Lower Extremity Flashcards by Terrianna Emerson

questions to ask during history

are there any associated activities that cause pain?
is there. reduced range of motion?
what was the onset?
muscle weakness?
any joint redness or swelling?
numbness or tingling?

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cancer red flags

age over 50 
history of cancer 
weight loss 
unrelenting night pain 
failure to improve

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fracture red flag

age over 50
trauma
steroid use
osteoporosis

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infection red flags

IVDU 
steroid use 
fever/ chills 
temp over 100.4 F 
failure to improve

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cauda equina syndrome red flags

saddle anesthesia
bowel bladder dysfunction
loss of sphincter control
major motor weakness

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cauda equina syndrome

bilateral lower extremity radiating pain
bilateral lower extremity weakness
saddle anesthesia
sphincter dysfunction in the bowel and bladder dysfunction

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physical exam supine test

inspect hip and legs
palpate
Hip ROM
knee ROM

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practical exam palpation

popliteal fossa for pulse and cyst 
calf and achilles tendon 
ankle and foot while checking for edema 
posterior tibial pulse 
dorsalis pedis pulse

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Hip ROM

supine:
active hip flexion
passive abduction, adduction , internal ad external rotation

seated:
resisted hip flexion

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Knee ROM

supine:
passive knee flexion and extension

seated:
resisted knee flexion and extension

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physical exam seated test

resisted hip flexion
resisted knee flexion and extension
Ankle ROM

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Ankle ROM

seated:
ankle active dorsiflexion, plantar flexion, inversion & eversion
toe dorsiflexion, plantar flexion

resisted ankle dorsiflexion, plantar flexion

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physical exam standing

back to you 
inspect spinal curvature 
and ROM 
active flexion 
and active but supported extension lateral bending

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patient returns to seating for what ROM test

lateral rotation

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lower extremity arterial supply

abdominal aorta 
external iliac artery 
femoral artery
popliteal artery 
posterior tibial artery 
medial and lateral plantar artery 
dorsalis pedis artery

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normal spine curvatures

cervical lordosis
thoracic kyphosis
lumbar lordosis
sacrococcygeal kyphosis

lordosis

inward, concave

kyphosis

outward, convex

spine examination inspection

back towards you
note posture with feet together and hands at side
-is head erect
-are shoulders and pelvis level?
inspect from the sides evaluating spinal curvatures concavity in cervical and lumbar regions
convexity in thoracic and sactococcygeal regions

pediatric thoracic kyphosis

congenital

developmental thoracic kyphosis

adolescent

postural thoracic kyphosis

adolescent adult

degenerative thoracic kyphosis

adult, older

congenital alterations

failure of segmentation

failure of formation

what is scheuermann's disease

more vertebrae curvature with wedged shaped vertebrae (normally rectangle)

levoscoliosis

C shaped curvature to the left

Dectroscoliosis

c shaped curvature to the right

which curve pattern of the thoracic spine is more common

curvature to the right 85 to 90% of the time patients will have right thoracic curative

curve patterns deformities are due to

combination of lateral curvature and trunk rotation

what is the scoliometer threshold

7 to 10°indicates the need for radiographs | knees should be straight during reading

during what ROMs should you stabilize the patient

spine extension lateral bending rotation

what is lumbar radiculopathy

dysfunction or irritation of a particular nerve root

lumbar radiculopathy | symptoms

pain sensory impairment weakness diminished deep tendon reflexes

how do we determine nerve root in lumbar radiculopathy

look at the distributions

is sciatica radiculopathy

no, it is not equivalent

why would you see a falsely apparent leg length discrepancy

there may be “shortening” on the concave side as a result of Dextroscoliosis Levoscoliosis

Sciatica

Pain, numbness, or tingling in the leg | caused by injury to/ pressure/ compression on nerve

nerves involved in sciatica

L3-L5 or S1-S3 | or the sciatic nerve itself

sciatica red flag

weakness