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Extremity Clet > Lab Final > Flashcards

Lab Final Flashcards

1
Q

Complain of tendinitis in shoulder flexion

A

Speed’s test - contact bicipital groove, resisted speed 45 degrees

Pain and/or tenderness at bicipital groove indicates bicipital tenditnitis

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2
Q

Locking/grinding of knee, retropateller pain, catching

A

Synovial plica test

Involved side up/30 deg/push patella medially with superior hand/rot tibia in/extend fully/flex again to 30/repeat with lat push/ext rot

Popping, snapping or clunking

Medial pain indicates medial synovial plica syndrome
Lateral pain indicates lateral synovial plica syndrome

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3
Q

Posterior elbow pain

A

Valgus overload test
Elbow 90/valgus/full passive extension

Pain in posterior elbow with reproduction of lock/catch or inability to fully extend indicates posterior impingement syndrome

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4
Q

Knee hit from behind, Painless, giving way

A

Godfrey sag sign
90/90/contract hamstrings

Proximal tibia sags due to lack of posterior constraint indicating tear/sprain of PCL

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5
Q

Deep anterior hip pain

A

Hip impingement sign
Supine 90/90/slight ADD/forceful int rot

Sharp anterior catching hip pain indicates hip impingement syndrome

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6
Q

Anterior should instability; deep ant shoulder pain with occasional locking; follow up to a positive O’Brien’s

A

Anterior slide test
Hand on hip, press sup and ant on hummers, pt hold

Popping, cracking, crepitus and pain at the ant/sup shoulder indicates superior or anterior glenoid labrum tear

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7
Q

Acute anterior knee instability

A

Lachman test
Knee 30 deg/pull tibia away from femur

Gapping with tibia moving away from femur indicates ACL or posterior oblique ligament instability

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8
Q

Heel pain radiating to big toe

A

Test for plantar fascitis
Dorsiflex ankle/big toe/palpate med long arch

Sharp pain along the medial longitudinal arch indicates plantar fascitis

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9
Q

Lateral hip and thigh pain

A

Modified ober test
Involved side up/flex bottom leg/stabilize sacrum/ext top leg and hip back/lower leg

Hip and lateral thigh remains in abduction and pt has thigh pain indicates TFL contracture/ITB syndrome

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10
Q

Lateral elbow pain

A

Cozens test
Wrist extension

Pain over the lateral epicondyle indicates lateral epicondylitis

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11
Q

Labrum injury - ant shoulder pain (deep or superficial)

A

O’Brien’s
Arm straight out/thumb down/cross chest 10 deg/I press down/repeat with supination

Deep anterior pain indicates labrum tear
Superficial pain indicates AC joint problem

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12
Q

High ankle injury - difficulty weight bearing

A

Distal tib/fib squeeze - squeeze 5 seconds

Pain reproduced while squeezing or worse upon release indicates high ankle sprain of tibio femoral lig and/or interosseous syndesmosis

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13
Q

Supraspinatus weakness

A

Empty can test
Arm emptying can ABD 90/bring forward 40 deg/I push down and in

Resistance to pressure stresses supraspinatus muscle and tendon insertion indicates tear or rupture to supraspinatus muscle or tendon with possible suprascapular neuropathy

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14
Q

Gluteal insufficiency; 3-9 yo with limp/adductor lurch

A

Trendelenbergs
Stand on one ft/observe iliac crests

High iliac crest on supported side indicates weak gluteus medius muscle/LCP/SCFE based on age

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15
Q

Infraspinatus/teres minor weakness; protector muscle responsible for facilitating posterior rotation

A

Patte hornblower test
90/90 straight out/abd 15 deg/grab back of arm with my arm/pt pushes back

Pain or inability to ext rotate against resistance indicates infraspinatus or teres minor tendinopathy

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16
Q

Medial elbow pain

A

Reverse mills test
Elbow ext/supinated/I extend wrist passively

Reproduction of pain in medial elbow indicates medial epicondylitis/golfers elbow

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17
Q

Can’t jog because of lateral knee pain

A

Noble test
Ft on table to 60 deg/press lat femoral condyle/extend knee fully while maintaining pressure

Worse pain through 30-40 deg flexion/extension indicates ITB syndrome or lateral knee impingement syndrome

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18
Q

Clicking sensation in biceps tendon

A

Abbott saunders
Full ABD/ext rot and bring down/maintain biceps tendon contact

Palpable or audible click in bicipital groove indicates subluxation or dislocation of biceps tendon; rupture of transverse ligament or tendon subluxation beneath the subscapularis muscle belly

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19
Q

Anterior arm pain with weakness

A

Maximum elbow flexion
Pt puts elbows into max flex for 3 min

Reproduction of parasthesia into ulnar nerve distribution with possible weakness on handshake indicates cubital tunnel syndrome

20
Q

Instability of biceps tendon

A

Yergasons
Inf traction/resist hitchhiker thumb out

Local pain and/or tenderness at the bicipital groove indicates tendinitis

Audible click or biceps tendon subluxates or dislocates indicates instability of biceps tendon possibly assocaited with a torn transverse humeral ligament

21
Q

Heel pain while walking

A

Fat pad squeeze
Press heel/squeeze heel and press into it/prone

Pain diminishes during procedure or feels less tender indicates fat pad sydnrome

Same or worse pain indicates plantar fascitis, heel spur, calcaneal stress fx

22
Q

Painful giving way of knee

A

Apley compression
Straight down/int rot down/ext rot down

Patient points to pain.
Pain on the medial side indicates medial meniscus tear
Pain on the lateral side indicates lateral meniscus tear

23
Q

Differentiate between labrum and AC

Labrum injury
Anterior shoulder pain (deep or superficial)

A

O’bRiens
Arm straight out/thumb down/cross chest 10 deg/I press down/repeat with supination

Deep anterior pain indicates labrum tear

Superficial pain indicates AC joint problem

24
Q

Decreased ROM and stiffness in shoulder

A

Mazion shoulder maneuver
Dugas then reverse dugas

Inability to actively raise the elbow to teh forehead due to pain and/or stiffness indicates early stage adhesive capsulitis or non inflammatory capsular adhesions

25
Q

Knee pain on prolonged sitting (cinema sign)

A

Patella femoral grinding test (clarke sign)
Web knee and ask for quads contraction

Retropatellar pain and inability to hold quad contraction indicates degenerative changes of patellar facets and/or within trochlear groove; chondromalacia patella

26
Q

Hip pain (SI joint) and low back pain distinguish

A

Belt test
Bend forward/brace scarum/bend forward

Low back pain with both positions indicates lumbar

No pain when stablized indicates pelvic involvement

27
Q

Instability and slipping out sensation of shoulder/clunking

A

Sulcus sign
With load and shift
Elbow to 90/grab wrist/press forearm with other hand

Sulcus will appear anterolateral at this motion attempts to dislocate indicates inferior shoulder instability and possibly inf dislocation

  1. +1 = <1 cm
  2. +2 = 1-2 cm
  3. +3 = >3 cm
28
Q

Painful giving way of knee supine

A

Mcmurray sign
90/90/ext rot/flex knee all the way up/extend with valgus stress/repeat with in and varus stress

Clicking sound or pain by the knee joint indicates medial meniscus tear with external rotation or lateral meniscus tear with internal rotation

29
Q

Clumsiness and weakness when gripping pen to write

A

Fromet paper alternate
Hold paper between thumb and first finger straight

Patient flexes thumb thereby recruiting median nerve to compensate for apparent weakness indicates weakness or palsy of adductor pollicis muscle/ulnar nerve/will have wasting of dorsal thumb web

30
Q

Stress fx of hip

A

Anvil test
Slightly elevate ft/strike calcaneus

Local pain in long bone or hip joint indicates possible fx of long bone or hip joint pathology

31
Q

Weakness on power grip

A

Maximum elbow flexion
Pt puts elbows into max flex for 3 min

Reproduction of parasthesia into ulnar nerve distribution with possible weakness on handshake indicates cubital tunnel syndrome

32
Q

Sharp anterior shoulder pain only when working overhead

A

Anterior slide test
Hand on hip, press sup and ant on humerus, pt hold

Pop/crack/crepitus and pain at ant/sup shoulder indicates superior or anterior glenoid labrum tear

33
Q

Anterior instability of the shoulder

A

Anterior apprehension with relocation test
A look of pain or apprehension with test; press heel of hand into shoulder

Pt senses relief upon relocation confirms anterior instability of GH joint and rules out tendinitis

34
Q

Bursitis in the shoulder

A

Dawbarn test
Deep palpation with pain; hold palpation and ABD past 90 deg

Decrease in pain/tenderness indicates subacromial bursitis

35
Q

Determine anterior or posterior shoulder impingement

A

Hawkin kennedy test
90/90 forward; passive int rotation

Local pian indicates supraspinatus tendinitis
Anterior pain indicates anterior impingement
Posterior pain implicates stretch of teres minor and infraspinatus tendons which indicates posterior impingement

36
Q

Swelling and difficulty weight bearing due to recent knee injury

A

Bounce home test
Flex knee, grab heel, slowly fully extend

Knee remains in slight flexion indicates diffuse swelling of the knee possibly due to torn meniscus

37
Q

Leg length discrepancy

A

True - ASIS to medial malleolus then to opposite

Different measurements indicate bony abnormality above or below trochanter; anatomical short leg

Apparent - umbilicus to medial malleolus to both legs

Different measurements indicates tilted pelvis

38
Q

Juvenile genu valgus

A

Craig’s test for anteversion
Pron/knee 90/int rot hip until trochanter comes to table

Pain when int rot > 30 degrees indicates structural anteversion

39
Q

Transverse patellar fx

A

Dryer’s test
Supine SLR pain grab thigh/SLR/no pain

Indicates patellar fracture

40
Q

Rule out OCD

A

Wilson’s test
90/90/int rot/extend knee

Pain indicates medial femoral condyle

90/90/ext rot/extend knee

Pain indicates lateral femoral condyle

41
Q

Subscapularis weakness can’t tuck shirt in

A

Lift off test
Place back of hand on small of back/attempt to lift

Inability to perform test indicates subscapularis tendinopathy

42
Q

Anterior impingment of shoulder

A

Neer test
Passive forward flexion

Pain at the end of ROM indicates impingement with overuse injury of supraspinatus muscle or biceps tendon

43
Q

Differentiate between SI and hip joint

A

Hibbs
90/butt/out

Pain in hip indicates hip joint pathology

Pain in buttocks or pelvis indicates SI joint lesion

44
Q

Differentiate between impingement and AC joint

A

Painful arc test
Palm down/actively abduct

Pain worse between 70-110 indicates impingement with supraspinatus involvement

Pain worse at 160+ indicates joint involvement

45
Q

Evaluate for functional pronation

A

Navicular drop test
Measure from navicular tubercle to ground non weight bearing then stand and remeasure

Navicular drops more than 5/8” or 1.6cm indicates functional pronation

Extremity Clet (7 decks)

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