PCM Midterm Flashcards
Hip ROM
Flexion- 90 Flexion with knee flexed- 120-135 Extension- 15-30 Abduction- 45-50 Adduction- 20-30 Internal Rotation- 30-40 External Rotation- 40-60
What muscle is responsible for: Hip flexion? Hip extension? Hip abduction? Hip adduction?
Flexion- Iliopsoas
Extension- Gluteus maximus
Abduction- Gluteus medius and minimus
Adduction- Adductor longus
What is in the central compartment of the hip?
Labrum, ligamentum teres, articular surfaces
What is in the peripheral compartment of hip?
Femoral neck, synovial lining
What is in the lateral compartment of the hip?
Gluteus medius/minimus, piriformis, IT band, trochanteric bursae
What is in the anterior compartment?
Iliopsoas insertion and bursae
What is the log roll test? What compartments does it test for?
Nonspecific central or peripheral pathology
Patient supine, roll leg internally and externally
What are the 5 central compartment tests?
C-sign Labral loading Labral distraction Scour Apprehension FABER
What is the c-sign test?
What compartment?
What is a positive test?
What does it indicate?
Patient cups above trochanter with fingers
Central compartment
C-sign is positive
Indicates- labral pathology
What is labral loading?
What compartment?
What is a positive test?
What does it indicate?
Flex patients knee and hip 90, apply posterior force
Central compartment
Positive test- pain
Indicates- labral or cartilage pathology
What is labral distraction?
What compartment?
What is a positive test?
What does it indicate?
Labral loading, but pull femur anteriorly
Central compartment
Positive test- improve pain
Indicates- labral or cartilage pathology
What is the scour test?
What compartment?
What is a positive test?
What does it indicate?
Flex, externally rotate, and move in circular motion
Central compartment
Positive test- pain
Indicates- labral or cartilage pathology
What is apprehension FABER test?
What compartment?
What is a positive test?
What does it indicate?
Flex, abduct, and externally rotate hip
Central compartment
Positive test- apprehension
Indicates- anterior labral pathology
What are the 2 test for peripheral compartment of hip?
Ely’s test
Rectus femoris test
What is Ely’s test?
What compartment?
What is a positive test?
What does it indicate?
Patient prone, flex knees
Peripheral compartment
Positive test- ipsilateral hip raises
Indicates- rectus femoris contracture
What is rectus femoris test?
What compartment?
What is a positive test?
What does it indicate?
Patient supine, flex one hip to chest, let other fall over end of table
Peripheral compartment
Positive test- knee flexed less than 90
Indicates- rectus femoris contracture
What are the 6 tests for lateral compartment of hip?
Jump sign Straight leg raise test Ober's test Piriformis test Trendelenburg Patricks FABER
What is jump sign?
What compartment?
What is a positive test?
What does it indicate?
Patient seated, apply pressure to greater trochanter
Lateral compartment
Positive test- jumps with pressure
Indicates- trochanteric bursitis
What is straight leg raise test?
What compartment?
What is a positive test?
What does it indicate?
Raise leg with knee extended
Lateral compartment
Positive test- pain
Indicates- lateral compartment pathology
What is obers test?
What compartment?
What is a positive test?
What does it indicate?
Patient lat recumbent, abduct top leg and then lower
Lateral compartment
Positive test- cant adduct
Indicates- IT Band contracture
What is piriformis test?
What compartment?
What is a positive test?
What does it indicate?
Patient supine with hip and knee flexed with other leg over the flexed knee; have them abduct against resistance
Lateral compartment
Positive test- pain at greater trochanter
Indicates- piriformis pathology
What is trendelenburg test?
What compartment?
What is a positive test?
What does it indicate?
Patient stands, lifts one foot off floor
Lateral compartment
Positive test- cant keep hip level
Indicates- contralateral gluteus medius weakness
What is Patricks FABER test?
What compartment?
What is a positive test?
What does it indicate?
Hip flexed, abducted, external rotated. Brace contralateral ASIS and have them abduct against resistance
Lateral compartment
Positive test- pain
Indicates- gluteus medius weakness
What are the 3 tests for anterior hip compartment?
Patricks FABER
Psoas Test
Thomas Test
What is Patrick FABER for anterior compartment?
What compartment?
What is a positive test?
What does it indicate?
Hip flexed, abducted, externally rotated; brace contralateral ASIS, adduct against resistance
Anterior compartment
Positive test- medial groin pain
Indicates- iliopsoas pathology
What is psoas test?
What compartment?
What is a positive test?
What does it indicate?
Flex hip to 30 and then continue to flex against resistance
Anterior compartment
Positive test- pain/weakness
Indicates- iliopsoas pathology
What is thomas test?
What compartment?
What is a positive test?
What does it indicate?
Patient supine and pull knee to chest, lower one leg off table
Anterior compartment
Positive test- cant extend lowered leg completely
Indicates- iliopsoas contracture
What is genu Valgum?
Knees close together and feet further apart
Aka Knock Kneed
What is genu varus?
Legs are bowed
Bow legged
What is genu recurvatum?
Knees hyperextended
What is Q angle?
What is normal angle?
What sex has larger q angle?
Angle formed from line from ASIS to knee and from tibial tuberosity to knee
15 is normal
Females > males
What is knee ROM?
Flexion- 145-150 hamstrings
Extend- 0 quads
Internal/external rotate- 10
What nerve root is primarily tested by patellar reflex test?
L4
What is a positive test for valgus test of knee?
What does it indicate?
Positive valgus test- increased laxity or pain
Indicates- tibial collateral ligament (MCL) pathology
What is a positive varus test of knee?
What does it indicate?
Positive varus test- increased laxity or pain
Indicates- fibular collateral ligament (LCL) pathology
What are the tests for ACL and PCL stability?
ACL:
Anterior drawer test
Lachmans test
PCL:
Posterior drawer test
Reverse Lachmans test
Lachmans test- you pull tibia ant with one hand and push femur post with other
What is McMurrays test?
What does it test?
What is a positive test?
What does it indicate?
Patient supine with hip and knee flexed, then apply internal rotation with varus test or external rotation with valgus test and move into extension
Test for meniscus cartilage
Positive test- pain or clicking
Indicates- meniscus pathology
What is Aply Grind-compression test?
What is a positive test?
What does it indicate?
Prone with knee flexed, provide anterior force and rotate
Positive test- pain
Indicates- meniscus pathology
What is Apley Grind- distraction test?
What is a positive test?
What does it indicate?
Patient prone with knee flexed, pull leg up and rotate
Positive test- pain with distraction
Indicate- collateral ligament pathology
What is patellar laxity test?
What is positive test?
What does it indicate?
Patient supine, push patella laterally with thumbs
Positive test- apprehension
Indicates- history of patellar instability
What is patellar compression test?
What is a positive test?
What does it indicate?
Patient supine, apply downward force on knee and move medially and laterally
Positive test- pain
Indicates- inflammation or chondromalacia
What is patellar-femoral grinding test?
What is a positive test?
What does it indicate?
Patient supine, push patella inferiorly and have patient flex quads
Positive test- pain
Indicates- chondromalacia
What is patellar glide test?
What is a positive test?
What does it indicate?
Have patient flex and extend knee while you palpate
Positive test- clicking
Indicates- articular surface damage
What is the primary stabilizer of the medial ankle?
Deltoid ligament
What makes up the medial longitudinal arch of the foot?
Calcaneus, talus, navicular, cuneiforms, metatarsals 1-3
What makes up the lateral longitudinal arch of the foot?
Calcaneus, cuboid, metatarsal 4 and 5
What makes up the transverse distal tarsal arch of the foot?
Navicular, cuboid, cuneiforms, and proximal metatarsals
What is ankle ROM?
Dorsiflex- 15-20
Plantarflex- 50-65 (55-65)
Inversion- 35 (20-35)
Eversion- 20 (10-20)
What is the primary nerve root tested in the Achilles reflex test?
S1
What is anterior drawer test for ankle?
What is a positive test?
What does it indicate?
Hold calcaneus with one hand and distal tibia/fibula with other and apply anterior force on calcaneus
Positive test- pain or increased laxity
Indicates- anterior talofibular tear
What is Talar tilt test?
What is a positive test?
What does it indicate?
Hold distal tibia/fibula with one hand and calcaneus with other hand and invert calcaneus
Positive test- increased laxity
Indicates- calcaneofibular ligament pathology
What is eversion test of ankle?
What is a positive test?
What does it indicate?
Hold distal tibia/fibula with one hand and hold midfoot with other hand and evert
Positive test- increased laxity
Indicate- deltoid ligament pathology
What is the squeeze test for ankle?
What is a positive test?
What does it indicate?
Squeeze around distal tibia/fibula and then let go
Positive test- pain at syndesmosis
Indicates- syndesmosis pathology or high ankle sprain
What is cross leg test of ankle?
What is a positive test?
What does it indicate?
Have patient cross affected leg over opposite knee
Positive test- pain at distal ankle
Indicates- syndesmosis pathology
What is Thompson test of ankle?
What is a positive test?
What does it indicate?
Squeeze calf
Positive test- no plantar flexion
Indicates- achilles tendon rupture
At what spinal level is the spine of the scapula?
At what level is the inferior angle of the scapula?
T3
T7
What is ROM of glenohumeral joint?
Flexion- 180 Extension- 60 Abduction- 180 Horizontal abduction- 130-145 Horizontal adduction- 40-50 Internal/external rotation- 90
What is the ROM of the AC joint?
Internal/external rotation- 10
With regards to the SC joint, in what direction does the proximal clavicular head move with: Abduction Adduction Horizontal flexion Horizontal extension
Abduction- inferiorly
Adduction- superiorly
Horizontal flexion- posteriorly
Horizontal extension- anteriorly
What muscles are responsible for the following scapulothoracic joint movements: Elevation Depression Protraction Retraction Upward rotation Downward rotation
Elevate- upper trapezius and levator scapulae
Depress- lower trapezius and lower rhomboid
Protract- serratus anterior
Retract- middle trapezius and rhomboids
Upward rotate- upper trapezius and serratus ant
Downward rotate- rhomboids, levator scapulae, lat dorsi
What are the two tests for rotator cuff/supraspinatus tests?
Empty can test
Drop-arm test
What is empty can test?
What is a positive test?
What does it indicate?
Flex shoulder to 90 while abducting to 45 then internally rotate so thumbs point down and then press down on arm while they resist
Positive test- pain
Indicates- supraspinatus pathology
What is drop-arm test?
What is a positive test?
What does it indicate?
Patient abducts arm 90 and then slowly adducts
Positive test- arm will drop rapidly
Indicates- supraspinatus pathology
What are the two tests for GH instability?
Apprehension test
Sulcus sign
What is apprehension test of GH joint?
What is a positive test?
What does it indicate?
Abduct shoulder 90 and flex elbow 90 then force into external rotation
Positive test- apprehensive
Indicate- GH instability
What is sulcus sign of GH joint?
What is a positive test?
What does it indicate?
Pull humerus inferiorly
Positive test- sulcus appears below acromion
Indicates- GH instability
What are the 2 test for long head of biceps?
Yergasons test
Speeds test
What is Yergasons test?
What is a positive test?
What does it indicate?
Have patient supinate and externally rotate against resistance
Positive test- pain in bicipital groove
Indicates- bicipital tendonitis
What is speeds test?
What is a positive test?
What does it indicate?
Arm flexed with hand supinated, have them flex arm more against resistance
Positive test- pain in bicipital groove
Indicates- bicipital tendonitis
What are the two tests for rotator cuff impingement?
Neer impingement test
Hawkins test
What is neer impingement test?
What is a positive test?
What does it indicate?
Pronate forearm and passively flex shoulder to full ROM
Positive test- pain
Indicates- subacromial bursa impingement
What is hawkins test?
What is a positive test?
What does it indicate?
FLex shoulder and elbow to 90, then adduct and passively internally rotate humerus
Positive test- pain
Indicates- subacromial bursa impingement
What are the coupled motions of Apley scratch test?
Upper- external rotation and abduction
Lower- internal rotation and adduction
What is lift off test?
What is a positive test?
What does it indicate?
Have patient internally rotate and adduct arm so arm is behind back; have them push off against resistance
Positive test- weakness
Indicates- subscapularis pathology
What is the carrying angle?
What is normal?
What is cubitus varus?
What is cubitus valgus?
Made by axis of arm and forearm
Normal is 5-15 with females having larger
Cubitus varus- <5
Cubitus valgus- >15
What is ROM of Elbow?
Flexion- 140-150
Extension- 0 to -5
Pronate/supinate- 90
What is valgus stress test of elbow?
What is a positive test?
What does it indicate?
Apply valgus stress to elbow to induce ulnar abduction
Positive test- pain or increased laxity
Indicates- UCL pathology
What is varus stress test of elbow?
What is a positive test?
What does it indicate?
Apply varus stress test to elbow to induce ulnar adduction
Positive test- pain or increased laxity
Indicates- RCL pathology
What is tinel test of elbow?
What is a positive test?
What does it indicate?
Tap between olecranon and medial epicondyle in ulnar groove
Positive test- tingling sensation
Indicates- ulnar nerve entrapment or cubital tunnel syndrome
What is Golfers elbow test?
What is a positive test?
What does it indicate?
Flex elbow 90, supinate, and have patient flex wrist against resistance
Positive test- pain at medial epicondyle
Indicates- medial epicondylitis
What is Tennis elbow test?
What is a positive test?
What does it indicate?
Elbow flexed 90 and pronated and have patient extend against resistance
Positive test pain at lateral epicondyle
Indicates- lateral epicondylitis
What is Nursemaids Elbow?
Child gets pulled by arms
Subluxation of radial head and tearing annular ligament
Restricted on posterior glide
What are coupled motions of elbow?
Ulnar adduction with supination
Ulnar abduction with pronation
Radial head anterior glide with supination
Radial head posterior glide with pronation
What are ROM of wrist?
Extension- 70
Flexion- 80-90
Adduction/ulnar deviation- 30-40
Abduction/radial deviation- 20-30
What are coupled motions of wrist?
Flexion and posterior carpal glide
Extension and anterior carpal glide
Adduction and ulnar abduction
Abduction and ulnar adduction
What nerve does the OK sign test?
Anterior interosseous nerve
What is Tinels Sign for Carpal tunnel syndrome?
What is a positive test?
What does it indicate?
Tap between thenar and hypothenar eminence
Positive test- tingling to thumb, index, and middle finger
Indicates- median n entrapment or carpal tunnel syndrome
What is Phalen’s sign test?
What is a positive test?
What does it indicate?
Hold dorsal aspects of hands together for about a minute
Positive test- reproduction of symptoms of carpal tunnel syndrome
Indicates- median nerve entrapment or carpal tunnel syndrome
What is Allens test?
What is a positive test?
What does it indicate?
Hold both ulnar and radial arteries, then let go of one and look at color return to hand, then repeat and let go of other artery
Positive test- color doesn’t return when you let go of an artery
Indicates- whatever side doesn’t return color means that artery is occluded
What is finkelsteins test?
What is a positive test?
What does it indicate?
Make a fist with thumb tucked in and adduct/ulnar deviate
Positive test- pain at lateral wrist
Indicates- DeQuervains syndrome- inflamed abductor pollicis longus or extensor pollicis brevis (lateral border of anatomical snuff box)
