Spine And Lower Extremity Flashcards
(116 cards)
1
Q
Where do you test for edema?
A
Dorsum of foot
Behind medial malleolus
Shins
2
Q
What is stasis dermatitis?
A
A result of chronic venous insufficiency with incompetent valves and high pressure in capillaries.
Tissue damage and brawny edema
3
Q
What is a positive bulge sign and what does it suggest?
A
If you stroke the medial side of the knee upwards, and then stroke the lateral side downwards, and you see a Bulge of fluid on the medial side.
Suggests Minor*** effusion
4
Q
What direction of hip ROM does the Patrick’s Test/FABER test evaluate?
A
Hip abduction
5
Q
What is the Adams Forward bending test?
A
Patient bends forward and you inspect for limb length discrepancy as well as scoliosis
6
Q
What is a positive posterior drawer sign
A
Excessive laxity suggests a PCL tear
7
Q
What are the ankle and foot motions that you must test ROM for in the practical? Which ones are required to do strength testing?
A
Dorsiflexion* and plantar flexion*
Inversion* and eversion*
Toe flexion and extension
(* denotes ones you must strength test)
8
Q
What nerve root:
Weakness of plantar flexion of foot and big toe
A
S1
9
Q
When palpating the lower leg, what does a palpable “cord” suggest
A
Thrombosed vein
10
Q
Are bakers cysts painful
A
If they leak fluid or rupture
11
Q
What vertebral level is the straight leg raising test most sensitive for?
A
L5-S1
12
Q
How do you test the lateral meniscus with McMurrays test
A
Internally rotate at the heel
Flex and extend the knee while providing varus stress
13
Q
What nerve root:
Trouble with “squat and rise” test
A
L4
14
Q
How often are popliteal arteries bilateral
A
50% of the time
15
Q
What is the most common aneurysm of the peripheral vascular system?
A
Popliteal artery aneurysm
16
Q
What is a positive seated SLR test/“flip sign”
A
When you passively extend their knee, they will “flip back” due to pain
17
Q
What is kyphosis?
A
Thoracic convexity is too extreme
“Hunchback”
18
Q
What is pes planus
A
Flat foot
19
Q
What are the landmarks of the ankle and foot that you must palpate for the practical
A
Achilles’ tendon
Medial malleolus
Lateral malleolus
Calcaneus
Tarsals
Metatarsals
MTP joints
IP joints
20
Q
What does the McMurray Test for
A
Meniscus **
21
Q
What test is this:
Stabilize distal tibia
Grasp calcaneus and pull forward
A
Anterior drawer test of ankle
22
Q
What is the best position for the patient to be in in order to test hip extension?
A
While standing (Do not have to do for practical)
23
Q
How do you document edema?
A
Grade and how far up the leg it goes
“3+ pitting edema to mid-calf”
24
Q
What is varus?
A
“Bow legs”
RUM makes your knees spread apart
25
What nerve root:
Pt can not walk on toes
S1
26
What is this test:
Patient in supine position, knee flexed 20-30 degrees
Stabilize distal femur in one hand, while attempting to displace tibia anteriorly with the other
Lachman
27
What is the galeazzi test?
Patient lies supine with knees flexed 90 and feet together and flat on table
Check to see if the patellae are the same height
28
What is a positive trendelenberg test?
If the patient stand on their right leg and their left hip drops.
Indicates weak hip on the RIGHT side.
(Or vice versa)
29
What nerve root:
Ankle jerk reflex diminished
S1
30
Who is most likely to get a popliteal artery aneurysm
Males
Over 65
31
What ROM tests must be done in the hip?
| Which ones require strength testing for the practical?
Abduction* and adduction*
Flexion* and extension
Internal and external rotation
(* denotes the ones you must also strength test)
32
How do you palpate a bakers cyst?>
Extend the knee
33
What two pulses do you need to check on the feet?
Dorsalis pedis
Posterior tibialis
34
What is a positive McMurrays test
Clicking and popping with flexion and extension
35
Where should your hands be when you do the FABER test?
One on patients knee and the other on their other hip**
*MUST stabilize their pelvis
36
What position is the patient in when you test hip flexion?
Supine
37
What is lordosis
Extreme lumbar concavity
38
What does a positive seated SLR/“flip sign” indicate?
Spinal nerve compression/irritation
39
What is this:
| Dilated, tortuous, superficial veins that result from defective structure and function of the valves
Venous insufficiency
40
What does it mean to inspect for patellar tracking during the inspection of the knee?
Making sure the patella goes straight up and down
41
Can you do hip and knee ROM testing at the same time while the patient is supine, as long as you verbalize it?
Yes
42
How do you test the medial meniscus with mcmurray test
Externally rotate at heel
Flex and extend the knee while providing valgus stress to knee
43
What are the 3 names for the FABER test?
FABER
Patrick Test
Figure of Four
44
What are you looking for when the patient bends forward and touches their toes?
Scoliosis
45
Where is the dorsalis pedis pulse?
Dorsum of foot
Over 1st-2nd metatarsals
46
What nerve root:
| Numbness on bottom of foot and on back of calf?
S1
47
What exam do we use to assess for hypertrophy or atrophy of leg muscles
Circumference measuring exam
48
What is scoliosis?
Spine is curved laterally
49
How do you do the valgus stress test?
Stabilize lateral joint line**
Place other hand on distal tibia
ABduct the tibia in relation to the femur
DO IT TWICE 0 and 30 degrees of flexion
Evalaute the medial joint space
50
What does “pitting” edema mean
The indentation stays there
51
What is a positive anterior drawer sign of the knee
Anterior translation of the tibia without a firm endpoint
52
What does a positive posterior sag sign suggest?
PCL tear
53
How do you do the straight leg raising test/ Lasegues test
Pt supine and you lift their straightened leg straight up
Looking for radiating** pain in the affected limb
dorsiflexing ankle may increase pain response
54
How do you do the varus stress test?
Stabilize the medial** joint line
Put other hand on distal tibia
ADduct the tibia in relation to the femur
DO IT TWICE at 0 and 30 degrees of knee flexion
Evaluate lateral joint space
55
What grade would you give a bounding pulse
4+
56
When do you start the inspection of the hip and thigh?
Right after the abdomen/inguinal exam becasue the patient is already supine
57
What is the most useful test for diagnosing an ACL tear?
Lachman
58
Do you test hip adduction/abduction actively or passively
Passively.
You move the patients leg
59
When testing hip flexion, can you do them both at the same time
No
60
What motions do you have to test ROM and strength testing for in the knee?
Flexion and extension
61
If you find pulsatile swelling behind the knee, what do you think it is
Popliteal artery aneurysm
62
What parts of the spine do you need to palpate
Spinous processes
Paravertebral muscles
63
What knee landmarks do you need to palpate for the practical
Quadriceps tendon
Patella
Patellar tendon
Medial and lateral joint lines
Tibial tiberosity
64
How do you test for ballottement of the patella?
Compress the suprapatellar pouch and press down on the patella. Feel for fluid under the patella and look for fluid returning to the suprapatellar pouch
65
What does the Thompson test test for
Achilles’ tendon tear
66
What grade would a diminished, weak, but still palpable pulse get
1+
67
What does the pelvic compression test evaluate?
Pelvic stability
| Little value
68
If a patient has a tender/painful area, should you palate it right away?
No, always palpate tender areas last
69
What is the clinical presentation of venous insufficiency?
Dull ache or pressure sensation after prolonged standing
Pain gets better with elevation
Ankle edema and ankle ulcers
Thrombosis
70
What is pes cavus
High arch of the foot
71
What is the range of grades for edema
0-4+
72
What disease is associated with pes cavus (high arch)
Charcot-Marie Tooth disease
73
What skin temperature and cap refill time would be expected with peripheral artery insufficiency?
Cool skin
Delayed cap refill (more than 2 seconds)
74
How do you perform the Thompson test?
Have patient kneel on stool or lie prone with foot hanging off table
Squeeze their calf
Observe for plantar flexion
75
What are the 2 tests to test for leg length discrepancy?
Galeazzi
Comparing measured distance from ASIS to medial malleolus
76
Do you need to actually examine the inguinal region for nodes, pulses, and hernias?
No just verbalize
77
If you see one arm or leg that is way more swollen than the other, what should you suspect?
Lymphedema
78
What nerve root:
| Knee jerk reflex diminished
L4
79
What nerve root:
| Weakness with extension of quadriceps
L4
80
What is a positive FABER/Patrick test?
SI joint pain
81
How do you palpate the popliteal pulse?
Knee should be flexed
Press DEEP
82
What is the other name for the Straight Leg Raising test?
Lasegue’s Test (Sign)********
83
What does the anterior drawer test of the knee test for?
ACL tear
84
What is a bakers cyst
A synovial fluid test in the popliteal space
85
How do you grade the amplitude of pulses?
0 absent unable to palpate
1+ diminished, weaker than expected
2+ brisk, normal
3+ increased
4+ bounding
86
What nerve root:
| Pain down lateral side of leg
L5
87
What is a normal grade of pulse
2+
88
What does the Apley Compression test test for
Meniscus injury
89
What are you doing with your hands for the anterior drawer test of the knee
Pushing in with thumbs on the joint lines
Pulling with your fingers on the hamstring insertions
**PUlling tibia forward and checking for excessive forward movement**
90
What is valgus?
“Knock knees”
| GUM makes your knees stick together
91
What are the two ways venous insufficiency can present
Varicose
Stasis dermatitis
92
How do you test for an MCL injury
Valgus stress test
93
How do you do the apley compression test
Patient supine
Flex knee to 90 degrees
Pres down on foot and grind it back and forth
Then do it again with a distraction
94
What is Brawny edema and what is it caused by?
Non pitting edema
Caused by stasis dermatitis/venous insufficiency
95
What are the two ways that ROM must be tested
Actively
Passively
96
Why do neuropathic ulcers get so bad
The diabetic patients cant feel them
97
What are the landmarks you must palpate in the hip and thigh?
Iliac crest*
Anterior superior iliac spine
Pubic symphysis*
Greater trochanter
Ischial tuberosity*
Quadriceps
Hamstrings
Femur
(* denotes ones you just verbalize for practical)
98
Where should you auscultation for bruits if you suspect peripheral artery disease
Abdominal aorta
Femoral artery
Popliteal artery
99
What does the FADIR test for?
Impingement
100
What does the posterior drawer sign test for
PCL tear
101
How do you test for an injury to the LCL
Varus Stress Test
102
What are these signs of if you see them in the feet/ankles:
Pallor
Dependent rubor
Distal hair loss
Atrophic skin, nail changes
Ulcers
Necrosis/gangrene
Peripheral artery insufficiency
103
What ROM directions do you need to test in the spine
Flexion
Extension
Rotation
Lateral bending
104
What nerve root:
| Pain down front of leg
L4
105
What causes venous insufficnecy
Incompetent valves
106
What test do you use for minor knee effusions vs large effusions
Minor: bulge sign
Large: Ballottement
107
What is a positive Thompson test?
Foot does not plantar flex when you squeeze their calf
108
Where is the posterior tibial pulse?
Behind and slightly below the MEDIAL malleolus
109
Do you need to do ROM and strength testing on both sides?
Yes, always compare bilaterally
110
What does the straight leg raising test test for?
Lumbosacral radiculopathy
And/or
Sciatic neuropathy
111
What is the most SENSITIVE test for diagnosing an ACL tear
```
Pivot test
(Must be done under sedation)
```
112
What pulses do you need to check for if you suspect peripheral artery insufficiency??
Femoral
Popliteal
Dorsalis pedis
Tibial
113
What never root:
| Weakneess with dorsiflexion of foot and big toe
L5
114
What are the subdivisions of the lower extremity?
Hip
Thigh
Leg
Ankle
Foot
- hindfoot
- mid Foot
- forefoot
115
What nerve root:
| Pain down back of leg
S1
116
What nerve root:
| Difficulty walking on heels
L5
