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Clinical skills 6 written exam > CS written Exam > Flashcards

CS written Exam Flashcards

1
Q

Adaptive pain?

A

helpful or protective pain that promotes tissue healing and recovery

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2
Q

maladaptive pain?

A

as pain felt in the absence of obvious tissue damage. This includes functional pain and central/peripheral sensitisation and is typically pain that is disproportionate to the tissue injury or pain that persists well after tissues have healed.

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3
Q

Yellow flag?

A

psychological and social factors that could potentially reduce a patients ability to adequately recover. These include patient attitudes and beliefs, emotions, behaviours and family and workplace factors

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4
Q

Red flag?

A

are indicators of possible serious pathology such as inflammatory or neurological conditions, structural musculoskeletal damage or disorders, circulatory problems, suspected infections, tumours or systemic disease. If suspected, these require urgent further investigation and often surgical referral.

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5
Q

Things to look for on a cervical AP Xray:

A
  • SP rotation
  • IVDs and joint spaces
  • Trachea in midline
  • lung apices
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6
Q

AP open mouth X-ray?

A
  • exclude tumours
  • lateral masses dont overlap more than 2mm
  • dens tilt <5 degrees
  • tongue can create false # line
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7
Q

Cervical lateral X-ray?

A
  • cX lordosis
  • 4x lines
  • 3 x spaces
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8
Q

4 lines on cervical lateral X-ray?

A

Anterior and posterior VB lines
spinolaminar line
post. cervical line

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9
Q

3 spaces on lateral cervical X-ray?

A

atlantodental space: <2mm
retropharyngeal space (@C2) - <7mm
retrotracheal line @C7 - <2mm

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10
Q

Apprehension/relocation test

  • Positive:
  • indicates:
A
  • Positive: pain or inability to resist

- indicates: infraspinatus strain/tear

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11
Q

Lift off test

  • Positive:
  • indicates:
A
  • Positive: inability to lift hand or pain

- indicates: subscapularis lesion

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12
Q

Hawkins kennedy test

A
  • Positive: pain

- indicates: impingement

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13
Q

Neers Impingement

A

arm in IR and raised forcibly in the scapular plane

  • Positive: reproduction of pain
  • indicates: impingement
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14
Q

Empty can

A
  • Positive:
    weakness to resistance indicates supraspinatus tear

Pain suggests tendinosus

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15
Q

Painful arc & weakness of resisted ER can indicate?

A

impingement

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16
Q

Whiplash grade 1?

A

neck pain with no physical findings

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17
Q

Whiplash grade 2?

A

neck pain with physical findings but no neuro signs

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18
Q

Whiplash grade 3?

A

neck pain with neuro deficit

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19
Q

Whiplash grade 4:

A

neck pain with evidence of fracture or dislocation

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20
Q

Recommendations for neck pain?

A
  • return to normal activities
  • exercise and ROM exercises
  • low load isometrics
    NSAIDS and simple analgesics
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21
Q

labral tear orthopedic tests?

A
  • FADDIR
  • FABER
  • clicking, catching or locking
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22
Q

labral tear treatment?

A
  • unloading damaged labrum
  • reduce repetitive hip movements
  • increase motor control in deep stabilisers of the hip
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23
Q

Terrible or unhappy triad?

A

ACL, MCL, medial meniscus

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24
Q

2 orthos for ACL tears?

A

anterior draw

lachmans

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25
Q

Thessaly test?

A

single leg stance and rotation with knee bent at 5 degrees and then 20 degrees

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26
Q

Thessaly test positive?

A

joint line tenderness
locking or catching
indicates meniscal damage

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27
Q

plantar fasciitis risk factors?

A
  • high BMI, excessive pronation, long periods of standing

- decrease hamstring and ankle flexibility

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28
Q

plantar fasciitis treatment?

A
  • reduce agg factors: footwear, taping
  • strengthening of midfoot, gastrocs and intrinsic mm.
  • towel pick up exercises, dry needling
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29
Q

Medial tibial stress syndrome RFs?

A

biomechanial loading issues:

  • excess pronation, overloading of tib post, FDL and soleus
  • high levels of plantar flexion
  • increased load, poor footwear
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30
Q

MTSS treatment?

A

load managment, ankle mobilisation, K tape

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31
Q

Varus?

A

lower bone angled inwards

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32
Q

Valgus?

A

lower bone angle outwards

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33
Q

Achilles tendinopathy treatment?

A
  • load management
  • biomech. compensations of hips, Lx, ankles knees
  • isometric contractions
  • slow concentric heel raises
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34
Q

Lateral ankle sprain treatment?

A
  • decrease swelling : RICER in acute
  • gradually return to normal activity with gait as normal as possible
  • biomech compensations
  • mobilisation of ankle, subtalar and midtarsal joints
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35
Q

what are the 3 lower limb neurodynamic tests?

A

Slump: sciatic +/- tibial

SLR: SC stenosis/ meningeal CT’s and sciatic +/- tibial

Prone knee bend: femoral nerve

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36
Q

Upper limb ND test 1:

A

abduct 110

median, anterior interosseous and C5-7

37
Q

Upper limb ND test 2:

A

abduct 10

median, musculocutaneous

38
Q

Upper limb ND test 3:

A

abduct 110/10 with pronation

radial nerve

39
Q

Upper limb ND test 4:

A

abduct and flex elbow to 90 each and hand to ear with wrist extension
- ulnar nerve, C8-T1 nerve roots

40
Q

ULND mnemonic?

A

MI5-7

MAM RU 81

41
Q

SIJ orthopedic tests?

A
  • flamingo (SL stance)
  • active SLR
  • thigh thrust
42
Q

Hip orthos

A 
FADDIR
Flexion IR
FABER
Trendelenburg
resisted hip abduction
patella pubic percussion
43
Q

FADDIR positive indicates?

A

FAI

44
Q

Flexion IR positive indicates?

A

labral tear and/or FAI

45
Q

Trendelenburg positive indicates?

A
  • glute medius weakness
  • gluteal tendinopathy
  • OA
46
Q

resisted hip abduction?

A

gluteal tendinopathy

47
Q

patellar-pubic percussion

A

femoral fracture

48
Q

3 compression sites of TOS?

A
  • between anterior and middle scalenes (scalene traingle)
  • between first rib and clavicle
  • under pec minor
49
Q

orthos for TOS

A
  • adsons - pulse with neck ext, ipsi SB and arm in ext, abd, supination
  • roos test -5min
50
Q

frozen shoulder treatment strategies

A
  • keeping ROM.
  • address biomech compensations
  • advice/reassurance
51
Q

cardiac pain sites and radiations

A 
retrosternal
parasternal
jaw
neck
inner arms
epigastrium
interscapular
52
Q

thoracic mobility exercises

A

cat/camels
thread the needle
book openers
knees to chest

53
Q

T3-L5 neutral extension normal coupled motion

A

Type 1

54
Q

T3-L5 flexion normal coupled motion

A

Type 2

55
Q

Common structures causing groin pain

A

adductors, iliopsoas, inguinal, pubic regions

56
Q

Common structures causing hip pain?

A

extraarticular: GTPS
Intraarticular: FAI, labral tear, osteonecrosis, acetabular dysplasia

57
Q

GTPS management?

A 
modify load (reduce by 50%) and agg factors
progressive loading
58
Q

carpal bones in proximal row? (lateral to medial)

A

Scaphoid
Lunate
Triquetrum
Pisiform

59
Q

carpal bones in distal row (lateral to medial)

A

Trapezium
Trapezoid
Capitate
Hamate

60
Q

Shoulder red flags

A
  • tumour
  • inflammatory arthropathy (RA, gout)
  • visceral disease
  • septic arthritis
  • fracture/dislocation
  • CV signs and symptoms
61
Q

Which modality of imaging is used for what?

A
  • X-ray: acute pain presentations
  • ultrasound for RC pathologies
  • MRI for capsule/ligament tears
62
Q

Xray views of the shoulder

A

AP
lateral
axial
scapular Y

63
Q

AP shoulder X-ray good for:

A 
AC joint space
subacromial space (~9mm)
64
Q

lateral shoulder Xray good for:

A

evaluating dislocations

65
Q

axial shoulder xray?

A

prevents clavicle superimposition

66
Q

elbow xray views?

A

AP
lateral flexion
medial oblique

67
Q

wrist xray views

A

PA
lateral
oblique
scaphoid

68
Q

why is itimportant to image scaphoid in acute presentations?

A

necrosis: poor blood supply

69
Q

why is itimportant to image scaphoid in acute presentations?

A

avascular necrosis: poor blood supply

70
Q

Thoracic Xray views:

A

AP, lateral, specific rib views

71
Q

AP TX Xray look for?

A

pedicle rotation, SP alignment
- Cobb-lipman: lines drawn across top and bottom Vx of scoli and an inverted angle is calculated

  • Risser-Ferguson: centres of top and boom vertebra and angle is calculated
72
Q

T1 weighted MRI show fat as?

A

bright white

73
Q

Lumbar X ray views?

A 
AP lumbopelvic
lateral lumbosacral (sacral base angle = 35-45 degrees)
posterior oblique (pars #)
74
Q

shentons line?

A

Hip AP: curvilinear line traced under the surface of the femoral neck and continued across the joint of the inferior pubic ramus

75
Q

general spinal red flags

A
  • history of trauma
  • corticosteroid use
  • age over 50
  • systemic signs of tumour
  • risk factors/signs of infection
76
Q

acute cervical pain red flags: not including general

A
  • HA, dysphagia, vomiting
  • neurological symptoms in the limbs (both)
  • CV risk factors
77
Q

acute thoracic pain red flags:

A
  • major trauma or minor trauma if over 50 and RFs for weak bone)
  • pain at multiple sites
  • pain at rest, night pain
  • chest pain without a reasonable explanation
78
Q

acute low back pain:

A
  • minor trauma if over 50 and RFs for weak bone
  • pain at multiple sites and at rest
  • AAA: absence of aggravating factors
79
Q

transient side effects of HVLA?

A
  • increase pain/discomfort
  • stiffness
  • HA
  • Tiredness/fatigue
  • radiating pain
80
Q

sentence for transient side effects of HVLA

A

you may experience a temporary increase in pain, stiffness or pain that may radiate to other areas, you may feel an increase i levels of fatigue or a headache. However its important that you understand that these are usually temporary and these symptoms should reside within 24-72 hours if they present at all.

81
Q

Substantiative reversible impairment: cervical

A
  • disc herniation
  • nerve root compression
  • cervical/upper thoracic strain
82
Q

Substantiative reversible impairment: Thoracic spine

A
  • rib or vertebral fracture

- shoulder, thoracic, rib sprain

83
Q

Substantiative reversible impairment: Lumbar

A
  • vertebral fracture
  • disc herniation
  • shoulder, thoracic spine, rib or pelvic strain
84
Q

Serious/unreversible risks cervical:

A
  • unresolved disc herniation/nerve root compression
  • spinal cord compression
  • stroke
85
Q

Serious/non-reversible risks: Thoracic

A
  • fracture that may disrupt the spinal canal

- spinal cord compression

86
Q

Serious/non-reversible risks: lumbar

A
  • significant fracture causing a disruption tot he spinal canal
  • unresolved nerve root compression or disc injury
  • cauda equina syndrome (compression of the nerves of the lower spinal cord
87
Q

signs of CAD?

A
  • thunderclap headache
  • Horner’s syndrome (miosis, sweating ipsilateral)
  • severe unilateral neck and facial pain
  • abnormal BP
  • history or family history of migraine w/o aura
88
Q

Signs of VBI?

A 
signs of ischemia:
- dizziness/vertigo
nausea/vomiting
blurred vision
facial paraesthesia
drop attack

Clinical skills 6 written exam (2 decks)

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