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Physical Diagnosis > spine and LE: Abn > Flashcards

spine and LE: Abn Flashcards

1
Q

clinical presentation

  • pallor
  • dependent rubor
  • distal hair loss
  • atrophic skin, nail changes
  • ulcers
  • necrosis
A

Peripheral artery insufficiency

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2
Q

clinical presentation

  • dull ache or pressure sensation after prolonged standing; relieved with elevation
  • dependent ankle edema and ankle ulcerations may develop
  • superficial thrombosis.thrombophlebitis may occur
A

venous insufficiency

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3
Q

what is stasis dermatitis

A
  • due to chronic venous insufficiency with incompetent valves and higher pressure in capillary bed
  • tissie is damaged and inflammed
  • brawny edema: non-pitting edema
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4
Q

what is trendelenburg test

A
  • test with patient standing and have them raise one knee
  • evaluate for hip drop, which indicates weak hip abductors on the contralateral side (straight leg)
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5
Q

what impingment test is used to test FAI: Femoroacetabular Impingement

A

FADIR

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6
Q

what is the patrick test

A

FABER test: figure of four

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7
Q

valgus pressure

A

leg goes laterally; tests medial ligaments

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8
Q

varus pressure

A

foot returns in; tests lateral ligaments

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9
Q

clinical presentation

  • synovial fluid cyst located in the popliteal space
  • palpable as fluctuant fullness
  • may be painful or result in calf swelling if they leak or rupture
A

baker’s cyst

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10
Q

what is the most common aneurysm of the peripheral vascular system

A

popliteal artery aneurysm

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11
Q

pulsatile swelling behind the knee is concerning for what

A

popliteal artery aneurysm

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12
Q

what is bulge sign: technique and function

A
  • minor knee effusions
  • with leg straight, place pressure over suprapatellar pouch while “milking” knee joint fluid down one side and up the other in order to observe a bulge
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13
Q

describe technique and function of ballottement of the patella

A
  • large effusion
  1. compress suprapatellar pouch and sharply push patella against femur
  2. feel for fluid under the patella and observe for fluid returning to suprapatellar pouch
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14
Q

what is the anterior drawer test of the knee

A
  • evaluation of ACL tear
  1. supine with hips flexed and knees flexed at 90
  2. stabilize foot flat on table
  3. thumbs on medial and lateral joint line with fingers on hamstring insertions
  4. pull tibia forward checking for excessive forward movement
  5. positive: anterior translation
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15
Q

what is the posterior drawer test of the knee

A
  • evaluate PCL tear
    1. similar to anterior drawer except that the tibia is pushed back
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16
Q

lachman’s test: function and technique

A
  • ACL: most useful test for diagnosing ACL tear
  1. patient in supine position, knee flexed to 20-30 degrees
  2. stabilize distal femur in one hand while attempting to displace the tibia anteriorly with the other
17
Q

posterior sag sign

A
  • PCL injury
  • note the amount of posterior sag relative to the other leg
  • checked in both extension and 90 degrees of flexion with both internal and external rotation
18
Q

McMurray test: medial meniscus technique

A
  1. knee flexed
  2. grasp heel with one hand and joint line of knee with thumb and index finger
  3. medial meniscus
    1. externall rotate heel, flex maximally, then slowly extend the knee while providing valgus stress to the knee
19
Q

McMurray test: lateral meniscus technique

A
  1. knee flexed
  2. grasp heel with one hand and joint line of knee with thumb and index finger
  3. lateral meniscus
  4. internally rotate heel, flex maximally, then slowly extend the knee while providing varus stress to the knee
20
Q

pes planus

A

flat foot

21
Q

pes cavus

A

high arch

22
Q

anterior drawer test of ankle

A
  1. stabilize the distal tibia
  2. grasp the calcaneus and pull forward
23
Q

Homan’s sign: function and technique

A
  • evaluation for DVT
  1. passive dorsiflexion of the foot in a patient with calf pain, tenderness, or swelling
  2. positive: calf pain increased with dorsiflexion

**variability in reliability and validity

24
Q

thompson test: function and technique

A
  • achilles tendon rupture
  1. have patient kneel on stool and squeeze calf
  2. observe for plantar flexion
25
Q

identify the postural deformity

A

Kyphosis

26
Q

identify the postural deformity

A

lordosis

27
Q

90% of thoracic cerves are to what side?

A

convex to the right

28
Q

how do you test for limb length discrepancy

A
  • compare aligned legs at the medial malleolus in supine positions and measuring from ASIS to medial malleolus
29
Q

straight leg raising test: function and technique

A
  • lumbosacral radiculopathy and/or sciatic neuropathy
    • most sensitive for L5-S1
  1. passive ROM while supine with knees extended
    1. dorsiflexion of ankle may further increase response
  2. positive: radiating pain in affected limb
30
Q

flip sign

A

lumbar radiculopathy

  1. patient seated with hands on table
  2. passively extend knee
  3. positive sign: patient will “flip back” due to pain
31
Q

motor weakness L4

A

extension of quadriceps

32
Q

motor weakness of L5

A

dorsiflexion of great toe and foot

33
Q

motor weakness of S1

A

plantar flexion of great toe and foot

34
Q

screening exam of L4 radiculopathy

A

squat and rise

35
Q

screening exam of L5 radiculopathy

A

heel walking

36
Q

screening exam of S1 radiculopathy

A

walking on toes

37
Q

reflexes L4

A

knee jerk diminised

38
Q

reflexes L5

A

none reliable

39
Q

reflexes S1

A

ankle jerk diminished

Physical Diagnosis (16 decks)

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