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Assessment II > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

Tenosynovitis + example

A

Inflammation of the synovial sheath of the tendon
ex. tenosynovitis of extensor digitorum longus

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2
Q

Stenosing tenosynovitis + example

A

Inflammation of the synovial sheath of the tendon such that it narrows and presses on the tendon
ex. stenosing tenosynovitis of extensor hallucis longus

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3
Q

Ganglionic cyst + example

A

Localized inflammation of the synovial sheath such that it results in a lump under the skin
ex. ganglionic cyst of extensor digitorum longus

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4
Q

Trigger phenomenon

A

A form of stenosing tenosynovitis where localized swelling of the synovial sheath causes the tendon to jam in the sheath and suddenly let go
ex. trigger phenomenon of flexor digitorum longus

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5
Q

Nerve disorder example

A

Morton’s neuroma (3rd + 4th metatarsals press on the plantar nerve)

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6
Q

Neurovasular disorders (2)

A

Raynauds’s
Anterior compartment syndrome

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7
Q

L1 dermatome

A

Lower back above L2-L3 and lateral buttock to groin

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8
Q

L2 dermatome

A

Lower back to lateral side at iliac crest, posterior lateral thigh and upper anterior lateral to medial thigh (sling)

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9
Q

L3 dermatome

A

Lower back, posterior/medial thigh and medial knee, medial upper shin

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10
Q

L4 dermatome

A

Lateral side of mid to lower posterior thigh, lateral knee, medial anterior shin, medial posterior calf, medial malleolus to anterior big toe

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11
Q

L5 dermatome

A

Small strip from lateral upper calf, top of the foot and under surface of big, 2nd, 3rd toes

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12
Q

S1 dermatome

A

Lower lateral border of calf to heel and lateral side of foot to plantar fourth and fifth toes

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13
Q

S2 dermatome

A

Down centre of posterior leg from buttock to under surface of heel

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14
Q

Bowel and bladder nerves (motor, sensory, main one)

A

Motor: S2-S4
Sensory: S3-S5
Main: S3

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15
Q

2 types of passive ROM testing

A
  1. taking the client’s limb through ROM without their help
  2. Overpressure after active ROM
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16
Q

Why is overpressure applied and why is it important?

A

To evaluate the end feel
Helps determine if the joint is normal or pathological

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17
Q

2 types of muscle testing and how they’re recorded

A

Isometric: strong or weak
Isotonic: graded 0-5

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18
Q

What are isometrics used for?

A
  1. Testing myotomes
  2. Rule out inert tissue and test individual muscle groups
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19
Q

3 normal end feels

A

Tissue stretch
Soft tissue approx
Bone to bone

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20
Q

Bone to bone

A

Sudden hard stop, painless
Solid stop, no give

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21
Q

Soft tissue approx

A

Yielding compression stops movement

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22
Q

Tissue strecth

A

Hard or firm stop with slight give

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23
Q

5 abnormal end feels

A

Bone to bone
Springy block
Capsular
Empty
Muscle spasm

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24
Q

Muscle spasm

A

Sudden hard stop, accompanied by pain “vibrant twang”

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25
Capsular
Like tissue stretch but not where you'd expect it
26
Bone to bone
Like normal bone to bone but not where you'd expect it
27
Empty
No mechanical resistance felt by the examiner, but movement impossible due to pain
28
Springy block
Like tissue stretch but joint has a springy, rebound effect
29
Capsular pattern
When there is limitation of movement that is proportional and specific to the joint
30
Non capsular pattern
Limited movement, but does not correspond to the classic pattern for that joint
31
3 examples of non capsular pattern
Ligamentous adhesion Internal derangement of a joint Extra-articular lesion
32
How long do how hold isometrics for the pelvis?
Only long enough to determine if there is pain
33
What actions do you do for pelvis isometrics?
Hip adduction/abduction Hip flexion/extension Lumbar flexion
34
L2 myotome
Hip flexion
35
L3 myotome
Knee extension
36
L4 myotome
Ankle dorsiflexion
37
L5 myotome
Big toes extension
38
S1 myotome
Ankle eversion or hip extension
39
S1 S1 myotome
Knee flexion
40
What are isotonics used for? How>
Used for muscle testing Resistance is applied to a limb as patient moves through ROM
41
3 types of reflexes
Superficial Deep tendon/muscle stretch Pathologic
42
Umbilicus type of reflex + nerve root
Superficial reflex Upper: T7-T9 Lower: T11-T12
43
Pathologic reflex example + what is signifies
Babinski - upper motor neuron lesion
44
Babinski
Position: supine or sitting with knee straight and supported Test action: stabilize tib/fib and draw the end of the hammer from lateral heel, up the side of the foot across the ball of the foot to the plantar surface or the first MTP area Normal response - toes curl Positive response - big toe extends, other abduct
45
Simple segmental defintion
Impulse comes from the periphery, into the spinal cord and back out to the periphery, without going to the higher up centers
46
4 considerations while testing muscle
1. Complete relaxation 2. Midrange position 3. Adequate stretch 4. Facilitation if reflexes are
47
Reflex grades
0 - absent 1- diminished 2 - normal 3 - exaggerated 4 - clonus
48
Upper motor neuron lesion findings
Increased tone Hyperreflexia Reduced or absent superficial reflexes Positive Babinski Positive hoffman sign Normal EMG Weakness in muscles below lesion
49
Lower motor neuron lesion findings
Decreased tone Decreased reflexes Fasciculation Fibrillation Abnormal EMG Weakness and pronounced atrophy of involved muscles
50
4 types of swelling
Synovial Fluid Pitting Longstanding soft tisse
51
Synovial
Boggy
52
Fluid
Soft and mobile
53
Pitting
Thick, slow moving, leaves indent
54
Longstanding soft tissue
Tough/leathery
55
L3-L4 reflex
Patellar reflex
56
L4-L5 reflex
Tibialis posterior
57
L5-S1 reflex
Medial hamstring
58
S1-S2
Lateral hamstring Achilles Extensor digitorum brevis
59
Spinal stenosis
Narrowing of the spinal canal causing compression of the cauda equina
60
Spinal stenosis symptoms
Pain in lumbar spine with radiation to extremity Paraesthesia of lower extremities Symptoms increase with extension and walking, decrease with flexion May affect bowel and bladder
61
Arthritis of facet joints symptoms
Sharp pain on same side with rotation, side flexion, extension Pulling sensation on opposite side No pain with isometrics Tenderness on palpation Positive lumbar kemps
62
Spondylolisthesis
Bilateral defect of pars interarticularis with forward slippage of a vertebral body and transverse processes on vertebra below
63
Spondylolisthesis Grade symptoms
Grade I: localized back pain Grade II + III: Localized and radiating pain along dermatome and paraesthesia. Varrying degrees of functional impairment, B/B problems
64
Concealed Spondylolisthesis
X-ray in supine: everything looks good X-ray in standing: it shows up (unstable segment)
65
Nerve root impingement signs/symptoms
Positive SLR, PKB test, valsalva, slump tests Weakness of affected myotomes Paraethesia of affected dermatomes Diminished reflexes of affected nerve root Altered posture
66
Osteophytes
Bony protrusion from vertebral body - constant back pain
67
Lumbar capsular pattern
Side flexion and rotation equally limited, extension
68
How to evaluates peripheral joints in lumbar scan
1. Squat test or AROM of each joint 2. PSIS or gillet's 3. Sacral sulcus
69
3 instances you wouldn't use the squat test
Pregnancy Obesity Poor balance Elderly Obvious lower extremity joint problems
70
Lumbar scan fill-ins
Goniometry Passive extension in prone Isometrics of lumbar spine Isotonics (rarely done) Local ST, SP, temp testing
71
SLR test
Position: supine Action: medially rotates and adducts the hip, then passively flexes the hip, keeping the hip medially rotated and adducted and the knee straight until the patient complains of pain or tightness. Slowly lets the hip extend passively until there is no pain or tightness. Then passively dorsiflexes the ankle then has the client flex their neck to see if pain returns PR: pain radiates down leg on that side L4-S3 dermatome Indicates: Nerve root impingement L4-S3
72
SLR test 0-35 degrees and 35-70 degrees
0-35: SI joint pathology 35-70: Dural impingement/nerve root
73
PKB test
Position: prone Action: Examiner passively flexes client's knee so their heel is touching their butt, hold for 45 seconds PR: reproduction of symptoms along L2 or L3 or L4 or femoral nerve root Indicates: Nerve root impingement of L2 or L3 or L4 or femoral nerve root
74
What needs to be ruled out for SLR and PKB test?
SLR: hamstring pain/tightness and SI joint pathology PKB: rec fem tighteness and SI joint pathology
75
PKB dural stretch degrees
80-100
76
Valsalva maneuver
Indicates: increased intrathecal pressure due to space occupying lesions Position: sitting Action: instruct patient to take a breath, hold it, and then bear down as if evacuating the bowels PR: increase symptoms in lower extremity or lower back
77
Slump test
Position: sitting with hands behind back and chin up Action: Ask patient to slump while examiner holds chin and head erect. If no symptoms, apply overpressure through neck or thoracic spine. If no symptoms, extend one of the patient’s knees. If no symptoms, passively dorsiflex patient’s ankle. If symptoms are reproduced, add neck extension at to see if symptoms decrease. (this confirms positive response) PR: Reproduction of patient’s symptoms along affected dermatome Indicates: Dural or nerve root impingement
78
Lumbar kemp's
Position: standing Action: Examiner stands behind patient and passively rotates, side flexes, and extends the patients spine with one hand, while stabilizing the opposite pelvis with the other hand. Apply downward pressure through shoulders using both hands PR: local pain on the side that is rotated, side flexed and extended Indicates: Facet joint sprain
79
If a patient states that sitting, coughing, sneezing results in leg pain, what structure is likely compressing the nerve root?
Disc protrusion (can also be a tumour)
80
Scoliosis (named after?)
Curvature of the spine, named after the convexity
81
Spinal stenosis vs. nerve root impingement
Spinal stenosis: symptoms are aggravated by extension/relieved by flexion NRI: opposite
82
Lordosis
Anterior curvature of the spine
83
Kyphosis
Posterior curvature of the spine
84
Structural vs non-structural scoliosis
Functional: curve disappears on flexion Structural: Curve is visible on flexion
85
Gibbus deformity
Sharp, angulated kyphosis
86
Effect of flexion in spinal stenosis vs. disc protrusion
Spinal stenosis: reduces pain because the cord stretches, narrows + fits in canal with less pressure Disc protrusion: Increase pain because it forces disc material posteriorly, where nerve roots are located, causing pressure on nerve roots
87
2 structures aggravated by lumbar lordosis
Anterior longitudinal ligament Facet joints
88
Purpose of scan
To determine if symptoms the patient is experiencing is due to a pathology in the lumbar spine, peripheral joints, or both
89
Landmarks for spinal flexion measurements
Whole spine: C7-S1 Thoracic: C7-T12 Lumbar: T12-S1
90
Grade 0
Zero No contraction palpated or visible
91
Grade 1
Trace Evidence of slight contractility but no joint movement
92
Grade 2-
Poor - Initiates motion w/o gravity
93
Grade 2
Poor Complete ROM w/o gravity
94
Grade 2 +
Poor + Initiates motion against grvaity
95
Grade 3-
Fair - Incomplete ROm against gravity
96
Grade 3
Fair Complete ROM against gravity
97
Grade 3 +
Fair + Complete ROM against gravity and minimal resistance

Assessment II (5 decks)

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