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YEAR 2 MSK - Clinical Practice > Assessment > Flashcards

Assessment Flashcards

To understand the important factors that contribute to a well rounded objective and subjective assessment

1
Q

Give an overview of some general observations

A
  • Haematoma( bruising)
  • Excessive hair growth
  • Effusion(swelling)
  • Atrophy/Hypertrophy
  • Oedema
  • Bony deformities
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2
Q

Give 2 key observations of the foot and ankle

A
  • Pes planus - Flat foot
  • Pes Cavus- High arch
  • Observe in both standing and supine
  • Any Erythema/Oedema/Haematoma/Effusion
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3
Q

Give 2 key observations of Gait

A
  • Antalgic ( Limp , pain response)

- Trendelenberg( defective hip abductor mechanism - Gluteus med and min)

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4
Q

Give the key observations of the shoulder-

A
  • Protraction and retraction
  • Elevation
  • Depression
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5
Q

What red flags indicate a more serious spinal pathology in the lumbar spine?

A
  • Age of consent
  • Violent trauma
  • Thoracic pain
  • PMH- Carcinoma
  • Systemic steroids
  • Drug abuse
  • Unexplained weight loss
  • Widespread neurology
  • structural deformities
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6
Q

What are the red flags for Cauda Equina Syndrome?

A
  • Difficulty passing urine
  • Loss of anal sphincter tone
  • Saddle anaesthesia
  • Widespread or progressive weakness in the legs or gait disturbance
  • Erectile dysfunction or changes in sexual function
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7
Q

Red flags for infection

A
  • Generally feeling unwell
  • High temperature
  • IVDU
  • recent surgery/open wounds
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8
Q

Red flags for a fracture

A
  • Trauma
  • Constant pain made worse on weight bearing
  • Swelling/bruising
  • Steroid use
  • Osteoporosis/Osteopenia
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9
Q

Red flags for inflammatory disorders( Ankylosing Spondylitis)

A
  • Gradual onset
  • Marked morning stiffness
  • Persisting limitation of spinal movements in all directions
  • Peripheral joint involvement/tendinopathies/aches
  • Skin irritation( Psoriasis)
  • Colitis
  • Family history
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10
Q

What are the special questions in a Hip assessment?

A
  • Clicking
  • Clunking
  • Giving way
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11
Q

What would you want to observe in a Hip assessment?

A
  • Posture in different positions
  • Assess for deformity/mal-alignment
  • Leg length discrepancy
  • lower limb rotation
  • Observe from different angles
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12
Q

What is the closed pack position of the hip?

A

Extension and medial rotation

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13
Q

What is the capsular pattern of the hip?

A
  • Flexion, abduction and medial rotation , with extension slightly limited however the order may vary
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14
Q

What muscle tests would you use for the hip?

A
  • Strength, Length, control and stability
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15
Q

What would you be feeling for when palpating in a hip assessment?

A
  • Temperature
  • Muscle tone
  • Tissue mobility
  • Bony alignment
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16
Q

Give the lower limb myotomes , the nerve innervation, the muscle supplied and the action.

L2-3

A

L2-3 - Femoral nerve , Illio-psoas = Hip Flexion

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17
Q

Give the lower limb myotomes , the nerve innervation, the muscle supplied and the action.

L3-4

A

Femoral nerve , quadriceps , knee extension

18
Q

Give the lower limb myotomes , the nerve innervation, the muscle supplied and the action.

L4-5

A

Deep peroneal nerve, Tibialis anterior , Dorsiflexion.

19
Q

Give the lower limb myotomes , the nerve innervation, the muscle supplied and the action.

L4-5 S-1

A

Deep peroneal nerve, Extensor hallucis longus , big toe extension

20
Q

Give the lower limb myotomes , the nerve innervation, the muscle supplied and the action.

L5-S1

A

Common peroneal nerve , peroneal longus and brevis, eversion

21
Q

Give the lower limb myotomes , the nerve innervation, the muscle supplied and the action.

L5-S1-2

A

Tibial nerve , gastrocnemius and soleus , Plantarflexion.

22
Q

Give the lower limb myotomes , the nerve innervation, the muscle supplied and the action.

L5-S1

A

Sciatic nerve , hamstrings , knee flexion

23
Q

What Myotome would you be testing with the patella tendon reflex?

A

L3-4 , knee extension

24
Q

What myotome would you be testing with the achilles tendon reflex?

A

L5-S1-2 , Plantarflexion

25
Q

What would a hyperflexic reflex indicate?

A
  • UMN lesion , bilaterally
26
Q

What would a hypoflexic reflex indicate?

A
  • LMN lesion , low tone
27
Q

What would an absent reflex response indicate?

A
  • LMN lesion
28
Q

What is obers sign?

A

Tests - TFL and ITB
Positive sign - Upper leg remains abducted and does not lower to plinth.
Procedure- Side lying w/hip and knee of lower leg flexed. Stabilise pelvis, passively abduct and extend upper leg with knee extended or flexed to 90 degrees , then allow it to drop towards the plinth

29
Q

What is obers sign?

A

Tests - TFL and ITB
Positive sign - Upper leg remains abducted and does not lower to plinth.
Procedure- Side lying w/hip and knee of lower leg flexed. Stabilise pelvis, passively abduct and extend upper leg with knee extended or flexed to 90 degrees , then allow it to drop towards the plinth

30
Q

What is the Thomas test?

A

Tests - Hip flexion contracture
Positive sign- Opposite leg lifts off plinth
Procedure- Patient supine, patient hugs knee to chest

31
Q

What is Trendelenberg’s sign?

A

Tests - Stability of the hip, strength of hip abductors
Positive sign- Pelvis on opposite side drops
Procedure- Patient stands on one leg

32
Q

What would you include in your functional assessment?

A
  • Gait
  • Squats
  • Steps/stairs
  • hopping
  • Running
  • Jumping
  • Single leg stand
  • Squat
33
Q

Give the special questions for the knee assessment

A
  • Clicking
  • Locking
  • Giving Way
  • Ascent/Descent of stairs/Hill
34
Q

What strength testing would you carry out on the knee?

A

Quads-Can test in supine ( place your knee under theres in approx 30 deg flex) or sitting. Ensure testing IRQ and SLR
Hams - Can test in supine with your knee under theres or in sitting.

35
Q

How was your carry out length testing for a knee assessment?

A

Quads- Prone knee bend or Thomas Test

Hams ( and gastroc)- Popliteal Angle in Supine

36
Q

How was you access the stability of the knee?

A

Non-weight bearing- IR flex and ext

Weight bearing- Single leg dip and lunges

37
Q

What is the valgus stress test?

A

Tests- in 20-30 deg flex - MCL
Positive sign- Excessive movement compared to opposite knee
Procedure- Pt supine, stabilise ankle and then apply medial stress to joint at 0 deg , 20deg and 30 deg flexion.

38
Q

What is the capsular pattern for the shoulder- LAM

A
  • Lateral rotation
  • Abduction
  • Medial rotation
39
Q

What are the special questions for the shoulder?

A
  • Steroid use
  • Past trauma
  • Clicking,popping,cruncing
  • Locking
  • Age ( Arthritis,Capsulitis)
  • PMH ( Diabetes , capsulitis, RA)
  • Previous dislocation/instability.
40
Q

What are the red flags in shoulder assessment?

A
  • Non mechanical pain
  • Hx Ca
  • Sudden loss external rotation
  • Pancoast tumour- Cancer located in the top right apex of the lung.

YEAR 2 MSK - Clinical Practice (2 decks)

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