Orthopedic Exam Flashcards
normal range of cervical flexion
60 degrees
normal range of cervical extension
75 degrees
normal range of cervical rotation
80 degrees
normal range of cervical lateral flexion
45 degrees
normal range of thoracic flexion
25-45 degrees
normal range of thoracic extension
25-35 degrees
normal range of thoracic rotation
35-50 degrees
normal range of shoulder flexion
180 degrees
normal range of shoulder extension
50 degrees
normal range of shoulder abduction
180 degrees
normal range of shoulder adduction
50 degrees
normal range of shoulder internal and external rotation
90 degrees
normal range of elbow flexion
140-150 degrees
normal range of elbow extension
0-10 degrees
normal range of elbow supination and pronation
90 degrees
normal range of wrist flexion
90 degrees
normal range of wrist extension
70 degrees
normal range of wrist radial deviation
20 degrees
normal range of wrist ulnar deviation
55 degrees
nonspecific neck pain with radiating symptoms into one arm
cervical radiculopathy
neck pain with bilateral upper extremity symptoms
cervical myelopathy
best methods for identifying myelopathy
Hoffman’s, deep tending reflexes in upper extremity, inverted supinator reflex, suprapatellar quadriceps reflex, hand withdrawal reflex, Babinski sign, clonus of the ankle
purpose of Lhermitte’s test
to traction the posterior column of the spinal cord
findings of Lhermitte’s test and what it means
findings=electric shock like sensation radiating down the neck and spine
means=posterior column disease or MS
characteristic findings with meningitis
fever, neck stiffness, altered mental state
findings of Kernig sign and what it means
with patient lying supine Dr tries to completely extend the leg - if pain prevents it and headache increases then the sign is positive (usually accompanied by involuntary flexion of opposite knee and hip)
means=positive sign means meningitis
findings of Brudzinski sign and what it means
with patient lying supine Dr tries to flex patient’s head - if headache increases and both knees flex then positive sign
means=positive sign means meningitis
purpose of Soto-Hall test
done when suspected fracture of vertebra
findings of Soto-Hall test and what they mean
findings=localized dull or sharp pain in the cervical spine that may radiate into thoracic spine
mean=possible fracture
purpose of Valsalva’s maneuver
tests for presence of space occupying lesion within spinal column that is communicating with spinal cord meninges
findings of Valsalva’s maneuver and what it means
findings=sharp accentuation of pain at level of lesion
means=space occupying lesion
purpose of Dejerine’s sign
to determine if there’s a space occupying lesion in the cervical area
findings of Dejerine’s sign and what it means
coughing, sneezing, straining during defecation increase pressure and aggravate symptoms
means=lesion is present such as herniated or protruding disc, spinal cord tumor, spinal compression fracture
purpose of swallowing test
to determine if there may be a space occupying lesion, sprain, strain, fracture, disc protrusion, tumor
findings of swallowing test and what it means
findings=presence of pain or difficulty swallowing
means=dysphagia is present (something is causing irritation)
purpose of Naffzinger’s test
to create a pooling of the venous sinuses that will cause increase in cerebral spinal fluid pressure
findings of Naffzinger’s test and what it means
findings=sharp accentuation of pain at the level of the lesion
mean=there’s a lesion present
purpose of distraction test
to determine IVF encroachment
findings of distraction test and what it means
findings=test is positive in relieving pain in the cervical area
means=IVF encroachment
purpose of foraminal compression test
to determine IVF encroachment and nerve root involvement
findings of foraminal compression test and what they mean
findings=when the Dr exerts downward pressure on head in neutral position and during bilateral rotation and there’s either localized pain or radicular pain
means=localized pain means foraminal encroachment, radicular pain means pressure on the nerve root
purpose of Jackson compression test
to determine IVF encroachment and nerve root involvement
findings of Jackson compression test and what it means
findings=can have pain on opposite side or on same side
means=if there’s pain on opposite side of lateral flexion means muscular strain, pain on the side of lateral flexion means facet or nerve root involvement
purpose of maximum cervical compression
to determine IVF encroachment and nerve root involvement
findings of maximum cervical compression and what it means
findings=can have pain on opposite side or same side
means=pain on the same side means nerve root or facet involvement, pain on opposite side means muscle strain
purpose of spurling’s test
to determine IVF encroachment and nerve root involvement
findings of spurling’s test and what it means
findings=pain
means=IVF encroachment and nerve root involvement
