Etc.

Question 1

Soft Tissue Palpation of the Knee

Answer 1

quads:
rectus femoris
v. intermedius (deep to r. fem)
v. medialis
v. lateralis

prepatellar bursa
infrapatellar tendon
superficial infrapatellar bursa

mcl
lcl

medial meniscus
lateral meniscus

pes anserine (A-P: SGT)
sartorius
gracilis
semitendinosus

gastrocnemius

popliteal fossa

Question 2

Bony Palpation of the Knee

Answer 2

patella
tibial tubercle

medial femoral condyle (ext rot.)
medial tibial plateau

lateral femoral condyle (int rot.)
lateral tibial plateau

fibular head

Question 3

Muscle Test

Tibialis Anterior

Answer 3

dorsiflexion and inversion

tibialis anterior, deep peroneal nerve

Question 4

Brachioradialis Reflex

Answer 4

slight forearm flexion

A/E: radial nerve
IC: C6 spinal cord

mild stretch, strike, test bilaterally

Question 5

Biceps Reflex

Answer 5

elbow flexion

A/E: musculocutaneous nerve
IC: C5 spinal cord

mild stretch, strike, test bilaterally

Question 6

Triceps Reflex

Answer 6

elbow extension

A/E: radial nerve
IC: C7 spinal cord

mild stretch, strike, test bilaterally

Question 7

Patellar

Answer 7

knee extension

A/E: femoral nerve
IC: L2,3,4 spinal cord

mild stretch, strike, test bilaterally

Question 8

Achilles

Answer 8

foot plantarflexion

A/E: tibial nerve
IC: S 1,2 spinal cord

mild stretch, strike, test bilaterally

Question 9

C5 Muscle Test

Answer 9

Deltoid: shoulder abduction (axillary)

Biceps: forearm flexion (musculocutaneous)

Question 10

Lymph Nodes of Head and Neck

Answer 10

“checking for size, consistency, mobility and condition”

occipital

preauricular
postauricular

tonsilar
submandibular
submental

facial

anterior chain
posterior chain

supraclavicular

Question 11

Aortic Maneuver

Answer 11

seated
aortic/erb’s
deep breath, exhale while leaning forward

diaphragm - high pitched murmurs

Question 12

Mitral Maneuver

Answer 12

supine
mitral area (apical impulse)
bell - low pitched murmurs
left lateral recumbent

deep breath and hold

Question 13

Cardinal Fields

Answer 13

observing for parallel mvmt, noting any nystagmus

Trochlear = down and in (4)
Abducens = lateral (6)
Oculomotor all others (3)

Question 14

Tactile Fremitus

Answer 14

decrease = air
(COPD, emphysema)

increase = fluid/mass
(consolidation, tumor)

Question 15

Valsalva

Answer 15

( + ) radiating pain from the site of lesion (usually reproducing cervical or lumbar complaint)

( i ) SOL, possible disc pathology

Question 16

Swallowing Test

Answer 16

( + ) difficulty swallowing

( i ) SOL at anterior portion of cx spine, possible esophageal/pharyngeal injury, anterior disc defect, mm spasm or osteophpytes

Question 17

L’Hermitte Sign

Answer 17

supine/seated, passive neck flexion

( + ) electric shock-like sensations down the spine and/or through extremities

( i ) dural irritation, severe spinal cord injury or degeneration

Question 18

Auscultate Major Abdominal Arteries

Answer 18

Aorta, Renals, Common Iliacs

bell
bruits
turbulent bloodflow

Question 19

Uvular/palateal

Answer 19

glossopharyngeal

medulla

vagus

Question 20

Abdominal Reflex

Answer 20

umbilicus deviation to stroked side
absence only normal if bilateral

upper T7-10 spinal nerves
lower T11-12 spinal nerves

spinal cord T7-T12

upper T7-10 spinal nerves
lower T11-12 spinal nerves

Question 21

Interscapular

Answer 21

T2-7 spinal nerves

T2-7 spinal cord

dorsal scapular nerve

Question 22

Plantar Reflex

Answer 22

curling of toes

tibial nerve
spinal cord S1-2
tibial nerve

Question 23

Gaenslen

Answer 23

KNEE TO CHEST

( + ) pain on affected SI jt stressed into extension

( i ) Generalized SIjt lesion
Anterior SI ligament sprain
Inflammation of SI jt

Question 24

Palpate spleen

Answer 24

stand on left

inferior hand under costovertebral angle,
PA pull

deep breath and hold

feel edge of spleen as it pushes downwards towards your fingers

Question 25

Lower Extremity auscultate arteries

Answer 25

femoral (inferior and medial to inguinal lig) popliteal (pop fossa) dorsalis pedis ( medial dorsum of foot) posterior tibialis (post to med. malleolus)

Question 26

Weber

Answer 26

Place the handle of the vibrating tuning fork on the midline of the skull and ask the patient to compare the intensity of the sound in the two ears. Normal: sound is equal in both ears. (+) Conductive deafness: sound lateralizes to the bad ear. (+) Sensorineural deafness: sound lateralizes to the good ear.