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Physical Dx Final > Spine/LE > Flashcards

Spine/LE Flashcards

(63 cards)

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1
Q

Arteries in the leg

A

Femoral artery
popliteal artery
dorsalis pedis
posterior tibial

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2
Q

Venous system in the leg

A

Superficial: Great and small saphenous veins
Deep: femoral vein
Communicating or perforating veins

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3
Q

PVD Arterial ulcers

A

intermittent claudication pain, NO EDEMA, NO PULSE/WEEK PULSE, NO DRAINAGE round/smooth sores, black eschar;

Location: toes and foot

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4
Q

PVD Venous ulcers

A 
dull achy pain
lower leg EDEMA
pulse present, drainage
sores w/ irregular borders
Yellow slough or Ruddy skin

Location: ankles

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5
Q

Signs of PVD

A

dangling foot makes pain better, elevating feet makes it works

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6
Q

Tx for PVD

A

antiplatelets, surgical (Fempop bypass)

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7
Q

Peripheral Artery Insufficiency sigsn

A

pallor, rubor, distal hair loss, atrophic skin/nail changes, Ulcers, Necrosis; check pulses, skin = cool, cap refill delayed; auscultate for bruits (aorta, femora, popliteal)

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8
Q

Venous insufficiency

A

dilated, tortous superficial veins due to defective structure and function of valves

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9
Q

Clinical presentation of venous insufficiency

A

dull achy/pressure after prolong standing; relieved with elevation
dependent ankle edema and ulcerations
superficial thrombosis/thromophlebitis

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10
Q

Stasis Dermatitis

A

Due to chronic venous insufficiency with incompetent valves and higher pressure in capillary bed; tissue is damaged and inflamed;
BRAWNY EDEMA: non-pitting

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11
Q

Brawny-edema

A

non-pitting edema found with Stasis Dermatitis

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12
Q

Lymphadema

A

lymph obstruction causing severe usually one sided swelling

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13
Q

Gangrene

A

necrosis/black

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14
Q

Principles of leg exam

A 
inspection
palpation
ROM
Neuro (motor)
Vascular
Specialized
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15
Q

Type of joint is the hip joint

A

Ball & Socket

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16
Q

Landmarks to palpate on the hip

A

ASIS
Greater Trochanter
Quads, Hamstrings Femur

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17
Q

Trendelenburg Test

A

Stand on one leg; hip drop means weak hip abductors on the contralateral side

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18
Q

FADIR

A

Adduction with internal rotation of the hit; tests for hip joint

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19
Q

FABER

A

abduction, external rotation (figure 4, patricks test); test for ipsilateral hip problem or contralateral SI joint issue

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20
Q

Knee palpation

A 
Quad tendon
Patella
Patellar tendon
Medial & Later joint lines
Tibial Tuberosity
Popliteal fossa/pulse
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21
Q

Palpation of Lower leg

A 
tibia/fibula
musculature
calf tenderness
swelling
achilles tendon
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22
Q

Palpable cord

A

Thrombosed vein

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23
Q

Genus Varum

A

Bow-legged, knees more lateral, may have waddling gait

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24
Q

Genu Valgum

A

Knock-kneed/pigeon toed; knees more medial

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25
Baker's cyst
synovial fluid cyst located in the popliteal space; palpable as fluctuant fullness; may be painful or result in calf swelling if they leak fluid or rupture; extend knee to palpate a baker's cyst
26
Popliteal aneurysm
due to atheroclerotic vascular disease; M>F, >65 YO; more common aneurysm of peripheral vascular; bilateral 50% of time
27
Dx of popliteal aneurysm
Pulsatile swelling behind the knee
28
Bulge Sign
With leg straight, place pressure over suprapatellar pouch while "milking" knee joint fluid down one side and up the other to observe a pulge; looks for presence of minor effusion
29
Ballottement
Compress suprapatellar pouch and sharply push patella against femur; feel for fluid under the patella and observe for fluid returning to the suprapatellar pouch; Test for LARGE EFFUSION
30
Valgus stress test
MCL stabilize lateral joint line and place one hand on distal tibia; ABduct tibia vs. femur, restricting axial rotation; complete at 0 and 30 degrees of flexion; estimate medial joint space and evaluate sitffness of endpoint to determine amount of laxity
31
Varus stress test
LCL | stabilize medial joint like; ADduct tiba vs. femur; estimate for laxity
32
Anterior Drawer
``` ACL; stabilize foot (sit on it), thumbs on medial and lateral joint line with fingers on hamstring insertion; pull tibia foreward checking for excessive movement (+) anterior translation without firm endpoint ```
33
Posterior Drawer Sign
PCL | push tibia pack; excessive laxity suggests PCL tear
34
Lachman
ACL patient supine, knee flexed 20-30 degrees; stabilized distal femur in one hand while attempting to displace tibia anteriorly with the other; most useful test for ACL; aymmetry compared to other leg and soft endpoint = ACL tear
35
Posterior Sag sign
PCL; back of legs sagging compared to other; anterior tibial surace normally lies 1 cm anterior to the femoral surface; check in both extension and 90 degree flexion with both internal and external rotation
36
ACL tests
Anterior drawer, Lachman
37
McMurray test
Meniscus Medial meniscus: flex knee, externally rotate at heel, flex maximally, then slowly extend the knee while providing valgus stress to knee Lateral: internally rotate at heel, flex maximally, then slowly extend the knee while providing (varus) stress to knee
38
Ankle joint
``` weight bearing joint absorbs impact of gait Hinge joint (tibiotalar, subtalar (talocalcaneal) ```
39
Foot joints
Tarsal/metatarsal joint | PIP/DIP joint
40
Pes planus
flat foot; loss of foot arch
41
Pes Cavus
High arch
42
Neuropathic Ulcers
Diabetic Neuropathy
43
Palpation of foot and ankle
``` Achilles tendon medial and lateral malleoli calcaneus metatarsal MTP and IP joints ```
44
Where to check for pitting/non-pitting edema
Dorsum of foot, behind medial malleolus or on shins
45
Grading of pitting edema
0-4+
46
Foot pulses
Doralis pedis: lateral to tendon on first digit | Posterior tibial pulse: behind the MEDIAL malleolus
47
Pulse grading
``` 0- absent, unable to palpate 1+- diminished, weaker than expected 2+- brisk, normal 3+- increased 4+- bounding ```
48
Anterior drawer test for ankle
Grasp calcaneus and pull forward; looking for sprain
49
Thompson Test
have patient knee and squeeze calf; foot should plantar flex if normal; will be (-) in injury to achilles tendon
50
Spine vertebrae #'s
``` 7 Servical 12 Thoracic 5 Lumbar 5 Sacrum (fused) 4 Coccyx (fused) ```
51
Inspection of spine
posture, head erect, shoulders and pelvis level; | spinal curvature
52
Palpation of spine
spinous processes | paravertebral mm. (tenderness/spasm)
53
ROM for spine
flexion/extension lateral bending (suitcase) rotation (look over shoulder)
54
Scoliosis
lateral curvature of the spine
55
Kypohsis
Increased outer curvature of spine leading to hunchback
56
Lordosis
excessive inward curve of spine
57
Testing for LLD
Galeazzi | Compare medial malleolus
58
Straight leg raising test (SLR)
tests lumbosacral radiculopathy and/or sciatic neuropathy (L5-S1); Passive ROM while supine with knees extended; dorsiflex ankle may further reproduce pain (+): radiating pain in affected limb (note degree of elevation) (aka Laseque's test)
59
Another name for SLR
Lasegue's Test (Sign)
60
Seated SLR Test/Flip sign
patient seated, passively extend knee (+) Patient will "flip back" due to pain
61
L4 radiculopathy
Pain: later thigh, anterior leg Numbness: medial joint line Weakness: extension of quads Reflexes: knee diminished
62
L5 Radiculopathy
Pain: buttocks, lateral thigh/leg Numbness: lateral calf Weakness: dorsiflexion of great too and foot **heel walking test
63
S1 radiculopathy
Pain: posterior butt/leg Numbness: posterior calf, plantar surface of the foot Weakness: plantar flexion of great toe/foot ***walk on toes test Reflex: ankle jerk diminished

Physical Dx Final (4 decks)

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