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2b > Joint Examinations > Flashcards

Joint Examinations Flashcards

1
Q

What do you look for when observing gait?

A
  • Gait cycle
  • Symmetry
  • Assess turning
  • Any signs of discomfort
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2
Q

Observe hips: what you looking for (from front)?

A
  • Scars
  • Pelvic tilt
  • Quadricep wasting
  • Joint deformity
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3
Q

Observe hips: what you looking for (from side)?

A
  • Lumbar lordosis
  • Knee flexion
  • Foot arches
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4
Q

Observe hips: what you looking for (from back)?

A
  • Scoliosis
  • Iliac crest alignment
  • Gluteal muscle bulk
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5
Q

When palpating hip, what you looking for?

A
  • Tenderness
  • Warmth
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6
Q

What could tenderness of hip suggest

A

Trochanteric bursitis

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7
Q

Describe Thomas’s test

A
  • Place hand under the spine
  • Passively fee the unaffected leg as far as possible
  • Your hand should detect the lumbar lordosis flattening
  • With unaffected leg flexed, the contralateral leg should be flat on the bed
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8
Q

What are the Special tests for a hip exam

A
  • Thomas’s test
  • Trendelenberg’s test
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9
Q

How do you measure actually leg length?

A

ASIS -> medial malleolus

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10
Q

How to you measure apparent leg length?

A

umbilicus -> medial malleolus

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11
Q

What do you do to complete hip exam?

A

Examine spine, knees, neuromuscular exam of lower limbs and view any available imaging

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12
Q

What do you look for in exam of hands (inspection)

A
  • Skin
  • Scars
  • Muscle wasting
  • Deformity
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13
Q

On palmar surface of hand: what 2 things to you particularly look for?

A
  • Dupuytren contracture
  • Thenar and hypothenar wasting
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14
Q

Where can you touch on palmar surface of hand to test median nerve?

A

Thenar bulk

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15
Q

Where can you touch on palmar surface of hand to test ulnar nerve?

A

little finger

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16
Q

Where can you touch on hand to test radial nerve?

A

dorsal surface mear thumb

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17
Q

What does tenderness in anatomical snuffbox indicate?

A

scaphoid fracture

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18
Q

How should patient be positioned and dressed for shoulder exam?

A

standing
top off

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19
Q

Shoulder inspection: what do you look for?

A
  • head and neck posture
  • Symmetry of shoulders
  • Deltoid wasting
  • Scars

(skin, scars, muscle wasting, deformity)

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20
Q

Shoulder test; What does empty can test test for? and how is it done?

A

Assess for weakness of supraspinatus

arms out stretched and as if emptying can of beans

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21
Q

Hands exam: What are the 4 look things?

A
  • Skin: colour
  • Scars: trauma
  • Muscle wasting: thenar muscles
  • Deformity: RA, dextrupens contracture
  • Symmetry: differences between the hands
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22
Q

Hands exam: what are the 4 feel things?

A
  • Palpate: every joint + wrist (lumps or tenderness)
  • Temprate: compare temps
  • Neurate: palmar and dorsal surfaces
  • Vascular: cap refill, pulse
23
Q

Hands exam: What are the 4 move things?

A
  • Test actions: fist, back out, spread out fingers, all the thumb ones
  • Power grip
  • Hold a pen
  • Buttons
24
Q

Hand exam: what are the 4 special tests?

A
  • Sensory: ulnar, medien, radial
  • Motor:
  • Tinnels
  • Phalens
25
Q

Hand exam special tests: what special tests to check motor function?

A
  • Ulnar: crossed fingers, grip paper, abduct against resistance
  • Median: Palmar abduction (thumb)
  • Radial: wrist and finger dorsiflexion
26
Q

Knee exam: what do you inspect form the front?

A
  • Valgus, varus deformity
  • knee swelling
  • quadricep bulk
27
Q

Knee exam: what do you inspect form the side?

A
  • knee hyperextension?
  • foot arches
  • toe deformity
28
Q

Knee exam: what do you inspect form behind?

A
  • gluteal muscle bulk
  • popliteal swellings
  • hindfoot abnormalities
29
Q

Knee exam: what does patella tap test for?

A

Allows for detection of large joint effusions

30
Q

knee exam: what does swipe test test for?

A

allows detection of small joint effusions

31
Q

What would you do to complete knee examination?

A
  • examine hip
  • examine ankle
  • perform neurovascular examination of both lower limbs
32
Q

What do you look for in general inspection in foot exam? (not on foot)

A
  • uneven footwear
  • foreign objects in shoes
  • bandages
  • dressings
33
Q

What do you look for in inspection of foot exam?

A
  • skin, scars, muscle wasting, deformity
    -ulcers
    -oedema
  • joint deformity
34
Q

Foot exam: What hidden spaces do you need to check in inspection?

A
  • Between the toes
  • back of the heel
35
Q

What pulses do you check in foot exam? find it on yoself

A
  • Posterior tibial pulse
    (located posterior and inferior to the medial malleolus)
  • Dorsalis pedis pulse
    (located lateral to the extensor hallucinate longus tendon)
36
Q

Foot exam: explain how you would test vibration

A
  • check they know what it feels like (sternum)
  • hit tuning fork and ask patient to say when they can feel it vibrating and when stopped
  • place on ball of foot
37
Q

what tuning forking should be used to check vibration in foot exam

A

128 Hz

38
Q

Foot exam: explain how to test reflex

A
  • Ankle jerk reflex
  • leg bent slightly to side
  • tap back of the ankle
39
Q

What would you do to complete diabetic foot exam?

A
  • peripheral vascular exam
40
Q

What exposure is required for GALS examination?

A

Remove shirt, wear shorts

41
Q

What initial questions do you ask in GALS examination?

A
  • Do you have any pain or stiffness in your joints, muscles or back?
  • Do you have any difficulty getting dressed?
  • Do you have have any difficulty going up and down the stairs?
42
Q

GALS exam: what do you look for on inspection from the front?

A
  • Shoulder symmetry + muscle bulk
  • Elbow extension
  • Quadriceps bulk
  • Knee swelling and deformity
  • Foot deformity
43
Q

GALS exam: what do you look for inspection from the side?

A
  • Spine
  • Knee flexion (/hyperextension)
  • Foot arches
  • Toe deformity
44
Q

GALS exam: what do you look for on inspection from the back?

A
  • Shoulder symmetry
  • Spinal alignment
  • Iliac crest alignment
  • Gluteal muscle bulk
  • Popliteal swellings
  • Hind-foot abnormalities
45
Q

What do you do for arms bit of GALS?

A
  • Shoulder: arms behind head
  • Hands and wrists:
    • look: supinate
    • feel: tenderness over MCP joint
    • move: fist, grip strength, piano fingers
46
Q

What do you do for Legs bit of GALS?

A
  • Passive movement
  • Joint effusion (patellar tap)
  • Feet: look, feel (MTP joint)
47
Q

What passive movement do you do for legs of GALS?

A
  • with patient lying down: flex knee and hip
  • internal and external rotation of hip joint (with hip and knee flexed to (90))
48
Q

What do you do for spine of GALS

A
  • lumbar flexion: measure expansion
  • cervical spine lateral flexion (45)
49
Q

what would you do to complete GALS screening examination?

A
  • focused examination of joints with suspected pathology
  • further imaging if indicated
50
Q

Spinal exam: what do you feel for when palpating spinal processes?

A
  • Alignment
  • Irregularities
  • Tenderness
51
Q

Spinal exam: What do you feel for when palpating paraspinal muscles?

A

Any areas of tenderness or spasm

52
Q

Explain how to test thoracic rotation

A

Ask patient to cross arms and then rotate as much as possible

53
Q

What are the two points on the back for schooners test?

A

10ch above and 5cm below posterior superior iliac spine (PSIS)

54
Q

Schober’s test: how big should the distance be between the two points once the patient has bent over?

A

Greater than 20cm

2b (9 decks)

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