spine and hips

Question 1

ROM back (extension/hyper extension)

Answer 1

extension=0

hyperextension=30deg

Question 2

ROM back (forward flexion)

Answer 2

75deg

Question 3

ROM back (lateral bending)

Answer 3

35deg left and right

Question 4

ROM hip (flexion)

Answer 4

120deg

Question 5

ROM hip (extension/hyperextension)

Answer 5

extension=0

hyperextension=30

Question 6

ROM hip (ABduction)

Answer 6

45deg

Question 7

ROM hip (ADduction)

Answer 7

30deg

Question 8

ROM hip (rotation at EXTENSION)

Answer 8

external=45deg

internal=40deg

Question 9

ROM hip (rotation at FLEXION)

Answer 9

external=45deg

internal=40deg

Question 10

thoracic kyphosis

Answer 10

increased convex curvature of the thoracic spine (humpback)

Question 11

lumbar lordosis

Answer 11

accentuation of the lumbar curvature of the spine

Question 12

kyphoscoliosis

Answer 12

combination of lateral curvature and convex curvature of the spine

Question 13

gibbus deformity

Answer 13

type of kyphosis resulting in a sharp (almost pointy) convex curvature of the spine

Question 14

scoliosis

Answer 14

lateral curvature of the spine

Question 15

the distraction test

Answer 15

one hand under the chin and other under occiput, gently lift (distract) head to remove weight from neck; pt should have pain relief due to narrowing of neural foramen (relieving nerve compression)

Question 16

the Adson test

Answer 16

locate radial pulse, then ABduct (away from body), extend (behind patient), and rotate (thumbs up!) the arm–if theres diminished or absent radial pulse=compression of subclavian artery

Question 17

straight leg raising test

Answer 17

to determine cause of back pain: with pt supine, raise straight leg (support foot) and dorsiflex foot–if pain on dorsiflexion, could be caused by sciatic nerve (vs tight hamstrings)

Question 18

the valsalva test

Answer 18

ask patient to bear down (like in bowel movement), if pain is felt in back or radiating down legs the origin is probably intrathecal (subarachnoid space of spinal cord) pressure

Question 19

the compression test

Answer 19

press down on the top of pt’s head while they are sitting or supine; if pain is produced, is it in cervical spine? or extremity-if so, note exact distribution and if it follows any dermatomes-can locate neurologic level of pathology

Question 20

the Hoover test

Answer 20

cup hand under straight leg, have pt raise opposite leg, should feel downward pressure on cupped foot (absence of pressure=patient is not really trying)

Question 21

the pelvic rock test

Answer 21

with pt supine, grasp pelvis with thumbs on iliac spines and palms on iliac tubercles then forcibly compress pelvis towards midline; pain around sacroiliac joint indicates pathology in the joint itself

Question 22

Trendelenburg test

Answer 22

used to determine strength of gluteus medius muscle: observe the patient standing (look for dimples posteriorly above the iliac spines), ask patient to raise one leg (dimple on that side should raise). If the dimple on raised leg side actually descends or stays put POSITIVE trendelenburg sign–glut medius muscle (of leg pt is STANDING on) is weak or nonfunctioning

Question 23

pelvic obliquity

Answer 23

uneven anterior or posterior superior iliac spines while patient is standing (could be due to leg length discrepancy, scoliosis)

Question 24

Fabere Patrick test

Answer 24

with pt supine, bring foot of one leg to knee of opposite leg (hip joint is now flexed, ABducted, and externally rotated); if pain in inguinal area resting or with downward pressure, may be pathology in sacroiliac joint

Question 25

Thomas test

Answer 25

with patient supine, fully extend one leg flat and flex other leg (knee to chest)–look if extended leg remains flat on table–lifting of extended leg indicates hip flexion contracture of extended leg

Question 26

C5 (motor, sensory, neuro)

Answer 26

motor: deltoid and biceps
sensory: lateral arm
neuro: brachial reflex

Question 27

C6 (motor, sensory, neuro)

Answer 27

motor: wrist extensors (extensor carpi radialis longus, brevis and ulnaris)
sensory: thumb web space and index finger
neuro: brachioradialis reflex

Question 28

C7 (motor, sensory, neuro)

Answer 28

motor: triceps, wrist flexor muscles, finger extensors
sensory: middle (long) finger pad
neuro: triceps reflex

Question 29

C8 (motor, sensory, neuro)

Answer 29

motor: finger flexors, ABductors, ADductors
sensory: ring and little finger along ulnar side of hand
neuro: no reflex

Question 30

L4 (motor, sensory, neuro)

Answer 30

motor: have patient walk on heels–tibialis anterior
sensory: test sensation over medical calf/foot–deep peroneal nerve
neuro: patellar reflex

Question 31

L5 (motor, sensory, neuro)

Answer 31

motor: have patient lift great toe against resistance–extensor hallicus longus
sensory: test sensation over web space of great toe–deep peroneal nerve
neuro: no reflex

Question 32

S1 (motor, sensory, neuro)

Answer 32

motor: patient walk on tip toes–peroneus, gastrocnemius, soleus
sensory: sensation over lateral foot–peroneus longus & brevus
neuro: achilles reflex