MS 4

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  1. ballotable patella test / patellar tap test -- for what? how?
    • infrapateelar effusion
    • supine, knee in ext, do soft tap over central patella, looking for "dancing patella" sign
  2. fluctuation test - indicates what? how?
    • knee joint effusion
    • supine, knee ext, place on hand over suprapatellar pouch and other over ant knee jt, push with each alternately and look for movement/fluid
  3. Noble compression test - for what? how?
    • ITB friction syndrome
    • supine, hop at 45, knee at 90 flex
    • put pressure on lat fem condyle and extend the knee
    • pos if there's pain at approx. 30 flex
  4. vertebral artery test
    • supine, extend, rot to each side
    • first do it with head on table, then with head cradled off table
    • hold each pos 30 sec before progressing to next step
  5. transverse ligament stress test for head
    • supine, glide C1 ant -- should have firm endfeel
    • pos: soft end feel, dizzy, nystagmus, lump in throat, nausea
  6. anterior shear test - for what? how?
    • integrity of upper c-spine ligs and capsules
    • supine, head on table, glide C2-7 ant
    • pos: soft end feel, dizzy, nystagmus, lump sensation in throat, nausea
  7. foraminal compression test
    for what?
    • Spurling's
    • dysfunction / compression of nerve root
    • sitting, head SB, compress head
    • pos: pain a/o paresthesia in dermatomal pattern for involved n root
  8. maximum cervical compression test
    for what
    • compression of neural structures at intervertebral foramen a/o facet dysfunction
    • sitting, passively move into SB and ipsilat rot for non involved then involved side
    • pos: pain a/o paresthesia in dermatomal pattern
  9. Lhermitte's sign?
    for what?
    • dysfunction of spinal cord a/o UMNL
    • long sit, passively flex head and one hip, knee is straight
    • pos: pain in spine and into UE or LE
  10. Romberg test id's what?
    • UMNL
    • (do it for 30 sec)
  11. Lasegue's test
    for what?
    • dysfunction of neuro structures to LE
    • supine, legs on table, passively flex on ehip w knee ext until pt has shooting pain, then slowly loer limb until pain subised and passively do DF
    • pos: reproduction of neuro symptoms when foot is DF
  12. femoral n. traction test
    • pt SL on non-involved side
    • trunk neutral, head slightly flexed
    • passively extend hip, first w knee bent, then, if that's not painful, w knee straight
    • pos: neuro pain in ant thigh
  13. pos Babinski
    ext of big toe and splaying/abd of others
  14. quadrant test (particularly for L spine?)
    ids what?
    how for iv foramen
    how for facet
    • compression of neural structures at IV foramen and facet dysfunction
    • standing
    • iv foramen: SB L, rot L, ext to maximally close L iv foramen (repeat for R side)
    • facet: sb L, rot R, ext to maximally compress facet jt on L
    • pos: pain a/o presthesia in dermatomal pattern, or localized pain if facet problem
  15. how to do bicycle (van Gelderen's) test
    • have a pt first ride a stationary bike sitting upright, then in slumped pos
    • if can ride longer when slumped, pain is due to stenosis
    • otherwise, claudication
  16. Gillet's test
    • standing, lift one leg
    • PT is on the PSISes
    • pos if there's no mvmnt compared to sacrum (neg if it goes post)
  17. ipsilateral anterior rotation test
    for what?
    • assessing ant movement of ilium rel to sacrum
    • put thumb under PSIS and other on sacrum at same level
    • have the pt ext that leg
    • PSIS should move sup
    • neg if no mvmnt
  18. Gaenslen's test
    for what?
    • SI jt dysfunction
    • SL at EOB holding bottom knee to chest
    • passively ext hip of uppermost limb
    • pos: pain in SI jt
  19. Goldthwait's test
    for what? how
    • differentiate btwn dysfunction in L spine vs SI jt
    • supine, Pt fingers btwn SP of L-spine
    • passively do SLR
    • if there's pain before palpation of mvmnet in lumbar segments, pain is 2/2 SI jt
  20. what's happening at the hip during heel strick
    glut max and hammies are working eccentrically to resist flexion moment
  21. what's happening in knee at heel strike
    eccentric quads contraction to prevent buckling

    becomes concentric after foot flat to bring femur over tibia
  22. what's happening in knee at midstance?
    at toe off?
    • midstance: gastroc beginning to work concentrically to start knee flexion
    • toe-off: quads contract eccentrically
  23. what's happening in ankle at foot flat and mid stance?
    PFers are activated eccentrically to control DF
  24. Paget's disease, aka, describe
    • osteitis deformans
    • metabolic bone disiease involving abnormal osteoclastic and osteoblastic activity
  25. scoliosis, when to use bracing, when surgery
    • < 25 degrees -- conservative tx
    • 25-45 --- use orthoses
    • > 45 -- surgery
  26. spondylosis
    degenerative osteoarthritis of the joints between the center of the spinal vertebrae and/or neural foramina
  27. symptoms of spinal accessory n involvement
    • can't abd arm above 90
    • pain in shoulder on abd
  28. symptoms of long thoracic nerve involvement
    • pain or inability to flex full extended arm
    • winging starts at 90 flexion
  29. symptoms of suprascapular nerve involvement
    • pain on shoulder flexion
    • shoulder weakness
    • pain w scap abd
    • pain w contralat cervical rot
  30. symptoms of axillary (circumflex) n involvement
    inabilitiy to abd arm w neutral rot
  31. mechanism for ant inf shoulder dislocation (most common dir)
    abd w forceful ER, tearing the inf GH lig, ant capsule, and occasionally the glenoid labrum
  32. mechanism for post shoulder dislocation
    horiz add w IR
  33. Hill-Sachs lesion
    compression fracture of post hum head
  34. Bankart lesion
    avulsion of antero-inf capsule and inferior GH lig
  35. S&S of labral injuries
    • pain that can't be localized to a specific point
    • pain is worth w overhead activities or when arm is behind back
    • weakness
    • instab in shoulder
    • pain on resisted GH flex
    • tender over ant shoulder
Card Set:
MS 4
2014-07-09 21:29:51
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