NMS II OSCE II- tests

Question 1

Anterior innominate test

Answer 1

have patient stand
put unaffected foot forward
have them bend forward to touch their toes
if their back foot stays on the floor, have them put their forward foot more forward until they have to go on their toes with their back foot

Question 2

belt test

Answer 2

patient stands
have them bend forward and touch their toes, note pain
put your hip against their sacrum and have them bend forward again, note pain

Question 3

erichsen’s test

Answer 3

patient supine

doctor compresses SI joints, creating a double IN ilium

Question 4

gaenslen’s

Answer 4

patient supine
doctor brings unaffected knee toward patient’s chest
doctor slowly hyper-extends the affected leg

Question 5

goldthwait’s

Answer 5

patient is supine

doctor palpates L5 and S1 with one hand and elevates the affected leg with the other hand

Question 6

Hibb’s

Answer 6

patient prone

doctor flexes knee to 90 degrees, internally rotates femur by pushing foot laterally

Question 7

iliac compression

Answer 7

patient on unaffected side

doctor compresses iliac crest on the affected side toward the table, essentially creating a double EX ilium

Question 8

lewin gaenslen

Answer 8

patient on unaffected side
doctor hyper extends leg
patient brings other leg up to chest

Question 9

yeoman’s

Answer 9

patient prone

doctor applies pressure to sacrum with one hand and placed other hand under affected knee and lift knee off table

Question 10

actual leg length

Answer 10

patient is supine with feet together

doctor measures from apex of ASIS to center of medial malleolus

Question 11

apparent leg length

Answer 11

patient is supine with feet together

doctor measures from umbilicus to center of medial malleolus

Question 12

allis sign

Answer 12

patient lies supine with knees and hips flexes flat on table

doctor observes femur and tibia length

Question 13

anvil

Answer 13

patient is supine

doctor stands at foot of table, elevates a straight leg and hits bottom of heel with clenched fist

Question 14

gauvain’s

Answer 14

patient lies with affected side up
doctor places one hand on abdominal muscles and other hand grabs just above the ankle
abduct leg and internally and externally rotates thigh

Question 15

hip telescoping

Answer 15

patient is supine
doctor passively flexes hip and knee on affected side to 90 degrees
grab thigh on affected side with one hand and other hand on thigh, just above knee
push femur into table and distracts femur from table

Question 16

patrick’s

Answer 16

patient supine, doctor on unaffected side
patient puts leg into “figure 4” position
stabilize opposite ASIS and applies downward pressure on knee on affected side

Question 17

ober’s

Answer 17

patient lies with affected side up
doctor stands behind patient and stabilizes pelvis
doctor uses other hand to abduct and extend the thigh and hip
doctor slides hand from knee to ankle while keeping knee bend and allows knee to adduct

Question 18

thomas test

Answer 18

patient supine, actively pulls unaffeted knee to chest while keeping other leg straight on table

Question 19

trendelenburg

Answer 19

patient stands on affected foot and raises unaffected foot up on the ground
doctor stands behind patient and observes for pelvic unleveling

Question 20

ortolani’s

Answer 20

infant is supine
doctor grabs both thighs at lesser trochanter
doctor flexes and abducts thighs bilaterally

Question 21

abduction (valgus) stress test

Answer 21

patient is supine with legs straight

doctor stabilizes medial ankle and pushes lateral to medial at knee

Question 22

adduction (varus) stress test

Answer 22

patient lies supine with legs straight

doctor stabilizes lateral ankel and pushes medial to lateral at knee

Question 23

apley’s compression test

Answer 23

patient lies prine with knees flexed at 90 degrees
doctor grabs foot, pushes down and medially and laterally rotates foot
doctor grabs foot, pulls up and medially and laterally rotates foot

Question 24

patella ballotment

Answer 24

patient lies supine with leg straight

doctor pushes down on patella and move it lateral and medial, palpating for motion and looking for a boggy sensation

Question 25

bounce home test

Answer 25

patient is supine

doctor lifts leg and bends knee to 20 degres. then allows knee to drop to full extension

Question 26

clarke’s sign

Answer 26

patient is supine and doctor applies SI pressure on top of patella
patient contracts quadriceps

Question 27

mcmurray sign

Answer 27

patient is supine with hip and knee flexed to 90 degrees
doctor stabilizes knee and grips heel with other hand
doctor rotates tibia externally while applying a varus stress while extending leg
doctor rotates tibia internally while applying a valgus stress while extending leg

Question 28

lateral pivot shift maneuver

Answer 28

patient is supine with hip and knee flexed to 5 degrees

doctor applies internal rotation, valgus stress and flexes knee

Question 29

lachman

Answer 29

patient is supine

doctor holds femur and pushes up on tibia

Question 30

drawer test

Answer 30

patient lies supine with knee flexed to 90 degrees
doctor sits on patient’s foot
doctor pulls tibia anteriorly then pushes tibia posteriorly, looking for excess motion

Question 31

Q angle test

Answer 31

patient standing
draw line from ASIS to midpoint of patells
draw another line from tibial tuberosity through midpoint of patella
measure angle between those lines