Misc Trivia Flashcards
What is temporal arteritis?
inflammation of the temporal artery.
- within the differential for cervical pain or TMJ, as it can create headaches and/or jaw pain, as well as vision loss, fever, and fatigue
- would expect labs to be off (e.g., a high ESR)
What is Horner’s syndrome?
- interruption of the sympathetic nerves to the eye/face
- characterized by 4 things:
- drooping eyelid (ptosis)
- pupil constriction (miosis)
- lack of sweating on affected side of face (anhidrosis)
- sinking of eyeball into socket
What is a Bell’s palsy?
- facial muscle weakness unilaterally; looks like a drooping face on one side
- often follows a viral infection
- typically will resolve within 6 months
What are Well’s Criteria for DVT? (8, +1)
- active cancer
- immobility for 3 days or major surgery within the past 4 weeks
- calf swelling > 3cm compared to CL limb
- entire leg swollen
- localized tenderness along deep venous system
- pitting edema > in symptomatic leg
- paralysis, paresis, or recent plaster immobilization
- previously documented DVT
- alternative diagnosis to DVT is more likely (-2 to score)
Describe the standard presentation for ankylosing spondylitis.
- more likely in men, usually in early (<30, can be early adulthood ~17 or so as well)
- inflammatory disease, usually impacting the SIJ first, often involving the spine. Pain often begins at hips or low back
- spine begins to stiffen, often in flexion
- pain worsens with lack of movement, improved with movement. Worse in the mornings
- can often involve other joints, such as the ankles, knees, etc
- can see swelling in joints as well
What is the standard presentation for psoriatic arthritis?
Will there be morning stiffness?
- inflammatory arthritis associated with the skin condition of psoriasis (red skin topped by silvery scales)
- characterized by fluctuating joint pain/stiffness/swelling; morning stiffness
- may have nail bed changes
What is the standard presentation for a reactive arthritis?
- arthritis that is triggered by infection in another part of the body.
- typically involves the knees, ankles, or feet
- subtype is Reiter’s syndrome is characterized by discomfort with urination and eye inflammation
Differentiate between Ehler’s Danlo’s, Marfan’s, and Morquio.
Ehler’s Danlo’s - people are generally bendy, and bruise easily. Impacts connective tissue, primarily skin, joints, and blood vessel walls.
Marfan’s - people wispy; tall, thin, and twiggy. Impacts connective tissue, primarily heart, eyes, blood vessels, and bones. Long arms, legs, fingers.
Morquio - progressive pediatric disorder, usually becoming symptomatic between 1-3 yo. Kids look like dwarves
What is the CPR for T-spine manips for shoulder pain?
o Pain-free shoulder flexion < 127* o Shoulder internal rotation < 53* at 90* abduction o Neer’s test negative o Not taking meds for shoulder pain o Symptoms < 90 days
Phalen’s test screens for _____.
- carpal tunnel syndrome
Berger’s (Buerger’s) test screens for _______.
- arteriole insufficiency.
- seems more typical for the LE, but has been referenced for other areas as well
Bunnel Littler test screens for ______.
- PIP capsular restriction
- basically comparing muscle length insufficiency vs capsular restrictions when PIP ROM is restricted. Flex the PIP with the MCP extended vs flexed. If it’s the same, the restriction is likely due to capsular restriction
A Herbeden’s node is at the _____ while a Bouchard’s node is at the ______.
- Herbeden’s is at the DIP
- Bouchards is at the PIP
What are the two CPRs for success vs improvement with a core stabilization program?
Success
- positive prone instability test
- aberrant movement present (Gower’s, painful arc, catching, etc)
- age <40
- SLR >91*
Improvement
- negative prone instability test
- aberrant movements absent
- FABQ physical activity score > 9
- no lumbar hypermobility w/ prone spring testing
What’s the best way to differentiate between deep vs superficial peroneal nerve involvement?
- Deep does toe extensors and cutaneous sensation between digits 1-2; also TA
- Superficial is mainly cutaneous, but does the peroneals (evertors)
A painful shoulder arc between 120-160* is most concerning with involvement of what structure?
- AC joint
What structures run through the quadrilateral space in the shoulder?
- axillary nerve (delts, teres minor, I think something else) and posterior circumflex artery
What’s the difference between an Erb’s and Duchenne’s palsy? What are they?
- they’re the same thing
- waiter’s tip position, C5-6 injury
What Cobb angles are considered abnormal and appropriate for management via bracing? Via surgery?
- > than 20* is when bracing begins to be a consideration
- > than 40* is when surgery begins to be a consideration
Where is the relative position of the odd facet on the patella?
- medial
A Morton’s neuroma occurs where?
- on the foot.
- typically between the 3rd and 4th toes
What does Sinding Larsson Johannson syndrome look like?
- irritation under the patella tendon; avulsion fx of the inferior pole of the patella
What are normal/abnormal values for ABI?
- normal: 0.90-1.30
- moderate PAD: 0.40-0.90
- severe PAD: < 0.40
What is Sever’s disease?
- a traction apophysitis of the calcaneus posteriorly
- most commonly a pediatric condition
With McMurray’s test, if the tibia is externally rotated, which meniscus is being biased for provocation?
- medial meniscus
What is the directional relationship for upper cervical arthrokinematics in a neutral position for SB/rot?
- opposite
What is Bakody’s sign?
- alleviation of UE symptoms when placing hand on the top of the head; can be active or passive.
- indicative of C4-6 radiculopathy
What is Kemp’s test?
- test to rule in facet generated pain in the lumbar spine
- Pt can be seated or standing. Is “passively” directed into flexion, rotation, lateral flexion, and then extension.
- looking for pain and/or paresthesias in the lower back or LEs
- if pain is relatively local, more likely due to facet irritation, especially if above the knee. Otherwise greater potential for nerve irritation
What demographics are common with an anterior ankle impingement syndrome?
- football (soccer) players and dancers
What is thought to be the pathophysiology behind anterior ankle impingement syndrome?
- osteochondrosis of soft tissue/cartilage structures in the anterior ankle
- cause relative thickening/tightening of the anterior ankle tissue
- result of repetitive microtrauma
What movements/positions are likely to be irritating with anterior ankle impingement syndrome?
- end range plantarflexion or dorsiflexion
What is the inverted supination test? What is it used for?
o Used to identify cervical myelopathy/upper motor neuron signs
o Forearm in slight pronation
o Tap near the styloid px at the brachioradialis attachment
o Quick finger flexion is positive; essentially hyperreflexivity
What are the primary differences between a vascular vs neurogenic claudication in terms of:
- posture
- positional relief
- walking distance/symptom irritation
- pulses
- back pain
- LE pain
- inclines vs declines
Neurogenic claudication:
- alleviated with flexion, aggravated with extension
- alleviated with sitting (flexion)
- provoked with varied walking distances
- intact pulses
- back pain is common
- LE pain is often B
- worse on declines, better on inclines (ext vs flx)
Vascular claudication:
- unaffected by spinal position
- alleviated with rest, regardless of position
- provoked with consistent walking distances
- diminished pulses
- back pain uncommon
- LE pain variable
- incline vs decline more related to exertion; more likely aggravated with incline
