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WVSOM -- CS1; Musculoskeletal

Spurlings Test Extension of spine with rotation and sidebending toward involved side while compressing down on the spine to exacerbate nerve root impingement
Compression Test In a patient with neck pain or pain tha radiates below the elbow. An axial load is placed on the spine.
Distraction Test Distracting teh spine by poutting one palm of one hand under teh patient's chin and the other hand at teh occiput and lifting the head will relieve pain.
Valsalva Have patient hold their breath and bear down as if having a bowel movement.
Neck Flexion 45 degrees
Neck Extension 55 degrees
Neck lateral Bending 40 degrees
Neck Rotation 70 Degrees
Spine of teh Scapula T3
Shoulder Abduction 180 degrees
Shoulder Adduction 50 degrees
Shoulder Flexion 180 degrees
Shoulder internal rotation 90 degrees
Shoulder External Rotation 90 degrees
APLEY Scratch Test Hold Hands behind the back. Test for adhesive capsulities (frozen shoulder). Quickest active way to evaluate a patient's range of motion.
Frozen Shoulder occurs when there is NO glenohumeral motion
Yergason Test to evaluate stability of biceps tendon in bicipital groove. Palpale long head of biceps, flex patiens forearm at a right angle adn stabilize the elbow. Externally rotate forearm. (+) test if tendon pops out of groove
Drop arm Tests tear in rotator cuff, expecially supraspinatus muscle.
Supraspinatus Test Empty can test. Flex arm 90 degrees and abduct arm 30 degrees and then rotate arms like pouring out a can of beer
Neer test Internally rotate shoulder and then forward flex the arm 150 degrees. Increased shoulder pain indicates impingement of the muscles due to rotator cuff inflammation or tear
Hawkins Test flex elbow 90 degrees and arm to 90. Internally rotate the humberus. Pain indicates rotator cuff tear or impingement
Apprehension Test Test is used when you are dealing with a possible subluxing anterior shoulder. Postive test occurs when patient exhibits fear and apprehension when you are pushing the shoulder from teh posterior
Jerk Test internally rotate arm and flex at 90 degrees with elbow flexed 90 degrees. Push the humerous posteriorly at teh elbow. Postive if subluxxation or dislocation occurs.
Suclus Test Pull down on teh arm relaxed at patient's side. If subluxation occurs there will be widening of the suculs between teh humerus and acromion
Elbow Flexion 150 degrees
Elbow Extension 0/-5 degrees
Elbow Supination 90 degrees
Elbow Pronation 90 degrees
Ligamentous stability To determine stability of the medial and lateral collateral ligaments of the elbow
Tinel's sign Checking for irritation or entrapment of the ulnar nerve as it passes through the ulnar groove
Tennis elbow test pronate the forearm with the elbow bent. Patient makes a fist and extends the elbow. Pain will be at lateral epicondyle if positive.
Anatomic snuffbox bound by teh extensor pollicis brevis, extensor pollicis longus, and abductor pollicis longus
Ganglion Cyst Enlargement from joint capsules and tendon sheaths
heberden's Node enlargement of DIP joint due to inflammation in osteoarthritis
Bouchard's node enlargement of PIP joint due to inflammation in osteoarthritis
Swan Neck Deformity Results from shortening of the interosseous muscles which results in flexion of mcp joints, hyperextension of PIP joints and flexion of DIP joints
Boutonniere deformity results from flexion of PIP joints with hyperextnesion of DIP joints. Commonly seen with Rheumatoid Arthritis.
Wrist Flexion 80 degrees
Wrist extension 70 degrees
Ulnar deviation 55 degrees
Radial deviation 20 degrees
Finger flexion 90 degrees
Finger extension 20 degrees
Finger Abduction 20 degrees
Finger Adduction 0 degrees
Thumb flexion 50 degrees
THumb opposition 0 degrees
THumb opposition patient should be able to touch the tip of his thumb to each of the other fingertips
Flexor digitorum superficialis muscle flexes the phalanges at the PIP. Hold patients fingers in extension, except for the finger being tested. Isolates the flexor digitorum superficialis tendon. Then have patient to flex the finger in question at teh PIP
Flexor digitorum profundus Muscle flexes teh phalnges at the DIP. Isolate teh DIP joint by stabilizing the meacarpophalangeal and interphalangeal joints in extension. Ask patient to flex the finger at the distal interphalangeal joint.
Allen Test Patency of the ulnar artery before taking ABGs
Tinel's sign Median nerve test for carpel tunnel. Tap on median nerve at the wrist right above the flexor retinaculum.
Phalen's Test performed by flexing the patient's wrist to its maximum degree and holding it in that position for at least a minute.
Upper Extremity Reflexes Biceps (C5), Triceps (C7) and Brachioradialis (C6)
Lumbar Spine Flexion 75-90 degrees
Lumbar Spine Extension 30 degrees
Lumbar Spine Lateral Bending 35 degrees
Lumbar Spine Rotation 30 degrees
Straight leg raising test Tests for nerve root irritation or lumbar disk herniation at L4-S1 levels. Patient lies supine with neck flexed. Lift leg upward by supporting teh foot around the calcaneus with the knee straight. Sciatic nerve pain extending the whole leg indicates a pro
Lasegue sign Pain in straight leg raising test with less than 30 degrees of raising
Bragard stretch test extend leg to just below where pain is felt, then dorsiflex the foot. Confirms a positive straight leg test
Femoral stretch test patient prone, extend leg positive is sign of nerve root irritation, often L1-3
Hip Flexion with knee extended 90 degrees
Hip Flexion with knee flexed 120 degrees
Hip Extension (knee extended) 30 degrees
Hip Abduction up to 45 degrees
Hip adduction up to 30 degrees
Hip internal rotation 40 degrees
Hip external rotation 45 degrees
Trendelenburg Test tests for weak abductor muscles. Patient stands on one foot. If the iliac crest drops on the side of the lifted leg, then the hip abductor muscles on the weight bearing side are weak.
Thomas Test tests for flexion contractures of teh hip. Test is positive when there is normal flexion of the left leg and there is about 15 degrees of flexion contracture on the opposite hip.
Patrick Test/FABER Test detects pathology in the hip as well as sacroiliac joint. Patient lies supine on the table and place the foot of involved side on opposite knee. Stress the SI joint and extend the range of motion by placing one hand on the flexed knee joint and the other
Knee flexion 130 degrees
Knee Extension full extension is 0 degrees, may be 15 degrees hyperextension
Knee internal rotation 0-10 degrees
Knee external rotation 0-10 degrees
Anterior Drawer Test tests for ACL tear. grasp leg just below the knee and jerk the tibia forward. Abnormal forward mobility of 2 cm or more is a positive test.
Posterior Drawer Test PCL tear. Abnormal backward mobility of 2 cm or more is a positive test.
Lateral ligament stability testing tests stability of lateral collateral ligament.
Medial ligament stability testing tests stability of medial collateral ligament.
McMurry Test Tests for a meniscal tear. An audible "click" within the medial joint line during the test indicates a probable tear in the medial meniscus.
Apley Test (compression) Tests for meniscal tear. Hold plantar surface of teh patient's heel and apply a compressive force while internally and externally rotating the heel. Pain is postive test
Apley Test (distraction) Tests for ligament injury. Cup one hand around the posterior heel and place other hand at the distal end of the thigh. Pull up while preventing the femur form rising and externally and internally rotating the foot.
Lachman's Test ACL tear. Patient lies supine with extremity between 20 and 30 degrees flexion. Stabilize the distal lateral femur and greasp medial proximal tibia. apply pressure through the fingers and the palm of the hand that translates the tibia anteriorly
Ballottement tests for excess fluid or effusion in the knee.
Ankle dorsiflexion 20 degrees
Ankle plantar flexion 45 degrees
subtalar inversion 30 degrees
Subtalar eversion 20 degrees
Forefoot abduction 10 degrees
Forefoot adduction 20 degrees
Thompson-Doherty Squeeze Test tests for ruptured achilles tendon. Squeeze calf and notice the motion of the foot. Normally squeezing produces plantar flexion. ruptured achiles produces little or no motion
Homan's Sign tests for DVT in calf. Dorsiflex the foot. The test is positive when dorsiflexion elicits pain in the calf area (not reliable by itself)
Drawer Sign tests for disruption of Anterior talofibular ligament. 3 + factors: 1. anterior and posterior muscles which actuate the ankle must be relaxed with knee at 90 degrees. 2. ankle must be positioned at 10-20 degrees plantar flexion 3. For right ankle testi
Diarthrosis Joint Synovial Joint
Amphiarthrosis Symphysis and Sundesmosis joints
Synarthrosis Suture and Synchondrosis Joints
Pes Planus Foot remains flat even whennot bearing weight
pes cavus high instep, may be associated with claw toes
Claw toe hyperextension of teh metatarsophalangeal joint
Hallus valgus lateral deviation of the great toe. May have overlap with the second toe
Thumb Abduction Test Isolates teh strength of the abductor pollicis brevis muscle. associated with carpel tunnel syndrome
Barlow-Ortolani maneuver Testing hip dislocation in infant to 1 year.
Allis sign Dectect hip dislocation or shortened femur. With baby supine flex both knees with feet on the table. Unequal knee height is positive test
Genu varum bow leg
Genu valgum Knock-Knee
Gower sign Child rises from a sitting position by placing hands on the legs and pushing the trunk up
Ankylosing Spondylitis hereditory, chronic inflammatory disease initially affecting the lumbar spine and sacroiliac joints. Begins with low back and progresses to reduced spinal movement
Lumbosacral radiculopathy herniated lumbar disk.
Lumbar stenosis hypertrophy of teh ligamentum flavum and facet joints resulting in narrowing of the spinal canal
Carpel Tunnel Syndrome Compression on the median nerve caused by thickening of its flexor tendon sheath.
Gout Disorder of purine metabolism resulting form an elevated serum uric acid level. A form of arthritis
Temporomandibular Joint Syndrome TMJ. painful jaw movement caused by congenital anomalies, malocclusion, trama, arthritis, adn otehr joint diseases.
osteomyelitis infection in teh bone, usually results from an open wound or systemic infection
Bursitis inflammation of the bursa. resulting from constant friction between the skin and tissues around teh joint.
Paget Disease Osteitis Deformans. Metabolic focal disorder of the bone. Excessive bone resorption and excessive bone formation produce a mosaic pattern of lamellar bone
Fibromyalgia painful, nonarticular condition that primarily affects teh muscles. Widespread pain adn aching, persistent fatigue, generalized morning stiffness, multiple tender points (11 or more) at nine bilateral sites
Osteoarthritis deterioration of the articular cartilage covering the ends of bone in synovial joints
Rheumatoid Arthritis chronic, systemic, inflammatory, progressive disorder of joints. Disease onset is characterized by an unremitting fever, maculopapular rash, and arthitis
Strain excessive stretching by focrceful contraction beyond its functional capacity.
Sprain Stretching or tearing a supporting ligament of a joint
Dislocation complete separation of teh congtact between two bones in a joint
Fracture partial or complete break in teh continuity of a bone resulting from trauma.
Tenosynovitis tendonitis; inflammation of teh synovium-lined sheath around a tendon. common sites include the shoulder, knee, heel and wrists
Rotator Cuff Tear Microtrauma to the rotator cuff muscles, most often the supraspinatus. Occurs with repeated overhead lifting as the muscle and tendon are compressed under the acromion.
Myelomeningocele spina bifida; congenital neural tube defects with incomplete closure of the vertebral column. Permits meninges and sometimes spinal cord to protrude into a saclike structure
Talipes Equinovarus clubfoot; fixed congential defect of the ankle and foot. combination of position deformities includes inversion of the foot at the ankle and plantar flexion with the toes lower than the heel.
Metatarsus Adductus Metatarsus Varus; most common congenital foot deformity. Can be eitehr fixed or flexible. caused by intrauterine positioning. Medial adduction of eh toes adn forefoot resulting in angulation at the tarsometatarsal joint.
Developmental dysplasia of the hip condition present at birth in which the femoral head has an inappropriate relationship with the acetabulum. wide range of severity. will either be dislocation or subluxation. Joint ligaments allow displacement of teh femoral head
Legg-calve-perthes Disease avascular necrosis of teh femoral head resulting from a decreased blood supply to the femoral head. Most common in males between 3 adn 11. child may have a limp that is painless, loss of internal rotation, loss of abduction and decreased ROM.
Osgood-Schlatter Disease traction apophysitis (inflammation of a bony outgrowth) of the anterior aspect of the tibial tubercle in association with inflammation of the anterior patellar tendon.
Slipped Capital femoral epiphysis disorder inw hich teh capital femoral epiphysis slips over the neck of the femur.Often in children who are obese, taller than most and between 8 and 16
Muscular Dystrophy group of genetic disorders involving the gradual degeneration of the muscle fibers. Characterized by progressive symmetric weakness and muscle atrophy or pseudohypertrophy from fatty infiltrates.
Scoliosis physical deformity with a concave curvature of teh anterior vertebral bodies, convex posterior curves, and lateral rotation of the thoracic spine. lateral curvature is greater than 10 degrees, but may vary from 20-60 degrees
Radial Head Subluxation nursemad's elbow. Disclocation injury caused by jerking the arm upward while the elbow is extended. jerking pulls apart teh elbow joint and tears the margin of the annular ligament around the radial head into the joint and allows the torn ligament to beco
Osteoporosis silent progressive disease in which a decrease in bone mass occurs because bone resoorption is more rapid than bone deposition
Dupuytren Contracture affects palmar fascia of one ore more fingers and tends to be bilateral.
Created by: tjamrose
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