PE

Question 1

Patellar reflex

Answer 1

L4 nerve root

Question 2

Achilles reflex

Answer 2

S1 nerve root

Question 3

L4 dermatome

Answer 3

anterior knee

Question 4

L5 dermatome

Answer 4

big toe, anterior ankle and foot

Question 5

S1 dermatome

Answer 5

pinky toe, lateral side of foot

Question 6

Piriformis syndrome presentation

Answer 6

pain exacerbated by hip ER

+ log roll test
+ FAIR test

Question 7

Log Roll Test

Answer 7

+ test = pain

posterior pain = piriformis syndrome
anterior/groin pain = intra-articular pathology
clicking = acetabular labral tear

Question 8

FAIR Test

Answer 8

Flexion Adduction IR

+ test = pain in sciatic/gluteal area

Piriformis syndrome

Question 9

Psoas syndrome presentation

Answer 9

Pain with standing

+ Thomas test
+ FABER test
- Log roll

Question 10

Thomas Test

Answer 10

Pt supine with LEs hanging off table, pt grabs one knee and pulls it to chest

+ test = inability to fully extend leg or other leg raises off table

Psoas syndrome

Question 11

FABER Test

Answer 11

Flexion ABduction, ER

+ test = pain

groin pain = intra-articular pathology

anterior pain = psoas syndrome

Question 12

Jump Sign

Answer 12

press on greater trochanter

+ test = pt jumps or withdraws

Trochanteric bursitis

Question 13

Ober Test

Answer 13

Pt lateral recumbent, top knee flexed, physician adducts top hip

+ test = pain at greater trochanter or inability to adduct

IT Band Syndrome

Question 14

Inspection: “C Sign”

Answer 14

suggests hip joint pathology

Question 15

Hip Labral Loading

Answer 15

+ test = pain

labral or cartilaginous pathology

Question 16

Hip Labral Distraction

Answer 16

+ test = improvement in pain

labral or cartilaginous pathology

Question 17

Scour Test

Answer 17

Pt supine, flex hip and knee, load into hip and then ER and IR

+ test = pain

labral or cartilaginous pathology

Question 18

SLR

Answer 18

+ test = pain or resistance

*Resisted SLR = SCFE or femoral acetabular impingement

lateral leg pain at 15-30 = IT band

Neuro pain at 30-60 = sciatica, L4-S1 disc herniation

Pain after 70 degrees = muscle strain, hip pathology, hamstring tightness, SI joint pathology

Question 19

Fibular Head motion

Answer 19

Dorsiflexion/Pronation/Eversion = anterior FH movement

Plantarflexion/Supination/Inversion = posterior FH movement

Question 20

Valgus Test

Answer 20

+ test = laxity, absent endpoint, pain

MCL sprain or tear

Question 21

Varus Test

Answer 21

+ test = laxity, absent endpoint, pain

LCL sprain or tear

Question 22

Lachman’s Test

Answer 22

+ test = laxity, absent endpoint

ACL sprain or tear

Question 23

Anterior Drawer Test (knee)

Answer 23

+ test = laxity, absent endpoint

ACL sprain or tear

Question 24

Posterior Drawer Test (knee)

Answer 24

+ test = laxity, absent endpoint

PCL sprain or tear

Question 25

McMurray's Test

Answer 25

Medial meniscus = ER + Valgus force then extension Lateral meniscus = IR + Varus force then extension + test = click or pain during extension

Question 26

Apley's Grind

Answer 26

Compression +test = pain with compression or rotation Distraction +test = pain relief with distraction

Question 27

Bounce Home Test

Answer 27

Flex knee and drop it + test = failure to fully extend knee meniscus injury, effusion or both

Question 28

Patella-Femoral Grind

Answer 28

+ test = crepitus or pain chondromalacia patella

Question 29

X-ray

Answer 29

I want to look at a high density structure fast, cheap and portible first line test

Question 30

CT w/ Contrast

Answer 30

CT radiography with observation of blood vessels b/c IV iodine contrast relatively affordable, fast (trauma), very useful 3D image can cause kidney damage relatively high risk of radiation

Question 31

MRI

Answer 31

Highest resolution image no ionizing radiation expensive claustrophobic cannot use if pt has metal implants

Question 32

Ultrasound

Answer 32

Cheap fast, portable, no ionizing rads not able to visualize structures behind bone and bigger anechoic structures

Question 33

Talar Tilt Test

Answer 33

Inversion test of ankle + test = laxity, increased ROM, pain anterior talofibular ligament or calcaneofibular ligament injury

Question 34

Anterior Drawer Test (ankle)

Answer 34

+ test = pain, no springing, laxity ATF ligament injury

Question 35

Eversion test

Answer 35

+ test = laxity, increased ROM, pain deltoid ligament injury

Question 36

Squeeze test

Answer 36

pain at syndesmosis syndesmotic (high) ankle sprain

Question 37

Thompson Test

Answer 37

squeeze calf to test Achilles T. + test = absence of plantarflexion achilles tendon rupture

Question 38

Homan's sign

Answer 38

+ test = pain with dorsiflexion DVT

Question 39

Tibiotalar joint movements

Answer 39

dorsiflexion with posterior glide plantarflexion with anterior glide

Question 40

Subtalar joint motions

Answer 40

inversion with posterolateral glide eversion with anteromedial glide

Question 41

Scoliosis at risk of serious pathology

Answer 41

Do adam's forward bend test ATR >7 degrees Cobb >/= 10 degrees

Question 42

Scoliosis Red Flags

Answer 42

onset before 8 severe pain rapid curve progression left thoracic curve neurological deficits

Question 43

Cauda Equina Syndrome

Answer 43

herniation impinges sacral nerves immediate surgical intervention needed

Question 44

Osteomyelitis

Answer 44

inflammation of disc due to infection *can occur with or without fever