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Physical Assessment > 3. Back & Hip Tests & Disorders > Flashcards

3. Back & Hip Tests & Disorders Flashcards

1
Q

Straight Leg Raise Test

A

Assesses for sciatica; passively flex hip w/ knee straight; lower leg slightly; dorsiflex (+) finding is pain in sciatic n. at any point

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2
Q

Opposite Straight Leg Test

A

Assesses for sciatica in opposite leg; passively flex unaffected hip with straight knee

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3
Q

Hoover Test

A

Tests for fakers; should feel pressure from opposite foot when asking patient to raise a leg

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4
Q

Patrick’s Test

A

Tests SI joint, Adductor muscle tightness; Ligament tightness

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5
Q

Pelvic Rock Test

A

Tests for pelvic fracture; Providers hands on ASIS bilat; press inward then down & out; (+) = pain with minimal pressure

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6
Q

Beevor’s Sign

A

Tests abdominal muscle weakness; observe umbilicus during crunch. (+) = umbilicus moves to stronger, uninvolved side

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7
Q

Trendelenburg Test

A

Tests for weak glut medius; Patient stands on one leg; (+) on weight-bearing leg if opposite hip drops

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8
Q

Ober Test

A

Test for IT band tightness; Pt in lat decub on unaffected side, passively flex knee to 90, abduct hip, release leg; (+) = leg does not drop

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9
Q

Modified Ober Test

A

Test for IT band tightness; Pt in lat decub on unaffected side, passively flex knee to 90, abduct & extend hip, release leg; (+) = leg does not drop

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10
Q

Piriformis Test

A

Test for piriformis strain or tightness; Pt in lat decub on unaffected side; knee flexed; passively adduct hip & press medially; (+) pain at location of piriformis

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11
Q

Femoral Nerve Test

A

Pt in lat decub on unaffected side; passively extend hip and flex knee to 90 to stretch femoral n. (+) = pain or paresthesias along femoral n.

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12
Q

Thomas Test

A

Test for tight hip flexors; pt supine, actively flex one hip & knee to chest & hold; (+) = extended leg flexes off table

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13
Q

Kendell Test

A

Test for tight rectus femoris; pt supine with one glut off table, actively hug both knees to chest, drop one leg off table; (+) = hanging leg straight at knee

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14
Q

Nobel’s Test

A

Test for IT band syndrome; pt supine with knee flexed, apply pressure lat to knee while extending; (+) = pain experienced at IT band at 30 flexion

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15
Q

Renne’s Test

A

Test for IT band syndrome; pt stands on affected leg, actively flexes to 30-40; (+) = pain experienced at IT band at 30 flexion

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16
Q

Low Back Muscle Strain – Mechanism

A

Mechanism = forceful contraction or overstretch

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17
Q

Low Back Muscle Strain – S/Sx

A

S/Sx = Pain, edema, muscle spasm, RoM affected depends on muscle

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18
Q

Low Back Ligament Sprain – Mechanism

A

Mechanism = Sudden hyperextension w/ trunk rotation; faulty posture

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19
Q

Lumbar Disc Herniation

A

Intervertebral disc bulges or ruptures; places pressure on spinal nerves exiting intervertebral foramen

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20
Q

Lumbar Disc Herniation – Protrusion

A

Disc bulges posteriorly or laterally; no rupture

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21
Q

Lumbar Disc Herniation – Prolapsed

A

Outermost fibers of Anulus contain nucleus pulposis

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22
Q

Lumbar Disc Herniation – Extrusion

A

Anulus perforated, portion of nucleus moves into epidural space

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23
Q

Lumbar Disc Herniation – Sequestrated

A

Nucleus pulposis outside of disc

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24
Q

Spina Bifida

A

Birth defect; lack of fusion of neural arch of one or more vertebrae; weakness in region; Possible loss of stability due to muscle and ligament attachment; spinal cord may protrude

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25
Sacroiliitis
Inflammation of SI joint; excessive movement of joint; common in pregnancy; point tender at SI joint; pain with sitting on hard surface; pain with lying on supine on hard surface; pain-free when standing
26
Spondylosis
Degeneration of intervertebral disc
27
Spondylolysis
Scottie Dog Fracture/Stress fracture; Defect in articular processes of vertebra (fx); Repeated hyperextension & hyperflexion; L5-S1; L4-L5; possibly asymptomatic; Unilateral LBP, radiates to opposite side; increased pain with lat rot, limited ext
28
Spondylolisthesis
Scottie Dog Decapitated; Forward slippage of superior vertebra on inferior one; Radiating LBP; Limited hip flexion, trunk ext
29
Ankylosing Spondylitis
Fusion of cervical vertebrae & SI joint; Males 20-40 yrs; Genetic; Achilles tenosynovitis; Uveitis
30
Cauda Equina Syndrome
Saddle anesthesia; buttocks, posterior upper & lower legs; paralysis; bladder & bowel incontinence
31
Hip dislocation
Joint very stable; occurs when knee is flexed; posterior (90%)
32
Anterior hip dislocation
10% of hip dislocations; Leg shortened; ABD; flex; ER; Medical emergency due to potential FEMORAL NERVE damage
33
Posterior hip dislocation
90% of hip dislocations; MVA most common mechanism; HIP & KNEE FLEXED WITH IR & ADD; SCIATIC NERVE DAMAGE POSSIBLE
34
Congenital Hip Dislocation
Born with dislocation; Galeazzi's Sign
35
Galeazzi's Sign
Knee lower on dislocated side when placed on firm surface with hips and knees flexed; indicative of congenital hip dislocation
36
Ortolani's Sign
Passively abd hip; (+) = click palpable or audible due to reduction; sign of congenital hip dislocation
37
Hip fracture – Location
1) femoral neck; 2) Intertrochanteric line
38
Hip fracture – Mechanism
Mechanism = Trauma, twisting
39
Hip fracture – S/Sx
Pain in groin, anterior thigh; Loss of IR; Hip held in ER; Shock likely
40
Slipped Capital Femoral Epiphysis
BOYS 10-17 YRS.; slipping of epiphyseal line due to prolonged stress; Limping in ER; Affected limb is shorter; Limited ABD, FLEX, IR; No Hx of injury; pain in groin, ant thigh, and referred to knee
41
Slipped Capital Femoral Epiphysis – Complication
Avascular necrosis; cell death due to lack of O2
42
Legg-Hipp-Perthes Disease
BOYS 3-12 YRS; blood supply to femoral head is interrupted & avascular necrosis develops; flattening of articular cartilage; necrosis of tissue; UNEXPLAINED LIMP; SHORTENED LIMB; DECREASED HIP ROM; pain in groin and ant thigh; Pain referred to abdomen or knee
43
Ischial bursitis – Mechanism
Overuse; direct trauma; SITTING ON HARD SURFACE FOR EXTENDED PERIOD OF TIME; falling on butt
44
Ischial bursitis – S/Sx
Point tender; pain with extension
45
Trochanteric Bursitis – Mechanism
Overuse, direct trauma, SYSTEMIC INFECTION
46
Trochanteric Bursitis – S/Sx
Pain, edema, crepitus, decrease abduction
47
Gluteus Max Strain – Mechanism
Forceful contraction, overstretching;
48
Gluteus Max Strain – S/Sx
S/Sx = Hx of sudden sharp pain & weakness; pain; decrease RoM w/ extension; point tender; may palpate defect
49
Hip flexor strain – muscles
Iliopsoas; Rectus femoris
50
Groin Strain – muscles
Adductors; Gracilis
51
Gluteus Medius strain – S/Sx
Point tender; REFERRED PAIN INTO GLUTS; (+) Trendelenburg
52
Piriformis Strain
SI joint pain; gluteal pain which radiates down back of thigh into gastroc
53
Sciatica – S/Sx
S/Sx = Pain in sciatic notch; Radiates down leg;
54
Sciatica – Mechanism
Mechanism = Direct blow to nerve; COMPRESSION DUE TO PIRIFORMIS MUSCLE STRAIN
55
Contusion – Mechanism
Mechanism = Direct blow
56
Contusion – S/Sx
S/Sx = Pain, edema, ecchymosis
57
Contusion complication
Myositis ossificans
58
Common contusion areas
Greater trochanter; Crest of ilium; Coccyx
59
Sprains – Mechanism
Mechanism = Violent twist; external blow; foot planted & trunk forced in opposite direction
60
Sprains – S/Sx
S/Sx = Pain w/ add, abd, flex; inability to circumduct leg
61
Lateral Femoral Cutaneous Nerve Impingement
Nerve impinged; numbness anterior, lateral thigh; Direct blow, edema, trauma
62
Osteoarthritis
>50 yrs; pain in groin, referred to knee; pain with activity; stiffness,edema, limping; Held in ER
63
Biceps – Nerve & Nerve root for DTRs
Musculocutaneous – C6
64
Brachioradialis – Nerve & Nerve root for DTRs
Musculocutaneous – C6
65
Triceps – Nerve & Nerve root for DTRs
Radial – C7
66
Patellar – Nerve & Nerve root for DTRs
Femoral – L4
67
Achilles – Nerve & Nerve root for DTRs
Tibial/Sciatic – S1
68
Trapezius - Myotome
C4
69
Deltoid – Myotome
C5
70
Biceps – Myotome
C6
71
Triceps – Myotome
C7
72
Finger flexors – Myotome
C8
73
Finger abductors – Myotome
T1
74
Thumb opposition – Myotome
T1
75
Quadriceps – Myotome
L4
76
Great toe extension – Myotome
L5
77
Gastrocnemius – Myotome
S1
78
Rectal sphincter – Myotome
S3/4
79
Posterior upper head - Dermatome
C2
80
Tip of shoulder – Dermatome
C5
81
Thumb – Dermatome
C6
82
Middle finger – Dermatome
C7
83
Little finger – Dermatome
C8
84
Nipples – Dermatome
T4
85
Umbilicus – Dermatome
T10
86
Groin – Dermatome
L1
87
Medial knee – Dermatome
L3
88
Ant. Knee & Med. ankle – Dermatome
L4
89
Great toe, dorsum of foot – Dermatome
L5
90
Lat. Ankle & Little toe – Dermatome
S1
91
Heel & Plantar – Dermatome
S2
92
Perianal area – Dermatome
S5
93
Light touch spinal tract
Dorsal column
94
Tactile discrimination
Dorsal column
95
Pressure/Deep Touch
Ant. Spinothalamic
96
Vibration
Dorsal column
97
Joint position
Dorsal column
98
Pain
Lat. Spinothalamic
99
Temperature
Lat. Spinothalamic
100
Balance, Proprioception
Spinocerebellar
101
Somatosensory pathway
Sensory stimulus > SC/Brainstem > Thalamus
102
1st Order Neurons
Peripheral nerves to medulla
103
2nd Order Neurons
Medulla to thalamus
104
3rd Order Neurons
Thalamus to cerebrum
105
1st Order Neurons – Dorsal Column
Ipsilateral; lesion of spinal nerves or spinal tract
106
2nd Order Neurons – Dorsal Column
Contralateral; Medulla > crossover > thalamus
107
3rd Order Neurons – Dorsal Column
Contralateral; Thalamus > Sensory cortex > Postcentral (upper limbs) & paracentral (lower limbs) gyrus
108
1st Order Neuron – Spinothalamic
Ipsilateral; SC > Dorsal horn
109
2nd Order Neuron – Spinalthalamic
Contralateral; Dorsal horn SC > crossover > Spinalthalamic tract to thalamus
110
3rd Order Neuron – Spinalthalamic
Contralateral; Thalamus > Sensory cortex
111
Lesion in Spinal Nerve – Dorsal Column
Ipsilateral impairment
112
Lesion in Spinal Nerve – Spinothalamic
Ipsilateral impairment
113
Lesion in SC Tract – Dorsal Column
Ipsilateral impairment
114
Lesion in SC Tract – Spinothalamic
Contralateral impairment
115
Motor Pathway
Corticospinal tract
116
Lesion in Spinal Nerve – Corticospinal tract
Ipsilateral impairment
117
Lesion in SC Tract – Corticospinal tract
Ipsilateral impairment
118
Signs of Lower Motor Neuron Lesion
Decreased muscle tone (flaccidity); Decrease or absent DTR
119
Signs of Upper Motor Neuron Lesion
Increased muscle tone (spasticity); Increased DTR or clonus

Physical Assessment (13 decks)

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