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year 3 OSCE > MSK hip, knees and feet > Flashcards

MSK hip, knees and feet Flashcards

1
Q

In what position do you assess the patient for hip examination?

A

Both standing and sitting down

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2
Q

What are you looking for when patient is standing in hip examination?

A

Muscle atrophy and bulking

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3
Q

What are you looking for when patient is lying in hip examination?

A

Flexion deformity
One leg longer than other (measure)
scars

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4
Q

What bony landmark are you measuring from for the length of the leg?

A

ASIS to medial malleolus

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5
Q

What bony landmark are you feeling for in hip examination?

A

Greater tronchanter and surrounding muscles

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6
Q

What movements do you do in hip examination?

A

flexion
Internal and external rotation
Thomas test
Trendelenburg’s test

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7
Q

What is Thomas test looking for?

A

A fixed flexed deformity

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8
Q

What is Trendelenburg’s test looking for?

A

Proximal gluteal muscle strength

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9
Q

If their is positive tranderlengurgs test what does that indicate?

A

Weak hip abductor muscle to the contralateral side of the pelvis

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10
Q

In function what are you assessing for in hip examination?

A

Gait

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11
Q

What two gaits are you looking for in function part of hip examination?

A

Antalgic (painful) gait and trandelengurg’s (waddle) gait

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12
Q

What are you looking for anterior when the patient is standing in knee examination?

A 
Scars
Rash --> psoriasis 
Effusion
Quadriceps wasting
valgus and varus deformity 
Asymetery
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13
Q

What are you looking for side on when the patient is standing in knee examination?

A

Fixed flexion deformity

Swelling in the popliteal area

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14
Q

What are you looking for posteriorly on when the patient is standing in knee examination?

A 
Scars
Rash --> psoriasis 
Effusion
Quadriceps wasting
valgus and varus deformity 
Asymetery
Popliteal swelling
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15
Q

What is

a) valgus
b) varus deformity?

A

a) knocked knee

b) bowed leg

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16
Q

When the patient is lying down what are you feeling for

A 
Temperature 
Alignment of the knee for any tenderness and swelling
Popliteal swelling 
Patella tap 
Cross fluctuation
17
Q

What are you investigating in patella tap?

A

effusion

18
Q

If the patella tap is negative what other assessment do you do?

A

cross fluctuation test

19
Q

What landmarks are you palpating when you feel around the knee?

A

Femoral condyle
Inferior pole of the patella
Inferior patella tendon
Tibial tuberosity

20
Q

What movements do you assess in knee examination?

A

flexion and extension

21
Q

What are the special test?

A

Anterior and posterior draw test

Medial and lateral collateral ligament test

22
Q

What is the anterior and posterior draw test examination?

A

Anterior and posterior crucial ligaments respectively

23
Q

What does a positive anterior or posterior draw test indicate?

A

Anterior or posterior cruciate damage/laxity

24
Q

What are you looking for at the feet when the patient is lying down?

A 
Nail changes
Rash
Swelling
Toe alignment --> halux valgus
Skin changes
Plantar aspect for callus formation
25
Q

What are you looking for at the feet when the patient is lying down?

a) anterior
b) posteriorly

A

a) weight bearing, arch of the foot, toe clawing

b) valgus or varus of the subtalar joint and Achilles tendon

26
Q

How do you assess the arch of the foot?

A

Ask the patient to go on tip toes and the downwards arch will disappear

27
Q

What do you feel in foot and ankle assessment?

A

Temperature
Peripheral pulses
Achilles tendon
The joints in the foot and ankle

28
Q

What are the joints in the foot and ankle that you feel?

A 
Gentally squeeze the MTP joints for pain
Taral joints
Ankle joint
Subtalar joint
Medial and lateral malleolus 
Proximal fibula
29
Q

What movements do you do actively and passively in the foot examination?

A

Foot dosiflexion, plantar flexion, inversion and eversion

Toe dorsiflexion, plantar flexion, abduction and adduction

30
Q

What extra joint do you move in passive movement in ankle?

A

Midtarsal joint movement

31
Q

What do you look for in gait in foot and ankle examination?

A

Heal lift, stance, toe off and full cycle

32
Q

What is the Ottowa Ankle Rule for acute kidney injury?

A

Palpate and ask if they have pain in the navicular, base of 5th metarsal and posterior aspect of the laterl/medial malleolus

year 3 OSCE (14 decks)

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