Musculoskeletal System Review Session 2 (via Scorebuilders)

Question 1

Describe how to perform and a positive test of: Patrick’s Test (FABER Test)

Answer 1

Perform: Foot of test leg is on top of knee of opposite
leg in “4-position” Examiner lowers the knee
slowly towards the table

(+) Test: postive test indicated by test leg knee
remaining above the opposite straight leg
If positive then test indicates hip jt may be
affected, that there may be iliopsoas spasm, or
that the SI jt may be affected

Question 2

Describe how to perform and a positive test of: Anterior Labral Tear Test (FADDIR Test)

Answer 2

Perform: Examiner brings hip into full flexion, ER,
Abduction as starting position. The examiner
then extends the hip combined with medial
rotation and adduction. Take the patient
through the motion

(+) Test: positive test indicated by the production of pain
or the reproduction of patient’s symptoms with
or without a click.

Question 3

Describe how to perform and a positive test of: Quadrant Test (Scouring Test)

Answer 3

Perform: Examiner flexes and adducts the hip. Hip
faces pt’s opposite shoulder and resistance
is felt. Then hip is taken into abduction while
maintaining flexion.

(+) Test: Examiner looks for any irregularity in movement, pain or apprehension which may give an indication of pathology. This motion also causes impingement of femoral neck against acetabular rim and pinches adductor longus, pectineus, iliopsoas, sartorius, TFL. Could also be osteochondritis dessicans, labral tear

Question 4

Describe how to perform and a positive test of: Craig’s Test

Answer 4

Perform: Patient is prone with knee flexed to 90°. Palpate posterior aspect of greater trochanter of femur, rotate greater trochanter until trochanter is parallel with table. Then measure angle between vertical line
and midshaft of tibia

(+) Test: In adults the normal Anteversion angle is between 8°-15.
Greater than 15° - Femoral Anteversion.
Less than 8°- Femoral Retroversion

Question 5

Describe how to perform and a positive test of: Trendelenburg Sign

Answer 5

Perform: Patient is standing, have them stand on one leg, their non-affected leg first, then affected.

(+) Test: Normally pelvis on the opposite side rises
which indicates negative test
If Pelvis on non-stance side drops when the
patient stands on one leg then indicates a
weak gluteus medius or unstable hip on the
stance side.

Question 6

How would you perform a true leg length assessment?

Answer 6

Perform a Weber-Barstow maneuver then measure from the inferior edge of the ASIS to the inferior end of the medial mallelous. Measure both sides

Question 7

Describe how to perform and a positive test of: Sign of the Buttock

Answer 7

Perform: passively take the pt through straight legt
raise. If there is limitation in straight leg raise,
examiner flexes the knee to see whether
further hip flexion can be obtained. (Flexing
the knee removes the hamstrings and Sciatic
Nerve from being part of the test)

(+) Test: If knee flexion does not increase hip flexion
there is a lesion in the buttock or hip, not the
sciatic nerve or hamstrings. Could also be
limited trunk flexion caused by ischial bursitis,
neoplasm, buttock abscess or hip pathology

Question 8

Describe how to perform and a positive test of: Thomas Test

Answer 8

Perform: Examiner initially checks for lordosis which is
a sign of tight hip flexors. The examiner
passively flexes one hip bringing knee to the
chest. The patient holds the flexed hip
against the chest

(+) Test: If there is a flexion contracture, the straight leg
will rise off the table. If there is a hip flexor
contracture, the straight leg will rise off the
table. If lower leg is pushed down onto the
table the patient may exhibit and increased
lordosis, again a positive sign. This test
posteriorly tilts the pelvis which causes the rise
of contralateral femur if tight or contractured
hip flexors

(What do you think)

Lack of Full hip extension with knee flexion less than 45° indicates iliopsoas tightness. If full extension is reached in this position it would indicates rectus femoris tightness. If any hip external rotation is observed it may indicate ITB tightness

Question 9

Describe how to perform and a positive test of: Kendall Test (Rectus Femoris Test)

Answer 9

Perform:Pt flexes one knee onto the chest and holds
it. The angle of the test knee should be at 90
degrees when the opposite knee is flexed.
Make sure to guard the patient as the patient
lies down on the table

(+) Test: If angle of knee off table increases, a
contracture is probably present. Examiner
should try and passively flex knee back to 90
to check. If no palpable tightness in rectus
femoris, could be joint capsule tightness.
Angle of the knee will increase if there is tight
rectus femoris. This test also checks for hip
tightness. So this and Thomas test can be
combined.

Question 10

Describe how to perform and a positive test of: Ely Test (Rectus Femoris Test)

Answer 10

Perform: Examiner passively flexes the patients knee
and watches pelvis while patient is prone

(+) Test: during passive flexion of pt’s knee, the pt’s hip
on the same side spontaneously flexes,
indicating that the rectus femoris muscle is
tight on that side and that the test is positive.
Both sides should be tested and compared

Question 11

Describe how to perform and a positive test of: Ober Test

Answer 11

Perform: With patient in side- lying, examiner starts in flexion, then abducts and
extends hip, and then slowly adduct the leg.
Keep the knee extended so ITB is stretched.
It is important to stabilize the pelvis so that it
doesn’t fall backward.

(+) Test: Test is postive if the leg remains abducted and
does not fall to the table. Which means a tight
ITB and tensor fascia lata

Question 12

Describe how to perform and a positive test of: Noble Compression Test

Answer 12

Perform: Stand on same side of pt. Find lateral
epicondyle of knee go slightly proximal and
squeeze. This causes compression of ITB to
the femur. Then passively extend knee while
palpating, you will feel the ITB slide down.

(+) Test: As you passively extend the knee, at 30
degrees patient will complain of pain at the
area where you are compressing. This is
positive for runner’s knee. Pt’s will complain
“that’s what it feels like when I run”

Question 13

Describe how to perform and a positive test of: Piriformis Test

Answer 13

Perform: While patient is in sidelying, examiner stabilizes hip with one hand, flex
hip to 60 degrees with knee
flexion, applies pressure to the knee. Can
apply resistance by having
patient push up against downward pressure
on ankle, causes hip ER

(+) Test: Pain elicited in muscle is piriformis tightness.
Pain experienced in buttock and sciatica could
be sciatic nerve being pinched by piriformis

Question 14

Describe how to perform and a positive test of: 90-90 Straight Leg Raise

Answer 14

Perform: Patient ACTIVELY flex Hip to 90 degrees have pt grab
behind thigh, and actively straighten the knee
stretching the hamstrings. Use a goniometer
to measure the extension of the knee.
Opposite leg should be flexed to keep pelvis
neutral and prevent any low back pathology

(+) Test: For normal flexibility in the hamstrings, knee
extension should be within 20 degrees of full
extension.

Question 15

Describe how to perform and a positive test of: Tripod Sign

Answer 15

Perform: With patient in the seated position, t sits at edge of table, knees flexed,
examiner passively extends the knee

(+) Test: positive if patient brings hands back to relieve
tension in hamstrings by extending hip. This
test could also be positive for sciatic nerve
problems because the nerve is being
stretched, but the symptoms might slightly
different

Question 16

Describe how to perform and a positive test of: Valgus Stress Test

Answer 16

Perform: examiner applies a valgus stress (pushes the
knee medially) at the knee while the ankle is
stabilized in slight lateral rotation either with
the hand or leg held between the exainer’s
arm and trunnk. the knee is first in full
extension and then it is slightly flexed (20 -
30 degrees) so that it is unlocked

(+) Test: if the test is positive, tibia moves away from
the femur an excessive amount when a valgus
stress is applied . Test the MCL, posterior
oblique ligament, posterior cruciate ligament
and posteromedial capsule

Question 17

Describe how to perform and a positive test of: Varus Stress Test

Answer 17

Perform: examiner applies a varus stress (pushes the
knee laterally) at the knee while the ankle is
stabilized either with the hand or leg held
between the examiner’s arm and trunk. The
knee is first in full extension and then it is
slightly flexed (20 - 30 degrees) so that it is
unlocked

(+) Test: If the test is postive, tiba moves away from the
femur an excessive amount on the lateral
aspect of the leg. Tests the LCL, posterolateral
capsule, arcuate-popliteus complex, iliotibial
band, biceps femoris tendon

Question 18

Describe how to perform and a positive test of: Lachman’s Test

Answer 18

Perform: examiner holds knee between extension and
30 degrees of flexion. One hand stabilizes
femur, the other pulls tibia forward

(+) Test: This is the best indicator of ACL injury,
especially the posterolateral band. Postive
sign is indicated by a mushy or soft end feel
when the tibia is moved forward on the femur.
Make sure to stabilize the femur properly.
Structures involved ACL, Posterior oblique
ligament, arcuate-popliteus complex

Question 19

Describe how to perform and a positive test of: Anterior Draw Test

Answer 19

Perform: Knee flexed to 90, hip flexed to 45, draw tibia
forward

(+) Test: If tibia draws forward more than 6mm it is
positive. The following structures could be
affected: ACL, posterior capsule, deep MCL
fibers, IT band, Posterior oblique ligament,
Arcuate-popliteus complex

Question 20

Describe how to perform and a positive test of: Posterior Draw Test

Answer 20

Perform: hip flexed to 45 knee flexed to 90. draw tibia posteriorly

(+) Test: If tibia displaces posteriorly, torn PCL

Question 21

Describe how to perform and a positive test of: Posterior Sag Sign

Answer 21

Perform: hip flexed to 45 knee flexed to 90

(+) Test: In this position, the tibia drops back or sags
back on the femur becaue of gravity if the PCL
is torn.
Observe the Tibial Tuberosity and compare
bilaterally. If you suspect ACL, test PCL to rule
it out with the Sag test because if PCL is torn
and you perform a anterior draw test you will
be taking the tibia from posterior to neutral
which could mean false positive

Question 22

Describe how to perform and a positive test of: Slocum Test

Answer 22

Perform: Hip flexed to 45 and knee flexed to 90. Grab above the malleoli. externally rotate 15
degrees and pull anterior or posteriorly and
then repeat the test by internally rotating to
30 degrees and pull anterior or posteriorly

(+) Test: When doing the slocum test, IR pull on lateral
side and ER pull on Medial side.Anteromedial
tibia draws forward when test is performed
with foot in 15 degrees external rotation. With
foot in 30 degrees of internal rotation draw
tibia forward again anterolateral tibia draws
forward

Question 23

Describe how to perform and a positive test of: Hughston Drawer Sign

Answer 23

this test can be done simultaneously as the
slocum test with the only difference being,
you are pushing instead of pulling and
pushing for IR on the medial side and for ER
on the lateral side

Question 24

Describe how to perform and a positive test of: Lateral Pivot Shift Test

Answer 24

Perform: Patient lies supine with hip flexed and
abducted 30 degrees in 20 degrees of medial
rotation. Examiner hold patients foot in one
hand while the other hand is placed at the
knee placing valgus torque and internal
rotation on tibia. Heel of hand placed behind
fibula. Knee will likely sublux at around 30-40
degrees of flexion

(+) Test: A positive test is indicated by anterior
subluxation of lateral tibial plateau under
femoral condyle. Knee will spontaneously
sublux at 40 degrees. Test will not work if IT
band is torn

Question 25

Describe how to perform and a positive test of: McMurray Test

Answer 25

Perform: Knee completely flexed, examiner externally
rotates the tibia and extends the knees while
applying a varus force to test the medial
meniscus.
A click,pop, catching felt while palpating the
joint line is indicative of a torn meniscus. Pt will
feel Pain and it is also possible that the patient
can kick you
Then the examiner medially rotates the tibia
while extending the knee and applying a
valgus force to test the lateral meniscus.

(+) Test: A click,pop, catching felt while palpating the
joint line is indicative of a torn meniscus. Pt will
feel Pain

Question 26

Describe how to perform and a positive test of: Apley Test

Answer 26

Perform: knee flexed to 90, Patient’s thigh is anchored
to table with examiners thigh. The tibia is
internally and externally rotated with
distraction. The knee is then compressed
while rotated medially and laterally.

(+) Test: If rotation plus distraction is more painful,
lesion is probably ligamentous. If rotation plus
compression is more painful, lesion is probably
meniscus pathology

Question 27

Describe how to perform and a positive test of: Mediopatellar Plica Test

Answer 27

Perform: Affected knee flexed 30 degrees resting on
examiners hand, which holds the other leg
for support. The patella is then pushed
medially with the thumb

(+) Test: Pain or clicking is a positive test due to
pinching of edge of plica between medial
femoral condyle and patella

Question 28

Describe how to perform and a positive test of: Hughston Plica Test

Answer 28

Perform: Examiner flexes the knee and medially
rotates tibia. Examiner presses the patella
medially with the heel of the other hand and
palpates the medial femoral condyle with
fingers of same hand. Examiner extends and
flexes the knee while feeling for popping of
the plica under the fingers

(+) Test: Popping, clicking, snapping at 30-60 degrees
is a positive test

Question 29

Describe how to perform and a positive test of: Brush Test

Answer 29

Perform: Examiner brushes medial and inferior to
knee up to suprapatella 3 times. With
opposite hand the examiner strokes down
the lateral side of the patella.

(+) Test: A wave of fluid passes medial to the joint line
and bulges just below the medial distal portion
of the patellar border

Question 30

Describe how to perform and a positive test of: Clarke Sign

Answer 30

Perform: Examiner presses down superior to patella.
The patient is then asked to contract the
quadriceps muscles

(+) Test: If the test causes retropatella pain and the
patient cannot hold a contraction the test is
positive indicating patellofemoral dysfunction

Question 31

Describe how to perform and a positive test of: Q-Angle

Answer 31

Perform: Angle between quadriceps and patellar
tendon. Point one arm at ASIS, the other arm
down midshaft of tibia. Fulcrum at the Patella

(+) Test: Normal Q angle is 13 for males and 18 for
females with straight knee

Question 32

Describe how to perform and a positive test of: Fairbanks Apprehension Test

Answer 32

Perform: Knee flexed to 30. Examiner pushes the
patella laterally

(+) Test: If patient is aprehensive and feels like patella
is going to dislocate, they will contract the
quadriceps which is a positive sign.

Question 33

What are the 3 types of normal end feel?

Answer 33

Firm - Ankle DF, Finger Ext, Hip IR, forearm supination

Question 34

What are the 4 types of abnormal end feel and provide examples?

Answer 34

Empty- Joint inflammation, fracture, bursitis

Firm- Increased tone, tightening of the capsule, ligament shortening

Hard- Fracture, OA, osteophyte formation

Soft- Edema, Synovitis, ligament instability/tear

Question 35

What 2 measurement techniques are used in “Densitometry?

Answer 35

Hydrostatic weighting- Most widely used lab procedure. Calculates density of the body by immersing a person in water and measure water displaced. > limitation: doesn’t account for residual lung volume.

Plethysmography- Utilizes amount of air displaced during testing within a specialized closed chamber.

Question 36

A healthy range of body fat for men and women is?

Answer 36

Men= 12-18%
Whores= 18-23%

Question 37

What is skinfold measurement (Anthropometry)?

Answer 37

Determines overall % of body fat with measurement of 9 standard sites. Relies on the theory that the amount of subcutaneous fat is proportional to total fat in body.

Question 38

What are the 9 standard skinfold sites?

Answer 38

Abdominal
Triceps- MOST COMMON
Biceps
Chest/pecs
Medial calf
Midaxillary
Subscapular- MOST COMMON
Suprailiac
Thigh

Question 39

Describe skinfold procedure

Answer 39

1. All measurements on RIGHT SIDE
2. Take multiple measurements
3. Skinfold calipers positioned 1 cm away from examiners fingers when pinching.
4. Wait 1-2 sec before reading caliper
5. Maintain pinch of site during the reading.
6. Theres a shitload of formulas not described in detail.

Question 40

Give BMI break down (numbers for each level)

Question 41

What is BIA and its protocol?

Answer 41

Bioelectrical impedance analysis= assess body composition uses small electrical current and measures resistance/ opposition of current flow. Equation: height squared/ resistance

Protocol:

1. No eating/drinking within 4 hours prior to testing
2. No physical activity 12hrs prior
3. Pee within 30 min before test
4. No booze for 48 hrs before test
5. Avoid excessive water intake prior to testing.

Question 42

What are the manual muscle testing grades for 0-3?

Answer 42

0/5= No muscle contraction

1/5 (trace) = Muscle contraction palpable no joint movement

2-/5 (Poor minus) = Does not complete ROM in gravity eliminated.

2/5 (Poor)= Complete ROM gravity eliminated

2+/5 (Poor Plus) = Able to initiate movement against gravity.

3-/5 (Fair Minus) = Doesn’t complete ROM against gravity, but does complete more than half of the range

3/5 (Fair)= Complete ROM without resistance

Question 43

Manual muscle scores for 3+ to 5

Answer 43

3+/5 (Fair Plus) = Complete ROM against MIN resistance

4-/5 (Good Minus) = Complete ROM against Min-Mod resistance

4/5 (Good)= Mod resistance

4+/5 (Good Plus) = Mod-Max resistance

5/5 Normal) Max resistance

Question 44

Describe how to perform and a positive test of: Anterior Draw Test of the Ankle

Answer 44

Perform: Patient lies supine with 20° PF, draw the talus forward on the mortise.

(+) Test: Medial deviation of the foot could be indicative of Anterior Talofibular ligament tear. If performed in dorsiflexion and medial deviation occurs, both deltoid and anterior talofibular ligaments could be torn.

Question 45

Describe how to perform and a positive test of: External Rotation Test of the Ankle (Kleiger Test)

Answer 45

Perform: Patient is seated with knee at 90° and ankle in plantigrade. An ER moment is applied to the ankle.

(+) Test: “High ankle sprain” if pain is reproduced over the anterior or posterior tibiofibular ligaments and the interosseous membrane.

Question 46

Describe how to perform and a positive test of: Test for Peroneal Tendon Dislocation

Answer 46

Perform: Patient is prone with the knee flexed to 90°. Patient is asked to DF and PF with eversion as the therapist provides IR resistance.

(+) Test: If the tendon subluxes from the lateral malleolus, the test is positive.

Question 47

Describe how to perform and a positive test of: Thompson Test

Answer 47

Perform: Patient is prone or kneels on a chair. The examiner squeezes the calf muscle.

(+) Test: The absence of PF is indicative of Achille’s tendon rupture.

Question 48

Describe how to perform and a positive test of: Patla Tibialis Posterior Length Test

Answer 48

Perform: Patient is prone with knee flexed to 90°, calcaneus held in eversion, and ankle in dorsiflexion. The examiners other hand is in contact with the 2nd,3rd, and 4th metatarsal bases with the thumb pressing on the navicular bone.

(+) Test: A reproduction of the patient’s pain symptoms is indicative of a positive test.

Question 49

Describe how to perform and a positive test of: Homan’s Sign

Answer 49

Perform: Patient is in supine, and the ankle is passive DF with the knee extended.

(+) Test: Pain in the calf is indicative of DVT. Note* it is also important to consider tenderness to palpation, swelling, and/ or loss of dorsal pedal pulse to determine if the test if truly positive. For the sake of the test: REFER OUT

Question 50

For Tinel’s sign, where do you tap for: Anterior Deep Peroneal Nerve? Posterior Tibial Nerve?

Answer 50

Ant Deep Peroneal: dorsum of the foot.

Post Tib: Posterior to Medial Malleolus.

Question 51

Describe how to perform and a positive test of: Talar Tilt

Answer 51

Perform: Patient is in sidelying with knee flexed to 90°. Foot remains in neutral, and patient presses foot into ABD and ADD

(+) Test: Excessive ADD is indicative of a sprained calcaneofibular ligament.

Question 52

Describe how to perform and a positive test of: Foraminal Compression Test

Answer 52

Perform: Patient is seated and laterally flexed. Therapist provides compression by applying pressure to the top of the head.

(+) Test: Pain radiating down the flexed side and could be indicative of nerve root compression. This test is usually administered in addition to the Distraction Test.

Question 53

Describe how to perform and a positive test of: Vertebral Artery Test

Answer 53

Perform: The patient is positioned in supine and the therapist brings the head into extension, lateral flexion, and rotation to the ipsilateral side.

(+) Test: Patient becomes dizzy, has nystagmus, slurred speech, or loss of consciousness may be indicative of a compressed vertebral artery.

Question 54

Describe how to perform and a positive test of: Sharp Purser Test

Answer 54

Perform: Patient is seated, PT places one hand over the pt’s forehead while the thumb of the other hand is placed over thespinous process of the axis to stabilize it. The patient is asked to slowly flex the head; while this is occurring, the examiner presses backward with the palm.

(+) Test: This test is used to determine subluxation of the atlas on the axis. If the transverse ligament that maintains the position of the odontoid process relative to the C1 is torn, C1 will translate forward (sublux) on C2 on flexion. Thus examiner may find the patient hesitant to do Forward flexion if the transverse ligament is damaged. Positive test indicated if the examiner feels the head slide backward during movement. The slide backward indicates the subluxation of the atlas has been reduced, and the slide may be accompanied by a clunk

Question 55

Describe how to perform and a positive test of: Lateral Alar Ligament

Answer 55

Perform: Supine Place pt’s head in neutral position. PT stabilizes the axis with a wide pinch grip around the spinous process and lamina. PT then side bends the head and axis.

(+) Test: Normally if the ligament is intact, minimal side flexion occurs, with a strong capsular end feel and a solid stop.

Question 56

Describe how to perform and a positive test of: Rotational Alar Ligament

Answer 56

Perform: Patient is Sitting. PT grips the lamina and the spinous process of C2 between the finger and thumb. While stabilizing C2, the PT passively rotates the pt’s head left or right moving to the “no symptom” side first.

(+) Test: If more than 20° to 30° of rotation is possible w/out C2 moving, it is indicative of injury to the contralateral alar ligament especially if the lateral flexion test is positive in the same direction. ­ If the excessive motion is in the opposite direction for both tests, the instability is due to an increase in the neutral zone in the joint

Question 57

Describe how to perform and a positive test of: Romberg Test

Answer 57

Perform: Standing Pt asked to stand with feet together with eyes open and then. Pt asked to close their eyes. The position is held for 20 – 30 seconds.

(+)Test: If the body begins to sway excessively or the pt loses balance, the test is considered positive for an upper motor neuron (UMN) lesion.

Question 58

Describe how to perform and a positive test of: Shoulder Abduction Test

Answer 58

Perform: PT passively or the patient actively elevates the arm through abduction, so that the hand or forearm rests on top of the head.

(+)Test: Decrease in or relief of Sx indicates a cervical extradural compression problem such as a herniated disc, epidural vein compression, or nerve root compression, usually in the C4­C5 or C5­C6 area If the pain increases with the positioning of the arm, it implies that pressure is increasing in the interscalene triangle.

Question 59

Describe how to perform and a positive test of: Slump Test

Answer 59

Perform: Patient is Sitting. Pt is asked to “slump” so that the spine flexes and the shoulder sag forward while the PT holds the chin and head erect. Patient is asked if any Sx are produced. If NO Sx are produced, the examiner then passively extends one of the patient’s knees to see if symptoms are produced. If NO Sx are produced, the examiner then passively dorsiflexes the foot of the same leg to see if Sx are produced.

(+)Test: Symptoms of sciatic pain or reproduction of the patient’s symptoms indicates a positive test, implicating impingement of the dura and the spinal cord or nerve roots. Make sure to repeat the test on both legs.

Question 60

Describe how to perform and a positive test of: Straight Leg Raise (Leseague’s Test)

Answer 60

Performance: Patient is in supine and is relaxed. PT passively medially rotates the hip, and adducts the hip. The knee is extended. PT flexes the hip until pt complains of pain or tightness in the back or back of the leg. PT then slowly and carefully drops the leg back (extends it) slightly until the patient feels no pain or tightness. Pt is then asked to flex the neck so the chin is on the chest, or the examiner may dorsiflex the foot, or both actions may be done simultaneously.

(+) Test: If the pain is primarily back pain, it is more likely a disc herniation from compression on the anterior aspect of the spinal cord or the pathology causing the pressure is more central. If pain is primarily in the leg, it is more likely that the pathology causing the pressure on neurological tissues is more lateral. Pain that increases with neck flexion, ankle dorsiflexion, or both indicates stretching of the dura mater of the spinal cord or a lesion w/in the spinal cord (e.g. disc herniation, tumor, meningitis). Pain that does not increase with neck flexion may indicate a lesion in the hamstring area (tight hamstrings) or in the lumbosacral or SI joints.

Question 61

Describe how to perform and a positive test of: Bowstring Test

Answer 61

Performance: The PT carries out a straight leg raise test and pain results. While maintaining the thigh in the same position, examiner flexes the knee to 20 degrees which will reduce the Sx. Thumb or finger pressure is then applied to the popliteal area to reestablish the painful radicular Sx.

(+) Test: The test indicates tension or pressure on the sciatic nerve and is a modification of the straight leg raise test.

Question 62

Describe how to perform and a positive test of: Babinski Sign

Answer 62

Perform: Examiner takes reflex hammer and runs it along the 5th metatarsal, then medially to the 1st metatarsal.

(+) Test: A positive Babinski test or reflex suggests and upper motor neuron lesion if present on both sides and may be evident in the lower motor neuron lesions if see only on one side. The reflex is demonstrated by extension of the big toe and abduction (splaying) of the other toes.

Question 63

Describe how to perform and a positive test of: Oppenheim Test

Answer 63

Perform: Examiner runs fingernail along the crest of the patient’s tibia.

(+) Test: A negative test is indicated by no reaction or no pain. A positive test is indicated by a postive babinski sign and suggests and upper motor neuron lesion

Question 64

Describe how to perform and a positive test of: Beevor Sign

Answer 64

Perform: ­ Patient is in supine and flexes the head against resistance, coughs, or attempts to sit up with the hands resting behind the head.

(+) Test: The sign is positive if the umbilicus does not remain in straight line when the abdominals contract, indicating pathology in the abdominal muscles (i.e paralysis)

Question 65

Describe how to perform and a positive test of: Gillet Test

Answer 65

Perform: ­ While patient is Standing, examiner palpates the PSISs with one thumb and the other thumb parallel w/ the first thumb on the sacrum. Patient is then asked to stand on one leg while pulling the opposite knee up toward the chest (this causes the innominate bone on the same side to rotate posteriorly and the sacrum to rotate to the same side.)

(+) Test: If the SI joint on the side on which the knee is flexed moves minimimally or up, the joint is said to be hypomobile, or “blocked” indicating a positive test. On the normal side the PSIS moves down inferiorly.

Question 66

Describe how to perform and a positive test of: Piedallu’s Sign (Scorebuilders refers to this as Forward Flexion Test)

Answer 66

Perform: ­ Pretty much the same as Gillet but in sitting position

(+) Test: If the SI joint on the side on which the knee is flexed moves minimimally or up, the joint is said to be hypomobile, or “blocked” indicating a positive test. On the normal side the PSIS moves down inferiorly.

Question 67

Describe how to perform and a positive test of: Supine to Sit Test

Answer 67

Perform: Pt is supine with the legs straight. Examiner ensures the medial malleoli are level. Patient is asked to sit up, and the examiner observes whether one leg moves up (proximally) farther than the other.

(+) Test: If one leg moves up farther than the other, then it is believed to be that there is a functional leg length difference resulting from a pelvic dysfunction caused by pelvic torsion or rotation. It may also be caused by spasm of the lumbar muscles in the presence of lumbar pathology.

Question 68

Describe how to perform and a positive test of: Approximation Test (Transverse Posterior Stress)

Answer 68

Perform: Pt is in side lying position and the examiner’s hands are placed over the upper part of iliac crest, pressing toward the floor.

(+) Test: The movement causes forward pressure on the sacrum, An increased feeling of pressure in the SI joint indicates a possible sacroiliac lesion and/or sprain of the posterior sacroiliac ligaments. Note* Gapping Test performed for SI Dysfunction, specifically Transverse anterior SI ligaments, is performed in similar fashion.

Question 69

Describe how to perform and a positive test of: Gaenslen’s Test

Answer 69

Perform: Pt lies on the side with the upper leg (test leg) hyperextended at the hip. Patient holds the lower leg flexed against the chest. Examiner stabilizes the pelvis while extending the hip of the uppermost leg. Patient can lie supine with the test leg being extended over the edge of table

(+) Test: Pain indicates a positive test, The pain may be caused by an ipsilateral SI joint lesion, hip pathology, or an L4 nerve root lesion

Question 70

Describe how to perform and a positive test of: Femoral Shear Test

Answer 70

Perform: Pt lies in the supine position. Examiner slightly flexes, abducts, and laterally rotates the patient’s thigh at approx 45 degrees from the midline. Examiner then applies a graded force through the long axis of the femur, which causes an anterior to posterior shear stress to the SI joint on the same side.

(+) Test: Pain in the SI joint indicates a positive test, could be SI joint lesion, hip pathology etc.

Question 71

Name the grades for Joint Mobilization and describe

Answer 71

Grade I: small amplitude movement performed at the beginning of the range.
Grade II: Large amplitude movement performed within the range, but not reaching the limit of the range and not returning to the beginning of the range
Grade III: Large amplitude movement performed up to the limit of range.
Grade IV: Small amplitude movement performed at the limit of range
Grade V: small amplitude, high velocity thrust performed at limit of range

Question 72

What is a Bankart Lesion?

Answer 72

Detachment of the humeral head from the glenoid labrum

Question 73

Legg-Calve-Perthes Disease is caused by what?

Answer 73

Degeneration of the femoral head due to lack of blood supply (i.e. avascular necrosis of the hip)

Question 74

What is a Craigh-Scott KAFO?

Answer 74

Specifically designed for SCI patients with paraplegia. This design allows a person to stand with a posterior lean of the trunk

Question 75

What is a parapodium?

Answer 75

A standing frame designed to allow a patient to sit when necessary. Ambulation is achieve by shifting weight and rocking. It is primarily used by the pediatric population.

Question 76

What is a Milwaukee brace?

Answer 76

cervical-thoracic-lumbo-sacral orthosis

Question 77

What is a Taylor brace?

Answer 77

thoraco-lumbo-sacral orthosis

Question 78

What is a reciprocating gait orthosis (RGO)?

Answer 78

An HKAFO that incorporates a cable system that when the patient shifts weight, the cable system advances the contralateral LE

Question 79

What is the difference between a Forequarter amputation and a Shoulder disarticulation?

Answer 79

Forequarter: removal of UE AND Shoulder girdle

Shoulder disarticulation: Removal of the UE through the shoulder

Question 80

What is a hemicorporectomy?

Answer 80

Removal of the Pelvis AND BOTH LEs

Question 81

What is the difference between a Syme’s amputation and a Chopart’s amputation?

Answer 81

Syme’s: surgical removal of the foot at the ankle joint with the removal of the malleoli

Chopart’s: Disarticulation at the midtarsal joint