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Extremity Clet > Lab Final > Flashcards

Lab Final Flashcards

(45 cards)

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1
Q

Complain of tendinitis in shoulder flexion

A

Speed’s test - contact bicipital groove, resisted speed 45 degrees

Pain and/or tenderness at bicipital groove indicates bicipital tenditnitis

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2
Q

Locking/grinding of knee, retropateller pain, catching

A

Synovial plica test

Involved side up/30 deg/push patella medially with superior hand/rot tibia in/extend fully/flex again to 30/repeat with lat push/ext rot

Popping, snapping or clunking

Medial pain indicates medial synovial plica syndrome
Lateral pain indicates lateral synovial plica syndrome

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3
Q

Posterior elbow pain

A

Valgus overload test
Elbow 90/valgus/full passive extension

Pain in posterior elbow with reproduction of lock/catch or inability to fully extend indicates posterior impingement syndrome

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4
Q

Knee hit from behind, Painless, giving way

A

Godfrey sag sign
90/90/contract hamstrings

Proximal tibia sags due to lack of posterior constraint indicating tear/sprain of PCL

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5
Q

Deep anterior hip pain

A

Hip impingement sign
Supine 90/90/slight ADD/forceful int rot

Sharp anterior catching hip pain indicates hip impingement syndrome

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6
Q

Anterior should instability; deep ant shoulder pain with occasional locking; follow up to a positive O’Brien’s

A

Anterior slide test
Hand on hip, press sup and ant on hummers, pt hold

Popping, cracking, crepitus and pain at the ant/sup shoulder indicates superior or anterior glenoid labrum tear

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7
Q

Acute anterior knee instability

A

Lachman test
Knee 30 deg/pull tibia away from femur

Gapping with tibia moving away from femur indicates ACL or posterior oblique ligament instability

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8
Q

Heel pain radiating to big toe

A

Test for plantar fascitis
Dorsiflex ankle/big toe/palpate med long arch

Sharp pain along the medial longitudinal arch indicates plantar fascitis

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9
Q

Lateral hip and thigh pain

A

Modified ober test
Involved side up/flex bottom leg/stabilize sacrum/ext top leg and hip back/lower leg

Hip and lateral thigh remains in abduction and pt has thigh pain indicates TFL contracture/ITB syndrome

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10
Q

Lateral elbow pain

A

Cozens test
Wrist extension

Pain over the lateral epicondyle indicates lateral epicondylitis

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11
Q

Labrum injury - ant shoulder pain (deep or superficial)

A

O’Brien’s
Arm straight out/thumb down/cross chest 10 deg/I press down/repeat with supination

Deep anterior pain indicates labrum tear
Superficial pain indicates AC joint problem

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12
Q

High ankle injury - difficulty weight bearing

A

Distal tib/fib squeeze - squeeze 5 seconds

Pain reproduced while squeezing or worse upon release indicates high ankle sprain of tibio femoral lig and/or interosseous syndesmosis

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13
Q

Supraspinatus weakness

A

Empty can test
Arm emptying can ABD 90/bring forward 40 deg/I push down and in

Resistance to pressure stresses supraspinatus muscle and tendon insertion indicates tear or rupture to supraspinatus muscle or tendon with possible suprascapular neuropathy

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14
Q

Gluteal insufficiency; 3-9 yo with limp/adductor lurch

A

Trendelenbergs
Stand on one ft/observe iliac crests

High iliac crest on supported side indicates weak gluteus medius muscle/LCP/SCFE based on age

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15
Q

Infraspinatus/teres minor weakness; protector muscle responsible for facilitating posterior rotation

A

Patte hornblower test
90/90 straight out/abd 15 deg/grab back of arm with my arm/pt pushes back

Pain or inability to ext rotate against resistance indicates infraspinatus or teres minor tendinopathy

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16
Q

Medial elbow pain

A

Reverse mills test
Elbow ext/supinated/I extend wrist passively

Reproduction of pain in medial elbow indicates medial epicondylitis/golfers elbow

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17
Q

Can’t jog because of lateral knee pain

A

Noble test
Ft on table to 60 deg/press lat femoral condyle/extend knee fully while maintaining pressure

Worse pain through 30-40 deg flexion/extension indicates ITB syndrome or lateral knee impingement syndrome

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18
Q

Clicking sensation in biceps tendon

A

Abbott saunders
Full ABD/ext rot and bring down/maintain biceps tendon contact

Palpable or audible click in bicipital groove indicates subluxation or dislocation of biceps tendon; rupture of transverse ligament or tendon subluxation beneath the subscapularis muscle belly

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19
Q

Anterior arm pain with weakness

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A

Maximum elbow flexion
Pt puts elbows into max flex for 3 min

Reproduction of parasthesia into ulnar nerve distribution with possible weakness on handshake indicates cubital tunnel syndrome

20
Q

Instability of biceps tendon

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A

Yergasons
Inf traction/resist hitchhiker thumb out

Local pain and/or tenderness at the bicipital groove indicates tendinitis

Audible click or biceps tendon subluxates or dislocates indicates instability of biceps tendon possibly assocaited with a torn transverse humeral ligament

21
Q

Heel pain while walking

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A

Fat pad squeeze
Press heel/squeeze heel and press into it/prone

Pain diminishes during procedure or feels less tender indicates fat pad sydnrome

Same or worse pain indicates plantar fascitis, heel spur, calcaneal stress fx

22
Q

Painful giving way of knee

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A

Apley compression
Straight down/int rot down/ext rot down

Patient points to pain.
Pain on the medial side indicates medial meniscus tear
Pain on the lateral side indicates lateral meniscus tear

23
Q

Differentiate between labrum and AC

Labrum injury
Anterior shoulder pain (deep or superficial)

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A

O’bRiens
Arm straight out/thumb down/cross chest 10 deg/I press down/repeat with supination

Deep anterior pain indicates labrum tear

Superficial pain indicates AC joint problem

24
Q

Decreased ROM and stiffness in shoulder

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A

Mazion shoulder maneuver
Dugas then reverse dugas

Inability to actively raise the elbow to teh forehead due to pain and/or stiffness indicates early stage adhesive capsulitis or non inflammatory capsular adhesions

25
Knee pain on prolonged sitting (cinema sign)
Patella femoral grinding test (clarke sign) Web knee and ask for quads contraction Retropatellar pain and inability to hold quad contraction indicates degenerative changes of patellar facets and/or within trochlear groove; chondromalacia patella
26
Hip pain (SI joint) and low back pain distinguish
Belt test Bend forward/brace scarum/bend forward Low back pain with both positions indicates lumbar No pain when stablized indicates pelvic involvement
27
Instability and slipping out sensation of shoulder/clunking
Sulcus sign With load and shift Elbow to 90/grab wrist/press forearm with other hand Sulcus will appear anterolateral at this motion attempts to dislocate indicates inferior shoulder instability and possibly inf dislocation 1. +1 = <1 cm 2. +2 = 1-2 cm 3. +3 = >3 cm
28
Painful giving way of knee supine
Mcmurray sign 90/90/ext rot/flex knee all the way up/extend with valgus stress/repeat with in and varus stress Clicking sound or pain by the knee joint indicates medial meniscus tear with external rotation or lateral meniscus tear with internal rotation
29
Clumsiness and weakness when gripping pen to write
Fromet paper alternate Hold paper between thumb and first finger straight Patient flexes thumb thereby recruiting median nerve to compensate for apparent weakness indicates weakness or palsy of adductor pollicis muscle/ulnar nerve/will have wasting of dorsal thumb web
30
Stress fx of hip
Anvil test Slightly elevate ft/strike calcaneus Local pain in long bone or hip joint indicates possible fx of long bone or hip joint pathology
31
Weakness on power grip
Maximum elbow flexion Pt puts elbows into max flex for 3 min Reproduction of parasthesia into ulnar nerve distribution with possible weakness on handshake indicates cubital tunnel syndrome
32
Sharp anterior shoulder pain only when working overhead
Anterior slide test Hand on hip, press sup and ant on humerus, pt hold Pop/crack/crepitus and pain at ant/sup shoulder indicates superior or anterior glenoid labrum tear
33
Anterior instability of the shoulder
Anterior apprehension with relocation test A look of pain or apprehension with test; press heel of hand into shoulder Pt senses relief upon relocation confirms anterior instability of GH joint and rules out tendinitis
34
Bursitis in the shoulder
Dawbarn test Deep palpation with pain; hold palpation and ABD past 90 deg Decrease in pain/tenderness indicates subacromial bursitis
35
Determine anterior or posterior shoulder impingement
Hawkin kennedy test 90/90 forward; passive int rotation Local pian indicates supraspinatus tendinitis Anterior pain indicates anterior impingement Posterior pain implicates stretch of teres minor and infraspinatus tendons which indicates posterior impingement
36
Swelling and difficulty weight bearing due to recent knee injury
Bounce home test Flex knee, grab heel, slowly fully extend Knee remains in slight flexion indicates diffuse swelling of the knee possibly due to torn meniscus
37
Leg length discrepancy
True - ASIS to medial malleolus then to opposite Different measurements indicate bony abnormality above or below trochanter; anatomical short leg Apparent - umbilicus to medial malleolus to both legs Different measurements indicates tilted pelvis
38
Juvenile genu valgus
Craig’s test for anteversion Pron/knee 90/int rot hip until trochanter comes to table Pain when int rot > 30 degrees indicates structural anteversion
39
Transverse patellar fx
Dryer’s test Supine SLR pain grab thigh/SLR/no pain Indicates patellar fracture
40
Rule out OCD
Wilson’s test 90/90/int rot/extend knee Pain indicates medial femoral condyle 90/90/ext rot/extend knee Pain indicates lateral femoral condyle
41
Subscapularis weakness can’t tuck shirt in
Lift off test Place back of hand on small of back/attempt to lift Inability to perform test indicates subscapularis tendinopathy
42
Anterior impingment of shoulder
Neer test Passive forward flexion Pain at the end of ROM indicates impingement with overuse injury of supraspinatus muscle or biceps tendon
43
Differentiate between SI and hip joint
Hibbs 90/butt/out Pain in hip indicates hip joint pathology Pain in buttocks or pelvis indicates SI joint lesion
44
Differentiate between impingement and AC joint
Painful arc test Palm down/actively abduct Pain worse between 70-110 indicates impingement with supraspinatus involvement Pain worse at 160+ indicates joint involvement
45
Evaluate for functional pronation
Navicular drop test Measure from navicular tubercle to ground non weight bearing then stand and remeasure Navicular drops more than 5/8” or 1.6cm indicates functional pronation

Extremity Clet (7 decks)

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