OPP special tests

waziyuta's version from 2015-10-25 13:01

Section 1

Question Answer
spurling testtests nerce root impingement in neural foramina (MC cervical disk C5-6)
Wallenberg/DeKlyne's testtests for vertebral artery insufficiency
FABERE testosteoarthritis of hip vs. sacroiliitis of SI joint (Flexion, ABduction, External rotation, Extension)
Hip drop testlumbar sidebenting
walking on heelstests L5 nerve root (L4-L5 disc)
walking on toestests S1 nerve root (L5-S1 disc)
ober testfor illiotibial band contraction
Trendelenberg testfor gluteus medius weakness
Arm drop/empty can testrotator cuff injury
Yergason's testbicepts tendonitis (forearm pronated and externally rotated and then flexed against resistance)
Speed's testbicepts tendonitis (supinated forearm flexed to 90 degrees against resistance while bicipital groove is palpated)
Yergason's or speed's testbicepts tendonitis
Apprehension testchronic shoulder dislocation
Hyperabdution testThoracic outlet syndrome (pec minor)
Costoclavicular testThoracic outlet syndrome (1st rib and claviclel)
Apley's scratch testsevaluates shoulder motion
phalen's testcarpal tunnel syndrome
Tinel's testcarpal tunnel syndrome
Allen testtest patency of radial and ulnar arteries
Finkelstein testDeQuervain's tenosynovitis

Section 2

Question Answer
how is scoliosis named?scoliosis is named after the convexity of the curve
what is double major scoliosis2 scolitotic curves
in scoliosis, the scapula is more prominant on scapula more prominant on convex side (rib hump)
what do you treat fist in scoliosis?treat apex of the curve 1st
in scoliosis, to what side do the vertebrae rotate?Type I curve so vertebrae rotate away from concavity (ex NSBrRl); toward convexity convex side = vertebral side
pump handle ribsribs 1-5
bucket handle ribsribs 6-10
caliper ribsribs 11 and 12
elevated or exhalation restricted ribinhalation SD
depressed or inhalation restricted ribexhalation SD
treatment of group of inhalation SD ribstreat most inferior first
treatment of group of exhalation SD ribsTreat most superior first (superman exhales his breath)
Rib 1 treatmentAnterior/middle scalene
Rib 2 treatmentPosterior scalene
Ribs 3-5 treatmentPectoralis minor
Ribs 6-10 treatmentSerratus anterior
Ribs 11-12 treatmentRib 11:Latissimus Dorsi or Rib 12-Quadratus lumborum
the motion most common to ribs 1-5 will allow and increase in what axis during inhalation?A-P axis (Pump handle ribs)
the motion most common to ribs 6-10 will allow and increase in what axis during inhalation?trasverse axis (bucket handle ribs)
the motion most common to ribs 11 & 12 will allow and increase in what axis during inhalation?A-P axis and Transverse axis (Caliper ribs)
MC SD of temporal boneinternally rotated temporal bone
Tinnitustreat temporal bones
Anosmiatreat ethmoid bone
temporal bone dysfunction can cause problems in what 3 nervesGlossopharyngeal CN9, Vagus CN10, Accessory CN11
baby with sucking/swallowing dificultytreat creanially by decompression of occipital condyles
in TMJ, the chin deviates to deviates to side of restriction
MC pubic dysfunction in post=partum womanABducted - pubic gapping

Section 3

Question Answer
coxa valga leads to what issue in the kneecoxa valga --> genu vara (bull legged) < >
coxa vara leads to what issue in the kneecoxa vara --> genu valga (knock kneed) ><
angle formed between the head and neck of the femur and its shaft is decreased (105 degrees)coxa vara
angle formed between the head and neck of the femur and its shaft is increased (160 degrees)coxa valga
what coxa has the femoral shaft furthest from the midlinecoxa vara
treatment of choice for adhesive capsulitis (frozen shoulder)7 stages of spencer
L5 rotates ? on L on LL5 always rotates opposite to axis, forward torsion L5 is neutral (type 1) --> L5 N RrSl
L5 rotates ? on L on RL5 always rotates opposite to axis, backward torsion L5 is flexed/extended (type 2) --> L5 F/E RlSl
right leg outtrunk rotates left, wt bear on left-->LonL (L5 N RrSl) right inominate moves posterior to anterior as right heal strikes
muscles of the rotator cuffSITS Supraspinatus, Infraspinatous, Teres minor, subscapularis
which rotator cuff muscle is the internal rotatorsubscapularis
Winging of scapulaSALT serratus anterior, long thoracic nerve
MC shoulder dislocationsanterior/inferior
for every 15 degrees of shoulder ABduction10 degrees is glenohumeral and 5 degrees is scapular rotation 2:1 glenohumeral joint/scapula
tennis elbowlateral epicondyle, pain with wrist extension
golfers elbowmedial epicondyle, pain with wrist flexion
Posterior radial headP&Ps go together Posterior radial head can Pronate, restricted in supination
Superior radial headAnterior radial head can supinate, restricted in pronation
ABducted distal ulnaolecranon glides more medial, wrist ADucts, increase carrying angle
ADducted distal ulnaolecranon glides more lateral wrist ABucts, decreased carrying angle
claviacal dysfunctions of SC jointADucted clavical and Horizontal extension
Bouchard's nodesPIP joint osteophyte seen in OA
Herberden's nodesDIP joint osteophyte seen in OA
Swan neck deformityExtension of PIP/flexion of DIP seen in RA
Boutonniere deformityFlexion of PIP/extension of DIP seen in RA
DeQuervain's tenosynovitis Abductor pollicis longus and extensor pollicis brevis
pes anserinus/anserineThe pes anserinus is the anatomic term used to identify the insertion of the conjoined tendons Sartorius, Gracilis, and Semitendinosus into the anteromedial proximal tibia.
pes anserinus/anserine mneumonicSay Grace before tea Sartorius, Gracilis, semiTendinous
terrible triadMCL, ACL. lateral miniscus
joint most stable: kneeextension
joint most stable: elbowextension
joint most stable: ankledorsiflexed
joint most stable: wristextension

Section 4

Question Answer
Anterior fibular head DEA = Dorsiflex foot, evert foot, anterior fibular head
Posterior fibular headPIP = Planterflex foot, invert foot, posterior fibular head
Foot is pronated, where is fibular head?foot pronarion = anterior fibular head
Foot is supinated, where is fibular head?foot supination = posterior fibular head
treatment of anterior fibular headtreat DEA with PIP
treatment of posterior fibular headtreat PIP with DEA
treatment for pronated footpronated foot = anterior fibular head (DEA); treat DEA with PIP
treatment for supinated footsupinated foot = posterior fibular head (PIP); treat PIP with DEA
where is the fibular head most commonly found in a sprained anklesupination of foot = posterior fibular head
fibular head dysfunction can causeperoneal neve impingment
patient presents after they sprain there ankle with numbness down the lateral side of the foot and leg. what SD is causing that? posterior fibular head - sprain your ankle --fibular head goes posterior -->peroneal nerve gets entraped
Q-anglefirst line goes from the ASIS to the middle of the patellata, second line goes from the tibia tubercule up
Q-angle in gunu valgumQ-angle is increased in gunu valgum
Q-angle in genu varaQ-angle is decreased in gunu vara
pronation of the footdorsiflex, eversion, ABduction
supination of the footplantarflex, inversion, ADuction
dysfunction of navicular bonenavicular drops down planterly and rotates medially
dysfuntion of cuboid bonecuboid drops down planterly and rotates laterally
first ligament sprained in an ankle sprainAnterior talofibular (ATF) Always Tears First [ATF = grade 1]
second ligament sprained in an ankle sprainCalcaneofibular (CF) [ATF + CF =grade 2]
third ligament sprained in an ankle sprainPosterior talofibular (PTF) [ATF + CF + PTF = grade 3]
grade 1 ankle sprain[ATF = grade 1]
grade 2 ankle sprain[ATF + CF =grade 2]
grade 3 ankle sprain[ATF + CF + PTF = grade 3]
Anterior talofibular (ATF ligamentalus to fibua DO NOT confuse with anterior tibiofibular!!
Calcaneofibular (CF) ligamentcalcaneous to fibula
Posterior talofibular (PTF) ligamenttalus to fibula
which bone is common to both the medial and lateral longitudinal arches of the footcalcaneous
the q-angle in increase in genu valgum and coxa varum
pars defects (spondylolysis) is diagnosed with what x-rayoblique views of the lumbar spine
spondylolisthesis is diagnosed with what x-raylateral views of the lumbar spine
Nerve entrapment at Guyon's canal affects the ulnar nerve
ulnar nerve motoradduction and abduction of the digits, extending the PIP of the little finger, and opposing the little finger
ulnar sensorySensory symptoms include numbness in the palmar surface of the little finger and ulnar half of the ring finger, and the entire little and ring fingers on the dorsal aspect.
(opposition of thumb and thumb flexion)median nerve.
extension of the wristradial nerve ("extensor"). Radial nerve palsy would cause deficits in extensors of the wrist and digits, and the forearm supinators.
forearm pronationprimarily controlled by the median nerve.
superior transverse axis of sacrumrespiratory flexion and extension & Sphenobasilar (cranial) flexion and extension (level of S1)
middle transverse axis of sacrumpostural sacral axis (level of S2)
inferior transverse axis of sacrumiliosacral motion - walking

section 5

Question Answer
radial nerve damageparalysis of wrist extensors, digits, and forearm supinators were present (results in wrist drop).
median nerveresponsible for pronation, flexion of the hand at the wrist joint, and thumb opposition. Patients may also experience "ape hand" deformity.
ulnar nerve damageresults in the classic claw hand deformity (hyper-extension of the MCP and flexion at the PIP joints of the 4th and 5th digits).
axillary nerve damagedamaged most commonly with compression of the axilla with a crutch or fracture of the surgical neck of the humerus. It causes weakness in shoulder abduction due to paralysis of the teres minor muscle and deltoid muscles.
winging of the scapulalong thoracic nerve (C5,C6,C7) give you wings to heaven
Absent patellar reflexA disc herniation most commonly impinges on the nerve root of the vertebrae below; Absent patellar reflex is caused by L4 nerve root compromise.
Infraspinatusexternal rotation
Teres minorexternal rotation
Subscapularisinternal rotation
presents with a patient with an internally rotated and extended upper extremityErb-Duchenne’s palsy
weakness of the anterior serratuswhinged scapula due to long thoracic nerve injury
wrist dropradial nerve damage
Klumpke’s paralysisclaw hand and loss of sensation of the fourth and fifth digits (damage to lower trunk of the brachial plexus after the C8/T1 nerve roots)
Damage to the upper trunk of the brachial plexus (C5/6)internally rotated and extended upper extremity—Erb-Duchenne’s palsy
Injury to the lower trunk of the brachial plexus (C8/T1)Klumpke’s paralysis and results in claw hand and loss of sensation of digits four and five—when these symptoms are accompanied by Horner’s syndrome (miosis, ptosis, anhydrosis), consider a Pancoast tumor as the etiology.
Winging of the scapula is caused by injurylong thoracic nerve which innervates the serratus anterior.
ulnar nerve damage results inloss of sensation of the fourth and fifth digits and can result in bishop’s hand—flexion of digits four and five and wasting of the hypothenar eminence.
Tennis elbow painLateral epicondylitis causes lateral elbow and forearm pain. Pain is exacerbated by wrist extension and supination against resistance
Shortening of the SCM causesthe head to be sidebent towards the affected side and chin pointed toward the opposite shoulder (Sidebend towards and rotate away)