Overuse, direct trauma, SYSTEMIC INFECTION

46

Trochanteric Bursitis – S/Sx

Pain, edema, crepitus, decrease abduction

47

Gluteus Max Strain – Mechanism

Forceful contraction, overstretching;

48

Gluteus Max Strain – S/Sx

S/Sx = Hx of sudden sharp pain & weakness; pain; decrease RoM w/ extension; point tender; may palpate defect

49

Hip flexor strain – muscles

Iliopsoas; Rectus femoris

50

Groin Strain – muscles

Adductors; Gracilis

51

Gluteus Medius strain – S/Sx

Point tender; REFERRED PAIN INTO GLUTS; (+) Trendelenburg

52

Piriformis Strain

SI joint pain; gluteal pain which radiates down back of thigh into gastroc

53

Sciatica – S/Sx

S/Sx = Pain in sciatic notch; Radiates down leg;

54

Sciatica – Mechanism

Mechanism = Direct blow to nerve; COMPRESSION DUE TO PIRIFORMIS MUSCLE STRAIN

55

Contusion – Mechanism

Mechanism = Direct blow

56

Contusion – S/Sx

S/Sx = Pain, edema, ecchymosis

57

Contusion complication

Myositis ossificans

58

Common contusion areas

Greater trochanter; Crest of ilium; Coccyx

59

Sprains – Mechanism

Mechanism = Violent twist; external blow; foot planted & trunk forced in opposite direction

60

Sprains – S/Sx

S/Sx = Pain w/ add, abd, flex; inability to circumduct leg

61

Lateral Femoral Cutaneous Nerve Impingement

Nerve impinged; numbness anterior, lateral thigh; Direct blow, edema, trauma

62

Osteoarthritis

>50 yrs; pain in groin, referred to knee; pain with activity; stiffness,edema, limping; Held in ER

63

Biceps – Nerve & Nerve root for DTRs

Musculocutaneous – C6

64

Brachioradialis – Nerve & Nerve root for DTRs

Musculocutaneous – C6

65

Triceps – Nerve & Nerve root for DTRs

Radial – C7

66

Patellar – Nerve & Nerve root for DTRs

Femoral – L4

67

Achilles – Nerve & Nerve root for DTRs

Tibial/Sciatic – S1

68

Trapezius - Myotome

C4

69

Deltoid – Myotome

C5

70

Biceps – Myotome

C6

71

Triceps – Myotome

C7

72

Finger flexors – Myotome

C8

73

Finger abductors – Myotome

T1

74

Thumb opposition – Myotome

T1

75

Quadriceps – Myotome

L4

76

Great toe extension – Myotome

L5

77

Gastrocnemius – Myotome

S1

78

Rectal sphincter – Myotome

S3/4

79

Posterior upper head - Dermatome

C2

80

Tip of shoulder – Dermatome

C5

81

Thumb – Dermatome

C6

82

Middle finger – Dermatome

C7

83

Little finger – Dermatome

C8

84

Nipples – Dermatome

T4

85

Umbilicus – Dermatome

T10

86

Groin – Dermatome

L1

87

Medial knee – Dermatome

L3

88

Ant. Knee & Med. ankle – Dermatome

L4

89

Great toe, dorsum of foot – Dermatome

L5

90

Lat. Ankle & Little toe – Dermatome

S1

91

Heel & Plantar – Dermatome

S2

92

Perianal area – Dermatome

S5

93

Light touch spinal tract

Dorsal column

94

Tactile discrimination

Dorsal column

95

Pressure/Deep Touch

Ant. Spinothalamic

96

Vibration

Dorsal column

97

Joint position

Dorsal column

98

Pain

Lat. Spinothalamic

99

Temperature

Lat. Spinothalamic

100

Balance, Proprioception

Spinocerebellar

101

Somatosensory pathway

Sensory stimulus > SC/Brainstem > Thalamus

102

1st Order Neurons

Peripheral nerves to medulla

103

2nd Order Neurons

Medulla to thalamus

104

3rd Order Neurons

Thalamus to cerebrum

105

1st Order Neurons – Dorsal Column

Ipsilateral; lesion of spinal nerves or spinal tract

106

2nd Order Neurons – Dorsal Column

Contralateral; Medulla > crossover > thalamus

107

3rd Order Neurons – Dorsal Column

Contralateral; Thalamus > Sensory cortex > Postcentral (upper limbs) & paracentral (lower limbs) gyrus

108

1st Order Neuron – Spinothalamic

Ipsilateral; SC > Dorsal horn

109

2nd Order Neuron – Spinalthalamic

Contralateral; Dorsal horn SC > crossover > Spinalthalamic tract to thalamus

110

3rd Order Neuron – Spinalthalamic

Contralateral; Thalamus > Sensory cortex

111

Lesion in Spinal Nerve – Dorsal Column

Ipsilateral impairment

112

Lesion in Spinal Nerve – Spinothalamic

Ipsilateral impairment

113

Lesion in SC Tract – Dorsal Column

Ipsilateral impairment

114

Lesion in SC Tract – Spinothalamic

Contralateral impairment

115

Motor Pathway

Corticospinal tract

116

Lesion in Spinal Nerve – Corticospinal tract

Ipsilateral impairment

117

Lesion in SC Tract – Corticospinal tract

Ipsilateral impairment

118

Signs of Lower Motor Neuron Lesion

Decreased muscle tone (flaccidity); Decrease or absent DTR

119

Signs of Upper Motor Neuron Lesion

Increased muscle tone (spasticity); Increased DTR or clonus