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Assessment II > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

Tenosynovitis + example

A

Inflammation of the synovial sheath of the tendon
ex. tenosynovitis of extensor digitorum longus

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2
Q

Stenosing tenosynovitis + example

A

Inflammation of the synovial sheath of the tendon such that it narrows and presses on the tendon
ex. stenosing tenosynovitis of extensor hallucis longus

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3
Q

Ganglionic cyst + example

A

Localized inflammation of the synovial sheath such that it results in a lump under the skin
ex. ganglionic cyst of extensor digitorum longus

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4
Q

Trigger phenomenon

A

A form of stenosing tenosynovitis where localized swelling of the synovial sheath causes the tendon to jam in the sheath and suddenly let go
ex. trigger phenomenon of flexor digitorum longus

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5
Q

Nerve disorder example

A

Morton’s neuroma (3rd + 4th metatarsals press on the plantar nerve)

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6
Q

Neurovasular disorders (2)

A

Raynauds’s
Anterior compartment syndrome

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7
Q

L1 dermatome

A

Lower back above L2-L3 and lateral buttock to groin

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8
Q

L2 dermatome

A

Lower back to lateral side at iliac crest, posterior lateral thigh and upper anterior lateral to medial thigh (sling)

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9
Q

L3 dermatome

A

Lower back, posterior/medial thigh and medial knee, medial upper shin

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10
Q

L4 dermatome

A

Lateral side of mid to lower posterior thigh, lateral knee, medial anterior shin, medial posterior calf, medial malleolus to anterior big toe

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11
Q

L5 dermatome

A

Small strip from lateral upper calf, top of the foot and under surface of big, 2nd, 3rd toes

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12
Q

S1 dermatome

A

Lower lateral border of calf to heel and lateral side of foot to plantar fourth and fifth toes

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13
Q

S2 dermatome

A

Down centre of posterior leg from buttock to under surface of heel

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14
Q

Bowel and bladder nerves (motor, sensory, main one)

A

Motor: S2-S4
Sensory: S3-S5
Main: S3

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15
Q

2 types of passive ROM testing

A
  1. taking the client’s limb through ROM without their help
  2. Overpressure after active ROM
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16
Q

Why is overpressure applied and why is it important?

A

To evaluate the end feel
Helps determine if the joint is normal or pathological

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17
Q

2 types of muscle testing and how they’re recorded

A

Isometric: strong or weak
Isotonic: graded 0-5

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18
Q

What are isometrics used for?

A
  1. Testing myotomes
  2. Rule out inert tissue and test individual muscle groups
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19
Q

3 normal end feels

A

Tissue stretch
Soft tissue approx
Bone to bone

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20
Q

Bone to bone

A

Sudden hard stop, painless
Solid stop, no give

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21
Q

Soft tissue approx

A

Yielding compression stops movement

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22
Q

Tissue strecth

A

Hard or firm stop with slight give

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23
Q

5 abnormal end feels

A

Bone to bone
Springy block
Capsular
Empty
Muscle spasm

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24
Q

Muscle spasm

A

Sudden hard stop, accompanied by pain “vibrant twang”

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25
Q

Capsular

A

Like tissue stretch but not where you’d expect it

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26
Q

Bone to bone

A

Like normal bone to bone but not where you’d expect it

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27
Q

Empty

A

No mechanical resistance felt by the examiner, but movement impossible due to pain

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28
Q

Springy block

A

Like tissue stretch but joint has a springy, rebound effect

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29
Q

Capsular pattern

A

When there is limitation of movement that is proportional and specific to the joint

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30
Q

Non capsular pattern

A

Limited movement, but does not correspond to the classic pattern for that joint

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31
Q

3 examples of non capsular pattern

A

Ligamentous adhesion
Internal derangement of a joint
Extra-articular lesion

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32
Q

How long do how hold isometrics for the pelvis?

A

Only long enough to determine if there is pain

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33
Q

What actions do you do for pelvis isometrics?

A

Hip adduction/abduction
Hip flexion/extension
Lumbar flexion

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34
Q

L2 myotome

A

Hip flexion

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35
Q

L3 myotome

A

Knee extension

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36
Q

L4 myotome

A

Ankle dorsiflexion

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37
Q

L5 myotome

A

Big toes extension

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38
Q

S1 myotome

A

Ankle eversion or hip extension

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39
Q

S1 S1 myotome

A

Knee flexion

40
Q

What are isotonics used for? How>

A

Used for muscle testing
Resistance is applied to a limb as patient moves through ROM

41
Q

3 types of reflexes

A

Superficial
Deep tendon/muscle stretch
Pathologic

42
Q

Umbilicus type of reflex + nerve root

A

Superficial reflex
Upper: T7-T9
Lower: T11-T12

43
Q

Pathologic reflex example + what is signifies

A

Babinski - upper motor neuron lesion

44
Q

Babinski

A

Position: supine or sitting with knee straight and supported
Test action: stabilize tib/fib and draw the end of the hammer from lateral heel, up the side of the foot across the ball of the foot to the plantar surface or the first MTP area
Normal response - toes curl
Positive response - big toe extends, other abduct

45
Q

Simple segmental defintion

A

Impulse comes from the periphery, into the spinal cord and back out to the periphery, without going to the higher up centers

46
Q

4 considerations while testing muscle

A
  1. Complete relaxation
  2. Midrange position
  3. Adequate stretch
  4. Facilitation if reflexes are
47
Q

Reflex grades

A

0 - absent
1- diminished
2 - normal
3 - exaggerated
4 - clonus

48
Q

Upper motor neuron lesion findings

A

Increased tone
Hyperreflexia
Reduced or absent superficial reflexes
Positive Babinski
Positive hoffman sign
Normal EMG
Weakness in muscles below lesion

49
Q

Lower motor neuron lesion findings

A

Decreased tone
Decreased reflexes
Fasciculation
Fibrillation
Abnormal EMG
Weakness and pronounced atrophy of involved muscles

50
Q

4 types of swelling

A

Synovial
Fluid
Pitting
Longstanding soft tisse

51
Q

Synovial

A

Boggy

52
Q

Fluid

A

Soft and mobile

53
Q

Pitting

A

Thick, slow moving, leaves indent

54
Q

Longstanding soft tissue

A

Tough/leathery

55
Q

L3-L4 reflex

A

Patellar reflex

56
Q

L4-L5 reflex

A

Tibialis posterior

57
Q

L5-S1 reflex

A

Medial hamstring

58
Q

S1-S2

A

Lateral hamstring
Achilles
Extensor digitorum brevis

59
Q

Spinal stenosis

A

Narrowing of the spinal canal causing compression of the cauda equina

60
Q

Spinal stenosis symptoms

A

Pain in lumbar spine with radiation to extremity
Paraesthesia of lower extremities
Symptoms increase with extension and walking, decrease with flexion
May affect bowel and bladder

61
Q

Arthritis of facet joints symptoms

A

Sharp pain on same side with rotation, side flexion, extension
Pulling sensation on opposite side
No pain with isometrics
Tenderness on palpation
Positive lumbar kemps

62
Q

Spondylolisthesis

A

Bilateral defect of pars interarticularis with forward slippage of a vertebral body and transverse processes on vertebra below

63
Q

Spondylolisthesis Grade symptoms

A

Grade I: localized back pain
Grade II + III: Localized and radiating pain along dermatome and paraesthesia. Varrying degrees of functional impairment, B/B problems

64
Q

Concealed Spondylolisthesis

A

X-ray in supine: everything looks good
X-ray in standing: it shows up (unstable segment)

65
Q

Nerve root impingement signs/symptoms

A

Positive SLR, PKB test, valsalva, slump tests
Weakness of affected myotomes
Paraethesia of affected dermatomes
Diminished reflexes of affected nerve root
Altered posture

66
Q

Osteophytes

A

Bony protrusion from vertebral body - constant back pain

67
Q

Lumbar capsular pattern

A

Side flexion and rotation equally limited, extension

68
Q

How to evaluates peripheral joints in lumbar scan

A
  1. Squat test or AROM of each joint
  2. PSIS or gillet’s
  3. Sacral sulcus
69
Q

3 instances you wouldn’t use the squat test

A

Pregnancy
Obesity
Poor balance
Elderly
Obvious lower extremity joint problems

70
Q

Lumbar scan fill-ins

A

Goniometry
Passive extension in prone
Isometrics of lumbar spine
Isotonics (rarely done)
Local ST, SP, temp testing

71
Q

SLR test

A

Position: supine

Action: medially rotates and adducts the hip, then passively flexes the hip, keeping the hip medially rotated and adducted and the knee straight until the patient complains of pain or tightness. Slowly lets the hip extend passively until there is no pain or tightness. Then passively dorsiflexes the ankle then has the client flex their neck to see if pain returns

PR: pain radiates down leg on that side L4-S3 dermatome

Indicates: Nerve root impingement L4-S3

72
Q

SLR test 0-35 degrees and 35-70 degrees

A

0-35: SI joint pathology
35-70: Dural impingement/nerve root

73
Q

PKB test

A

Position: prone

Action: Examiner passively flexes client’s knee so their heel is touching their butt, hold for 45 seconds

PR: reproduction of symptoms along L2 or L3 or L4 or femoral nerve root

Indicates: Nerve root impingement of L2 or L3 or L4 or femoral nerve root

74
Q

What needs to be ruled out for SLR and PKB test?

A

SLR: hamstring pain/tightness and SI joint pathology
PKB: rec fem tighteness and SI joint pathology

75
Q

PKB dural stretch degrees

A

80-100

76
Q

Valsalva maneuver

A

Indicates: increased intrathecal pressure due to space occupying lesions

Position: sitting

Action: instruct patient to take a breath, hold it, and then bear down as if evacuating the bowels

PR: increase symptoms in lower extremity or lower back

77
Q

Slump test

A

Position: sitting with hands behind back and chin up

Action: Ask patient to slump while examiner holds chin and head erect. If no symptoms, apply overpressure through neck or thoracic spine. If no symptoms, extend one of the patient’s knees. If no symptoms, passively dorsiflex patient’s ankle. If symptoms are reproduced, add neck extension at to see if symptoms decrease. (this confirms positive response)

PR: Reproduction of patient’s symptoms along affected dermatome

Indicates: Dural or nerve root impingement

78
Q

Lumbar kemp’s

A

Position: standing

Action: Examiner stands behind patient and passively rotates, side flexes, and extends the patients spine with one hand, while stabilizing the opposite pelvis with the other hand. Apply downward pressure through shoulders using both hands

PR: local pain on the side that is rotated, side flexed and extended

Indicates: Facet joint sprain

79
Q

If a patient states that sitting, coughing, sneezing results in leg pain, what structure is likely compressing the nerve root?

A

Disc protrusion (can also be a tumour)

80
Q

Scoliosis (named after?)

A

Curvature of the spine, named after the convexity

81
Q

Spinal stenosis vs. nerve root impingement

A

Spinal stenosis: symptoms are aggravated by extension/relieved by flexion
NRI: opposite

82
Q

Lordosis

A

Anterior curvature of the spine

83
Q

Kyphosis

A

Posterior curvature of the spine

84
Q

Structural vs non-structural scoliosis

A

Functional: curve disappears on flexion
Structural: Curve is visible on flexion

85
Q

Gibbus deformity

A

Sharp, angulated kyphosis

86
Q

Effect of flexion in spinal stenosis vs. disc protrusion

A

Spinal stenosis: reduces pain because the cord stretches, narrows + fits in canal with less pressure
Disc protrusion: Increase pain because it forces disc material posteriorly, where nerve roots are located, causing pressure on nerve roots

87
Q

2 structures aggravated by lumbar lordosis

A

Anterior longitudinal ligament
Facet joints

88
Q

Purpose of scan

A

To determine if symptoms the patient is experiencing is due to a pathology in the lumbar spine, peripheral joints, or both

89
Q

Landmarks for spinal flexion measurements

A

Whole spine: C7-S1
Thoracic: C7-T12
Lumbar: T12-S1

90
Q

Grade 0

A

Zero
No contraction palpated or visible

91
Q

Grade 1

A

Trace
Evidence of slight contractility but no joint movement

92
Q

Grade 2-

A

Poor -
Initiates motion w/o gravity

93
Q

Grade 2

A

Poor
Complete ROM w/o gravity

94
Q

Grade 2 +

A

Poor +
Initiates motion against grvaity

95
Q

Grade 3-

A

Fair -
Incomplete ROm against gravity

96
Q

Grade 3

A

Fair
Complete ROM against gravity

97
Q

Grade 3 +

A

Fair +
Complete ROM against gravity and minimal resistance

Assessment II (5 decks)

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