B6-101 MSK Exam: Lower Limb Flashcards by Felicia Jones

when would you expect to see swelling from a meniscal tear?

next day

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worst pain in the first few steps after getting out of bed

plantar fasciitis

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pathogen associated with causing septic hip in kids

H. flu

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AROM means

patient moves joint under own power

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PROM means

practitioner moves joint

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it is important in cervical spin injury to allow […] before checking […]

AROM before PROM

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examine [injured/uninjured] side first

uninjured

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active movement against full resistances

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active movement with gravity only

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no active movement but detectable flicker or trace of muscle contraction

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mass that fluctuates in size is likely

ganglion cyst

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patients with discogenic back pain will want to remain in what posture?

standing

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intervertebral disc pressure is highest in what position?

sitting

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pain radiating down posterior thigh and past knee on straight leg test can indicate

sciatic nerve pain

**lower lumbar root

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pain radiating down anterior thigh with passive hip hyperextension or knee flexion can indicate

femoral nerve pain

**upper lumbar root

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right scapula elevated on Adams Forward Bending test indicates

adolescent idiopathic scoliosis

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hip arthritis typically presents as pain where?

front of hip

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trochanteric bursitis typically presents as pain where?

side of hip

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pain in the back of the buttock indicates an issue with what area?

lumbar spine/facet

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kid with loss of abduction of hip may be

Legg-Calves-Perthes

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referred pain from the obturator nerve can go to the

knee

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it is common for hip pathology to present as isolated […] pain

knee

**evaluated hip ROM for knee pain

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pain with loss of hip internal rotation can indicate

arthritis
fracture
slipped capital femoral epiphysis (kid)

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how would a patient with a hip fracture present?

hip and leg externally rotated

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how would a patient with hip dislocation present?

"position of modesty" adducted, flexed, internally rotated

positive trendelenburg sign indicates weak [2]

gluteus medius and minimus

normal hip drops and torso swings over to weak hip to maintain balance

positive trendelenburg sign

in a positive "apprehension" test the patient will

guard against lateral displacement of the patella

apprehension tests checks for

instability/dislocation/subluxation of patella

anterior drawer tests for

ACL integrity

positive Lachman's indicates

ACL injury

best imaging for suspected ACL/PCL tear

MRI

valgus stress applied at the ankle that illicits pain and laxity indicates damage to

MCL

MCL and LCL tests should be performed at what degrees of extension?

0 and 30 **in full extension, the posterior capsule may cause false negative

varus stress applied at the ankle that illicits pain and laxity indicates damage to

LCL

all meniscus exam tests will be positive in patients with

arthritis

describe the McMurray test

1. flex knee 2. rotate and extend knee while palpating medial or lateral side **clicking or pain is considered positive

"click" in medial compartment on McMurray indicates

medial meniscus tear **same for lateral

what way do you rotate the foot in McMurray to evaluate for medial meniscus tear?

externally

what way do you rotate the foot in McMurray to evaluate for lateral meniscus tear?

internally

apley grind tests evaluates for

meniscus tear

thessaly test evaluates for

meniscus tear

widely considered to be the most sensitive exam for meniscus tear

thessaly test

[...] syndrome occurs frequently in runners and cyclers

IT band

tenderness over the lateral aspect of the knee about 2 cm above the joint line

IT band syndrome

tenderness over the lateral aspect of the knee 1 cm below the joint line over Gerdy's tubercle

IT bursitis

pain is illicited on palpation of the anterior tibial tuberosity

Osgood-Schlatter

anterior knee pain below the patellar tendon in a patient 12-14

Osgood-Schlatter

plantar bruising suggests

lisfranc fracture

if a patient with flat foot is able to form an arch on toe rise, that indicates

flexible flatfoot (benign finding)

if a patient with flat foot is not able to form an arch on toe rise, that indicates

rigid flat foot **structural issue, usually talocalcaneal coalition

most common cause of rigid flatfoot

talocalcaneal coalition

pain anterior to the distal fibula

anterior talofibular ligament sprain

why are medial ankle sprains less common than lateral?

deltoid ligament is much stronger

tests for the integrity of the achilles

Thompson's **squeezing calf normally illicits plantar flexion, but when achilles is gone this response is absent

tests the integrity of the anterior talofibular ligament

anterior drawer test

tests the integrity of the calcaneofibular ligament

talar tilt test

no movement illicited upon squeezing calf (thompson's)

achillies tendon rupture

pain worse first steps out of bed but improves with standing

plantar fasciitis

1st MTP joint arthritis/bone spur

hallux rigidus

pain and limited 1st MTP joint AROM/PROM in extension

hallux rigidus

tibia glides anteriorly to femur when knee is at a 90 degree angle

positive anterior drawer **ACL tear

tibia glides posterior to femur when knee is at a 90 degree angle

positive posterior drawer sign **PCL tear

medial widening in valgus stress test

MCL injury

lateral widening in varus stress test

LCL injury

during flexion/extension, pain/popping on internal rotation of knee

lateral meniscus tear **LIME = Lateral Internal, Medial External

during flexion/extension, pain/popping on external rotation of knee

medial meniscus tear **LIME = Lateral Internal, Medial External

subchondral bone resorption and collapse of wedge shaped portion of femoral head leads to severe joint space collapse

AVN

causes of AVN

alcoholism steroids trauma irradiation sickle cell the bends gauchers

repeated aspirations of aseptic bursitis can cause

septic bursitis

ligament inferior to lateral malleolus

calcaneofibular

ligament posterior to lateral malleolus

posterior talofibular

most commonly injured ligament from inversion injuries

ATFL

an intact achilles tendon will [...] with calf squeezing

plantar flex

L1-L3 disc herniation would typically give [...] nerve symptoms in the [...] region

femoral hip/thigh

L3-L4 disc herniation would result in

diminished patellar reflex

L4-L5 herniation would result in

loss of sensory to dorsum of foot, no reflex deficits

S1 nerve root gives sensory to [...] and motor to [...]

lateral foot motor to ankle plantar flexors, achilles