Ortho Flashcards
For ligamentous instability
or ruptured cruciate
ligaments (ACL, PCL).
* Abnormal forward or
backward sliding of the tibia
with respect to the femur
indicating laxity or tear of
the anterior (forward slide)
or posterior (backward slide)
cruciate ligament of the
knee.
Drawer Sign
Testing integrity of ACL. More
sensitive than anterior drawer
test.
* With the patient supine and the
knee flexed to 20 degrees, the
tibia is pulled anteriorly. A
“give” reaction or mushy end
point indicates a torn A
Lachman’s sign
- Testing for meniscal tear.
- Occurrence of a cartilage click during manipulation of the knee; indicative of meniscal injury.
- Gold standard test: MRI
McMurray Test
Testing for meniscal injury.
* Tibial rotation on femur with traction or compression with the patient prone and knee flexed
Apley test, aka “compression test, grinding”
Tests De Quervain’s tenosynovitis, aka: radial styloid
tenosynovitis.
* Swelling of thumb tendons caused by repetitive motion.
* Examiner grasps the thumb and ulnar deviates the hand sharply. Positive test if sharp pain occurs
along the distal radius
Finkelstein test
lightly tapping (percussing) over the nerve to
elicit a sensation of tingling or “pins and needles” in the distribution of the nerve
Test for carpal tunnel syndrome, aka: median nerve compression
Tinel’s sign
Firmly hold the backs of your hands
together with your fingers pointing down, while keeping your arms parallel to the floor. If within a minute, you experience numbness, tingling, pain or a combination, you likely have nerve involvement
Test for carpal tunnel syndrome, aka: median nerve compression.
Phalen’s maneuver
test done to determine whether a patient with low
back pain has an underlying nerve root
sensitivity, often located at L5 (sciatic
nerve pain).
* With the patient lying down on their
back on an examination table or exam
floor, the examiner lifts the patient’s
leg while the knee is straight
straight leg raise
To diagnose a distal biceps tendon
rupture, avulsion, or a tear
Hook test
Best for bone injuries such as fractures
To diagnose: disease of bone degeneration
(OA), dislocations, fractures, tumors,
infections
Xray
Used primarily to diagnose conditions in
organs and soft tissues
Takes a 360-degree image, uses radiation
To diagnose: appendicitis, cancer, trauma,
heart disease, musculoskeletal disorders
infectious diseases
CT
Used primarily to scan the spine, brain,
breasts, muscles, abdomen, and neck
No radiation
Best for soft tissue injuries such as tendons and
cartilages.
MRI
Wrist pain on palpation of the
snuffbox.
* Usually from fall, landing on a
hyperextended wrist.
* Initial X-ray normal, repeat 2 weeks Xray shows scaphoid fracture.
* Thumb spica splint, refer to hand surgeon.
Navicular fracture
Cause: high impact injuries (MVA, trauma, falls).
* More common/dangerous in elderly, immobility =
pneumonia, DVT.
* S&S: depend on degree and location. Sudden onset
one-side hip pain. Unable to bear weight.
Ecchymosis, swelling, bladder and or fecal incontinence, vaginal or rectal bleeding, hematuria,
numbness, unequal leg length, etc.
* Internal hemorrhage. Check ABCs
Pelvic/Hip fracture
- Aka: shin splints.
- Causes: microtears in muscle and bone tissue.
Pain caused by overuse along shinbone.
Generally brought on by high-impact exercise
that overloads the tibia, excessive physical
activity (runners, flat foot). - Tx: RICE, NSAIDS, PT.
Medial Tibial Stress Syndrome or Fracture
torn ligament
sprain
torn muscle or tendon
strain
Most commonly occur on ankle, knee, wrist.
* Acute: abrupt force beyond its functional ROM
(sports).
* Chronic: repetitive movements= overuse.
* S&S: pain, swelling, bruising, joint instability,
difficulty bearing weight
Sprain (torn ligament)
Mild. Able to bear weight and
ambulate.
Strain 1 sprain
-Moderate. Ecchymosis, swelling,
pain. Painful ambulation and
bearing weight.
-Consider Xray, referral.
grade 2 sprain
-Referral to ED. Inability to bear
weight, not able to ambulate, severe
bruising.
grade 3 sprain
Microtears on a tendon(s) cause inflammation
and pain.
* S&S: shoulder pain with certain movements.
Intensified with arm elevation and abduction
(reaching to the back pocket). Local tendon
tenderness on anterior area of shoulder.
* Common: athletes that participate in overhead
sports (volley, handball, tennis, baseball).
* Tx: RICE, NSAIDS, PT.
Supraspinatus tendinitis, aka: cuff tendinitis
An irritation of the tissue connecting the forearm muscle to the elbow.
Lateral Epicondylitis (tennis elbow)
Serena Williams hitting a backhand
A condition that causes pain on
the inner side of the elbow
Medial Epicondylitis (golfers’ elbow)
