PE Flashcards
Patellar reflex
L4 nerve root
Achilles reflex
S1 nerve root
L4 dermatome
anterior knee
L5 dermatome
big toe, anterior ankle and foot
S1 dermatome
pinky toe, lateral side of foot
Piriformis syndrome presentation
pain exacerbated by hip ER
+ log roll test
+ FAIR test
Log Roll Test
+ test = pain
posterior pain = piriformis syndrome
anterior/groin pain = intra-articular pathology
clicking = acetabular labral tear
FAIR Test
Flexion Adduction IR
+ test = pain in sciatic/gluteal area
Piriformis syndrome
Psoas syndrome presentation
Pain with standing
+ Thomas test
+ FABER test
- Log roll
Thomas Test
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
FABER Test
Flexion ABduction, ER
+ test = pain
groin pain = intra-articular pathology
anterior pain = psoas syndrome
Jump Sign
press on greater trochanter
+ test = pt jumps or withdraws
Trochanteric bursitis
Ober Test
Pt lateral recumbent, top knee flexed, physician adducts top hip
+ test = pain at greater trochanter or inability to adduct
IT Band Syndrome
Inspection: “C Sign”
suggests hip joint pathology
Hip Labral Loading
+ test = pain
labral or cartilaginous pathology
Hip Labral Distraction
+ test = improvement in pain
labral or cartilaginous pathology
Scour Test
Pt supine, flex hip and knee, load into hip and then ER and IR
+ test = pain
labral or cartilaginous pathology
SLR
+ 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
Fibular Head motion
Dorsiflexion/Pronation/Eversion = anterior FH movement
Plantarflexion/Supination/Inversion = posterior FH movement
Valgus Test
+ test = laxity, absent endpoint, pain
MCL sprain or tear
Varus Test
+ test = laxity, absent endpoint, pain
LCL sprain or tear
Lachman’s Test
+ test = laxity, absent endpoint
ACL sprain or tear
Anterior Drawer Test (knee)
+ test = laxity, absent endpoint
ACL sprain or tear
Posterior Drawer Test (knee)
+ test = laxity, absent endpoint
PCL sprain or tear
McMurray’s Test
Medial meniscus = ER + Valgus force then extension
Lateral meniscus = IR + Varus force then extension
+ test = click or pain during extension
Apley’s Grind
Compression +test = pain with compression or rotation
Distraction +test = pain relief with distraction
Bounce Home Test
Flex knee and drop it
+ test = failure to fully extend knee
meniscus injury, effusion or both
Patella-Femoral Grind
+ test = crepitus or pain
chondromalacia patella
X-ray
I want to look at a high density structure
fast, cheap and portible
first line test
CT w/ Contrast
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
MRI
Highest resolution image
no ionizing radiation
expensive
claustrophobic
cannot use if pt has metal implants
Ultrasound
Cheap fast, portable, no ionizing rads
not able to visualize structures behind bone and bigger anechoic structures
Talar Tilt Test
Inversion test of ankle
+ test = laxity, increased ROM, pain
anterior talofibular ligament or calcaneofibular ligament injury
Anterior Drawer Test (ankle)
+ test = pain, no springing, laxity
ATF ligament injury
Eversion test
+ test = laxity, increased ROM, pain
deltoid ligament injury
Squeeze test
pain at syndesmosis
syndesmotic (high) ankle sprain
Thompson Test
squeeze calf to test Achilles T.
+ test = absence of plantarflexion
achilles tendon rupture
Homan’s sign
+ test = pain with dorsiflexion
DVT
Tibiotalar joint movements
dorsiflexion with posterior glide
plantarflexion with anterior glide
Subtalar joint motions
inversion with posterolateral glide
eversion with anteromedial glide
Scoliosis at risk of serious pathology
Do adam’s forward bend test
ATR >7 degrees
Cobb >/= 10 degrees
Scoliosis Red Flags
onset before 8
severe pain
rapid curve progression
left thoracic curve
neurological deficits
Cauda Equina Syndrome
herniation impinges sacral nerves
immediate surgical intervention needed
Osteomyelitis
inflammation of disc due to infection
*can occur with or without fever
