Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NYCC Patient Assessment 1 > Malingering and hip LE tests > Flashcards

Malingering and hip LE tests Flashcards

1
Q

What is malingering?

A

Faking a complaint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do you do if your findings and their complaints don’t match (malingering)?

A

Refer out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How should a case be recorded if you suspect malingering?

A

Might be a psychogenic or emotional component to their complaint
The patient findings do not correlate with my clinical expectation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are reasons or indications for malingering?

A

History or exam correlation
Pain drawings
Personal gain (worker’s comp)
Emotional needs
Patient says and writes two different things

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What orthopedic tests are used for malingering?

A

Hoover’s test
Plantar flexion test
Axial loading test
Petryn flip test
Magnuson’s test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is a Hoover’s test performed?

A

With the patient supine, the examiner raises the heel and asks the patient to lift the affected leg. Downward pressure should be felt on the unaffected side as the patient attempts to lift the symptomatic leg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a positive finding for Hoover’s test?

A

ABSENCE of downward pressure on the UNAFFECTED side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is indicated by a positive finding for Hoover’s test?

A

Malingering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If a Hoover’s test is performed and a patient cannot lift their right leg which they claim is hurting. You note no pressure on the other leg, how is this recorded and what is indicated?

A

Positive Hoover’s test indicating malingering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a Hoover’s test used for?

A

Malingering for a patient indicating lower limb weakness or paralysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is a Plantar Flexion test performed?

A

Doctor performs a straight leg raise to the point of pain, lowers it, then PLANTAR FLEXES the foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a positive finding for a Plantar Flexion test?

A

Complaint of exacerbation of sciatic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is indicated by a positive finding for a Plantar Flexion test?

A

Malingering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a Plantar Flexion test used for?

A

Malingering in a patient reporting sciatic-like pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is an axial loading test performed?

A

Patient standing, the examiner applies approximately 2 pounds of axial pressure to the top of the head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a positive result for an axial loading test?

A

Report of exacerbation of low back or leg pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is indicated by a positive result for an axial loading test?

A

Malingering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is an Axial Loading Test used for?

A

Malingering in a patient reporting low back or sciatic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is Petryn’s Flip Test performed?

A

Doctor performs passive knee extension on the affected leg without prior warning to the patient. Best performed incidental to other exam procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a positive result for Petryn’s Flip Test?

A

NO exacerbation of leg pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is indicated by a positive result for Petryn’s Flip Test?

A

Malingering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When is a Petryn’s Flip Test performed?

A

Malingering in a patient reporting sciatic-like pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What LE orthopedic tests are used for malingering in a patient complaining of sciatic pain?

A

Plantar Flexion Test
Axial Loading Test
Petryn Flip Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How is Magnuson’s test performed?

A

The patient is questioned regarding the site of pain. Then other examination procedures are introduced by way of distraction. The patient is requested to point to the area of pain again.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is a positive finding for Magnuson’s test?

A

Inconsistency in localizing the same site of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is indicated by a positive finding for Magnuson’s test?

A

Malingering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How can a patient with a hip condition present to your office?

A

Gait abnormality
Pain standing or sitting
Foot flare or internal rotation
Clicking in hip
Knee, SI, foot, ankle, or spine symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What can be used to measure leg length insufficiency?

A

Radiograph
Tape measure
Muscle tests
Allis/Galeazzi’s test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are possible signs that may indicate a leg length deficiency or insufficiency?

A

Unequal shoulder or pelvis height
PI ilium (SI extension restriction) on side of long leg
Knee or shoulder issues without trauma
Adjustments that do not hold
Difficult to adjust

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What three areas can a snapping hip syndrome occur?

A

Psoas major
Labrum
IT band

31
Q

A patient with a prone long leg will likely have a ____________ ilium or an SI ______________ restriction on the longer side?

A

PI, Extension

32
Q

An actual leg length check is more accurate than an apparent leg length check (TRUE/FALSE)?

A

t

33
Q

What is Allis/Galeazzi’s sign?

A

Patient is supine, knees flexed and the HEELS EVEN on the examining table. Doctor observes from the inferior and bilaterally for evidence of asymmetry in the tibia or femur length AFTER the patient has been adjusted

34
Q

What is a present finding for Allis/Galeazzi’s sign?

A

Knee height and tibial length differences for determination of congenital hip dislocation, tibial, or femoral shortening

35
Q

When is an Allis/Galeazzi’s sign performed?

A

After the patient has been adjusted

36
Q

What is indicated by a present Allis/Galeazzi’s sign?

A

Anatomical leg length deficiency

37
Q

When performing an Allis/Galeazzi’s sign where does the doctor stand to observe tibial inequality?

A

Anterior

38
Q

When performing an Allis/Galeazzi’s sign where does the doctor stand to observe femoral inequality?

A

Lateral

39
Q

What is an actual leg length measurement?

A

ASIS to the medial malleolus

40
Q

What is an apparent leg length measurement?

A

Umbilicus to the medial malleolus

41
Q

What is a significant finding for an apparent or actual leg length measurement?

A

Greater than 3 mm difference between right and left leg

42
Q

What muscle is the primary hip flexor?

A

Iliopsoas

43
Q

What muscle is responsible for lumbar lordosis?

A

Iliopsoas

44
Q

What orthopedic test can differentiate between a tight two joint hip flexor or tight iliopsoas muscle?

A

Thomas Test

45
Q

How is a Thomas Test performed?

A

Patient is instructed to sit close to the edge of the table. Patient flexes and holds one knee towards their chest. Then the patient is assisted into supine position while holding their knee until the low back is flat on the table.

To differentiate between RF or TFL vs Iliopsoas tightness, perform passive extension of the knee which puts slack into the 2-joint hip flexors without affected the psoas

46
Q

What is a positive finding for a Thomas Test?

A

Hip flexion, which brings the thigh off of the examining table

47
Q

What is indicated by a positive finding for a Thomas Test?

A

Contracture of the hip flexors (RF, TFL)
If thigh approximates table with passive knee extension the shortness is in the TFL or RF
IF not, there is a short psoas

48
Q

If a Thomas Test is performed and the patients thigh approximates the table with passive knee extension, how is this recorded and what is indicated?

A

Positive Thomas Test indicating a tight TFL/ITB or RF

49
Q

If a Thomas Test is performed and the patients thigh does NOT approximate the table with passive knee extension, how is this recorded and what is indicated?

A

Positive Thomas Test indicating a tight iliopsoas

50
Q

What are other names for Patrick’s test?

A

Fabere or sign of four

51
Q

How is a Patricks/Fabere/Sign of Four Test preformed?

A

Patients hip is flexed, abducted, and externally rotated so that the ankle of the side being tested is crossed superior to the opposite knee (Have patient make a four with their legs).
Doctor may apply pressure to the femur downward toward the floor while stabilizing the opposite ASIS

52
Q

What is a positive finding for a Patricks/Fabere/Sign of Four Test?

A

Inability to perform motions or report of pain at the femoroacetabular joint

53
Q

What is indicated by a positive finding for a Patricks/Fabere/Sign of Four Test?

A

Femoracetabular joint lesion

54
Q

What orthopedic tests are specific to indicating a femoroacetabular joint lesion?

A

Patricks/Fabere/Sign of Four Test
Laguerre’s Test

55
Q

How is Laguerre’s Test performed?

A

Performed as per Patricks but with the hip flexed to 90 degrees and overpressure on the knee to increase external rotation of the hip performed in multiple degrees of hip flexion

56
Q

What is a positive finding for Laguerre’s Test?

A

Report of pain at the FA joint

57
Q

What is indicated by a positive finding for Laguerre’s Test?

A

Femoroacetabular joint lesion

58
Q

What are the origin and attachment site for the TFL?

A

Iliocristalis tubercle to Gerdy’s tubercle

59
Q

How is Ober’s Test performed?

A

With the patient in side-lying position and the femur lined up along the mid axillary line, the doctor holds the ilium down firmly with one hand and grasps the flexed knee with the other.
Doctor moves the upper leg into flexion, then abducts and extends the hip back to a neutral position in mid axillary line. Lower the leg slowly toward the table while supporting the medial knee

60
Q

What is a positive finding for Ober’s test?

A

Inability to ADduct the hip back to its neutral position

61
Q

What is indicated by a positive finding for Ober’s test?

A

IT band contracture

62
Q

What orthopedic test is used to determine a tight iliotibial band?

A

Ober’s Test

63
Q

How is Trendelenberg’s test performed?

A

With patient standing and examiner behind the patient, instruct the patient to flex one knee up toward the chest

64
Q

What is a positive finding for Trendelenberg’s test?

A

Observe the gluteal fold on the flexed side for downward deviation as well as lateral translation of the weight bearing hip

65
Q

What is indicated by a positive finding for Trendelenberg’s test?

A

Weakness of gluteus medius or minimus on standing leg side

66
Q

What orthopedic test can determine weakness of the gluteus medius and minimus?

A

Trendelenberg’s test

67
Q

What is the action of gluteus medius and minimus?

A

Abduction and medial rotation of the hip

68
Q

What gaits are associated with gluteus medius pathology?

A

Trendelenberg gait
Gluteus medius lurch

69
Q

Hibb’s test can be done for what complaints?

A

Hip and SI

70
Q

A patient has a dim feeling of numbness overt their vastus medialis. What peripheral nerve is likely affected and what gait may they present with?

A

Obturator nerve; possible circumduction gait due to weakness of ADductors

71
Q

What nerve root should be considered if a patient has trouble lifting their toes?

A

L5

72
Q

What LE orthopedic test is a differential diagnosis test with the patient supine?

A

Goldthwaite

73
Q

What LE orthopedic test(s) is/are a differential diagnosis test with the patient standing?

A

Belt test/Supported Adams/Supported Bending Forward

74
Q

What LE orthopedic test(s) is/are a differential diagnosis test with the patient prone?

A

Nachlas and Ely’s Heel to Buttock Test

NYCC Patient Assessment 1 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions