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D2-4/CBL > CLINICAL PRACTICE > Flashcards

CLINICAL PRACTICE Flashcards

1
Q

EMPTY CAN TEST

A

abduction, horizontal flexion, internal rotation. Resisted upwards pressure
Testing integrity supraspinatus muscle/tendon.

Positive – pain or weakness in supraspinatus tendon. Indicates pathology or rotator cuff pathology

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2
Q

MYOTOMES SHOULDER GIRDLE + JOINT

A

Shoulder girdle
Elevation depression – C3-5
Protraction – C5-7
Depression – C3-T1

Shoulder joint
Adduction, lateral rotation – C5-6
Abduction – C6-8
Flexion, extension, medial rotation – C5-8

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3
Q

OSTEOARTHRITIS - general

A

Past history of fracture or major injury.
No heat, redness [inflammation]. Improved with heat or simple analgesia.

Signs of effusion, and reduced range of movement. Passive movement not painful.

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4
Q

LOWER MOTOR NEURON LESION

A

o Loss Sensation
o Loss Movement
o Reduced Tone (flaccid paralysis)
o Loss Reflexes

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5
Q

TENNIS ELBOW TEST

A

resisted middle finger extension
Looking for tennis elbow pathology.

Positive – pain or weakness resisted movement indicates tennis elbow.

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6
Q

IDEAL DEGREES OF MOVEMENT FOR HIP ROTATION medial/lateral

A

45

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7
Q

MENISCAL INJURY

A

twisting injuries on a flexed and weight bearing knee
Weight bearing, knee bent and rotation. Can be spontaneous in older patients
Antalgic gait with joint line tenderness. Extension often limited with pain.

Effusion testing positive. May be positive in other meniscal tests [McMurray test]

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8
Q

VALGUS/VARUS STRESS TEST

A

application of valgus and varus stress on ligament
Testing collateral ligaments – MCL [valgus] + LCL [varus]

POSITIVE – increased pain, laxity and no firm end point

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9
Q

FINKELSTEINS TEST

A

ulnar deviation of closed fist
Looking signs of tensosynovitis in abductor pollicis longus and extensor pollicus brevis

Positive – extreme pain upon ulnar deviation. Potential pain when even making fist.

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10
Q

SCAPHOID FRACTURE TESTING

A

palpating around snuff box
Looking for pain/tenderness/swelling in snuff box

Positive – pain/swelling upon palpation. Painful axial pressure on thumb.

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11
Q

IDEAL DEGREES OF MOVEMENT FOR HIP ADDUCTION

A

20-30

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12
Q

UPPER LIMB POSTERIOR MYOTOMES

A

ELBOW Extensors – C7-8
WRIST Extensors – C7-8
FINGERS Extensors – C7-8
RADIOULNAR Supination – C5-6

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13
Q

SAG SIGN

A

looking at tibia architecture
looking for posterior cruciate ligament injury

positive – tibia sagging backwards [downwards]; loss of knee architecture

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14
Q

PLANTAR FASCITIS / ACHILLES TENDINOPATHY

A

worse when cold in mornings - reduces as warming up

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15
Q

EXPLAIN FABER TEST

A

HIP SPECIAL TEST!
flexion, abduction, external rotation
Looking at pain and range of movement.

Intraarticular problems – osteoarthritis etc

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16
Q

MCL INJURY

A

Valgus stress on a partially flexed knee
Downhill skiing [no-contact], force to lateral aspect of leg [contact]

Pain when knee ‘falls in’. Antalgic gait, localised superficial swelling on medial knee. Tender over MCL upon palpation and at full extension and flexion. Valgus test positive for pain, laxity and no end point.

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17
Q

BOUTONNIERE DEFORMITY

A

DIP hyperextended. PIP flexed.
Rheumatoid arthritis. Disruption of central slip in extensor mechanism.

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18
Q

PERONEAL [fibularis] TENDON STRAIN

A

inversion injury

Pain lateral ankle around distal fibula. Pain may radiate proximally. Pain with eversion around fibula.

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19
Q

LOWER LIMB POSTERIOR MYOTOMES

A

HIP Abduction – L4-S1
HIP Extensors – L4-S1
KNEE Flexors – L5,S1
ANKLE Plantarflexion – S1,2
TOES Flexors, ab/ad – S2,3
FOOT Eversion – L5,S1

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20
Q

SCAPHOID FRACTURE

A

falling on an outstretched hand
Most frequently fracture carpal bone.

Deep, dull pain in radial wrist, often mild- Worse when gripping or squeezing. Also pain with movement, especially radial deviation. Restricted radiocarpal movement. Swelling, tenderness and bruising in snuff box. Axial pressure along thumb also painful.

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21
Q

PATELLA TAP TEST

A

KNEE
compress suprapatellar pouch and tap patella
Looking for signs of effusion

Positive – feeling the tap of the patella

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22
Q

POWER GRADING

A
  1. Complete paralysis
  2. Flicker only
  3. Movement without gravity
  4. Movement with gravity but no further resistance
  5. Movement against resistance but subpar
  6. normal
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23
Q

DESCRIBE AN ACL INJURY

A

usually non-contact: pivoting and sudden deceleration.
Giving away sensation/instability. Antalgic gait, swelling. Mild tenderness over joint line. Movement restricted by hemarthrosis.

Lachmann’s test and anterior draw test positive.

24
Q

TENNIS ELBOW

A

extensor tendinopathy
Overuse and repetitive stress on the extensor tendons of the forearm, particularly the extensor carpi radialis brevis

Lateral elbow pain, weakness in gripping

25
Q

EXPLAIN FADIR TEST

A

HIP SPECIAL TEST
Flexion, adduction, internal rotation
Looking at pain and range of movement

intraarticular problems – Osteoarthritis, labral tears and femoral-acetabular impingement

26
Q

SHOULDER DISLOCATION

A

force on glenohumeral joint that makes humeral head release
‘stop sign position’, falling on an outstretched arm, Sports, gymnastics, weightlifting etc

[anterior dislocation] Arm held abducted and externally rotated. Shoulder squared off, anterior bulge; Palpable humeral head. Reduced pulse pressure in hands. All movements limited and painful

27
Q

ANTERIOR DRAW TEST OF THE KNEE

A

applying anterior force to tibia
Testing anterior cruciate ligament
Hip at 45 degrees flection and knee held at 90 degrees flexion

Positive – increased anterior movement of tibia on femur and soft end point

28
Q

REFLEX GRADING

A
  1. Absent
  2. Depressed [requires reinforcement]
  3. Normal
  4. Brisk
  5. Very brisk [only finger tap required]
29
Q

HAND GRIP STRENGTH TEST

A

gripping doctors fingers
Assesses the overall strength of the hand and forearm muscles, particularly the flexor muscles in the forearm

30
Q

POSTERIOR DRAW TEST OF THE KNEE

A

posterior force to tibia
Testing posterior cruciate ligament

Positive – increased posterior movement of tibia on femur with soft end point

31
Q

5TH METATARSAL FRACTURE

A

inversion injury

Unable to weight bear. Pain with ankle eversion. Swelling of lateral foot with pain that worsens with ice. Tender over bone

32
Q

STRESS FRACTURES - GENERAL

A

pain with activity that extends to constant pain
worse with weight bearing

33
Q

IDEAL DEGREES OF MOVEMENT FOR HIP EXTENSION

A

20-30 lying prone

34
Q

DESCRIBE LCL INJURY

A

varus stress on a partially flexed knee
Downhill skiing [no-contact], force to medial aspect of leg [contact]
Pain when sharply turning. Localised swelling over lateral joint line. Tender to palpate over LCL, and pain when at full extension and flexion.

Varus test positive for pain, laxity and no firm end point.

35
Q

RHEUMATOID ARTHRITIS - general

A

Inflammation – erythema, heat and swelling. Associated with loss of appetite, weight loss, lethargy and fever. Generally unwell looking, significantly reduced range of movement, even passive.

36
Q

FUNCTIONAL OPPOSITION TEST HAND

A

Tap each finger to thumb
Measures fine motor control, often used to evaluate neuromuscular function and hand-eye coordination

37
Q

IDEAL DEGREES OF MOVEMENT FOR HIP
FLEXION

A

120-130

38
Q

SWAN NECK DEFORMITY

A

flexed DIP, hyperextended PIP
Damage to volar plate and PIP and extensor tendon

39
Q

UPPER LIMB ANTERIOR MYOTOMES

A

Elbow Flexor – C5-6
Wrist Flexor – C6-7
Fingers Flexor – C7-8
Adduction/abduction – C8-T1
Radioulnar Pronation – C6-7

40
Q

OPPOSITIONAL TEST HAND

A

thumb and index finger touching, try to separate
Primarily evaluates the thenar muscles. Weakness here could indicate median nerve dysfunction

41
Q

LOWER LIMB ANTERIOR MYOTOMES

A

Hip Adduction -L2-4
Hip Flexors – L1-3
knee Extensors – L3,4
Ankle Dorsiflex – L4,5
Toes Extensors – L5,S1
Foot Inversion – L4,5

42
Q

TRENDELENBURG TEST

A

HIP TEST
standing on one leg for up to a minute
Looking at gluteus Medius strength – being able to keep pelvis stable

Sound side sags

43
Q

DESRIBE PCL INJURY

A

direct blow to anterior tibia with flexed knee
Dashboard injury, contact opponent, fall on knee, hyperextension
Antalgic gait and swelling, mild tenderness over joint line. Movement restricted by hemarthrosis.

Positive posterior draw and sag sign.

44
Q

UPPER MOTOR NEURON LESION

A

o Loss Sensation
o Loss Movement
o Increase Tone
o Reflexes Increased

45
Q

MODIFIED LIFT OFF TEST

A

hand pressing on belly with elbow/wrist in line
Testing subscapularis muscle

Positive – pain or elbow moving backwards; cannot maintain internal rotation

46
Q

ATFL SPRAIN

A

inversion injury
Lateral ankle pain with bruising and tenderness over ligament

Positive anterior draw test – no laxity or firm end point

47
Q

SWIPE TEST

A

KNEE
swiping knee medially, superiorly and then laterally
Looking for signs of effusion

Positive – bulging on opposite aspect of swipe

48
Q

FROZEN SHOULDER

A

capsule of shoulder becomes inflamed and scars
idiopathic; common in diabetics or after surgery.

[phase 1] PAINFUL and inflamed, [phase 2] FROZEN; painful and restricted, [phase 3] THAWING; inflammation reduced. Less painful but still restricted.

49
Q

IDEAL DEGREES OF MOVEMENT FOR HIP ABDUCTION

A

40-50

50
Q

DE QUERVAINS TENSOSYNOVITIS

A

Inflammation in tendon sheath of abd pollicus longus / extensor pollicis brevis
Repeated movements like picking an object

Pain in Finkelstein’s test. Painful thumb extension and abduction. Worse with resisted movements

51
Q

DESCRIBE ANTERIOR DRAW TEST OF THE ANKLE

A

anterior pressure on ATFL

Testing integrity of ATFL. Also useful for grade 2-3 ligament tears

52
Q

LACHMANNS TEST

A

steady pull of tibia anteriorly
Testing anterior cruciate ligament – ACL should stop movement
Knee held at 12-30 degrees flexion

Positive rupture – increased anterior movement [laxity] and no end point

53
Q

ROTATOR CUFF TEARS

A

trauma to shoulder
Falls. OR degenerative or chronic. Repeated overhead work, falls etc over time, not allowing healing. Supraspinatus tendon can also degenerate – tears with very little trauma.

Shoulder pain worse with movement/at night. Clicking or popping in the shoulder, with swelling/tenderness and/or painful arc. Difficulty in overhead activities.

54
Q

AC JOINT TESTING

A

overpressure on arm across body
Testing integrity of acromioclavicular joint.

Positive – Pain localized at the AC joint suggests AC joint injury (sprain, separation, arthritis).

55
Q

OLECRANON BURSITIS

A

inflammation of bursa over olecranon
Precipitated by trauma.

Pain, swelling and erythema over olecranon

D2-4/CBL (2 decks)

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