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Advanced Patient Evaluation > Diagnostics > Flashcards

Diagnostics Flashcards

1
Q

which test has a 90% specificity for assessing supraspinatus involvement?

A

Empty can test

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2
Q

what are some impingement tests that can be done for rotator cuff injuries?

A

Hawkins test
Drop Arm test
Neer test

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3
Q

Elbow/shoulder flexed @ 90 degree angle with sharp anterior shoulder pain with passive internal rotation

A

hawkins test

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4
Q

pain with inability to lift arm above shoulder level or hold it or severe pain when slowly lowering the arm after the shoulder is abducted to 90 degrees

A

drop arm test

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5
Q

arm fully pronated (thumbs down) with pain during forward flexion (while shoulder is held down to prevent shrugging)

A

neer test

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6
Q

inflamed bursa and/or tendon repeatedly pulled under coracoacromial arch. Pain and crepitus at subacromial space. Positive impingement tests (hawkins)

A

RTC impingement syndrome

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7
Q

what are symptoms of RTC impingement syndrome?

A

Gradual onset
referred pain
night pain
anterior/lateral pain
pain with abduction

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8
Q

what are symptoms of rotator cuff tears?

A

recurrent pain for several months, night pain
unable to/ difficulty abducting arm

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9
Q

what would you see on physical exam for a RTC tear?

A

normal PROM and decreased AROM
positive empty can test
palpable tenderness at greater tuberosity
may be atrophy over supraspinatus muscle belly

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10
Q

when would you operate on RTC tear?
when do you not operate? What is something to keep in mind?

A

operative in full thickness tears, acute, younger patient
non-operative in partial thickness tears, elderly, atrophy, chronic tears
*most tears self-limiting

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11
Q

Posterolateral compression fracture that occurs as a result of recurrent anterior dislocations of the shoulder

A

Hill-sachs lesion

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12
Q

what view do you want to get a posterior dislocation in for X-ray

A

Scapular Y and axillary lateral views best

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13
Q

what position is the arm in for anterior glenohumeral dislocation?

A

abduction and external rotation

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14
Q

what position is the arm in for posterior glenohumeral dislocation?

A

adducted and internally rotated

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15
Q

what are symptoms of AC joint separation?

A

point tenderness over AC joint,
(step off) deformity
edema
pain with lifting arm

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16
Q

best way take imaging for AC joint separation?

A

2-6 degrees is widening at the AC joint; use 10 pound weight to better visualze

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17
Q

Type of AC joint separation that has sprained AC ligaments but normal CC ligaments. radiography is normal

A

type 1

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18
Q

Type of AC joint separation that has disruption of the AC ligaments; sprained CC ligaments. Radiography shows widened AC joint and slight elevation of the clavicle

A

Type II

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19
Q

Type of AC joint separation that has disruption of the AC and CC ligaments. Radiography shows moderate elevation of clavicle

A

Type III

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20
Q

Type of AC joint separation that has posterior displacement through the trapezius muscle. Axillary view shows posterior displacement

A

Type IV

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21
Q

treatment of AC joint separation?

A

for types 1-3; treatment is non-operative. Sling for comfort and ROM exercises

types 4-6; operative repair almost always indicated

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22
Q

traction force when shoulder is forcefully depressed and head/neck tilted to opposite side

A

burner/stinger

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23
Q

symptoms of burner/stinger

A

sharp burning pain radiating to hand, weakness
entire arm is limp and hanging at side
may last minutes to weeks

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24
Q

what is the appropriate diagnosis and treatment for a burner/stinger?

A

X-rays of cervical spine and shoulder series, MRI if symptoms persist
no return to sports until asymptomatic
refer if symptoms persist

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25
Q

palpable defect with popeye deformity
audible snap or pop

A

bicepts tendon rupture (proximal)

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26
Q

what does the scarf test look for?

A

AC impingement

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27
Q

What does the lift off test for?

A

RTC, isolates subscapularis

28
Q

what does the apprehension test look for?

A

shoulder dislocation
(sulcus sign too)

29
Q

treatment for biceps tendon rupture?
What is something to note?

A

non-operative unless athlete or active adult < 40y/o
left with deformity but good function

30
Q

idiopathic thickening and contraction of capsule resulting in increased pain and decreased ROM;
Also characterized as shoulder stiffness due to inflammation (especially with diabetes and hypothyroidism)

A

Adhesive capsulitis (frozen shoulder)

31
Q

symptoms of adhesive capsulitis (frozen shoulder)

A

progressive loss of ROM (freezing phase) followed by steady improvement (thawing phase)
-usually has a “bad side”
-painful AROM and PROM
increased motion at scapula to compensate

32
Q

how do you treat adhesive capsulitis?

A

NSAIDs, heat, PT (PROM only, no strength exercises)
corticosteroid injection
manipulation and possible debridement under general anesthesia

33
Q

lifting, swing or pulling a child (longitudinal traction) while the forearm is pronated and extended

A

Subluxation of the radial head (nursemaid’s elbow)

34
Q

how do you treat subluxation of the radial head?

A

closed reduction; place pressure on the radial head with supination of the elbow followed by flexion of the elbow

35
Q

inflammation of the tendon insertion of the extensor carpi radialis brevis muscle due to repetitive pronation of the forearm and excessive wrist extension

A

Lateral epicondylitiis

36
Q

inflammation of the pronator teres-flexor carpi radialis muscles due to repetitive overuse & stress at the tendon insertion of flexor forearm muscle

A

Medial epicondylitis

37
Q

what are symptoms of lateral epicondylitis?

A

lateral elbow pain especially with gripping, forearm pronation & wrist extension against resistance

38
Q

what are symptoms of medial epicondylitis?

A

tenderness over the medial epicondyle worse with pulling activities

39
Q

what nerve provides sensation to the volar aspect of the thumb, index, long and radial half of the ring finger; motor to the flexor muscle of the forearm and hand as well as those muscles responsible for flexion, abduction, opposition and extension of the thumb

A

Median

40
Q

what nerve provides sensation to ulnar half of the ring finger and small finger; motor innervation to part of the forearm and majority of the hand

A

ulnar

41
Q

sensation to radial 3/4th of dorsal hand and dorsal thumb, index, long and radial half of ring to PIP joint; motor to posterior UE muscles

A

radial

42
Q

what is the SAFE position?

A

MP flexed, PIP and DIP extended (relaxes intrinsics, keeps collaterals stretched)

43
Q

dorsal angulation of fragment
extension injury
PE: edema, tenderness, “dinner fork deformity”

A

colles fracture

44
Q

how do you treat a colles fracture?

A

reduce by slightly exaggerating, then reversing MOI while applying traction
-splint acutely, then cast when swelling goes down

45
Q

volar angulation; flexion injury

A

smith fracture

46
Q

fracture of proximal portion of thumb metacarpal involving CMC joint
how do you treat this fracture

A

Bennet fracture
treatment: thumb spica splint/cast if nondisplaced
if angulation, displacement or intraarticular irregularity- surgery

47
Q

FOOSH; tenderness in anatomic snuffbox
how do you treat this fracture

A

Scaphoid gracture
thumb spica cast if snuffbox tenderness; repeat x-ray/bone scan/ CT
high incidence of nonunion

48
Q

rupture of extensor tendon or avulsion of dorsal distal phalanx
PE: “droop at DIP” unable to extend
how do you treat this fracture

A

mallet finger

Continuous splinting in extended position

49
Q

rupture/avulsion of flexor from distal phalanx; forced hyperextension against active flexion
how do you treat this fracture

A

jersey finger

usually requires surgery

50
Q

finger flexed at the DIP joint, unable to extend at the DIP joint

A

mallet finger

51
Q

finger flexed at the PIP joint and hyperextended at DIP

A

Boutonniere Deformity

52
Q

muscle: Deltoid, Bicepts
Sensation: deltoid
Reflex: biceps

A

C5

53
Q

muscle: Wrist extenstion
Sensation: Thumb, index or forefinger
reflex: brachioradialis

A

C6

54
Q

muscle: wrist flexion, triceps
sensation: middle (or long) finger
reflex: Triceps

A

C7

55
Q

Muscle: intrinsics
sensation: ring and little (or small)
reflex: None

A

C8

56
Q

which organism do you typically see with a human bite?

A

Eikenella corrodens

57
Q

which organism do you typically see with a dog bite?

A

strep. Viridans, E.corodens

58
Q

which organism do you typically see with a cat bite?

A

Pasteurella multicoda

59
Q

disruption to the neck musculature and ligaments- particularly the ALL, PLL?

A

soft tissue injury-(whiplash)

60
Q

A clinical diagnosis based on head tilt in association with a rotatory deviation of the cranium

A

Torticollis

61
Q

Narrowing of the central spinal canal or foramen, usually a gradual result of adding which may lead to pressure on the spinal cord

A

spinal stenosis

62
Q

what are some signs of spinal stenonsis

A

global upper extremity weakness, loss of coordination, numbness in hands, loss of vibration sense or proprioception, may have bowel or bladder changes

63
Q

in what condition would you see, unilateral arm pain (radiculopathy), weakness, numbness and tingling

A

C-spine herniated nucleus pulposus

64
Q

defined as cervical spine osteoarthritis- signs of disc narrowing, osteophytes and obliques to see foramina on X-ray

A

cervical spondylosis

65
Q

inflammation of the muscles, joints, ligaments of the cervical spine. partial tears are more painful than full tears

A

cervical strain/spine

Advanced Patient Evaluation (2 decks)

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