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Patient Assessment > Orthopedics > Flashcards

Orthopedics Flashcards

1
Q

H&P Overview: History (3 points of interest)

A
  • joint
  • muscular
  • skeletal
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2
Q

H&P Overview: Physical Exam (steps in examination)

A
  • inspection
  • palpation
  • range of motion
  • manual muscle testing
  • neuro and vascular testing
  • special tests
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3
Q

HPI: Joint Symptoms

A
  • change in size/contour
  • swelling/redness
  • pain (constant / intermittent / with specific movement)
  • laterality
  • location of joint (anterior, posterior, medial, lateral)
  • effet on ADLs
  • locking/giving way
  • associated events
  • timing (temporal factors)
  • self-treatment
  • medications
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4
Q

HPI: Muscular Symptoms

A
  • location
  • character
    • limitation of movement
    • weakness/fatigue
    • paralysis, tremor, tic, spasm, clumsiness, wasting, pain
  • precipitating factors
    • injury, strenuous activity, sudden movement, stress
  • self treatment
    • heat, ice, splints, rest, massage
    • medications
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5
Q

HPI: Skeletal Symptoms

A
  • character
    • limping or difficulty w/ gait
    • numbness, tingling, pressure sensation
    • pain w/ movement
    • crepitus
    • deformity: change in contour
  • associated event
    • injury, recent fx, strenuous activity, sudden movement, stress, postmenopause
  • self treatment
    • rest, splints, chiropractic, acupuncture
    • medications
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6
Q

HPI: Injury (5 questions)

A
  • MOI:
    • direct trauma, overuse, sudden change in direction, forceful contraction, overstretch
  • sensation:
    • click, pop, tearing, numbness, tingling, catching, locking, grating, snapping, warmth/coldness, wt. bearing status
  • pain:
    • location, type, onset (sudden/gradual), aggravating/alleviating factors, position of comfort
  • swelling:
    • location, timing (activity vs. injury)
  • self treatment
    • rest, ice, heat, splints, meds
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7
Q

Past medical history (4 questions)

A
  • trauma
    • nerves, soft tissue, bones, joints, residual problems, bone infections, loss of limb
  • surgery
  • chronic illness
    • CA, arthritis (osteo vs. autoimmune), osteoporosis, renal or neuro disorder, DM, HTN, CAD, PVD, sickle cell, hemophilia
  • skeletal deformities or congenital anomalies
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8
Q

Family History

A
  • congenital abnormalities
  • scoliosis or back problems
  • OA / autoimmune disorders
  • genetic disorders
  • cancer
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9
Q

Social History

A
  • employment
  • exercise
  • functional abilities
  • weight changes
  • height changes
  • nutrition
  • tobacco or alcohol use
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10
Q

OA risk factors

A
  • obesity
  • FH of OA
  • hypermobility syndromes
  • aging (>40 y/o)
  • injury / high level of sports activities
  • occupation w/ overuse of joints
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11
Q

Osteoporosis risk factors

A
  • race
  • light body frame, thin
  • FH of osteoporosis
  • nulliparous
  • amonrrhea or menopause before 45
  • sedentary lifestyle
  • inadequate Ca+ or Vit D intake
  • excessive carbonated drinks
  • scoliosis, RA, CA, MS, chronic illness, previous fractures
  • metabolic disorders, DM, hypercortisolism, hypogonadism, hyperthyroidism
  • drugs decreasing bone density
  • cigarette smoking or heavy EtOH use
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12
Q

body planes

A
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13
Q

limb range of motion

A
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14
Q

Physical exam - key points

A
  • inspection
    • general appearance
    • skin and subcutaneous tissues
    • symmetry
  • palpation
    • joints (above and below)
    • muscle tone
  • range of motion (active and passive)
  • special testing
  • neuro and vascular exam
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15
Q

PE - gait analysis

A
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16
Q

PE - manual muscle testing (MMT)

A
  • evaluates function and strength
  • break test- isometric hold
  • make test- resistance through ROM
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17
Q

PE - palpation steps

A
  • localize point of maximum tenderness

(“point to where it hurts most”)

  • start at unaffected side/away from painful area
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18
Q

Cervical Exam MMT/Nerves

A
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19
Q

UE Sensory Exam

A
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20
Q

Cervical Spine Special Test

A

Spurling’s test

21
Q

Impingement Tests

A

Neer sign & Hawkins sign

22
Q

Rotator Cuff Tear Tests

A

Empty Can test & Drop Arm test

23
Q

Bicipital Tendinitis tests

A

Speeds test & Yergason’s test

24
Q

Shoulder Instability / Labral Pathology tests

A

Apprehension test & Sulcus sign

25
Q

SLAP Tear test

(superior labrum anterior and posterior)

A

O’Brien test

26
Q

AC joint sprain / OA test

A

Cross Body test

27
Q

Epicondylitis test

A

Long Finger test

28
Q

Cubital Tunnel Syndrome test

A

Tinel’s sign

29
Q

Elbow Instability tests

A

Varus Stress test / Valgus Stress test / Milking Maneuver

30
Q

Carpal Tunnel tests

A

Phalen’s test & Tinel’s sign

31
Q

DeQuervain Tenosynovitis test

A

Finkelstein test

32
Q

Collateral Ligament testing

(MCP/PIP/DIP instability)

A

Valgus and Varus stress test

33
Q

Measuring Q-Angle

A
34
Q

Measuring Leg Length

A
35
Q

Leg Innervation

A
36
Q

Lumbar Spine Special Tests

A
  • straight leg raise
  • seated SLR
  • FABER (flexion-abduction-external rotation) test
37
Q

Lumbar Spine Waddle Signs

A
  • non-organic tenderness
    • pt. standing- light touch should not cause pain
  • axial subluxation
    • pt. standing- light downward pressure on head should not cause lumbar pain
  • seated SLR
    • distracted pt. will not lean back
  • sensory exam
    • monofilament should not cause pain
38
Q

Hip ROM

A
39
Q

Hip Special Tests 1

A
  • Trendelenburg test
  • Thomas test
  • Log roll
40
Q

Hip Special Tests 2

A
  • hamstring flexability
  • Piriformis test
41
Q

Knee Joint Effusion Special Tests

A

Ballottement and Bulge

42
Q

Knee Medial and Lateral Meniscus Speical Test

A

McMurray Test

43
Q

Knee ACL Special Tests

A
  • Lachman test
  • Anterior Drawer test
44
Q

Knee PCL Special Test

A

Posterior Drawer

45
Q

Knee MCL & LCL Special Tests

A

Valgus and Varus Stress Tests

46
Q

Knee Patellar Dislocation Special Test

A

Patellar Apprehension Sign

47
Q

Ankle Laxity Special Test

A

Anterior Drawer Test

48
Q

Achilles Tendon Special Test

A

Thompson Test

49
Q

Foot Neuropathy Special Test

A

Foot Squeeze Test - Morton’s Neuroma

Patient Assessment (7 decks)

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