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OSCEs > Surgical Exams > Flashcards

Surgical Exams Flashcards

1
Q

Hands

- Look (5)

A

Five Hand Visuals

  1. Elbow lump (RA)
  2. Lost cascade
    - Jersey injury
  3. Boutonniere’s
    - Central slip rupture
  4. Swan neck
    - Stress on plate or PIP
    - Trauma
    - RA, cerebral palsy
  5. Guttering
    (RA)
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2
Q

Hands

- Feel (6)

A

Hand exam feel

  1. Warmth
  2. Hydrosis
  3. MCPs
    - RA
  4. DIPs
    - OA
  5. Congruent?
  6. Dupuytren’s
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3
Q

Hand exam

- Move

A

Hand exam move

  1. Wrist flexion and deviation

2 Thumb movements

  • Thumb extend is radial
  • Thumb ABduct is palmar
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4
Q

Hand exam

- Functional assessment

A

Hand function tests

  1. Pinch grip
    - OK Sign
    - IO nerve
  2. Power grip
    - eg. Spanner
  3. Key grip
  • Froment’s Test
  1. Hook grip
    - eg. Climbing
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5
Q

Hand exam
- Special tests

Thumb and wrists

A

Hand Special Tests

Thumb

  1. Bones
    - Anatomical snuffbox
    (Scaphoid)
    - Scaphoid palpation
    - Scaphoid balloting
  2. Finkelstein’s test
    - De Quervain’s
    - Grasp thumb with fingers
    - Ulnar deviation pain

Wrist

  1. Neurovascular
    - Allen’s test
    - Cap refil
  2. Tinnel’s
    - Carpal
    - Cubital (lateral condyle)
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6
Q

Spine

- Look (5)

A

Spine exam look

  1. Muscle
  2. Scoliosis
  3. Listing (acute scoliosis)
  4. Lordosis and kyphosis
  5. Gait
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7
Q

Spine

- Feel (3)

A

Spine Exam - Feel

1. Palpate spinous processes
(Middle two fingers)
2. Palpate sacroiliac joints
3. Palpate paraspinal muscles
(tenderness and spasm)
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8
Q

Spine

- Move (4x3)

A

Spine Exam - Move

Cervical

  1. Look to ceiling
  2. Look to toes
  3. Right shoulder
  4. Left shoulder

Thoracic

  1. Seated, Cross arms
  2. Look to left
  3. Look to right
  4. Back to middle
Lumbar
1. Flex
	-	Modified Schober’s Test
(touch toes)
2. Extend
3. Rotate
4. Lateral flexion
(Hand down to toes)
	-	Correction of scoliosis?
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9
Q

Spine

- Move (4x3)

A

Spine Exam - Move

Cervical

  1. Look to ceiling
  2. Look to toes
  3. Right shoulder
  4. Left shoulder

Thoracic

  1. Seated, Cross arms
  2. Look to left
  3. Look to right
  4. Back to middle
Lumbar
1. Flex
	-	Modified Schober’s Test
(touch toes)
2. Extend
3. Rotate
4. Lateral flexion
(Hand down to toes)
	-	Correction of scoliosis?
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10
Q

Spine

- Special (3)

A

Spine special test

  1. Modified Schober’s
  2. Straight leg raise
    • Pain on other side
  3. Femoral nerve stretch
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11
Q

Spine

- Completion (5)

A

Spine

  1. Thank
  2. Neuro vascular
    - Upper
    - Lower
  3. Review imaging
  4. Above
  5. Below
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12
Q

Shoulder

- Look (4)

A

Shoulder Exam Look

  1. Left/right
  2. Front/back
  3. Wasting
    - Cuff tear
  4. Popeye
    - Long head
    (Clavicle to radius)
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13
Q

Shoulder

- Feel (2)

A

Shoulder feel

  1. Temperature
  2. Girdle
    - Clavicle
    ACJ
    - Scapula
    GHJ
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14
Q

Shoulder

- Move (6)

A

Shoulder Exam Move

  1. Winging
    - Dynamic/static
  2. Compound
    - Hands behind head
  3. Painful arcs
    GH 45º-60º
    ACJ 170º-180º
  4. Cuff tests
    Jobe’s/Empty Can (Supra)
    Gerber’s/Lift off (sub)
    Hornblower’s/Ext Rot. (infra/TM)
  5. Impingement
    - Hawkins
    - Neers
    Scarf
  6. Instability
    - Apprehension
    (abduct, ext. rot)
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15
Q

Shoulder

- Three Special Tests

A

Shoulder special tests

  1. Neers test
    • Depress scapula
    • Internally rotate arm
    • Positive for pain during passive full flexion
  2. Hawkin’s test
    • 90º flexion at shoulder and elbow
    • Positive for pain on passive internal rotation of shoulder
  3. Scarf test
    • 90º flexion at shoulder and elbow
    • Positive with pain on passive abduction of shoulder
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16
Q

Shoulder

- Completion

A

Shoulder exam completion

  1. Thank
  2. Neurovascular both
  3. Imagining
  4. Above and below
17
Q

Hip

- Look

A

Hip Exam Look

1 Anterior, lateral posterior

2 Gait

3 Lie flat

18
Q

Hip

- Gaits

A

Hip Gaits

  1. Trendelenburg
  2. Antalgic
  3. Short leg
19
Q

Hip

- Feel

A

Hip exam feel

  1. Temperature
  2. Greater Trochanter
  3. ASIS
20
Q

Hip

- Move

A

Hip exam move

  1. Active flexion and ext
  2. Passive flex
  3. Passive rotation int/ext
  4. Passive ab/adduct
  5. Prone - passive extension
21
Q

Hip

- Special Tests

A

Hip tests

  1. Trendelenberg
  2. Thomas
    • Hip flexion test
    • Supine patient
    • Hold unaffected knee to chest
    • Positive with loss of extension of other leg
  3. Apparent and true length
22
Q

Hip

- Thomas Test

A

Thomas Test

  1. Hand under lumbar lordosis
  2. Single knee up to test
  3. Positive with other leg involvement (iliopsoas tension)
23
Q

Hip

- Leg length (3 measures)

A

Measure leg length?

  1. True leg length
    • ASIS to Medial Malleolus
  2. Apparent leg length
    • Xiphisternum to medal malleolus
  3. Femur vs tibial shortening
    - Bend knee
24
Q

Hip

- Completion

A

Hip exam completion

  1. Thank
  2. Above/below
  3. Neurovascular of both lower limbs
  4. Imaging
25
Q

Knee

- Look

A

Knee Look

  1. Gait
  2. Anterior, lateral, posterior
  3. Lay on bed
26
Q

Knee

- Feel

A

Knee Ex Feel

  1. Temperature
  2. Quadriceps bulk
  3. Knee while extended
  4. Tap and Sweep
  5. Flexed palpation
    - Fossa
    - Tibial tuberosity
    - Fibula head
27
Q

Knee

- Move

A

Knee Ex. Move

  1. Flex/ext
  2. Passive flex/ext
28
Q

Knee

- Special Tests

A

Special knee tests

  1. Bulge/tap/sweep tests
    • Effusion
  2. Varus and Valgus stress tests
  3. Drawer tests
  4. Lachmann’s test
  5. ?McMurray’s test
    • Meniscal tear
    • Flex knee and internally rotate
    • Positive if pain on extension
29
Q

Knee

- Completion

A

Knee ex. completion

  1. Thank
  2. Neurovascular
  3. Above and below
  4. Imaging
30
Q

Foot

- Look

A

Foot exam - Look binaries

  1. Hind foot
    • Varus/valgus
  2. Mid-foot
    • Pes Planus/Pes cavus
  3. Toes
    • Deformity
31
Q

Foot

- Gaits

A

Foot exam - Gaits

  1. Foot drop
    • Tibialis anterior
  2. Antalgic
  3. Protective
    • Excessive lateral contact
32
Q

Foot

- Feel

A

Foot Ex. Feel

  1. Temp
  2. Pulses (DP, PT)
  3. MTP squeeze
  4. Ankle joints
  5. Gastrocnemius and achilles
33
Q

Foot

- Move

A

Foot Ex. Move

  1. Active plantar and dorsi
  2. Active toe flex/ext
  3. Active in/eversion
  4. All passive
  5. Passive subtalar joint
  6. Passive midtarsal joint
34
Q

Foot

- Special

A

Foot exam: Special tests

  1. Drawer test
    • One hand on leg
    • Draw and dorsiflex foot
  2. Thompson/Simmond’s test
    • Prone patient, dangling foot/flexed knee
    • Calf squeeze
35
Q

Vascular exam

- 8 Steps

A

Vascular exam steps

  1. General
  2. Radial and carotid
  3. AAA and bruits
  4. Femoral and bruits
  5. Popliteal
  6. DP and PT
  7. Buerger’s
  8. BPs, ABPI, CVS
36
Q

Hernia exam

- 8 Steps

A

Hernia exam steps

  1. Inspect groins
  2. Location of hernia
    - Relation to landmarks
  3. Size and temperature
  4. Consistency and mobility
  5. Cough/strain
  6. Reducibility technique
    - Pt Comfort

7 Inguinal lymph nodes

  1. Femoral pulses
37
Q

Abdo Exam

- Closing suggestions

A

Abdo ex closing

  1. PR exam
  2. External genitalia
  3. Stoma exam

OSCEs (8 decks)

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