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PCM 2 final > back/ LE > Flashcards

back/ LE Flashcards

1
Q

examination?

A

inspect, palpate, ROM, neuro, special tests, osteopathic findings

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2
Q

L spine inspection

A

position of pelvis & iliac crests, sacral base, ear in line with shoulder

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3
Q

gait

A

stance weight bearing, swing non weight bearing,

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4
Q

spinal landmarks

A

T3 spine of scapula
T7 inferior angle scapula
L4 just above iliac crests

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5
Q

L spine ROM?

A

F, E, SB, R

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6
Q

L spine muscle strength scale?

A

0 = no movement
1 = muscle twitch without joint movement
2 = movement only with gravity eliminated
3 = movement against gravity only
4 = movement against gravity & some resistance
5 = movement against gravity and full resistance

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7
Q

lumbar neuro exam dermatomes

A

anterior tibialis = patellar tendon reflex = L4 dermatome
extensor hallucis longus = no reflex = L5 dermatome
gastroc-soleus = achilles tendon = S1 dermatome

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8
Q

viscero somatic reflexes?

A

small intestine = T10-11
ovaries & testes = T10-11
colon & rectum = T12-L2
bladder = T12-L2
uterus = T12-L2
prostate = T12-L2

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9
Q

most common cause of pain in Lspine?

A

L5-S1 injury bc posterior longitudinal ligament narrows as it goes down the spine making herniation of disc easier –> Sciatica

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10
Q

Sciatica

A

unilat pain from L5 through buttock down leg to foot
-consider herniated disc, stenosis, lumbar facet pain, SI joint or mass lesion vs peripheral compression

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11
Q

test for sciatica?

A

SLR

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12
Q

hip joint?

A

spheroidal synovial joint
*check for necrosis of femoral head

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13
Q

hip ROM

A

flex - 135
extend - 30
abduct - 45
adduct - 20
rotate (varus = ext R = 50 / valgus = int R = 30)

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14
Q

Trendelenburg

A
  • gluteus medius
  • stand on one leg, glute medius on standing leg should contract
  • if cannot remain level the glute medius is weak on the standing leg
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15
Q

Thomas Test

A
  • for flexion contractures d/t tight posas
    -flex hip so thigh touches abd, upon extending 1 hip should lie flat on table
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16
Q

FABER

A

flex, abduct, external rotation
-put in figure 4 & push down on knee = pain in groin

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17
Q

FAIR/FADIR

A

flex, adduct, internal rotation
-supine, flex knee, ext rotate lower leg
-pain in groin, femoral acetabular impingement, labral tear, piriformis syndrome

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18
Q

Ober Test

A

evaluates IT band for contracture/tightness
- lie on opposite side w/ top leg flexed up, knee to 90, allow leg to lower until restricted
- neg = return to full resting / pos = remains abducted

19
Q

hip special tests

A
  1. leg length (asis to medial malleolus)
  2. psoas strength (seated, raise knee, resist pressure down)
  3. piriformis (palpate, supine, knees to chest, hold heels
20
Q

knee joint

A

condylar synovial joint

21
Q

effusions

A
  1. bulge = minor in suprapatellar pouch
  2. balloon = large
  3. balloting = large
22
Q

Knee ROM

A

flex = 125
extend = 10-15
internal rotation @ 90 = 10-30
external rotation @ 90 = 10-40

23
Q

bursitis

A

prepatellar = anteror
anserine = medial
baker’s cyst = posterior
*equal with active or passive ROM

24
Q

patellofemoral grind

A

supine w/ knee extended, compress patella against femur, tighten quads – chondromalacia or patellofemoral syndrome

25
Q

apprehension test

A

dislocation or subluxation of patella
- attempt to manually dislocate patella laterally (look at face)

26
Q

anterior drawer sign

A

supine flex hip & knees flex @ 90, pull tibia forward
positive pain = ACL tear

27
Q

Lachman test

A

knee flexed to 15 & externally rotate, grasp femur & tibia and move in opposite directions
-asymmetric movement = ACL tear

28
Q

posterior drawer sign

A

supine hip & knee flexed to 90, push tibia posteriorly
- positive test = PCL tear

29
Q

key features of a meniscus tear?

A

locking or giving out, not feeling they can trust the knee, a catching sensation or true catching of the knee

30
Q

McMurray test

A

knee @ 90:
-medial: ext R tibia, heels in, extend knee
-lateral: int R tibia, heels out, extend knee
**specificity: 85-95% / sensitivity: 50-65%

31
Q

Apley’s compression test

A

prone w/ knee flexed to 90, lean onto heel compressing both menisci, rotate heel for pain

32
Q

Thessaly test

A

stand, rotatary motion on one leg
* more sensitive & specific for meniscal injury

33
Q

MCL special test?

A

Valgus (abduct)
- supine, flex knee slightly, push medially against knee while laterally against ankle

34
Q

LCL special test?

A

Varus (adduct)
- supine, flex knees slightly, push laterally against knee while medially against ankle

35
Q

Thompson test

A

prone, leg bent to 90, squeeze calf & observe for normal PF
-normal function Achilles
*best done within 48 hours of injury

36
Q

ankle hinge joint?

A

tibiotalar joint
subtalar (talocalcaneal joint)

37
Q

lateral malleolus joint

A

anterior talofibular, calcaneofibular, posterior talofibular

38
Q

high ankle sprain?

A

syndesmosis between fibular & tibia

39
Q

anterior drawer for ankle

A

general lig stability
-grip calcaneus & lower tibia, pull calcaneus forward while pushing tibia posterior (shouldnt feel lax)

40
Q

talar tilt test

A

invert calcaneus, if talus gaps or rocks in mortise, the ATF & calcaneofibular ligs are torn = positive test

41
Q

Kleiger test

A

cup heel & externally rotate
-neutral/DF: interosseous membrane / high ankle sprain
-modified K: PF + eversion - deltoid ligament

42
Q

squeeze compression test

A

positive if pan in tibiofibular & interosseous membrane while squeezing tibia & fibula

43
Q

Ottawa rules

A

ankle: unable to bear weight immediately AND in ER
foot: tender base 5th metatarsal & can’t bear weight immediately & in ER

PCM 2 final (7 decks)

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