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84 Cards in this Set

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List the 3 Lateral ankle Ligaments
(aka the Lateral collateral L. of ankle)
1. Ant. Talo-Fibular L.
2. Post. Talo-Fibular L.
3. Calcaneofibular L.
Which two mm tendons run on medial side of Ankle?
Position relative to Medial Malleolus?
Both the Anterior and Posterior Tibialis run to medial Side.
-Tibialis Post, --behind malleulus
-Tibialis Ant, --in front of malleolus
What Tendon attaches to base of 5th MT
Fibularis Brevis
---though Fib Longus also runs on lateral side of ankle, it slings under the foot to the medial side
What test would you perform/how if Pt can't clear foot when walking?
What specifically is being tested
Ankle dorsiflexion test--whether inability to dorsiflex is due to Gastroc (spans 2jnts) or Soleus.
--Pt sitting. Have Extend Leg and Dr attempts DF.
--Pt flexes knee as seated permits, this way Gastroc mm. is RELAXED
if better, problem was Gastroc.
-if no change, was Soleus
Which Ortho test tests for tear in the Ant. Talo-Fibular L. ?
--How Performed?
-Positive?
Drawer Sign on ankle
-Pull Calc toward you while locking out prox. tibia/fibula.
-Positive is Lack of Rebound
Homan's sign tests for?
Performed?
Positive?
Thrombophlebitis/DVT
-Pt Prone, squeeze calf AND apply Dorsiflexion.
Pos= Pain
--SEND FOR DOPPLER
Which Ortho tests for Ant. Tibio-Fibular Sprain?
-Performed?
-Positive?
The Squeeze Test (High Ankle Sprain OR Interosseous Mem Path)
-Squeeze Tib/Fib together Proximal of Ankle
--Pos= pain on LATERAL side
What test might you perform if Pt injured themself during maneuver with Dorsiflexion and Eversion
Might be HIGH Ankle Sprain with Ant. Tibio-Fib L.
Use Squeeze test
If Calcaneo-Fibular L. injury (L. from Calc to lateral maleoulus), what test is indicated?
Performed?
Pos=?
Talar Tilt Test for calcaneofib L.
--INVERT Calcaneous while locking out Tib/Fib above
-Pos=if Talus Gaps and Rocks in ankle mortise
--can modify and EVERT to test Deltoid L. medially
The Thompson Test tests for what?
Position? Performed?
Positive=?
Achilles' Tendon integrity
-Pt Prone w/ feet OFF table. Squeeze Calf
--Positive if NO Plantar Flexion
----If no PlantarFlxn = complete tear
Name the 3 dorsiflexors of the foot/ankle
Tibialis Anterior
EXTENSOR Hallicus Longus
Extensor Digitorum Longus
Name the 6 plantarflexors of foot/ankle
Gastroc/Soleus (if affected, pr with DorsiFlxn)
Tibialis Posterior
Flexor Hallicus Longus
Flexor Digitorum Longus
Fibularis Longus/Brevis
Reflex for Achilles' Tendon and Anle
0
--If affected, what is messed up in stride?
S1
--problem clearing foot/dim abiltiy to dorsiflex to clear toes while walking
Name the 2 Talus Dysfunctions
Dorsiflexed Talus Dyx
Plantar Flexed Talus Dys
How are Talus Plantar OR Dorsi Flexion Dysfunctions Tested
--Use DF for example
--Pt Position?
--Performed?
--Positve?
Pt is Supine.
-Grab Ant. Ankle and note degree of DorsiFlexion in BOTH Ankles while stabalizing posterior or ankle just above calcaneous.
---Pos Dys if--RELATIVE TO other ANkle---it lives in DF/restricted to PF
If Pt has problem walking,which Ortho and Osteo Eval will you do
Thompson Test to check Achilles, if okay, then Ankle Dorsiflexion test to check Gastroc/Soleus.
Lastly, Osteo Eval for PLANTAR Flexed Talus DYs.
--if so, it lives in plantar flex, restriction to dorsiflexion = problem walking.
How is a Calcaneus Inversion Dys tested
-Similar to DF/PF Talus Dys, you -one hand cups forfoot/anterior of ankle to stabilize, but instead Invert the cupped calcaneous with other hand
What are the Osteo Evaluative Tests for Navicular/Cuboid and Cuneiforms 1-3
Plantar - Bone-- Dysfunction
How is Plantar Cuboid Dys Evaluated
Rotate Navicular (medial side, cuboid is lateral) toward Plantar surface, if Plantar Navicular Dys, then this Lateral Aspect of the bone should rotate down/plantar with ease, with restriction to rotating to the dorsal surface
List the 2 Osteopathic Evaluative maneuvers for Ankle. (4 if include ant/post)
1. Anterior or Posterior Lateral Malleolus Dysfunctions
---just translate Malleolus for/back on BOTH sides noting any TARTs
2. Ant/Post Tibia on Talus
--grab forfoot/lockout Talus and translate Tibia for/back. BILATERALLY with TARTs
List 5 Important Osteopathic Evals for Foot
--up to/not including MTs and MT/Phalanges
1. DF/PF Talus Dys
2. Inv/Ev Calcaneus Dys
3. Plantar Navicular Dys (relative to lateral part of bone)
4. Plantar Cuboid Dys (relative to medial aspect of bone)--
5. Plantar Cuneiform Dys (ant. to navicular, so lock out navicular)
What bones need to be locked out when Osteopathically Eval the Cuboid for Plantar Dysf?
The Navicular?
The Cuneiform?
Cuboid is ant to Calcaneus, so lock out Calc
-Navic is ant of Talus, so lock out Talus
-Cuneiform 1 is ant. to Navic, so lock out Navic
Begin of Hip and Knee Starts?
--Which Landmark is Lateral to Pubic Symphysis
Here?
--The pubic tubercle
---Ischial Tuberosity is posterior, you sit on it.
List sup/med and lat border of Femoral Triangle
Lateral is Sartorious
Medial is Adductor Longus
Superior is Inguinal Lig.
--in/b/w Lat and Med is NAVEL
Nerve is lateral most, vein is medial most
What are the 3 major flexors of the hip?
iliopsoas
Sartorius (also flexes knee in talor position)
Rectus Femoris (also extends knee)
What is grading scale for mm strength?
0- no nerve reflex
1-can feel twitch, no mvmt
2-assited mvmnt/can't oppose gravity
3-can oppose gravity, not resistance
4-can oppose resistance, but weakened compared to other side
5--good
---Designate X out of 5!
What innervates Glut. MAX?
Medi?
Mas is Inferior Gluteal N. S1
Medius is Superior Gluteal N. L5
Obturator N., esp L2-L4 are important for what leg fxn?
Adduction. Adductor Longus is L2-L4
Femoral Neck and
Synovial Lining are in what Hip compartment?
Peripheral
What are contents of Central Compartment
-Labrum (pain dec. with distraction/unloading)
-Ligamentum Teres (pain INC. w/ distraction)
-Articular Surfaces
List the 4 Lateral Compartment Str.
Gluteus Medius
Gluteus Minimus
IT Band
Trochanteric Bursae
-Deep, --Superficial
List the 2 Psoas Compartment Str.
Iliopsoas Insertion
Iliopsoas Bursae
Where does Iliopsoas Insert?
On Lesser trochanter?
Which mm insert at the greater trochanter
Medius and Minimus

--Maximus more or less inserts on IT band. It is an Extensor
Cupping just above greater trochanter indicates what?
C-sign or a Central Compartment Pathology/Labral Pathology.
What are nerve/roots for Iliopsaos Flexion?
Femoral N.
L1-3
Dermatomes for Hip/thigh?
L1- L3
Skin:
Lateral Femoral Cutaneous N. root?
Posterior femoral Cutaneous N. root?
Lat Fem Cut = S3

Post Fem Cut = S2
The Log roll tests which 2 compartments?
Log ROll for Central and Peripheral Hip Pathologies
For Which Compartment is FABER done Passively--just you push?
--What force do you apply?
Central Compartment--FABER is Apprehension, ie, YOU apply the External Rotation to determineL a Labral Path or a Central Hip Inpingement
How is the FABER conducted in the Lateral Compartment?
What is it testing for?
FABER in Lateral is Active (only passive in Central C.).
-Pt pushes leg toward table/ext rotates against your Hand
-Think Gluteus Medius issue
For Which compartment is the 3rd Faber test useful?
-Active, with Pt Internally or Externally Rotating?
Psoas Compartment. Because Iliopsoas is Flexor & Internal Rotator.
--Pt must ADduct and Interally Rotate against Dr. posterior force
For this Ortho maneuver, you flex hip & knee to 90degrees and apply posterior force
-What compartment/pathology if positive
-Labral Loading
---Central Compartment.
--Pos for Labral Path if Pain on loading
What Central C. test might indicate a Ligamentum Teres tear?
Labral Distraction
--If + Pain when distracted think Lig.Teres tear.
--If relief when distracted, this is Positive for Labral Path.
Presence of Clicks or Pain during this passive omega maneuver indicates what sort of pathology?
Test name?
Scour: Passive test In Central Compartment
--Click or Pain = Labral or Articular Cartilage lesion
This test, Lateral Compartment Pathology & ITB Syndrome
Straight Leg-
--leg above 15 degrees with pain = IT band synd
What test tests for IT band contracture?
Performed?
Ober's Test.
Passively flex and ABduct leg of Pt in Lateral Recumbant, then allow to drop looking for catching.
If trochanteric bursitis is suspected. What might you perform?
Jump Sign
This test is specific for Gluteus Medius/Superior Gluteal N. fxn.
Trendelenburg
--active/
What Test tests for FLEXION COntractures of the Hip?
--How performed?
Thomas Test (Psoas)
-dr puts hand under lumbar to lock out spine mvmt. Pt grabs knees while supine then lets 1 go at a time, noting the extension achieved of leg let go. Lack of Ext indicates the Flexion Contracture= Postive Thomas Test
Test for flexion of Psoas
Psoas Test
-Pt sits on table (OR Supine), tries to flex hip against resistance
Demonstrate and Describe a Hip External Rotation Dys?
Have Pt lay supine. passively check ROM bilaterally, if one side is restricted to internal rotation, than they Have a Hip External Rotation Somatic Dysfunction
Medial top portion of tibia?
Medial tibial plateau
---lateral tibial plateau too on other side
Adjectives for knee grading:
grinding, squishy, boggy, laxity tenderness
What landmark is just superior to Medial Epicondyle of femur
Adductor Tubercle
Achy diffuse pain, not sharp in knee. Think?
Q-angle and excess genu valvus/varus
What Ortho Test tests for MCLs with leg extended, then slightly flexed?
Valgus (pushing knee inward) stresses the MCL
--Valgus Stress Test
What Ortho Test tests for LCL with leg extended, then slightly flexed?
Varus Stress Test.
--push knee outward with extened then with it slightly flexed at knee/ this varus stress pulls on LCL
Best Ortho test for possible meniscal tears?
--Perfromed for Medial Men?
--For Lateral Men?
Aplley Compression Test
-Pt Prone, dr applis force through tibia from calcneuos.
-Add External Rotation to Test MEDIAL
--Add Interal Roation to Tes Lateral Meniscus
How is Apley Distraction performed to demonstrate a Collateral Ligament Tear.
Meniscus?
-Pt Prone, dr distract leg AND Apply Internal/External Rotation.
--If Ligament, PAIN with Distraction-
---If Meniscal, Relief with Distraction (think Meniscus = Labrum, and Labrum is rlieved in distraction
Which APley test is only specific for Meniscal Issues, NOT Collateral Ligament tears
Apley Compression.
--Pain is post for Meniscus
----does not concern Ligamaments
What test is used for determining a Tear in the Collateral Ligaments OR presence of meniscal path?
The Apley Distraction Test
--Pain with distraction is Collateral Ligaments
--If Relief with Distraction, then it's a Meniscal Issue
Which Test used for possible ACL tear?
Drawer Test.
--Pull Pt Tibia Anterior from behind.
--Positive: 1. Joint Laxity/No End Feel
A drawer test with Anterior Shift of Lateral Plateau when Tibia is Medially Rotated indicates what?
ACL as usual, but with Medial rotation, may have LCL as well
A drawer test with Anterior Shift of Medial Plateau of Tibia, when Tibia Externally Rotated indicates what?
ACL as usual, but with External/Lateral Rotation of Tibia, think MCL too
How is McMurry Tested
-Positive indicates what?
Tests Posterior Medial Meniscus tear:
--Pt Supine. Staring with Knee Flexed. Calcaneus griped one hand. Knee with Other. As you Extend Leg, Apply External rotation and Valgus Force.
---Positive for Posterior Medial meniscus= Clicks, Pops may be tear
A McMurry modified with INternal Rotation and Varus Force as you extend a flexed leg of Supine PT tests for a tear of what?
Posterior Lateral Meniscal Tear
--Varus, INTERNAL, extension
Chondromalacia of patella may be tested via what Ortho Test?

Positive is?
Patella femoral grinding test
--Pt supine, leg extended
---Push patella distal in trochlear groove
-----Positive: crepitus or pain
---Resist as Pt flexes quads
Describe how to do Ballotable Patella aka Patellar Apprehension
-What is test for?
For Effusions from Suprapatellar Pouch.
--Pt is supine,
Palpate/compress suprapatellar pouch OR push patella against femur
---positive is palpable fluid returning to pouch
Nerve and Roots for the Hamstrings?
Sciatic N.
L5-S1
Knee reflexes are predominantly what?

Primary for Triceps
L2-L4

L4 is Patellar

--C7 (
This Test is performed with Pt supine, leg slightly flexed. One hand grips distal femur and applies posterior force, other hand grabs Proximal tibia (from posterior aspect/calf) and applies Anterior Force of Tibia along with EXTERNAL/Lateral Rotation
This Is Lachmans Test--a prefered ORthopedic Exam
-positive is: too much forward mvmt = ACL tear
External Ear Landmarks:
List 2 sets paired-named structures and the remaining 4 parts of Auricle
Helix - Antihelix
Tragus - Antitragus
Lobule
Concha -- leads up t-->
External Auditory Meatus
Triangular Foass
List the 6 Structures/Element so Internal Ear-Typmanic Membrane
Pars tensa
Pars flaccida
Chorda Tympani N.
Cone of Light*
Umbo
Manubrium/Malleus Arm
Which 2 sinuses are on/deep to bridge of nose
Ethmoid and Sphenoid
Where lips meet face
Vermillion Border
Progression of Moth from top/front to back of throat is ? in anatomical terms
Hard Palate --> soft palate --> Palatine tonsils -->Posterior Wall of Oropharynx
Inside of cheeks called?
Buccal Mucosa
What nerves involved in Gag Reflex?
CN 9
CN 10
List Landmark lines for Chest Inspection--Also consider them when doing Respiratory Exam
Midsternal Line, Post/Ant/Mid Axillary Line, MCL. Pectus Carinatum/Excavatum
-Evaluate Respiratory Rhythm, pattern, rate
-Tracheal Position
--Palpate: rib motion
-Thoracic Expansion
What 4 adventitious lung sounds might be auscultated?
Wheezes, Crackles, Rhonchi, Pleural Frxn Rub
For which Heart sounds is the Bell best ?
S3 and S4,
Low pitched murmur
For which heart sounds is the diaphram best?
S1 S2,
high pitched sounds
What part of steth used for listening to carotid pulse
Bell.
Palpate 1 side at a time only.
Ask Pt to hold breath. hold yours too