Ortho Exams Week 8

Question 1

What is the patient position for craig’s test for anteversion (toes point medially) and retroversion (toes point laterally)?

Answer 1

prone with knee flexed to 90 degrees

Question 2

What ortho test is this?
-patient is prone with knees flexed to 90 degrees
-doctor internally rotates patient hip until greater trochanter is parallel to the floor (palpate trochanter while doing it)
-measure the angle between knee and tibia

Answer 2

craig’s test for anteversion (toes point medially) and retroversion (toes point laterally)

Question 3

What is a positive sign for craig’s test for anteversion and retroversion?

Answer 3

less than 8 degrees OR greater than 15 degrees

Question 4

What does a positive sign for craig’s test for anteversion and retroversion indciate?

Answer 4

less than 8 degrees= femoral retroversion (external femoral torsion)

greater than 15 degrees= femoral anteversion (internal femoral torsion)

Question 5

What is usually self resolving in infants and toddlers?

Answer 5

anteversion and retroversion

Question 6

What is the patient position for quadriceps “Q” angle?

not on practical

Answer 6

standing

note: this is best seen on xray

Question 7

What ortho test is this?
-patient is standing
-extend a line through tibial tuberosity and the center of the patella upward
-connect another line from the ASIS through the center of the patella
-the angle formed by these 2 lines is the?

not on practical

Answer 7

quadriceps “Q” angle

Question 8

What is a positive sign for Q angle?

not on practical

Answer 8

men: 14 degrees+ or less than 3 degrees

women: 17 degrees+ or less than 3 degrees

Question 9

What does a positive sign for Q angle indicate?

not on practical

Answer 9

1) IT band syndrome
2) patella tracking
3) runners knee
4) genu valgum “knock knee” and femoral anteversion

Question 10

Anterior hip pain may be what?

Answer 10

1) pathology
2) DJD
3) hip flexor pain/tendonitis
4) iliopsoas bursitis
5) stress fractures

Question 11

Lateral hip pain may be what?

Answer 11

1) trochanteric bursitis
2) IT band syndrome
3) meralgia paresthetica

Question 12

Posterior hip pain may be what?

Answer 12

pain is usually outside of the hip such as lumbar DJD, facet arthropathy, spinal stenosis, SI joint, ot aorto-vascular occlusive disease

Question 13

Groin pain may be what?

Answer 13

1) ligamentum teres tear
2) acetabuluar labrum tear
3) adductor strain
4) hernia

Question 14

Retropatellar pain is often referred to as runners knee due to?

Answer 14

abnormal patella tracking in the femoral groove (trochlea)

Question 15

What are the 3 retropatellar pain tests?

Answer 15

1) Q angle (not on practical)
2) patellar grinding test/ clarke’s sign
3) fouchet’s sign

Question 16

What is the patient position for patellar grinding test/clarke’s sign?

Answer 16

supine

Question 17

What ortho test is this?
-patient is supine
-doctor places pressure on patella with web of hand (between thumb and fingers) in downward direction to prevent superior movement of the patella
-patient is told to flex quad

Answer 17

patellar grinding test/clarke’s sign

Question 18

What is a positive sign for patellar grinding test/clarke’s sign?

Answer 18

retro patellar pain (where patella meets trochlea) and possible clicking

Question 19

What does a positive sign for patellar grinding test/clarke’s sign indicate?

Answer 19

patella femoral arthralgia or runners knee

Question 20

What is the patient position for fouchet’ sign?

Answer 20

supine

Question 21

What ortho test is this?
-patient is supine
-doctor presses down on patient patella with both hands stacked together
-if patient has no pain then doctor rubs patella transversely across patellar groove

Answer 21

fouchet’s sign

Question 22

What is a positive sign for fouchet’s sign?

Answer 22

pain under patella, audible or palpable click with transverse motion

Question 23

What does a positive sign for fouchet’s sign indicate?

Answer 23

patella femoral arthralgia

Question 24

What are the 3 knee stability tests?

Answer 24

1) abduction stress test/valgus stress test
2) adduction stress test/varus stress test
3) apley’s distraction test

Question 25

What is the patient position for abduction stress test/valgus stress test?

Answer 25

supine

Question 26

What ortho test is this? -patient is supine -doctor extends patient leg and applies a valgus stress to the knee via abducting the foot, and then does the same with leg in 30 degrees of flexion if theres no excessive movement in extension

Answer 26

abduction stress test/valgus stress test

Question 27

What is a positive sign for abduction stress test/valgus stress test?

Answer 27

medial knee laxity/instability and possible pain

Question 28

What does a positive sign for abduction stress test/valgus stress test indicate?

Answer 28

medial/tibial collateral ligament sprain

Question 29

What aids the MCL in stabilization?

Answer 29

oblique popliteal ligament

Question 30

What is the patient position for adduction stress test/varus stress test?

Answer 30

supine

Question 31

What ortho test is this? -patient is supine -doctor extends patient leg while applying varus stress to the knee via adducting the foot -repeat with leg in 30 degrees flexion if the knee does not excessively move in extension

Answer 31

adduction stress test/varus stress test

Question 32

What does a positive sign for adduction stress test/varus stress test indicate?

Answer 32

lateral/fibular collateral ligament sprain

Question 33

What is a positive sign for adduction stress test/varus stress test?

Answer 33

lateral knee laxity/instability and possible pain

Question 34

What aids the LCL in stabilization?

Answer 34

tendon of the popliteus muscle when the knee is flexed

Question 35

What is the patient position for apleys distraction test?

Answer 35

prone

Question 36

What ortho test is this? -patient is prone with knee flexed to 90 degrees -doctor stabilizes patient femur with their knee -doctor grasps patient ankle if affected leg with both hands and distracts tibia from femur while rotating leg both internally and externally

Answer 36

apley's distraction test

Question 37

What is a positive sign for apleys distraction test?

Answer 37

-pain in knee -laxity/instability -excessive rotation

Question 38

What does a positive sign for apleys distraction test indicate?

Answer 38

MCL or LCL sprain/tear

Question 39

Which meniscus is more commonly injured?

Answer 39

medial

Question 40

What are the 4 meniscus tests?

Answer 40

1) apley's compression test 2) mcmurray sign 3) thessaly test 4) bounce home test

Question 41

What is the patient position for apleys compression test?

Answer 41

prone

Question 42

What ortho test is this? -patient is prone and affected knee is 90 degrees -doctor places downward force through tibia to compress knee and then internally and externally rotate tibia (grab leg not foot)

Answer 42

apleys compression test

Question 43

What is a positive sign for apleys compression test?

Answer 43

knee pain

Question 44

What does a positive sign for apleys compression test indicate?

Answer 44

medial or lateral meniscus injury heel points to direction of test- ex: heel points medially and theres knee pain= medial meniscus problem

Question 45

What is the patient position for mcmurray sign?

Answer 45

supine

Question 46

What ortho test is this? -patient is supine with the thigh at 90 degrees and the knee fully flexed off the table -doctor internally and externally rotates patient knee feeling for the knee joint line for popping and clicking -if no popping yet, then the doctor will extend knee while applying combination of varus, valgus, internal, and external rotation (move from flexion to extension between each)

Answer 46

mcmurray sign

Question 47

What is a positive sign for mcmurray sign?

Answer 47

painful click or snap is heard or felt by patient

Question 48

What does a positive sign for mcmurray sign indicate?

Answer 48

meniscal injury/tear internal rotation (toes in, heels out)= lateral meniscus external rotation (toes out, heels in)= medial meniscus

Question 49

What is the patient position for thessaly test?

Answer 49

standing

Question 50

What ortho test is this? -patient is standing and holding hands with doctor -patient stands on one leg with knee flexed at 5 degrees while twisting side to side -if no findings, have patient squat to 20 degrees of knee flexion and twist side to side

Answer 50

thessaly test

Question 51

What is a positive sign for thessaly test?

Answer 51

knee pain, catching, or popping

Question 52

What does a positive sign for thessaly test indicate?

Answer 52

meniscal injury or tear

Question 53

What is the patient position for bounce home test?

Answer 53

supine

Question 54

What ortho test is this? -patient is supine -doctor lifts patient leg and slightly flexes knee, then "drops" the bent knee while still holding leg and the knee should extend

Answer 54

bounce home test

Question 55

What is a positive sign for bounce home test?

Answer 55

knee does not fully extend or theres poor motion during extension

Question 56

What does a positive sign for bounce home test indicate?

Answer 56

joint mice due to: 1) meniscal injury/tear 2) osteochondritis dissecans 3) effusion

Question 57

What are the 4 ACL tests?

Answer 57

1) knee drawer test 2) lachman's test 3) lateral pivot shift test 4) slocums test

Question 58

What is the patient position for knee drawer test?

Answer 58

supine

Question 59

What ortho test is this? -patient is supine with knee flexed to 90 degrees -doctor sits on patient's foot and places both hands behind proximal tibia and pulls gently forward and then backward

Answer 59

knee drawer test

Question 60

What is a positive sign for knee drawer test?

Answer 60

anterior or posterior movement greater than 5mm and possibly painful

Question 61

What does a positive sign for knee drawer test indicate?

Answer 61

anterior movement greater than 5 mm= ACL tear posterior movement greater than 5mm= PCL tear

Question 62

What sign should you look for if patient has a PCL tear?

Answer 62

sag sign

Question 63

What test should you follow up with if you get a positive on knee drawer test?

Answer 63

slocums test to check for medial and lateral stabilizers

Question 64

What is the patient position for lachmans test?

Answer 64

supine

Question 65

What ortho test is this? -patient is supine with knees flexed at 20-30 degrees, foot on table -doctor stabilizes femur with lateral hand and tibia is pulled forward with medial hand

Answer 65

lachman's test

Question 66

What is a positive sign for lachman's test?

Answer 66

soft end feel and/or excessive movement when tibia is pulled forward

Question 67

What does a positive sign for lachman's test indicate?

Answer 67

instability or ACL tear

Question 68

What is the patient position for lateral pivot shift test?

Answer 68

supine

Question 69

What ortho test is this? -patient is supine with hip flexed and knee is held at 10 degrees flexion -doctor internally rotates the tibia amd applies a P->A force through the proximal tibia to displace it and then passively flexes the knee

Answer 69

lateral pivot shift test

Question 70

What is a positive sign for lateral pivot shift test?

Answer 70

tibia shifts to normal during flexion, possible clunk or pain

Question 71

What does a positive sign for lateral pivot shift test indicate?

Answer 71

instability and ACL tear

Question 72

Slocums test is also known as

Answer 72

modified drawer test

Question 73

What is the patient position for slocums test?

Answer 73

seated or supine

Question 74

What ortho test is this? -patient is seated or supine with hip flexed to 45 degrees and knee 90 degrees with foot on table -doctor rotates heel medially and sits on patient foot and tugs P->A -doctor then rotates heel laterally, sits on it and tugs P->A

Answer 74

slocums test

Question 75

What is a positive sign for slocums test?

Answer 75

excessive mobility and potential pain

Question 76

What does a positive sign for slocums test indicate?

Answer 76

anterior medial rotational instability or anterior lateral rotational instability (multiple sprains)

Question 77

What are the 2 tests for IT band syndrome?

Answer 77

1) nobles compression test 2) Rennes test

Question 78

What is the patient position for nobles compression test?

Answer 78

supine

Question 79

What ortho test is this? -patient is supine -doctor flexes patient hip and knee in the air to 90 degrees while compressing the IT band into the femoral condyle and slowly straightening the knee/hip

Answer 79

nobles compression test

Question 80

What is a positive sign for nobles compression test?

Answer 80

pain over femoral condyle as the knee straightens

Question 81

What does a positive sign for nobles compression test indicate?

Answer 81

IT band syndrome

Question 82

IT band slides behind the femoral condyle at what angle?

Answer 82

30 degrees, aka the impingement zone

Question 83

What is the patient position for rennes test?

Answer 83

Standing

Question 84

What ortho test is this? -patient is standing and steps up onto a stool with their knees bent -other option is the patient squats on the floor and then stands up -for either option, doctor will compress the IT band into the femoral condyle -patient may hold onto doctors shoulder if needed

Answer 84

rennes test

Question 85

What is a positive sign for rennes test?

Answer 85

pain over the femoral condyle as the knee straightens

Question 86

What does a positive sign for rennes test indicate?

Answer 86

IT band syndrome

Question 87

_____________ weakness increases Q angle and genu valgum which may contribute to IT band syndrome

Answer 87

abductor