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Flashcards in VERBALS LAB MIDTERM Deck (43):
1

Bony Palpation:  SHOULDER

  1. Sternoclavicular Articulation
  2. Clavicle
  3. Coracoid Process
  4. Acromioclavicular Articulation
  5. Acromion
  6. Greater Tuberosity of the Humerus
  7. Bicipital Groove
  8. Lesser Tuberosity of the Humerus
  9. Spine of the Scapula
  10. Body of Scapula
  11. Scapulothoracic Articulation

2

Soft Tissue Palpation:  SHOULDER

  1. Rotator Cuff Muscle:  Supraspinatus, Infraspinatus, Teres Minor, Subscapularis
  2. Subacromial Bursa
  3. Subdeltoid Bursa
  4. Axillary Borders:  Pectoralis Major, Serratus Anterior, Axillary Lymph Nodes, Latissimus Dorsi, Bicipital Tendon
  5. Prominent Muscles of Region:  Sternocleidomastoid, Biceps, Deltoid as a whole, (anterior, middle and posterior portion of deltoid), Trapezius, Rhomboid (minor and major)

3

RANGE OF MOTION:  SHOULDER

  • Flexion:  180
  • Abduction:  180
  • External Rotation:  90
  • Internal Rotation:  70
  • Extension:  60
  • Adduction:  50

 

Scapular retraction, elevation, protaction

4

Yergason Test (Cipriano)

POSITIVE:  

- Localized Pain and/or tenderness at the bicipital groove

- Audible click or the biceps tendon subluxes or dislocates

 

INDICATES:  

- Bicipital Tendinitis

- Instability of the biceps tendon possibly associated with a torn transverse humeral ligament

5

Abbott-Saunders Test

POSITIVE:  

- Palpable and/or audible click

INDICATES:  

Subluxation or dislocation of the biceps tendon due to a rupture of the transverse humeral ligament or tendon subluxation beneath subscapularis muscle belly/tendon

6

SPEED TEST

POSITIVE:  

- Pain and/or tenderness in the bicipital groove

INDICATES:

- Bicipital Tendinitis

7

APLEY TEST:

POSITIVE:

- Exacerbation of pain

INDICATES:

- Degenerative tendinitis of rotator cuff tendons (usually supraspinatus)

8

IMPINGEMENT SIGN:

POSITIVE:

- Pain in the shoulder 

INDICATES:

- Overuse injury to the supraspinatus and possibly biceps tendon

9

DUGAS TEST

POSITIVE:

- Inability to touch the opposite shoulder and/or inability of the elbow to touch the chest

INDICATES:

- Acute dislocation of the shoulder (glenohumeral joint)

10

ANTERIOR APPREHENSION TEST

POSITIVE:

- Patient will have a noticeable look of apprehension or alarm on their face with possible pain

INDICATES:

- Chronic anterior dislocation of the shoulder (glenohumeral joint)

11

POSTERIOR APPREHENSION TEST

POSITIVE:  

- Patient will have a noticeable look of apprehension or alarm on their face with possible pain

INDICATES:

- Chronic Posterior dislocation of the glenohumeral joint

12

DROP ARM TEST/ aka CODMAN DROP ARM TEST

POSITIVE:

- Patient will not be able to lower the arm slowly or the arm drops suddenly

INDICATES:

- Rotator cuff tear, usually supraspinatus

13

DAWBARN TEST

Deep palpation of shoulder elicits well-localized tender area, by subacromial bursa

 

POSITIVE

- Decrease in pain and/or tenderness

INDICATES:

- Subacromial bursitis

14

BONY PALPATION OF THE ELBOW

  1. Medial Epicondyle
  2. Medial Supracondylar line of the humerus
  3. Groove of the ulnar nerve
  4. Trochlea
  5. Olecranon
  6. Olecranon fossa
  7. Lateral Epicondyle
  8. Lateral Supracondylar line of the humerus
  9. Radial head

15

SOFT TISSUE PALPATION of ELBOW

  1. Ulnar Nerve
  2. Wrist flexor muscles (Palpate as a unit and individually)
    1. Pronator Teres
    2. Flexor Carpi Radialis
    3. Palmaris Longus
    4. Flexor Carpi Ulnaris
  3. Medial Collateral Ligament
  4. Supracondylar Lymph Nodes
  5. Brachial Artery
  6. Triceps Muscle
  7. Lateral Collateral ligament
  8. Biceps
  9. Olecranon Bursa
  10. Elbow Flexors muscles "mobile wad of three" (palpate as a unit and individually)
    1. Brachioradialis
    2. Extensor Carpi Radialis Longus
    3. Extensor Carpi Radialis Brevis

16

Range of motion:  ELBOW

  • Elbow Flexion:  150
  • Elbow Extension:  0
  • Forearm Supination (radio-ulnar joint): 80
  • Forearm Pronation: 80

17

MEDIAL COLLATERAL LIGAMENT TEST

POSITIVE:

- Excessive gapping & pain

INDICATES:

- Medial Collateral ligament tear and/or instability

18

LATERAL COLLATERAL LIGAMENT TEST

POSITIVE:

- Excessive gapping & pain

INDICATES:

- Lateral collateral ligament tear and/or instability

19

TINEL ELBOW SIGN

  " This is my Taylor Reflex Hammer it feels something like this, is that ok? "

 

POSITIVE:

- Pain and/or tenderness at the site being tapped and paresthesia in the ulnar nerve distribution area (fingers 4,5)

INDICATES:

- Neuroma of the ulnar nerve

20

COZEN TEST

POSITIVE:

- Pain over the lateral epicondyle

INDICATES:

- Lateral Epicondylitis (Tennis Elbow)

21

MILLS TEST

POSITIVE:

- Pain over the lateral epicondyle

INDICATES:

- Lateral Epicondylitis (Tennis elbow)

 

22

GOLFER ELBOW TEST

POSITIVE:  

- Pain over the medial epicondyle

INDICATES:

- Medial Epicondylitis

23

BONY PALPATION:  CERVICAL SPINE

ANTERIOR ASPECT:  

  1. Hyoid Bone
  2. Thyroid Cartilage
  3. First Cricoid Ring
  4. Mandible

POSTERIOR ASPECT:

  1. Occiput
  2. Inion (EOP)
  3. Superior Nuchal Line
  4. Mastoid Processes
  5. Spinous processes of Cervical Vertebrae
  6. Facet Joints

24

SOFT TISSUE PALPATION:  CERVICAL SPINE

  1. Sternocleidomastoid muscle
  2. Anterior lymph node chain
  3. Posterior lymph node chain
  4. Thyroid gland
  5. Carotid Pulse
  6. Supraclavicular Fossa
  7. Trapezius Muscle
  8. Greater Occipital Nerves
  9. Superior Nuchal Ligament

25

RANGE OF MOTION:  CERVICAL SPINE

ACTIVE AND PASSIVE

  • ​Flexion 50
  • Extension 60
  • Lateral Bending Left 45
  • Lateral Bending Right 45
  • Left Rotation 80
  • Right Rotation 80

26

FORAMINAL COMPRESSION 

POSITIVE:

  1. Exacerbation of localized cervical Pain
  2. Exacerbation of cervical pain with a radicular component

INDICATES:

  1. Foraminal Encroachment or facet pathology without nerve root compression
  2. Foraminal Encroachment or facet pathology with nerve root compression

27

CERVICAL DISTRACTION TEST

POSITIVE:

  1. Diminished or absence of local cervical pain
  2. Diminished or absence or radiating pain
  3. Increase of cervical pain

INDICATES:

  1. Foraminal encroachment without nerve root compression
  2. Foraminal encroachment with nerve root compression
  3. Muscular strain, ligamentous sprain, myospasm or facet capsulitis

28

SPINAL PERCUSSION TEST

   " This is my Taylor reflex hammer it feels something like this "

 

POSITIVE:  

  1. Local Pain
  2. Radiating 

INDICATES:

  1. Possible fractured vertebrae, ligamentous involvment (spinous pain), and muscular involvment (muscular pain)
  2. Possible disc pathology

29

SHOULDER DEPRESSION TEST

POSITIVE:  

  1. Localized pain on the side being tested
  2. Radicular pain on either side

INDICATES:

  1. Localized Pain:  Dural sleeve adhesion, and muscular adhesion/contracture, or spasm, or ligamentous injury
  2. Radiating Pain:  On side being tested neurovascular bundle compression, dural sleeve adhesions, or Thoracic Outlet Syndrome.  On opposite side being tested foraminal encroachment with nerve root compression

30

VALSALVA MANEUVER

POSITIVE:  Radiating pain from site of lesion (usually recreating the complaint in cervical or lumbar area of the spine)

 

INDICATES:  Space occupying lesion (e.g. disc pathology)

31

SWALLOWING TEST

POSITIVE:  Difficulty in swallowing

 

INDICATES:  Space-Occupying lesion at anterior portion of cervical spine.  Possibly esophageal or pharyngeal injury, anterior disc defect, muscle spasm or osteophytes etc.

32

SOTO-HALL SIGN

POSITIVE:  Generalized pain in the cervical region, which may extend down to the level of T2

 

INDICATES:  Non-specific test for structural integrity of cervical region

33

KERNIG SIGN

POSITIVE:  Inability to fully extend the leg and/or pain (usually in the neck region)

 

INDICATES:  Meningeal irritation/meningitis

34

O' DONOGHUE MANEUVER

POSITIVE:  

  1. Pain during passive range of motion
  2. Pain during resisted range of motion

INDICATES:

  1. Ligamentous sprain.  (Passive ROM stresses ligaments)
  2. Muscle/tendon strain.  (Active ROM stresses muscles and tendons)

35

Bony Palpation Wrist and Hand

Radial Syloid Process

 Ulnar Styloid Process,

Lister's Tubercle,

Scaphoid (navicular),

Lunate, Triquetrium,

Pisiform,

Trapezium,

Trapezoid,

Capitate,

Hamate,

Hook of Hamate,

Metacarpals,

Phalanges

36

Soft Tissue Palpation: Wrist and Hand

Ulnar Artery,

Radial Artery,

Palmaris Longus Tendon,

Carpal Tunnel Region,

Thenar Eminence,

Hypothenar Eminence,

Palmar Aponeurosis,

Tissues surrounding proximal interphalangeal joints,

Tissues surrounding distal interphalangeal joints,

Distal tufts of fingers

37

Range of Motion: Wrist and Hand

Wrist Flexion 80,

Wrist Extension 70, 

Wrist Ulnar Deviation 30,

Wrist Radial Deviation 20,

Finger Abduction,

Finger Adduction,

Finger Flexion,

Finger Extension,

Thumb Flexion,

Thumb Extension,

Finger Opposition 

38

Tinel Wrist Sign

  "  This is my Taylor reflex hammer, it feels something like this, is that ok? " 

 

POSITIVE:  Reproduction of pain, tenderness, and/or paresthesia in the median nerve distribution area (1st, 2nd, 3rd, and the lateral 1/2 of the 4th digit)

 

INDICATES:  Median Neuritis, possibly Carpal Tunnel Syndrome 

 

39

PHALEN SIGN AND REVERSE PHALEN SIGN 

aka Prayer Sign

Elbows same level as shoulders for 60 seconds

 

POSITIVE:  Reproduction of pain and/or paresthesia in the median nerve distribution area (thumb, 2nd, 3rd, and the lateral 1/2 of the 4th digit)

 

INDICATES:  Median Neuritis, possibly Carpal Tunnel Syndrome

40

FINKELSTEIN TEST

POSITIVE:  Pain distal to the radial styloid process

 

INDICATES:  Stenosing tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons (DeQuervain's Disease)

41

ALLEN TEST

     57, 58, 59, 60 ...... both hands pumping, bring them down both closed, open at same time, then let off of one artery and compare (TURN HEAD)

 

POSITIVE:  A delay of more than 10 seconds (Evans 5 sec) in returning a reddish color to the hand

 

INDICATES:  Radial or Ulnar Artery insufficiency.  The artery held (occluded) by the examiner is not the artery being tested

42

RETINACULAR TEST

Patient presents with difficulty flexing the DIP joint

 

POSITIVE:  

1)  Flexion of the distal interphalangeal joint cannot be achieved

2)  Flexion of the distal interphalangeal joint is achieved

 

INDICATES:

 

1)  Joint Capsule Contracture

2)  Tight Retinacular Ligament

43

BUNNEL - LITTLER TEST

Patient presents with difficulty flexing the PIP joint

 

POSITIVE:  

  1. Flexion of the proximal interphalangeal joint cannot be achieved
  2. Flexion of the proximal interphalangeal joint is achieved

INDICATES:

  1. Joint Capsule Contracture
  2. Tight intrinsic muscles