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Stack #13598
musculoskeletal (H&P exam)
| Question | Answer |
|---|---|
| Hallux Rigidus | arthritis of the big toe |
| plantar heel pain | most common hindfoot problem |
| pump bump | superficial irritation of the posterior heel |
| sever's disease | 5-7 y/o w/ heel pain from starting new sport |
| plantar fascitis | tearing pain in the morning when 1st step out of bed |
| plantar fascistis | tx with injection or surgery as last option |
| morton's neuroma | swelling of small nerve bwt 3/4th toes |
| tarsal tunnel syndrome | pain @ medial aspect of foot, worse as day goes on |
| inversion sprain | most common ankle sprain |
| bony tenderness | when you should order a radiograph for an ankle injury |
| sesamoid palpation | under 1st toe |
| palapation of peroneal tendons | outside at base of 5th metatarsal |
| tarsal tunnel syndrome | sx worse w/ progression of day & pain shoots up foot |
| Dx stress fracture | palpate metatarsal and push up from bottom |
| dx hallux rigidus | reduced dorsiflexion or plantar flexion of great toe |
| sesamoid fracture | pain under 1st metatarsal from a jump/fall |
| resisted inversion | tests strength of posterior tibial tendon |
| resisted eversion | test strength of peroneal muscles |
| L1 intact | patient can push toe down against resistance |
| L5 intact | can resist against toe dorsifelxion |
| ATF | tears first on ankle inverison |
| anterior drawer test | to show anterior instability of talus in ankle mortise |
| Thompson test | sign for Achilles tendon rupture |
| achilles tendinitis | feels like kicked in the calf |
| excessive pronation of the foot | mechanism for posterior tibial tendinitis |
| posterior tibial tendinitis | pain/tenderness just posterior to medial malleolus |
| Low back pain | affects 60-80% of population at some time |
| breast, lung, renal, adrenal, thyroid, prostate cancers | most often metastisize to bone |
| mylopathy or paralysis | most signficant adverse outcome of spinal stenosis |
| cauda equina | pt chg's bowel or bladder function |
| menigomyelocele | outpuching of a nerve |
| causes of <10 y/o back pain | leukemia, congen kyphosis, menigomyelocele |
| cause of teens back problems | spondylolisthesis, kyphosis |
| cause of middle aged back problems | disc injury, C-spine and L-spine herniations |
| cause of older peoples back problems | degen, herniation, instability, tumors |
| low back pain in children | uncommon & always warrants evaluation |
| nerve entrapment | sx: bilateral shoulder pain |
| whiplash from MVA | neck pain & transient numbness in the arm |
| entrapment of C4-C5 | pain radiates to lateral shoulder |
| entrapment of C5-C6 | pain/numness of thumb & radial aspect of forearm |
| entrapment of C6-C7 | pain/numbness in triceps, index finger and long finger |
| herniated cervical disc | most comfortable with hand of symptomatic arm on their head |
| intrinsic should problems | most comfortable with arms at thier sides |
| SI joint or Buttock | common radiation point for low back pain |
| trochanteric bursitis in women | often mimicks sciatica |
| neurofibromatosis | genetic disorder where tumors grow on nerve roots |
| spinal trauma | all must have radiographic exam done |
| spondylolysis | defect of the pars articularis |
| dx spondylolysis | scotty dog wearing a collar |
| sx of spondylolysis | sx worse with extension |
| mechanism for spondylolisthesis | suddent twisting/lifting motion |
| sx of spondylolisthesis | flexion bothers them more |
| dx spondylolisthesis | can palpate step-off deformity |
| first physical sign of spondylolisthesis | tightness in hamstrings |
| low back sprain | feel twinge in back with twisting motion |
| #1 test for chronic low back pain | physical exam |
| lumbar radiculopathy | abrupt onset of pain, prefers to stand up for comfort |
| sciatica | LBP w/ some degree of neurogenic dysfxn in the leg |
| problem w/ L4 | quad weakness & decreased knee jerk reflex |
| problem w/ L5 | foot drop b/c affects tibialis anterior |
| problem w/ S1 | can't toe walk/achilles reflex lost |
| flip sign | pt jerks back when leg raised due to pain |
| what does flip sign test | herniation |
| femoral stretch test | pt prone, then hip extension to ID pain |
| L5-S1 disc herniation | damage to S1 nerve root |
| L4-L5 disc herniation | damage to L5 nerve root |
| spinal stenosis | narrowing of spinal canal |
| lateral recess stenosis | impingement on tract where nerve root exits central canal |
| foramina stenosis | impingement where indiv. nerve roots exit out to the body |
| central stenosis | impingment where spinal cord and cauda equina are located |
| vascular claudication | gets worse w/ activity & not relieved by rest |
| neurogenic claudication | worse w/ activity but relieved by rest |
| improves spinal stenosis | flexion of lumbar spine |
| romberg test | eyes closed & feet together to see if pt can balance |
| scoliosis | rotational deformity >10 degrees |
| forward bending | most sensitive test for scoliosis |
| cobb angle | 1st and last degree of curvature in spine |
| brace treatment | curve >30-40 degree range o |
| surgery to fuse vertebra | curve >50 degrees |
| facet arthropathy | pain w/ twisting/extension w/o radiation, just localized |
| cause of myelopathy | spinal stenosis compressing cord leads to degeneration |
| signs of myelopathy | difficulty walking, generalized weakness, poor balance |
| rheumatic disorder of back | ankylosing spondylitis |
| ankylosing spondylitis presentation | stiff in AM, fatigue, young male |
| dx bone tumors | bone scan if x-ray normal but high suspscion |
| HLA B27 is assoc. with this disease | ankylosing spondylitis |
| shoulder shrug | C4 |
| deltoid muscle | C5 |
| biceps muscle | C6 |
| triceps muscle | C7 |
| finger flexors | C8 |
| finger abd/adduction | T1 |
| lateral arm sensation | C5 (sensation testing) |
| lateral fforearm sensation | C6 (sensation testing) |
| 3rd dinger sensation | C7 (sensation testing) |
| 4th/5th finger sensation | C8 (sensation testing) |
| medial arm sensation | T1 (sensation testing) |
| distraction test | relieves pain due to narrowing |
| compression test | tests neural foramern, facet joints, muscle spasm |
| valsalva test | test for herniated disc/tumor |
| tibialis anterior muscle testing | L4 nerve root-muscle |
| extensor hallicus longus muscle testing | L5 nerve root-muscle |
| peroneus longus & brevis muscle testing | S1 nerve root-muscle |
| patellar relfex (DTRs) | L4 nerve root -reflex |
| achilles tendon relfex (DTRs) | S1 nerve root-reflex |
| medial leg & foot sensation | L4 nerve root-sensation |
| lateral leg & dorsum of foot sensation | L5 nerve root-sensation |
| lateral foot sensation | S1 nerve root-sensation |
| #1` test for disc herniation | straight leg raising test |
| malingerer test | Hoover test |
| what does + SLR test indicate | sciatica |
| + hoover test | no downward pressure thru heel |
| kernig test | passive forward flex neck w/ pt supine |
| screen for meningitis | kernig test |
Created by:
chrismcdev
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