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PCM I > Exam 1 OSCEs > Flashcards

Exam 1 OSCEs Flashcards

1
Q 
HTN classifications: 
pre-HTN
stage 1 HTN 
stage 2 HTN 
HTN crisis
A

120-139/80-89
>140/90
>160/100
>180/120

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2
Q 
BMI:
underweight 
normal 
overweight 
obesity I 
obesity II 
extreme obesity
A 
< 18.5 
18.5 - 24.9 
25 - 29.9 
30 - 34.9
35 - 39.9
>40
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3
Q 
DTRs:
biceps 
brachioradialis 
triceps 
patellar 
Achilles
A 
C5 
C6 
C7 
L4 
S1
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4
Q 
dermatomes: 
C4 
C6 
C8 
T4 
T10 
L5 
S1 
L1-L3 
L4 
L5
S1-S4
A

top of shoulder

radial aspect of forearm

5th digit

nipple line

umbilicus

great toe

posterolateral calf/little toe

anteromedial thigh

patella and big toe

anterior leg and ankle and big toe

posterior thigh

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5
Q

apprehension test

A
  • patient is seated or supine
  • shoulder ABducted to 90 degrees and elbow flexed to 90 degrees
  • use 1 hand to palpate bicipital groove and monitor there, while the other hand grasps the patient’s wrist

(+): pain and/or tendon subluxation out of groove; unstable bicipital

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6
Q

Speed’s test

A
  • patient arm flexed (50-90 degrees) at the shoulder w/ hands supinated
  • slightly flex patient’s elbow
  • resist at forearm while patient flexes shoulder

(+): bicipital tendonitis of longhead biceps

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7
Q

empty can test

A
  • flex shoulders to 90 degrees while horizontally abducting to 45 degrees
  • internally rotate both arms so thumbs are pointing down
  • press down on forearms while patient resists

(+): rotator cuff pathology (supraspinatus)

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8
Q

drop-arm test

A

-patient abducts arm to 90 degrees, then slowly drops arm

(+): arm will drop; full thickness tear of supraspinatus

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9
Q

painful arc test

A

(+): pain elicited within 60 to 120 degrees of shoulder abduction; subacromial impingement and/or rotator cuff injury

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10
Q

Neer impingement

A
  • stabilize patient’s shoulder
  • w/ forearm pronated, passively flex shoulder to fully flexed position

(+): subacromial bursa or rotator cuff impingement

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11
Q

Hawkins test

A
  • flex shoulder to 90 degrees
  • flex elbow to 90 degrees and passively rotate the humerus into external rotation

(+): rotator cuff or subacromial bursa impingement

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12
Q

lift off test

A
  • place patient’s arm into internal rotation and extension
  • patient pushes arm into further internal rotation as physician resists

(+): weakness; subscapularis weakness

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13
Q

cross arm test

A

-physician passively adducts patient’s arm across their chest and rests patient’s hand on their opposite shoulder

(+): AC joint pathology

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14
Q

carrying angle:
males
females

A

5 degrees in males

10-15 degrees in females

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15
Q

cubitus varus

A

< 5 degrees; adduction of ulna

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16
Q

cubitus valgus

A

> 15 degrees; abduction of ulna

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17
Q

anatomic snuffbox:
medial border
lateral border
proximal border

A

medial: extensor pollicus longus
lateral: extensor policus brevis, abductor pollicis longus
proximal: radial styloid process

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18
Q

valgus stress test (elbow)

A
  • arm slightly abducted and externally rotated
  • forearm supinated and flexed to 30 degrees
  • slight medial valgus stress

(+): sprained medial (ulnar) collateral ligament; lateral blow

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19
Q

varus stress test (elbow)

A
  • arm slightly abducted and internally rotated
  • elbow flexed to 15 degrees
  • slight lateral virus stress

(+): sprained lateral (radial) collateral ligament; medial blow

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20
Q

Tinel test

A

-tap b/w olecranon and medial epicondyle in the ulnar groove

(+): ulnar nerve entrapment/cubital tunnel syndrome (carpal tunnel syndrome)

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21
Q

Golfer’s elbow test

A
  • patient’s elbow is flexed to 90 degrees
  • forearm placed in supination with palm facing up
  • place hand over patient’s wrist to resist movement; instruct patient to flex wrist

(+): medial epicondylitis

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22
Q

Tennis elbow (Cozen’s) test

A
  • patient’s elbow is flexed to 90 degrees
  • forearm placed in pronation w/ palm facing down
  • instruct patient to extend wrist against resistance

(+): lateral epicondylitis

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23
Q

Nursemaid’s elbow

A

radial head instability

annular ligament tear and/or radial head subluxation from annular ligament; often result from trauma w/ traction of child’s extended arm

restricted to posterior glide (pronation)

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24
Q

Ok sign

A

indicative of fracture of humerus

anterior interosseous nerve

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25
Q

Phalen’s sign

A
  • place dorsal aspects of patient’s hands together and force into flexion
  • hold for 60 seconds
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26
Q

DeQuervian’s tenosynovitis

A
  • dorsolateral wrist & thumb pain; grip weakness
  • if you have a newborn, texting, gaming, etc.

Finkelstein test: make a fist encompassing thumb and ulnar deviate wrist

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27
Q

Handlebar palsy

A

Guyon’s canal (hamate and pisiform) entrapment of ulnar nerve

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28
Q

Gamekeeper/Skier’s thumb

A

tear of ulnar collateral ligament of MCP

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29
Q

mallet finger

A

extensor tendon injury at DIP

30
Q

trigger finger

A

inflammation and narrowing of flexor tendon sheath

31
Q

jersey finger

A

avulsion of flexor digitorum profundus from fingertip

32
Q

Dupuytren’s contracture

A

abnormal CT thickening in palmar fascia

33
Q

Cole’s fracture

A

distal radius fracture w/ dorsal and radial displacement; “dinner fork”

Smith = ventral displacement

34
Q

Conteggia fracture

A

proximal ulna; dislocation of radial head

35
Q

Galeazzi fracture

A

distal radius; dislocation of ulna

36
Q

Nightstick fracture

A

isolated fracture of the mid shaft/distal ulna from direct blow

37
Q 
hip compartments: 
central
peripheral 
lateral 
anterior
A

central: labrum, ligamentum teres, articular surfaces
peripheral: femoral neck, synovial lining
lateral: gluteus medius/minimus, piriformis, IT band, trochanteric bursae
anterior: iliopsoas

38
Q

Log roll

A

-internal/external rotation

(+): central or peripheral compartment pathology

39
Q

C-sign

A

-above the trochanter

(+): labral pathology

40
Q

labral loading

A

-flex the patient’s knee and hip to 90 degrees; load into the femur

(+): labral or cartilaginous pathology

41
Q

labral distraction

A

-distract patient’s femur away from innominate

(+): improvement of pain; labral or cartilaginous pathology

42
Q

scour

A
  • flex and externally rotate hip
  • load into socket and articulate through annular ROM

(+): labral or articular cartilage pathology

43
Q

apprehension FABER

A
  • flexed, abducted, and externally rotated
  • push down on knee to induce further external rotation

(+): labral pathology

44
Q

rectus femoris test

A
  • patient is supine; 1 hip is flexed up to the chest
  • the other leg is bent over the edge of the table

(+): knee flexion < 90 degrees; rectus femoris contraction

45
Q

jump sign

A

-pressure at greater trochanter

(+): trochanteric bursitis

46
Q

straight leg raise

A

-patient supine; flex patient’s hip w/ knee extended

(+): pain over lateral leg, especially at > 15 degrees; IT band contracture

30-60 degrees: lumbosacral radiculopathy and/or sciatic neuropathy
> 70 degrees: mechanical low back pain d/t muscle strain or joint disease

47
Q

piriformis test

A
  • patient supine w/ hip and knee flexed, one ankle crossed over contralateral knee
  • patient abducts against resistance

(+): pain over greater trochanter; piriformis spasm or pathology

48
Q

patrick’s FABER

A
  • patient hip is flexed, abducted, and externally rotated
  • brace contralateral ASIS; patient externally rotates/abducts against resistance

(+): gluteus medius pathology

49
Q

patrick’s FABER (anterior/iliopsoas)

A
  • patient’s hip is flexed, abducted, and externally rotated
  • brace contralateral ASIS; patient internally rotates/adducts against resistance

(+): iliopsoas insufficiency or pathology

50
Q

Thomas test

A

-one leg is lowered to the table to test the flexibility of the hip flexors

(+): inability to fully extend, or extended leg raises off table; hip flexor contraction

51
Q 
Q angles: 
genus valgum
genus varus
genus recurvatum 
normal
A

valgum: increased Q angle
varus: decreased Q angle
recurvatum: backward curvature r/t hyperextension
normal: 15 degrees; females increased

52
Q

knee valgus test

A
  • flex knee to 30 degrees
  • apply a medial force on proximal tibia while abducting the lower the leg

(+): MCL issues

53
Q

knee varus test

A
  • flex knee to 30 degrees
  • apply a lateral force to the proximal tibia while adducting the lower leg

(+): LCL issues

54
Q

anterior drawer test

A
  • flex knee to 90 degrees
  • sit on patient’s foot and grasp proximal tibia w/ both hands, pulling tibia anteriorly

(+): excessive translation; ACL issues

55
Q

Lachlan’s test

A
  • cephalad hand on distal thigh, superior to patella
  • caudad hand grasps the proximal tibia
  • flex the knee 10-30 degrees, using caudad hand to pull the tibia anteriorly while the cephalad hand stabilizes the thigh

(+): ACL insufficiency

56
Q

McMurray’s test:
lateral
medial

A
  • hip and knee flexed; caudad hand on ankle and cephalad hand on distal femur
  • lateral: internal rotation and varus stress, then extension
  • medial: external rotation and valgus stress, then extension

(+): pain or click w/ extension; medial or lateral meniscus tear

57
Q

Apley grind/compression test

A
  • patient prone w/ hip 90 degrees
  • downward force on foot w/ compressive force on meniscus, while rotating the foot internally and externally

(+): meniscal injury, collateral ligament injury, or both

58
Q

Apley grind/distraction test

A
  • patient prone w/ hip 90 degrees
  • stabilize thigh, then apply upward traction to the leg while rotating it

(+): pain with distraction is collateral ligament; relief of pain is meniscal

59
Q

Patellar laxity & apprehension tests

A

laxity: one hand above and one hand below the joint; thumbs placed on medial side of patella; push patella laterally

(+): previous patellar dislocation or severe instability

60
Q

patellar compression (grind) test

A
  • supine w/ knee extended
  • compressive load to patella w/ one hand while moving the patella medial and lateral

(+): inflammation, chondromalacia, injury to the patellofemoral articular surfaces

61
Q

patella-femoral grinding test

A

-compress patella caudally into trochlear groove & instruct pt to tighten quads against resistance

(+): roughness of articulating surfaces (chondromalacia)

62
Q

patellar glide test

A
  • sitting or supine; slowly extend and flex the knee while physician monitors quality of motion
  • place hand lightly over patella to increase sensitivity

(+): damage to articular surface

63
Q

ankle anterior drawer test

A
  • grasp posterior calculus w/ one hand and distal tibia/fibula with the other, monitoring anteriorly at the anterior talus
  • provide anterior force on calcaneus while stabilizing the distal tibia/fibula; normal springing of calcaneus back to neutral should occur

(+): ATF ligament pathology/tear (lateral ankle sprain)

64
Q

talar tilt test

A
  • grasp distal tibia/fibula w/ one hand and inferior calcaneus w/ the other, blocking motion of the calcaneus on the talus
  • invert talus to evaluate ROM

(+): calcaneofibular ligament pathology/tear, also tests some ATF (lateral ankle sprain)

65
Q

eversion test

A
  • grasp distal tibia/fibula with one hand and plantar surface of the mid-foot w/ the other hand
  • evert the foot

(+): deltoid ligament pathology (medial ankle sprain)

66
Q

squeeze test

A
  • wrap hands around leg proximal to the ankle, contacting distal tibia/fibula w/ both thenar eminences
  • squeeze for 2-3 seconds, then rapidly release

(+): syndesmosis pathology (high ankle sprain)

67
Q

cross log test

A
  • patient crosses affected ankle over opposite knee
  • apply pressure to distal fibula of affected leg

(+): syndesmosis pathology (high ankle sprain)

68
Q

thompson test

A
  • patient prone w/ foot off table
  • squeeze patient’s calf and observe for plantar flexion

(+): Achilles tendon rupture

69
Q

Homan’s sign

A
  • patient laying or seated w/ knee extended
  • dorsiflex patient’s foot; can apply lateral compression to calf

(+): thrombophlebitis or acute DVT

70
Q

Moses sign

A
  • patient seated or supine w/ knee slightly flexed or extended
  • induce an anterior compression on the gastrocnemius muscle into the posterior aspect of the tibia

(+): DVT of the posterior tibial veins

PCM I (1 decks)

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