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Flashcards in Lab Info Deck (98)
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1
Q

name the ranges of motion for the knee

A

Flexion 135
Extension 0
external rotation
internal rotation

2
Q

name the bony landmarks for bony palpation for the knee

A
  • patella
  • medial tibial plateau
  • tibial tubercle
  • medial femoral condyle
  • lateral tibial plateau
  • Lateral femoral condyle
  • fibula head
3
Q

name the soft tissue palpation for the knee

A
  • quadriceps muscle
    - vastuc lateralis
    - vastus medialis
    - Vastus intermedius
    - Rectus femoris
  • infrapatellar tendon
  • bursae
    - prepatellar
    - superficial infrapatellar
  • Medial meniscus
  • lateral meniscus
  • Pes aserine
    - Gracilis
    - Sartorius
    - semitendinosus
  • Popliteal fossa
  • Lateral collateral ligament
  • medial collateral ligament
  • gastrocnemius muscle
4
Q

McMurray Sign

A

Positive= Clicking sound or pain by knee joint
indicates= tear of medial meniscus if positive on external rotation
- tear of lateral meniscus if positive on internal rotation
the higher the leg is raised during extension when positive is elicited, the more posterior of the meniscal injury

5
Q

Medial collateral test , aka abduction stress test aka valgus stress test

A
  • positive = gapping and/or elicited pain above/at/or below joint line
  • indicates= torn medial collateral ligament
6
Q

lateral collateral test aka adduction stress test aka varus test

A
  • positive= gapping and/or elicited pain above/ at/ or below the knee joint

indicates= torn lateral collateral ligament

7
Q

Bounce home test

A
  • positive= knee does not go into full extension (slight flexion remains)
  • indicates = diffuse swelling of the knee, accumulation of fluid, due to possible torn meniscus
8
Q

Drawer test

A

positive

  1. Gapping> 6mm tibia moves posterior when the leg is pushed
  2. Gapping > 6mm tibia moves anterior when the leg is pulled

indicates:
1. torn posterior cruciate ligament
2. torn anterior cruciate ligament

9
Q

Lachman test

A

positive : Gapping with the tibia moving away from the femur
indicates: anterior cruciate ligament or posterior oblique ligament instability

10
Q

Apprehension test for the patella

A

positive: apprehension, distress of facial expression, contraction of quadriceps to bring patella back on line
indicates: chronic patella dislocation or pre- disposition to dislocation

11
Q

Patella Femoral Grinding test ( Clarke sign)

A

positive : retropatellar pain and the pt is unable to hold quadriceps contraction

indicates: degenerative changes of the patellar facets and/ or within the trochlear groove ( chondromalacia patella)

12
Q

Patella Ballottment test

A

Positive: a floating sensation of the patella

indicates: a large amount of swelling in the knee

13
Q

Apley compression test

A

positive= pattient points to side of pain

indicates= pain on medial side is medial meniscus tear.
pain on lateral side is lateral meniscus tear

14
Q

Apely distraction test

A

Positive= pt will point to side of pain

indicates= pain on the medial side indicates medial collateral ligament tear, pain on the lateral side indicates lateral collateral ligament tear

15
Q

say the verbals for the heart examination for pulsations

A
  1. check A.P.E.T.M.E areas for pulsations
    • aortic
    • pulmonic
    • Erb’s point
    • tricuspid
    • Mitral — while at this location, check for an apical impulse for location and amplitude
  • Epigastric Pulsations ( hand flat toward oft shoulder)
    • pulsations coming from superior to inferior may be right ventricular enlargement
    • pulsations coming inferior to superior (P-A) may indicate abdominal aortic aneurysm)
  1. Check A.P.E.T.M.E areas for thrills (ball of hand)
    Thrills turbulent flow, causing palpable vibrations
    - check same areas as before (A.P.E.T.M.E)ol,
16
Q

Verbal the auscultation for high pitch sounds of the heart

A

Using the DIAPHRAGM
- aortic - right side at 2nd ICS at the right sterna border
- pulmonic : left side at 2nd ICS at the left sternal border
S2 is best heard at this location / listen for accentuated or diminished or splitting sounds
- Erb’s Point : left side 3rd ICS at the left sternal border listen for general cardiac sounds
- Tricuspid: left side 4th ICS at the left sternal border
listen for general cardiac sounds

  • Mitral : left side 5th IS , mid-clavicular line
    S1 is best heard at this location
    listen for accentuated,dimished or splitting sounds
    at the mitral area use the diaphragm and auscultate for S1 while palpating the carotid pulse to see for pairing
  • Epigastric: soft tissue inferior to tip of typhoid process listen for the presence of high pitched sounds
17
Q

Verbal auscultation for low pitch heart sounds

A

using the bell

  • Aortic: right side at 2nd ICS at right sternal border
  • Pulmonic : Left side at 2nd ICS at the left sternal border , listen for accentuated, diminished or splitting of sounds
  • Erb’s point Left side 3rd ICS at the left border
  • Tricuspid : left 4th ICS
  • Mitral Left side 5th ICS , mid - clavicular line
    listen for accentuated, diminished or splitting of sounds
  • Epigastric: Soft tissue inferior to tip of typhoid process.. Have the patient take a deep breath in and hold … listen for bruits
18
Q

state the special maneuver for mitral murmurs

A
  • patient in left lateral recumbent position
  • use the bell (low pitch) at apical impulse area
  • ask pt to take a deep breath in and hold
19
Q

State the special maneuver for Aortic murmurs

A
  • pt in seated position
  • listen at left sternal border ( Erb’s point) for best heard heart sounds using the diaphragm (high pitched)
  • ask pt to take deep breath in and lean forward while exhaling all the air
20
Q

Name the bony palpations for the foot and ankle

A
  • calcaneus
  • sustentaculum
  • medial malleolus
  • lateral malleolus
  • talus
  • navicular
  • cunoid
  • 3 cuneiforms
  • 5 metatarsals
  • metatarsalphalangeal joints
21
Q

name the soft tissue palpation of the foot and ankle

A
  • tibialis posterior tendon
  • spring ligament
  • tibialis anterior tendon
  • deltoid ligament
  • fibular/ peroneus brevis
  • achilles tendon
  • plantar aponeurosis
  • anterior talofibular ligament
  • posterior tibial artery
  • dorsal tibial artery
22
Q

name the ranges of motion for the ankle and foot

A
  • ankle dorsiflexion 20
  • ankle plantar flexion 50
  • subtalar inversion 5
  • subtalar eversion 5
  • 1st MTP joint flexion
  • 1st MTP joint extension
23
Q

Drawer sign

A

positive = translation with the talus moving away from or toward the tibia
indicates
1. with the tibia being pushed/ foot pulled = tear/instability of the anterior talofibular ligament
2. with the tibia pulled/ foot pushed = a tear/ instability of posterior talofibular ligament

24
Q

Ankle dorsiflexion test ( Hoppenfield)

A

Positive:
1. the foot cannot dorsiflex with knee extend, but is able to with knee flexed
2. the foot cannot dorsiflex in either knee position
Indicates:
1. contracture of the gastrocnemius muscle
2. contracture of the soles muscle

25
Q

Rigid or supple feet test

A

Positive :
1. absence of medial longitudinal arch in both positions
2. presence of medial longitudinal arch while seated with a loss of medial longitudinal arch while standing
Indicates :
1. Rigid flat feet
2. Supple flat feet

26
Q

Homans sign

A

Positive :
deep pain in the calf
indicates: deep vein thrombophlebitis

27
Q

Thompson test

A

positive : absence of foot plantar flexion motion

Indicates: achilles tendon rupture

28
Q

Morton Test

A

Positive: Sharp pain in the forefoot
Indicates: Metatarsalgia or neuroma ( usually at the 3rd and 4th metatarsal interspace )

29
Q

range of motion for hip and pelvis

A
flaxion 120 
extension 30 
abduction 45 
adduction 45 
internal rotation 45 
external rotation 45 
flexion, adduction 
flexion,abduction and external rotation
30
Q

range of motion for lumbar

A
flexion 25 
extension 30 
left lateral bending 25 
right lateral bending 
left rotation 30 
right rotation 30
31
Q

Hoover sign

A

Positive : lack of counter- pressure on the healthy side
Indicates : lack of organic basis for paralysis (Malingering/hysteria) with organic hemiplagia, the patient will still exert downward pressure when attempting to raise paralyzed leg

32
Q

Straight leg raiser (SLR)

A

Positive: Radiating pain and/or dull posterior thigh pain
Indicates : sciatic radiculopathy or thigh hamstrings
Positive between 35-70 degrees= possible discogenic sciatic radiculopathy
> 70 degrees = tight hamstrings

33
Q

Goldthwaith sign

A

Positive: localized pain, low back or radiating pain down the leg
indicates: Lumbo-sacral or scaroiliac pathology . Pain occurring after the lumbar spinouses move= possible limbo-sacral problem ….. pain occurring before the lumbars move= possible sacroiliac problem

34
Q

braggard sign

A

Positive: radiating pain in posterior thigh
indicates: Sciatic radiculopathy

35
Q

Buckling Sign

A

Positive: Pain in the posterior thigh with sudden knee flexion (buckle)
Indicates: Sciatic radiculopathy

36
Q

Bowstring Sign

A

Positive: Pain in the lumbar region or radiculopathy
indicates: Sciatic nerve root compression, helps rule out tight hamstrings

37
Q

Lasegue Test

A

Positive: reproduction of sciatic pain before 60 degrees
indicates: Sciatica

38
Q

Milgram Test

A

Positive: inability to perform test and / or low back pain
indicates: weak abdominal muscles or space occupying lesion

39
Q

Valsalva Maneuver

A

Positive: Radiating pain from site of lesion (usually recreating the complaint in cervical or lumbar area of the spine)

Indicates: Space occupying lesion (disc pathology)

40
Q

Bechterew Test

A

Positive: reproduction or radicular pain or inability to perform correctly due to tripod sign

indicates: Sciatic Radiculopathy

41
Q

Neri Bowing Test

A

Postitive: pain accompanied by flexion of the knee on the affected side and body rotation away from the affected side

Indicates: Positive with a variety of low back pathologies. Hamstring tension on the pelvis may trigger the response

42
Q

Anterior Innominate test aka Mazion Pelvic Maneuver (Advancement Sign)

A

Positive: the inability to bend at the waist more than 45 degrees, because of either/or

  1. radiating pain along sciatic nerve, either unilateral or bilateral
  2. Low back pain ( lumbar or pelvic regions)

Indicates:

  1. Sciatic neuralgia or radiculopathy , etc possibly due to lumbar disc pathology
  2. anterior ( rotational) displacement of the ilium relative to the sacrum
43
Q

Lewin Standing Test

A

Positive : Radiating pain down the leg causing flexion of the knees

Indicates: Gluteal, Lumbosacral or sacroiliac pathologies

44
Q

Heel walk

A

Positive: Inability to perform test

indicates: L4-L5 disc lesion (L5 nerve root)

45
Q

Toe walk

A

Positive: Patient walks on toes

Indicates : L5- S1 disc lesion ( S1 nerve root)

46
Q

Ely Heel to Buttock Test

A

Positive

  1. inability to raise thigh
  2. pain in the anterior thigh
  3. pain in the lumbar region

Indicates

  1. Iliopsoas spasm
  2. Inflammation of lumbar nerve roots
  3. Lumbar nerve root adhesions
47
Q

Minor’s Sign

A

Positive:
knee flexion of affected leg while supporting upper body weight on the unaffected side

Indicates:
Sciatica, lumbosacral or SI joint lesion

48
Q

Belt test ( supported adam test, supported bending test)

A

Positive:
Low back pain

indicates:
- pain during unsupported and supported bending= Lumbar involvement

  • Pain during unsupported but no pain during supported= pelvic involvement
49
Q

Kemp’s test

A

Positive:
1. pain radicular, recreating existing sciatic pain
indicates : disc protrusion
- medial disc- positive pt leans away from side of pain
- lateral disc - positive pt leans into side of pain
2. positive - local pain

indicates: localized pain may indicate lumbar spasm or facet capsulitis

50
Q

Linder’s Sign

A

Positive: pain along sciatic distribution or sharp, diffuse pain

indicates: sciatic radiculopathy

51
Q

Turyn’s Sign

A

Positive : pain in the gluteal region or radiating sciatic pain

indicates: sciatic radiculopathy

52
Q

Sicard’s Sign

A

(like braggarts except flex big toe)

Positive: posterior thigh pain

indicates: Sciatic radiculopathy , usually from disc lesion

53
Q

Bonnet’s Sign

A

Positive: pain in the posterior thigh or leg

indicates: Sciatic ( possibly piriformis syndrome) = pain in immediately or before SLR

54
Q

Fajersztajn’s test aka well- leg raising test aka cross over sign

A

positive: 1. Pain down affected leg
2. decreased in pain down affected leg

Indicates - 1. medial disc protrusion ( cross over sign)
2. Lateral Disc Protrusion

55
Q

Femoral stretch Test

A

Positive : pain in the anterior portion of the thigh

Indicates : traction on the femoral nerve indicating involvement of the 2nd, 3rd, and 4th lumbar nerve roots

56
Q

L4 nerve root

A
  • disc level L3
  • Muscle test: foot dorsiflexion and inversion : tibialis anterior ( deep fibular nerve)
    Reflex: patellar tendon
    sensation: medial aspect of leg, medial foot , medial aspect of big toe
57
Q

L5 nerve root

A

disc level L4
Muscle test- foot dorsiflexion
- Big toe dorsiflexion: extensor hallucis longus ( depp fibular )
- Toes 2,3,4 dorsiflexion: extensor digitorum longus and brevis ( deep fibular )
- Hip and Pelvis abduction: gluteus medius and minimus ( superior gluteal nerve)

Reflex : none
Sensation : Lateral leg, dorsum of foot and middle three toes

58
Q

S1 nerve root

A
  • disc level L5
  • Muscle tests (3)
    • foot plantar flexion : gastrocnemius and soles ( tibial nerve )
      • Foot platnar flexion and eversion: fibular/ peroneus longs and brevis ( superficial fibular/ peroneal nerve)
      • Hip extension: gluteus maximus ( inferior gluteus nerve)

Reflex: achilles
Sensation : posterior aspect of the leg, lateral aspect of foot, and lateral aspect of little toe

59
Q

Leg Length Discrepancy

A

Positive : different measurements

True = bony abnormality above or below level of trochanter difference ( anatomical short leg)

Apparent = pelvic obliquity (tilted pelvis)

60
Q

Allis sign (galeazzi sign)

A

Positive : differnece in height and anteriority of the knees

Indicate:

  1. if one knee is lower= ipsilateral congenital hip dislocation or tibial discrepancy ( anatomical short leg0
  2. if one knee is anterior= ipsilateral congenital hip dislocation or femoral discrepancy ( contralateral anatomical short leg)
61
Q

Thomas Test

A

Positive: Lumbar spine remains lordosis (should flatten) and hip or leg flexes

indicates : contracture of the hip flexors (iliospoas)

62
Q

Anvil test

A

Positive : Localized pain in long bone or in hip joint

Indicates : possible fracture of long bones or hip joint pathology

63
Q

Patrick Test aka FABERE sign

A

Positive: pain in the hip region
Indicates: hip joint pathology

64
Q

Laguerre Test

A
Positive: 
1. pain in the hip joint 
2. pain in the sacroiliac joint 
Indicates: 
1. Hip joint pathology 
2. mechanical problem of the sacroiliac joint
65
Q

Gaenslen Test

A

Positive: pain on the affected SI joint stressed into exstention

indicates: general sacroiliac joint lesion, anterior sacroiliac ligament sprain, or inflammation of the SI joint

66
Q

Lewin_ Gaenslen test

A

Positive: pain on the affected SI joint stressed into extension

Indicates : genral sacroiliac joint lesion, anterior sacroiliac ligament sprain, or inflammation of the SI joint

67
Q

Hibb test

A

Positive:

  1. pain in the hip region
  2. pain in the buttock/pelvic region

indicates:
1. Hip joint pathology
2. sacroiliac joint lesion

68
Q

Ober test

A

Positive : affected thigh remains in abduction ( normal biomechanics , thigh will adduct)

Indicates: contraction of the iliotibial band or tense fascia kata

69
Q

Pelvic rock test aka iliac compression test

A

Positive: pain in either sacroiliac joint

indicates: sacroiliac joint lesion

70
Q

nachlas test

A

positive: pain in the buttock and/or lumbar region
indicates: sacroiliac joint lesion, or lumbar pathology

71
Q

Yeoman Test

A

Positive: pain deep in Si joint

indicates: sprain of the anterior sacroiliac ligaments

72
Q

Ely sign

A

Positive : hipe on side being tested will flex causing the buttock to raise off the table

indicates: rectus femoris or hip flexor contracture

73
Q

Ely heel to buttock

A

Positive:

  1. inability to raise the thigh
  2. pain in the anterior thigh
  3. pain in the lumbar region

Indicates:

  1. iliopsoas spasm
  2. inflammation of lumbar nerve roots
  3. lumbar nerve root adhesions
74
Q

Trendelenburg Test

A

Positive: high iliac crest on supported side and low crest on side of elevated leg

Inidcates:
weak gluteus medius muscle on the supported side

75
Q

Range od motion for the cervical spine

A
  • flexion 50
  • extension 60
  • lateral bending left 45
    lateral bending right 45
  • left rotation 80
  • right rotation 80
76
Q

Foraminal Compression Test

A

Positive:

  1. Exacerbation of localized cervical pain
  2. exacerbation of cervical pain with a radicular component

Inidcates :

  1. Foraminal encroachment or facet pathology without nerve root compression
  2. foraminal enchraochment or facet pathology with nerve root compression
77
Q

Cervical Distraction Test

A

Positive:

  1. diminished or absence of pain
  2. increase of cervical pain

Indicates:

  1. foraminal encroachment (local pain dimities), nerve root compression (radicular pain dimities)
  2. Muscular strain, ligamentous sprain , myospasm, facet capsulitis
78
Q

Spinal Percussion test

A

Positive:
1. Local pain
.2. Radiating pain

Indicates:
1. Localized pain — dural sleeve adhesion, and muscular adhesion/contracture, or spasm or ligamentous injury

  1. Radiating Pain — on side being tested neuromuscular bundle compression, dural sleeve adhesions or thoracic outlet syndrome
    - on opposite side being tested foramina enchjroachment with nerve root compression
79
Q

Swallowing Test

A

Positive :
Difficulty Swallowing

Indicates:
Space - occupying lesion at the anterior portion or cervical spine. Possibly esophageal or pharyngeal injury, anterior disc defect, muscle spasm or osteophytes etc.

80
Q

Soto - Hall Sign

A

Positive:
Genralized pain in the cervial region, which may extend down to the level of T2

Inidcates:
non- specific test for structural integrity of cervical region

81
Q

Kernig Sign

A

Positive:
Inability to fully extend the leg and/or pain ( usually in the neck region)

Indicates: Meningeal irritation / meningitis

82
Q

O’Donoghue Maneuver

A

Positive:

  1. pain during passive range of motion
  2. Pain during resisted range of motion

Indicates:

  1. ligamentous sprain (passive ROM stresses ligaments)
  2. Muslce/ tendon strain (active ROM stresses muscles and tendons
83
Q

Brudzinkis sign

A

Positive:
- involuntary knee flexion

Indicates:
- meningeal irritation or nerve root lesion

84
Q

Jackson Compression Test

A

Positive :

  1. Exacerbation of localized pain
  2. Exacerbation of radicular pain

Indicates:

  1. Foraminal enchroachment w/o nerve root compression or facet pathology
  2. foraminal enchroachment with nerve root compression
85
Q

Maximal Compression Test

A

Positive

  1. pain on the concave side
  2. pain on the convex side

Indicates

  1. foraminal enchroachment with or w/o nerve root compression
  2. Muscular strain
86
Q

Bakody Sign ( shoulder abduction Test)

A

Positive:
decrease or absence of radiating pain

Indicates:
cervical foraminal compression, nerve root entrapment ( usually C5-C6)

87
Q

Tinel wrist sign

A

positive: reproduction of pain, tenderness and/ or paresthesia in the median nerve distribution area ( thumb, 2nd, 3rd and the lateral 1/2 of the 4th digit)

88
Q

Phalen sign ( reverse Phalen)

A

positive: reproduction of pain, tenderness and or paresthesia in the median nerve distribution area ( thumb, 2nd, 3rd, and the lateral 1/2 of the 4th digit)

89
Q

Finkelstein Test

A

Postive: pain distal to the radial styloid process
Indicates: stenosing tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons ( DeQuervain’s disease)

90
Q

Bunnel- Littler test

A

Positive
1. flexion of the proximal interphalangeal joint cannot be achieved
2. Flexion of the proximal interphalangeal joint is achieved
Inidcates:
1. Joint capsule contracture
2. tight intrinsic muscles

91
Q

Retinacular Test

A

Positivee :

  1. flexion of the distal interphalangeal joint cannot be achieved
  2. Flexion of the distal interphalangeal joint is achieved

Indicates:

  1. joint capsule contracture
  2. tight intrinsic muscles
92
Q

Allen Test

A

Positive:
delay of more than 10seconds in returning a reddish color in the hand

Indicates :
radial or ulnar artery insufficiency. the artery being held or occluded by the examiner is not the artery being tested

93
Q

Fromet paper sign

A

Positive:
the patient is unable to maintain grip on the paper

Indicates: ulnar nerve paralysis

94
Q

Direct light reflex

A

Response: ipsilateral pupillary constriction when light is shined in the eye

Afferent: Optic Nerve II
Integrating Center: Midbrain
Efferent: Oculomotor nerve III

95
Q

Indirect Light

A

Response: contralateral pupillary constriction

96
Q

State the pathology for percussion of the chest and lung

A
  • normal sound is resonant
  • hyper- resonance indicates air in the lungs = emphysema or bronchial obstruction
  • Dullness or flat sound indicates fluid or mass in the lung = lung consolidation, compressed lung or tumor
97
Q

State the pathology for tactile fremitus

A
  • decreased/ absent is caused by air in the lungs= - emphysema or bronchial obstruction
    increased fremitus is caused by fluid or mass in the lungs = lung consolidation, compressed lung or tumor
98
Q

State the breath sounds for chest and lung

A
  • vesicular - heard over most lung fields … low pitched short expirations, listening for abnormal audible breath sound
  • bronchovesicular- heard over main bronchus and upper right posterior field medium pitch and expiration equals inspiration