PCM MIDTERM Flashcards
(155 cards)
1
Q
Direct pupillary light reflex
A
when light is shined in the eye, that pupil constricts
2
Q
Consensual pupillary light reflex
A
when light shined in eye, pupil of the other eye also constricts
3
Q
Red reflex
A
normal reflection of the retina
4
Q
Snellen eye chart
A
20/20 normal
held at 14 inches from eyes
be sure to test both eyes open, then covering one eye at a time
5
Q
What movement is allowed in the coronal plane?
A
sidebending (lateral flexion)
6
Q
What axis runs perpendicular to the coronal/frontal plane?
A
anterior/posterior axis
7
Q
What movement is allowed in the sagittal plane?
A
flexion and extension
8
Q
What axis runs perpendicular to the sagittal plane?
A
the transverse (right-left axis)
9
Q
What movement is allowed in the transverse plane?
A
rotation
10
Q
What axis runs perpendicular to the transverse plane?
A
longitudinal axis (superior-inferior axis)
11
Q
Explain the gravitational line
A
viewing the patient from the side:
imaginary line that starts at or slightly anterior to the lateral malleolus, passes across the lateral condyle of the knee, the greater trochanter, through the lateral head of the humerus at the tip of the shoulder to the external auditory meatus.
if plane is through the body, would intersect body of third lumbar vertebrae (L3 or L2) and anterior sacrum
12
Q
Postural decompensation in the coronal, horizontal, and sagittal plane lead to what?
A
Coronal: scoliosis
Horizontal: rotation
Sagittal: kyphosis/lordosis
13
Q
Detail kyphosis
A
concavity anteriorly and convexity posteriorly
14
Q
Detail lordosis
A
convexity anteriorly and concavity posteriorly
15
Q
Detail scoliosis
A
lateral curvature in the coronal/frontal plane can create a C or S shaped deviation
16
Q
Kypholordotic
A
head forward; exaggerated kyphosis/lordosis; anterior pelvic shift; abdomen anterior; hips slightly flexed
17
Q
Swayback
A
head forward; decreased lumbar lordosis; posterior tilt of pelvis
18
Q
Flatback
A
head forward; lower thoracic kyphosis flattening; lumbar lordosis flattened
19
Q
Pectus excavatum
A
funnel chest
abnormally depressed lower sternum
compression of structures
20
Q
Pectus carinatum
A
pigeon chest
abnormal prominence of sternum anteriorly
AP diameter increased
21
Q
What does the central compartment consist of?
A
labrum; ligamentum teres; articular surfaces
22
Q
What does the peripheral compartment consist of?
A
femoral neck; synovial lining
23
Q
What does the lateral compartment consist of?
A
gluteus minimus; gluteus medius; iliotibial band; trochanteric bursae (deep and superficial)
24
Q
What does the psoas (anterior) compartment consist of?
A
iliopsoas insertion; iliopsoas bursae
25
What is C-sign?
if you ask the patient where you hurt and make a C with their hand
26
Symptoms of central compartment problems
C-sign
Catching and locking
Pain in the lumbar spine; groin (medial); pelvic rim; in the a.m. or after a run
Instability
Can have low back pain that radiates into the groin
27
Causes of central compartment problems
trauma; twisting on a hip that has excess weight on it; repetitive strain (Golfers)
28
Pathology of central compartment
```
labral tears
ligamentum teres disruption
osteochondral defects
chondromalacia/osteoarthritis
loose bodies (float around in the central compartment causing problems)
```
29
Log Roll Test
have patient lay supine
take extremity and roll it as a log
contain above and below the knee and just roll the leg; if it hurts then +
specific to central and peripheral compartment
30
labral loading test
FOR CENTRAL C
take hip and knee and flex to 90 degrees
support patient and press down; pressing the femoral head into the acetabulum so forcing pressure on the ring
31
labral distraction test
FOR CENTRAL C
then hook underneath the knee and lift the hip
Pain should be relieved
32
Scour test
FOR CENTRAL C
start at 90 degrees of hip and knee flexion
instead of loading straight down he is going to run the extremity through an omega sign or annular movement
(You are taking the femoral head and grinding it around in the acetabulum so if you have a loose body that will not feel well)
33
Apprehension (FABER) test for central compartment
abduct and external rotate flexed hip and the doctor will press down; if pain +
stabilize the ASIS on opposite side
34
Symptoms of peripheral compartment issues
catching/locking
pain with hip movement (deep hip and groin)
limited range of motion
INJURY: congenital; post trauma (fall and MVA)
35
Pathology of the peripheral compartments
Loose bodies; impingement syndrome (PINCER type: when the socket is affected of the ball and socket joint; CAM type: the femoral neck instead of being tapered it can be more cylindrical in nature)
Synovitis (synovial lining that gets irritated that can cause PCP)
36
Describe Ely's test.
FOR PERIPHERAL C
lay patient prone; flex knee 90 degrees and we can push them even further
looking for it he has tension then when he goes to flex his foot to the gluteal then his hip will lift off the table and thats a + test because the rectus femoris is tight
37
Describe Rectus Femoris test.
FOR PERIPHERAL C
slide towards edge of the table and he will hug both knees and then let go of one knee and thats what we are going to test
we are looking for how much flexion his knee has; should have 90 degrees of flexion so if less then its a + test
38
Symptoms of a lateral compartment issue
weakness (difficulty with lifting leg to climb stairs)
pain (lateral hip, pelvic rim, radiating down leg to knee, knee pain)
instability
39
Pathology of the lateral compartment
overuse "training for a marathon"
IT Band syndrome: tension in the IT band where it gets shortened
Bursitis
Rotator cuff tendonopathies: gluteus medius and minimus
40
Bursitis test.
"jump sign" find greater trochanter and we press on it and if he jumps or withdrawals then thats +
41
ITB Syndrome
FOR LATERAL C
"Straight leg test"
can be used for tight hamstrings, nerve root compression for lumbar disc pathology or IT band problems
With IT band problems the pain will be in the lateral aspect and it will be at greater than 15 degrees once you engage the IT band
"Ober's Test"
lay the patient on the left side (you can stand anterior or posterior to them)
If IT band is shortened he is going to want to abduct so he won't want to adduct INABILITY TO ADDUCT
He will bend the knee a little bit and stabilize at the hip and then let go. And he should fall down correctly; if the leg stays up then that would be a + test
42
Testing for Rotator cuff pathology in the LATERAL C
PIRIFORMIS TEST
patient supine; flex the knee up and lay the foot flat on the table; cross the opposite foot over that knee so we are testing the left side because that is the opposite foot; have patient push the opposite knee against you if there is pain then its +
TRENDELENBURG
have patient stand up; us stand behind him; have patient lift one foot of the ground and we are looking for what his pelvis does; look at the hip of the opposite foot because that is the weight bearing side
if there is weakness then when he lifts his foot off the ground the pelvis will drop on the lifted side because the weight bearing side muscles aren't strong enough to hold the hips level
FABER
place hand on lateral aspect of bended knee and then have him try to push against me (my hand under the knee) and his hip will lift off the table; if weakness or pain then thats a + test
43
Symptoms of Anterior compartment
Pain (anterior hip; medial groin; anterior deep thigh)
| Hyperextension (jumping, running) overuse
44
Pathology of Anterior compartment
Psoas tendonitis; iliopsoas bursitis (at the insertion site)
45
FABER test for ANTERIOR C
put hand on top of knee and have him press up against our hand
46
Psoas Test
FOR ANTERIOR C
| have patient place foot flat against the table and have him lift his leg against our hand on the knee
47
Thomas Test
FOR ANTERIOR C
slide patient to the end of the table; we are looking for the inability to extend his hip and if his hip stays up flexed then that is the iliopsoas muscle being tight
INABILITY TO EXTEND
48
What is the Q angle and whats the normal degree?
Normal 15 degrees
Angle measured between straight lines created from ASIS to center of the patella and tibial tuberosity to center of the patella
49
Genu valgum
posture with knees close together and feet farther apart (knock-kneed)
50
Genu varus
posture where the legs appear bowed with feet together (bow-legged)
51
Genu recurvatum
posture seen from a lateral view, where the knee has a backward curvature
52
Patellar reflex tests what dermatome
primarily L4
| L2-4
53
Testing to MCL ligament
VALGUS
patient supine and examiner supports the patient's lower leg, with the knee flexed to 30 degrees
hands are placed on the medial and lateral aspects of the patient's knee
while providing lateral resistance at the knee, move the lower leg so that the ankle shifts laterally while holding the distal femur in place
+ test: increased laxity, soft or absent endpoint or pain
INDICATES MCL disruption
54
Testing LCL ligament
VARUS
examiner and patient in same position as the valgus stress test. while providing medial resistance, examiner moves the lower leg so that the ankle shifts medially.
This test is done at 30 degrees of flexion and neutral
+ test: increased laxity, soft or absent endpoint or pain
INDICATES LCL disruption
55
Anterior draw test: explain it and what its testing?
patient supine with knee flexed to 90 degrees; examiner sits on the patient's foot and grasps the proximal tibia with both hands, pulling the tibia anteriorly
+ test: excessive translation when compared to the other knee
INDICATES: ACL insufficiency
56
Lachlan's Test: explain it and what its testing
Patient supine; examiner places cephalad hand on the distal thigh, superior to the patella; ciudad hand grasps the proximal tibia; flexing the knee to 15-30 degrees, the examiner uses his ciudad hand to pull the tibia anteriorly while the cephalad hand stabilizes the thigh
+ test: increased laxity; soft or absent end point
INDICATES: ACL insufficiency
57
Posterior drawer test: explain it and what its testing
patient supine with knee flexed to 90 degrees; examiner sits on the patients foot and grasps the proximal tibia with both hands, translating the tibia posteriorly
+ test: excessive translation, particularly when compared to the opposite side
INDICATES: PCL deficiency, posterior capsular injury or disruption
58
Reverse Lachman's Test: explain it and what its testing
patient supine; examiner places cephalad hand on the distal thigh, superior to patella; ciudad hand grasps the proximal tibia; flexing the knee to 15-30 degrees
the proximal hand stabilizes the femur while the distal hand pushes the tibia posterior
+ test: increased laxity; soft or absent end point when compared to the opposite joint
INDICATES: PCL deficiency/post capsule deficiency
59
McMurray's Test: explain it and what its testing
patient is supine, with hip and knee flexed; examiner uses caudad hand to control the ankle and cephalad hand placed on distal femur
Rotate the tibia into internal rotation and applies a VARUS stress, then continues the leg into extension
Rotate the tibia into external rotation and applies a VALGUS stress, then continues the leg into extension
+ test: pain or a painful click during extension
INDICATES: possible medial (external rotation) or lateral meniscus tear (internal rotation)
60
Apley Grind--Compression test (PART 1)
TESTS MENISCAL INJURY
patient prone with knee flexed to 90 degrees
use downward force on the foot to provide a compressive force on the meniscus, while rotating the foot internally and externally
+ test: pain with rotation and/or compression
INDICATES: possible meniscal injury (Collateral ligament or both)
61
Apley Grind--Distraction test (PART 2)
TESTS COLLATERAL LIGAMENTOUS INJURY
patient prone with knee flex to 90 degrees
stabilize the thigh, then applies upward traction to the leg while rotating it (traction reduces meniscal pressure, but increases ligamentous strain)
+ test: pain with distraction and rotation
INDICATES: possible collateral ligament damage
62
Patella Laxity Test
one hand above and one hand below the joint; thumbs placed against the medial side of the patella; examiner pushes laterally, assessing range of motion
63
Patellar Apprehension Test
when testing laxity to the point of restriction, ask the patient if the maneuver provokes any discomfort or sense of instability
+ test: sense of apprehension or instability
INDICATES: possible previous patellar dislocation or severe instability
64
Patellar Compression (Grind) Test
patient supine and knee extended; provide compressive load to the patella with one hand while moving the patella medial and lateral
+ test: pain with compression
if it reproduces symptoms that could be indicative of something with patella femoral articulation
INDICATES: possible inflammation, chondromalacia, or injury to the patellofemoral articular surfaces
65
Patella-Femoral Grinding
compress patella caudally into trochlear groove and instruct patient to tighten quadriceps against resistance
+ test: crepitation or pain
INDICATES: roughness of articulating surfaces (i.e. chondromalacia)
66
Patellar Glide Test
patient sitting or supine will slowly extend and flex the knee, while physician notes quality of the articular motion; placing hand lightly over the patella can increase sensitivity of the test
+ test: palpable or audible crepitus, pain, or catching of the patella
INDICATES: possible damage to the articular surface
67
Chondromalacia
cartilage degeneration, softening
poor alignment/tracking of the patella
can be associated with an abnormal Q angle
68
Osgood-Schlatter disease
overuse injury
common in adolescents
avulsion of secondary ossification center of tibial tubercle
69
Where is the deltoid ligament located?
medial ankle
70
Where would you take the posterior tibial pulse?
right behind the medial malleolus
71
How would you test for capillary refill of the toes
blanch out the toes and see how fast the color returns
72
Forefoot adduction & abduction are testing what joints?
talonavicular & calcaneocuboid joints
73
Inversion & Eversion are testing what joints?
talocalcaneal, talonavicular & calcaneocuboid joints
74
Dorsiflexion & Plantar flexion are testing what joints?
talus, tibia & fibula
75
What makes the medial longitudinal arch?
talus, navicular, cuneiforms 1-3 & metatarsals 1-3
76
What makes up the lateral longitudinal arch?
calcaneus, cuboid & metatarsals 4-5
77
What makes up the transverse distal tarsal arch?
navicular, cuboid, cuneiforms 1-3 & proximal metatarsals
78
Monofilament test
test is performed on the plantar aspect of the foot
doctor has patient close their eyes
monofilament is placed on the 1st and 4th pad of toes and at base of first, third and fifth plantar MTP joints with enough pressure to cause a slight bend of the monofilament
+ test: if patient cannot feel the monofilament
IMPORTANT IN DIABETIC FOOT EXAM
79
ROM of dorsiflexion
15-20 degrees
80
ROM of plantarflexion
55-65 degrees
81
ROM of subtalar inversion
20-30 degrees
82
ROM of subtalar eversion
10-20 degrees
83
ROM of forefoot adduction
20 degrees
84
ROM of forefoot abduction
10 degrees
85
Components of pronation
dorsiflexion, abduction & eversion of calcaneus
5 degrees
86
Components of supination
plantar flexion, adduction & inversion of calcaneus
20 degrees
87
What innervates the dorsiflexors of the foot?
deep fibular nerve (L4/L5) mainly L5
88
What innervates the plantar flexors of the foot?
tibial nerve (L5, S1/S2)
89
What innervates fibularis longus/brevis?
superficial fibular nerve (L5)
90
The achilles reflex tests what nerve root?
S1
91
Anterior Drawer test of the foot
grasp the posterior calcaneus with one hand and cup the distal tibia/fibula with the other hand, monitoring anteriorly at the anterior talus
provide anterior force on calcaneus while stabilizing the distal tibia/fibula
normal springing of calcaneus back to neutral should occur
+ test: pain (sprain), no springing, excessive motion, gapping (tear)
anterior/laxity: ATF ligament pathology/tear
92
Talar Tilt Test
grasp the distal tibia/fibula with one hand and the inferior calcaneus with the other, blocking motion of the calcaneus on the talus
invert the talus to evaluate ROM
+ test: laxity, increased ROM or pain
calcaneofibular ligament pathology/tear and some ATF
93
Eversion test
grasp distal tibia/fibula with one hand and grasps the mid foot from the plantar surface of the foot with the other hand
doc everts/pronates the foot to evaluate ROM
+ test: laxity, increased ROM or pain = deltoid ligament pathology
94
Squeeze test (HIGH ANKLE SPRAIN)
wrap hands around leg proximal to the ankle, contacting the distal tibia/fibula with both thenar eminences: squeeze for 2-3 seconds--rapidly release
+ test: pain at syndesmosis: syndesmosis pathology, high ankle sprain
95
Cross Leg Test
for evaluating high ankle sprain:
Patient seated
patient crosses affected leg over opposite knee
patient then applies pressure to proximal fibular of affected leg
+ test: pain at distal ankle = syndesmotic injury
96
Thompson Test
patient prone with foot off the table
doc squeezes the calf
+ test: absence of plantar flexion; achilles tendon rupture
97
Homan's Sign
indicates thrombophlebitis or acute deep venous thrombosis
patient laying or seated with knee extended; doc dorsiflexes the foot (some add lateral compression of calf as well) with knee extended
+ test is pain with dorsiflexion
98
Venous thrombosis
the presence of edema, erythema and increased warmth of the skin of the lower leg increases suspicion for DVT
need to get a venous doppler to rule out clot
99
Moses Sign
indicates deep vein thrombosis of the posterior tibial veins
patient seated or supine
induce an anterior compression on the gastrocnemius muscle into the posterior aspect of the tibia
+ test: pain with anterior compression--not lateral compression
100
Inversion ankle sprain (LATERAL SPRAIN)
80-85% of all ankle sprains
ankle inversion with plantar flexion
Involves: ATF, calcaneofibular and PTF ligaments
swelling and ecchymosis over involved area
101
High Ankle sprains
10% of all ankle sprains
ankle eversion and rotation (some dorsiflexion)
Involves: anterior inferior tibiofibular and syndesmosis
Pain more common on medial aspect with minimal swelling; pain worse with weight bearing
102
Plantar Fascitis
inflammation of origin of plantar aponeurosis
worse with first steps, improves through day: patient will complain pain is worst when they get out of bed in the morning
point tenderness of calcaneus
Causes: tight calves, repetitive high impact activities, high arches, obesity, new/changes in activities
103
Morton's Neuroma
inflammation and thickening of tissue that surrounds the nerve between toes
most commonly between 3rd and 4th toes
reports feeling like they are walking on a marble; palpable in web space, which will replicate pain
104
Turf toe
inflammation and pain at base of 1st MTP
pain and bruising at base of great toe
caused by hyperextension of great toe causing damage to the joint capsule: can damage sesamoids and flexor tendon
common due to activities performed on hard surface
105
Achilles Tendonitis
inflammation at achilles tendon
presents as sharp heel pain and stiffness at mid-Achilles tendon to insertion: worse with strenuous exercising, better with walking
Causes: tight calf muscles, sudden change in activity, poorly fitting shoes, incorrect running technique
106
What nerve root supplies the big toe and the pinky toe?
L5-big toe and S1-pinky toe
107
What muscles are used in shoulder flexion?
anterior deltoid and coracobrachialis: 180 degrees
108
What muscles are used in shoulder extension?
latissimus dorsi and teres major: 60 degrees
109
What muscles are used in shoulder abduction?
supraspinatus and mid-deltoid: 180 degrees
| Horizontal abduction: 40-55 or 130-145
110
What muscles are used in shoulder adduction?
pectoralis major and latissimus dorsi
| horizontal adduction: 40-50 and 130-140
111
What muscles are used in shoulder external rotation?
infraspinatus and teres minor: 90 degrees
112
What muscles are used in shoulder internal rotation?
subscapularis and pectoralis minor: 90 degrees
113
How much rotation happens at the AC joint?
10 degrees
114
What muscles are used in scapular retraction?
rhomboid major and minor
115
What muscles are used in scapular protraction?
serratus anterior
116
What muscles are used in scapular elevation?
upper trapezius and levator scapulae
117
What muscles are used in scapular depression?
lower trapezius and lower rhomboids
118
What nerve root supplies the thumb and lateral side of the arm?
C6
119
What nerve root supplies the 2nd and 3rd phalanges?
C7
120
What nerve root supplies the ring and pinky finger?
C8
121
Empty Can Test
TEST ROTATOR CUFF Ms.
flex patients shoulders to 90 degrees while also abducting approximately 45 degrees.
then internally rotate both arms so thumbs are pointing down and press down on the forearms while patient resists
+ test: pain or weakness
INDICATES: rotator cuff pathology (specifically supraspinatus)
122
Drop-Arm Test
patient abducts arm 90-180 degrees then slowly drops arm.
+ test: arm will drop or gentle tap on wrist will cause arm to drop
INDICATES: full thickness tear of supraspinatus
123
Apprehension shoulder test
patient is seated or supine
shoulder abducted to 90 degrees and elbow flexed to 90 degrees
stabilize patient's shoulder with one hand and force arm into external rotation with the other hand
+ test: patient apprehensive of repeat dislocation
INDICATES: glenohumeral instability
124
Sulcus Sign
grasp patient's elbow and apply inferior traction
+ test: indentation appears in area beneath the acromion
INDICATES: glenohumeral instability
125
Yergasons Test
patients arm at side with elbow flexed 90 degrees
examiner uses one hand to palpate the bicipital groove and monitors there, while the other hand grasps the patient's wrist; have patient supinate and externally rotate against doctor's resistance
+ test: pain and/or tendon subluxation out of the groove
INDICATES: unstable bicipital tendon/subluxation, bicipital tendonitis
126
Speeds Test
patients arm forward flexed at the shoulder with hand supinated
slightly flex patient's elbow; resist at forearm while patient further flexes shoulder
+ test: pain in bicipital groove
INDICATES: bicipital tendonitis of long head of biceps
127
Neer Impingement Test
stabilize patient's shoulder; forearm is pronated; passively flex shoulder to fully flexed position
+ test: pain
INDICATES: subacromial bursa or rotator cuff impingement
128
Hawkins Test
flex shoulder to 90 degrees, flex elbow to 90 degrees, slightly adduct and passively rotate the humerus into internal rotation
opposes the rotator cuff against the coracoacromial ligament and acromion
+ test: pain
INDICATES: rotator cuff (usually supraspinatus) or subacromial bursa impingement
129
Apley Scratch Test (testing AROM)
Upper: patient abducts arm placing palm of hand behind their neck with palm facing toward the body; patient should attempt to scratch the lowest possible vertebrae
**coupled external rotation and abduction
Lower: patient places arm behind their back with palm facing outward and dorm of hand resting on their mid back ; patient should attempt to scratch the highest possible vertebrae
**coupled internal rotation and adduction
130
Lift Off Test
place patient's arm into internal rotation and adduction
patient extends arm into as doctor resists
+ test: weakness (inability to resist)
INDICATES: subscapularis weakness
131
Biceps brachii reflex
tap on your thumb over tendon; C5
132
Brachioradialis reflex
tap on tendon; C6
133
Triceps reflex
tap on tendon; C7
134
Upper extremity dermatomes
```
C5 = lateral arm
C6 = lateral forearm & thumb
C7 = middle finger
C8 = medial forearm & pinky finger
T1 = medial arm
```
135
What muscles are involved in elbow flexion?
biceps brachii; brachialis; brachioradialis
136
What muscles are involved in elbow extension?
triceps brachii, anconeus
137
What muscles are involved in elbow supination?
supinator, biceps brachii
138
What muscles are involved in elbow pronation?
pronator teres, pronator quadratus
139
Valgus stress test of the elbow
arm slightly abducted and externally rotated; forearm supinated and flexed (to approximately 30 degrees)
slight medial directed valgus stress is applied to elbow joint
+ test: pain/tenderness with palpation and valgus stress; increased laxity (degree of laxity correlates to degree of injury to UCL or MCL)
140
Varus Stress test of the elbow
arm slightly abducted and internally rotated; elbow flexed
a slight varus stress is applied to the elbow joint
+ test: pain or increased laxity in LCL (radial collateral ligament)
141
Tinel Test
For ulnar nerve entrapment
tap between olecranon and medial epicondyle in ulnar groove
+ test: eliciting tingling sensation down forearm within ulnar nerve distribution
INDICATES: ulnar nerve entrapment, cubital tunnel syndrome
142
Golfer's Elbow Test
for medial epicondylitis
patient's elbow is flexed to 90 degrees and forearm is placed in supination with the wrist neutral and palm facing up
the examiner places one hand under the proximal forearm for stabilization and the other hand over the patient's wrist to resist movement. instruct the patient to flex the wrist
+ test: pain/tenderness around the medial epicondyle
143
Tennis Elbow Test (COZENS TEST)
for lateral epicondylitis
patients elbow is flexed to 90 degrees and forearm is placed in pronation with wrist neutral and palm facing down
examiner places one hand under proximal forearm for stabilization and the other hand over the patient's hand to resist movement. instruct patient to extend the wrist
+ test: pain/tenderness around lateral epicondyle; may radiate down lateral forearm
144
Olecranon bursitis
olecranon bursa lies superficial to posterior elbow joint
posterior elbow distention and discomfort due to overuse
or occupational or athletic injury
region is often painless and range of motion is normal
145
Little League Elbow
pain over the medial epicondyle, initially after throwing (repetitive valgus distraction forces), progresses to persistent pain
most common elbow injury during childhood (growth plates not fused)
146
Radial head instability "Nursemaids elbow"
annular ligament tear and/or radial head subluxation from annular ligament
pain with palpation of radial head with anterior displacement of radial head and restriction to posterior glide
elbow will be slightly pronated; flexed and held close to trunk
147
Coupled motions at the elbow:
ulnar adduction with supination
ulnar abduction with pronation
radial head anterior glide with supination
radial head posterior glide with pronation
148
Ok Sign Test
testing for the anterior interosseous nerve
patient cannot make an O with thumb and forefinger pinched together they would make more of a triangle
149
Tinel's Sign
indicates entrapment of median nerve or carpal tunnel syndrome
can be elicited by tapping over the transverse carpal ligament with either the tip of the examiners finger or reflex hammer with the patient's wrist held in extension
+ test: parasthesias/numbness/tingling/pain radiating to the thumb; index and middle finger
150
Phalen's Sign
place dorsal aspects of patient's hands together and force into wrist flexion. Hold for 60 seconds
+ test: any reproduction of symptoms: paresthesias in the distribution of the median nerve
151
Allen Test
evaluates functioning of radial and ulnar arteries
occlude both arteries while patient makes a fist; have patient open and close fist; palm should be pale
release pressure on ulnar artery and observe for color return to hand within 5-10 seconds. Repeat with radial artery
152
DeQuervain's Tenosynovitis
pain and inflammation from repetitive overuse of tendons in first dorsal compartment
patients complain of dorsal-lateral wrist and thumb pain, occasionally with radiation into lateral hand and thumb
Possible inflammation sites: abductor pollicis longus; extensor pollicis brevis;
Will have positive Finkelstein test
153
Finkelstein test
utilized to assess for tenosynovitis of the 1st dorsal compartment
examiner asks patient to make a fist encompassing their thumb and ulnar deviate the wrist
+ test: increased pain in first dorsal compartment/lateral wrist
154
Scaphoid fracture
most common carpal bone fracture due to falling forwards/backwards on outstretched hand
patient complains of dull ashiness deep in radial aspect of wrist after a fall
155
Colle's Fracture
fracture of the distal radius in the forearm with dorsal (posterior) and radial displacement of the wrist and hand
