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Physical Diagnosis Exam 3 (Lauren) > Spine And Lower Extremity > Flashcards

Spine And Lower Extremity Flashcards

1
Q

Where do you test for edema?

A

Dorsum of foot

Behind medial malleolus

Shins

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2
Q

What is stasis dermatitis?

A

A result of chronic venous insufficiency with incompetent valves and high pressure in capillaries.

Tissue damage and brawny edema

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3
Q

What is a positive bulge sign and what does it suggest?

A

If you stroke the medial side of the knee upwards, and then stroke the lateral side downwards, and you see a Bulge of fluid on the medial side.

Suggests Minor*** effusion

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4
Q

What direction of hip ROM does the Patrick’s Test/FABER test evaluate?

A

Hip abduction

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5
Q

What is the Adams Forward bending test?

A

Patient bends forward and you inspect for limb length discrepancy as well as scoliosis

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6
Q

What is a positive posterior drawer sign

A

Excessive laxity suggests a PCL tear

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7
Q

What are the ankle and foot motions that you must test ROM for in the practical? Which ones are required to do strength testing?

A

Dorsiflexion* and plantar flexion*

Inversion* and eversion*

Toe flexion and extension

(* denotes ones you must strength test)

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8
Q

What nerve root:

Weakness of plantar flexion of foot and big toe

A

S1

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9
Q

When palpating the lower leg, what does a palpable “cord” suggest

A

Thrombosed vein

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10
Q

Are bakers cysts painful

A

If they leak fluid or rupture

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11
Q

What vertebral level is the straight leg raising test most sensitive for?

A

L5-S1

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12
Q

How do you test the lateral meniscus with McMurrays test

A

Internally rotate at the heel

Flex and extend the knee while providing varus stress

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13
Q

What nerve root:

Trouble with “squat and rise” test

A

L4

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14
Q

How often are popliteal arteries bilateral

A

50% of the time

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15
Q

What is the most common aneurysm of the peripheral vascular system?

A

Popliteal artery aneurysm

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16
Q

What is a positive seated SLR test/“flip sign”

A

When you passively extend their knee, they will “flip back” due to pain

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17
Q

What is kyphosis?

A

Thoracic convexity is too extreme

“Hunchback”

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18
Q

What is pes planus

A

Flat foot

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19
Q

What are the landmarks of the ankle and foot that you must palpate for the practical

A

Achilles’ tendon

Medial malleolus

Lateral malleolus

Calcaneus

Tarsals

Metatarsals

MTP joints

IP joints

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20
Q

What does the McMurray Test for

A

Meniscus **

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21
Q

What test is this:
Stabilize distal tibia

Grasp calcaneus and pull forward

A

Anterior drawer test of ankle

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22
Q

What is the best position for the patient to be in in order to test hip extension?

A 
While standing 
(Do not have to do for practical)
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23
Q

How do you document edema?

A

Grade and how far up the leg it goes

“3+ pitting edema to mid-calf”

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24
Q

What is varus?

A

“Bow legs”

RUM makes your knees spread apart

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25
Q

What nerve root:

Pt can not walk on toes

A

S1

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26
Q

What is this test:
Patient in supine position, knee flexed 20-30 degrees

Stabilize distal femur in one hand, while attempting to displace tibia anteriorly with the other

A

Lachman

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27
Q

What is the galeazzi test?

A

Patient lies supine with knees flexed 90 and feet together and flat on table

Check to see if the patellae are the same height

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28
Q

What is a positive trendelenberg test?

A

If the patient stand on their right leg and their left hip drops.
Indicates weak hip on the RIGHT side.

(Or vice versa)

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29
Q

What nerve root:

Ankle jerk reflex diminished

A

S1

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30
Q

Who is most likely to get a popliteal artery aneurysm

A

Males

Over 65

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31
Q

What ROM tests must be done in the hip?

Which ones require strength testing for the practical?

A

Abduction* and adduction*

Flexion* and extension

Internal and external rotation

(* denotes the ones you must also strength test)

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32
Q

How do you palpate a bakers cyst?>

A

Extend the knee

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33
Q

What two pulses do you need to check on the feet?

A

Dorsalis pedis

Posterior tibialis

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34
Q

What is a positive McMurrays test

A

Clicking and popping with flexion and extension

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35
Q

Where should your hands be when you do the FABER test?

A

One on patients knee and the other on their other hip**

*MUST stabilize their pelvis

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36
Q

What position is the patient in when you test hip flexion?

A

Supine

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37
Q

What is lordosis

A

Extreme lumbar concavity

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38
Q

What does a positive seated SLR/“flip sign” indicate?

A

Spinal nerve compression/irritation

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39
Q

What is this:

Dilated, tortuous, superficial veins that result from defective structure and function of the valves

A

Venous insufficiency

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40
Q

What does it mean to inspect for patellar tracking during the inspection of the knee?

A

Making sure the patella goes straight up and down

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41
Q

Can you do hip and knee ROM testing at the same time while the patient is supine, as long as you verbalize it?

A

Yes

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42
Q

How do you test the medial meniscus with mcmurray test

A

Externally rotate at heel

Flex and extend the knee while providing valgus stress to knee

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43
Q

What are the 3 names for the FABER test?

A

FABER

Patrick Test

Figure of Four

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44
Q

What are you looking for when the patient bends forward and touches their toes?

A

Scoliosis

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45
Q

Where is the dorsalis pedis pulse?

A

Dorsum of foot

Over 1st-2nd metatarsals

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46
Q

What nerve root:

Numbness on bottom of foot and on back of calf?

A

S1

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47
Q

What exam do we use to assess for hypertrophy or atrophy of leg muscles

A

Circumference measuring exam

48
Q

What is scoliosis?

A

Spine is curved laterally

49
Q

How do you do the valgus stress test?

A

Stabilize lateral joint line**

Place other hand on distal tibia

ABduct the tibia in relation to the femur

DO IT TWICE 0 and 30 degrees of flexion

Evalaute the medial joint space

50
Q

What does “pitting” edema mean

A

The indentation stays there

51
Q

What is a positive anterior drawer sign of the knee

A

Anterior translation of the tibia without a firm endpoint

52
Q

What does a positive posterior sag sign suggest?

A

PCL tear

53
Q

How do you do the straight leg raising test/ Lasegues test

A

Pt supine and you lift their straightened leg straight up

Looking for radiating** pain in the affected limb

dorsiflexing ankle may increase pain response

54
Q

How do you do the varus stress test?

A

Stabilize the medial** joint line

Put other hand on distal tibia

ADduct the tibia in relation to the femur

DO IT TWICE at 0 and 30 degrees of knee flexion

Evaluate lateral joint space

55
Q

What grade would you give a bounding pulse

A

4+

56
Q

When do you start the inspection of the hip and thigh?

A

Right after the abdomen/inguinal exam becasue the patient is already supine

57
Q

What is the most useful test for diagnosing an ACL tear?

A

Lachman

58
Q

Do you test hip adduction/abduction actively or passively

A

Passively.

You move the patients leg

59
Q

When testing hip flexion, can you do them both at the same time

A

No

60
Q

What motions do you have to test ROM and strength testing for in the knee?

A

Flexion and extension

61
Q

If you find pulsatile swelling behind the knee, what do you think it is

A

Popliteal artery aneurysm

62
Q

What parts of the spine do you need to palpate

A

Spinous processes

Paravertebral muscles

63
Q

What knee landmarks do you need to palpate for the practical

A

Quadriceps tendon

Patella

Patellar tendon

Medial and lateral joint lines

Tibial tiberosity

64
Q

How do you test for ballottement of the patella?

A

Compress the suprapatellar pouch and press down on the patella. Feel for fluid under the patella and look for fluid returning to the suprapatellar pouch

65
Q

What does the Thompson test test for

A

Achilles’ tendon tear

66
Q

What grade would a diminished, weak, but still palpable pulse get

A

1+

67
Q

What does the pelvic compression test evaluate?

A

Pelvic stability

Little value

68
Q

If a patient has a tender/painful area, should you palate it right away?

A

No, always palpate tender areas last

69
Q

What is the clinical presentation of venous insufficiency?

A

Dull ache or pressure sensation after prolonged standing

Pain gets better with elevation

Ankle edema and ankle ulcers

Thrombosis

70
Q

What is pes cavus

A

High arch of the foot

71
Q

What is the range of grades for edema

A

0-4+

72
Q

What disease is associated with pes cavus (high arch)

A

Charcot-Marie Tooth disease

73
Q

What skin temperature and cap refill time would be expected with peripheral artery insufficiency?

A

Cool skin

Delayed cap refill (more than 2 seconds)

74
Q

How do you perform the Thompson test?

A

Have patient kneel on stool or lie prone with foot hanging off table

Squeeze their calf

Observe for plantar flexion

75
Q

What are the 2 tests to test for leg length discrepancy?

A

Galeazzi

Comparing measured distance from ASIS to medial malleolus

76
Q

Do you need to actually examine the inguinal region for nodes, pulses, and hernias?

A

No just verbalize

77
Q

If you see one arm or leg that is way more swollen than the other, what should you suspect?

A

Lymphedema

78
Q

What nerve root:

Knee jerk reflex diminished

A

L4

79
Q

What nerve root:

Weakness with extension of quadriceps

A

L4

80
Q

What is a positive FABER/Patrick test?

A

SI joint pain

81
Q

How do you palpate the popliteal pulse?

A

Knee should be flexed

Press DEEP

82
Q

What is the other name for the Straight Leg Raising test?

A

Lasegue’s Test (Sign)**

83
Q

What does the anterior drawer test of the knee test for?

A

ACL tear

84
Q

What is a bakers cyst

A

A synovial fluid test in the popliteal space

85
Q

How do you grade the amplitude of pulses?

A

0 absent unable to palpate

1+ diminished, weaker than expected

2+ brisk, normal

3+ increased

4+ bounding

86
Q

What nerve root:

Pain down lateral side of leg

A

L5

87
Q

What is a normal grade of pulse

A

2+

88
Q

What does the Apley Compression test test for

A

Meniscus injury

89
Q

What are you doing with your hands for the anterior drawer test of the knee

A

Pushing in with thumbs on the joint lines

Pulling with your fingers on the hamstring insertions

PUlling tibia forward and checking for excessive forward movement

90
Q

What is valgus?

A

“Knock knees”

GUM makes your knees stick together

91
Q

What are the two ways venous insufficiency can present

A

Varicose

Stasis dermatitis

92
Q

How do you test for an MCL injury

A

Valgus stress test

93
Q

How do you do the apley compression test

A

Patient supine

Flex knee to 90 degrees

Pres down on foot and grind it back and forth

Then do it again with a distraction

94
Q

What is Brawny edema and what is it caused by?

A

Non pitting edema

Caused by stasis dermatitis/venous insufficiency

95
Q

What are the two ways that ROM must be tested

A

Actively

Passively

96
Q

Why do neuropathic ulcers get so bad

A

The diabetic patients cant feel them

97
Q

What are the landmarks you must palpate in the hip and thigh?

A

Iliac crest*

Anterior superior iliac spine

Pubic symphysis*

Greater trochanter

Ischial tuberosity*

Quadriceps

Hamstrings

Femur

(* denotes ones you just verbalize for practical)

98
Q

Where should you auscultation for bruits if you suspect peripheral artery disease

A

Abdominal aorta

Femoral artery

Popliteal artery

99
Q

What does the FADIR test for?

A

Impingement

100
Q

What does the posterior drawer sign test for

A

PCL tear

101
Q

How do you test for an injury to the LCL

A

Varus Stress Test

102
Q

What are these signs of if you see them in the feet/ankles:
Pallor

Dependent rubor

Distal hair loss

Atrophic skin, nail changes

Ulcers

Necrosis/gangrene

A

Peripheral artery insufficiency

103
Q

What ROM directions do you need to test in the spine

A

Flexion

Extension

Rotation

Lateral bending

104
Q

What nerve root:

Pain down front of leg

A

L4

105
Q

What causes venous insufficnecy

A

Incompetent valves

106
Q

What test do you use for minor knee effusions vs large effusions

A

Minor: bulge sign

Large: Ballottement

107
Q

What is a positive Thompson test?

A

Foot does not plantar flex when you squeeze their calf

108
Q

Where is the posterior tibial pulse?

A

Behind and slightly below the MEDIAL malleolus

109
Q

Do you need to do ROM and strength testing on both sides?

A

Yes, always compare bilaterally

110
Q

What does the straight leg raising test test for?

A

Lumbosacral radiculopathy

And/or

Sciatic neuropathy

111
Q

What is the most SENSITIVE test for diagnosing an ACL tear

A 
Pivot test
(Must be done under sedation)
112
Q

What pulses do you need to check for if you suspect peripheral artery insufficiency??

A

Femoral

Popliteal

Dorsalis pedis

Tibial

113
Q

What never root:

Weakneess with dorsiflexion of foot and big toe

A

L5

114
Q

What are the subdivisions of the lower extremity?

A

Hip

Thigh

Leg

Ankle

Foot

  • hindfoot
  • mid Foot
  • forefoot
115
Q

What nerve root:

Pain down back of leg

A

S1

116
Q

What nerve root:

Difficulty walking on heels

A

L5

Physical Diagnosis Exam 3 (Lauren) (4 decks)

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