Neuromusculoskeletal (NMS) Diagnosis (Irene Gold) Part II and III Flashcards Preview

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Flashcards in Neuromusculoskeletal (NMS) Diagnosis (Irene Gold) Part II and III Deck (799):
1

What is the clinically word for loss of smell?

Anosmia

2

What is the term for a distorted sense of smell?

Parosmia

3

How is the optic nerve tested for Visual acuity?

Snellen Eye Chart

4

What two cranial nerves are tested with the Direct Light Reflex?

Cranial nerves II (2) and III (3)

5

What three things happen to the eyes during the Accommodation test?

Eyes Converge
Pupils Constrict
Lens Convex

6

What are the two muscles of the eye that have Parasympathetic control?

Ciliary muscles (lens shape)
Constrictor Papillae

7

What is the clinically term for deviation of one or both eyes?

Strabismus

8

What is the cause for a patient to have ptosis; drooping of an eyelid?

Weakness or paralysis of the Levator Palpebrae

9

Jaw Jerk reflex test what Cranial nerve?

Cranial Nerve V (5), both sensory and motor

10

What two directions does the Superior oblique muscle move the eye?

Down and In

11

How is the sensory component of Cranial nerve V tested?

Touch the following areas of the face with a cotton wisp:
Forehead
Cheekbone
Chin

12

What two cranial nerves are tested with the Corneal Reflex?

Cranial Nerve V-Afferent
Cranial Nerve VII-Efferent

13

What is a normal finding of the Corneal Reflex?

Both eyes blinking
Tearing of the eyes

14

What is the name of the test, when the mandible is lightly tapped with a reflex hammer?

Jaw jerk reflex

15

What is a positive finding of the Jaw Jerk reflex?

Jaw draws upwards

16

What two Cranial nerves are tested during the Oculocardiac reflex?

Cranial nerve V- Afferent
Cranial Nerve X- Efferent

17

What is the normal finding of the Oculocardiac reflex?

A decrease in heart rate when pressure is applied to the eye

18

What part of the tongue is motor and given general sensation by Cranial nerve V?

Anterior 2/3

19

What three things does the Anterior 2/3 of the tongue determine?

Hot
Cold
Pain

20

What three muscle of mastication help to close the jaw, and are innervated by cranial nerve V?

Temporalis
Internal Pterygoid
Masseter

(TIM)

21

What muscle innervated by cranial nerve V, opens the jaw?

External Pterygoid

22

What is another name for Trigeminal Neuralgia?

Tic Douloureaux
Can lead to Cranial Nerve V Palsy

23

What condition is describe as:
"Extreme, sporadic, sudden burning or shock like pain that last anywhere from a few seconds to as long as two minutes per episode."

Pain is lightening like, repetitive excruciating pain. Happening several times per day, one onside of the face/cheek.

Trigeminal Neuralgia

24

What cranial nerve is anterior 2/3 of the tongue for tastes such as Sweet, Sour, Salty?

Cranial Nerve VII (7) Facial

25

What cranial nerve indicates the bitter taste?

Cranial Nerve IX (9)

26

What condition is described as:
"Unilateral Facial Paralysis caused by trauma, virus or immune mediated response and is not permanent.

Pain is initially seen behind the ipsilateral ear, twitching, weakness/paralysis, drooping of the eyelid, corner of the mouth, dry eye and decreased taste sensation."

Bell's Palsy

27

What are two treatments for Bell's Palsy?

Eye Patch
Artificial tears

28

Is Bell's Palsy an Upper or Lower Motor Neuron Lesion?
What Cranial nerve is effected?

Lower Motor Neuron Lesion
Cranial Nerve VII (7) Facial

29

What are two findings that distinguish Bell's Palsy from a Stroke?

Ipsilateral Motor loss of entire face
Forehead does not wrinkle

30

How are you able to tell a Stroke from Bell's Palsy?

Contralateral motor loss below the eye
Able to wrinkle the forehead

31

What Cranial Nerve and type of Lesion is a Stroke?

Cranial Nerve VII (7) Facial
Lesion- Upper Motor Neuron Lesion

32

What reflex will be decreased in a person with a stroke?

Corneal Reflex

33

Of the two conditions; Bell's Palsy and Stroke, which one will not have control of their saliva?

Stroke

34

What is the care plan for a patient with a stroke?

Co-Care with a Neurologist and adjust

35

What three exams can you perform to see if a patient has a Vestibular/Balance issue?

Mittelemeyer
Romberg's
Barany Caloric Test

36

What three test can be done to see if a patient has a Cochlear/Hearing problem?

Weber/Rinne
Whisper
Auditory Acuity/Watch Test

37

What are two other names for Meniere's Disease?

Central Vertigo
Endolymphatic Hydrops

38

What are three symptoms of Endolymphatic Hydrops?

Episodic rotational vertigo
Hearing Loss
Tinnitus (Ringing in the ears)

39

What two cranial nerves are tested in the Gag/Pharyngeal, Uvula, Carotid Reflexes?

Cranial Nerve IX (9) Afferent (Glossopharyngeal)
Cranial Nerve X (10) Efferent (Vagus)

40

By massaging what artery in the neck can you make the heart rate drop?

Carotids

41

What muscle elevates the pharynx and larynx; also dilates the pharynx to allow for swallowing?

Stylopharyngeus

42

What cranial nerve is responsible for allowing us to speak (Phonation)?

Cranial Nerve X (10) Vagus

43

What muscles are sensory or Cranial Nerve X?

Epiglottis
Laryngeal muscles; swallowing (Palate, Pharynx)

44

What three reflex are motor of the Vagus (C.N. X)?

Gag
Carotid
Uvular

45

What side will the Palate and Uvula deviate if there is a lesion?

Opposite side
Towards the strong side

46

What two muscles are innervated by Cranial Nerve XI (Spinal Accessory Nerve)?

Trapezius
Sternocleidomastoid (SCM)

47

What is the name of the condition that is caused by a spasm (Lateral Flex to the same side and Rotate to the Opposite side) of the Sternocleidomastoid (SCM)?

Torticollis
Wry Neck

48

If there is a lesion of Cranial Nerve XII (Hypoglossal) and the patient sticks out their tongue which side will it deviate to?

Deviates to the side of the lesion

49

When testing reflexes, what are two guidelines to follow?

Perform Bilaterally
Test the normal (unaffected) side first

50

What is Westphal's Sign?

An absence of any of the Deep Tendon Reflexes (DTR)

51

In what reflex is a Westphal's sign most often seen?

Patellar Reflex (LMNL)

52

What is the name that produces more of a reflex by cortical distraction?

Jendrassik's Maneuver AKA Reinforcement Test

53

What is the score on the Wexler Scale (DTR) for "Absent with Reinforcement"?

0+

54

When would a 1+ be seen on the Wexler Scale (DTR)?

Hypoactive with no reinforcement or Normal with reinforcement

55

What is a normal score on the Wexler Scale (DTR)?

2+

56

What type of lesion will you see a 3+,4+ and 5+ on the Wexler Scale (DTR)?

Upper Motor Neuron Lesion (UMNL)

57

What would indicate a 5+ on the Wexler Scale (DTR)?

Hyperactivity with sustained clonus

58

What is the score given on the Wexler Scale (DTR) for Hyperactivity with transient clonus?

4+

59

When is a 3+ score given on the Wexler Scale (DTR)?

Hyperactivity

60

What Nerve and Nerve Root are tested in the Jaw Jerk Reflex?

Nerve- Trigeminal
Nerve Root- Cranial Nerve V (5) Both sensory and motor

61

In the Biceps Reflex what Nerve and Nerve Root are tested?

Nerve- Musculoculocutaneous
Nerve Root- C5

62

When testing the Brachioradialis Reflex what Nerve and Nerve Root are tested?

Nerve- Radial
Nerve Root-C6

63

When testing the Triceps Reflex what Nerve and Nerve Root are tested?

Nerve- Radial
Nerve Root-C7

64

When testing the Patellar AKA Knee Jerk Reflex what Nerve and Nerve Root are tested?

Nerve-Femoral
Nerve Root-L4

65

When testing the Medial Hamstring Reflex what Nerve and Nerve Root are tested?

Nerve-Sciatic
Nerve Root-L5

66

When testing the Achilles AKA Ankle Jerk Reflex what Nerve and Nerve Root are tested?

Nerve-Tibial
Nerve Root-S1

67

What is the name of the superficial reflex that has the doctor stroke the inner thigh and the testicle raises ipsilateally?

Cremasteric Reflex (L1)

68

What are the Afferent and Efferent nerves when the Cremasteric and Geigel Reflexes is done?

Afferent- Femoral Nerve
Efferent- Genitofemoral Nerve

69

How is the Plantar Reflex performed?

Stoke up on the sole of the foot, from heal to toe

70

What is a positive finding of a Plantar Reflex?

Curing of the toes
Pulling away of the foot

71

What in the name of Afferent and Efferent nerve stimulated when the Plantar reflex is done?

Tibial for both

72

What is a normal finding for the Abdominal Reflex?

Umbilicus moves towards the side being stroked

73

What are the Afferent and Efferent nerves being stimulated in the Abdominal and Beevor's Reflexes?

Afferent AND Efferent:
Upper T7-T9 and Lower T10-T12

74

How is the Beevor's Reflex test performed:

Patient does a partial sit-up and the doctor observes the umbilicus

75

What is a normal finding for the Beevor's Reflex?

Umbilicus will stay midline

76

What is another name for an Upper Motor Neuron Lesion (UMNL)?

Myelopathy

77

Which type of Lesion includes the Brain and Spinal cord, but not the Anterior Horn Cells?

Upper Motor Neuron Lesion (UMNL)

78

What area must be effected for a Lower Motor Neuron Lesion (LMNL) to be present?

Anterior Horn Cells out to the Myoneural junction

79

What type of paralysis is seen in an Upper Motor Neuron Lesion (UMNL)?

Spastic

80

What type of Deep Tendon Reflexes (DTR) are seen in a patient with an Upper Motor Neuron Lesion (UMNL)?

Hyperactive

81

Are Pathological Reflexes Absent or Present in an Upper Motor Neuron Lesion (UMNL)?

Present; Babinski

82

In what type of lesion will you see Clonus present?

Upper Motor Neuron Lesion (UMNL)

83

What are four characteristics of an Upper Motor Neuron Lesion that will be Absent?

**Superficial Reflexes**
Reaction of degeneration
Atrophy
Fasciculations

84

When is Flaccid paralysis seen?

Lower Motor Neuron Lesion (LMNL)

85

What kind of Deep Tendon Reflexes (DTR) will be seen in a Lower Motor Neuron Lesion (LMNL)?

Hypoactive/Absent

86

In a Lower Motor Neuron Lesion (LMNL) what finding will you see in the following characteristics:
Pathological Reflexes
Clonus
Superficial Reflexes

Absent

87

What three characteristics of a Lower Motor Neuron Lesion (LMNL) will be Present?

**Reaction of Degeneration**
Atrophy
Fasciculations

88

What three Visceral Organ Reflexes will be absent in both Upper Motor (UMNL) and Lower Motor Neuron Lesions (LMNL)?

Ciliospinal
Oculocardiac
Carotid Sinus

89

How is the Ciliospinal Reflex performed?

Pinch the neck, noting the dilation of the eyes

90

What reflex is done by pressing on the eye and decreasing the heart rate by 10 beats per minute?

Oculocardiac

91

By pressing on the Carotid artery what two things will decrease/slow?

Slow the heart rate
Decease the pressure

92

What pathological reflex is performed by stroking the lateral aspect of the foot up to the great toe?

Babinski

93

What is a positive finding of the Babinski reflex?

Dorsiflexion of the great toe with splaying of the other toes

94

What four other pathological reflexes all have the small positive findings as the Babinski reflex?

Chaddock
Oppenheim
Gordon's Calf
Schaefer

95

What pathological reflex is performed by stroking the lateral malleolus to the fifth toe?

Chaddock

96

How is Oppenheim's pathological reflex performed?

Stroke down the Tibial crest to the ankle

97

What is the name of the pathological reflex that is being performed when the calf is squeezed below the knee?

Gordon's Calf

98

How is Schaefer's pathological reflex test done?

Squeeze the Achilles tendon

99

What pathological reflex is tested by tapping on the ball of the foot/tip of the toes?

Rossolimo

100

What is a positive response to Rossolimo's reflex?

Plantar flexion of the great toe with curing of the other toes

101

How is Hoffman's pathological reflex performed?

Doctor extends middle phalanx and flicks distal phalanx inferior (Two F's in Hoffman's= Forceful FIick)

102

What is a positive response to Hoffman's reflex?

Flexion and adduction of the thumb and flexion of the fingers

103

What other pathological reflex has the same positive response as Hoffman's?

Tromner's

104

How is Tromner's pathological reflex performed?

Doctor sharply taps the tips of the middle three fingers (T in Tromner's= Tap)

105

What pathological reflex is being described:
"Doctor strokes the pisiform of the patient"?

Gordon's Finger

106

What is a positive finding to the Gordon's Finger reflex?

Flexion of the wrist and fingers or thumb and index finger

107

How is Chaddock's Wrist pathological reflex performed?

Doctor strokes the distal ulnar side of the forearm near the wrist

108

What is a positive finding to the Chaddock's Wrist reflex?

Flexion of the wrist with extension and fanning of the fingers

109

What is a Normal (5) muscle grade?

Complete range of motion against gravity with full resistance

110

What muscle grade is given if there is "Complete range of motion against gravity with some resistance"?

Good (4)

111

What is the definition of a Fair (3) muscle grade?

Complete range of motion against gravity

112

When is a muscle grade of Poor (2) given?

Complete range of motion with gravity eliminated

113

What muscle grade is given when there is "evidence of slight contractility with no joint movement"?

Trace (1)

114

What is the muscle grade given when there is "No evidence of contractility"?

Zero (0)

115

What are the two motor/body activity carried out by the C5 nerve root?

Arm Abduction
Forearm Flexion

116

What two muscles are innervated by the C5 nerve root?

**Biceps Brachii** (Deep Tendon Reflex for C5)
Middle Deltoid

117

Where is the dermatome/sensory level of C5 nerve root?

Lateral arm

118

What disorder is seen in both the C5 and C6 nerve roots?

Erb's Palsy (Waiter Tip)
C6= Wrist Drop

119

What are the motor/body activity carried out by the C6 nerve root?

Wrist extension
(C6= Motor Cycle Chicks)

120

What are the two motor/body activity carried out by the C7 nerve root?

Wrist Flexion
Finger Extension

121

What are the motor/body activity carried out by the C8 nerve root?

Finger flexion
(C8 "Grap All 8)

122

What are the two motor/body activity carried out by the T1 nerve root?

Finger Abduction
Finger Adduction

123

What are the motor/body activity carried out by the T5-T12 nerve roots?

Trunk Flexion

124

What are the motor/body activity carried out by the L1-L3 nerve roots?

Hip flexion

125

What are the three motor/body activity carried out by the L2-L4 nerve roots?

Hip flexion
Hip adduction
Knee extension

126

What are the two motor/body activity carried out by the L4 nerve root?

Inversion
Dorsiflexion

127

What are the three motor/body activity carried out by the L5 nerve root?

Toe extension
Heel walk
Hip abduction

128

What are the three motor/body activity carried out by the S1 nerve root?

Eversion
Plantar Flexion
Hip Extension

129

What are the motor/body activity carried out by the S2-S4 nerve roots?

Anal Wink

130

What three muscles are innervated by the C6 nerve root?

Extensor Carpi Ulnaris
Extensor Carpi Radialis
Brachialis (Deep Tendon Reflex of C6)

131

What three muscles are innervated by the C7 nerve root?

Flexor Carpi Ulnaris
Flexor Carpi Radialis
Triceps (Deep Tendon Reflex of C7)

132

What three muscles are innervated by the C8 nerve root?

Flexor Digitorum Superficialis
Flexor Digitorum Profundus
Lumbricals

133

What two muscles are innervated by the T1 nerve root?

Dorsal Interossei
Palmer Interossei

134

What muscle is innervated by the T5-T12 nerve roots?

Rectus Abdominus

135

What muscle is innervated by the L1-L3 nerve roots?

Illiopsoas

136

What two muscles are innervated by the L2-L4 nerve roots?

Quadriceps
Adductors

137

What muscle is innervated by the L4 nerve root?

Tibialis Anterior

138

What four muscles are innervated by the L5 nerve root?

Extensor Digitorum
Extensor Hallucis Longus
Gluteus Medius
Gluteus Minimums

139

What three muscles are innervated by the S1 nerve root?

Peroneus Longus
Peroneus Brevis
Gluteus Maximus

140

What two muscles are innervated by the S2-S4 nerve roots?

Levator Ani
Coccygeus

141

Where is the dermatome/sensory level of C6 nerve root?

Lateral forearm
Digits 1 and 2

142

Where is the dermatome/sensory level of C7 nerve root?

3rd digit, middle finger

143

Where is the dermatome/sensory level of C8 nerve root?

Medial Forearm
Digits 4 and 5

144

Where is the dermatome/sensory level of T1 nerve root?

Medial Elbow

145

Where is the dermatome/sensory level of T5-T12 nerve root?

Respective vertebral level

146

Where is the dermatome/sensory level of L1-L3 nerve roots?

L1- Inguinal Ligament
L2- Oblique below L1
L3- Oblique across the knee

147

Where is the dermatome/sensory level of L4 nerve root?

Medial aspect of leg and foot

148

Where is the dermatome/sensory level of L5 nerve root?

Lateral aspect of the leg across the dorsum of the foot and big toe

149

Where is the dermatome/sensory level of S1 nerve root?

Lateral aspect of foot and plantar surface of foot

150

Where is the dermatome/sensory level of S2-S4 nerve roots?

Perianal

151

What disorder is seen in both the L4 and L5 nerve roots?

Foot Drop

152

What disorder is seen in C7 nerve root?

Klumpke's Paralysis (LMNL)
Radial Nerve

153

What disorder is seen in C8-T1 nerve roots?

Klumpke's Paralysis (LMNL)
Radial Nerve

154

What disorder is seen in L1-L3 nerve roots?

Meralgia Paresthetica

Lateral Femoral Cutaneous; mainly L2 and L3

Lat, Fem, Cut; She is 23 and to Cut(e) Fem me

155

What disorder is seen in S2-S4 nerve roots?

Cauda Equina

156

What is the motor/body action carried out by the Axillary Nerve?

Arm Abduction

157

What is the motor/body action carried out by the Musculocutaneous Nerve?

Elbow Flexion

158

What is the motor/body action carried out by the Medial Plantar Nerve?

Toe Extension

159

What is the motor/body action carried out by the Sciatic Nerve?

Flexion of the knee

160

What is the motor/body action carried out by the Obturator Nerve?

Hip Adduction

161

What are three motor/body actions carried out by the Radial Nerve?

Wrist extension
Finger extension
Thumb Abduction

162

What are the two motor/body actions carried out by the Media Nerve?

Thumb pinch
Opposition of the thumb

163

What are the two motor/body actions carried out by the Ulnar Nerve?

Abduction of the 5th Digit
Adduction of the thumb

164

What are the two motor/body actions carried out by the Dorsal Scapular Nerve?

Elevation of the Scapula
Retraction of the Scapula

165

What is the motor/body action carried out by the Long Thoracic Nerve?

Protraction of the Scapula

166

What are the two motor/body actions carried out by the Femoral Nerve?

Hip Flexion
Knee Extension

167

What are three motor/body actions carried out by the Peroneal Nerve?

Foot Dorsiflexion
Inversion
Eversion

168

What two muscles are innervated by the Axillary Nerve?

Deltoid
Teres Minor

169

What three muscles are innervated by the Radial Nerve?

Wrist Extensors
Finger Extensors
Triceps

170

What three muscles are innervated by the Musculocutaneous Nerve?

Biceps
Brachialis
Coracobrachilis

171

What four muscles are innervated by the Median Nerve?

Wrist Flexors
Thumb Flexors
Thumb Abductors
Thenar

172

What three muscles are innervated by the Ulnar Nerve?

Finger Abductors
Finger Adductors
Thumb Adductors

173

What two muscles are innervated by the Dorsal Scapular Nerve?

Rhomboids
Levator Scapula

174

What muscle is innervated by the Long Thoracic Nerve?

Serratus Anterior

175

What muscles are innervated by the Obturator Nerve?

Hip Adductor muscles

176

What two muscles are innervated by the Femoral Nerve?

Illiopsoas
Quadriceps

177

What muscle is innervated by the Sciatic Nerve?

Hamstrings

178

What three muscles are innervated by the Peroneal Nerve?

**Tibialis Anterior**
Toe Extensors
Peroneals

179

What muscles are innervated by the Medical Plantar Nerve?

Toe Flexor Muscles

180

What is the dermatome/sensory pattern of the Axillary Nerve?

Lateral Arm

181

What is the dermatome/sensory pattern of the Radial Nerve?

Dorsal web between thumb and index finger

182

What is the dermatome/sensory pattern of the Musculocutaneous Nerve?

Lateral Forearm

183

What is the dermatome/sensory pattern of the Median Nerve?

Distal Radial hand
2nd digit

184

What is the dermatome/sensory pattern of the Ulnar Nerve?

Distal Ulnar Hand
5th Digit

185

What is the dermatome/sensory pattern of the Lateral Femoral Cutaneous Nerve?

Lateral Thigh

186

What is the dermatome/sensory pattern of the Saphenous Nerve?

Medial Leg
Anteromedial Knee

187

What is the dermatome/sensory pattern of the Obturator Nerve?

Medial Thigh

188

What is the dermatome/sensory pattern of the Femoral Nerve?

Anteromedial Thigh
Anteromedial Leg

189

What is the dermatome/sensory pattern of the Sciatic Nerve?

Anterior Leg
Posterior Leg
Sole of the foot
Dorsum of the foot

190

What is the dermatome/sensory pattern of the Peroneal Nerve?

Anterior Leg
Dorsum of the foot

191

What disorder is seen with Axillary Nerve involvement?

Glenohumeral Dislocation

192

What three disorders is seen with Radial Nerve involvement?

Wrist Drop
Crutch Palsy
Erb's Palsy

193

What three Nerves have an Impingement disorders when they are involved?

Musculocutaneous
Obturator
Femoral

194

What three disorders is seen with Median Nerve involvement?

Carpel Tunnel
Ape Hand
Pronator Teres

195

What disorder is seen with Ulnar Nerve involvement?

Claw Hand

196

What disorder is seen with Dorsal Scapular Nerve involvement?

Flaring of the Scapula

197

What disorder is seen with Long Thoracic Nerve involvement?

Winging of the Scapula

198

What disorder is seen with Lateral Femoral Cutaneous Nerve involvement?

Meralgia Paresthetica (L2,L3)

199

What disorder is seen with Sciatic Nerve involvement?

Piriformis Syndrome (15%)

200

What disorder is seen with Peroneal Nerve involvement?

Fibular Head Fracture

201

What disorder is seen with Median Plantar Nerve involvement?

Tarsal Tunnel Syndrome

202

What type of pain is along a sensory distribution of a nerve root?

Dermatogenous

203

What is the definition of Myotogenous pain?

Pain that originates within a muscle

204

What type of pain is described as "Pain that arises from structures derived from embryological sclerotomes"?

Scleratogenous

205

What kind of pain occurs along the course of a dermatome due to nerve root irritation?

Radicular

206

What is the name of the pain that is "Pain along scleroderm of origination involving more then one kind of tissue"?

Referred (Shared Pathways)

207

What are the four characteristics of Muscle pain?

Cramping
Spasm
Aching
Dull

208

What are the four characteristics of Nerve pain?

Shooting
Radiating
Burning
Tingling

209

What are the two characteristics of Circulation pain?

Throbbing
Pulsating

210

What are the six characteristics of Bone Cancer pain?

Constant
Deep
Boring
Nocturnal
Progressive
Unremitting

211

What are the three characteristics of Scleratogenous pain?

Poorly localized
Dull
Ache

212

What is the characteristic of Myofascial pain?

Trigger Point

213

What are the two pain referral sites for a Gallbladder issue?

Right Shoulder
Inferior Scapula

214

What is the pain referral site for a Pancreas issue?

Spine at T10 level (Epigastric)

215

What are the three pain referral sites for a Heart issue?

Left Shoulder
Medial Left arm
Left Jaw/Side of the face

216

What is the pain referral site for a Intestinal issue?

Periumbilical

217

What is the pain referral site for a Kidney issue?

Flank

218

What is the pain referral site for a Ureter issue?

Groin

219

What is the pain referral site for a Bladder issue?

Suprapubic Area

220

What are the two pain referral sites for a Appendix issue?

Epigastric- Early
Right Lower Quadrant (RLQ)- Late

221

Where is the site of Carpal Tunnel Syndrome?

Under the Flexor Retinaculum

222

What are five causes of Carpal Tunnel Syndrome?

Trauma
Obesity
Hypothyroidism
Rheumatoid Arthritis
Fluid Retention during pregnancy

223

In Carpal Tunnel Syndrome where is the numbness and tingling usually located?

First three digits

224

What three signs may indicate Carpal Tunnel Syndrome?

Thenar Atrophy
Nocturnal Pain
Weak Opponens Pollicis (Ape Hand Appearance)

225

What two orthopedic exams will be positive in a patient with Carpal Tunnel Syndrome?

Tinel's test at the wrist
Phalen's Test

226

What are three treatments for a patient with Carpal Tunnel Syndrome?

Adjust (Lunate A-P)
Cock up splint
Vitamin B6

227

What condition of the Median Nerve/Anterior Interosseous Nerve is seen between the heads of the Pronator Teres at the elbow?

Pronator Teres Syndrome

228

In a patient with Pronator Teres Syndrome where are the three areas they will experience pain and paresthesia?

Palmar (Volar) aspect of the forearm
Lateral palm
Lateral digits

229

What causes Pronator Teres Syndrome?

Hypertonic Muscles i.e. Mechanics and Carpenters; work with a screwdriver, similar motion

230

What movements will cause pain in a patient with Pronator Teres Syndrome?

Pronation
Wrist flexion

231

What muscle of the hand will be atrophied in a patient with Pronator Teres Syndrome?

Thenar (Palm)

232

What orthopedic test will be positive in a patient with Pronator Teres Syndrome?

Pinch Grip Test

233

What are the two treatments for Pronator Teres Syndrome?

Trigger Point Therapy
Spray and Stretch

234

What are the two sites where the Ulnar Nerve can become trapped?

Tunnel of Guyon (Under the hook of the hamate)
Cubital Tunnel (Elbow)

235

What are two causes of Ulnar Nerve Entrapment?

Direct Trauma
Repetitive Microtrauma

236

What three signs will a patient present with that has Ulnar Nerve Entrapment?

Pain
Tingling/Numbness of the last 2 digits
Weakness of the Adductor Pollicis (Claw Hand Deformity)
Hypothenar atrophy (Pisiform)

237

Of the two entrapments; Tunnel of Guyon and Cubital Tunnel, which one will have weak wrist flexion on the ulnar side?

Cubital Tunnel Entrapment

238

What is the name of the condition that happens from a lower brachial plexus injury from childbirth?

Klumpke's Palsy (C8-T1)

239

What does Klumpke's Palsy look like?

Claw hand deformity with flexion of the wrist (Crumple Arm)

240

What is the description of the condition of Wrist Drop?

Unable to extend elbow and wrist

(Radial Nerve Involvement)

241

What is the name of the condition that has arm in "Adduction, Internal Rotation, and Flexion of the Wrist"?

Erb's Palsy AKA Waiter's Tip Deformity

(Radial Nerve Involvement)

242

What is the site that causes Saturday Night/ Crutch Palsy?

Spiral Groove

(Radial Nerve Involvement)

243

What are three causes of Saturday Night/Crutch Palsy?

Trauma
**Lead Poisoning**
Pressure from crutches

244

What reflex will be decreased in a patient with Radial Nerve involvement?

Triceps

245

In a patient with Radial Nerve involvement where will there be decreased sensation? (Three areas)

Posterior Arm
Posterior Forearm
Posterolateral three and a half (3.5) fingers

246

What are three causes of Winging Scapula?

Trauma
Iatrogenic
Idiopathic

247

What nerve is injured to cause Scapular Winging?

Long Thoracic Nerve

248

What muscle has paralysis in Scapular Winging?

Serratus Anterior

249

What nerve is damaged to cause Flaring of the Scapula?

Dorsal Scapular Nerve

250

What muscle has paralysis in Flaring of the Scapula?

Rhomboids

251

Where is the site of Meralgia Paresthetica?

Pelvic Brim under the inguinal ligament

252

What are three causes of Meralgia Paresthetica?

External pressure (Utility Belt i.e. Cops or Construction)
Obesity
Tight Jeans

253

What kind of symptoms are present with Meralgia Paresthetica?

Burning pain over the anterolateral thigh

254

What are two treatments for Meralgia Paresthetica?

Weight loss
Loose fitting clothes

255

Where are three sites of Sciatic pain?

Pelvis
Hip
Popliteal Fossa

256

What are five causes of Sciatica?

Trauma
Traction
Wallet Pressure
Piriformis contracture
Muscle spasm

257

Where will a patient with Sciatica have pain?

Posterior:
Buttock
Thigh
Leg, to the floor

258

What two leg movements will be decreased in a patient with Sciatica?

Weak knee flexion
Decreased Achilles Reflex

259

What is one possible differential diagnosis for Sciatica?

Facet involvement, **Facet will NEVER cross the knee**

260

What nerve is involved in Tarsal Tunnel Syndrome?

Medial Plantar Nerve; Branch from the Tibial Nerve

261

What three symptoms would a patient with Tarsal Tunnel Syndrome present with?

Burning Paresthesia
Decreased sensation on the soles of feet
Weak muscles of the foot

262

What two motions will cause pain in Tarsal Tunnel Syndrome?

Walking
Standing

263

What are three treatments for Tarsal Tunnel Syndrome?

Adjust
Orthotic support
Foot in slight inversion

264

What is another name for Morton's Neuroma?

Intermetatarsal Neuroma

265

What are five causes of Intermetatarsal Neuroma?

-Freiberg's Disease; avascular necrosis of a metatarsal, usually the 2nd one
-Repetitive Microtrauma
-Narrowed toed shoes
-Rheumatoid Arthritis (RA)
-Foot Deformities

266

Where does a patient with Morton's Neuroma have pain? (Two places)

Toes
Dorsum of the foot

267

What is one possible way to decrease pain in Morton's Neuroma?

Shoes with a bigger toe box

268

What orthopedic test will be positive for Intermetatarsal Neuroma?

Morton's Squeeze Test

269

What is the common site to have a Common Peroneal Nerve problem?

Fibular Head

270

What is the cause of Common Peroneal Nerve issues?

Trauma

271

What is the treatment for Common Peroneal Nerve complaints?

Adjust
Refer if there is a fracture

272

What two symptoms and where is the pain located in a patient with Common Peroneal Nerve issues?

Pain in the lateral leg
Weak Peroneal muscles
Foot drop

273

What nerve is involved in Anterior Compartment Syndrome?

Deep Peroneal Nerve (Medial Leg)

274

What condition has similar signs and symptoms to Deep Peroneal Nerve?

Charcot Marie Tooth

275

What four muscles can the Deep Peroneal Nerve effect?

Tibialis Anterior
Extensor Hallucis Longus
Extensor Digitorum Longus
Peroneus Tertius

276

What is the treatment for Deep Peroneal Nerve issues?

Medical Emergency

277

What is the name of the finger condition that is a "deformity in which the fingertip is curled in and cannot be straightened itself"?

Mallet Finger

278

What is the cause of the Mallet Finger Deformity?

Injury

279

What two finger conditions are seen in Rheumatoid Arthritis (RA)?

Swan Neck Deformity
Boutonniere Deformity

280

What is the finger deformity described by the following "Hyper-flexion of the Distal Interphalangeal (DIP) and hyper-extension of the Proximal Interphalangeal (PIP)"?

Swan neck deformity

281

How is the Boutonniere Deformity described?

Hyper-extension of the Distal Interphalangeal (DIP) and hyper-flexion of the Proximal Interphalangeal (PIP)

282

What finger condition has "an abnormal thickening underneath the skin of the palm and fingers"?

Dupuytren's Contracture

283

What two fingers are affected with Dupuytren's Contracture?

Last two finger, curl into the palm
(Middle finger may be involved in later)

284

What is the name of the finger condition that has a finger "Locked in a flexed position"?

Trigger Finger

285

What causes Trigger Finger?

**Tendons** of the flexed finger become inflamed or swollen

286

How is Trigger Finger corrected?

Finger is straightened by person, swollen tendon is forced into the sheath, causing a popping or snapping sound

287

What are the two inflamed tendons seen in De Quervain's Tenosynovitis?

**Extensor Pollicis Brevis**
**Abductor Pollicis Longus**

288

How is De Quervain's Tenosynovitis treated?

Bracing of the thumb and wrist

289

What orthopedic exam will be positive for De Quervain's Tenosynovitis?

Finkelstein's Test

290

What three functions does the Cerebrum help with?

Sensory Interpretation
Motor Interpretation
Language

291

What are five conditions that may effect the Cerebrum?

Stoke (Cardiovascular Accident; CVA)
Cerebral Palsy
Alcoholism
Alzheimer's
Tumor

292

What two functions are controlled by the Cerebellum?

Balance
Coordination

293

What are four possible problems that will be seen in a patient that has a Cerebellar issue?

Dysmetria (Past Pointing)
Dyssynergia (Lack of Coordination)
Diadochokinesia (Rapid Alternating Movements)
Unable to perform Tandem Gait

294

What are three conditions that are seen in Cerebellar Issues?

Multiple Sclerosis (MS)
Alcoholism
Cerebral Palsy

295

What three sensation is determined by the Posterior Columns?

Two point discrimination
Vibration (128 tuning fork on the distal joint)
Position Sense

296

When performing Romberg's test, when are the Posterior Columns tested?

When the patient closes their eyes

297

What four conditions are seen when the Posterior Columns are affected?

Multiple Sclerosis (MS)
Tabes Dorsalis
Leprosy
Diabetes Mellitus

298

What tract has to deal with Voluntary Movement and flexors of the hands and feet?

Corticospinal (Pyramidal) Tract

299

What tract is involved in an Upper Motor Neuron Lesion (UMNL)?

Corticospinal (Pyramidal) Tract

300

What two sensations are sensed by the Lateral Spinothalamic tract?

Pain
Temperature

301

What tract is involved in a Syringomyelia?

Lateral Spinothalamic Tract

302

What Tract is the sensation of Crude Light Touch?

Anterior Spinothalamic Tract

303

What tract deals with balance reflexes and postural muscles?

Vestibulospinal Tract

304

What two conditions can be seen if a patient has an issue with their Vestibulospinal Tract?

Benign Paroxysmal Positional Vertigo (BPPV)
Labyrinthitis

305

What is the function of the Rubrospinal Tract?

Muscle tone and synergy to the proximal flexors of the extremities

306

What spinal tract deals with "Muscle tone and synergy to voluntary extensor muscles"?

Reticulospinal Tract

307

What spinal tract crosses at the medullary pyramids and travels to the flexors of the extremities?

Lateral Corticospinal Tract

308

What does the Ventral Corticospinal tract effect?

Crosses at the segmental level
Goes to the flexors of the trunk

309

What condition is a "cyst of the central canal of the spinal canal"?

Syringomyelia

310

Where is the congenital weak area of the spine that is seen with Syringomyelia?

C5-C6

311

What is the common finding of Syringomyelia?

Loss of pain and temperature over the shoulders in a cape like distribution

312

What condition is a demyelination of the central nervous system (CNS)?

Multiple Sclerosis

313

What cells are responsible for myelination of the Central nervous system (CNS)?

Oligodendrocytes

314

What population is often affected by Multiple Sclerosis (MS) and Myasthenia Gravis?

Females aged 20-40

315

What can cause an increase in the exacerbation of Multiple Sclerosis (MS)?

Moving from cold to warm climates

316

What are the signs and symptoms of Multiple Sclerosis (MS)?

Diplopia
Scotomas (Partial Loss of vision or blind spot)
Transient Blindness
Optic Neuritis (Retrobulbar Neuritis)
Pain
Vertigo
Upper Motor Neuron Lesion (UMNL) in legs, causing distal weakness

317

What is the name of the positive orthopedic exam in Multiple Sclerosis (MS)?

Lhermitte's Test

318

What are the three components of Charcot's Triad, in Multiple Sclerosis (MS) patients?

SIN

Scanning Speech
Intention Tremor
Nystagmus

319

What are two ways to Diagnosis Multiple Sclerosis (MS)?

MRI (Best)
Cerebrospinal Fluid (CSF) exam; Increase in Proteins

320

What is always affected first in Myasthenia Graves?

Motor Cranial Nerves

321

In the condition of Myasthenia Graves what is makes it an Autoimmune Disorder?

The body makes antibodies against the acetylcholine receptors

322

What condition is a dysfunction of the Myoneural junction and is a weakness of the cranial nerves that later effects the proximal muscles?

Myasthenia Graves

323

What are the early signs of Myasthenia Graves?

Ptosis
Diplopia (Double Vision)
Dysarthria
**Fatigue of muscles** (Especially after exercise)
Muscle weakness varies during the day; **worse at day's end**

324

What test is done on patients with Myasthenia Graves?

ACHr test

325

What test is done to diagnosis Myasthenia Graves?

Tensilon Test

326

What type of drug is used to treat Myasthenia Graves?

Cholinesterase Inhibiting Drugs

327

What is the name for Lou Gehrig's Disease?

Amyotrophic Lateral Sclerosis (ALS)

328

What is first effected in Amyotrophic Lateral Sclerosis (ALS)?

Hands

329

Who usually has Amyotrophic Lateral Sclerosis (ALS)?

Males less than 40 years of age

330

What part of the spine is effected in Amyotrophic Lateral Sclerosis (ALS)?

Corticospinal tract
Anterior horn

331

What is a differential diagnosis of Amyotrophic Lateral Sclerosis (ALS)?

Lateral Canal Stenosis

332

What are the signs/symptoms of Amyotrophic Lateral Sclerosis (ALS)?

Fasciculations
Spasticity
Increase in Deep Tendon Reflexes (DTR)

333

What kind of lesions are seen in Amyotrophic Lateral Sclerosis (ALS)?

Lower Motor Neuron Lesion (LMNL) in the arms
Upper Motor Neuron Lesion (UMNL) in the legs

334

What is another name for Posterolateral Sclerosis (PLS)?

Combined System Disease

335

What areas of the spinal cord are effected in Combined Systems Disease?

Degeneration of:
Posterior Columns
Corticospinal Tracts

336

A deficiency in what Vitamin leads to Posterolateral Sclerosis (PLS)?

B12 (Pernicious Anemia)
Stomach Issue (Gut or Colon)

337

What test will be positive in Combined Systems Disease?

Shilling Test

338

What kind of paresthesia is seen in Posterolateral Sclerosis (PLS)?

Glove and Stocking
(Neurological Symptoms are irreversible)

339

What is the name of the condition that has a "hemisection (partially severed) spinal cord; usually caused by injury"?

Brown Sequard

340

In Brown Sequard, what is effected Ipsilateral and what is effected Contra-lateral?

Ipsilateral:
Motor function
Dorsal Columns

Contra-Lateral:
Loss of:
Pain
Temperature

341

What condition is described as "A non-progressive motor disorder of the cerebral cortex due to anoxia to the brain prenatally or during birth trauma"?

Cerebral Palsy

342

What type of Gait, Paralysis and two types of Movements are seen in patients with Cerebral Palsy?

Gait: Scissored (Tight Adductors)
Paralysis: Spastic
Movements:
Athetoid (Most Common)
Choreiform

343

What is another name for Parkinson's Disease?

Paralysis Agitans

344

What condition is "Chronic progressive associated with loss of dopamine in the Substantia Nigra causing Basal Ganglionic dysfunction"?

Parkinson's Disease

345

What tract is effected in Paralysis Agitans?

**Extrapyramidal Tract**

346

At what age is Parkinson's usually seen?

Over the age of 50, with a gradual onset

347

What are the signs and symptoms of Paralysis Agitans?

Resting tremor (Pill rolling)
Mask like face
Festinating gait
Cogwheel/Lead pipe rigidity
Forward stooped posture
Bradykinesia (Slow walking)

348

What condition is "Inflammatory polyneuropathy of the **Peripheral Nervous System (PNS)**, linked to recent immunization or recent flu infection"?

Guillain-Barre Syndrome

349

What kind of paralysis is Guillain-Barre Syndrome?

Ascending; begins in the legs. Sensory symptoms

350

When can Guillain-Barre Syndrome become a medical emergency?

If it reaches the diaphragm

351

What condition is seen in tertiary syphilis, effecting the posterior columns?

Tabes Dorsalis

352

What kind of pupil will be seen in a patient with Tabes Dorsalis?

Argyll Robertson's- pupil accommodates but no response to direct light

353

What kind of gait may be present in Tabes Dorsalis?

Slappage Gait

354

What two body functions are effected in Tabes Dorsalis?

Coordination
Balance

355

What condition is seen in Boys aged 3-7, that is a recessive sex linked disorder?

Muscular Dystrophy (Erb's Duchenne)

356

What kind of gait is seen in Muscular Dystrophy?

Waddling gait, weakness of proximal leg muscles

357

What three postural signs will you see in a patient with Muscular Dystrophy, besides gait?

Toe walking
Hyperlordosis (Pot-Belly Stance)
Pseudohypertrophy of the calves

358

What orthopedic exam can help diagnosis Muscular Dystrophy?

Gower's Sign

359

In the condition of Muscular Dystrophy what will be the lab findings?

Large increase in CPK (CK-MM)
Decrease in Creatinine

360

What condition is "mental deterioration and amnesia"?

Alzheimer's

361

What is the most definitive diagnosis for Alzheimer's?

Autopsy

362

What is the most common age of on set for the condition of Huntington's Chorea?

35-44

363

What kind of disease is Huntington's Chorea?

Neurodegenerative genetic disorder

364

What are the thing affected in Huntington's Chorea?

Muscle coordination
Cognitive decline
Dementia

365

What is the name of the condition that is "Hereditary and affects both moth and sensory nerves"?

Charcot Marie Tooth Disease

366

What are the three typical signs and symptoms of a patient that has Charcot Marie Tooth Syndrome?

Weakness of the foot and lower leg muscles
Foot Drop paired with a High Steppage Gait
Frequent trip and falls

367

What muscles of the lower leg are affected over time in Charcot Marie Tooth Syndrome?

Peroneal Muscles

368

What percentage of the gait cycle is Stance phase?

60%

369

What are the three phases of the Stance Phase?

Heel Strike (When heel hits the ground)
**Most stretch on the Sciatic Nerve**

Foot Strike (When heel of the foot is on the ground)
Toe Off (When up on toe and about to kick off)

370

What percentage of the gait cycle is in Swing Phase?

40%

371

What is the definition of Swing Phase?

Leg is swinging, no weight

372

What are the two parts of Swing Phase?

Early Swing
Late Swing

373

What two muscle cause Acceleration of the thigh?

Illiopsoas
Rectus Femoris

374

What muscle can sprinters easily tear off the Anterior Inferior Spine due to it's cartilaginous apophysis attachment?

Rectus Femoris

375

The hamstring assist in what part of the gait cycle?

Deceleration

376

What type of athlete is prone to pulling their hamstring?

Stop quickly
Forceful kicking

Hamstring is pulled of the ischial tuberosity

377

The Heel Strike fires what group of muscles?

Dorsiflexors (Tibialis Anterior innervated by the Deep Fibular (Peroneal) Nerve))

378

What muscle eccentrically contracts to absorb energy of the knee to prevent bucking, during the Heel Strike phase of the Gait Cycle?

Quadriceps

379

During Foot Strike of the Gait Cycle what muscles contact to hold the body up right?

Abductors

380

What muscles contract to move the body forward during the Foot Strike phase?

Plantar Flexors= Triceps Surae
Gastrocnemius
Soleus
Plantaris

381

During the Toe Off phase of the Gait Cycle what muscle concentrically contracts to help the body move ahead by elongating the lower limb?

Quadriceps

382

How is a Propulsion/Festinating/Shuffling gait described?

Forward leaning posture with small shuffling steps

383

What condition is seen to have a Propulsion/Festinating/Shuffling gait?

Parkinson's Disease

384

How is a Scissored gait described?

Knee's crossed at midline while walking (Tight Adductors)

385

What condition is a Scissored gait often seen in?

Cerebral Palsy

386

How is a Trendlenburg gait described?

Weak Gluteus Medias, causing lurching and drastic pelvic tilting on the affected side

387

What condition is a Waddling gait often seen in?

Muscular Dystrophy

388

What three conditions is a Steppage gait often seen in?

Anterior Compartment Syndrome
Foot Drop
**L4 Lesion**/ Paralysis of the Tibialis Anterior

389

What condition is a Slappage/Sensory Ataxia gait often seen in?

Posterior Columns Disease
(Difficult walking in the dark)

390

What two conditions is a Circumduction/Hemiplegic gait often seen in?

Stroke; swinging; unilaterally
Spastic Hemiplegia

391

What condition is a Spastic gait often seen in?

Upper Motor Neuron Lesion (UMNL)

392

What condition is a Drunken/Motor Ataxic gait often seen in?

Cerebellum issues (Wide based gait)

393

Where does 50% of flexion and extension occur in the cervical spine?

Occiput-C1

394

At what level does 50% of rotation occur in the cervical spine?

C1-C2

395

What is another name for Bakody's Test?

Shoulder Abduction Test

396

How is Bakody's Test performed?

Patient is seated, actively places affected arm/palm on top of their head. Elbow should be at the level of their head

397

What is considered a Positive Bakody's Test?

Relief of pain

398

What does Bakody's Test indicate?

Intervertebral Foramen (IVF) Encroachment

399

How is Foraminal Compression Test performed?

Patient is seated actively rotates head side to side.
Doctor presses down in a neutral position.
Rotate head to each side and apply downward pressure

400

How is Jackson's Compression Test performed?

Patient is seated, doctor lateral flexes patient's head to one side and applies downward pressure. Repeat on other side.

401

How is Maximum Cervical Compression Test performed?

**Never Touch the Patient**
Patient is seated, actively rotate, laterally flex and extend to one side. **Do NOT come back to Neutral**

If no pain have the patient maximally laterally flex. Repeat on the other side.

**No Compression/Downward pressure applied**

402

How is Distraction Test performed?

Patient seated, doctor exerts upward pressure on patient's head removing the weight of the patients head for the neck.

403

How is Shoulder Depression Test performed?

Patient is seated, doctor presses down on shoulder of patient while laterally flexing cervical spine away from shoulder. Perform on other side.

404

How is Soto Hall Sign performed?

Patient is supine, doctor places one hand on sternum while passively flexing patient's head toward chest.

405

What is considered a Positive Foraminal Compression Test?

Radicular Pain/Localized Pain

406

What is considered a Positive Jackson's Compression Test?

Radicular Pain/Localized Pain

407

What is considered a Positive Maximum Foraminal Compression Test?

Radicular Pain/Localized Pain

408

What is considered a Positive Distraction Test and what does it indicate, for both an increase and decrease in pain?

Decrease in Pain= Nerve root Compression/Space Occupying Lesion (SOL)

Increase in Pain=Sprain/Strain

409

What is considered a Positive Shoulder Depression Test?

Pain

410

What is considered a Positive Soto Hall Sign?

Localized Pain

411

What does Foraminal Compression, Jackson's Compression, Maximal Foraminal Compression Test indicate?

Nerve Root Compression/ Facet Syndrome

412

What does Shoulder Depression Test indicate?

**Nerve Root Adhesions**

413

What does Soto Hall Sign indicate? (Two things)

Compression Fracture (Anterior Pain)
Ligament Damage (Posterior Pain) (Sprain/Strain)

414

What four orthopedic exams can be performed to indicate a Space Occupying Lesion (SOL)?

Valsava's Maneuver
Naffziger's Test
Milligram's
Dejerine's Triad

415

How is Spurling's Test performed?

**Most aggressive for closing off Intervertebral Foramen (IVF)**

Patient actively maximally rotates and laterally flexes head to the affected side. Doctor delivers a vertical blow to the top of the head.

(Can be done bilaterally or with the neck in hyperextension)

416

How is Naffziger's Test performed?

Patient is seated while doctor applies digital pressure over the jugular veins bilaterally.

Can place blood pressure cuff around patient's neck and pump to 40 mm Hg and hold for ~30 seconds (NOT RECOMMENDED)

If patient has no pain, instruct them to cough

417

How is Valsava's Maneuver performed?

Doctor ask the patient to bare down like they are having a bowel movement

418

What is considered a Positive Spurling's Test?

Pain in the neck, shoulder or arm

419

What is considered a Positive Valsava's Maneuver Test?

Radicular Pain

420

What is considered a Positive Naffziger's Test?

Pain

421

What is a contraindication to Naffziger's Test?

Vascular Compromise

422

What is another name for Thoracic Outlet Syndrome (TOS)?

Neurovascular Compression Syndrome

423

Who should you refer a patient to if they have a Cervical Rib?

Orthopedist

424

How do you perform Allen's Test?

Patient seated with elbow flexed and forearm is supinated, ask the patient to pump the hand, keep closed while doctor occludes the radial and ulnar arteries until hand is blanched. Patient slowly opens the hand while doctor opens one artery and records filling time. Repeat on other artery.

425

What is a Positive Allen's Test?

Delay of more than 10 seconds for blood to return

426

What does a Positive Allen's Test indicate?

Occlusion of corresponding artery

427

How is Adson's Test performed?

Patient seated, doctor slightly abducts, extends and externally rotates the arm while taking the radial pulse.
Patient rotates the head towards the side being tested and extends head. Patient than takes a deep breathe.

428

What is another name for Adson's Test?

Scalenus Anticus Test

429

What is a Positive Adson's Test?

Alteration in **amplitude** of Radial Pulse

430

What does a Positive Adson's Test indicate?

Cervical Ribs

431

What is another name for Modified Adson's Test?

Scalenus Medius Test

432

How is Modified Adson's Test performed?

If Adson's test was NEGATIVE. Patient rotates their head to the opposite side, extends head and takes a deep breathe.

433

What is a Positive Modified Adson's Test?

Alteration in **amplitude** of the Radial Pulse

434

What does a Positive Modified Adson's Test indicate?

Subclavian Artery
Scalenus Medius Syndrome

435

What is another name for the Costoclavicualar Maneuver?

Eden's Test

436

How is Eden's Test performed?

Doctor palpates the radial pulse while drawing the patients shoulder down and back. The patient then flexes the chin to chest.

437

What is a Positive Eden's Test?

Alteration in the **amplitude** of the Radial Pulse

438

What does a Positive Eden's Test indicate?

Compression between the first rib and clavicle

439

What is another name for Wright's Test?

Hyperabduction Maneuver

440

How is Wright's Test performed?

Patient seated while the doctor palpates the radial pulse. Each arm is individually abducted to 180 degrees.
-Doctor notes angle at which radial pulse diminishes or disappears.

441

What is a Positive Wright's Test?

**Lower Arm is the affected arm** (+)

If pulses are lost with more than 10 degrees different between arms

442

What does a Positive Wright's Test indicate?

Pectoralis Minor Syndrome
*Axillary Artery*

443

What does a Reverse Bakody's Maneuver look like?

Seated patient actively places hand on top of head

444

What is a Positive Bakody's Maneuver?

Increase Pain

445

How is Halstead's Test performed?

Patient extends head back. Doctor slightly abducts the arm then applies downward ("Hal Down on the arm") traction on the arm while taking pulse.

446

What is a Positive Halstead's Test?

Alteration in the amplitude of Radial Pulse

447

What does a Positive Halstead's Test indicate?

Cervical Rib; Refer to an Orthopedist

448

How is Bikele's Sign performed?

Patient actively abducts the shoulder to 90 degrees with the elbow flexed to 90 degrees and then extends the shoulder. Now patient extends the elbow.

449

What is a Positive Bikele's Sign?

Resistance and increased radicular pain

450

What three things are indicated by a Positive Bikele's Sign?

Thoracic Outlet Syndrome (TOS)
Brachial Plexus Neuritis
Meningeal Irritation

451

How is Roo's Test performed?

Patient is seated. Both arms are at 90 degrees then patent abducts and externally rotates them.
The patient then repeatedly open and closes the fists for 3-5 minutes.

452

What is a positive Roo's Test?

Reproduction of symptoms or unusual discomfort

453

What does an Positive Roo's Test indicate?

Thoracic Outlet Syndrome (TOS)

454

Which one of the four rotator cuff **tendons** is most frequently torn?

Supraspinatus

455

Where is the Supraspinatus Muscle usually torn from?

Insertion point; the humeral head of the greater tuberosity

456

What is the best diagnosis for a Rotatory cuff tear?

MRI

457

What is the recommended treatment for Rotor Cuff injuries?

Codman's Exercises

458

What is the action of the Supraspinatus muscle?

Abduction

459

What is the nerve supply to the Supraspinatus muscle?

Suprascapular Nerve

460

Where does the Supraspinatus muscle insert?

Greater Tubercle of the humerus

461

What is the action of the Infraspinatus muscle?

External Rotation of the arm

462

What is the nerve supply to the Infraspinatus muscle?

Suprascapular Nerve

463

What is the insertion of the Infraspinatus muscle?

Greater Tubercle of the humerus

464

What is the action of the Teres Minor muscle?

External Rotation of the arm

465

What is the nerves supply of the Teres Minor muscle?

Axillary Nerve

466

What is the insertion of the Teres Minor Muscle?

Greater Tubercle of the humerus

467

What is the nerve supply of the Subscapularis muscle?

Subscapular Nerve

468

What is the action of the Subscapularis muscle?

Internal Rotation of the arm

469

What is the insertion of the Subscapularis muscle?

Lesser tubercle of the humerus

470

At what two joints does abduction of the shoulder occur?

Glenohumeral
Scapulothoracic articulation

471

What is the appropriate ratio of movement between the Glenohumeral joint and the Scapulothoracic articulation when the shoulder is abducted?

2:1

472

What does a decrease ration of the Glenohumeral joint and Scapulothoracic articulation indicate?

Adhesive Capsulitis AKA Frozen Shoulder

473

What two muscles elevate the scapula?

Trapezius
Levator Scapula

474

What two muscles retract the scapula?

Rhomboid (Major and Minor)

475

What muscle protracts the scapula?

Serratus Anterior

476

How is Apley's Scratch Test performed?

Patient is seated and instructed to actively put hand behind the head and touch the opposite superior angle of the scapula.
-Then place hand behind the back and touch the opposite inferior angle of the scapula

477

What is a Positive Apley's Scratch Test?

Pain or decreased Range of Motion (ROM)

478

What does a Positive Apley's Scratch Test indicate?

Degenerative Tendonitis of Rotator Cuff

479

How is Codman's Drop Arm Test performed?

Doctor passively abducts arm to about 90 degrees, then suddenly removes support.

-This causes deltoid to contract suddenly causing an increase in pain

480

What is a Positive Codman's Drop Arm Test?

Inability to maintain arm position

481

What does a Positive Codman's Drop Arm Test indicate?

Supraspinatus Tear

482

How is the Apprehension Test performed?

Doctor abducts and slowly externally rotates the affected shoulder.

483

What is a Positive Apprehension Test?

Patient shows sign of alarm

484

What does a Positive Apprehension Test indicate?

Chronic Shoulder Dislocation

485

How is Dugas' Test performed?

Patient places the hand of the affected shoulder on the opposite shoulder and attempts to touch the chest with the elbow

486

What is a Positive Dugas' Test?

Unable to perform

487

What does a Positive Dugas' Test indicate?

Acute Shoulder Dislocation

488

How is Dawbarn's Sign performed?

Test **Da-Bursa**

Deep palpitation by the doctor over the subacromial bursa elicits pain. Without moving the fingers the arm Is passively abducted.

489

What is a Positive Dawbarn's Sign?

Reduction of Pain

490

What does a Positive Dawbarn's Sign indicate?

Subacromial Bursitis; Most common Hydroxyapatite Deposition Disease (HADD)

491

How is Yergason's Test?

Patient flexes the elbow to 90 degrees while seated. Doctor palpates the bicipital tendon and resists the patient's attempt to actively supinate the hand and flex the elbow.

492

What is a Positive Yergason's Test?

**NOT positive for pain**

Audible click or snap in the bicipital groove

493

What does a Positive Yergason's Test indicate?

**Bicipital Tendon Instability**

494

What are two other names for Lateral Epicondylitis?

Radio Humeral Bursitis
Tennis Elbow

495

What muscle is affected in Lateral Epicondylitis?

Extensor Carpi Radialis Brevis

496

What movements will cause pain in the condition of Lateral Epicondylitis?

Wrist extension
Pronation of the elbow

497

What are two other names for Medial Epicondylitis?

Little leaguers Elbow
Golfer's Elbow

498

What muscle is affected in Medial Epicondylitis?

Flexor Carpi Ulnaris

499

What movement will cause pain in the condition of Medial Epicondylitis?

Flexion of the wrist, medial portion of the elbow

500

What are three treatment/case management for both Lateral and Medial Epicondylitis?

Transverse Massage
Underwater ultrasound
Counterforce brace

501

How is Cozen's Test performed?

Patient's elbow is flexed to 90 degree with the forearm pronated and fist dorsiflexed.
Doctor stabilizes the elbow and resists the patient's dorsiflexion.

502

What is a Positive Cozen's Test?

Pain in the lateral elbow

503

What does a Positive Cozen's Test indicate?

Lateral Epicondylitis

504

How is Reverse Cozen's Test performed?

Patient is seated with arm close to the body. Patient makes a fist and flexes wrist with supination. Doctor resist flexion of wrist while supporting the elbow.

505

What is a Positive Reverse Cozen's Test?

Pain In the medial elbow

506

What does a Positive Reverse Cozen's Test indicate?

Medial Epicondylitis

507

How is Mill's Test Performed?

Patient is instructed to extend the forearm, make a fist, flex the wrist and then maximally pronate the forearm.

This test can be performed passively by the doctor

508

What is a Positive Mill's Test?

Pain on the lateral Elbow

509

What does a Positive Mill's Test indicate?

Lateral Epicondylitis

510

How is Tinel's Sign at the Wrist performed?

Percuss over the flexor retinaculum of the wrist and the Tunnel of Guyon

511

What is a Positive of Tinel's sign at the Wrist?

Tingling into the lateral three finger or the medial two fingers

512

What does a Positive of Tinel's Sign at the Wrist indicate?

Carpal Tunnel Syndrome
Ulnar Nerve Impingement

513

How is Phalen's Sign performed?

Patient flexes the wrists maximally and hold the position for up to 60 seconds by pushing both wrist together

514

What is a Positive Phalen's Sign?

Tingling into the first three digits of the hand

515

What does a Positive Phalen's Sign indicate?

Carpal Tunnel Syndrome

516

How is Froment's Sign performed?

Doctor places a piece of paper between the patients thumb and index fingers and attempts to pull the paper out

517

What is a Positive Froment's Sign?

Unable to keep paper between finger

518

What does an Positive Froment's Sign indicate?

Ulnar nerve palsy

519

How is Finkelstein's Test performed?

Patient is asked to make a fist with the thumb tucked inside. Then the fist is deviated in the ulnar direction.

520

What two muscles are being evaluated during Finkelstein's Test?

Extensor Pollicis Brevis
Abductor Pollicis Longus

521

What is a Positive Finkelstein's Test?

Pain over the anatomical snuff box

522

What does a Positive Finkelstein's Test indicate?

De Quervain's Disease (Stenosing Tenosynovitis)

523

What is another name for De Quervain's Disease?

Stenosing Tenosynovitis

524

How is a Straight Leg Raiser (SLR) Test performed?

Patient is supine with legs extended. Doctor places one hone under the heel and the other over the knee and slowly raised the leg.

525

What is a Positive Straight Leg Raiser (SLR) Test?

Pain down the affected side

526

What are three possible indications from a Positive Straight Leg Raiser (SLR) Test?

Sciatica
Disc/Space Occupying Lesion (SOL)
Lumbar lesion

527

How is Bragard's Test Performed?

After pain with a Straight Leg Raiser (SLR), the leg is lowered below the point of discomfort and the foot is sharply dorsiflexed

528

What is a Positive Bragard's Test?

Pain in the affected leg

529

What does a Positive Bragard's Test indicate?

Sciatica

530

How is Sicard's Sign performed?

Perform a Straight Leg Raiser (SLR), lower the leg 5 degrees and dorsiflex big toe.

531

What is a Positive Sicard's Sign?

Pain in the affected leg

532

What does a Positive Sicard's Sign indicate?

**Sciatica**

533

How is Turyn's Sign performed?

While the patient is in the supine position, doctor dorsiflexes the big toe

534

What is a Positive Turyn's Sign?

Pain in the Gluteal region

535

What does a Positive Turyn's Sign indicate?

Sciatica

536

What is another name for the Well Leg Raiser (WLR)?

Fajerstazn's

537

How is a Well Leg Raiser (WLR) performed?

Straight Leg Raiser (SLR) with dorsiflexion of the foot performed on the asymptomatic side of a sciatic patient

538

What is a Positive Well Leg Raiser (WLR)?

Pain down Symptomatic (Sciatic) side

539

What does a Positive Well Leg Raiser (WLR) indicate?

Medial Disc Lesion

540

How is Millgram's Test performed?

Patient is supine with limbs extended. Patient is asked to elevate legs six (6) inches off the table and hold for as along as possible, up to 60 seconds

541

What is a Positive Millgram's Test?

Pain

542

What does a Positive Millgram's Test indicate?

Space Occupying Lesion (SOL)

543

How is Goldthwait's Sign performed?

Patient is supine with affected leg raised slowly while doctor's hand is under the lumbosacral portion of the spine.

544

What is a Positive Goldthwait's Sign?

Pain

545

What does a Positive Goldthwait's Sign indicate? (Three different indications)

0-30 degrees: Sacroiliac (SI) Joint
30-60 degrees: Lumbosacral Joint
60-90 degrees: Lumbar Spine or Contralateral SI Joint

546

How is Linder's Test performed?

Patient's head is passively flexed to the chest

547

What is a Positive Linder's Test?

Pain in the lumbar spine radiating to the sciatic nerve

548

What does a Positive Linder's Test indicate?

Root Sciatica

549

How is Bowstring's Test performed?

Doctor performs a Straight Leg Raiser (SLR) to the point of pain. The knee is flexed slightly and placed on the doctor's shoulder. Digital pressure is placed above the popliteal fossa and then in the popliteal fossa.

550

What is a Positive Bowstring's Test?

Pain in lumbar spine region or Radiculopathy

551

What does a Positive Bowstring's test Indicate?

Sciatica (BEST TEST)

552

How is Bonnet's Sign performed?

Patient supine, doctor stands on the side being tested. Doctor internally rotates leg, adducts leg and then performs a Straight Leg Raiser (SLR)

553

What is a Positive Bonnet's Sign?

Radicular Pain into the limb

554

What does a Positive Bonnet's Sign indicate?

Piriformis Syndrome

555

What is another name for Belt's Test?

Supported Adam's Test

556

How is Belt's Test Performed?

Patient bends forward and the doctor notes when the pain occurs.
Then doctor stands sideways behind the patient and grasps the Anterior Superior Iliac Spine (ASIS) and braces their hip into the sacrum.
The patient flexes again and range of motion is noted.

557

What is a Positive Belt's Test?

Pelvic Lesion: No pain when pelvis is stabilized
Spine Lesion: Pain will be present with and without stabilization

558

How is Kemp's Test performed?

Patient seated/standing and supported by the doctor.
Doctor rotates the patient's trunk from the original position and circumducts the trunk towards the affected side and then away from the affected side.

559

What is a Positive Kemp's Test?

Sciatic Pain Down the involved side

560

What does a Positive Kemp's Test indicate?

Posteromedial Disc: Positive Kemp's away from pain
Posterolateral Disc: Positive Kemp's into pain

561

How is Neri's Bowing Test performed?

When patient is bending forward at the waist the knee flexes on the side of involvement

562

What is a Positive Neri's Bowing Test?

Knee buckling

563

What does a Positive Neri's Bowing Test indicate? (Four Possibilities)

Tight Hamstrings
Lower Disc issue
Lumbosacral Issue
Sacroiliac Joint issue

564

How is Becterew's Test performed?

Patient seated. Patient attempts to extend each leg, one at a time. Doctor places one hand on the side being tested to resist hip flexion by the patient.
Patient then attempts to extend both legs together with both thighs stabilized by the doctor.

565

What is a Positive Becterew's Test?

Pain or Leaning Back

566

What does a Positive Becterew's Test indicate?

Disc
Posteromedial disc if pain when good leg is raised

567

How is Minor's Sign performed?

Ask the patient to rise form a seated position

568

What is a Positive Minor's Sign?

Patient will support body with uninvolved side balancing on good side

569

What does a Positive Minor's Sign indicate?

Sciatica

570

What is the Positive findings for the following test:
Gaenslen's Test
Lewin-Gaenslen's Test
Iliac Compression Test
Hibb's Test
Yeoman's Test

Pain in the Sacroiliac (SI) Joint

571

What is the Indication for the following test:
Gaenslen's Test
Lewin-Gaenslen's Test
Iliac Compression Test
Hibb's Test
Yeoman's Test

Sacroiliac (SI) Lesion

572

What is the best test for the Sacroiliac (SI) joint?

Yeoman's Test

573

How is Yeoman's Test Performed?

Doctor stabilizes Sacroiliac (SI) joint testing with other hand. Doctor flexes the leg of the affected side and hyperextends the thigh by lifting knee off the table.

574

How is Gaenslen's Test Performed?

Patient is supine, involved side near the edge of the examining table. Opposite knee and thigh fully flexed and fixed against the abdomen of the patient.
The involved leg is gradually extended off the table by the doctor.
Doctor applies downward pressure against clasped knee and knee of the extended hip.

575

How is Lewin-Gaenslen's Test Performed?

Patient side lying on unaffected side and pulls lower knee to chest.
Doctor stands behind patient, stabilizes pelvis and hyperextends the top thigh

576

How is Iliac Compression Test Performed

Patient in side-lying position with involved side up.
Doctor hands are placed over the upper part of the iliac crest.
Doctor exerts downward pressure.

577

How is Hibb's Test Performed?

Doctor stabilizes pelvis on side they are standing. With other hand, doctor grasps the ankle of the opposite leg and flexes the knee to 90 degrees. The doctor slowly pushes the leg laterally away producing

**Internal rotation of the hip**
Sacroiliac (SI) Joint or Hip Pathology

578

How is Hip Abduction Stress Test Performed?

Patient is lying on non-effected side. Patient actively abducts the leg, the doctor the exerts downward pressure on the proximal knee.

579

What is a Positive Hip Abduction Stress Test?

Pain at the Posterior Superior Iliac Spine (PSIS)

580

What does a Positive Hip Abduction Stress Test indicate? (Two indications)

Sacroiliac (SI) joint problems
Gluteus Medius Weakness

581

How is Nachlas Test Performed?

Patient's leg flexed to 90 degree. Heel is approximated to the same buttock. Doctor stabilizes the side they are testing

582

What is a Positive Nachlas Test?

Pain in the Sacroiliac (SI) Joint

583

What are two indications of Nachlas Test?

Sacroiliac (SI) joint lesion
If pain in anterior thigh; Femoral Nerve Stretch

584

How is Patrick's FABERE Test Performed?

Patient supine. Thigh is Flexed, Abducted, Externally Rotated and Extended while downward press is placed on the opposite Anterior Superior Iliac Spine (ASIS) and same knee

585

What is a Positive Patrick FABERE Test?

Pain in the hip

586

What does a Positive Patrick FABERE Test indicate?

Hip Lesion

587

How is Laguerre's Test Performed?

**Patrick FABERE in the Air**

Patient supine. Thigh is Flexed, Abducted, Externally Rotated and Extended while downward press is placed on the opposite Anterior Superior Iliac Spine (ASIS) and same knee

588

What is a Positive Laguerre's Test?

Pain in the hip

589

What does a Positive Laguerre's Test indicate?

Hip Lesion

590

How is Thomas Test Performed?

Patient supine, thigh is flexed with the knee bent up to the abdomen.

591

What is a Positive Thomas Test?

Opposite knee/thigh rises off the table

592

What does a Positive Thomas Test Indicate?

Hip flexion contracture

593

How is Allis Test Performed?

Patient supine, both knees flexed to 90 degrees with feet placed flat on the table and both malleoli approximated.

Doctor compares the height of the knees

594

What is a Positive Allis Test?

Significant difference in knee height

595

What does a Positive Allis Test indicate?

On knee taller an one more forward=
Posterior displacement of the femoral heal
Short femur

If one leg is Taller= Tibial Problem
If one knee is Forward= Femur Problem

596

How is Ortolani's Test Performed?

Infant is supine. Leg are abducted and externally rotated

597

What is a Positive Ortolani's Test?

Palpable or Audible Click

598

What does a Positive Ortolani's Test indicate?

Congenital Hip Dysplasia

599

How is Barlow's Test Performed?

Infant supine, hip in Adduction, gentle posterior pressure on each hip, one at a time

600

What is a Positive Barlow's Test?

Deep sounding "Thunk" as the femoral head subluxates Out of the socket

601

What does a Positive Barlow's Test indicated?

Congenital Hip Dysplasia

602

How is Ober's Test Performed?

Patient is side lying, involved side up.
Doctor places on hand on the pelvis. Thigh is abducted and extended.
Doctor then allows the leg to drop into adduction

603

What is a Positive Ober's Test?

Knee stays elevated (Abducted)

604

What does a Positive Ober's Test indicate?

Tensor Fascia Lata (TFL) Contracture

605

How is Ely's SIGN Performed?

Patient Prone. The heel is approximated to the same buttock after flexion of the knee

*No Stabilization*
**Sign-Same-pSoas**

606

What is a Positive for Ely's SIGN?

Pain

607

What does a Positive Ely's Sign indicate?

Rectus Femoris Contracture
pSoas

608

How is Ely's TEST Performed?

Patient prone. The heel is approximated to the opposite buttock and hyperextended

609

What is a Positive Ely's TEST?

Pain

610

What does a Positive Ely's TEST indicate?

Hip Lesion
Illiopsoas irritation
Inflamed lumbar nerve roots

611

How is Trendelenburg's Test Performed?

Patient stands and raises one foot of the floor and then the other, while the doctor observes the buttock/pelvis

612

What is a Positive Trendelenburg's Test?

Buttock/Pelvis on the foot that is raised off the floor drops
Patient will have Low Back Pain (LBP)

613

What does a Positive Trendelenburg's test indicat3e?

Hip Abductors are week on stance (Grounded) led side

614

What Knee condition is described as "Swelling and pain immediately after and injury"?

Ligament Tear

615

How is a Meniscal Tear described?

Swelling occurs 12-24 hours after injury. Unable to lock out joint

616

What are two other names for Chondromalacia Patella?

Patellofemoral Tracking Disorder
Runner's Knee

617

What muscle pulls the patella lateral in Runner's Knee?

Vastus Lateralis

618

What motion/action is most provocative in Patellofemoral Tracking Disorder?

Walking down stairs

619

What condition is caused by Chondromalacia Patella?

Retropatelar Degenerative Joint Disease

620

What two orthopedic test are performed to confirm Chondromalacia Patella?

Clark's
Fouchet's

621

What knee condition is seen in athletes doing repetitive knee extensions?

Osgood Schlatter's

622

What bone is injured in Osgood Schlatter's Disease?

Avulsion fracture of the Tibial tuberosity

623

What are two things to know about Osteochondritis Dessicans? (Knee Condition)

Avascular Necrosis (AVN)
Knee Locks out of Extension

624

What orthopedic test is used to confirm Osteochondritis Dessicans?

Wilson's Sign

625

What is the name of the knee condition that is "Prepatellar bursitis after repetitive pressure on the knee"?

Housemaid's Knee

626

What is another name for Jumper's Knee?

Patellar Tendonitis

627

Where is the pain in Tensor Fascia Lata (TFL) Syndrome?

Lateral knee

628

What causes the pain in Tensor Fascia Lata (TFL) Syndrome?

A shortened Tensor Fascia Lata (TFL)

629

What population and movements make Tensor Fascia Lata (TFL) Syndrome worse?

Population: Runners
Movements: Walking or running up and down hill or stairs

630

What three orthopedic test are used to test/check the integrity of the collateral ligaments of the knee?

Abduction Stress Test (Valgus Stress Test)
Adduction Stress Test (Varus Stress Test)
Apley's Distraction Test

631

What is another name for Abduction Stress Test?

Valgus Stress Test

632

How is the Abduction Stress Test Performed?

Patient is supine. Doctor applies valgus stress to the knee while abducting the foot in full extension and at 30 degrees of flexion

633

What is a Positive Valgus Stress Test?

Increased Pain or Laxity

634

What does a Positive Abduction Stress Test indicate?

Medial Collateral Ligament Involvement

635

What is another name for Varus Stress Test?

Adduction Stress Test

636

How is the Adduction Stress Test Performed?

Patient is supine. Doctor applies Varus stress to the knee while adducting the foot in full extension and at 30 degrees flexion

637

What is a Positive Adduction Stress Test?

Increased Pain or Laxity

638

What does an Positive Adduction Stress Test indicate?

Lateral Collateral Ligament Involvement

639

How is Apley's Distraction Test Performed?

Patient is prone, knee flexed to 90 degrees. Doctor anchors the thigh of the patient and grasps proximal to the foot and applies upward pressure and rotates the leg internal and externally.

**Heel points to the side being tested**

640

What is a Positive Apley's Distraction Test?

Pain in the knee

641

What does a Positive Apley's Distraction Test indicate?

Collateral Ligament Tear

**Heel points to the side of torn ligament**

642

What four Orthopedic Test can be performed for the Cruciate Ligaments of the Knee?

Drawer Test
Slocum's Test
Lachman's Test
Posterior Sag Sign

643

How is Drawer Test Performed?

Patient is supine. Knee is flexed to 90 degrees and hip to 45 degrees. Doctor Stabilizes the foot on the table.
Tibia is then drawn forward and back

644

What is a Positive Drawer Test?

Pain or Joint Laxity

645

What does a Positive Drawer Test indicate?

Anterior (Pulling A-P) Anterior Cruciate Ligament (ACL) tear

Posterior (Pulling P-A) Posterior Cruciate Ligament (PCL) tear

646

How is Slocum's Test Performed?

**Rotary Instability**

Patient is Supine. Knee is flexed to 90 degrees foot is put into internal and external rotation.
Doctor stabilizes the foot and grasps the leg with thumbs palpating the knee joint.
Doctor pulls the tibia applying P-A stress in the knee

647

What is a Positive Slocum's Test?

Pain or Joint Laxity

648

What does a Positive Slocum's Test indicate?

External Rotation: Anterior Cruciate Ligament (ACL) AND Medial Cruciate Ligament (MCL)

Internal Rotation: Anterior Cruciate Ligament (ACL) AND Lateral Cruciate Ligament (LCL)

649

How is Lachman's Test Performed?

**Best test for the Anterior Cruciate Ligament (ACL)**

Patient supine. Knee is flexed to 30 degrees
Doctor stabilizes the femur with one hand and pulls the tibia forward with the other

650

What is a Positive Lachman's Test?

Soft End Feel

651

What does a Positive Lachman's Test indicate?

Anterior Cruciate Ligament (ACL) instability

652

How is Posterior Sag Sign Performed?

**Dashboard to Tibia in a motor vehicle accident**

Patient Supine. knees flexed to 90 degrees, hip flexed to 45 degrees
Doctor compares the prominence for the Tibial tuberosites

653

What is a Positive Posterior Sag Sign?

Tibial drops back (sags) on the femur

654

What does a Positive Posterior Sag Signe indicate?

Posterior Cruciate Ligament (PCL) tear

655

What three orthopedic test can be performed to test the Meniscus of the knee?

MuMurray Sign
Apley's Compression Test
Bounce Home Test

656

What is the best orthopedic exam for the Meniscus of the knee?

McMurray Sign

657

What is lacking to the Meniscus of the knee?

Nerve Supply

658

If a patient has a meniscus issue how long will it be after an injury until you see swelling?

12-24 hours

659

How is MuMurray Sign Performed?

Patient supine. Doctor flexes the thing and leg to 90 degrees.
Doctor places one hand on the knee, grasps the patient's heel.
Doctor Externally rotates the leg, and then slowly extends the knee.
Doctor then internally rotates the leg and brings it into extension with a valgus stress to the joint

660

What is a Positive MuMurray Sign?

Painful click or snap heard

661

What does a Positive MuMurray Sign indicate?

Lateral Meniscus: Internal Rotation

Medial Meniscus: External Rotation

662

How is Apley's Compression Test Performed?

Patient Prone with knee flexed to 90 degrees
Doctor anchors the thigh of the patient and grasp proximal to the foot and applies downward pressure and rotates the leg internally and externally.

*Heel Points to the side being tested*

663

What is a Positive Apley's Compression Test?

Pain in the knee

664

What does a Positive Apley's Compression Test indicate?

Lateral Meniscus: External Rotation

Medial Meniscus: Internal Rotation

**Heel Points to side of Pathology**

665

How is Bounce Home Test Performed?

Patient is supine, knee is flexed completely
Knee is dropped into extension

666

What is a Positive Bounce Home Test?

Incomplete Extension

667

What does a Positive Bounce Home Test indicate?

Meniscus Tear
12-24 hours before you will see swelling

668

What two orthopedic tests can be to check the Patella?

Apprehension Test of the Patella
Clarke's Sign AKA Patellar Grinding Test

669

What is another name for Clarke's Sign?

Patellar Grinding Test

670

How is Apprehension Test of the Patella Performed?

Patient supine.
Doctor displaces patella medial to lateral

671

What is a Positive Apprehension Test of the Patella?

Patella will feel dislocated and the quadriceps contracts
Look at face for alarm/apprehension

672

What does a Positive Apprehension Test of the Patella indicate?

Chronic Patellar Dislocation

673

How is Clarke's Sign Performed?

Patient supine, with knee extended
Doctor applies superior to inferior pressure on the superior pole of the patella and ask the patient to contract the quadriceps

674

What is a Positive of Clarke's Sign?

Retropatellar Pain
Inability to sustain a contraction of the quadriceps

675

What does a Positive Clarke's Sign indicate?

Chondromalacia Patella

676

What are three additional orthopedic exams that can be done on the knee?

Wilson's Test
Dreyer's Test
Noble Compression Test

677

How is Wilson's Test Performed?

Patient is seated and actively extends and flexes knee with tibia internally rotated.
When 30 degrees is reached the pain increases and is relieved by external rotation of the tibia

678

What is a Positive Wilson's Test?

Decrease in Pain

(This test has been seen on Boards lately)

679

What does a Positive Wilson's Test indicate?

Osteochondritis Dessicans (Avascular Necrosis)

680

How is Dreyer's Test Performed?

Patient supine. Asked to raise their extended leg, unable to do so.
Doctor applies pressure to the quadriceps muscle and patient can lift their leg

681

What is a Positive Dreyer's Test?

Patient can only lift their leg with pressure is applied to the quadriceps muscle

(This test has been seen on Boards lately)

682

What does a Positive Dreyer's Test indicate?

Fractured Patella

683

How is Noble Compression Test Performed?

Patient supine. Hip and knee are both flexed at 90 degrees
Doctor applies pressure to the lateral femoral condyle while extending the knee

684

What is a Positive Noble Compression Test?

Pain over the area of Pressure

685

What does a Positive Noble Compression Test indicate?

Tensor Fascia Lata (TFL) Syndrome

AKA

Illiotibial Band Syndrome

686

What are three abnormalities of the foot?

Pes Planus
Talipes Equinovarus
Pes Cavus

687

What condition is commonly called "Flat Feet" and have the heads of the tarsals displaced medially and downward (Plantarward)?

Pes Planus

688

What are the two treatments for Pes Planus?

Exercise foot muscles, pull a towel in with toes
Orthotics

689

What is another name for Club Foot?

Talipes Equinovarus

690

How is Talipes Equinovarus described?

Most common birth defect, heel is elevated and foot is turned inward

691

What is the condition of very high arches and toes are in flexion?

Pes Cavus

692

What is a treatment of Pes Cavus?

Orthotics

693

What is a patient with Pes Cavus prone to?

March/Stress Fracture

694

What is the name of the nerve tumor most commonly between the 3rd and 4th metatarsal head?

Morton's Neuroma

695

What is another name for a Metatarsal Stress Fracture?

March Fracture

696

What is the name of the condition that is often seen with pain in the morning and brought on by a heel spur?

Plantar Fasciitis

697

In the condition of Plantar Fasciitis when does the pain decrease?

Throughout the day

698

What is one possible treatment of Plantar Fasciitis?

Deep tissue massage

699

What is the name of the condition that has a burning pain on the sole of the foot (Medial Plantar Nerve)?

Tarsal Tunnel Syndrome

700

What two orthopedic test that can be used to check for Achilles Tendon Rupture?

Thompson's Test AKA Simmond's Test/Trauma

701

What is the most common sprain/strain of the ankle?

Inversion

702

What grade of Sprain/Strain has "No ligaments torn, but may have slight swelling or decreased range of motion"?

Grade 1

703

What is the treatment for a Grade 1 sprain/strain?

PRICE
Protect
Rest
Ice
Compress
Elevate

704

How is a Grade 2 Sprain/Strain described? (Three characteristics)

Incomplete or partial Rupture
Lots of swelling and bruising
Almost no range of motion (immobilize 2-3 weeks)

705

What are the characteristics of a Grade 3 sprain/strain?

Complete Tear
Surgical Case
Refer to and Orthopedist

706

How is the Anterior Front Drawer Test Performed?

Patient Supine. Doctor places hand around anterior aspect of the lower tibia while grasping calcaneus in the palm of the other hand and then pulls calcaneus forward.

707

What is a Positive Anterior Foot Drawer Test?

Talus slides forward

708

What does a Positive Anterior Foot Drawer Test indicate?

Anterior Talofibular Ligament Instability
Calcanofibular Ligament
Posterior Talofibular Ligament

709

How is the Medial and Lateral Stability Test Performed?

Patient is seated or supine.
Doctor grasps the patient's foot and passively inverts and everts the foot.

710

What is a Positive Medial and/or Lateral Stability Test?

Excessive gapping on either side

711

What does a Positive Medial and/or Lateral Stability Test indicate?

During Inversion- Anterior Talofibular or Calcaneofibular ligament tear

During Eversion- Deltoid Ligament Tear

712

What is another name for Thompson's Test?

Simmond's Test

713

How is Thompson's Test performed?

Patient Prone; feet hanging off the table
Doctor flexes knee to 90 degrees and squeezes the calf

714

What is a Positive Thompson's Test?

No Plantar flexion of foot

715

What does a Positive Thompson's Test indicate?

Achilles' tendon Rupture

716

What are the five Malingering test?

Burn's Bench Test
Hoover's Sign
Lasegue's Sitting Test
Magnusson's Test
Mannnkopf's Sign

717

How is Burn's Bench Test Performed?

Patient is instructed to kneel on a table 18 inches off the floor, bend forward at the trunk and touch the floor.
Doctor holds the ankle

718

What is a Positive Burn's Bench Test?

Patient refuses to preform test

719

How is Hoover's Sign Performed?

Patient supine
Doctor places one hand under each heel and ask patient to lift affected limb

720

What is a Positive Burn's Bench Test?

Doctor does not fell the unaffected side pressing downward

721

How is Lasegue's Sitting Test Performed?

Patient is seated upright on the edge of the table/chair (with no back rest)
Doctor faces the patient and usually under the guise of "Checking circulation" extends the patient's legs below the knee, one at a time, so the limb is parallel with the floor

722

What is a Positive Lasegue's Test?

No pain when there had been a Positive Straight Leg Raiser (SLR)

723

How is Magnusson's Test Performed?

At the beginning of the Case History, patient is asked to point to the site of pain
Doctor marks it with a skin marking pencil/documents on paperwork
Doctor later ask patient to point to site of pain

724

What is a Positive Magnusson's Test?

Patient does not point to the originally spot of pain

725

How is Mannkopf's Sign Performed?

Doctor takes a resting pulse rate
Doctor then applies pressure over the painful area and takes pulse rate again

726

What is a Positive Mannkopf's Sign?

An increase in pulse rate of 10 beats per minute

727

What does a Positive Mannkopf's Sign indicate?

Not a Malinger (Pulse Rate does not change)

728

What are four orthopedic exams that can be used to diagnosis Ankylosing Spondylitis?

Chest Expansion Test
Forresiter's Bowstring Sign
Lewis Supine Test
Amoss Sign

729

How is Chest Expansion Test Performed?

A tape measure placed around the 4th intercostal space.
Patient exhales completely, measurement is taken
Patient inhales completely, measurement is taken

**Normal 1.5-3 inches difference**

730

What is a Positive Chest Expansion Test? (Both Genders)

Women: Less than a 1.5 inch difference
Men: Less than a 2 inch difference

731

How is Forrestier's Bowstring Sign Performed?

Patient standing, have them bend to each side

732

What is a Positive Forrestier's Bowstring Test?

Muscle tightness on the ConCave side

733

How is Lewin Supine Test Performed?

Patient Supine
Doctor supports the legs on the table. Patient in then asked to do a sit-up with out using their hands

734

What is a Positive Lewin Supine Test?

Unable to perform a Sit-up without the use of their hands

735

How is Amoss Sign Performed?

Patient is asked to go from a side-lying to a seated position

736

What is a Positive Amoss Sign?

Localized thoracolumbar pain
Lack of Range of Motion

737

What are three things a Positive Amoss Sign Indicate?

Ankylosing Spondylitis
Intervertebral Disc Syndrome
Severe Sprain/Strain

738

What condition are all indicated by:

Chest Expansion Test
Forrestier's Bowstring Test
Lewin Supine Test
Amoss Sign

739

Is it possible to diagnosis Ankylosing Spondylitis on x-Ray?

Yes

740

In a patient with Meningeal Irritation what are four symptoms will they present with?

Fever
Headache
Photophobia
Nuchal Rigidity

741

In a patient with Meningeal Irritation, when evaluating the Cerebrospinal Fluid (CSF) what macronutrient will be seen in each type and will it be increased or decreased?

Viral: Increase in Proteins (Lymphocytes)

Bacterial: Decrease in Glucose

742

What two orthopedic exam Indicate Meningeal Irritation?

Brudzinski Sign
Kernig's Sign

743

How is Brudzinski Sign Performed?

Patient supine
Doctor passively flexes the patient's head approximating chin to chest

744

What is a Positive Brudzinski Sign?

Buckling of the patient's knee

745

How is Kernig's Sign Performed?

Patient Supine
Doctor flexes the hip and knee to a 90/90 position and then attempts to extend the knee

746

What is a Positive Kernig's Sign?

Patient resists extension
Resistance causes a Kicking motion

747

How is Gower's Sign Performed?

When patient is arising from a supine position, patient turns prone and then climbs up themselves

748

What does a Positive Gower's Sign indicate?

Muscular Dystrophy

749

How is Lhermitte's Sign Performed?

Patient seated or supine
Patient actively and passively flexes chin to chest

750

What is a Positive Lhermitte's Sign?

Sharp electric shock like sensation don the the spine into the extremities

751

What three conditions does a Positive Lhermitte's Sign indicate?

Multiple Sclerosis**
Myelopathy
Demyelination cord lesions

752

How is Libman's Test Performed?

Doctor places thumbs on mastoid process, applies pressure until patient expresses discomfort

753

What is Libman's Test used for?

Pain threshold of a Patient

(Can also be used for a malingering test)

754

How is Rust Sign performed?

Patient spontaneously grasp the head/neck with both hands when rising from a lying position

755

What are three indications of a Positive Rust Sign?

Cervical instability due to a sprain/strain
Fracture
Rheumatoid Arthritis (RA)

756

How is Schepelmann's Sign Performed?

Patient raises both arms over head while seated and laterally bends to each side

757

What does a Positive Schepelmann's Sign indicate?

Concave Side pain: Intercostal Neuralgia

Convex Side pain: Pleurisy or Myofascitis

758

How is Dejerine's Triad Performed?

Patient has pain brought on by coughing, sneezing or bearing down

759

What does a Positive Dejerine's Triad indicate?

Space Occupying Lesion (SOL)

760

How is Hofman's Sign Performed?

Patient Supine
Hip and knee flexed to 90 degrees
Doctor squeezes and dorsiflexes the foot simultaneously

761

What is a Positive Homan's Sign?

Deep Calf Pain

762

What does a Positive Homan's Sign indicate?

Deep Vein Thrombosis (DVT)

763

How is O'Donohue's Test Performed?

Patient actively moves any joint against resistance (Muscle being tested) and then
Doctor passively (Ligament being tested) move the joint through full range of motion (ROM)

764

What is a Positive O'Donohue's Test?

Pain in the joint/area being tested

765

What does a Positive O'Donohue's Test indicate?

Pain at Passive Range of Motion (ROM): Sprain (Ligament)

Pain at Active Range of Motion (ROM): Strain (Muscle)

766

What rating on the Wexler Scale (Deep Tendon Reflexes) indicate a Lower Motor Neuron Lesion (LMNL)?

0+
1+

767

What function does a Afferent Nerve have?

Sensory

768

What is the function of a Efferent Nerve?

Motor

769

What nerve has Worse pain at night?

Median Nerve

770

What nerve innervates the lateral forearm and hand?

Median Nerve

771

What nerve innervates the medial forearm and hand?

Ulnar Nerve

772

What nerve innervates the posterior arm and hand?

Radial Nerve

773

What are four things that can cause Scleratogenous Pain?

Facet
Sacroiliac (SI) joint
Scapular--Thoracic articulation
Tempromandibular Joint (TMJ)

774

What condition will be seen in a patient who was baking cookies and burned their skin on a hot pan but did not realize it until they smelled burning skin/flesh?

Syringomyelia

775

In what condition is it a contraindication of any heating modalities (i.e. Paraffin Baths)

Multiple Sclerosis

776

What area of the brain is effected with a Lateral Nystagmus?

Cerebellum

777

What area of the brain is effected if the patient has a Vertical Nystagmus?

Brain Stem

778

What is the name of the test performed on patients with Myasthenia Gravis that has a decreased response overtime due to Acetylcholine receptors?

Holly-Jolly EMG

779

In the condition of Brown Sequard, what side will have Motor and Sensory loss?

Motor Loss: Ipsilateral Side of lesion
Sensory Loss: Contralateral Side of lesion

780

What "Type" of writing will you see in a patient with Parkinson's Disease?

Very small (Microgaphy), trying to hide they resting tremor in their hand

781

What is another name for Gillian-Barre Syndrome?

Laundry's Paralysis

782

What condition is seen in a patient who goes to the bathroom at night without turning on the lights?

Tabes Dorsalis

(Decreased light is very similar to closing the eyes, Posterior Columns problem)

783

What condition will have difficulty walking upstairs?

Muscular Dystrophy

784

What is the name of the condition that has chronic wide spread pain?

Fibromyalgia

785

How is Fibromyalgia confirmed?

Pain at 11 of 18 tender points

786

What four symptoms are associated with Fibromyalgia?

Fatigue
Sleep disturbances
Joint Stiffness
Depression

787

What are five things that can cause a Space Occupying Lesion(SOL)?

Disc
Intervertebral Foramen (IVF) encroachment
Tumor
Inflammation
Subluxation

788

What type of lesion is a Space Occupying Lesion (SOL), said to be?

Lower Motor Neuron Lesion (LMNL)

789

If a patient has pain on Ulnar deviation what is being affected?

Triangular Fibrocartilage Complex

790

What orthopedic exam is paired with Nobel's Compression Test?

Ober's Test`

791

Cruciate Ligaments are name for what?

Where they attach to the tibia (Cross your fingers)

792

What is the most injured muscle of the Quadriceps?

Vastus Medialis

793

What knee ligament is the most injured ligament?

Anterior Cruciate Ligament

794

What meniscus is the most injured?

Medial Meniscus

795

What action causes and Unhappy Triad?

A blow to the lateral side of the knee, then planted into the ground

796

What three Structures are injured in an Unhappy Triad?

Medial Collateral Ligament
Anterior Cruciate Ligament
Medial Meniscus

797

What two findings of the knee will be present if there is a Meniscus tear?

Walking and the knee gives way
Knee locks out (Bucket handle)

798

What two grading of Sprain/Strain can be seen by a Chiropractor?

Grade 1
Grade 2

799

Achilles tendon rupture is most commonly seen in patients who use what?

Corticosteroids