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Block 12 - Neurological, Neuromuscular and Musculoskeletal Disease > ALS Lecture 4 - Examination of the Limbs DONE > Flashcards

ALS Lecture 4 - Examination of the Limbs DONE Flashcards

1
Q

gait cycle

A

1 foot contacts ground -> same foot contracts ground

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2
Q

2 phases of gait cycle

A

stance, swing

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3
Q

stance phase

A

foot in contact with ground

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4
Q

swing phase

A

foot not in contact with ground

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5
Q

stance phase constitutes what percent of gate cycle?

A

60

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6
Q

5 movements in stance phase

A

heel strike, foot flat (loading response), mid stance, terminal stance (push off), toe off (pre-swing)

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7
Q

heel strike

A

heel is first bone to touch ground

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8
Q

foot flat (loading response)

A

weight onto reference leg

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9
Q

foot flat (loading response) is important for

A

weight-bearing, shock absorption, forward progression

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10
Q

mid stance

A

alignment (leg below body), balance body weight on reference foot

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11
Q

terminal stance (push off)

A

heel of reference foot rises while toe still on ground

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12
Q

toe off (pre-swing)

A

toe of reference foot rises, swings int air, beginning of swing phase of gait cycle

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13
Q

swing phase constitutes what percent of gate cycle?

A

40

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14
Q

3 parts to swing phase

A

initial swing, mid swing, terminal swing

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15
Q

pathological disorders of gait (4)

A

antalgic, slapping foot, foot drop, trendelenburg

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16
Q

antalgic gait

A

pain in any limb, pt walks with limp so foot on painful side on ground less

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17
Q

slapping foot gait

A

weakness in dorsiflexors, in heel strike foot can’t come up

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18
Q

foot drop gait

A

completely weak dorsiflexors, in swing foot dangles, toes strike floor and higher step

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19
Q

trendelenburg gait

A

weakness of hip abductors gluteus medius and minimus, on side pt is standing on, lean over to shift centre of mass to other side so they don’t fall

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20
Q

orthopaedic exam

A

look, feel, move, x-ray

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21
Q

look in orthopaedic exam

A

deformity, muscle wasting, scars, gait abnormalities

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22
Q

move in orthopaedic exam

A

range of movements, resisted movement for muscle power

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23
Q

GALS screening examination

A

gait, arms, legs, spine

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24
Q

shoulder joint type

A

ball and socket

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25
Q

shoulder range of movement

A

large

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26
Q

should be able to abduct arthritis up away from body ______ degrees

A

180

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27
Q

shoulder abduction test

A

stand behind patient, feel bottom of scapula, feel scapula move as arm abducts

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28
Q

what degree of shoulder abduction is by scapulothoracic joint?

A

60-180

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29
Q

what degree of shoulder abduction is by glenohumeral joint?

A

120-180

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30
Q

shoulder external rotation and abduction test (1)

A

abducted position, humerus is externally rotated, uncomfortable if previous anterior dislocation

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31
Q

shoulder external rotation and abduction test (2)

A

apley scracth test, see how far pt can reach over shoulder

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32
Q

shoulder internal rotation and abduction test

A

see how far pt can get hand up back, measured as level on thoracic spine
also bring arm across to shoulder (at front)

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33
Q

shoulder flexor power test

A

stabilise joint, resist arm move forwards

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34
Q

shoulder extensor power test

A

stabilise joint, resist arm move backwards

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35
Q

shoulder adductor power test

A

stabilise joint, resist arm move down towards body

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36
Q

shoulder abductor power test

A

stabilise joint, resist arm move up away from body

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37
Q

shoulder elevation power test

A

put hands on shoulders and resist shoulders shrugging

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38
Q

test for shoulder sensation (which nerve and where)

A

axillary, sergeant’s stripe

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39
Q

elbow joint type

A

hinge

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40
Q

elbow flexion power test

A

support elbow, test flexion against resistance

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41
Q

elbow extension power test

A

support elbow, test extension against resistance

42
Q

elbow supinator power test

A

support elbow, test forearm supination against resistance

43
Q

elbow pronation power test

A

support elbow, test forearm pronation against resistance

44
Q

wrist dorsiflexion is ___degrees

A

70

45
Q

wrist palmar flexion is ___degrees

A

80

46
Q

demonstrate ulnar and radial deviation of wrist

A

done

47
Q

metacarpophalangeal flexion is ___degrees

A

90

48
Q

metacarpophalangeal extension is ___degrees

A

30-45

49
Q

proximal interphalangeal joint flexion is ___degrees

A

0-100

50
Q

distal interphalangeal joint flexion is ___degrees

A

90

51
Q

distal interphalangeal joint flexion is ___degrees

A

10

52
Q

test for long extensor power

A

movement of metacarpophalangeal joints against resistance

53
Q

test for finger flexor power

A

grip patient’s fingers and pull up while asking them to resist

54
Q

test for finger abductor power

A

spanning hand, move fingers away from midline, ask them to resist adduction movement and keep fingers open

55
Q

test for finger adductor power

A

use a paper or banknotes the patient holds between their fingers and try to pull the note

56
Q

pinch grip

A

picking up small objects

57
Q

power grip

A

hand makes space for item being held, flexing all joints in the hand

58
Q

thomas test for fixed flexion deformity of hip (3 steps)

A
  1. lie patient on flat, firm couch
  2. place hand under lumbar lordosis
  3. flexion of hip should eliminate lumbar lordosis
59
Q

test hip extension

A

lie patient on front, lift leg, should be 20-30 degrees

60
Q

test hip abduction (2 steps)

A
  1. feel anterior superior iliac spine on leg being tested.

2. abduct hip, feel with other hand

61
Q

test hip adduction

A

on back, push leg over other leg

62
Q

test hip external rotation

A

use foot to rotate hip out

63
Q

test hip internal rotation

A

use foot to rotate hip in

64
Q

femoral neck anteversion ____degrees

A

10-15

65
Q

trendelenburg test (3 steps)

A
  1. pt stand on leg with problem
  2. put fingers on anterior superior iliac spines
  3. feel dip on opposite side
66
Q

knee joint type

A

hinge type synovial

67
Q

hyperextension of knee is ___degrees

A

-10

68
Q

flexion of knee is ___degrees

A

130-140

69
Q

knee deformities (3)

A

genu varum, genu valgum, genu recurvatum

70
Q

genu varum

A

bowed legs, common arthritis

71
Q

genu valgum

A

knock knees, arthritis on outside of knee, away from midline

72
Q

genu recurvatum

A

back knee, hyperextension of knee

73
Q

test medial collateral ligament stability

A

push knee into valgum position (inwards), stabilise knee with one hand and stretch ligament

74
Q

test lateral collateral ligament stability

A

push knee into varus position (outwards)

75
Q

Drawer test use

A

assess suspected rupture cruciate ligament in knee

76
Q

Drawer test method for ACL

A
  1. pt lay back, feet flat, knees up
  2. stabilise feet, pull tibia forward
  3. if CAN be pulled forwards = positive drawer test = ACL rupture
77
Q

Drawer test method for PCL

A
  1. pt lay back, feet flat, knees up
  2. stabilise feet, push tibia backwards
  3. if CAN be pushed backwards = positive drawer test = PCL rupture
78
Q

test for quadriceps muscle power

A

resist leg extension

79
Q

test for hamstring muscle power

A

resist leg flexion

80
Q

schober test is for

A

lumbar spine flexion and extension

81
Q

schober test (2 steps)

A
  1. compare fixed point on spine about 10cm apart using 2 fingers
  2. ask pt to bend forwards to touch toes, 10cm should go to 15cm, then lean back
  3. ask pt to run hand down each thigh
82
Q

true leg length

A

affected limb is physically shorter than other

83
Q

apparent leg length discrepancy

A

pelvis tilted up on one side, e.g. scoliosis, one leg seems shorter

84
Q

measure leg length from

A

umbilicus to medial malleolus of ankle

85
Q

if one leg is definitely shorter, check if tibia or femur is shorter by

A

position hip at 45, knee at 90, if tibia shorter knee not as high from front, if femur shorter knee further back than side

86
Q

rotator cuff is an important

A

shoulder joint stabiliser

87
Q

rotator cuff is a (what type of thing?)

A

tendon

88
Q

rotator cuff attaches to

A

greater tuberosity of humerus

89
Q

muscles of the rotator cuff

A

supraspinatus, infrapsinatus, teres minor, subscapularis

90
Q

drop arm test is for

A

rotator cuff function

91
Q

drop arm test

A
  1. hold patient arm out at side
  2. release hand, ask pt to keep arm in place
  3. if major rotator cuff tear arm will drop a bit
92
Q

L4 lesion motor loss

A

tibialis anterior, resisted dorsiflexion of foot

93
Q

L4 lesion reflex loss

A

missing knee jerk reflex, definite L4 problem

94
Q

L4 lesion sensation loss

A

L4 dermatome on medial part of lower leg/foot

95
Q

L5 lesion motor loss

A

extensor hallucis longus, extension of big toe

96
Q

L5 lesion reflex loss

A

none

97
Q

L5 lesion sensation loss

A

L5 dermatome on dorsum of foot

98
Q

S1 lesion motor loss

A

peroneus longus and brevis, eversion of foot

99
Q

S1 lesion reflex loss

A

very specific to ankle jerk reflex

100
Q

S1 lesion sensation loss

A

S1 dermatome on lateral part of lower leg/foot

Block 12 - Neurological, Neuromuscular and Musculoskeletal Disease (28 decks)

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