PD - lower limb/back Flashcards
Valgus stress test
MCL
Varus stress
LCL
Anterior drawer/Lachman
ACL
Posterior drawer
PCL
McMurray
Medial/lateral meniscus
Patellar apprehension
Knee fully extended. Move patella laterally and medially
Patellar subluxation/dislocation
Most likely location for disc herniation?
L5/S1
S1 –> difficulty with plantar flexion, sensation loss of lateral calcaneus and foot
L4/L5
L5 –> difficulty with big toe dorsiflexion, sensation loss of dorsal of foot
L1 nerve root
myotome, dermatome, reflex
myotome: hip flexion
dermatome: anterior lateral thigh
no reflex
L2 nerve root
myotome, dermatome, reflex
myotome: hip flexion and adduction
dermatome: anterior medial thigh
reflex: patella tendon
L3 nerve root
myotome, dermatome, reflex
myotome: knee extension
dermatome: distal medial thigh and knee
reflex: patella tendon
L4 nerve root
myotome, dermatome, reflex
myotome: ankle dorsiflexion
dermatome: medial malleolus
reflex: patella tendon
L5 nerve root
myotome, dermatome, reflex
myotome: toe extension (great toe)
dermatome: lateral leg and dorsum of foot
no reflex
S1 nerve root
myotome, dermatome, reflex
myotome: ankle plantar flexion and eversion
dermatome: lateral calcaneus and foot
reflex: achilles tendon
Faber test
flex, ABduct, externally rotate
supine, flex knee, foot on opposite knee
pain ipsilateral hip = pathology of hip joint
pain opposite in buttock region –> sacroiliac joint pathology
Patrick’s test
flex, ABduct, externally rotate
supine, flex knee, foot on opposite knee
PUSH DOWN
pain –> pathology of sacroiliac joint
Thompson test
Achilles tendon test
pt prone, squeeze calf –> should platarflex foot
straight leg raising
sciatica
pt supine, flex thigh at hip (w/ knee in extension)
+ if pain radiating all the way down to foot
crossed straight leg
sciatica
(due to herniated disc/space-occupying lesion in lumbar spine)
pt supine, raise leg opposite of painful leg
nuchal/kernig/brudzinski tests
meningeal irritation tests
Adams forward bend test
scoliosis
hoover test
tests for effort
pt supine, ask to raise weak leg, should feel a downward force applied to opposite leg
if no downward force –> possible malingering
S2-S4
anus dermatome
anal wink reflex
grading of strength
5 – Normal: Complete range of motion against gravity with full resistance
4 – Good: Complete range of motion against gravity with some resistance
3 – Fair: Complete range of motion against gravity
2 – Poor: Complete range of motion with gravity eliminated
1 – Trace: Evidence of muscle contraction, but no joint motion
0 – Zero: No evidence of muscle contractility
peripheral nerve distributions…
Saphenous nerve –
Peroneal nerve –
Sural nerve –
Saphenous nerve – medial foot
Peroneal nerve – dorsum of foot
Sural nerve – lateral foot
Posterior aspect if cervical spine
- Occiput
- Inion (protuberance at base of skull)
- Superior nuchal line (on the external surface of the occipital bone)
- Spinous processes of the cervical vertebrae
- Prominence of the 7th cervical vertebra
normal hip flexion
0-120
3/5 strength?
complete range of motion against gravity
Order of musculoskeletal exam of knee
inspection palpation range of motion muscle strength tests integrated function tests special tests
patellar reflex is an example of which kind of test…
integrated function test
Which is not on lateral aspect of foot/ankle?
a.
Cuboid Bone
b. Navicular Bone c. 5th Metatarsal d. Anterior Talofibular Ligament
navicular –> medial
achilles reflex tests which nerve roots?
S1-S2
primary neck flexor
sternocleidomastoid
biceps reflex mainly involves which nerve root
C5
foot drop –> lesion compressing which nerve root?
L4
T or F
Brudzinski’s test –> ask the patient to lie supine, then flex one leg at the hip and knee. Extend the knee to elicit pain or resistance, a sign of meningeal irritation.
No, that is Kernig’s.
Brudzinski –> pt supine, flex pt’s neck, if pt lifts legs off bed to reduce pain –> meningismus is present
The Straight Leg Raise Test is positive if
The Straight Leg Raise Test is positive if passively raising (flexing) the straightened leg causes sharp pain to shoot down the leg to the foot/toe
kernig
for meningeal irritation
pt supine, flex thigh and leg, extend knee
+sign is pain w/ knee extension
hoover test
pt supine, ask to raise weak leg
if no downward force of other leg –> possible malingering
L1-L3
sensation
inguinal ligament to patellar ligament
