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(9th) > Ortho Dx > Flashcards

Ortho Dx Flashcards

1
Q

Maximal Cervical Compression

A

pt seated, dr standing behind.
The examiner instructs the pt to rotate the head and hyperextend the neck over the shoulder on the
side of rotation.

Perform bilaterally.

( + ) Pain on the concave side
( i ) Foraminal encroachment with or without nerve root compression
(based on presence or absence of radicular component)

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2
Q

Shoulder Depressor

A

pt seated, dr stabilizes pt’s laterally flexed head while pushing down on shoulder. (3 positives/indicators)

( + ) Localized pain on the side being tested
( i ) Dural sleeve adhesion, muscular adhesion, contracture, or spasm, or ligamentous injury

( + ) Radiating pain on the side being tested
( i ) Neurovascular bundle compression, dural sleeve adhesions, or
Thoracic Outlet Syndrome

( + ) Radicular pain on the side opposite
( i ) Foraminal encroachment with nerve root compression.

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3
Q

Mill’s Test/Maneuver

AKA Evan’s

A

( + ) pain over lateral epicondyle

i ) lateral epicondylitis (Tennis Elbow

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4
Q

Anterior Apprehension, bilaterally

A

( + ) pt will have a noticeable look of apprehension or alarm on their face with possible pain
( i ) Chronic anterior dislocation of the shoulder (glenohumeral joint)

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5
Q

Tinel Wrist

A

( + ) Reproduction of pain, tenderness and/or paresthesia in the median nerve distribution area (thumb, 2nd, 3rd, and the lateral ½ of the 4th digit).
( i ) Median neuritis, possibly Carpal Tunnel Syndrome

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6
Q

McMurray’s Test

A

( + ) Clicking sound or pain by knee joint.
( i ) Tear of medial meniscus if positive on external rotation
Tear of lateral meniscus if positive on internal rotation
The greater the angle the knee is flexed when the positive is elicited, the more posterior the meniscal injury.

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7
Q

Drawer Sign of the ankle

A

( + ) Translation with the talus moving away from or toward the tibia.
( i ) With tibia pushed/ foot pulled; a tear/instability of the anterior talofibular ligament.
With tibia pulled/foot pushed; a tear/instability of posterior talofibular ligament.

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8
Q

Lasegue’s Test

A

( + ) Reproduction of sciatic pain before 60 degrees

( i ) Sciatica

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9
Q

Bechterew’s

A

( + ) Reproduction of radicular pain or inability to perform correctly due to tripod sign.
( i ) Sciatic radiculopathy

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10
Q

Cozen

A

( + ) Pain over the lateral epicondyle.

i ) Lateral epicondylitis (Tennis Elbow

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11
Q

Posterior Apprehension

A

( + ) Patient will have a noticeable look of apprehension or alarm on their face with possible pain
( i ) Chronic posterior dislocation of the glenohumeral joint.

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12
Q

ROM: Cervical Spine

A

Active and Passive:

Flexion 50° 
Extension 60° 
L lateral flexion 45° 
R lateral flexion 45° 
L rotation 80° 
R rotation 80°
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13
Q

Ulnar Abduction stress test of elbow
/Medial Collateral Ligament Test
/Abduction Stress Test

A

( + ) Excessive gapping & pain.

( i ) Medial collateral ligament tear and/or instability

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14
Q

Drawer Sign of the knee

A

( + ) Gapping > 6mm (tibia moves posterior) when the leg is pushed.
( i ) Torn posterior cruciate ligament.

( + ) Gapping > 6mm (tibia moves anterior) when the leg is pulled.
( i ) Torn anterior cruciate ligament.

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15
Q

Laguerre

A

pt is supine, dr grasps the affected leg, flexes and externally rotates the hip and abducts the thigh (this test is similar to Patrick except the ankle of the affected leg
is not resting on the contralateral knee).
Examiner applies pressure to the end range of motion while stabilizing the contralateral ASIS (rest ankle on forearm and with other hand reach under arm to stabilize)

( + ) Pain in the hip joint
( i ) Hip joint pathology

( + ) Pain in the sacroiliac joint
( i ) mechanical probem of the sacroiliac joint

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16
Q

Bonnet Sign

A

pt supine, dr strongly INTernally rotates and ADducts the affected
leg across the midline and then performs a SLR

( + ) Pain in posterior thigh or leg.
( i ) Immediate pain is sciatic neuropathy from piriformis syndrome.

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17
Q

Femoral Stretch/Nerve Traction Test

A

pt lies on the unaffected leg side, hip and knee slightly flexed, pt straightens back and flexes neck.
The affected leg is extended by the dr at the hip approx. 15º
The affected knee is flexed (stretching femoral nerve)

( + ) Pain on the anterior portion of the thigh.
( i ) Traction on the femoral nerve indicating involvement of the 2nd, 3rd and 4th lumbar nerve roots.

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18
Q

Nachlas Test, State positive Ely’s (?)

A

pt prone, dr takes the heel of the affected leg and approximates it to the ipsilateral buttock while stabilizing the pelvis to prevent hip flexion.

( + ) Pain in the buttock and/or pain in the lumbar region
( i ) Sacroiliac joint lesion, or Lumbar pathology

Ely’s Sign (Ely Test – Cipriano)

pt prone, examiner passively flexes the patient’s knee toward the ipsilateral buttock.
( + ) Hip on side being tested will flex causing the buttock to raise off the table.
( i ) Rectus femoris or hip flexor contracture

19
Q

Hyperabduction Maneuver a.k.a. Wright Test

A

pt seated, examiner finds radial pulse in a neutral position and hyperabducts the patient’s arm slowly to full abduction while monitoring the pulse.

( + ) Pain and/or paresthesia, decreased or absent pulse, amplitude, pallor.
( i ) Compression of the axillary artery by pectoralis minor or coracoid process. Thoracic outlet syndrome.

20
Q

Golfer’s Elbow Test

A

( + ) Pain over the medial epicondyle.

( i ) Medial Epicondylitis

21
Q

Cervical Distraction

A

( + ) Diminished or absence of local cervical pain.
( i ) Foraminal encroachment without NR compression

( + ) Diminished or absence or radiating pain.
( i ) Foraminal encroachment with NR compression

( + ) Increase of cervical pain.
( i ) muscular strain, ligamentous sprain, myospasm or facet capsulitis

22
Q

Morton’s

A

( + ) Sharp pain in the forefoot.

i ) Metatarsalgia or neuroma (usually at the 3rd and 4th metatarsal interspace

23
Q

Brudzinski Sign

A

Patient supine, examiner flexes patient’s head to the chest.

+ ) Involuntary knee flexion.
( i ) Meningeal irritation or nerve root lesion (classic test for meningitis

24
Q

Kernig Sign

A

( + ) Inability to fully extend the leg and/or pain (usually in the neck region)
( i ) Meningeal irritation/ meningitis.

25
Q

Do an exam to evaluate for meningitis

A

Kernig’s/Brudzinski’s
( + ) Inability to fully extend the leg and/or pain (usually in the neck region)
( i ) Meningeal irritation/ meningitis.

( + ) Involuntary knee flexion.
( i ) Meningeal irritation or nerve root lesion (classic test for meningitis)

26
Q

Abbott Saunders

A

( + ) Palpable and/or audible click.
( i ) Subluxation or dislocation of the biceps tendon due to a rupture of the transverse humeral ligament or tendon subluxation beneath subscapularis muscle belly/tendon)

27
Q

Adduction stress test of the elbow
Lateral Collatteral ligament test
Radial adduction stress test (?)

A

( + ) Excessive gapping & pain.

( i ) Lateral collateral ligament tear and/or instability

28
Q

Yergason’s, bilaterally

A

( + ) Localized pain and/or tenderness at the bicipital groove.
( i ) bicipital tendinitis

( + ) Audible click or the biceps tendon subluxes or dislocates
( i ) Instability of the biceps tendon possibly associated with a torn transverse humeral ligament

29
Q

Codman’s, bilaterally

Drop Arm Test / a.k.a. Codman Drop Arm Test

A

( + ) Patient will not be able to lower the arm slowly or the arm drops suddenly.
( i ) Rotator cuff tear, usually supraspinatus.

30
Q

Minor’s Sign, intern demonstrate on self

A

Examiner instructs pt to stand. Observe for abnormal motion.

( + ) Knee flexion of affected leg while supporting upper body weight (hand on back or thigh) on unaffected side.
( i ) Sciatica, lumbosacral or sacroiliac joint lesion

31
Q

Advancement Sign
/Mazion’s Maneuver
/Anterior Inominate

A

The patient is standing. Examiner instructs patient to advance one leg forward approximately 2-3 feet. Patient is then instructed to bend forward from the waist and touch the advanced foot with both hands (advanced knee should be straight).

The inability to bend at the waist more than 45 degrees, because of either/or…
( + ) radiating pain along the sciatic nerve, either unilateral or bilateral
( i ) sciatic neuralgia or radiculopathy, etc., possibly due to lumbar disc pathology

( + ) low back pain (lumbar or pelvic regions)
( i ) anterior (rotational) displacement of the ilium relative to the sacrum.

32
Q

Kemp’s Test

A

pt either seated or standing with arms crossed in front of the chest. dr stands behind pt and stabilizes opposite PSIS. With other hand examiner reaches around pt and grasps patient’s shoulder. dr passively brings shoulder back and obliquely pushes shoulder towards opposite PSIS.

( + ) Pain usually radicular, recreating existing sciatic pain
( i ) Disc protrusion:
• In medial disc protrusion Kemps will be positive as the patient is leaning
AWAY from the side of pain.
• In lateral disc protrusion Kemps will be positive as the patient is leaning
INTO the side of pain.

( + ) Local pain
( i ) Localized pain may indicate lumbar spasm or facet capsulitis.

33
Q

Straight Leg Raiser

A

( + ) Radiating pain and/or dull posterior thigh pain.
( i ) Sciatic radiculopathy or tight hamstrings.
Positive between 35 – 70 degrees = possible discogenic sciatic radiculopathy
> 70 degrees = tight hamstrings

34
Q

Soto-Hall Sign

A

( + ) Generalized pain in the cervical region, which may extend down to the level of T2.

( i ) Non-specific test for structural integrity of cervical region.

35
Q

Bakody

A

( + ) decrease or absense of radiating pain
( i ) cx foraminal compression, NR
entraptment (usually C5/C6 level bc this motion elevates suprascapular nn and relieves traction on upper brachial plexus)

36
Q

Tinel Elbow Sign

A

( + ) pain and/or tenderness at the site being tapped and paresthesia in the ulnar nerve distribution area (fingers 4,5)

( i ) neuroma of ulnar nerve

37
Q

Fromet Paper

A

( + ) the patient is seen to flex the thumb thereby recruiting the median nerve to
compensate for apparent weakness

( i ) ulnar nerve paralysis (weakness or palsy of the adductor pollicus muscle)

38
Q

Phalen, Reverse Phalen/Prayer

A

( + ) reproduction of pain and/or paresthesia in the median nerve distribution area (1st, 2nd, 3rd and the lateral ½ of the 4th digit).

( i ) median neuritis, possibly Carpal Tunnel Syndrome

39
Q

Lindner Sign

A

Patient supine, examiner flexes patient’s head toward the chest.

( + ) pain along sciatic distribution or sharp, diffuse pain (leg)

( i ) sciatic radiculopathy

40
Q

Turyn

A

Patient supine, examiner dorsiflexes the big toe of the affected extremity with
the leg on the table (no hip flexion).

( + ) pain in the gluteal region or radiating sciatic pain.

( i ) sciatic radiculopathy

41
Q

Sicard

A

pt supine, examiner performs an SLR on the patient. Examiner lowers the raised
leg (5 degrees) from the point of pain and sharply dorsiflexes patient’s big toe.

( +) posterior thigh and leg pain.

( i ) sciatic radiculopathy (usually from disc lesion)

42
Q

Fajersztajn Test
Well-Leg-Raising Test
Cross-Over Sign

A

pt supine. Examiner performs a SLR on the patient’s unaffected leg to
75º or until it produces pain down the affected leg. If no pain is produced,
examiner dorsiflexes the foot.

( + ) pain down affected leg (Cross-Over Sign)
( i ) medial disc protrusion

( + ) decrease in pain down affected leg
( i ) lateral disc protrustion

43
Q

Ankle Dorsiflexion Test

Hoppenfeld

A

( + ) the foot cannot dorsiflex with knee extended, but is able to with knee flexed.
( i ) contracture of the gastrocnemius muscle

( + ) the foot cannot dorsiflex in either knee position
Indicates:
( i ) contracture of the soleus muscle

44
Q

Apley Scratch

A

( + ) exacerbation of pain

i ) degenerative tendinitis of rotator cuff tendons (usually Supraspinatus.

(9th) (10 decks)

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