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Clin Problem Solving > Final Exam > Flashcards

Final Exam Flashcards

1
Q

CPG for Cervical Manipualtion

A

3/4 for 90%
1. symptom duration < 38 days
2. positive expectation that manips will help
3. difference in rotaton ROM of 10 or greater in side comparison
4. pain with p-a spring testing in middle c spine

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2
Q

T spine manipulation CPG

A

4/6 = good probability of succes
1. symptoms < 30 days
2. no symptoms distal to shoulder
3. no aggravation of symptoms by looking up
4. FABQPA score less than 12
5. decreased upper t spine kyphosis
6. cervical extension ROM less than 30 deg

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3
Q

Lumbar manipulation CPG

A

4/5 = favorable response
1. symptoms < 16 days
2. FABQ < 19
3. at least one with with >35 deg IR
4. hypomobile lumbar spine
5. no symptoms below knee

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4
Q

Wainner’s diagnostic rule for cervical radiculopathy

A

4/4 net = 90% probability
1. + spurlings
2. + neck distraction
3. + ULTT A
4. involved side cervical rot < 60 deg

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5
Q

Shoulder impingement test cluster (3 tests that rule in SAPS)?

A

All 3 = rule in SAPS
+ painful arc
+ ER resistance test
+ hawkins kennedy

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6
Q

RC tear cluster (3 findings to help rule in RC pathology)

A

if all 3 = 98% probability
age > 65
night pain
ER weakness

OR

Age > 60
+ painful arc
+ drop arm test
+ infraspinatus

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7
Q

AC Joint Pathology Cluster

A

AC resisted extension
active compression test
cross body adduction test

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8
Q

Shoulder IR resisted strength testing outcomes

A

IR strength > ER = RC tendinopathy
ER strength > IR = intra-articular pathology

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9
Q

Diagnostic Tests for lateral epcondylitis

A

+cozen’s test
+mills test
+ maudsley test
+ pain with palpation

Cozens and maudsley = best for ruling out
mills = best for ruling in

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10
Q

Diagnostic cluster for medial epicondylitis

A

+ pain with resisted wrist flexion
+ pain with stretch of wrist flexors
+ golfers elbow test
+ pain with palpation

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11
Q

Carpal Tunnel CPG

A

5/5 = 90% probability
Positive flick sign
wrist ratio index > .67
symptom severity scale > 1.9
reduced median sensory to D1
age > 45

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12
Q

Ottawa foot and Ankle Rule

A

Get Xray if:
Ankle:
pain in malleolar region, malleolus bone tenderness, and inability to bear weight on limb
Foot:
metarsal pain in lateral or medial region, bone tenderness on 5th met or navicular, inability to bear weight

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13
Q

Criteria for Osteoarthritis

A

at least 4 = high probability
age > 50
stiffness < 30 mins in morning
crepitus
bony tenderness
bony enlargement
no palpable warmth

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14
Q

PCL diagnostic tests

A
  • decreased knee extension
    -posterior drawer (99% sp)
  • posterior sag (100% sp)
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15
Q

Meniscal Pathology Prediction Cluster

A

5/5 = 99% specific
1. history of mechanical catching or locking
2. joint line tenderness
3. + McMurrays test
4. pain with maximum passive knee flexion
5. pain with forced knee hyperextension

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16
Q

Patellofemoral Pain presentation

A
  • pain with squatting, stairs, sitting
  • pain with palpation of patella or medial femoral condyle
  • weakness of quads and hip abds
  • altered functional biomechanics in gait
17
Q

Pain Location for hip OA (ranked)

A
  1. Greater trochanter
  2. groin
  3. anterior thigh
  4. buttock
18
Q

UE myotomes

A

cspine = C1-C3
shoulder elevation = C4
Shoulder abduction = C5
Elbow flexion = C6
Elbow extension = C7
Wrist flexion = C7
Wrist extension = C6
Thumb extension = C8
Finger abduction = T1

19
Q

LE dermatomes

A

Upper thigh = L1
Middle thigh = L2
Lower thigh/knee = L3
medial shine/malleolus = L4
Lateral shin/top of foot/ great toe = L5
lateral border of foot/heel/med calf = S1
Popliteal fossa/post thigh = S2

20
Q

LE myotomes

A

L1-L2 = hip flexion
L3 = knee ext
L4 = ankle DF
L5 = great toe ext
S1 = ankle PF
S2 = knee flexion
S3-4 = toe flexion

21
Q

Shoulder Capsular Pattern Loss

A

IR loss > Abd loss > Flexion loss

22
Q

LBP manipulation group characteristics (lecture material)

A
  • no symptoms below knee
  • recent symptoms
  • hypomobility
  • low fear avoidance
  • more hip IR
23
Q

LBP stabilization group characteristics

A
    • prone instability test
  • aberrant movements
  • hypermobile
  • younger age
  • SLR > 90
24
Q

LBP traction group characteristics

A
  • neuro signs
  • leg symptoms
  • no centralization during movements
25
Q

Hick LBP CPR on stabilization

A
  • younger than 40
  • greater general flexibility
  • instability catch during flexion/extension ROM
  • positive prone instability test

3/4 = 67% chance of recovery with LBP program

26
Q

SLR interpretation

A

30-70 deg = disc herniation at L4-S1
less than 30 deg = sign of the buttock (BAD)
pain at greater than 70 deg = may indicate tight posterior muscles

27
Q

SLR nerve biases

A

TIbial N - ankle DF and eversion
Sural N = Ankle DF and inversion
Fibular = Ankle PF and Inversion

28
Q

3 Criteria for a positive neurodynamics special test

A
  1. reproduce comparable sign
  2. asymmetrical findings
  3. sensitizing movement changes symptoms
29
Q

Ottowa knee rules

A

> 55
tenderness at head of fibular
isolated tenderness of patella
inability to flex past 90
inability to walk four weight bearing steps immediately after or in emergency room

30
Q

Indications for thrust manipulation

A
  1. presence of dysfunction
  2. neuro effects to reduce pain and guarding
  3. mechanical effects to overcome restriction barriers
31
Q

Absolute contraindications of manipulation

A

Malignancy
cauda equina lesions
rheumatoid collagen necrosis
unstable c spine
VBI
spondylolisthesis
gross foraminal encroachment
being a child
pregnancy
fusions
psychogenic disorders
immed. postpartum
practitioner lack of ability

32
Q

Relative contraindications for manipulation

A

active acute inflammatory conditions
systemic disease
neuro deterioration
irritable patient
osteoporosis
radiculopathy
when subjective and objective dont add up
use of oral contraceptives
immediate postpartum
blood clotting disorder

33
Q

Risk associated with manipulation

A

fracture
dislocation
soft tissue strain
join sprain
stroke or VBI (cervical)
cauda equina insult (lumbar)

34
Q

Side effects of manipulation

A

local pain
headache
fatigue
radiating pain
paresthesia
dizziness
nausea
stiffness
hot skin
fainting

35
Q

What are the main characteristics of manipulation

A

high velocity
low amplitude
end range

36
Q

Combination Tests to confirm RC tear

A

Full supra = + empty can and + ER lag sing
Full infra = + er lag sign
Subscap = + lift off and + belly press

Clin Problem Solving (1 decks)

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