Clinical Science 3

Question 1

Schober’s test =

Answer 1

• Schober’s test assesses the amount of lumbar Flexion (limited)
• A markis made at the level of the posterior iliac spine on the vert column, ( aprox L5)
• Therapist then places one finger 5cm below this mark, adn another finger 10 cm above the mark
• Pt actively touches toes
• iF the increase in distance between the two fingers on the Pt’s spine is less than 5cm, this indicates limited lumbar Flexion

Question 2

Hoover’s Test =

Answer 2

Malingering Test

Question 3

Cervical spine loose packed position:

Answer 3

Midway between Flexion & Extension

Question 4

Cervical spine close pack position:

Answer 4

Extension

Question 5

Thoracic & Lumbar spine loose pack position:

Answer 5

Midway btw Flexion & Extension

Question 6

Thoracic and Lumbar closed pack position:

Answer 6

Extension

Question 7

Which way does the cervical/t-spine vertebrae translate on right side Flexion?

Answer 7

Side bending is coupled with axial rotation on the SAME side

Question 8

Which way do lumbar vertebrae translate on right side Flexion?

Answer 8

Side bending is coupled with axial rotation in the OPPOSITE side

Question 9

Cervical Spine ligaments that we test:

Answer 9

Alar, Transverse, Apical

Question 10

Most Common direction of disc Herniation:

Answer 10

Posterolateral

Question 11

S/sx of a slipped disc include:

Answer 11

P and numbness, MC on one side of the body
P that extends to your arms and/or legs
P that worsens at night
P that worsens after standing/sitting
P when walking short distances
Unexplained mm weakness
Tingling, aching, or burning sensations in the affected area

Question 12

Nerve that passes between L4 and L5

Answer 12

L5

Question 13

L5 nerve impingement =

Answer 13

Foot drop

Question 14

If the L5 near root is impinged, where is the impingement located?

Answer 14

Between L4 and L5

Question 15

If S1 nerve root is impinged, where is the impingement?

Answer 15

L5/S1

May cause loss of the ankle reflex

Question 16

Common S/sx assoc. with Facet lock / Facet jt pain :

Answer 16

• Mm spasm which can pull the spine out of alignment adn cause back pain
• Often Pt’s will report just bending over to tie shoes, adn suddenly not being able to take move
• The usual acute joint attack of back pain involving facet joint occurs suddenly with no warning

Question 17

Piriformis Syndrom:

Answer 17

• Pain behind hip adn buttocks
• Electric shock pains traveling Down the back of the lower extremity
• numbness in the lower extremity
• tenderness with pressure on the piriformis mm (often causes Pain when sitting on hard chairs)

Question 18

BAck strain S/Sx

Answer 18

Pain that worsens with movement
Mm cramping/spasm
Sudden uncontrolled mm contractions
Decreased function and/or ROM of joint
Difficulty walking, bending forward/sideways, standing straight

Question 19

Lumbago:

Answer 19

Pain in the mm joints of the low back

Question 20

Rule of 3 in the T-spine

Answer 20

T 1-3. T12. SAME

T 4-6. T11. 1/2 segment ABOVE

T 7-9. T10. Full segment ABOVE

Question 21

SPondyllisthesis

Answer 21

Forward displacement of the vertebra, especially L5

MC occurs after break or Fx

Backward displacement = Retrolisisthesis

Question 22

Spondylolysis

Answer 22

Defect of the Pars Interarticularis of the vertebral arch

Question 23

Spondylitis

Answer 23

INflammation of the joints of the vertebrae

Question 24

What’s indicative of Intrathorasic / Intrathorasic-Abdominal Pain while pooping?

Answer 24

Herniated Disc
Trauma
Tumor
Osteophyte in lumbar canal

(Valsalva Test)

Question 25

Trendelenburgs Gait:

Answer 25

Weak Glut Med (and Min) NO stabilization through stance phase = excess Lat movement to standing side If boy side are weak = side to side swing "Chorus Girl Swing" Also seen in congenital hip dislocation/ Coxa Vera

Question 26

Lurch Gait:

Answer 26

Weak Glut Max | Thorax lurches Posteriorly in Initial Contact (heel strike)

Question 27

Trendelenburg Test, positive =

Answer 27

Slouching hip of the affected aside while opposite foot is OFF the ground

Question 28

A woman walk in with shoulder Pan that came on gradually. She is experiencing night pain and Pain with ABduction. What could this be and what special test are indicated?

Answer 28

Frozen Shoulder Do an Impingement Test + Adhesive Capsulitis ABduction Test

Question 29

A man presents with Neuro signs in left arm, what special test would you perform?

Answer 29

Distraction/Compression Spurlings, Upper Limb Tension Test

Question 30

What is a step deformity?

Answer 30

AC Separation

Question 31

What is a Sulcus Sign?

Answer 31

Dislocated AC joint, humerus appears dropped from shoulder

Question 32

Colle's Fracture

Answer 32

Wrist fracture involving a break of the distal end of the Radius "Dinner Fork" appearance 25% of Colles Fx have Complex Regional Pain Syndrom (CRPS) @ 9 weeks, most Pain resolves

Question 33

What is Reflex Sympathetic Dystrophy? Also called Complex Regional Pain Syndrom CRPS

Answer 33

Condition characterized by diffuse Pain, swelling, limited mvmt that follows injury such as a Fx to arm or leg. S/Sx are always out of proportion to the injury and can linger long after the site has healed.

Question 34

Nursemaids Elbow involves:

Answer 34

Subluxation of head of radius from it's encirclement of the Annular Lig Radial subluxation Prox humeroradial dislocation

Question 35

Bouchard's Nodes:

Answer 35

Sign of RA or OA Hard bony outgrowths or gelatinous cysts on PIP jts of fingers / toes

Question 36

Heberden's Nodes

Answer 36

Hard, bony swellings that can develop in the DIPs Sign of OA

Question 37

OK sign - Pinch Test - Median Nerve / Ant Int Oss Nerve

Answer 37

Lesions of the Ant Int Oss nerve may cause weakness of: FPL FDP FDS Pronation Quadraus mm

Question 38

Histology of the Carpal Tunnel:

Answer 38

- Carpal Tunnel is an osteofibrous canal situated in the wrist - Goes from the carpal bones+flexor retinaculum - Contains Median Nerve + 9 tendons: FPL, FDS, FDP

Question 39

If asked to make the "OK" sign, patients who make a triangle instead exposes:

Answer 39

Weak FPL +FDP leading to weakness of the Flexion of distal phalanges of thumb and index finger = impairment of pincer mvmt + difficulty picking up sm items

Question 40

If you've torn your meniscus, you may experience the following signs on your knee:

Answer 40

``` "Popping" Inflam, stiffness Pain w twisting/rot mvmts Difficult straightening knee fully "Blocked" feeling when moving knee / Locked in place ```

Question 41

Terrible Triad:

Answer 41

Injury to ACL, MCL, Medial Menicus

Question 42

Housemaids Knee, aka:

Answer 42

Pre patellar Bursitis

Question 43

If a soccer player gets kicked in the back of the knee, what is most likely to be injured?

Answer 43

ACL Injury

Question 44

If a patient can't straighten the knee, it's most likely a:

Answer 44

Bucket Handle Tear (Med. Meniscal Injury)

Question 45

If someone if experiencing Pain going up stairs it is likely:

Answer 45

Patella Femoral Pain Syndrom Pain from posterior surface of the patella articulating with the femur out of alignment

Question 46

Hallmarks of Runners Knee:

Answer 46

No Pain on Knee Extension "Click" sound with extension Due to mm imbalance of Strong Vastus Lateralis (pulls knee Lat) Vs Weak Vastus Medialis (need to strengthen)

Question 47

What is a Reverse Q Angle?

Answer 47

Patella tracks Laterally and may sublux Pt needs to strengthen ADDuctors Stretch ITB + Vast Lat

Question 48

Screw Home Mechanism=

Answer 48

External Rot of Tibia on Femur in last 20* of Extension (Locking Mechanism) Open Chain: Tib Ext Rot on Femur + Ant glide to become more congruent on Femur Closed Chain: Femoral Int Rot on Tibia

Question 49

An Inversion Sprain of the Ankle commonly affects the:

Answer 49

Anterior Talofibular Ligament

Question 50

A tear to the Spring Ligament of the foot would cause:

Answer 50

Pronation (Drop Arch)

Question 51

Myotome C1-2

Answer 51

Neck FLX/EXT

Question 52

Myotome C3

Answer 52

Neck side FLX

Question 53

Myotome C4

Answer 53

Shoulder elevation

Question 54

Myotome C5

Answer 54

Shoulder ABduction

Question 55

Myotome C6

Answer 55

Elbow FLX / Wrist EXT

Question 56

Myotome C7

Answer 56

Elbow EXT / Wrist FLX

Question 57

Myotome C8

Answer 57

Ulnar Deviation Thumb EXT Finger FLX + ABduction

Question 58

Myotome T1

Answer 58

ABduction / ADDuction of Intrinsics

Question 59

Myotome L1-2

Answer 59

Hip FLX

Question 60

Myotome L3

Answer 60

Knee EXT

Question 61

Myotome L4

Answer 61

Ankle Dorsi FLX

Question 62

Myotome L5

Answer 62

Big Toe EXT

Question 63

Myotome S1

Answer 63

"Poo on shoe" Ankle Plantar FLX, Eversion, Hip EXT, Knee FLX

Question 64

Myotome S2

Answer 64

Knee FLX

Question 65

Myotome S3

Answer 65

Foot Intrinsics