CODO- Exam 1 Flashcards
(83 cards)
1
Q
Joint Evaluation
A
HIPROT
history, inspection, physical, ROM, other tests (Strength, Deep Tendon, Sensory, Special)
2
Q
H of HIPROT
A
History
Pain
Weakness
Deformity
Limited motion
Stiffness
Swelling, heat, redness
Joint noise (clicks, crepitus)
Systemic symptoms (fever, chills, rash,
anorexia, weight loss, weakness)
Trauma (fractures, sprains, dislocations)
3
Q
MSK exam nuances
A
4
Q
I of HIPROT
A
inspection
Contour
Swelling
Deformity
Muscle atrophy or fasciculation
Symmetry
Redness, bruising
Skin changes
5
Q
P of HIPROT
A
Anatomical landmarks
Tenderness
Heat
Swelling
Masses
Crepitus
6
Q
Muscle Strength Grading (OT)
A
7
Q
Deep Tendon Reflex (OT)
A
8
Q
Sensory testing (OT)
A
9
Q
Upper Limb Peripheral Nerves (arm)
A
10
Q
Arm Dermatomes (Anterior)
A
11
Q
Arm Dermatomes (Posterior)
A
12
Q
C5
A
Biceps Reflex
Deltoid and Biceps
sensation Lateral Arm and Axillary Nerve
13
Q
C6
A
Brachioradialis Reflex
Wrist Extension, Biceps
sensory- Lateral ABC nerve
14
Q
C7
A
Triceps Reflex
Wrist Flexors
Finger extension
Triceps
sensation to middle finger
15
Q
C8 Neurology
A
16
Q
T1 Neurology
A
17
Q
Major Peripheral Nerves Summary
A
18
Q
shoulder inspection
A
Contour
Swelling
Deformity
Muscle atrophy or fasciculation
Symmetry
Redness, bruising
Skin changes
19
Q
Shoulder Inspection
A
- scoliosis
- evenness of shoulder heights
- Scapular Winging
19
Q
palpate
A
20
Q
Range of Motion for Shoulder
A
21
Q
Shoulder Abduction Angle
A
180
22
Q
Shoulder Adduction Angle
A
45
23
Q
Shoulder Flexion Angle
A
180
24
Shoulder Extension Angle
45
25
Shoulder Internal Rotation
55
26
Shoulder External Rotation
40-45
27
Apley Scratch Test for ROM
28
Shoulder Strength Tests
give score out of 5 for each plane
29
Deep Tendon Reflexes of Upper Extremity- SC Roots
C5- Biceps
C6- BR
C7- Triceps
30
Spurling's Test
cervical nerve root compression
a positive test= duplicating shoulder pain or pain radiating into upper extremity
## Footnote
Neck extended, laterally
bent to affected side
31
apply scratch test
## Footnote
Patient touches superior
& inferior aspects of opposite scapula
loss of range of motion
32
empty can
rotator cuff tendonitis/tear
| AKA Jobe's Test/Supraspinatus Test
## Footnote
90° abduction in front, thumbs down
33
Neer's sign
Subacromial impingement
34
Hawkin's Test
Subacromial impingement
35
Drop Arm Test
The drop arm test is used to assess for full thickness rotator cuff tears, particularly of the supraspinatus.
36
Cross Arm Test Diagnosis
## Footnote
Forward elevation to 90° & passive adduction
AC Joint Pathology
37
Apprehension Test
Anterior glenohumeral instability
## Footnote
Anterior pressure on the humerus with external rotation
38
Relocation Test
Anterior glenohumeral instability
| Apprehension Test also looks for ant. glenohumeral instability
## Footnote
Posterior force on humerus while externally rotating the arm
39
Sulcus sign
Inferior glenohumeral instability
positive test is indicated by the development of abnormal sulcus under acromion during traction
## Footnote
Pulling downward on elbow or wrist. In another place, sulcus is listed as testing for posterior instability as well.
40
# Yergason and Speed test the same tendon
Yergason's Test
Biceps tendon instability or tendonitis or labral tear
patient resists supination whie examiners palpates bicipital groove
positive- pain in the shoulder, biceps tendon, subluxation of biceps tendon out of groove
41
Speed's Test
Biceps tendonitis or labral tear
## Footnote
Elbow flexed 10 to 30° & forearm supinated
42
O'Briens Test
Labral tear
Done just like the “empty can” test except the maneuver is done with the arm adducted slightly across midline
-Positive: pain in shoulder when done with thumb down, but less/no pain when done with palm up
## Footnote
arm 90 deg forward flexion with forearm pronated, arm
adducted across midline
43
Crank Test
Labral Tear
## Footnote
arm 90 deg forward flexion with forearm pronated, arm
44
Rotator Cuff Tendinopathy Tests
1. Empty can/Jobe’s
2. infraspinatous/resisted external rotation
3. Push-off/Gerber test
45
Infraspinatus/Teres Minor Testing
46
"Lift Off" Test
| AKA Gerber/ subscapularis testing
47
labral and biceps tendonapathy consideration
Significant overlap in test results for SLAP lesions and biceps tendonopathy
## Footnote
labral- o'brien's and crank
biceps- yergason's and speed's
48
Elbow Inspection: What 2 things to look for?
1. **carrying angle/valgus** (5 degrees for males and 10-15 for females)
2. **swelling /olecranon bursitis**
49
landmarks to palpate on the elbow
1. medial and lateral epicondyles
2. radial head
3. cubital tunnel
4. olecranon
50
what is normal range of motion for the elbow?
## Footnote
F/E; supination/pronation
Flexion- 135 degrees
Extension- 0-(-)5 degrees
supination and pronation- 90 degrees
51
what nerve roots are involved in elbow senation testing?
radial side- C5-C8
ulnar side- C8-T1
52
What motions are looked at during elbow strength testing?
1. F/E at wrist
2. F/E at elbow
3. supination/pronation
53
Special Tests for Elbow
1. **varus/valgus stress test**- lateral instability
2. **Tinel's**- cubital tunnel
3. **medial epicondylitis**- flex at wrist against resistance
4. **medial epicondylitis**-ext. at wrist against resistance
54
# There are four key ones.
Wrist Inspection Elements
1. general shape
2. fist
3. nails
4. deformities
55
Landmarks for wrist palpation
1. anatomical snuffbox (scaphoid bone, abd. poll. longus, ext. poll longus)
2. distal radius
3. distal ulna
4. carpal bones
56
What is normal range of motion for the wrist?
## Footnote
F/E; Ulnar and Radial Deviation
Flexion- 80 degrees
Extension- 70 degrees
Radial Deviation- 20 degrees
Ulnar Deviation- 30 degrees
57
Wrist Strength Testing
Flexion/Extension
58
Median N. distribution- Name the spinal nerves and areas innervated?
C6-8, T1
59
Ulnar Nerve Distribution
C8-T1
60
Radial Nerve Distribution
C6-8
61
What are 3 special tests for the wrist?
1. Tinel's (Carpal Tunnel)
2. Phalen's (Carpal Tunnel)
3. Finkelstein's (DeQuervains Tenosynovitis)
62
Tinel's
Tinel's test for carpal tunnel by tapping on carpal tunnel and lookinf for pain in the median nerve distribution.
63
Phalen's
similar to Tinel's but hold pressure on Carpal Tunnel for 60 s. Positive result is numbness/pain in the median nerve distribution.
## Footnote
when to use Tinel's vs phalens
64
Finkelstein's Test
test for tenosynovitis in abductor pollicis longus and extensor pollicis brevis\
Common with Cross-country skiers and video gamers
## Footnote
Tenosynovitis is inflammation in the synovium of the tendon sheath.
65
Thenar Eminence Atrophy due to Carpal Tunnel Syndrome
65
Herberden's Nodes
DIP Joints, osteoarthritis
65
Digit Inspection: What three elements to look for?
1. edema
2. nodules
3. contractures/deformities
## Footnote
contracture: a condition of shortening and hardening of muscles, tendons, or other tissue, often leading to deformity and rigidity of joints
66
Bouchard's Nodes
PIP Joints, osteoarthritis
66
Dupuytren's Contracture
66
Range of Motion for Digits
Flexion- 90 degrees
Extension- 30-45 degrees
abduction- 20 degrees
adduction- 0 degrees
| I am confused about these.
67
Strength testing for thumb and fingers
1. F/E- profundus and superficiales
2. Opposition (pinching)
3. Abduction- interossei (C8, T1)
67
Swan Neck Deformity
Caused by RA
67
Special Testing for Thumb and Fingers
Collateral Ligament Testing
## Footnote
ulnar collateral ligament
67
What can scaphoid fracture lead to...
avascular necrosis (typically in the outstretched hand)
68
What innervates the lateral deltoid?
Axillary Nerve
69
Tennis Elbow Tests
Lateral Epicondylitis
Varus/Valgus Testing
Cozen's test
70
CODO Ethics
## Footnote
Ethics
1. Autonomy Focus
2. Patient Needs come first
3. Justice- treating patients equally (w or w/o insurance)
4. Autonomy: Patient needs life saving surgery but hates needles
71
COPMAPS
begin with open-ended questions, non-verbal actions of listening
72
House structure in PPT
look in the PPT for this one
73
Altruism
Non-selfish regard
74
SOAP Note
S- subjective, what the patient tells you
O- physical findings
** write pertinent negatives, dont leave blank
75
