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PD Block 3 > Lower extremities > Flashcards

Lower extremities Flashcards

1
Q

Thompson or simmonds test

A

Pt lies face down, feet hanging off end of bed. Squeeze calf (tendon). If there is no movement (should be plantar flexion), it is positive for an achilles tendon rupture

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2
Q

Patellar ballottement test

A

Tests for joint effusion. Have pt extend knee, relax quad, and push down gently on the patella. If large amount of fluid the patella will rebound quickly

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3
Q

Anterior drawer sign knee

A

Tests the integrity of the ACL. Pt lies supine, knees flexed 90 degrees. Cup hands around knee, push on hamstring insertion points and pull the tibia towards you. If the tibia slides forward, it is most likely an ACL tear.

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4
Q

Homan sign

A

Have pt dorsiflex their foot. If they have severe pain, it may be indicative of a DVT

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5
Q

Ortolani

A

Tests for anterior hip dislocation in newborns (congenital). Hip is flexed, externally rotated, and abducted.

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6
Q

Patellar bulge sign

A

Tests the knee joint for minor effusions. Milk the fluid from the supra patellar pouch and lateral side into medial side. Fluid will refill on lateral or medial side depending on which way the milking occurred

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7
Q

Apprehension test

A

Test to see if patella is prone to lateral dislocation. Attempt to dislocate by pushing from medial to lateral. Look and see if patients face is apprehensive (may mean the patella is about to dislocate)

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8
Q

McMurray test

A

Test for posterior meniscus tears. Pt lies supine, legs flat.. Hold heel, flex leg, place other hand on knee joint, fingers medially and laterally. Rotate the leg internal and externally push on lateral side while rotating. If the pt has a posterior meniscus tear you will hear a “click”

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9
Q

Posterior drawer

A

Tests the integrity of PCL. Same position as anterior drawn, just push away on tibia. If tibia moves backward under the femur, it may be a torn PCL

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10
Q

Barlow test

A

Test used to see if the hip can be pushed easily out of its socket posteriorly. Done on newborns with congenital hip dislocation (opposite test of ortolani)

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11
Q

True leg length

A

Testing true leg length discrepancy . Measure from bone to bone (ASIS to medial malleolus) and compare legs.

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12
Q

Apparent leg length

A

Testing for no leg length discrepancy. The look of different length may be due to pelvic obliquity from hip or spinal issues. Measure from umbilicus to medial malleolus. If distances are unequal it is an apparent leg length discrepancy.

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13
Q

Apley compression or grinding test

A

Apley test is used to asses for meniscus tears. Pt should lie prone, with leg bent at 90 degrees. Clinician pushes down on heal to compress medial/lateral menisci. Rotate the tibia internally/externally. If painful, most likely a meniscal tear.

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14
Q

Apley distraction test

A

Determines if it is meniscal or ligament problems. Start with apley compression, then stabilize thigh by placing knee on pt, then pull up on the foot and rotate internally/externally. If it is ligament damage, the pt will complain of pain. If meniscus tear, test will not be painful.

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15
Q

Patellofemoral grinding test

A

Tests for quality of articular surfaces of patella and trochlear groove of femur. Pt supine, push patella towards feet (into trochlear groove), then have pt flex quad and keep resistance on the patella. The movement should be smooth. If any problem, there will be crepitus and is often associated with climbing stairs or standing up.

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16
Q

Varus stress

A

Tests the LCL stability. Press laterally against the knee, while pushing medially on the ankle.

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17
Q

Valgus stress

A

Tests the MCL stability. Press medially against the knee, while also pushing laterally on ankle. This will open the medial aspect of the knee if there is an MCL tear. This is the more common than tearing the LCL

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18
Q

Quad muscle names

A

Vastus lateralis/medialis

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19
Q

Where does patellar ligament attach

A

Inferior border of the patella, to the anterior portion of tibia (tibial tuberosity)

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20
Q

Hamstring muscle name

A

Biceps femoris

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21
Q

Bursae of patella (4)

A
  1. suprapatellar
  2. Superficial/deep infrapatellar
  3. pes anserine
  4. superficial prepatellar
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22
Q

4 ROM for the knee

A
  1. Flexion
  2. Extension
  3. Internal rotation
  4. external rotation
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23
Q

Flexion ROM for knee

A

135

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24
Q

Extension ROM knee

A

0

25
Q

Hyperextension ROM

A

10

26
Q

6 ROM for the hip

A
  1. Flexion
  2. extension
  3. Abduction
  4. Adduction
  5. Internal
  6. External
27
Q

Flexion ROM hip

A

115

28
Q

Extension ROM hip

A

0

29
Q

Hyperextension ROM hip

A

30

30
Q

Adduction ROM hip

A

30

31
Q

Abduction ROM hip

A

50

32
Q

Internal ROM hip

A

30

33
Q

External ROM hip

A

50

34
Q

4 ROM for ankle

A
  1. Plantar flexion
  2. Dorsiflexion
  3. Inversion
  4. Eversion
35
Q

2 ROM for teos

A
  1. Flexion

2. Extension

36
Q

Plantar flexion ROM

A

50

37
Q

Dorsiflexion ROM

A

20

38
Q

Inversion ROM

A

30

39
Q

Eversion ROM

A

20

40
Q

Flexion ROM toes

A

30

41
Q

Extension ROM toes

A

0

42
Q

Hyperextension ROM toes

A

50

43
Q

What is the DTR of the leg

A

Patellar reflex - L4

44
Q

Dermatome L4 supplies what area of leg

A

Anterior thigh, dips down at knee, and continues down along medial side of leg to foot

45
Q

Dermatome L3 supplies what area of leg

A

Spans the anterior, mid thigh, above the knee, wraps medially to about the calf

46
Q

Dermatome L2 supplies what area of the leg

A

Spans across, upper, mid thigh.

47
Q

Dermatome L1 supplies what area of the leg

A

Spans across inguinal area

48
Q

Dermatome L5 supplies what area

A

Around outer portion of buttocks and down the sides of legs where it wraps anterior at the calf and supplies sensation to most of the foot

49
Q

What is the DTR of the ankle

A

Achilles tendon reflex - S1 predominantly

50
Q

Dermatome S1 supplies what area

A

Middle portion of buttocks, down hamstring all the way to the foot. Innervates the lateral portion of the foot (pinky)

51
Q

Genu Varum

A

Bowlegged

52
Q

Genu Valgum

A

Knock knees

53
Q

Hammer toe

A

Metatarsophalangeal joint/DIP are hyperextended, while PIP joint is flexed. Usually due to tight shoes. Distal part of toe goes out (different than claw toes)

54
Q

Pes planus

A

“Flat feet” (no arch) Talar head displaces medially, stretches the spring ligament and the tibias posterior, resulting in loss of medial arch

55
Q

Genu recurvatum

A

Back kneed (aka hyperextension)

56
Q

Hallux valgus

A

Lateral deviation of great toe (bunion) - toes points out towards pinky

57
Q

Claw toe

A

Hyperextension of the metatarsophalangeal joints and FLEXION of PIP and DIP joints (different than hammer toe)

58
Q

Pes Cavus

A

Abnormally high arch

59
Q

Morton neuroma

A

Inflamed and painful nerve between the 3rd and 4th metatarsal heads.

PD Block 3 (10 decks)

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