Orthopedics Flashcards
(49 cards)
1
Q
H&P Overview: History (3 points of interest)
A
- joint
- muscular
- skeletal
2
Q
H&P Overview: Physical Exam (steps in examination)
A
- inspection
- palpation
- range of motion
- manual muscle testing
- neuro and vascular testing
- special tests
3
Q
HPI: Joint Symptoms
A
- change in size/contour
- swelling/redness
- pain (constant / intermittent / with specific movement)
- laterality
- location of joint (anterior, posterior, medial, lateral)
- effet on ADLs
- locking/giving way
- associated events
- timing (temporal factors)
- self-treatment
- medications
4
Q
HPI: Muscular Symptoms
A
- location
- character
- limitation of movement
- weakness/fatigue
- paralysis, tremor, tic, spasm, clumsiness, wasting, pain
- precipitating factors
- injury, strenuous activity, sudden movement, stress
- self treatment
- heat, ice, splints, rest, massage
- medications
5
Q
HPI: Skeletal Symptoms
A
- character
- limping or difficulty w/ gait
- numbness, tingling, pressure sensation
- pain w/ movement
- crepitus
- deformity: change in contour
- associated event
- injury, recent fx, strenuous activity, sudden movement, stress, postmenopause
- self treatment
- rest, splints, chiropractic, acupuncture
- medications
6
Q
HPI: Injury (5 questions)
A
- MOI:
- direct trauma, overuse, sudden change in direction, forceful contraction, overstretch
- sensation:
- click, pop, tearing, numbness, tingling, catching, locking, grating, snapping, warmth/coldness, wt. bearing status
- pain:
- location, type, onset (sudden/gradual), aggravating/alleviating factors, position of comfort
- swelling:
- location, timing (activity vs. injury)
- self treatment
- rest, ice, heat, splints, meds
7
Q
Past medical history (4 questions)
A
- trauma
- nerves, soft tissue, bones, joints, residual problems, bone infections, loss of limb
- surgery
- chronic illness
- CA, arthritis (osteo vs. autoimmune), osteoporosis, renal or neuro disorder, DM, HTN, CAD, PVD, sickle cell, hemophilia
- skeletal deformities or congenital anomalies
8
Q
Family History
A
- congenital abnormalities
- scoliosis or back problems
- OA / autoimmune disorders
- genetic disorders
- cancer
9
Q
Social History
A
- employment
- exercise
- functional abilities
- weight changes
- height changes
- nutrition
- tobacco or alcohol use
10
Q
OA risk factors
A
- obesity
- FH of OA
- hypermobility syndromes
- aging (>40 y/o)
- injury / high level of sports activities
- occupation w/ overuse of joints
11
Q
Osteoporosis risk factors
A
- race
- light body frame, thin
- FH of osteoporosis
- nulliparous
- amonrrhea or menopause before 45
- sedentary lifestyle
- inadequate Ca+ or Vit D intake
- excessive carbonated drinks
- scoliosis, RA, CA, MS, chronic illness, previous fractures
- metabolic disorders, DM, hypercortisolism, hypogonadism, hyperthyroidism
- drugs decreasing bone density
- cigarette smoking or heavy EtOH use
12
Q
body planes
A
13
Q
limb range of motion
A
14
Q
Physical exam - key points
A
- inspection
- general appearance
- skin and subcutaneous tissues
- symmetry
- palpation
- joints (above and below)
- muscle tone
- range of motion (active and passive)
- special testing
- neuro and vascular exam
15
Q
PE - gait analysis
A
16
Q
PE - manual muscle testing (MMT)
A
- evaluates function and strength
- break test- isometric hold
- make test- resistance through ROM
17
Q
PE - palpation steps
A
- localize point of maximum tenderness
(“point to where it hurts most”)
- start at unaffected side/away from painful area
18
Q
Cervical Exam MMT/Nerves
A
19
Q
UE Sensory Exam
A
20
Q
Cervical Spine Special Test
A
Spurling’s test
21
Q
Impingement Tests
A
Neer sign & Hawkins sign
22
Q
Rotator Cuff Tear Tests
A
Empty Can test & Drop Arm test
23
Q
Bicipital Tendinitis tests
A
Speeds test & Yergason’s test
24
Q
Shoulder Instability / Labral Pathology tests
A
Apprehension test & Sulcus sign
25
SLAP Tear test
(superior labrum anterior and posterior)
O'Brien test
26
AC joint sprain / OA test
Cross Body test
27
Epicondylitis test
Long Finger test
28
Cubital Tunnel Syndrome test
Tinel's sign
29
Elbow Instability tests
Varus Stress test / Valgus Stress test / Milking Maneuver
30
Carpal Tunnel tests
Phalen's test & Tinel's sign
31
DeQuervain Tenosynovitis test
Finkelstein test
32
Collateral Ligament testing
| (MCP/PIP/DIP instability)
Valgus and Varus stress test
33
Measuring Q-Angle
34
Measuring Leg Length
35
Leg Innervation
36
Lumbar Spine Special Tests
* straight leg raise
* seated SLR
* FABER (flexion-abduction-external rotation) test
37
Lumbar Spine Waddle Signs
* non-organic tenderness
* pt. standing- light touch should not cause pain
* axial subluxation
* pt. standing- light downward pressure on head should not cause lumbar pain
* seated SLR
* distracted pt. will not lean back
* sensory exam
* monofilament should not cause pain
38
Hip ROM
39
Hip Special Tests 1
* Trendelenburg test
* Thomas test
* Log roll
40
Hip Special Tests 2
* hamstring flexability
* Piriformis test
41
Knee Joint Effusion Special Tests
Ballottement and Bulge
42
Knee Medial and Lateral Meniscus Speical Test
McMurray Test
43
Knee ACL Special Tests
* Lachman test
* Anterior Drawer test
44
Knee PCL Special Test
Posterior Drawer
45
Knee MCL & LCL Special Tests
Valgus and Varus Stress Tests
46
Knee Patellar Dislocation Special Test
Patellar Apprehension Sign
47
Ankle Laxity Special Test
Anterior Drawer Test
48
Achilles Tendon Special Test
Thompson Test
49
Foot Neuropathy Special Test
Foot Squeeze Test - Morton's Neuroma
