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Ortho > Cervical & Lumbar Exam > Flashcards

Cervical & Lumbar Exam Flashcards

1
Q

Chief Complaints of the Cervical Spine

A 
Posterior neck pain
Upper trap/shoulder pain
Pain between the shoulder blades
Weakness
Alterations in fine motor control
Numbness: specific or generalized
Ataxic gait
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2
Q

Things to Observe of the Patient’s Movements & Actions

A

General appearance
Abnormal pain behaviors
Mood & affect
Gait

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3
Q

Inspection of the Cervical Spine

A

Skin

Posture

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4
Q

Palpation of the Cervical Spine

A

Cervical point tenderness
Muscle spasms
Lymphadenopathy

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5
Q

Range of Motion for the Cervical Spine

A

Flexion
Extension
Lateral bending
Rotation

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6
Q

Sensory Testing Area for C5

A

Lateral upper arm

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7
Q

Sensory Testing Area for C6

A

Lateral forearm

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8
Q

Sensory Testing Area for C7

A

Middle finger

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9
Q

Sensory Testing Area for C8

A

Ulnar border of the hand

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10
Q

Sensory Testing Area for T1

A

Medial upper arm

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11
Q

Grades of Muscle Strength & Description

A 
5/5: normal power
4/5: active movement against gravity with resistance
3/5: active movement against gravity
2/5: active movement without gravity
1/5: trace or flicker of movement
0/5: no movement
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12
Q

Muscle Strength Testing of C5

A

Deltoids

Biceps

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13
Q

Muscle Strength Testing of C6

A

Biceps

Wrist extension

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14
Q

Muscle Strength Testing of C7

A

Wrist extension
Wrist flexors
Triceps
Finger extension

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15
Q

Muscle Strength Testing of C8

A

Finger flexion

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16
Q

Muscle Strength Testing of T1

A

Intrinsics (fanning fingers)

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17
Q

Special Cervical Spine Tests

A

Axial loading
Foraminal compression test (Spurling’s)
Hoffman’s Reflex

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18
Q

What is a positive Spurling’s sign?

A

Pain radiates to arm toward which head is side flexed

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19
Q

Describe Hoffman’s Reflex

A

Have the hand relax
Flick the end of the middle finger
(+) other fingers may flex

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20
Q

What does a positive Hoffman’s reflex reflect?

A

Presence of an upper motor neuron lesion from spinal cord compression

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21
Q

Reflex for C5

A

Biceps

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22
Q

Reflex for C6

A

Brachioradialis

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23
Q

Reflex for C7

A

Triceps

24
Q

Reflex for C8

A

None

25
Q

Range of Motion of the Shoulder

A 
Flexion
Extension
Abduction
Internal rotation
External rotation
Across the chest
26
Q

Chief Complaints of Lumbar Vertebrae

A 
Back pain
Buttock pain
Leg pain
Weakness
Numbness/tingling
27
Q

Inspection of the Lumbar Spine

A

Skin
Muscle spasms
Posture

28
Q

Palpation of the Lumbar Spine

A

Point tenderness
Trochanteric tenderness
SI joint pain

29
Q

Range of Motion of the Lumbar Spine

A

Flexion
Extension
Lateral bending
Rotation

30
Q

Tests for Gait

A

Tip toe walking
Heel walking
Tandem gait (drunk driver test)

31
Q

Sensory Testing for L1

A

Groin

32
Q

Sensory Testing for L2

A

Midanterolateral thigh

33
Q

Sensory Testing for L3

A

Distal anteromedial thigh

34
Q

Sensory Testing for L4

A

Medial ankle

35
Q

Sensory Testing for L5

A

Dorsum of foot

36
Q

Sensory Testing for T1

A

Lateral border of foot

37
Q

Muscle Strength Testing for L1

A

Hip flexors

38
Q

Muscle Strength Testing for L2

A

Hip flexors
Hip adductors
Quadriceps

39
Q

Muscle Strength Testing for L3

A

Hip flexors
Hip adductors
Quadriceps

40
Q

Muscle Strength Testing for L4

A

Hip adductors
Quadriceps
Ankle inversion
Hip abductors

41
Q

Muscle Strength Testing for L5

A 
Ankle inversion
Hip abductors
EHL, toe extensors
Ankle eversion
Ankle plantar flexion
42
Q

Muscle Strength Testing for S1

A

Ankle eversion

Ankle plantar flexion

43
Q

Muscle Strength Testing for S2

A

Ankle eversion

Ankle plantar flexion

44
Q

Motor, Reflex & Sensory of L4

A

M: tibialis anterior (ankle dorsiflexion)
R: patella tendon
S: medial aspect of the foot

45
Q

Motor, Reflex & Sensory of L5

A

Extensor hallucis longus
R: none
S: dorsum of the foot

46
Q

Motor, Reflex & Sensory of S1

A

M: Peroneus longus & brevis (ankle eversion)
S: Achilles tendon
S: lateral aspect of the foot

47
Q

Special Tests for the Lumbar Spine

A

Babinski sign
Ankle clonus
Supine/sitting straight leg raise
Femoral nerve stretch test

48
Q

What does a positive Babinski sign or ankle clonus reflect?

A

Presence of an upper motor neuron lesion from spinal cord compression

49
Q

Describe a Femoral Nerve Stretch Test

A

Patient lies prone with the knee passively flexed to the thigh

50
Q

What is considered a positive femoral nerve stretch test?

A

Anterior thigh pain

51
Q

Reflex for L4

A

Patellar tendon

52
Q

Reflex for S1

A

Achilles tendon

53
Q

Special Tests for SI Joint Irritation

A

Compression
Distraction
Faber’s

54
Q

Describe Compression as an SI Joint Irritation Test

A

Patient lies with affected side up
Hips at 45 degrees & knees at 90 degrees
Downward pressure on the iliac crest

55
Q

Describe Distraction

A

Patient supine with examiner on affected side
Examiner hands on ASIS with arms crossed
Application of pressure downward & laterally

56
Q

Describe Faber’s

A

Patient supine with examiner on affected side
Leg of affected side bent with foot on opposite knee
Downward & lateral pressure applied

Ortho (22 decks)

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