Orthopedic exams Test
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| A. pt supine. grasp pts ankle and fully flex knee on affected side such that the heel is close to the buttock. place hand over knee and externally rotate and slowly extend knee keeping hip partially flexed. thud or click = medial meniscus damage. int=lat menB. Pt's backache caused by disc herniation lateral to nerve root, pt leans away from side with lesion. if herniation is medial to nerve root pt leans to side with lesion. Post central disc herniation pt stands straight and stiff in slight flexion.C. PROM. raise pt's shoulders by abducting arms. pts elbows are extended and shoulders externally rotated (palms up) Doc supports arm while patient flexes elbows. pain = irritation of roots of brachial plexus D. passively flex patient's forearm, fingers and wrist, then passively pronate and extend elbow. lateral epicondylitis E. seated pt attempts to flex, extend, laterally bend and rotate neck while doctor resists movement. PROM pain = muscle strain, AROM pain = ligamentous sprainF. mark 5cm below PSIS and 10cm above psis midline. pt bends forward and doc measures the difference between the 2 marks and subtracts 15. if increase is less than 5 = ankylosing spondylitisG. pt in supine position and have them flex knees at 90 degrees. sit on pts feet and push tibia posterior and pull it anteriorly. perform on both legs excessive movement >6mm torn cruciate ligamentH. passively flex DIP, then extend finger and passively flex MCP and DIP. if no change in degree of flexion = restriction of fibrous capsule of DIP joint. if increase in flexion=contraction of lumbrical muscleI. attempt to completely extend the partly flexed knee of the supine patient. if this action causes pain or other knee to flex involuntarily = meningeal irritation, meningitisJ. instruct seated pt to rotate the neck to the shoulder and extend the head to the affected side, if no pain instruct pt to flex neck while in rotation. perform bilaterally, pain in affected arm = nerve root compression or facet involvement.K. invert pts ankle. anterior talofibular or calcaneofibular ligament damage (inversion sprain)L. compress region of palm of the wrist just distal to distal crease with both thumb in an anteroposterior direction. hold with thumbs 15secs to 2 mins. tingling or paresthesia = carpal tunnel syndromeM. ask pt to place palm of hand on top of head with elbow level with head. pain = scalenus anterior type of TOSN. pt is supporting head with both hands = cervical fracture or severe sprainO. resisted active hip external rotation and abduction elicits pain = piriformis syndrome P. Pt supine. Lift affected leg with knee flexed and place on Doc's shoulder. apply firm pressure on hamstring muscles and then in popliteal fossa. irritation of roots of sciatic nerve.Q. palpate pts shoulder for tender spots. hold tender spot and abduct pts arm. if pain is relieved = subaromial bursitisR. pt supine knees extended. doc hand over medial joint line and ankle. attempt to adduct leg. pain - LCL injuryS. Pt supine. Doc raises extended leg, internally rotates foot and adducts extended limb = piriformis syndromeT. pt supine. raise affected leg with one hand while other hand is under lumbar region. pain before l-spine begins to move 0-30 SI joint pathology, pain 30-60 lumbosacral joint pathology, 60-90 lumbar region pathology |
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polystachya
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