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84 Cards in this Set
- Front
- Back
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. |
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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 |
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What Tendon attaches to base of 5th MT
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Fibularis Brevis
---though Fib Longus also runs on lateral side of ankle, it slings under the foot to the medial side |
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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 |
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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 |
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Homan's sign tests for?
Performed? Positive? |
Thrombophlebitis/DVT
-Pt Prone, squeeze calf AND apply Dorsiflexion. Pos= Pain --SEND FOR DOPPLER |
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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 |
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What test might you perform if Pt injured themself during maneuver with Dorsiflexion and Eversion
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Might be HIGH Ankle Sprain with Ant. Tibio-Fib L.
Use Squeeze test |
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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 |
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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 |
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Name the 3 dorsiflexors of the foot/ankle
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Tibialis Anterior
EXTENSOR Hallicus Longus Extensor Digitorum Longus |
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Name the 6 plantarflexors of foot/ankle
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Gastroc/Soleus (if affected, pr with DorsiFlxn)
Tibialis Posterior Flexor Hallicus Longus Flexor Digitorum Longus Fibularis Longus/Brevis |
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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 |
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Name the 2 Talus Dysfunctions
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Dorsiflexed Talus Dyx
Plantar Flexed Talus Dys |
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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 |
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If Pt has problem walking,which Ortho and Osteo Eval will you do
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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. |
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How is a Calcaneus Inversion Dys tested
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-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
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What are the Osteo Evaluative Tests for Navicular/Cuboid and Cuneiforms 1-3
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Plantar - Bone-- Dysfunction
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How is Plantar Cuboid Dys Evaluated
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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
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List the 2 Osteopathic Evaluative maneuvers for Ankle. (4 if include ant/post)
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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 |
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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) |
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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 |
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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. |
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List sup/med and lat border of Femoral Triangle
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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 |
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What are the 3 major flexors of the hip?
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iliopsoas
Sartorius (also flexes knee in talor position) Rectus Femoris (also extends knee) |
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What is grading scale for mm strength?
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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! |
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What innervates Glut. MAX?
Medi? |
Mas is Inferior Gluteal N. S1
Medius is Superior Gluteal N. L5 |
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Obturator N., esp L2-L4 are important for what leg fxn?
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Adduction. Adductor Longus is L2-L4
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Femoral Neck and
Synovial Lining are in what Hip compartment? |
Peripheral
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What are contents of Central Compartment
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-Labrum (pain dec. with distraction/unloading)
-Ligamentum Teres (pain INC. w/ distraction) -Articular Surfaces |
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List the 4 Lateral Compartment Str.
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Gluteus Medius
Gluteus Minimus IT Band Trochanteric Bursae -Deep, --Superficial |
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List the 2 Psoas Compartment Str.
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Iliopsoas Insertion
Iliopsoas Bursae |
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Where does Iliopsoas Insert?
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On Lesser trochanter?
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Which mm insert at the greater trochanter
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Medius and Minimus
--Maximus more or less inserts on IT band. It is an Extensor |
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Cupping just above greater trochanter indicates what?
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C-sign or a Central Compartment Pathology/Labral Pathology.
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What are nerve/roots for Iliopsaos Flexion?
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Femoral N.
L1-3 |
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Dermatomes for Hip/thigh?
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L1- L3
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Skin:
Lateral Femoral Cutaneous N. root? Posterior femoral Cutaneous N. root? |
Lat Fem Cut = S3
Post Fem Cut = S2 |
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The Log roll tests which 2 compartments?
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Log ROll for Central and Peripheral Hip Pathologies
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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
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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 |
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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 |
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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 |
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What Central C. test might indicate a Ligamentum Teres tear?
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Labral Distraction
--If + Pain when distracted think Lig.Teres tear. --If relief when distracted, this is Positive for Labral Path. |
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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 |
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This test, Lateral Compartment Pathology & ITB Syndrome
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Straight Leg-
--leg above 15 degrees with pain = IT band synd |
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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. |
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If trochanteric bursitis is suspected. What might you perform?
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Jump Sign
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This test is specific for Gluteus Medius/Superior Gluteal N. fxn.
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Trendelenburg
--active/ |
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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 |
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Test for flexion of Psoas
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Psoas Test
-Pt sits on table (OR Supine), tries to flex hip against resistance |
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Demonstrate and Describe a Hip External Rotation Dys?
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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
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Medial top portion of tibia?
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Medial tibial plateau
---lateral tibial plateau too on other side |
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Adjectives for knee grading:
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grinding, squishy, boggy, laxity tenderness
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What landmark is just superior to Medial Epicondyle of femur
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Adductor Tubercle
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Achy diffuse pain, not sharp in knee. Think?
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Q-angle and excess genu valvus/varus
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What Ortho Test tests for MCLs with leg extended, then slightly flexed?
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Valgus (pushing knee inward) stresses the MCL
--Valgus Stress Test |
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What Ortho Test tests for LCL with leg extended, then slightly flexed?
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Varus Stress Test.
--push knee outward with extened then with it slightly flexed at knee/ this varus stress pulls on LCL |
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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 |
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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 |
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Which APley test is only specific for Meniscal Issues, NOT Collateral Ligament tears
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Apley Compression.
--Pain is post for Meniscus ----does not concern Ligamaments |
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What test is used for determining a Tear in the Collateral Ligaments OR presence of meniscal path?
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The Apley Distraction Test
--Pain with distraction is Collateral Ligaments --If Relief with Distraction, then it's a Meniscal Issue |
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Which Test used for possible ACL tear?
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Drawer Test.
--Pull Pt Tibia Anterior from behind. --Positive: 1. Joint Laxity/No End Feel |
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A drawer test with Anterior Shift of Lateral Plateau when Tibia is Medially Rotated indicates what?
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ACL as usual, but with Medial rotation, may have LCL as well
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A drawer test with Anterior Shift of Medial Plateau of Tibia, when Tibia Externally Rotated indicates what?
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ACL as usual, but with External/Lateral Rotation of Tibia, think MCL too
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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 |
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A McMurry modified with INternal Rotation and Varus Force as you extend a flexed leg of Supine PT tests for a tear of what?
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Posterior Lateral Meniscal Tear
--Varus, INTERNAL, extension |
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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 |
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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 |
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Nerve and Roots for the Hamstrings?
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Sciatic N.
L5-S1 |
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Knee reflexes are predominantly what?
Primary for Triceps |
L2-L4
L4 is Patellar --C7 ( |
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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
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This Is Lachmans Test--a prefered ORthopedic Exam
-positive is: too much forward mvmt = ACL tear |
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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 |
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List the 6 Structures/Element so Internal Ear-Typmanic Membrane
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Pars tensa
Pars flaccida Chorda Tympani N. Cone of Light* Umbo Manubrium/Malleus Arm |
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Which 2 sinuses are on/deep to bridge of nose
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Ethmoid and Sphenoid
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Where lips meet face
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Vermillion Border
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Progression of Moth from top/front to back of throat is ? in anatomical terms
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Hard Palate --> soft palate --> Palatine tonsils -->Posterior Wall of Oropharynx
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Inside of cheeks called?
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Buccal Mucosa
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What nerves involved in Gag Reflex?
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CN 9
CN 10 |
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List Landmark lines for Chest Inspection--Also consider them when doing Respiratory Exam
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Midsternal Line, Post/Ant/Mid Axillary Line, MCL. Pectus Carinatum/Excavatum
-Evaluate Respiratory Rhythm, pattern, rate -Tracheal Position --Palpate: rib motion -Thoracic Expansion |
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What 4 adventitious lung sounds might be auscultated?
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Wheezes, Crackles, Rhonchi, Pleural Frxn Rub
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For which Heart sounds is the Bell best ?
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S3 and S4,
Low pitched murmur |
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For which heart sounds is the diaphram best?
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S1 S2,
high pitched sounds |
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What part of steth used for listening to carotid pulse
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Bell.
Palpate 1 side at a time only. Ask Pt to hold breath. hold yours too |