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OSCEs > Locomotor Examinations > Flashcards

Locomotor Examinations Flashcards

1
Q

How do you begin a GALS assessment?

A

WIPE
Qs: pain/stiffness, dressing, stairs
Gen insp: crutches/stick/wheelchair
Gait

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2
Q

What do you comment on when looking in a GALS assessment?

A 
From behind:
Shoulders
Spinal alignment
Level of iliac crests
Hamstring bulk
Popliteal swelling
Calf muscles
Achiles and hindfoot swelling
From side:
thoracic kyphosis, lumbar lordosis
From front:
Deltoid bulk and symmetry
Knee alignment
Foot arches and deformity
When lying:
Soles & calluses
Arms & hands
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3
Q

What movements do you do in GALS?

A

Touch toes (measuring change in length between spinous processes)
Tip head sideways and chin to chest and extension
Jaw side to side
Sunbathing posture (elbows behind head)
Finger grip and dexterity
Hip and knee flexion

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4
Q

Which muscles does the radial nerve supply?

A 
Wrist extension
Finger extension
Triceps (extend elbows)
Brachioradialis (flex elbows mid pronation)
Supinator
Extend thumb
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5
Q

What is the radial nerve dermatome?

A

1st dorsal web space

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6
Q

Which movements are controlled by the median nerve?

A

Thumb abduction

2 radial lumbricals (MCP resist flexion, IP resist extension)

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7
Q

What extra tests are needed for median nerve exam?

A

Phalen (backs of hands together and press for 60 secs-> numbness/tingling?)
Tinnel (tap over carpal tunnel)

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8
Q

What do you look for in a spine exam?

A 
Scars
Pigmentation
Abnormal skin creases/hair growth
Scoliosis
Asymmetry
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9
Q

What do you do in a spine exam when the pt is prone?

A

Femoral nerve stretch test (with knee bent lift knee off bed)
Offer anal tone and perianal sensation

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10
Q

What do you do in a spine exam when the pt is supine?

A

Passive straight leg raise (note ROM)

Sciatic nerve stretch test (dorsiflexion of foot when straight leg raised slightly)

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11
Q

Name the muscles of the rotator cuff and function

A 
SITS
Supraspinatus (initiation of abduction)
Infraspinatus (external rotation)
Teres minor (external rotation)
Subscapularis (adduction)
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12
Q

What are you feeling for in a shoulder exam?

A

Temp
Tenderness (acromioclavicular, sternoclavicular)
Effusion (glenohumeral)

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13
Q

What other tests do you do after general active and passive movements

A

Test rotator cuff function (abduction, adduction and external rotation against resistance)
Push against wall (scapula winging)
Function (brush hair, put on coat)

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14
Q

What would signify carpal tunnel syndrome?

A

Wasting of thenar eminence

Phalen & tinel test-> tingling/pain ulnar fingers

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15
Q

What would signify ulnar nerve dysfunction?

A

Claw hand
Hypothenar eminence wasting
Froment sign positive (hold paper between thumb and forefinger, thumb IP joint flexes)

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16
Q

What would signify radial nerve dysfunction?

A

Wrist drop

Decreased sensation over anatomical snuffbox

17
Q

What are the specific tests for hip exam?

A

Trandelenberg
Real vs apparent leg length
Fixed flexion deformity (Thomas’ test)

18
Q

How do you do Thomas’ test?

A

Tests for fixed flexion deformity
Lie on back, bring one knee close to abdomen
Other leg should remain relaxed on floor
If other leg raises then fixed flexion defomity present

19
Q

Explain findings of trandelenberg test

A

If when lift R foot up, hips stay level= normal

If when lift R foot up, hips dip to R, shows weakness of L abductors (eg gluteus medius)

20
Q

Where do you measure real and apparent leg length?

A

Real: ASIS-> medial malleolus
Apparent: Umbilicus-> medial malleolus
Should be symmetrical

21
Q

What do you look for before beginning the examination in a foot & ankle exam?

A

Shoes and walking aids- pattern of wear

22
Q

What do you look for in a foot and ankle exam?

A

Deformities, foot arches
Scars, bruising, swelling
Ulcers, calluses, bunions, fungal toenails, ingrowing toenails
Measure calf circumference

23
Q

What do you do after looking in a foot and ankle exam?

A

Feel malleoli, tarsals, squeeze MTPs
Feeling for tenderness, temp, synovitis, cap refill
Pulses (dorsalis pedis, posterior tibial)
Gross sensation

24
Q

What do you do after feeling in a foot and ankle exam?

A

Ankle dorsiflexion and plantarfelxion, foot inversion and eversion
Toe flexion, extension, abduction and adduction
Simmond’s test

25
Q

Describe Simmond’s test

A

Triad to detect achilles tendon rupture
Pt prone w/feet hanging off the bed
1) angle of dangle (rupture= more dorsiflexed)
2) Squeeze calf bringing muscle off tibia (normal, plantar flexion will occur, absence=rupture)
3) Look/feel for gap in tendon

OSCEs (27 decks)

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