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Unit 2 MTP > Unit 2 DOCS > Flashcards

Unit 2 DOCS Flashcards

1
Q

Describe how to perform the Thomas test and how you interpret the findings

A

Testing for hip flexor tightness

Place pt supine (check for excessive lordosis)
Flex hip on unaffected side, bringing knee to chest (ask pt to hold)
Check affected hip for flexion

Affected leg comes off table = positive

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1
Q

Describe how to perform the Ober test and how you interpret the findings

A

Testing for tightness of IT band, gluteus medius and minimus

Lay pt on their side with affected hip up.
While pushing the iliac crest inferiorly, hold the ankle and passively abduct and extend the hip.
Align ankle on same plane as greater trochanter.

Leg stays abducted = positive
Knee moves inward toward exam table = negative

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2
Q

Describe how to perform the FABER test and how you interpret the findings

A

Testing for various impingements, iolopsoas, or sacroiliac involvement

Place pt supine.
Passively move leg of affected hip into flexion, abduction, external rotation (create figure 4 with foot over opposite knee)
Gently lower knee toward table

Pain or limited motion = positive

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3
Q

Describe how to perform the Trendelenburg test and how you interpret the findings

A

Testing for hip abductor stability, gluteus medius strength

Ask pt to stand squarely to assess normal hip alignment
Ask pt to stand on one foot for 30 seconds while maintaining alignment

Pelvis falls > 2cm = positive

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4
Q

Name at least 5 skin lesion characteristics

A

Morphology
Size
Configuration
Shape
Distribution
Location
Texture
Color

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5
Q

What are the steps of the Strain/Counterstrain technique?

A

Diagnose SD
Find counterstrain point
Tell pt tenderness is 10/10
Place pt in position that reduces pain to 0/10
Hold for 90 seconds
Slowly return to neutral
Recheck counterstrain point

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6
Q

Describe the different techniques of Strain/Counterstrain

A

Time defined - hold for 90 seconds
Release defined - hold until physician feels a release (pulsating/”let go”/etc)

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7
Q

What are the steps of a hip joint exam?

A

Inspect gait
Palpate anterior and posterior landmarks
Palpate inguinal ligament and bursas
Assess ROM
Perform special maneuvers

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8
Q

What are the neuromuscular maturity signs looked for on an APGAR test?

A

Posture
Square window (wrist)
Arm recoil
Popliteal angle
Scarf sign
Heel to ear

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9
Q

What are the physical maturity signs looked for on an APGAR test?

A

Skin
Lanugo
Plantar surface crease
Breast
Eye/ear
Genitals

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10
Q

If the patient presents with pronation of the foot (dorsal flexion, eversion, and abduction), you suspect the fibular is in what position?

What test would you use to check?

A

Anterior to the femur

Anterior drawer test

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11
Q

If the patient presents with supination of the foot (plantar flexion, inversion, adduction), you suspect the fibular is in what position?

What test would you use to check?

A

Posterior to the femur

Posterior drawer test

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12
Q

What is the treatment position of the MCL/medial meniscus counterstrain point?

A

Moderate knee flexion, internal rotation, and slight adduction of
the tibia

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13
Q

What is the treatment position of the LCL/lateral meniscus counterstrain point?

A

Moderate knee flexion, slight abduction, internal or external
rotation of the tibia. May require ankle dorsiflexion and eversion

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14
Q

What is the treatment position of the popliteus counterstrain point?

A

Slight flexion of the knee with internal rotation of the tibia

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15
Q

What is the treatment position of the gastrocnemius counterstrain point?

A

Marked plantar flexion of the ankle with knee flexion

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16
Q

What is the treatment position of the ACL counterstrain point?

A

Place an object/pillow under the distal femur to create a fulcrum. Apply a shearing force by moving the proximal tibia posteriorly on the femur

Note: Classic Jones treatment

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17
Q

What are the Ottawa knee rules?

A

55+
Tenderness at head of fibula
Patellar tenderness
Inability to flex knee >90 degrees
Inability to bear weight

18
Q

Explain the difference between the Anterior Drawer Test and the Lachman test

A

The ADT is done by laying pt supine with hip at 45 degrees and knee at 90 degrees, then pulling knee forward with sudden jerk

Lachman test is done by laying pt supine with knee bent ~20 degree angle and slight external rotation of the hip, then pulling knee firmly and keeping thigh stable

19
Q

What are the 12 systems of the Objective section?

A

Constitutional (vital signs, general appearance)
Eyes
ENT
CV
Resp/Pulm
GI
GU
MSK
Derm
Neuro
Psych
Heme/Immuno/Lymph

20
Q

Outline the proponents of an APGAR score and their point systems

A

Appearance - (0 - blue or pale body, body pink, face blue), (1 - body pink, extremities blue), (2 - completely pink)
Pulse (0 - absent), (1 - < 100), (2 - >100)
Grimace - (0 - no response), (1 - grimace), (2 - cough/sneeze)
Activity (0 - limp), (1 - some flexion), (2 - active motion)
Respiratory (0 - absent), (1 - slow, irregular), (2 - good, crying)

21
Q

List the special tests done on a newborn

A

Rooting reflex
Sucking reflex
Palmar grasp reflex
Plantar reflexes (Plantar grasp & Babinski)
Stepping reflex
Galant reflex (baby curves toward stroke on paraspinal region)
Asymmetric tonic neck reflex (limbs extend whichever way baby faces)
Moro (sudden drop = abduction & extension then adduction & flexion)

22
Q

Pathogenesis and clinical presentation of Legg-Calve-Perthes disease

A

Idiopathic avascular necrosis of proximal femoral epiphysis

Presents with painless limp, intermittent hip, knee, groin, thigh pain, Trendelenburg gait - loss of ABIR

23
Q

Pt presents with bilateral pain around groin and thigh, tenderness of hips. Foot is turned outward and has Trendelenburg gait. What is the mechanism causing these symptoms?

A

Slipped Capital Femoral Epiphysis

Metaphysis translates anterior and externally rotated (causing outward foot)
Epiphysis remains in acetabulum and lies posterior/inferior to metaphysis

24
Q

What are the three mechanisms by which a Trendelenburg Gait can be caused?

A

Failure of the fulcrum (LCP, dysplasia, dislocation)
Failure of the lever (g. troch avulsion, neck of femur mutation)
Failure of effort (L5 radiculopathy, S. Gluteal n damage, G medius and minimus damage/abscess)

25
Q

What are the physical signs and tests done on newborns to check for hip dysplasia or dislocation?

A

Physical signs: asymmetrical gluteal skin folds, short leg

Tests: Ortolani “click” test, telescoping

26
Q

HVLA is a ________ method using ____-amplitude, _____-velocity thrusting

A

Direct
Low
High

27
Q

List the indications for HVLA

A

SD that results in loss of motion causing asymmetry in articulation

28
Q

The muscles of the anterior arm are innervated by

A

Musculocutaneous and Radial nerves

29
Q

What is the difference in function between the brachialis and the biceps brachii

A

Brachialis flexes the forearm
Biceps brachii supinates the forearm and flexes in the supine position

30
Q

List the sites where the ulnar nerve can become impinged

A

Axilla
Struthers window
Cubital tunnel
Dionne’s canal

31
Q

What are the terminations of the Median Antebrachial v

A

Median cephalic v and median basilic v

32
Q

List the contents of the Cubital Fossa

A

Lateral to Medial - TAN

Tendon of Biceps Brachii
Artery, Brachial
Nerve, Median

33
Q

What are the boundaries of the Cubital Fossa

A

Superior: Imaginary border between epicondyle and humerus
Medial: Pronator teres
Lateral: Brachioradialis m
Floor: Brachialis

34
Q

What is a positive bicipital reflex indicative of?

A

Confirms the integrity of the musculocutaneous nerve (C5-C6)

35
Q

Describe a normal response when testing the bicipital myotatic reflex in the cubital fossa

A

An involuntary contraction of the biceps, felt as a momentary tensed tendon, usually with a brief jerk-like flexion of the elbow

A positive response is the normal response

36
Q

What is an excessive, diminished or prolonged (hung) bicipital reflex indicative of?

A

A central or peripheral nervous system disease or metabolic disorder (e.g. thyroid disease)

37
Q

Shoulder counterstrain of Levator Scapulae

A

Dr ipsilateral
Rotate pt head away
IR, ABD

38
Q

Shoulder counterstrain Supraspinatus

A

Supine
Flex/hold elbow/forearm
F ABD ER

39
Q

Shoulder counterstrain Infraspinatus (upper)

A

Supine
F shoulder 90-120 degrees
ABD, ER/IR

40
Q

Shoulder counterstrain infraspinatus (lower)

A

Lat recumbent CS side up
F shoulder 135-150 degrees
ABD, ER/IR

41
Q

Shoulder counterstrain subscapularis

A

Supine, Dr. Ipsilateral

E shoulder, IR

42
Q

Shoulder counterstrain pectoralis minor

A

Supine, Dr contralateral
Adduct arm across chest
Pull shoulder ant/inf

43
Q
A

Unit 2 MTP (5 decks)

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