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ChiroBoards3:Misc.

ChiroBoards3: Misc = ankle/foot tests; malingering tests; AS tests, other tests,

QuestionAnswer
Flat foot, aka Pes planus
Most common birth defect where heel is elevated and foot is turned inward = Talipes Equinovarus (club foot)
Club foot, aka talibes equinovarus
very high arch, toes in flexion. aka = Pes Cavus
Trt for Pes Cavus Orthotic stretch out
Type of fx people with pes cavus are prone to = March fracture
heel spur pain when walking in morning, Improves as day progresses plantar fasciitis
Pain and burning on soles of foot (medial plantar nerve) = Tarsal tunnel syndrome
Achilles tendon rupture, aka's : (2) Thompson's, aka Simmond's trauma
Foot = Thompson's Test = Explain (for feet!) Pt. prone; feet hanging off table; Dr. flexes knee to 90 degrees and squeezes calf. If no plantar flexion occurs in foot = Achilles tendon rupture
Pt. instructed to kneel on a table 18 inches from the floor, bend forward at the trunk and touch the floor. Doctor holds ankles. (The patient refuses to perform) Burn's Bench test (malingering)
Pt. supine. Doctor places one hand under each heel and asks pt. to lift affected limb. (The doctor doesn't feel the unaffected side pressing downward.) = Hoover's sign (malingering)
pt. is sitting upright on bench and doctor extends their leg under the guise of "checking circulation". Raise one leg at a time, parallel with floor (pt. has no pain when there had been a positive SLR test) Lasegue's Sitting (malingering)
Pt. points to area of pain on back and doctor marks it with a pencil. Later in exam, dr. asks patient to point again. (patient points to a different spot) = Magnusson's (malingering)
Doc takes resting pulse rate. Dr. then applies pressure over painful site and takes pulse rate again. (an increase of 10 bpm) Mannkopf's sign (not a malingerer) (less than 10 is malinger)
4 orthopedic tests for AS = Chest expansion test; Forrestier's Bowstring sign; Lewin Supine test; Amoss sign
Chest expansion test = procedure and normal values tape measure around 4th IC space. Measure on full exhale and full inhale Normal 1.5=3 inch difference
Positive sign for AS in chest expansion test = <1.5 in women ; <2 in men
While standing, the patient performs side bending to both sides. Positive sign is muscle tightening on the concave side Forrestier's Bowstring sign (sign of AS)
Patient supine;; Dr. supports legs on the table. Patient is then asked to sit up without using hands. Pt. is unable to perform. = Lewin Supine test (sign of AS)
Patient is asked to go from side lying position to seated position. Pt. gets localized thoracolumbar pain and/or lack of ROM. Amoss sign (indicates AS, IVD syndrome, or severe sprain/strain)
Dr. applies finger pressure over mastoid process. Pressure increased until patient expresses discomfort. This is used to determine pain threshold of pt. = Libman's test
Created by: bglasman on 2012-03-13



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