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PCM > PCM Midterm Competencies > Flashcards

PCM Midterm Competencies Flashcards

1
Q

what is/are the primary nerve root(s) involved in the action of hip flexion

A

L2-L4 and L1-L2 ventral rami

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2
Q

what is/are the primary nerve root(s) involved in the action of hip extension

A

inferior gluteal nerve

L5, S1, S2

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3
Q

what is/are the primary nerve root(s) involved in the action of hip Abduction

A

superior gluteal nerve L5, S1

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4
Q

what is/are the primary nerve root(s) involved in the action of hip aDduction

A

obturator nerve L2-L4

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5
Q

what are the contents of the central compartment of the hip?

A

labrum, ligamentum teres, articular surfaces

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6
Q

what are the contents of the peripheral compartment of the hip?

A

femoral neck, synovial lining

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7
Q

what are the contents of the lateral compartment of the hip?

A

gluteus medius, gluteus minimus, piriformis, IT band, trochanteric bursae

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8
Q

what are the contents of the anterior/iliopsoas compartment of the hip?

A

iliopsoas insertion, iliopsoas bursae

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9
Q

name the orthopedic test(s) that can be used to identify central compartment pathology

A 
log roll
C-sign
labral loading
labral distraction
scour
FABER apprehension
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10
Q

list pathologies of the central compartment

A

labral tears, tears of the ligamentum teres, osteochondral defects, chondromalacia/osteoarthritis, congenital hip dysplasia, loose bodies

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11
Q

list pathologies of the peripheral compartment

A

loose bodies, impingement syndrome, synovitis

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12
Q

list pathologies of the lateral compartment

A

IT band syndrome, bursitis, rotator cuff tendinopathies

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13
Q

list the pathologies of the anterior/iliopsoas compartment of the hip

A

psoas tendonitis, iliopsoas bursitis

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14
Q

what is the C-sign and what is it used for?

what is a positive sign and what does it indicate?

A

patient characteristically points to the source of pain with two fingers or cups just above the trochanter with the thumb and index finger
positive sign is characteristic pain, indicates labral pathology

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15
Q

what is labral loading?
what is a positive sign?
what does positive sign indicate?

A

knee and hip flexed, load into the labrum, central compartment test
positive sign is pain with the maneuver
indicates labral or cartilaginous pathology

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16
Q

what is labral distraction?
what is a positive sign?
what does positive sign indicate?

A

knee and hip flexed to 90 degrees; distract away from inominate, central compartment test
positive sign is improvement of pain
indicates labral or cartilaginous pathology

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17
Q

what is the scour test of the hip?
what is a positive sign?
what does positive sign indicate?

A

flexed/externally rotated hip; load into socket and articulate through annular motion; central compartment test
pain with the maneuver
indicates labral or articular cartilage pathology

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18
Q

what is the apprehension FABER test?
what is a positive sign?
what does positive sign indicate?

A

doctor induces further external rotation by applying posterior force at the knee
positive sign is anterior subluxation or apprehension/pain
indicates anterior labral pathology; can also be positive with impingment

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19
Q

what is Ely’s Test?
what is a positive sign?
what does positive sign indicate?

A

patient prone, passively flex patients knees
positive sign is ipsilateral hip raises off table
indicates rectus femoris contracture

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20
Q

what is the rectus femoris test?
what is a positive sign?
what does positive sign indicate?

A

peripheral compartment test
pt supine, hip flexed up to chest, other knee dangles
positive test is the dangling of greater than 90 degrees, indicating rectus femoris contracture

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21
Q

what is the jump sign?
what is a positive sign?
what does positive sign indicate?

A

lateral compartment test
pt seated, pressure applied to greater trochanter
positive test = pt withdraws or jumps with pressure
indicates trochanteric bursitis

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22
Q

what is straight leg raise test?
what is a positive sign?
what does positive sign indicate?

A

lateral compartment test
raise leg with knee extended; nonspecific
positive sign is pain with maneuver
indicates:
pain from 15-30 degrees - lumbar disc etiology
pain laterally at greater than 15 degrees - lateral compartment pathology

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23
Q

what is Ober’s Test?
what is a positive sign?
what does positive sign indicate?

A

lateral compartment test
pt lateral recumbent, doctor behind pt, doctor aBducts superior leg, allows it to aDduct while stabilizing hip
positive sign is inability to aDduct
indicates IT band contracture

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24
Q

what is piriformis test?
what is a positive sign?
what does positive sign indicate?

A

lateral compartment test
pt in FABER position, Pt aBducts against resistance
positive sign is pain over posterior aspect of greater trochanter
indicates piriformis spasm or pathology

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25
Q

what is trendelenburg test?
what is a positive sign?
what does positive sign indicate?

A

lateral compartment test
pt lifts one foot off ground
positive sign is the sagging of the hip
indicates contralateral gluteus medius weakness or superior gluteal nerve pathology

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26
Q

what is Patrick’s FABER test?
what is a positive sign?
what does positive sign indicate?

A

lateral compartment test
doctor braces contralateral ASIS, pt externally rotates/ABducts against resistance
positive sign is pain or weakness with maneuver
indicates gluteus medius pathology

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27
Q

what is Patrick’s FABER test for the anterior compartment?
what is a positive sign?
what does positive sign indicate?

A

doctor braces contralateral ASIS, pt internally rotates, ADducts against resistance
positive sign is anterior or medial groin pain/weakness
indicates iliopsoas insufficiency or pathology

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28
Q

what is the thomas test?
what is a positive sign?
what does positive sign indicate?

A

like rectus femoris test for the iliopsoas

indicates hip flexor conracture

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29
Q

what is psoas test?
what is a positive sign?
what does positive sign indicate?

A

flex hip to 30 degrees while patient further flexes against resistance
positive sign is pain or inability or snapping
indicates psoas contracture or pathology

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30
Q

what is anterior drawer test of the knee?
what is a positive sign?
what does positive sign indicate?

A

pull tibia anteriorly
excessive translation when compared to other knee
indicates ACL insufficiency

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31
Q

what is lachman’s test?
what is a positive sign?
what does positive sign indicate?

A

flexed knee to 15-30 degrees; pull tibia anteriorly
positive test is increased laxity or soft/absent end point
indicates ACL insufficiency

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32
Q

what is McMurray’s test?
what is a positive sign?
what does positive sign indicate?

A

rotates tibia into internal rotation and applies varus stress
also rotates tibia into external rotation and valgus stress
positive test is pain or painful click during the extension phase
indicates possible medial or lateral meniscus tear

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33
Q

what is Apley Grind-compression test?
what is a positive sign?
what does positive sign indicate?

A

compressive force on meniscus while rotating foot internally and externally
positive test is pain with rotation and/or compression
indicates possible meniscal injury (collateral ligament injury or both)

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34
Q

what is apley grind - distraction test?
what is a positive sign?
what does positive sign indicate?

A

upward traction to the leg while rotating internally and externally; traction reduces meniscal pressure but increases ligamentous strain
positive sign is pain with distraction and rotation and indicates possible collateral ligament damage

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35
Q

what is patellar laxity and apprehension test?
what is a positive sign?
what does positive sign indicate?

A

push patella laterally assessing ROM and pain
positive test is sense of apprehension or instability
indicates possible previous patellar dislocation or severe instability

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36
Q

what is the patellar compression (grind) test?
what is a positive sign?
what does positive sign indicate?

A

pt supine, knee extended; compressive load to patella while moving laterally and medially
positive test is pain with compression and indicates inflammation, chondromalacia, injury to patellofemoral articular surfaces

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37
Q

what is patello-femoral grinding test?
what is a positive sign?
what does positive sign indicate?

A

compress patella caudally; instruct patient to tighten quads against resistance
positive sign is crepitus or pain
indicates roughness of articulating surfaces (chondromalacia)

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38
Q

what is patellar glide test?
what is a positive sign?
what does positive sign indicate?

A

supine or sitting; slowly extend and flex knee; physician notes quality of motion
positive test is palpable or audible crepitus, pain or catching of patella
indicates possible damage to articular surface

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39
Q

what are the arteries to the foot at which we can obtain a peripheral pulse?

A

dorsalis pedis

posterior tibial artery

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40
Q

what is specific sensory testing done to the feetsies?

in what specific population of patients is this useful?

A

monofilament test

diabetics

41
Q

pronation of the foot involves the combination of what 3 movements?

A

eversion, dorsiflexion, abduction

42
Q

supination of the foot involves the combination of what 3 movements?

A

inversion
plantar flexion
adduction

43
Q

what is the nerve root being tested in the achilles tendon reflex?

A

S1

44
Q

what is anterior drawer test of the foot?
what is a positive sign?
what does positive sign indicate?

A

anterior force on calcaneus; normal springing of calcaneus back to normal should occur
positive sign is pain, no springing, excessive motion
indicates ATF tear or pathology

45
Q

what is talar tilt test?
what is a positive sign?
what does positive sign indicate?

A

block motion of calcaneus on talus; invert talus to evaluate ROM
positive sign is laxity, increased ROM or pain
indicates calcaneofibular ligament pathology or tear/some ATF pathology

46
Q

what is the eversion test of the foot?
what is a positive sign?
what does positive sign indicate?

A

doc everts foot to evaluate ROM
positive test is laxity, increased ROM or pain
indicates deltoid ligament pathology

47
Q

what is squeeze test?
what is a positive sign?
what does positive sign indicate?

A

squeeze distal tib/fib; rapid release
positive sign is pain at syndesmosis
indicates high ankle sprain, syndesmosis pathology

48
Q

what is cross leg test?
what is a positive sign?
what does positive sign indicate?

A

cross leg
positive sign is pain at distal ankle
indicates syndesmotic injury

49
Q

what is thompson test?
what is a positive sign?
what does positive sign indicate?

A

pt prone; foot off table; squeeze calf, lack of plantar flexion means achilles tendon rupture

50
Q

what is Homan’s sign?
what is a positive sign?
what does positive sign indicate?

A

DVT test; pt with knee extended; doc forcibly dorsiflexes the foot and adds some lateral compression of calf
positive sign is pain
suggestive of venous thrombosis

51
Q

what is Moses sign?
what is a positive sign?
what does positive sign indicate?

A

indicates DVT of posterior tibial veins
anterior compression on the gastrocnemius
positive sign is pain with anterior compression- NOT lateral compression

52
Q

hyperextension of 1 MTP joint can cause what?

A

turf toe

53
Q

what are the muscles responsible for flexion of the shoulder

A

anterior deltoid and coracobrachialis

54
Q

what are the muscles responsible for extension of the shoulder

A

latissimus dorsi

teres major

55
Q

what are the muscles responsible for abduction of the shoulder

A

supraspinatus and middle deltoid

56
Q

what are the muscles responsible for adduction of the shoulder

A

pectoralis major

latissimus dorsi

57
Q

what are the muscles responsible for external rotation of the shoulder

A

infraspinatus and teres minor

58
Q

what are the muscles responsible for internal rotation of the shoulder

A

subscapularis

pectoralis major

59
Q

what are the muscles responsible for retraction of the scapula

A

rhomboids

60
Q

what are the muscles responsible for protraction of the scapula

A

serratus anterior

61
Q

what are the muscles responsible for elevation of the scapula

A

upper trapezius

levator scapulae

62
Q

what are the muscles responsbile for depression of the scapula

A

lower traps

lower rhomboids

63
Q

what is empty can test?
what is a positive sign?
what does positive sign indicate?

A

positive sign is pain or weakness

indicates rotator cuff pathology specifically supraspinatus

64
Q

what is drop-arm test?
what is a positive sign?
what does positive sign indicate?

A

abduct arm, then slowly drop
positive sign is arm will drop or gentle tap on wrist causes arm drop
indicates full thickness tear of supraspinatus

65
Q

what is glenohumeral apprehension test?
what is a positive sign?
what does positive sign indicate?

A

apprehension with external rotation of arm

indicates glenohumeral instability

66
Q

what is sulcus sign?
what is a positive sign?
what does positive sign indicate?

A

apply inferior traction to the arm
indentation appears in area beneath the acromion
indicates glenohumeral instability

67
Q

what is Yergason’s test?
what is a positive sign?
what does positive sign indicate?

A

pt supinates and externally rotates against resistance

pain or tendon subluxation out of groove indicates unstable bicipital tendon/subluxation or bicipital tendonitis

68
Q

what is speed’s test?
what is a positive sign?
what does positive sign indicate?

A

resisted flexion of the shoulder at the forearm
positive is pain in bicipital groove
indicates bicipital tendonitis of long head of biceps

69
Q

what is neer impingement test?
what is a positive sign?
what does positive sign indicate?

A

forearm pronated, passively flex shoulder to full flexion
pain
indicates subacromial bursa or rotator cuff impingement

70
Q

what is hawkins test?
what is a positive sign?
what does positive sign indicate?

A

opposes rotator cuff against the coracoacromial ligment and acromion
pain
indicates rotator cuff (usually supraspinatus) or subacromial bursa impingement

71
Q

what is apley scratch test?
what is a positive sign?
what does positive sign indicate?

A

2 maneuvers

1) abducts and externally rotates upper arm
2) adducts and internally rotates lower arm

72
Q

decrease of the carrying angle is called what?

A

gunstock

73
Q

normal carrying angle is what?

A

5-15 degrees

74
Q

the biceps tendon reflex involves what nerve root

A

C5

75
Q

the triceps tendon reflex involves what nerve root

A

C7

76
Q

the brachioradialis tendon reflex involves what nerve root

A

C6

77
Q

positive tinnel’s test at the elbow is indicative of what?

A

ulnar nerve entrapment, cubital tunnel syndrome

78
Q

another name of tennis elbow test is

A

cozen’s test

79
Q

student’s elbow or miner’s elbow involves what

A

olecranon bursa

80
Q

describe little league elbow

A

constellation of symptoms

1) medial apophysitis
2) medial epicondyle avulsion fracture
3) medial collateral ligament tear

81
Q

what is nursemaids elbow

A

radial head instability
annular ligament tear/radial head subluxation
restricted to posterior glide, pain with palpation
anterior displacement of radial head

82
Q

describe coupled motions at the elbow

A

as ulna supinates, it also adducts
as ulna pronates it also abducts
radial head glides anteriorly with supination
radial head glides posteriorly with pronation

83
Q

what are the tendons involved in the anatomical snuffbox

A

extensor pollicis longus
abductor pollicis longus
extensor pollicis brevis

84
Q

what is OK sign test?

A

anterior interosseous nerve test

85
Q

what is phalen’s test/sign?

A

dorsal aspects of hands together for a minute

test CTS

86
Q

what is allen test

A

circulation to hand and wrist

87
Q

what is DeQuervain’s tenosynovitis?

what is finkelstein test?

A

first dorsal compartment pain
dorsal lateral wrist and thumb pain
ulnar deviation of fist yields pain at the region
possible inflammation sites are abductor polllicis longus and extensor pollicis brevis
repetitive use injury

88
Q

what is the most common carpal fracture

A

scaphoid
FOOSH injury
risk of avascular necrosis

89
Q

what is colles fracture

A

fracture of distal radius in the forearm with dorsal and radial displacement of the wrist and hand

90
Q

average step length

average stride length

A

14-16

28-32 inches

91
Q

average cadence

A

90-120 STEPS per minute

92
Q

what are the stages in the gait cycle

A

contact
mid-stance
propulsion
swing

93
Q

describe antalgic gait

A

painful gait

short stance phase on affected side

94
Q

describe arthrogenic gait

A

usually due to hip or knee stiffness
unaffected foot plantarflexes more than normal to increase clearance
affected leg is circumducted

95
Q

describe ataxic gait

A

unsteady, uncoordinated walk
feet thrown out and stance wide
may lurch or stagger
pt often watches feet when walking

96
Q

describe parkinsonian gait

A

small shuffling steps

hypokinesia

97
Q

describe foot drop/steppage gait

A

hip raised very high to clear toe

usually due to common fibular nerve pathology

98
Q

describe hemiplegic gait

A

stiff leg, no flexion at knee or ankle. each step rotates first away then toward the body. forms semicircle

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