OSCE for all joints and upper respiratory Flashcards
Log roll
+ pain
indicates central or peripheral pathology
C-sign
+patient makes a C just above the trochanter when you ask them where it hurts
indicates labral pathology (central)
Labral loading
+ pain when loading force added
indicates labral or cartilaginous pathology (central)
Labral distraction
+ pain gone when distracting force added
indicates labral or carilaginous pathology (central)
Scour
+ pain
indicates labral or articular cartilage pathology (central)
Apprehension FABER (1)
+pain apprehension
indicates labral pathology or impingement
Ely’s Test
+ipsilateral hip raises off table
indicates rectus femoris contracture (peripheral)
rectus femoris test
+knee flexion >90 degrees
indicates rectus femoris contracture (peripheral)
jump sign
+pain “jumping”
indicates trochanteric bursitis (lateral)
straight leg test
+pain past 15 degrees hip flexion
indicates IT band contracture
(pain less than 15 indicates lumbar disc etiology)
Ober’s test
+patient unable to adduct or has ratcheting while adducting hip
indicates IT band contracture (lateral)
piriformis test
+pain over posterior aspect of greater trochanter
indicates piriformis pathology (lateral)
trendelenburg
+inability to hold hips level
indicates gluteus medius weakness or superior gluteal nerve injury in leg you’re standing on (lateral)
Patricks FABER 2
+pain
indicates gluteus medius pathology (lateral)
Patricks FABER 3
+groin pain/weakness
indicates iliopsoas insufficiency (anterior)
psoas test
+pain/inability/snapping
indicates psoas contracture (anterior)
thomas test
+opposite leg raises off table, inability to fully extend
indicates hip flexor contracture (anterior)
Anterior drawer test (knee)
+anterior glide/laxity
ACL tear
Lachmans test
+anterior glide/laxity
ACL tear
posterior drawer/reverse lachman
+posterior glide/laxity
PCL tear
McMurrays
+pain/grinding
medial or lateral meniscus tear
Apleys grind test
+pain when compression force added
meniscus injury, collateral ligament injury, or both
Apleys Grind distraction test
+pain with distraction/rotation
collateral ligament damage
Patellar laxity/apprehension
+sense of apprehension/instability
previous patellar dislocation/instability
Patellar compression (grind) test
+pain with compression
inflammation, chondromalacia, injury to patellofemoral articular surfaces
Patellar femoral grinding
+pain or crepitus
roughness of articulating surfaces like in chondromalacia
patellar glide test
+crepitus, pain, catching
damage to articular surface
Anterior drawer test (ankle)
+pain, no springing, laxity
+ATF ligament tear (lateral ankle sprain)
Talar tilt (inversion)
+laxity, increased ROM
Calcaneofibular ligament pathology (lateral ankle sprain)
eversion test
+laxity, pain
deltoid ligament pathology (medial ankle sprain
squeeze test
+pain
high ankle sprain
cross leg test
+pain
high ankle sprain
thompson test
+absence of plantar flexion
achilles tendon rupture
Homans sign
+pain with dorsal flexion
DVT
Moses sign
+pain with anterior compression
DVT of posteiror tibial vein
point tenderness over calcaneous
Plantar fasciitis (plantar aponeurosis inflammation)
Mortons neuroma
“like im walking on a marble”
Turf toe
inflammation and pain at base of 1st MTP
achilles tendonitis
heel pain with activity
apprehension test
+apprehension
GH instability
sulcus sign
+indentation appears beneath acromion
GH instability
Yergasons test
+pain or tendon subluxation
bicipital tendonitis
Speeds test
+pain in bicepital groove
bicepital tendonitis
empty can test
+pain/weakness
rotator cuff, mostly supraspinatus
drop arm test
+arm drops
full thickness tear of rotator cuff
Neer impingment
+pain
subacromial bursa or rotator cuff impingement
Hawkins
+pain
subacromial bursa or rotator cuff impingement
Lift off test
+weakness
subscapularis pathology
Apleys scratch test
decrease ROM
yeah
Valgus stress test (knee)
+laxity
MCL tear
Varus stress test (knee)
+laxity
LCL tear
Varus stress test (elbow)
+laxity
Sprained radial collateral ligament
Valgus stress test (elbow)
+laxity
sprained UCL
Tinel test (elbow)
+tingling in 4 and 5 digit
ulnar nerve entrapment
Golfers elbow test
+pain on medial epicondyle
medial epicondylitis
Tennis elbow test
+pain on lateral epicondyle
lateral epicondylitis
Olecranon bursitis
pain on olecranon
Little league elbow
most common elbow injury during childhood
nursemaids elbow
dislocation of radial head from annular ligament
“Ok sign”
+cannot make O with their fingers
anterior interosseous nerve damage
Tinel sign (wrist)
+pain when tapping on wrist
indicates carpal tunnel syndrome
Phalens sign
+pain when pressing wrists together in flexion for 60 seconds
indicates carpal tunnel syndrome
Allen test
+hands do not reprofuse with blood after release
indicates lack of dual blood supply to hand
(contraindication for radial catheterization)
Finkelstein test
+pain with wrist adducting while holding thumb
indicates dequervians tenosynovitis
(adductor hallucis longus and extensor hallucis brevis
pain in snuffbox
scaphoid fracture
why is it important to diagnose and treat a scaphoid quickly
avascular necrosis can occur
Colles fracture
posterior displacement of radial head
Monteggia fracture
fracture to proximal ulna and dislocation of radial head
galeazzi fracture
distal radial fracture with dislocation of ulna
nightstick fracture
isolated fracture to midshaft of ulna from a direct blow
Weber test
normal=they hear tone equally on both sides
abnormal=sound lateralizes to one ear
Rinne test normal
AFTER Weber test check ear sound lateralized to
Air conduction>bone conduction=that ear is normal
indicating sensorineural loss in OPPOSITE ear
Rinne test abnormal
AFTER weber test check ear sound lateralized to
Bone conduction>air conduction=conductive hearing loss to that ear
Whisper test
normal:patient repeats sequence normally
negative indicates patient cant hear worth shit
What should you look for when looking into the nose with your otoscope?
inflamed turbinates mucosa color septal perforation foreign bodies ulcers/polyps
The turbinates are red and swollen with clear mucus, what could this be?
viral rhinitis
The turbinates are pale, blueish or red, what could this indicate?
allergies
what could septum deviation indicate?
drug use (cocaine)
Which sinus do you not need to worry about in someone younger than 7?
frontal sinus, not developed yet
Pain over the cheek bone under eyes indicates what?
maxillary sinitus
what are aphthous ulcers
cancer sores
what is chelitis
B12 or iron deficiency, red cracks in corners of mouth
what is gingivitis
swelling or ulceration of gums
What is a benign lump on the hard palate called?
torus palatinus
What does cobblestoning of the pharynx indicate?
sinus drainage down back of throat
What are the criteria for empiric antibiotic treatment of strep throat?
Age 1 for 3-13, 0 for 15-44, -1 for >45 Fever abscence of cough cervical adenopathy tonsillar exudate 4-5 of these do it, 2-3 do rapid strep test, 0-1 do nothing
