OSCE

Question 1

Hip ROM

Answer 1

Flexion- 90
Flexion with knee flexed- 120-135
Extension- 15-30
Internal rotation- 30-40
External rotation- 40-60
Abduction- 45-50
Adduction- 20-30

Question 2

What are the contents of the central compartment of the hip?

Answer 2

Labrum, ligamentum teres of femur, articular surfaces

Question 3

What makes up the peripheral compartment of the hip?

Answer 3

Femoral neck, synovial lining

Question 4

What makes up the lateral compartment of the hip?

Answer 4

Gluteus medius, gluteus minimus, piriformis, IT band, trochanteric bursae

Question 5

What makes up the anterior compartment of the hip?

Answer 5

Iliopsoas insertion, iliopsoas bursae

Question 6

What is the typical Q-angle? Which sex has a larger q angle?

Answer 6

Normal Q angle is about 15º

Females have larger q angle

Question 7

What is ROM of knee?

Answer 7

Flexion- 145-150
Extension- 0
Internal/External Rotation- 10

Question 8

Describe the test for internal/external rotation of the tibia on the femur?

Answer 8

Patient supine with hip and knee flexed to 90
Place both thumbs on tibial tuberosity and wrap hands around calf
Induce internal and external rotation

Question 9

Describe test for abduction and adduction of tibia on femur?

Answer 9

Have patient supine
Grasp distal femur and ankle
Apply Valgus (adduction) and Varus (abduction) stress tests

Question 10

Describe test for anteroposterior glide of tibia on femur?

Answer 10

Patient supine with knee flexed and foot flat on table with you sitting on it
Do the anterior drawer test but with reduced force

Question 11

Describe test for proximal fibular head dysfunction?

Answer 11

Patient supine with knee flexed and foot on table
Pinch fibular head and stabalize knee
Translate head anteriorly and posteriorly to assess ease of motion

Question 12

What makes up the medial longitudinal arch of the foot?

Answer 12

Calcaneus, talus, navicular, cunieforms, and metatarsals 1-3

Question 13

What makes up the lateral longitudinal arch of the foot?

Answer 13

Calcaneus, cuboid, metatarsals 4 and 5

Question 14

What makes up the transverse distal tarsal arch of the foot?

Answer 14

Navicular, cuboid, cunieforms, and proximal metatarsals

Question 15

Which ligament tears first in a classic ankle inversion?

Answer 15

Anterior Talofibular ligament

Question 16

What is the ROM of ankle?

Answer 16

Dorsiflex- 15-20
Plantarflex- 50-65
Invert- 35
Evert- 20
Adduct- 20
Abduct- 10
Metatarsal flex- 45
Metatarsal extend- 70-90

Question 17

Describe the test for anterior/posterior lateral malleolus dysfunction?

Answer 17

Patients knee flexed and foot flat on table

Pinch lateral malleolus and translate anteriorly and posteriorly

Question 18

Describe the test for talus dorsi/plantar flexion dysfunction?

Answer 18

Stabalize above ankle and grasp foot and bring into plantar and dorsi flexion

Question 19

Describe the test for calcaneus inversion/eversion dysfunction?

Answer 19

Place ankle at 90º
Grasp calcaneus and stabilize rest of foot
Bring into inversion and eversion

Question 20

Describe test for navicular plantar/dorsal glide dysfunction? Describe test for cuboid plantar/dorsal glide dysfunction? Is plantar or dorsal dysfunction more common?

Answer 20

Grip navicular or cuboid with index and thumb
Stabilize talus for navicular and calcaneus for cuboid
Move bone into dorsal and plantar glide

Plantar dysfunctions more common

Question 21

What is dorsal navicular dysfunction associated with?

Answer 21

Tight plantar fascia

Question 22

What is plantar cuboid dysfunction associated with?

Answer 22

Posterior fibular head

Question 23

Explain cuneiform plantar/dorsal glide dysfunction? Is plantar or dorsal dysfucntion more common?

Answer 23

Grip cuneiforms, stabilize navicular, and move into glide

Plantar dysfunction more common

Question 24

What 3 bones make up the shoulder girdle?

Answer 24

Scapula, clavicle, and humerus

Question 25

What 3 synovial joints make up the shoulder girdle?

Answer 25

Glenohumeral Acromioclavicular Sternoclavicular

Question 26

What are the 2 functional joints of the shoulder girdle?

Answer 26

Suprahumeral | Scapulothoracic

Question 27

What are the 2 accessory joints of the shoulder girdle?

Answer 27

Costosternal | Costovertebral

Question 28

What joints take part in EARLY shoulder ABduction?

Answer 28

Glenohumeral | Suprahumeral

Question 29

What joints take part in MID-LATE shoulder ABduction?

Answer 29

Scapulothoracic Sternoclavicular Acromioclavicular

Question 30

What is shoulder ROM?

Answer 30

``` Flex- 180 Extend- 60 Abduction- 180 Horizontal Abduction- 130-145 Horizontal Adduction- 40-50 Internal/External Rotation- 90 ```

Question 31

Explain the test for AC joint dysfunction? What is normal AC rotation expected to be?

Answer 31

Bring GH joint into 60 abduction and 60 horizontal adduction Internally/externally rotate GH joint Internal rotation of GH causes internal rotation of AC and vice versa for external rotation Normal AC rotation is 10º

Question 32

Explain flexion/extension test for SC joint dysfunction? What direction does the proximal clavicle move for flexion and extension?

Answer 32

Place fingers bilaterally on anterior aspect of SC joint Have patient reach towards the ceiling Horizontal flexion- proximal clavicle moves posterior Horizontal extension- proximal clavicle moves anterior

Question 33

Explain the test for SC joint abduction/adduction dysfunction? What direction does the proximal clavicle move for abduction and adduction?

Answer 33

Place fingers bilaterally on superior aspect of SC joint Have patient shrug shoulders Abduction- proximal clavicle moves inferiorly Adduction- proximal clavicle moves superiorly

Question 34

What is the carrying angle? What are the normal ranges for males and females?

Answer 34

Angle formed by axis of humerus and axis of forearm Males- 5º Females 10-15º

Question 35

What is ROM of elbow joint?

Answer 35

Flexion- 140-150 Extend- 0 - (-5) Supinate/Pronate- 90

Question 36

With regards to somatic dysfunction of elbow joint, is SD found in major or minor gliding motions of joint?

Answer 36

SD of elbow joint is found in minor gliding motions

Question 37

With regards to elbow SD, is the ulnohumeral or radiounlar joint primary?

Answer 37

Ulnohumeral joint SD is primary to radioulnar joint SD

Question 38

Describe test for ulnar abduction SD? What is the coupled motion?

Answer 38

Perform Valgus stress test | Ulnar abduction coupled with wrist adduction/ulnar deviation

Question 39

Describe test for ulnar adduction SD? What is the coupled motion?

Answer 39

Perform Varus stress test | Coupled motion is wrist abduction/radial deviation

Question 40

What is ROM of wrist?

Answer 40

Flexion- 80-90 Extension- 70 Abduction/ulnar deviation- 20-30 Adduction/radial deviation- 30-40

Question 41

What is wrist flexion coupled with?

Answer 41

Wrist flexion couples with dorsal/posterior carpal glide

Question 42

What is wrist extension coupled with?

Answer 42

Wrist extension coupled with ventral/anterior carpal glide

Question 43

What is ROM of Thoracic spine?

Answer 43

Rotation- 90 | Side bending- 40

Question 44

Explain the pneumonic BITE with regards to group rib dysfunction

Answer 44

``` Inhalation dysfunction (ribs restricted to exhalation and stuck superiorly), the bottom rib involved is the key rib Exhalation dysfunction (ribs stuck inferiorly), the top rib involved is the key rib ```