Examinations

Question 0

What are the Drawer tests and what do they show?

Answer 0

Flex knee to 90 degrees
Place both hands around the upper tibia (thumbs resting on tibial tuberosity, fingers under hamstrings)
Stabilise lower tibia with forearm and pull/push

ANTERIOR = tibia slides anteriorly under the fixed femur due to a torn anterior cruciate ligament

POSTERIOR = tibia slides posteriorly under the fixed femur due to a torn posterior cruciate ligament

Question 1

On what surfaces do you typically have psoriasis/eczema?

Answer 1

FLEXED SURFACES e.g. inside of arm, back of knee = eczema

EXTENDED SURFACES e.g. back of elbow, front of knee = psoriasis

Question 2

Describe the different phases of walking.

Answer 2

Cycle of limb extension (supports body weight) & limb flexion (throws body forwards)

STANCE PHASE: (60%)

1. Initial Contact/Heelstrike
2. Loading Response
3. Midstrike
4. Terminal Stance

Hip & knee extensors activated (hip & knee flexors relaxed)
Femur rotates medially on tibia
Tensor fascia lata (inserting into ilio-tibial tract) steadies pelvis of head of femur, steadies condyles of femur on tibia, gluteus maximus supports knee joint

SWING PHASE: (40%)

1. Preswing
2. Initial Swing
3. Midswing
4. Terminal Swing

Hip & knee flexors activated (hip & knee extensors relaxed)
Medial rotation of popliteus unlocks
Pelvis twists toward ground on free side due to gravity (tilt minimised by gluteus medius, gluteus minimus, & hip adductors contracting on fixed femur)

Question 3

How do you test for radial, ulnar, medial, and musculocutaneous sensation?

Answer 3

RADIAL = anatomical snuffbox/1st web space (dorsal)

ULNAR = medial edge of 5th digit

MEDIAN = lateral edge of index finger

MUSCULOCUTANEOUS = lateral forearm?

Question 4

Describe Tinel’s sign. What is it testing?

Answer 4

Tapping on wrist and palm of hand

Pain/tingling in thumb & lateral 3.5 digits = carpal tunnel syndrome

Question 5

Describe Phalen’s test. What is it testing?

Answer 5

Hold wrist in flexion for 10s

Pain/numbness in thumb & lateral 3.5 digits = carpal tunnel syndrome

Question 6

What is the difference between the mid-inguinal point and the midpoint of the inguinal ligament?

Answer 6

Mid-inguinal point = halfway between ASIS & public symphysis (site of femoral pulse)

Midpoint of inguinal ligament = halfway between ASIS & public tubercle (femoral nerve)

Question 7

Describe how you would aspirate the knee.

Answer 7

Superior anterolateral angle (less likely to hit anastomoses/veins)

Note: fat in aspirate -> tibial plateau fracture