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Ortho > Midterm > Flashcards

Midterm Flashcards

1
Q

Isometric motor test for elbow flexion (biceps) tests

A

C6

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2
Q

Isometric motor test for finger ab/adduction tests

A

T1

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3
Q

Isometric motor test for finger extension tests

A

C7

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4
Q

Isometric motor test for finger flexion tests

A

C8

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5
Q

Isometric motor test for shoulder abduction (deltoid) tests

A

C5

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6
Q

Isometric motor test for wrist extension tests

A

C6

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7
Q

Isometric motor test for wrist flexion tests

A

C7

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8
Q

Isometric motor test for elbow extension (triceps) tests

A

C7

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9
Q

Pain scale

A

+1/4: tenderness with no physical response
+2/4: tenderness with grimace/flinch
+3/4: tenderness with withdrawal (+ “jump sign”)
+4/4: withdrawal to sup palpation or gentle percussion

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10
Q

Motor testing grading scale

A

5/5 muscle completes ROM against gravity with full resistance
4/5 muscle completes ROM against gravity with some resistance
3/5 muscle completes ROM against gravity but wo resistance
2/5 muscle completes ROM with gravity eliminated
1/5 slight contractility, no jt motion
0/5 no evidence of muscle contraction

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11
Q

Biceps reflex nerve root

A

C5

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12
Q

Brachioradialis reflex nerve root

A

C6

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13
Q

Triceps reflex nerve root

A

C7

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14
Q

Hypperreflexia, Babinksi is

A

Present (abnormal)

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15
Q

Cauda equine syndrome sxs

A

Saddle paresthesia, bladder incontinence/retention, bowel incontinence, reduced DTRs, lower extremity weakness, radicular sxs covering nerve roots

**emergent!

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16
Q

Most dominant movements at C0/C1 joint

A

Flexion, extension

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17
Q

Ligaments that stabilize C1/C2 joint

A

Transverse ligament, alar ligament

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18
Q

What grade DTR is normoreflexive?

A

2+

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19
Q

If pt experiences pain with active and resisted neck movements but not passive ones, which tissues types affected?

A

Tendon, muscle

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20
Q

Allodynia upon palpation= grade…

A

4/4

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21
Q

Compression of nerve roots causes

A

Hyporeflexia

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22
Q

These help elicit DTRs

A

Lengthen muscle being tested

Add Jendrassik maneuver

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23
Q

Grimace or wince upon palpation = grade…

A

2/4

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24
Q

What movement differentiates upper div of trapezius from lavatory scapulae?

A

Rotation

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25
Q

Which movement likely to injure vertebral artery by over stretching?

A

Rotation

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26
Q

Three origins of pain

A

Nociceptive
Peripheral sensitization
Central sensitization

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27
Q

What is the one active PE that is performed on all pts with NMS complaint
(No matter the region, MOA, severity)

A

Active ROM

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28
Q

What 3 motions, in combo, maximally stress the vertebrobasilar vascular complex?

A

Rotation, extension, lateral flexion

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29
Q

Rust’s sign

A

Not a sign! An observation: Pt holds their neck still as they move around the office. Suggests instability

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30
Q

Bakody’s sign

A

Hx finding. Indicates nerve root irritation if pt reports relief from peripheral sxs with arm overhead

31
Q

Positive valsalva maneuver…

A

Creates radicular sxs down the arm if the problem in the neck

32
Q

Positive cervical compression test

A

Creates radicular sxs

(Compressed cervical spine and increased axial load)

Indicates: cervical disc herniation, spinal stenosis, nerve root irritation

33
Q

Spurling’s test

A

Pt actively laterally flex, doc compresses cervical spine

Positive –> radicular sxs

34
Q

Maximal cervical/formaminal compression test

A

Rotation, extension, lateral flexion

Done all at once!!
If positive –> radicular sxs

35
Q

Cervical distraction test

A

Lift pts head superiorly

Positive if radicular sxs go away with maneuver (100% specific)
Positive if pain worsens with maneuver

36
Q

Shoulder depression test

A

Pt head in lateral flexion, push down on shoulde

Positive–> radicular sxs, pain in brachial plexus area

37
Q

Soto Hall test

A

Pt supine, practitioner hand on sternum, max flex the patient’s neck

Used to confirm suspicion of: vertebral fracture,joint/lig injury, cervicothoracic strain, facet syndrome, disc derangement

(Positive–> + Brudzinski sign, pain)

38
Q

Vertebrobasilar artery insufficiency

A

Insufficient blood flow through vertebral and basilar arteries to midbrain, cerebellum, cerebrum

39
Q

Dx cluster for cervical radiculopathy

A

+ULTT of median n
Active cervical rotation
+ Distraction
+Spurling’s

40
Q

Canadian C spine rules for X-rays: any positive of the following..

A 
Cognitive awareness or neuro sxs
65+ yrs
Fearful of moving head when asked
Substantial mechanism of injury and/or axial load injury
Midline palpatory pain
41
Q

Resisted ROM

A

Muscles contracting…

Gives no information about the joints

42
Q

Passive ROM

A

Gives information about the joints, some about ligaments.

43
Q

Is the upper limb tension test a thoracic outlet test?

A

No.

Tests sensitivity of the median n to stretching. May or may not have anything to do with TOS

44
Q

Is scoliosis always clinically relevant?

A

no! You can have “severe” scoliosis with no pain. Usu not relevant.

45
Q

What is the best way to detect vasculogenic TOS?

A

Specifically look at vasculature! (Cap refill, etc) Best way..

but do these name tests:
Adson’s, reverse adson’s, Eden’s, Roos’ test, Wright’s test

46
Q

Scoliosis

A

Lateral curvature of the spine. Idiopathic–probably genetic.

Name by side of convexity.

47
Q

TOS

A

Cluster of symptoms that can usu be better diagnosed. Dx of exclusion.

Most common= neurogenic

48
Q

TOS tests..

A

Poor validity, high false positive rate

Best tests for involvement of scalenes: Reverse Adson’s, Adson’s

49
Q

ULTT

A

Positive: pain along course of peripheral n

Suggests excessive nerve tension/impingement

50
Q

Adson’s test

A

Take a breath, rotate head towards arm

Positive:’pulse goes away, paresthesia

51
Q

Median n ULTT very sensitive for..

A

Cervical radiculitis

52
Q

Each rib attaches to thoracic vertebra at which articulations?

A

Costovertebral joint, transverse costal jt

53
Q

What movement most dominant at atlantoaxial joint (C1/C2)

A

Rotation

54
Q

Grade 1 sprain

A

25-50% of ligament’s fibers are torn

55
Q

Adhesive capsulitis/ frozen shoulder syndrome assoc w

A

Thyroid problems, diabetes

Shoulder injury/surgery, cervical disk dz, open heart surgery

56
Q

Capsular pattern of the shoulder

A

External rotation, abduction, flexion, internal rotation

57
Q

Bicipital tendonosis

A

Degenerative changes on histo

58
Q

Failure to perform Gerber Lift may indicate..

A

Weak or torn subscapularis

59
Q

Positive Neer’s test with shoulder in external rotation

A

Impingement of biceps brachii tendon

60
Q

Normal ROM for shoulder adduction

A

175-185

61
Q

Ligament attaches scapula to scapula

A

Coracoacromial

62
Q

Shoulder girdle comprises…

A

Glenohumeral joint, acromioclavicular jt, scapulothoracic jt, sternoclavicular jt

63
Q

Biceps brachii attaches to

A

Glenoid labrum

64
Q

Attachment and action of supraspinatus

A

Greater tuberosity of humerus; abduction of glenohumeral jt

65
Q

Codman drop arm test and Empty can test

A

Assess tear of supraspinatus

66
Q

Hypertonicity of which muscles can compress brachial plexus

A

Scalenes

67
Q

Olecranon Manubrium Percussion Test

A

Tap on olecranon process as listen to Manubrium, check for fracture (if different L vs R)

68
Q

Bicipital subluxation

A

Bicipital tendon slips out of groove when transverse ligament is lax or ruptured

Sxs:’pain in glenohumeral region, audible snap, swelling, ecchymosis

69
Q

Diagnostic cluster for subacromial impingement

A

+Hawkin-Kennedy
+ painful arc
+ infraspinatus

70
Q

Diagnostic cluster for acromioclavicular pathology

A

AC Cross body adduction + AC resisted extension test + AC compression test

71
Q

Most common injury for wrist and hand?

A

FOOSH, fall on outstretched hand

72
Q

What is pt position necessary for elbow fracture screen

A

Supine

73
Q

If you suspect elbow fracture, also X-ray/look at…

A

Wrist and hand

Ortho (2 decks)

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