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25 Cards in this Set
- Front
- Back
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Tinnel's Sign |
Median nerve compression by lightly tapping over the median nerve in the carpal tunnel. Aching/numbness in the median nerve = + test. |
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Phalen's sign |
Median nerve compression by asking the pt to hold wrists in flexion for 60 seconds. Then ask the pt to press the backs of both hands together to form right angles. Numbness/tingling in the median nerve within 60 seconds is a positive test. |
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Cross Over test |
Adduct the pt.'s arm across the chest. Tests the Acromioclavicular joint. Pain/tenderness with adduction suggestion inflammation or arthritis of the AC joint. |
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Valgus stress test(MCL ligament) Adbuction |
Pt supine, knee slightly flexed, move thigh about 30 degrees laterally to the side of the table. Place one hand against the lateral knee to stabilize the femur and the other hand around the medial ankle. Push medially against the knee and pull laterally at the ankle to open the knee joint on the medial side. |
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Valgus stress test(MCL ligament) Adbuction |
Pain or gap in the medial joint line points to a ligamentous laxity and a partial tear of the MCL. Most injuries are on the medial side. |
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McMurray test |
medial/lateral meniscus tear |
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ACL PCL |
Anterior drawer test Posterior drawer test |
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Bulge sign |
For minor effusions. With knee extended, place the L hand above the knee, apply pressure on the suprapatellar pouch, milking fluid downward. Stroke dw on the medial knee and apply pressure to force fluid into the lateral area. Tap the knee just behind the lateral margin of the patella with the R hand. |
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+ Bulge Sign |
A fluid wave or bulge on the medial side btwn the patella and the femur is considered + for effusion. |
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Ballon Sign |
For major knee effusions Compress the knee on each side of the patella in the supra patellar pouch. Feel for fluid entering the spaces next to the patella. Palapable fluid wave = + effusion |
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Ballotting the patella |
Compress the supra patellar pouch and push the patella sharply against the femur. Watch for fluid returning to the supra patellar pouch. |
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Inflammatory Joint Pain - Rheumatoid arthritis |
*symmetric, tender, warm but seldom red *prominent in mornings after inactivity *Weakness, fatigue, wt loss and low fever **Frequent swelling of synovial tissue and damage to ligaments and tendons *Hands, feet, wrists, knees, elbows, ankles |
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Noninflammatory - Osteoarthritis |
*DJD within the joints, damage to the underlying bone and formation of new bone. *Knees, hips, hands, spine, wrists *additive but just one joint may be involved *Small effusions in joint may be present *Possibly tender but seldom warm or red *Frequent but brief in the am and after inactivity |
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Chronic RA in hands |
*Swelling/thickening of MCP/PIP *ROM limited *Fingers deviate toward ulnar side *Swan neck deformities-hyperextension of PIP and flexion of DIP. *Boutonniere-flexion of DIP |
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Osteoarthritis (DJD) in hands |
Herberden's nodules-DIP Bouchard's nodules-PIP Bony overgrowths Hard and painless |
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Gouty arthritis |
An inflammatory reaction to urate microcrystals *Base of big toe, instep of feet, ankles, knee and elbows *Usually just one joint, sudden, often at night *Often after surgery, injury, fasting or excessive alcohol or food intake. *Occassional attacks lasting up to 2 weeks *RED, HOT, TENDER may dv fever |
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herniated disc |
Sciatic nerve tenderness, midline back pain, listing of trunk to one side *cauda equina compression-risk of paralysis of limb or loss of bowel/bladder control most common at L5-S1 or L4-L5 tenderness of the spinous process, intervetebral joints, vertebral muscles, sacrosciatic notch. |
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Lyme disease |
From wood ticks Mental status change, facial or other weakness, stiff neck-CNS involvement An expanding erythematous patch early in an illness. |
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osteoporosis Risk factor |
>50 postmenopausal prior fragility fx, fam hx fragility fx in 1st relative Use of corticosteroids low dietary ca, vit d def tobacco/ETOH use Medical conditions Medications Inflamamatory disorders |
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Osteoporosis |
Risk measured by bone density Peak bone mass reached by 30 Common in hepatic and renal dz 10% loss in BD = 20% increase risk for fx T score <-2.5 or >2.5 SD below mean check for thoracic kyphosis, fx in spine/hip |
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Osteoporosis calcium and vit d recs |
Ca-1200mg, vit D 600 IU |
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Parathyroid hormone |
stimulate bone formation |
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Mech'l back pain causes |
70% age related 4% herniated discs 3% spinal stenosis 3% compression fx 2% spondylolisthesis |
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Mech'l back pain patterns |
Aching pain in the lumbosacral area, may radiate into the the lower leg. Commonly work related Age 30-50 Risk factors heavy lifting, poor conditioning, heavy lifting, obesity |
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Mech'l back pain physical signs |
Pain w/ back movement, loss of normal lumbar lordosis but no motor or sensory loss. |
