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PCM II Exam 1 > Back and LE (pitcher-10) > Flashcards

Back and LE (pitcher-10) Flashcards

1
Q

with an MSK CC, what other system should be check in ROS?

A

neuro

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2
Q

inspect back/LE for

A 
posture
position
deformity
edema
erythema
lesions
symmetry
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3
Q

palpation for back/LE for

A

tissue texture
warmth
tenderness

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4
Q

ROM of back/LE

A

each jt has own motion with hard/soft end feel

restricted ROM compared with other side

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5
Q

neuro exam for

A

sensation (soft, sharp, vibration)
reflexes
strength

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6
Q

what type of joint is the foot?

A

hinge

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7
Q

what type of jt is the knee?

A

synovial condylar

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8
Q

what type of jt is the hip?

A

synovial spheroidal

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9
Q

lumbar spine exam: inspection of posture

A

posture: pelvic and iliac crest positions, spinal curves from posterior and lateral views
sacral base: sulcus dimples at SI joint
lat: eat in line

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10
Q

lumbar spine exam: inspection of gait

A

gait: smooth, stance and swing, reflects issues related to spine, pelvis, knee, feet

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11
Q

lumbar spine exam: palpation

A 
TART
skin changes
paraspinal mm
TPs
SPs**
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12
Q

landmarks of Sps

A

t3-scapular spine
t7-inf scapula
l4-iliac crest

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13
Q

neuro exam of Lspine

A

reflexes
sensation
strength (use scale 5/5)

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14
Q

L4 dermatome

A

medial malleolus and some of tibia

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15
Q

L5 dermatome

A

big toe, 2nd toe, outside fibula

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16
Q

S1 dermatome

A

last few toes and heel

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17
Q

viscerosomatic reflex of small intestine and ovaries/testes?

A

T10-11

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18
Q

viscerosomatic reflex of colon, rectum, bladder, uterus, prostate?

A

T12-L2

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19
Q

cause of LBP

A 
sprain, strain, m. spasm, deconditioning
herniated/bulging discs, spinal stenosis, facet syndrome
OA
scoliosis
spondylolisthesis
sacroilitis, sciatica
infection
osteoporosis, vert fxx
metastasis/malignancy
referred pain from hip
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20
Q

what level(S) is/are most common area of injury/pain from Lspine?

A

L5-S1

why? PLSL narrows as it descends; herniation made easier

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21
Q

what is scoliosis

A

lateral curvature of spine

measure leg length (ASIS to med mall)

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22
Q

what is ankylosing spondylitis

A

chronic, inflammatory disease (B27)
pronounced lumbar lordosis
SI tenderness source of LBP

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23
Q

what is OA

A

degen disc dz
common in Lspine esp at L5-S1
**deterioration and loss of cartilage and normal bone

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24
Q

what is osteoporosis?

A

thinning of bone
affects Lspine ad hips commonly (DEXA scan)
**compression fxx cause pain

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25
Q

what increases risk of osteoporosis?

A

steroids

thin bones

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26
Q

what is sciatica?

A

pain radiates BELOW knee
pain u/l from l5
often shooting
worse w/sitting and Valsalva

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27
Q

possible causes of sciatica

A 
herniated disc
spinal stenosis
lumbar facet pain
SI jt or mass lession
-OR- peripheral compression
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28
Q

sciatic n. levels

A

L4, 5, S1, 2, 3

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29
Q

straight leg raise technique

A

raise leg, any pain?
lower leg to no pain, dorsiflex to produce pain
B/W 40-60 EXT

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30
Q

straight leg raise tests for

A

sciatica

hamstrings problem

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31
Q

synovial joints

A

bone ends covered with cartilage
synovial membrane secretes fluid lube
capsule and lig join bones together
strengthened by muscles

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32
Q

history of hip dislocation?

A

investigate for necrosis of femoral head

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33
Q

palpate pelvis upright

A

iliac crests
SI w/ forward flexion/ext
trochanteric bursa

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34
Q

palpate pelvis supine

A 
ASIS
pubic symphysis
trochanteric bursa
pelvic rock
inguinal ligament
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35
Q

palpate pelvis prone

A

SI joint
PSIS
ischial bursa

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36
Q

hip ROM

A

flex: 135
ext: 30
abd: 45
add: 20
rot: 90

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37
Q

rotation of lower leg at flexed position

A

medial: ext rot of hip 50
lateral: int rot of hip 30

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38
Q

structures at inguinal lig

A

NAVEL:

n, a, v, empty, LN

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39
Q

true hip pain

A

deep inguinal

NOT LATERAL

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40
Q

lateral hip pain?

A

check trochanteric bursa

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41
Q

trendelenburg

A

checks gluterus medius intake

pt stands on 1 leg which should contract gluteus medius on that side

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42
Q

gluteus medius action

A

keeps hips stable during gait

weak on standing leg side

43
Q

ober test

A

evaluates ITB syndrome
pt flexes knee and abducts at hip
if leg released and stuck, (+) and abnml

44
Q

thomas test

A

evaluates for flexion contractures due to tight psoas

pull knee to chest, other leg should remain flat

45
Q

FABER test

A

Flex, ABduct, ExtRot

reproduces pain or SI tenderness

46
Q

leg length

A 
from ASIS to medial malleolus
causes:
short femur
short tibia
scoliosis
add/flex deformity of hip
47
Q

psoas strength test

A

raise knee, resist pressure

48
Q

piriformis exam

A

knees to chest
hold heels
rotate knee L and R
compare ROM

49
Q

pelvic unit dysfunctions

A 
OA
inguinal hernia
bursitis (troch, ischial)
sciatica
lumbar spasms
fxx (trauma, osteoporosis)
scoliosis/leg length discrp
infxns (bone, bursa, tissue)
50
Q

palpation of knee/lower leg

A

bursa

patella

51
Q

ligaments in knee/lower leg provide?

A

passive stability

52
Q

menisci in knee/lower leg provide?

A

walking stability

53
Q

structures examined in knee

A

ACL, PCL, LCL, MCL
medial/lateral menisci
pes anserine
bursa: prepatellar, suprapatellar, pes

54
Q

bulge signq

A

minor effusion

55
Q

ballon sign

A

bigger effusion

56
Q

balloting sign

A

biggest effusion, push patella and fluid returns back into suprapatellar pouch

57
Q

palpation of knee

A

femoral condyles
tibial plateau
patellar tendon and patella
tibial tubercle

58
Q

knee ROM

A

flex: 135
ext: 10-15
int rot: 10-30
ext rot: 10-40

59
Q

prepatellar bursitis

A

from excessive kneeling

60
Q

anserine bursitis

A

excessive running
from valgus knee, arthritis
mixed up w/ anserine tendonitis

61
Q

baker’s cyst

A

cyst in popliteal fossa

check for swelling, tenderness

62
Q

patellofemoral grind test

A

compress patella against femur
tighten quads
feel for roughness, crepitus, pain

63
Q

complaints of going up stairs/rising from chair?

A

chondromalacia

patellofemoral syndrome

64
Q

apprehension test

A

tests for d/l, subluxation

manually d/l patella and observe facial expression

65
Q

anterior drawer sign

A

flex knee and hip
pull tibia anterior
checks ACL tear

66
Q

lachman test

A 
ONLY FOR ACL TEST
knee flexed 15, ext rot
grasp femur and tibia
move in opp directions
any snapping=(+)
67
Q

most important finding for lachman?

A

asymmetry

68
Q

posterior drawer test

A

hip and knee flexed to 90
tibia post against femur
PCL tear

69
Q

mcmurray test

A

rotate heel int and ext and then extend to hear pop/click
UNSPECIFIC test
checks menisci

70
Q

apley’s compression test

A

prone with knee flexed

lean into heel compressing menisci

71
Q

meniscal tear

A

locking/giving out
unable to trust knee
catching sensation
cannot extend leg fully

72
Q

thessaly test

A

stand, rotate on bent knee of 5, 10, 20 degrees

SENSITIVE to meniscal tear

73
Q

valgus stress test

A

flex knee, one hand on knee, push leg out

tests MCL

74
Q

varus stress test

A

flex knee, one hand on knee, push leg in

tests LCL

75
Q

PALPATE GASTROC AND SOLEUS

A

CHECK FOR PAIN AND SWELLING

76
Q

homan’s sign

A

for DVT

dorsiflex ankle with leg extended

77
Q

thompson test

A

for achilles rupture

prone, leg bent, squeeze calf and observe passive plantar flexion

78
Q

principal joints of hinge foot jt

A

tibiotalar

subtalar

79
Q

lateral malleolus ligaments

A

post TF, ATF, calcaneofib

80
Q

medial malleolus ligamen

A

deltoid

81
Q

ankle ROM

A

dorsiflex/plantar flex

inversion/eversion

82
Q

anterior ankle drawer test

A

checks lig stability
grip calcaneus in hand and lower tibia with other
pull calc forward and push tibia posterior

83
Q

testing subtalar jt

A

hold calcaneus and tibia,

evert and invert

84
Q

testing transverse tarsal jt

A

hold lower tibia and move whole foot to R and L

85
Q

morton’s neuroma

A

pain b/w 3 and 4 toes and ball of foot

check by compressing forefoot

86
Q

talar tilt test

A

pt sits with legs dangling
doc inverts calcaneus
if gapping occurs, ATF or calcaneofib lig are torn

87
Q

ankle/foot ROM

A 
dorsiflex: 20
plantar flex: 50
subtalar inversion: 35
eversion: 25
add: 20
abd: 10
flex big toe: 30
ext big toe: 80
88
Q

ankle sprain

A

stretch/tear lig

third deg: full tear

89
Q

ATF, calcaneofib lig

A

commonly injured

from inversion

90
Q

high ankle sprain

A

syndesmosis b/w fib and tib

91
Q

Ottawa rules

A

over 18
unable to bear weight after 4 steps
tenderness over post malleoli
SUSPECT FX

92
Q

why ottawa rules?

A

to avoid unnecessary radiography in anke injury

93
Q

bone spurs

A

bottom of calcaneus, point tenderness

94
Q

plantar fascitis

A

heel and arch pain

bad w/ initial weight bearing in morning

95
Q

pes planus

A

loss of longitudinal arch of foot (flat feet)

96
Q

hallux valgus

A

abnml abd of bigtoe (bunion)

97
Q

gout

A

red/sweeling/pain of great toe d/t uric acid crystal deposition

98
Q

pesudogout

A

like gout, from calcium pyrophos crystal desposition

99
Q

RA

A

compressive tenderness

100
Q

onychomycosis

A

fungally infected nails

101
Q

plantar warts

A

viral, plantar aspect of foot, thickening of skin w/ dark stippling spots

102
Q

corns

A

thickening of skin from abnml pressure over bony prominence (5th toe)

103
Q

hammertoes

A

hyperextension of MTP joint and flexion of IP jt (2nd toe common)

104
Q

ingrown toenails

A

red, bleeding, purulent d/c from edges of nails (great toe common)

PCM II Exam 1 (7 decks)

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