Exam 3 OSCEs Flashcards
If a patient has tight enough hamstrings what kind of dysfunction will they have?
hip extension dysfunction
What kind of restriction can lead to lateral knee pain?
IT Band restriction
hip abduction dysfunction
Grade: active muscle movement against gravity
3/5
Grade: barely detectable flicker
1/5
What all do you find in the central compartment of the hip?
labrum, ligamentum teres, articular surfaces
What all do you find in the peripheral compartment of the hip?
femoral neck, synovial lining
What all do you find in the lateral compartment of the hip?
gluteus medius, minimus, piriformis, IT band, trochanteric bursa
What all do you find in the anterior compartment of the hip?
Iliopsoas
If a patient has knock-knees what do we call that?
gene valgum
What are the nerve roots for the muscles in charge of knee extension?
L2-L4
What are the nerve roots for the muscles in charge of knee flexion?
L5-S1
A valgus force on the knee will cause what?
aDduction
What kind of dysfunction will have an ease of medial translator motion of the knee?
valgus
What does the anteroposterior glide of tibia on femur assess? How is it different from the anterior drawer test?
assess restricted motion, less force than drawer
draw assess excessive motion
What nerve runs around the fibular head and can get compressed by a fibular head fracture or somatic dysfunction?
common fibular
How do we assess the q angle?
one line goes from ASIS through patella
tibial tuberosity through patella
What are the medial bones of the foot?
navicular and cuneiforms
What bones make up the medial longitudinal arch?
calcaneus talus navicular cuneiforms 1-3 metatarsals 1-3
What makes up the transverse distal tarsal arch?
navicular, cuboid, cuneiforms 1-3, proximal metatarsals
What makes up the lateral longitudinal arch?
calcaneus
cuboid
metatarsals 4-5
What is the primary stabilizer of the medial ankle?
deltoid ligament
What does the plantar fascia attach to?
calcaneus and phalanges
What are the three tendons that pass through the tarsal tunnel?
posterior tibialis tendon
flexor digitorum longus
flexor hallicus longus
What does the fibularis longus attach to?
medial cuneiform and 1st metatarsal
What does the fibularis brevis attach to?
proximal portion of 5th metatarsal
An inversion injury to the forefoot can cause what ind of fracture where?
avulsion fracture of 5th metatarsal head = jones fracture
What does dorsiflexion and plantar flexion of the foot occur between?
talus and tib/fib
What does foot inversion and aversion occur between?
talus and calcaneus
What position should the foot be in to assess calcaneus inversion and eversion and why?
ankle at 90 to avoid excess laxity of joint
Plantar cuboid is associated with what?
posterior fibular head
Dorsal navicular is associated with
tight plantar fascia
Overall in the foot bones what kind of dysfunction is the most common?
plantar
What motions make up foot pronation?
abduction
eversion
dorsiflexion
What motions make up foot supination?
adduction
inversion
plantar flexion
What muscles are dorsiflexors? What nerve runs these bad boys and whatsthe root
tibialis anterior L4-L5
EHL L5
EDL L5
deep fibular
What muscles are in charge of plantar flexion? Nerve and roots!
gastric S1-S2 soleus S1-S2 FHL L5 FDL L5 tibialis posterior (also inverts) L5
What muscles are in charge of everting the foot? Nerve and root!
fibularis longus and brevis
superficial fibular nerve L5-S1
What spinous process and transverse processes are at the inferior angle of the scapula?
T7 spinous
T8 TPs
What vertebra is at the spine of the scapula?
T3
What type of spinal mechanics does thoracic vertebra exhibit?
type I and II
How do you assess passive side bending of vertebra?
push down on ipsilateral shoulder and monitor ipsilateral segmental sidebending
How do you assess passive rotation in a seated position?
induce rotation via front of ipsilateral shoulder and monitor ipsilateral segmental
If you’re assess thoracic spine and you have right PTPs on T7-9 and it doesn’t improve with flexion or extension what kind of dysfunction is it?
neutral so type I
What does a 3+ DTR look like?
very brisk may or may not be normal
What does a 4+ DTR look like?
repeating reflex, always abnromal
What is a normal DTR rated?
2+
Biceps DTR tests what nerve root?
Brachioradialis?
Triceps?
C5
C6
C7
What is the Spurling maneuver?
- compress head in neutral
- compress head in extension
- sideband away from affected side then toward affected side and add compression
What does a positive Spurling test look like and what does it indicate?
pain down arm in distribution of the nerve root
nerve root compression
What type of spinal mechanics does the OA joint exhibit?
modified type 1- primary motions are flexion and extension but they still go oposite
What type of spinal motion does the AA joint exhibit?
rotation only
What type of spinal mechanics does the cervical vertebra 2-7 exhibit?
modified type 2: primary motions are F/E but they R and SB same side
Where do you contact the OA joint to induce lateral translation?
occipital articulation
Where do you contact the OA joint to induce rotation?
occipital ridge
What is the key to assessing the AA joint?
fully flex the C spine
Where do you contact the AA joint to assess rotation?
lateral mass of atlas
the superior portion of the iliac crest corresponds with what spinous process?
L4
Patellar reflex
L4
Where would you have to have herniated disc to get a weird patellar reflex?
L3-L4
Achilles reflex
S1
What findings from the straight leg raising test (lasegue test) indicate what?
Less than 30 disc protrusion or rupture or radiculopathy
35-70 sciatic nerve irritation by stretching of dura
greater than 70 mechanical low back pain
How do you perform the hip drop test?
pt bend on knee with both feet on grounded displace weight to leg that is not bending at knee
What is the normal amount of lumbar side bending with the hip drop test? What is a positive test?
15-3
if it does not drop 15 it is positive test on the unsupported side
How would you document this hip drop test: r iliac crest drops 10
+ R hip drop test -> problem sidebending left
What type of spinal mechanics does lumbar vertebra demonstrate?
type I and II
If someone had a super duper small carrying angle what would happen
arms would hit hips when swinging during walking
Does ulnar abduction or adduction increasing the carrying angle
abduction
What kind of force causes ulnar abduction? What does the wrist do?
valgus (push medially on lateral elbow and laterally at wrist)
ulnar deviation
What is the reference point for naming ulnar abduction and adduction dysfunctions?
distal ulna
with supination which way does the radial head move?
anterior
Which way do the carpals move when we flex the wrist?
dorsal
What’s the point of reference for MCP abduction and adduction?
long finger (middle)
What does thumb abduction look like?
moves anterior from anatomical position
Contraction of what muscle can cause an inhalation rib dysfunction?
pec muscles mainly minor
What is an accessor muscle of inhalation when scapula is fixed in place such as when a patient is grasping a rail?
serratus anterior
Rib 12 can help you identify which vertebra?
T12
What ribs are typical? A typical?
typical 3-9
atypical all the rest duh
What kind of motion does rib 1 have?
50% pump 50% bucket
What kind of motion does rib 2 have?
primarily pump
What kind of motions do ribs 3-6 have?
mix of pump and bucket further down you go is bucket
Where do you place your hands to assess pump handle motion of ribs 3-6?
costochondral articulations
Where do you put your hands to assess bucket handle motion?
midaxxilary line
What kind of motions do ribs 7-10 have?
bucket
What kind of motions do the floating ribs have and how do you assess them?
caliper
patient prone
Restriction of ribs 11 and 12 is influenced by?
quadratus lumborum
if a patient falls on outstretch hand in front of them what kind of somatic dysfunction do you expect?
radial head posterior somatic dysfunction
If a patient falls back on an outstretched hand what kind of somatic dysfunction do you expect?
radial head anterior somatic dysfunction
