PD - lower limb/back

Question 1

Valgus stress test

Answer 1

MCL

Question 2

Varus stress

Answer 2

LCL

Question 3

Anterior drawer/Lachman

Answer 3

ACL

Question 4

Posterior drawer

Answer 4

PCL

Question 5

McMurray

Answer 5

Medial/lateral meniscus

Question 6

Patellar apprehension

Answer 6

Knee fully extended. Move patella laterally and medially

Patellar subluxation/dislocation

Question 7

Most likely location for disc herniation?

Answer 7

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

Question 8

L1 nerve root

myotome, dermatome, reflex

Answer 8

myotome: hip flexion
dermatome: anterior lateral thigh
no reflex

Question 9

L2 nerve root

myotome, dermatome, reflex

Answer 9

myotome: hip flexion and adduction
dermatome: anterior medial thigh
reflex: patella tendon

Question 10

L3 nerve root

myotome, dermatome, reflex

Answer 10

myotome: knee extension
dermatome: distal medial thigh and knee
reflex: patella tendon

Question 11

L4 nerve root

myotome, dermatome, reflex

Answer 11

myotome: ankle dorsiflexion
dermatome: medial malleolus
reflex: patella tendon

Question 12

L5 nerve root

myotome, dermatome, reflex

Answer 12

myotome: toe extension (great toe)
dermatome: lateral leg and dorsum of foot
no reflex

Question 13

S1 nerve root

myotome, dermatome, reflex

Answer 13

myotome: ankle plantar flexion and eversion
dermatome: lateral calcaneus and foot
reflex: achilles tendon

Question 14

Faber test

Answer 14

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

Question 15

Patrick’s test

Answer 15

flex, ABduct, externally rotate
supine, flex knee, foot on opposite knee
PUSH DOWN

pain –> pathology of sacroiliac joint

Question 16

Thompson test

Answer 16

Achilles tendon test

pt prone, squeeze calf –> should platarflex foot

Question 17

straight leg raising

Answer 17

sciatica

pt supine, flex thigh at hip (w/ knee in extension)

+ if pain radiating all the way down to foot

Question 18

crossed straight leg

Answer 18

sciatica
(due to herniated disc/space-occupying lesion in lumbar spine)

pt supine, raise leg opposite of painful leg

Question 19

nuchal/kernig/brudzinski tests

Answer 19

meningeal irritation tests

Question 20

Adams forward bend test

Answer 20

scoliosis

Question 21

hoover test

Answer 21

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

Question 22

S2-S4

Answer 22

anus dermatome

anal wink reflex

Question 23

grading of strength

Answer 23

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

Question 24

peripheral nerve distributions…

Saphenous nerve –
Peroneal nerve –
Sural nerve –

Answer 24

Saphenous nerve – medial foot
Peroneal nerve – dorsum of foot
Sural nerve – lateral foot

Question 25

Posterior aspect if cervical spine

Answer 25

* 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

Question 26

normal hip flexion

Answer 26

0-120

Question 27

3/5 strength?

Answer 27

complete range of motion against gravity

Question 28

Order of musculoskeletal exam of knee

Answer 28

``` inspection palpation range of motion muscle strength tests integrated function tests special tests ```

Question 29

patellar reflex is an example of which kind of test...

Answer 29

integrated function test

Question 30

Which is not on lateral aspect of foot/ankle? a. Cuboid Bone b. Navicular Bone c. 5th Metatarsal d. Anterior Talofibular Ligament

Answer 30

navicular --> medial

Question 31

achilles reflex tests which nerve roots?

Answer 31

S1-S2

Question 32

primary neck flexor

Answer 32

sternocleidomastoid

Question 33

biceps reflex mainly involves which nerve root

Answer 33

C5

Question 34

foot drop --> lesion compressing which nerve root?

Answer 34

L4

Question 35

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.

Answer 35

No, that is Kernig's. Brudzinski --> pt supine, flex pt's neck, if pt lifts legs off bed to reduce pain --> meningismus is present

Question 36

The Straight Leg Raise Test is positive if

Answer 36

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

Question 37

kernig

Answer 37

for meningeal irritation pt supine, flex thigh and leg, extend knee +sign is pain w/ knee extension

Question 38

hoover test

Answer 38

pt supine, ask to raise weak leg if no downward force of other leg --> possible malingering

Question 39

L1-L3

Answer 39

sensation | inguinal ligament to patellar ligament