spine and LE: Abn Flashcards
clinical presentation
- pallor
- dependent rubor
- distal hair loss
- atrophic skin, nail changes
- ulcers
- necrosis
Peripheral artery insufficiency
clinical presentation
- dull ache or pressure sensation after prolonged standing; relieved with elevation
- dependent ankle edema and ankle ulcerations may develop
- superficial thrombosis.thrombophlebitis may occur
venous insufficiency
what is stasis dermatitis
- due to chronic venous insufficiency with incompetent valves and higher pressure in capillary bed
- tissie is damaged and inflammed
- brawny edema: non-pitting edema
what is trendelenburg test
- test with patient standing and have them raise one knee
- evaluate for hip drop, which indicates weak hip abductors on the contralateral side (straight leg)
what impingment test is used to test FAI: Femoroacetabular Impingement
FADIR
what is the patrick test
FABER test: figure of four
valgus pressure
leg goes laterally; tests medial ligaments
varus pressure
foot returns in; tests lateral ligaments
clinical presentation
- synovial fluid cyst located in the popliteal space
- palpable as fluctuant fullness
- may be painful or result in calf swelling if they leak or rupture
baker’s cyst
what is the most common aneurysm of the peripheral vascular system
popliteal artery aneurysm
pulsatile swelling behind the knee is concerning for what
popliteal artery aneurysm
what is bulge sign: technique and function
- minor knee effusions
- with leg straight, place pressure over suprapatellar pouch while “milking” knee joint fluid down one side and up the other in order to observe a bulge
describe technique and function of ballottement of the patella
- large effusion
- compress suprapatellar pouch and sharply push patella against femur
- feel for fluid under the patella and observe for fluid returning to suprapatellar pouch
what is the anterior drawer test of the knee
- evaluation of ACL tear
- supine with hips flexed and knees flexed at 90
- stabilize foot flat on table
- thumbs on medial and lateral joint line with fingers on hamstring insertions
- pull tibia forward checking for excessive forward movement
- positive: anterior translation
what is the posterior drawer test of the knee
- evaluate PCL tear
1. similar to anterior drawer except that the tibia is pushed back
lachman’s test: function and technique
- ACL: most useful test for diagnosing ACL tear
- patient in supine position, knee flexed to 20-30 degrees
- stabilize distal femur in one hand while attempting to displace the tibia anteriorly with the other
posterior sag sign
- PCL injury
- note the amount of posterior sag relative to the other leg
- checked in both extension and 90 degrees of flexion with both internal and external rotation
McMurray test: medial meniscus technique
- knee flexed
- grasp heel with one hand and joint line of knee with thumb and index finger
- medial meniscus
- externall rotate heel, flex maximally, then slowly extend the knee while providing valgus stress to the knee
McMurray test: lateral meniscus technique
- knee flexed
- grasp heel with one hand and joint line of knee with thumb and index finger
- lateral meniscus
- internally rotate heel, flex maximally, then slowly extend the knee while providing varus stress to the knee
pes planus
flat foot
pes cavus
high arch
anterior drawer test of ankle
- stabilize the distal tibia
- grasp the calcaneus and pull forward
Homan’s sign: function and technique
- evaluation for DVT
- passive dorsiflexion of the foot in a patient with calf pain, tenderness, or swelling
- positive: calf pain increased with dorsiflexion
**variability in reliability and validity
thompson test: function and technique
- achilles tendon rupture
- have patient kneel on stool and squeeze calf
- observe for plantar flexion
identify the postural deformity
Kyphosis
identify the postural deformity
lordosis
90% of thoracic cerves are to what side?
convex to the right
how do you test for limb length discrepancy
- compare aligned legs at the medial malleolus in supine positions and measuring from ASIS to medial malleolus
straight leg raising test: function and technique
- lumbosacral radiculopathy and/or sciatic neuropathy
- most sensitive for L5-S1
- passive ROM while supine with knees extended
- dorsiflexion of ankle may further increase response
- positive: radiating pain in affected limb
flip sign
lumbar radiculopathy
- patient seated with hands on table
- passively extend knee
- positive sign: patient will “flip back” due to pain
motor weakness L4
extension of quadriceps
motor weakness of L5
dorsiflexion of great toe and foot
motor weakness of S1
plantar flexion of great toe and foot
screening exam of L4 radiculopathy
squat and rise
screening exam of L5 radiculopathy
heel walking
screening exam of S1 radiculopathy
walking on toes
reflexes L4
knee jerk diminised
reflexes L5
none reliable
reflexes S1
ankle jerk diminished
