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78 Cards in this Set
- Front
- Back
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Patients with referred pain:
a. Point to a specific area b. Point to a generalized area c. Complain of radiating pain d. Complain of weakness |
b
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What is the most critical element in an orthopedic assessment?
a. Special tests b. Range of motion testing c. History taking d. Postural evaluation |
c
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What are the three phases of orthopedic evaluation?
a. History taking, examination, and diagnosis b. History taking, special tests, and range of motion testing c. Special tests, range of motion testing, and palpation d. Palpation, range of motion, and observation |
a
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When does observation and inspection of the patient occur?
a. During the history taking process b. While performing the examination c. While the patient is disrobing d. Anytime |
d
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The first impressions are often most revealing during:
a. Orthopedic testing b. Postural evaluation c. History taking process d. Report of findings |
c
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The answers to the Critical 5 orthopedic physical examination questions
enable you to do what? a. Determine examination protocol b. Prescribe treatment plan c. Establish a differential diagnosis d. Take a history |
c
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Why would you use a stethoscope with an orthopedic examination of a
painful joint? a. Check for inflammation b. Rule out subluxation c. Reveal crepitation d. Examine the heart sounds |
c
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The basic elements of examining the patient following the history taking
process include: a. Vital signs b. Observation and inspection c. Palpation d. Range of motion testing e. Neurologic and orthopedic tests f. Clinical laboratory and diagnostic imaging g. All of the above |
g
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The most important resource for the development of the electronic patient
record is: a. The patient b. The computer c. The software d. The EPR |
a
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What finding might be revealed prior to the patient entering the exam room?
a. Restricted cervical range of motion b. Antalgia c. Gait abnormality d. All of the above |
d
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Define orthopedic test.
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Most often an orthopedic test is a provocative maneuver that replicates the
patient’s pain by stretching, compressing, or contracting tissues in order to reveal the involved tissues. Lehman Page 30 |
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Name the Critical 5 questions in orthopedics.
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pg 4
1) are any jts abnormal? 2) what is the nature of the abnormality? 3)what is the extent of the involvment? 4) are other features of diagnostic importance present? 5) do the answers to ques1 thru 4 provide sufficient data? |
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List the 5 essential steps in formulating a working diagnosis.
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1) hx taking
2) observation 3)palpation 4) orthopedic testing 5) clinical laboratory & imaging procedures |
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Define orthopedic palpation.
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process of assessing physical characteristics of jts and contiguous structures by touching or feeling pts body sometimes medical equipment can be used
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Describe the range of motion testing process.
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pt is examined symmetrically for AROM of all jts the maybe involved w/dysfxn or injury
then dr takes pt thru PROM evaluating endfeel of affected jt |
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The O’Donoghue’s Maneuver involves the use of passive and restrictive range
of motion testing in order to identify soft-tissue injury. When the patient experiences an increase in pain with passive flexion of the cervical spine after painless restrictive flexion, which tissue injury would you suspect? a. Cervical strain b. Cervical strain and sprain c. Cervical sprain d. Cervical myospasia |
c
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A patient presents for evaluation of their spine following an episode of severe
neck and arm pain with paresthesias and motor weakness in the left upper extremity. The patient has not been able to walk for long distances without increasing the neck and arm pain. While performing the history process, the patient places the left hand on the vertex of his skull for relief of the pain. Name the sign. a. Lhermitte’s b. Dejerine’s c. Bakody’s d. Rust’s |
c
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You are called into the office on a Sunday afternoon to evaluate a new
patient with a chief concern of neck pain following a roll-over motor vehicle accident. Observation during the history taking process reveals an anxious and disheveled male patient with cervical hard collar. He claims that he was released from the hospital on Saturday. Upon removal of the hard collar, the patient grasps both sides of his head and displays apprehension. What sign is being demonstrated by this patient? a. Lhermitte’s b. Dejerine’s c. Bakody’s d. Rust’s |
d
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A patient states that she is experiencing sharp, lancinating pain down the
spine and the left leg whenever she puts in her eye drops. You are familiar with a test that involves cervical flexion, which evokes such sensorial reactions. Which sign are you considering? a. Lhermitte’s b. Dejerine’s c. Bakody’s d. Rust’s |
a
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During the history taking process your patient coughs and experiences
severe neck pain with radiating pain down the left arm. You are familiar with a sign that is present when pain increases upon coughing, sneezing, and/or having a bowel movement. Which sign are you considering? a. Lhermitte’s b. Dejerine’s c. Bakody’s d. Rust’s |
b
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Your patient is a high school football star lineman. The coach asked that you
treat his neck and arm after he experienced a dead arm following a hard tackle. The patient advises you that he experienced a sharp, shooting pain down the affected arm when he reached into the back seat of his car to grab his coat. Which neurological sign do you suspect? a. Lhermitte’s b. Soto-Hall’s sign c. Bakody’s d. Bikele’s |
d
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Physical examination of your patient with neck and arm pain reveals a
positive shoulder depression test and a negative cervical distraction test. What do you suspect is wrong with this patient? a. Chronic joint dysfunction b. Myofascial pain c. Degenerative joint disease d. Acute cervical strain |
d
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Your patient is experiencing severe neck and arm pain following a rear-end
motor vehicle accident. In order to comply with the adage, “primum non nocere,” you decide to perform the least provocative maneuvers first and the most provocative maneuvers last during your orthopedic testing. Which test would you select as your initial special test? a. Cervical compression b. Valsalva’s c. Cervical distraction d. Soto-Hall |
b
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Your patient presents with a chief concern of severe neck pain, which he
originally related to a neck injury that took place 10 years prior. You perform cervical distraction and foraminal compression testing with resultant increased neck pain and radiating pain down the right arm to the thumb. What do you suspect is wrong with your patient? a. Acute myalgia b. Myofascial pain c. Nerve root compression d. Osteoporosis |
c
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A young patient presents with neck pain and stiffness after swimming in a
pond. He is febrile with nuchal rigidity. While performing cervical passive flexion with the patient in a supine position, you notice that the patient’s knees flex toward the abdomen. What condition is most likely the cause of your patient’s neck pain? a. Spinal subluxation b. Spinal strain c. Unstable cervical spine d. Spinal meningitis |
d
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Please describe the Valsalva maneuver and explain what condition would
cause a positive test with radicular pain down the arm. |
blank
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Please describe the cervical distraction procedure and the significance of a
positive distraction test. |
blank
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Describe the shoulder distraction maneuver and the significance of pain on
the ipsilateral side versus the contralateral side of the neck. |
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Structural scoliosis demonstrates the following findings with Adam’s position.
a. No change or minimal reduction in scoliotic curves b. Complete corrections of spinal scoliosis c. Significant increased scoliotic curves d. All of the above |
c
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Posture is which of the following?
a. Static state of spinal development b. Evolving functional state of the musculoskeletal system c. Insignificant physical finding d. Unrelated to spinal function and pain |
b
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Postural evolution of man affected which of the following anatomical
structures that establishes humans as superior to other mammals? a. Pelvic osseous structures b. Spinal vertebrae c. Cranium and brain d. Coccyx |
c
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Functional scoliosis is best described as a clinical finding and labeled as a
diagnosis with which of the following terms? a. Scoliosis b. “S” type scoliosis c. Postural imbalance d. Bad posture |
c
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According to White, “Ideal Posture” promotes one of the following functions.
Select one. a. Hypermobility of the cervical spine b. Hypomobility of the lumbar spine c. Painful range of motion d. Normal neuromechanical function |
d
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Which of the following conditions may occur due to a chronic postural
abnormality of the spine? a. Pain b. Degenerative joint disease c. Postural imbalance d. All of the above |
d
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Which of the following conditions is most likely to occur with a functional leg
length discrepancy? a. Scoliosis b. Pelvic obliquity c. Cardiac disease d. Chronic pulmonary disease |
b
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How would you determine the presence of pelvic obliquity?
a. Observation of erect posture b. Functional leg length testing c. Mensuration of leg lengths d. All of the above |
d
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How would you differentiate the presence of functional versus anatomical leg
length discrepancy? a. Muscle testing b. Kemp’s test c. Straight leg raise test d. Mensuration of extremities |
d
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How would you treat pelvic obliquity with a functional leg length discrepancy?
a. Spinal manipulation b. Heel lifts c. NSAIDS d. Surgical consultation |
a
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How would define posture?
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Describe how you would differentiate muscle hypertrophy from myospasia.
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Describe the physical findings that you would anticipate with a patient
presenting rounded shoulders. |
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Describe the physical findings that you would anticipate with a patient
presenting with FHP. |
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Describe how you would perform a spinal posture exam.
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The piriformis muscle is clinically significant because of its proximity to which
nerve? a. Gluteal b. Sciatic c. Pudenal d. Lumbar plexus |
b
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Palpation of an irritated sciatic nerve might produce which of the following
symptoms? a. Burning b. Aching c. Diplopia d. Nystagmus |
a
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Which method of testing is most accurate for mensuration of lumbar range of
motion? a. Eyeballing b. Goniometer c. Inclinometer d. Tape measure |
c
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The most common form of spondylolysis in young adults is which of the
following? a. Spondylolytic b. Degenerative c. Pathologic d. Dysplastic |
a
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Which orthopedic test indicates either spondylolysis or spondylolisthesis is
present due to an increased pain with testing? a. Segmental instability test b. One leg standing lumbar extension test c. SLR d. Bragard’s |
b
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Which orthopedic test indicates lumbar instability when the pain is reduced upon
testing? a. Segmental instability test b. One leg standing lumbar extension test c. SLR d. Bragard’s |
a
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When a patient presents with anterolisthesis of L5 on S1, how would you grade
the condition if the body of the vertebra slips anteriorward by 55%? a. Grade 1 b. Grade 2 c. Grade 3 d. Grade 4 |
c
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SLR testing indicates disc involvement when radicular sciatic pain is elicited at
which degree of elevation? a. 90 degrees b. 15 degrees c. 45 degrees d. 20 degrees |
c
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Which root tension test is most provocative?
a. Sicard’s b. Turyn’s c. SLR d. Bragard’s |
c
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Which root tension test produces radicular pain in the contralateral lower
extremity? a. Fajersztajn’s b. SLR c. Bragard’s d. Sicard’s |
a
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Which tests are utilized to differentiate lumbar and sacroiliac conditions?
a. Supported Forward Bending Test b. Kemp’s c. Goldthwaite’s d. Lindner’s |
a & c
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Which orthopedic test indicates meningeal irritation when the hips flex with
sharp, diffuse pain upon flexion of the cervical spine? a. Brudzinski b. Piriformis test c. Goldthwaite’s d. Lindner’s |
a
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When a patient with a lumbar disc lesion leans away from the lesion to attain
relief, which type of posterior lumbar disc lesion is present? a. Central b. Medial c. Lateral d. Prolapsed |
c
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When a patient with sciatic radiculopathy flexes at the waist, which lower
extremity will flex at the knee? a. Affected b. Contralateral c. Right d. Left |
a
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When performing a positive Fajersztajn’s test with the well leg, which type of
discopathy is suspected? a. Lateral b. Central c. Medial d. Fragmented |
c
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Which positive tension test for sciatic radiculopathy would indicate the most
severe irritation? a. SLR b. Bragard’s c. Sicard’s d. Bechterew’s |
c
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When a patient with sciatic radiculopathy presents with his right hand on the
lumbar spine and the left hand on the flexed left thigh, which side is symptomatic expressive a. Right b. Contralateral c. Ipsilateral d. Left |
d
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When the patient experiences low back pain with 80 degrees of SLR, which
anatomical structures suspected? a. Disc b. Lumbar zygapophyseal joints c. Sacroiliac joint d. Piriformis muscle |
b
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Which anatomical structures would be involved with sciatic pain at 20 degrees of
SLR? a. Disc b. Lumbar zygapophyseal joints c. Sacroiliac joint d. Piriformis muscle |
c & d
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Femoral nerve traction test would stretch which of the following nerve roots?
a. L1 b. L2 c. L3 d. L4 |
b, c, d
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Kemp’s Test may irritate the sciatic nerve on the contralateral side of oblique
bending with which of the following disc lesions? a. Medial disc b. Lateral disc c. Central disc d. Disc bulge |
a
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Kemp’s Test may irritate the sciatic nerve on the ipsilateral side of oblique
bending with which of the following disc lesions? a. Medial disc b. Lateral disc c. Central disc d. Disc bulge |
b
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With which spinal condition would you perform McKenzie’s Slide Glide Test?
a. Costochondritis b. Fracture c. Dislocation d. Scoliosis |
d
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When performing the spinal thoracic percussion test, what type(s) of reaction
might you anticipate? a. Localized pain b. Radicular pain c. Cavitation d. All of the above |
a
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What are the clinical signs and symptoms of scoliosis?
a. Paravertebral pain b. Postural alterations c. Difficulty breathing d. Intercostal neuralgia |
b
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When performing Adam’s Position procedure, if the scoliosis does not reduce
with trunk flexion, what condition would you suspect as a cause? a. Anatomic leg length inequality b. Functional leg length inequality c. Compression fracture of vertebral body d. Postural imbalance |
c
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A positive Soto-Hall test, a non-specific procedure indicates conclusively which
of the following diagnoses? a. Spinal strain b. Spinal sprain c. Spinal fracture d. None of the above |
d
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The presence of a Beevor’s sign indicates which of the following conditions?
a. Upper motor neuron lesion b. Lower motor neuron lesion c. Thoracic nerve root lesion d. Multiple sclerosis |
a
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When a patient with thoracic pain increases symptoms on the contralateral side
with lateral flexion, which of the following conditions would you suspect? a. Intercostal neuritis b. Costochondritis c. Pleuritis d. Pancoast’s tumor |
c
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A patient presents with thoracic pain and kyphoscoliosis, which orthopedic
special test(s) would be indicated? a. Palpation b. Observation c. Mensuration d. Range of motion |
c
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Passive scapular approximation testing might indicate a nerve root lesion at which
of the following spinal levels? a. T6-7 b. C6-7 c. T1-2 d. T11-12 |
c
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Which conditions might be painful with sternal compression testing?
a. Costochondritis b. Fractured rib c. Sprain of thorax d. Rib head subluxation |
a-d
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Describe the use of Adam’s Position procedure when evaluating a patient with
scoliosis |
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Describe the procedure used to demonstrate Scheplemann’s sign. What is the
rationale? |
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Describe the procedure and rationale of the cervical distraction test
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