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Patient Assessment > Summer Semester Final > Flashcards

Summer Semester Final Flashcards

1
Q

3 types of joints

A
  1. Cartilaginous (min movment - syphysis pubis)
  2. Fibrous ( immovable - skull sutures)
  3. Synovial (freely movable - hip/shoulder)
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2
Q

Busiest joint in the body?

A

Temporomandibular joint

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3
Q

An exaggerated thoracic kyphosis is…

A

hunchback –> gibbous

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4
Q

Exaggerated thoracic kyphosis in post menopausal women

A

Dowager’s hump…caused from osteoporotic wedge fx

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5
Q

If a patient comes in complaining of shoulder pain and during the physical exam you take them through ROM and provacative maneurvers w/o any pain then what is the most likely etiology of pain?

A

Neck pain

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6
Q

A patient bends forward to touch their toes and their lordosis does not flatten. What may this mean?

A

Paravertebral muscle spasm

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7
Q

A pt w/ suspected cervical radiculopathy may have neurologic deficits in _____

A pt w/ suspected cervical myelopathy may have….

A

Cervical radiculopathy –> neurologic defects in UE

Cervical myelopathy –> upper and lower extremity deficits

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8
Q

If a patient comes in with neck pain and when asked to swallow they report difficulty swallowing then they likely have…

A

Anterior cervical disk herniation

Bony osteophytes

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9
Q

Distinguish Adson’s test with Wright’s Test

A

Adson’s: pt turns head TOWARD arm being tested

Wright’s: pt turns head AWAY from arm being tested

Both test for Thoracic Outlet Syndrome (subclavian artery)

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10
Q

The iliac crests sit at which spinal level?

A

L4-L5

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11
Q

Describe the straight leg test

A

We lift pt’s leg and note pain. If pt has pain then we lower until they feel no more pain. Then we dorsiflex foot. If pain still occurs this is a positive sign and most likely herniated nucleus pulposus of a disc that is stretching the sciatic nerve

If no pain with dorsiflexion –> hamstring tightness

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12
Q

Describe the crossed straight leg raise test

A

Straight leg test on unaffected side and if pain occurs (on involved side) then it is even more suggestive that pt has a herniated disc

–> Add on test to straight leg test

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13
Q

What does the Hoover Test look for?

A

Malingers that say they are weak in a leg/can’t move it at all.

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14
Q

What is the normal “carrying angle” of elbow in females and males?

An inc. angle of ____ may indicate a hx of ____.

A dec. angle of ___ may indicate a hx of ____.

A

Females: 10 degrees
Males: 5 degrees

Angle > 15 –> hx of lateral epicondylar fx and epiphyseal damage as a child

Angle < 5 –> called a gunstock deformity and may indicate supracondylar fx as a child w epiphyseal injury

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15
Q

Where will a patient feel numbness/tingling with ulnar nerve compression?

A

Pinky finger and ring finger (maybe half of ring finger…most can’t distinguish)

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16
Q

Which is more common? Tennis elbow or golfer’s elbow?

A

Tennis elbow (latera epicondylitis)

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17
Q

Where do you palpate the brachioradialis muscle/how do you make it more prominant? (remember to use anatomical position)

A

Have pt place hand under table and pull up

Brachioradialis is anterolateral

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18
Q

Going from medial to lateral: median nerve, brachial artery, biceps tendon

A

Median nerve –> Brachial artery –> Biceps tendon

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19
Q

4 movements at the elbow and the degrees of movement associated

A
  1. Flexion - 135
  2. Extension - 0
  3. Pronation - 90
  4. Supination - 90
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20
Q

Tinel’s Sign (elbow) tests for _________.

A

Ulnar Nerve Compression

–> Tap on ulnar groove –> (+) is tingling in pinky/ring finger

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21
Q

Thickened palmar fascia over the palmar aspect of the hand causes flexion in 3-5th fingers is called….

A

Dupuytren’s contractures

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22
Q

Joints involved in RA vs. OA

A

RA: PIP, MCP, wrist joints (ulnar deviation)

OA: DIP, PIP

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23
Q

What is a Mallet finger?

A

WHAT YOU HAVE

After avulsion fx of distal phalanx - result of bony build up –> can’t flex finger

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24
Q

Swan neck and boutonniere deformities are associated with ____.

A

RA

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25
Q

Small closed space infection at the distal pulp of finger

A

Felon

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26
Q

Fingernail abscess usually infected with S. aureus

A

Paronychia

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27
Q

Atrophy of the thenar eminence would suggest…

A

Carpal Tunnel Syndrome (compression of median nerve)

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28
Q

Hypothenar atrophy indicates..

A

Ulnar nerve injury

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29
Q

Most commonly fxed carpal bone

A

Navicular

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30
Q

A pt presents w/ tenderness over the snuffbox. what does this indicate?

A

Navicular fx

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31
Q

What does the Finkelstein maneuver test for?

A

DeQuervian’s dz

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32
Q

Wrist Flexion/Extension (degrees)

Wrist ulnar/radial deviation (degrees)

A

Flexion - 80
Extension - 70
Ulnar deviation - 30
Radial deviation - 20

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33
Q

Where is a good place to check for pure radial nerve sensation?

A

Dorsal web space between the thumb and index finger

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34
Q

Phalen’s Test

A

Test for Carpal tunnel syndrome

Pt holds wrists together in flexed position for 1 minute…if tingling sensation it is positive

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35
Q

Allen’s test

A

Tests competency of radial and ulnar arteries…the pumping the hand and releasing one artery to look for collateral blood flow

36
Q

Genu valgus

A

Knock-knee

37
Q

Genu varus

A

Bow-legged

38
Q

Genu recurvatum

A

Hyperextended knees

39
Q

What can joint line tenderness be a sign of?

A

OA
Meniscal tears/cysts
Synovitis

40
Q

A lump on the tibial tubercle (anteriorly) is consistent with….

A

Osgood Schlatter Disease

41
Q

Is a Baker’s cyst usually medial or lateral?

A

Medial

42
Q

Special tests for possible ACL tear

A

Lachman - knee flexed 30 degrees, draw tibia toward you and look for laxity (knee is supported by hand)

Anterior Draw Test - sitting on feet and using two hands

43
Q

Which is more sensitive for an ACL tear? Lachman’s or Anterior Draw Test?

A

Lachman’s Test

44
Q

Special tests if MCL tear was suspected

A

Flex knees to 30 degrees, support femur w/ hand and apply valgus stress

45
Q

Normal laxity of MCL:
Grade 2 tear laxity of MCL:
Grade 3 tear laxity of MCL:

A

Normal: 0-5mm
Grade 2: 5-10mm
Grade 3: >10mm

46
Q

The knee can flex how many degrees? (do this via squatting

A

130 degrees

47
Q

McMurrays test

A

Assess for torn meniscus

Rotate knee first internally then externally

(+) is pain and joint line tenderness, further confirmation by audible click

48
Q

Apley Grind Test

A

Same as McMurray’s except pt is laying prone instead of supine

49
Q

Squeeze Test

A

Tests extensor dysfunction
Squeeze quad at it’s attachment to patella and then have pt gently tighten quad muscle

Pain is a positive response

50
Q

If a pt is noticed to have wear/tear on the medial side of their shoe what kind of foot anatomy do they have?

A

Flat feet

51
Q

Bunionette

A

Small bunion on lateral side of foot

aka Tailor’s Bunion

52
Q

Pump bump’s medical name is….

A

Haglunds deformity

53
Q

3 lateral ligaments of the ankle

A
  1. Anterior talofibular ligament
  2. Calcaneofibular ligament
  3. Posterior talofibular ligament
54
Q

Which of the lateral ligaments of the ankle is most often injured?

A

Anterior talofibular ligament

  • -> calcaneofibular injured in more severe sprains
  • -> posterior talofibular injured in the MOST SEVERE sprains
55
Q

Primary foot everter muscles

A

Peroneus longus and brevis

56
Q

Where does Morton’s neuroma most often appear?

A

Between 3rd and 4th MT head

57
Q

Ankle: dorsiflex/plantar flex/invert/evert and degrees associated

A

Dorsiflex: 20
Plantar flex: 50
Invert: 5
Evert: 5

58
Q

Where would you measure when wanting to measure leg length?

A

From superior iliac spine –> medial malleolus

run tape measure across medial side of knee

59
Q

If you suspect trochanteric bursitis after palpation then what other test can you do?

A

Move leg into abduction and external rotation (knee flexed) and this should produce pain

60
Q

Rectus femoris ____ the leg and gluteus medius _____ the leg.

A

flexes

abducts

61
Q

Hip ROM:

  • Abduction
  • Adduction
  • Flexion
  • Extension
  • Internal Rotation
  • External Rotation
A 
Abduction - 45
Adduction - 20
Flexion - 135
Extension - 30 
IR - 35
ER - 45
62
Q

Thomas Test

A

Determines presence of a flexion contracture of hip

Pt lies supine, we place hand in lordotic curve and have pt hold one leg flexed toward their chest

THE HIP BEING TESTED IS THE CONTRALATERAL HIP

Normal: lordotic curve flattens and contralateral leg remains on table
ABnormal: Contralateral leg comes off the table

63
Q

Condyloid joint

A

Permits movement in two axes, ex: wrist

64
Q

Saddle Joint

A

Biaxial joint; ex: carpometacarpal joint of thumb

65
Q

Pivot joint

A

Rotation in one axis (longitudinal); ex: proximal radioulnar joint

66
Q

____ weakness is usually myopathy; ____ weakness is usually a _____.

A

Proximal

Distal

67
Q

Do pts w/ polymyalgia usually have proximal muscle weakness or distal?

A

Promixal muscle weakness

68
Q

Symptoms of myasthenia gravis

A

Generalized weakness
Diplopia
Difficulty swallowing

69
Q

A persistence of the concavity of the spine may indicate ________.

A

Ankylosing Spondylitis

70
Q

What other etiologies should you keep in mind when a patient presents w/ shoulder pain?

A

It could possibly referred from either chest or abdomen

71
Q

A pt comes in w/ sudden onset of shoulder pain and says he was in a car accident and hit his shoulder against the window about 7 hours ago. What do you suspect?

A

Rotator cuff tear or rupture

72
Q

Hallmark of bicipital tendinitis

A

Reproduction of anterior shoulder pain during resistance to forearm supination

73
Q

What range of motion is first lost w/ degenerative disease of the hip?

A

External rotation

74
Q

Trendelenburg Test

A

Normal: pt puts weight on one foot (standing) and contralateral hip goes up

ABnormal: pt puts weight on one foot (standing) and contralateral hip goes down

75
Q

Tuberous sclerosis classic triad

A
  1. Mental retardation
  2. Seizures
  3. Adenoma sebaceum - occurs near nasolabial folds and over cheaks
76
Q

Kaposi’s Sarcoma frequently seen on the feet.

A

Can occur anywhere really. Bx to confirm dx

77
Q

Bullosis diabeticorum

A

Noninflammatory, blistering condition that usually occurs in pts w/ long-standing diabetes

Tense bullae develop on normal-appearing skin in acral areas

78
Q

Cutaneous larva migrans

A

Hookworms that invade bottom of feet and leave trails of their burrows. Parasite is unable to invade the dermis

79
Q

Sesamoiditis

A

Pain in ball of foot, usually effects young active people (ballerinas, catchers, joggers)

80
Q

Patient’s who cannot accomplish the finger-to-nose test (overshoot) may have _____.

A

Cerebellar disease

81
Q

Diadochokinesia

A

Rapid alternating movements

82
Q

Pt walks with a weak/spastic leg and arm is flexed at elbow. Gait?

A

Hemiplegia gait

–> probably from stroke

83
Q

Pt walks w/ head bowed, back bent over and shuffles with short, hurried steps. Gait?

A

Parkinsonian Gait

–> Parkinson’s Disease

84
Q

Pt walks with feet very far apart and moves clumsily

A

Cerebellar Ataxia

85
Q

Pt is walking with high steps and slaps feet down forcefully

A

Sensory ataxia

86
Q

Pt is walking with high steps

A

Foot Drop

Patient Assessment (2 decks)

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