Spine and LE Assessment Flashcards
(30 cards)
Where are the superficial inguinal nodes?
Horizontal group along the inguinal ligament and vertical group along the great saphenous vein
Arterial ulcers in peripheral vascular disease
Intermittent claudication pain, no edema, no pulse or weak pulse with no drainage, round smooth sores, black eschar
Sores on toes and feet
Venous ulcers in peripheral vascular disease
Dull achy pain, lower leg edema, pulse present with drainage, sores with irregular borders, yellow slough or ruddy skin
Sores on ankles
Signs of peripheral artery insufficiency
Pallor, dependent rubor, distal hair loss, atrophic skin, nail changes, ulcers, necrosis, gangrene
Cool skin temp
Delayed cap refill
Venous insufficiency
Dilated, tortuous superficial veins that result from defective structure and function of the valves
Clinical presentation of venous insufficiency
Dull ache or pressure sensation after prolonged standing and relieved with elevation
Dependent ankle edema and ankle ulcerations may develop
Maybe superficial thrombosis/thrombophlebitis
What is stasis dermatitis?
Due to chronic venous insufficiency with incompetent valves and higher pressure in capillary bed, tissue is damaged and inflamed Brawny edema (non-pitting edema)
What does lymphedema look like and what is it caused by?
Excessive swelling of the extremities due to lymphatic obstruction or they were destroyed/removed
What do you palpate through the LE?
ASIS, greater trochanter, quads, hammies, femur, quadriceps tendon, patella, patellar tendon, medial and lateral joint lines, tibial tuberosity, popliteal fossa (fullness/masses, pulse), tibia, fibula, calf muscles, achilles tendon, medial and lateral malleoli, calcaneus, metatarsals, MTP and IP joints
What does a positive Trendelenburg indicate?
Hip drop indicates weak hip abductors on the contralateral side (straight leg) and might be due to pain
What is a Baker’s cyst?
Synovial fluid cyst located in the popliteal space
Extend the knee to palpate
Popliteal artery aneurysm
Usually due to atherosclerotic vascular disease
Dx with pulsatile swelling behind the knee
When is a bulge sign seen?
In minor effusions
When do you do balottement of the patella?
In large effusions
What is the valgus stress test for?
MCL
What is the varus test for?
LCL
What is the McMurrays test for?
Externally rotate at heel for medial meniscus- extend knee while giving valgus stress
Internally rotate at heel for lateral meniscus- extend knee while giving varus stress to knee
Pes cavus
High arch
Pes planus
Flatfoot
In what condition do you see a neuropathic ulcer?
Diabetic neuropathy
How do you rate pitting edema?
Grade from 0 to 4+
Probably see it dorsum of foot, behind medial malleolus or on shins
Grading of pulses
0: absent, unable to palpate 1+: diminished, weaker than expected 2+: brisk, normal 3+: increased 4+: bounding
Postural deformities of the spine that we should be looking for
Scoliosis, kyphosis or lordosis
What do you always need to evaluate if you notice a discrepancy in the spine?
Limb length discrepancy
