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CODO II > MSK Lower Extremity > Flashcards

MSK Lower Extremity Flashcards

1
Q

Joint evaluation steps

A

HIPROT

History 
Inspection 
Palpation 
Range of Motion 
O
T other tests ( muscle strength testing, deep tendon reflexes, sensory testing, special tests
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2
Q

What tests are included in “other tests” in MSK lower extremity

A

muscle strength testing, deep tendon reflexes, sensory testing, special tests

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3
Q

Crepitus

A

grinding feeling in a joint

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4
Q

importance of mechanism of injury

A

can lead you down a certain path of diagnosis

did it turn inward? outward? what happened?

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5
Q

MSK exam starts with ____

A

watching patient get up on table

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6
Q

Fasciculation

A

worming of the muscle

sign of deinervation

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7
Q

bruising is indicative of what

A

indicates you tore something (connective tissue, joint capsule, ligament, bone, etc)

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8
Q

Active range of motion

A

the patient does it

limited by pain, weakness, severing, impingement in the joint

if it is limited we should move to evaluating passive motion

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9
Q

What are we looking at in Muscle strength testing

A

note bulk and tone
compare bilaterally
test against resistance

look for atrophy and asymmetry

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10
Q

Muscle strength grading

0

A

no muscle contraction (eg: nerve severed)

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11
Q

Muscle Strength Grading

1

A

Muscle belly moves but can not move the limb

even without resistance and gravity

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12
Q

Muscle Strength Grading

2

A

Movement of the body part with gravity eliminated

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13
Q

Muscle Strength Grading

3

A

Movement against gravity but nothing more

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14
Q

Muscular Strength Grading

4

A

Decreased strength bit able to move against resistance

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15
Q

Muscular Strength Grading

5

A

Normal Tissue Strength

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16
Q

In muscle strength grading were do we see the largest decrease in strength

A

between 5 and 4

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17
Q

Reflex Response

+4

A

hyperactive with clonus (instead of firing once it keeps jerking)

indicative of disease

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18
Q

Reflex Response

+3

A

Brisker than average

may indicate disease - compare to the other side if the same its not pathologic

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19
Q

Reflex Response

+2

A

Average, Normal

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20
Q

Reflex Response

+1

A

Diminished, low normal

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21
Q

Reflex Response

0

A

No response

22
Q

Patellar Nerve level

A

L4

23
Q

Achilles Nerve level

A

S1

24
Q

What do we look at in Sensory Testing

A

General Screening
Compare bilaterlly
Compare proximal to distal
Dermatomes

25
Q

Sciatic nevre

A

L4-S3

Herniated disc
Radiculopathy

26
Q

Peroneal nerve

A

L5-S2

FIbular head/Foot drop

27
Q

Lateral Femoral Cutaneous Nerve

A

L2-L3

Meralgia parasthetica

28
Q

Straight leg raise

A

Special testing for hip

Tests for herniated disc

How to: passively flex at the hip with leg straight

Positive test: pain radiates BELOW the knee

29
Q

Ober Test

A

Tests Iliotibial band tightness

How to: lift leg and bend at the knee and let it drop

Positive test= thigh dies not quickly fall to touch the opposite leg ( kind of hangs)

30
Q

Piriformis test

A

Aduct knee across midline

positive test= causes pain in sciatic distribution - pain down the leg

31
Q

Trendelenburg test

A

Testing Gluteus Muscle weakness

Have patient stand and lift their foot off the ground

positive test = trunk leans towards the side with the foot raised (lean opposite of the weak gluteus muscle)

32
Q

Patrick’s Faber Test

A

Hip/Sacroiliac

How to: Figure 4 with leg- place one hand on ASIS an one hand on the opposite knee and push to cause gaping

if it causes pain in the hip = Hip Issue
if it causes pain in sacroilicac = SI Issue

33
Q

Motion of the knee

A

Primarily Flexion

34
Q

valgus

A

away from midline

35
Q

Varis

A

toward midline

36
Q

Varus/Valgus testing

A

Medial and Lateral Collateral Ligaments

done with a little bit of knee flexion

No MCL= gaps open on valgus

Postive test = pain on gapping

37
Q

Anterior Drawer test

A

Tests ACL

Bend knee to 90 degrees and fix the foot
grab the tibia and pull it forward

Positive= lack of tight endpoint - pulls forward a lot

Remember to compare to opposite side

38
Q

Posterior Drawer test

A

Test PCL

Bend knee to 90 degrees and fix the foot. Grab the tibia and push backwards

Positive = lack of tight endpoint- push backwards a lot

Remember to compare to other side

39
Q

McMurray Test

A

Tests Meniscus

positive test = palpable or audible click at jointline

40
Q

Apley Grind

A

Test Meniscus

Patient prone, bend their knee- load and twist “pepper grinder”

Positive test = pain

41
Q

Patellar Apprehension test

A

Subluxation

positive test = fear/apprehension with patellar movement

42
Q

Lachman test

A

ACL

15-30 degree angle
hold the femur and pull up on the fibula

positive test = excessive anterior translation

43
Q

Fist ligament to go in ankle injury

A

Anterior talofibular ligament

44
Q

Which ligament anchors the tibia and fibula

A

anterior tibiofibular ligament

45
Q

Ankle anterior drawer

A

tests talofibular ligament

How to: grab tibia and calcanius
try and pull foot straight off tibia

46
Q

Inversion ankle test

A

tests calcaneofibular ligament and anterior talofibular ligament

how to: rock the talus out of the mortise

47
Q

Squeeze test

A

High ankle sprain test

How to: squeeze mid tibia/fibula together causes hinging

positive test results in pain at the ankle

48
Q

Thompson Test

A

Tests for Achilles Rupture

How to: squueze calf muscle - in normal condition foot should plantar flex

Positive test: foot does not move when squeezing calf

49
Q

Homan’s Sign

A

DVT test

Positive test = pain with dorsiflexion

50
Q

Squeeze test for Nortons Neuroma

A

squeeze foot (compress between metatarsals)

positive test = pain in foot and toes

CODO II (3 decks)

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