Quiz 2 Flashcards
the following is true of hip fractures in the elderly patient:
a. most commonly occurs in male patients
b. approximatley 15-20% of patients die within 1 year of fracture
c. upon initial presentation, the patient will always be able to bear weight and/or ambulate
d. patients will have a history of significant precipitating trauma
b. approximatley 15-20% of patients die within 1 year of fracture
a patient describes experiencing insidious onset of pain that they never felt before. when you ask them to identify the location of the pain they tell you that they feel the pain in their right hip. based only on this information, in order to arrive at the correct diagnosis, the physical examination must include at minimum, an evaluation of the:
A. right hip
B. bilateral hips
C. bilateral hips, knees and lumbosacral spine
D. bilateral hips and knees
C. bilateral hips, knees and lumbosacral spine
you suspect a patient has suffered a tear of their right medial meniscus, which of the following tests do you anticipate will be positive?
A. Modified Helfet’s test
B. anterior drawer test
C. lachman’s test
D. thomas test
A. Modified Helfet’s test
an infant is supine. grasping both of the thighs at the lesser trochanters, the doctor flexes and abducts the thighs bilaterally. an audible clunking is elicited. this finding indicates that the infant has:
A. a femoral neck fracture
B. an acetabular labral tear
C. congenital hip displasia
D. tibial and femoral length discrepancy
C. congenital hip displasia
the name of the orthopedic test described in the previous question is:
A. modified Helfet’s test
B. Ortolani’s test
C. thomas test
D. alli’s test
B. Ortolani’s test
upon measuring the actual leg length of a patient, you notice a discrepancy between the left and the right lower extremity. to determine the cause, you flex the knees and hips of the supine patient to 45 degrees making sure their heels are lined up and feet are resting flat on the table. you observe the alignment of the legs from the side of the treatment table and notice that the femur is protruding further caudally. this finding indicates that the cause of the actual leg length discrepancy is a:
A. functional leg length discrepancy
B. tibial length discrepancy
C. femoral length discrepancy
D. muscle length discrepancy
C. femoral length discrepancy
a patient, who is an avid runner, presents with a complaint of recurrent pain in their right hip and a history of recurrent right sided SI joint sublaxation. during the physical examination, which orthopedic tests will help you determine if contractures of the rectus femorismuscle and the TFL are contributing to this patients complaint?
A. Allis test and ober’s test
B. thomas test and Alli’s test
C. alli’s test and modified Helefit’s test
D. Ober’s test and thomas test
D. Ober’s test and thomas test
An 11 year old boy sustains a severe injury while playing soccer. you observe a palpable defect across the entire belly of the tight hamstring muscle that is associated with severe pain and swelling and complete fuctional loss. based on this clinical picture, until you prove otherwise, the initial working diagnosis is:
A. Grade 1 strain of the hamstring
B. grade 2 strain of the hamstring
C. avulsion fracture of the ischial apophysis
D. grade 3 strain of the hamstring
C. avulsion fracture of the ischial apophysis
a patient who is an avid soccer player is recovering from a grade 2 hamstring strain. on your advice, he has refrained from playing soccer during the rehabilitation and recovery phase of care but he is anxious to return to play. which of the following criteria is the BEST indication that the patient is ready to SAFELY return to playing soccer?
A. 4 weeks have gone by since the initial injury
B. 75% of normal ROM in the injured side is available
C. strength of the injured muscle is within 10% of unijured side.
D. the patient no longer feels pain in the injured muscle
C. strength of the injured muscle is within 10% of unijured side.
an 81 year old woman presents with a complaint of left sided hip pain. earlier that morning she was walking in her home and caught her left foot on a loose carpet. she stumbled and twisted her left leg but grabbed on a nearby table to prevent herself from falling. she is 5’1”, 90lbs and has been the same weight for decades. she leads a sedentary lifestyle and has never been active, even as a young girl. on physical examination she is able to ambulate with her cane but her gait is guarded and elecits severe pain in her left hip. left hip ROM is limited due to pain in all ranges, especially in internal rotation. based on the clinical picture provided, this patient is most likely suffering from:
A. acetabular labral tear
B. slipped capital epiphysis
C. subtrochanteric bursitis
D. femoral neck fracture
D. femoral neck fracture
a 39 year old man presents with a complaint of left sided groin pain. he cannot recall a traumatic episode that caused the pain. he rates the pain at 7/10. his 10 is traumatic Achilles tendon rupture 6 years ago. an avid runner for many years, he says that he has stopped running now due to the pain. he also has a hard time sleeping these days since the pain wakes him up at night. during gait analysis you observe that he is walking with a limp and he reports a feeling of clicking/ catching and locking in the hip with ambulation. Patrick’s test and Laguere’s test reproduce the paitents chief complaint. based on the clinical picture provided, this patient is most likely suffering from:
A. femoral neck fracture
B. acetabular labrum tears
C. myositis ossificans
D. slipped capital epiphysis
B. acetabular labrum tears
a 46 year old woman who is an avid runner presents with a complaint of painat her left lateral hip. the pain radiates along her left lateral thigh. the pain often wakes her at night when she rolls on to her left side. physical exam reveals tenderness and swelling of the greater trochanter, leg length discrepancy, and hypertonicity of the left IT band along with hyperpronation of both feet. left hip ROM is limited in internal rotation and patrick’s test elicits pain in the left hip. based on the clinical picture provided, this paitent is most likely suffering from:
A. subtrochanteric bursitis
B. femoral neck fracture
C. acetabular labral tears
D. slipped capital epiphysis
A. subtrochanteric bursitis
a 27 year old patient presents to your office complaining of right sided hip pain. during the history you uncover the following information: the patient is a non smoker, she does not have a personal or family history of cancer and she denies a history of menstrual irregularities, recent infection, fever, and weight loss or bowel and bladder problems. rest is palliative. based on the information attained from your line of questioning during the history thus far, which of the following conditions has NOT yet been considered as a potential source of the patients hip pain?
A. referred pain from the pelvic viscera
B. osteomyelitis
C. referred pain from the lumbar spine
D. metastatic disease
C. referred pain from the lumbar spine
while playing soccer, an athlete kicks the soccer ball sideways and suddenly experiences an incapacitating pulling pain in the groin at the pubic bone. which of the following conditions is MOST LIKELY to be causing the patients pain?
A. adductor magnus strain
B. hamstring strain
C. osteitis pubis
D.rectus femoris strain
A. adductor magnus strain
a 47 year old male patients presents complaining of an insidious onset of right sided groin pain that is exacerbated by weight bearing. he is walking with a limp. the pain was initially mild but has been getting progressively worse and is now presenting even at rest. he denies sensing a feeling of clicking, locking or giving away in the hip. the patient has a long time history of alcohol abuse and hyperlipidemia. which is the most likely diagnosis?
A. slipped capital epiphysis
B. accetabular labral tear
C. legg calve perthes disease
D. avascular necrosis of the femoral head
D. avascular necrosis of the femoral head
