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Patient Management II > Exam III Study Guide > Flashcards

Exam III Study Guide Flashcards

1
Q

HIP OA RISK FACTORS

A

Age greater than 50y
Male gender
Acetabular dysplasia

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2
Q

Hip OA clinical manifestations

A

Moderate anterior or lateral hip pain in weightbearing
Morning stiffness less than 1 hour

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3
Q

AVASCULAR NECROSIS RISK FACTORS

A

Age 30-60 y
Male gender
Long term steroid use
Trauma
Alcoholism

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4
Q

AVASCULAR NECROSIS CLINICAL MANIFESTATIONS

A

-Antalgic Gait
-Pain in the groin to medial knee
-Throbbing deep hip pain

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5
Q

Labral tear risk factors

A

Sudden onset-External rotation force in a hyperextended position
Traumatic onset- MVA, Fall
Gradual onset-Microtrama
History of Hip dysplasia

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6
Q

labral tear clinical manifestations

A

-Anterior hip and groin pain
- Dull ache which increases with activities such as running, brisk walking, twisting movements of the hip or climbing stairs
-Antalgic gait

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7
Q

TROCHNTERIC BURSITIS RISK FACTORS

A

Often idiopathic, repetitive microtrauma ie. Running, cycling

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8
Q

TROCHNTERIC BURSITIS CLINICAL MANIFESTATIONS

A

-Unilateral hip pain however able to walk

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9
Q

FEMOROACETABULAR
IMPINGMENT SYNDROME (FAI) RISK FACTORS

A

-motion-related clinical disorder of the hip involving premature contact between the acetabulum and the proximal femur
-Exposure to repetitive and often supraphysiologic hip rotation and hip flexion during development in childhood and adolescence (e.g. hockey, basketball or football).
-Family history (siblings)

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10
Q

FEMOROACETABULAR
IMPINGMENT SYNDROME (FAI) CLINICAL MANIFESTIONS

A

-stiffness and pain in the hip and/or groin
-aggravated with acceleration sports as well as squatting, climbing stairs and prolonged sitting

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11
Q

Obturator nerve entrapment risk factors

A

Idiopathic

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12
Q

Obturator nerve entrapment clinical manifestations

A
  • Medial thigh or groin pain
    -Weakness with leg adduction
    -Sensory loss in the medial thigh of the affected side
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13
Q

Hip OA special tests

A

-FABER
-Hip IR and flexion 15 degrees differ from uninvolved hip
-Arthritis Cluster
-balance assessments

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14
Q

avascular necrosis special tests

A

-Limited hip internal rotation, flexion, and abduction AROM and PROM

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15
Q

Labral tear special tests

A

-IR-Flex-Axial Compression maneuver
-FAIR
-FADDIR
-Posterior Labral Tear
test
-Thomas test

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16
Q

TROCHNTERIC BURSITIS special tests

A
  • Pain with palpation greater trochanter
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17
Q

FEMOROACETABULAR
IMPINGMENT SYNDROME (FAI)
special tests

A

-FADIR
-Diagnosis dependent on history

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18
Q

obturator nerve entrapment special tests

A

-Pain with extension and ABD of the hip
-decreased sensation obturator nerve distribution

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19
Q

Prone Instability Test

A

Patient lies prone over end of table with feet resting on floor
PT provides PA pressure to the lumbar spine at each level looking for provocation of pain
The patient is cued to lift legs off of floor
PT provides PA pressure to the lumbar spine at each level looking for provocation of pain

Positive: If pain is reduced in second movement

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20
Q

Manipulation Test Item Cluster

A

-Duration of symptoms <16 days
-No symptoms distal to knee
-Lumbar hypomobility
-At least one hip with greater than 35 degrees IR
-FABQ-W less than 19

4 of 5 predictors and no contraindications= manipulate

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21
Q

Coordination Impairment/ Stabilization Test Item Cluster

A

-Age less than 40
-Positive prone instability test
-Aberrant movement with ROM
-SLR greater than 90 degrees

3 or the 4 findings= coordination (multifidi and transverse abdominis)

22
Q

Direction Specific Exercise (Flexion)

A

Mainly older patients with spinal stenosis
LE symptoms come on after standing for walking for certain amount of time
Sitting improves symptoms
Flexion activities improve symptoms

23
Q

Direction Specific Exercise (Extension)

A

Symptoms distal to the buttock
Symptoms centralize with lumbar extension
Symptoms peripheralize with lumbar flexion

24
Q

Inferior glide

A

improves flexion and abduction

25
Q

Posterior glide

A

improves flexion and IR

26
Q

Anterior glide

A

improves extension and ER

27
Q

Scour test

A

for arthritis,

Patient is in supine close to edge of table. The examiner flexes hip to 90 degrees. Axial compression is applied as hip is moved into flexion and ADD and again in flexion and ABD

28
Q

Patrick test/ FABER (flexion, ABD, ER)

A

Patient is supine. Hip is placed in ER and horizontal abd with crossing of foot on opposite thigh. The examiner stabilizes the pelvis and applies a downward force through knee

Positive test= Anterior pain or discomfort
+LR 5.4, -LR 0.5 Hip Instability
Positive test= SI area pain or discomfort
+LR 1.37, -LR 0.64
Positive test = decreased ROM
+LR 1.9, -LR .61 Hip OA

29
Q

Arthritis Cluster

A

Squatting aggravates symptoms (+LR 6.1, -LR 0.79)
Pain with active hip flexion (lateral hip /groin)
Pain with active hip extension (lateral hip/ groin)
Scour tests with ADDuction causes lateral hip pain or groin pain (+LR 2.4, -LR 0.51)
Passive internal rotation ROM ≦ 25 degrees

30
Q

Trendelenburg’s sign

A

Position: Close to table (something to hold onto), standing on one leg (involved leg) and raise opposite leg (non-involved leg), i.e. knee toward chest.

Test: Clinician observes the response. Stance leg is the leg being assessed.

(-): Normally, pelvis on opposite side should rise.
(+): Pelvis drops on opposite side.
-> Indicates weak gluteus medius or an unstable hip.

31
Q

Internal rotation-flexion-axial compression maneuver

A

for labral tear

Patient is supine. Examiner flexes and internally rotates hip. Then applies axial compression. Provocation of pain is positive for suspected labral tear

32
Q

Flexion-adduction-Internal rotation test/ Click test/ (FAIR?)

A

Patient is sidelying. Examiner stabilizes pelvis while moving patients hip through 50-100 degrees flexion with Adduction and IR. Presence of a click is positive for possible labral tear.

Reproduction of sciatica- Piriformis syndrome?

33
Q

Posterior Labral Tear Test

A

Position: Supine, place test leg (start position) into full Flex, IR, & Add.
Test: Clinician Ext hip with ER & Abd.

(+): Pain or Reproduction S/S with or without “click”.
Groin pain or patient apprehension.
-> Labral tear, anterior hip instability, or Posterior-Inferior Impingement.

34
Q

FADIR – Flexion, Adduction, and IR Test

A

for FAI,

Position: Supine, place test leg (start position) into full Flex, ER, & full Abd.
Test: Clinician Ext hip with IR & Add..

(+): Pain or Reproduction S/S with or without “click”.
-> Anterior-Superior Impingement, OA

35
Q

Long stride walking special test

A

for Ischiofemoral Impingement,

Patient is asked to walk with long strides.
Pain at terminal extension
Positive: Pain relieves when a=walking with hip ABDucted

36
Q

Ischiofemoral impingement test

A

Patient is sidelying with affected leg on top
Examiner passively extends hip

37
Q

Patellar-Pubic-Percussion Test

A

for fracture,

Patient is supine
Therapist taps one patella at a time while auscultating pubic synthesis with a stephescope
Positive test= diminution of percussion noted on affected side

38
Q

Thomas test

A

Muscle length/provocation test for labral tear

The patient should be in the supine position. Have the patient flex both knees and hips by pulling the knees to the chest and holding it there. This will cause the lumbar lordosis to straighten out. Place your hand under the patient’s spine to identify lumbar lordosis. Straighten out and lower one leg.

39
Q

Ely test

A

for muscle length,

Patient is prone with passive knee flexion

40
Q

Ober test

A

for muscle length,

Patient is sidelying. Examiner flexes knee to 90 degrees and ABD and Extends hip until it is in line with trunk. Slowly allows hip to ADD while maintaining pelvis in neutral.

41
Q

True Leg Length measurement

A

Position: Supine, set pelvis square (patient lifts pelvis then back down), legs
about 15 to 20 cm (5-8 inches) apart & parallel.
Test: Clinician use tape measure to measure from ASIS to medial malleolus OR
ASIS to lateral malleolus (less affected by muscle mass).
Normal: A slight difference of 1 to 1 ½ cm (0.4 to 0.6 inch) is normal; but can
cause S/S.

(+): Different levels indicate asymmetry.

42
Q

Sacroiliac Pain Provocation Tests

A

3 tests positive indicates SI dysfunction

Distraction
Thigh Thrust
Gaenslen
Sacral thrust
Compression

43
Q

Distraction test

A

Hands over ASIS with force directly posterior

44
Q

Thigh thrust test

A

The sacrum is fixated against the table with the left hand, and a vertically oriented force is applied through the line of the femur
directed posteriorly, producing a posterior shearing force at the SIJ.

45
Q

Gaenslen

A

The pelvis is stressed with a torsion force by a superior/posterior force applied to the right knee and a posteriorly directed
force applied to the left knee, do not do during pregnancy

46
Q

Gillet Test

A

Patient stands with feet 12 inches apart

Palpate S2 with one hand and iliac spine with other

Patient flexes hip and knee on side of iliac palpation

Positive: NO movement of PSIS in a posterior direction compared to S2

47
Q

Standing Flexion Test

A

Patient is standing

Palpate PSIS Bilateral

Patient forward flexes as far as possible

Positive for hypermobility if one PSIS (+) moves further cranially

48
Q

Supine to long sit

A

Patient supine
Palpate medial malleoli and note leg length
Patient long sits
Note leg length
Positive if leg length changes

49
Q

Prone knee bend

A

Patient in Prone with knees extended.
Assess leg length
Passively flex knees to 90 degrees.
Assess leg length

Positive if leg length changes

50
Q

Neuro screen for diagnosing lumbosacral radiculopathy

A

Reflexes
Weakness
Sensory
+SLR

51
Q

Delitto PT classification system

A

Mobilization/manipulation
Direction specific repeated exercise
Stabilization
Traction

52
Q

Alrwaily PT classification system

A

movement control

Patient Management II (8 decks)

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