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
Thessaly test?
single leg stance and rotation with knee bent at 5 degrees and then 20 degrees
26
Thessaly test positive?
joint line tenderness locking or catching indicates meniscal damage
27
plantar fasciitis risk factors?
- high BMI, excessive pronation, long periods of standing | - decrease hamstring and ankle flexibility
28
plantar fasciitis treatment?
- reduce agg factors: footwear, taping - strengthening of midfoot, gastrocs and intrinsic mm. - towel pick up exercises, dry needling
29
Medial tibial stress syndrome RFs?
biomechanial loading issues: - excess pronation, overloading of tib post, FDL and soleus - high levels of plantar flexion - increased load, poor footwear
30
MTSS treatment?
load managment, ankle mobilisation, K tape
31
Varus?
lower bone angled inwards
32
Valgus?
lower bone angle outwards
33
Achilles tendinopathy treatment?
- load management - biomech. compensations of hips, Lx, ankles knees - isometric contractions - slow concentric heel raises
34
Lateral ankle sprain treatment?
- 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
35
what are the 3 lower limb neurodynamic tests?
Slump: sciatic +/- tibial SLR: SC stenosis/ meningeal CT's and sciatic +/- tibial Prone knee bend: femoral nerve
36
Upper limb ND test 1:
abduct 110 | median, anterior interosseous and C5-7
37
Upper limb ND test 2:
abduct 10 | median, musculocutaneous
38
Upper limb ND test 3:
abduct 110/10 with pronation | radial nerve
39
Upper limb ND test 4:
abduct and flex elbow to 90 each and hand to ear with wrist extension - ulnar nerve, C8-T1 nerve roots
40
ULND mnemonic?
MI5-7 | MAM RU 81
41
SIJ orthopedic tests?
- flamingo (SL stance) - active SLR - thigh thrust
42
Hip orthos
``` FADDIR Flexion IR FABER Trendelenburg resisted hip abduction patella pubic percussion ```
43
FADDIR positive indicates?
FAI
44
Flexion IR positive indicates?
labral tear and/or FAI
45
Trendelenburg positive indicates?
- glute medius weakness - gluteal tendinopathy - OA
46
resisted hip abduction?
gluteal tendinopathy
47
patellar-pubic percussion
femoral fracture
48
3 compression sites of TOS?
- between anterior and middle scalenes (scalene traingle) - between first rib and clavicle - under pec minor
49
orthos for TOS
- adsons - pulse with neck ext, ipsi SB and arm in ext, abd, supination - roos test -5min
50
frozen shoulder treatment strategies
- keeping ROM. - address biomech compensations - advice/reassurance
51
cardiac pain sites and radiations
``` retrosternal parasternal jaw neck inner arms epigastrium interscapular ```
52
thoracic mobility exercises
cat/camels thread the needle book openers knees to chest
53
T3-L5 neutral extension normal coupled motion
Type 1
54
T3-L5 flexion normal coupled motion
Type 2
55
Common structures causing groin pain
adductors, iliopsoas, inguinal, pubic regions
56
Common structures causing hip pain?
extraarticular: GTPS Intraarticular: FAI, labral tear, osteonecrosis, acetabular dysplasia
57
GTPS management?
``` modify load (reduce by 50%) and agg factors progressive loading ```
58
carpal bones in proximal row? (lateral to medial)
Scaphoid Lunate Triquetrum Pisiform
59
carpal bones in distal row (lateral to medial)
Trapezium Trapezoid Capitate Hamate
60
Shoulder red flags
- tumour - inflammatory arthropathy (RA, gout) - visceral disease - septic arthritis - fracture/dislocation - CV signs and symptoms
61
Which modality of imaging is used for what?
- X-ray: acute pain presentations - ultrasound for RC pathologies - MRI for capsule/ligament tears
62
Xray views of the shoulder
AP lateral axial scapular Y
63
AP shoulder X-ray good for:
``` AC joint space subacromial space (~9mm) ```
64
lateral shoulder Xray good for:
evaluating dislocations
65
axial shoulder xray?
prevents clavicle superimposition
66
elbow xray views?
AP lateral flexion medial oblique
67
wrist xray views
PA lateral oblique scaphoid
68
why is itimportant to image scaphoid in acute presentations?
necrosis: poor blood supply
69
why is itimportant to image scaphoid in acute presentations?
avascular necrosis: poor blood supply
70
Thoracic Xray views:
AP, lateral, specific rib views
71
AP TX Xray look for?
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
T1 weighted MRI show fat as?
bright white
73
Lumbar X ray views?
``` AP lumbopelvic lateral lumbosacral (sacral base angle = 35-45 degrees) posterior oblique (pars #) ```
74
shentons line?
Hip AP: curvilinear line traced under the surface of the femoral neck and continued across the joint of the inferior pubic ramus
75
general spinal red flags
- history of trauma - corticosteroid use - age over 50 - systemic signs of tumour - risk factors/signs of infection
76
acute cervical pain red flags: not including general
- HA, dysphagia, vomiting - neurological symptoms in the limbs (both) - CV risk factors
77
acute thoracic pain red flags:
- 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
acute low back pain:
- minor trauma if over 50 and RFs for weak bone - pain at multiple sites and at rest - AAA: absence of aggravating factors
79
transient side effects of HVLA?
- increase pain/discomfort - stiffness - HA - Tiredness/fatigue - radiating pain
80
sentence for transient side effects of HVLA
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
Substantiative reversible impairment: cervical
- disc herniation - nerve root compression - cervical/upper thoracic strain
82
Substantiative reversible impairment: Thoracic spine
- rib or vertebral fracture | - shoulder, thoracic, rib sprain
83
Substantiative reversible impairment: Lumbar
- vertebral fracture - disc herniation - shoulder, thoracic spine, rib or pelvic strain
84
Serious/unreversible risks cervical:
- unresolved disc herniation/nerve root compression - spinal cord compression - stroke
85
Serious/non-reversible risks: Thoracic
- fracture that may disrupt the spinal canal | - spinal cord compression
86
Serious/non-reversible risks: lumbar
- 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
signs of CAD?
- 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
Signs of VBI?
``` signs of ischemia: - dizziness/vertigo nausea/vomiting blurred vision facial paraesthesia drop attack ```