OSCE

Question 1

Special tests for shoulder & what they test for

Answer 1

“Empty can test” - supraspinatus
Painful arc - impingement of supraspinatus
Hornblowers sign - teres minor pathology
Gerber Lift off test - subscapularis

Question 2

Special tests for spine

Answer 2

Straight leg raise - sciatica
Extension with knee bent (pt prone) - femoral nerve stretch test (pain in thigh/inguinal region)
Schober’s test–tests the range of motion in the lumbar spine (mark 5cm above, 10 cm below dimples of venus; when bent over gap should be >20cm)

Question 3

Special tests for hips

Answer 3

Trendelenburg test - if hip falls on side with foot off ground = weak hip abductorson the contralateral side of the pelvis

Thomas test - dont do if hip replacement! (hand under lumbar, flex hip) detects fixed flexion deformity of hip

Question 4

Foot and ankle special tests

Answer 4

Simmonds’ test - if foot doesnt move when squeeze calf = ruptured achilles tendon

NB not a special test but dont forget- if flat feet ask to stand on tip toes, if corrects =rigid flat feet

Question 5

Where would you feel for a parasternal heave and what would it’s presence indicate?

Answer 5

Left sternal edge,

Sign of Right ventricular hypertrophy

Question 6

In CVS exam where do you papate for thrills?

Answer 6

Valvular thrills may be palpated in the valvuar areas

Question 7

Early systolic heart murmur?

Answer 7

Aortic stenosis (mild)

Question 8

Pan systolic heart murmur?

Answer 8

Severe aortic stenosis

Or mitral regurgitation (also has 3rd heart sound gallop)

Question 9

Mid systolic click followed by murmur for rest of systole

Answer 9

Mitral valve prolapse (murmur also louder & earlier in systole when standing)

Question 10

Early diastolic murmur?

Answer 10

Mild Aortic regurg (loudest in erbs point)

Mild pulmonic regurg

Question 11

Causes of pulmonary valve regurgitation ?

Answer 11

Infective endocarditis