79 Questions
Which joints are generally spared from Heberden and Bouchard nodes in osteoarthritis?
Metacarpophalangeal joints
What is the characteristic nature of Heberden nodes?
Hard and painless
What age group is commonly affected by Heberden and Bouchard nodes?
Middle-aged or older adults
Which deformity in the fingers is characterized by hyperextension of the proximal interphalangeal joints with fixed flexion of the distal interphalangeal joints?
Swan neck deformity
What is the less common finger deformity in chronic rheumatoid arthritis characterized by persistent flexion of the proximal interphalangeal joint with hyperextension of the distal interphalangeal joint?
Boutonnière deformity
What is the term for the inflammatory nodules seen in the acute or chronic stage of rheumatoid arthritis?
Rheumatoid nodules
In chronic rheumatoid arthritis, which muscles may undergo atrophy due to the condition?
Interosseous muscles
What is the initial sign of a Dupuytren contracture?
Thickened band over the flexor tendon of the fourth finger
What develops between the palm and finger in Dupuytren contracture?
Thickened fibrotic cord
In Dupuytren contracture, what is the characteristic of finger extension?
Limited
What is the purpose of the Finkelstein test?
To identify de Quervain tenosynovitis
During the Finkelstein test, in which direction is the wrist moved?
Toward the midline in ulnar deviation
What condition does the Finkelstein test help identify?
De Quervain tenosynovitis
Which fingers experience pain or numbness in Carpal Tunnel Syndrome?
Thumb, index, middle, and medial 4th fingers
What is assessed during Tinel’s sign for Carpal Tunnel Syndrome?
Tingling with tapping over the median nerve as it enters the carpal tunnel
What is the characteristic feature of Phalen’s sign in Carpal Tunnel Syndrome?
Numbness or tingling with pressing backs of hands together in acute flexion for 60 seconds
During the assessment for Carpal Tunnel Syndrome, what is checked for weak function?
Abduction or opposition of the thumb
What is the purpose of palpating for vertebral 'step-offs' in the lower lumbar area?
To identify if one spinous process seems unusually prominent or recessed in relation to the one above it
What can step-offs in the lower lumbar area indicate?
Spondylolisthesis, or forward slippage of one vertebra
What is a potential consequence of spondylolisthesis in the lower lumbar area?
Compression of the spinal cord
What does deformity of the thorax on forward bending, especially when the height of the scapulae is unequal, suggest?
Scoliosis
What is the most serious cause of low back pain that needs to be assessed for possible compression?
Cauda equina compression
What is the potential consequence of cauda equina compression if not promptly assessed and managed?
All of the above
What is the purpose of the Spurling test?
To test for cervical nerve root compression
When is the Spurling test considered positive?
When the patient feels pain going down the arm on the same side the head is turned
What should be done following the application of downward pressure in the Spurling test?
Use gentle traction to release pressure
What can cause the pelvis to drop on the opposite side and produce a waddling gait known as Trendelenburg gait?
Abductor weakness
What is the usual adaptation to interrupt the smooth pattern of gait due to lack of knee flexion or foot dorsiflexion?
Circumduction of the longer leg
What is observed when an individual stands up on the toes of the stance phase foot during the swing phase on the affected side to provide greater clearance?
Vaulting
What test can be used to test for reproducible pain in suspected groin strain due to forced abduction of the hip from sports injury?
FABER (Flexion, Abduction, External Rotation) test
What does a positive FABER (Flexion, Abduction, External Rotation) test indicate?
Pathology of the hip or sacroiliac joint
What does the Patrick test assess for in suspected groin strain due to forced abduction of the hip from sports injury?
Reproducible pain
What is the purpose of the FABER test in suspected groin strain?
To test for reproducible pain with resisted adduction
What does a positive FABER test indicate in the context of suspected groin strain?
Pathology of the hip or sacroiliac joint
What is the significance of pain elicited with resisted adduction in the FABER test for suspected groin strain?
Indicates potential pathology of the hip or sacroiliac joint
What is the purpose of the FABER (Flexion, Abduction, External Rotation) test in suspected groin strain?
To test for reproducible pain
What is observed with a positive FABER (Flexion, Abduction, External Rotation) test in suspected groin strain?
Pain elicited with resisted adduction
What does the FABER test assess for in suspected groin strain?
Reproducible pain with forced abduction of the hip
What is the purpose of the Patrick test?
To assess for groin strain
What is tested for in the assessment of Carpal Tunnel Syndrome with Tinel’s sign?
Reproducible pain with percussion over the median nerve
What does the FABER test assess for in suspected groin strain?
Reproducible pain
What is the purpose of the Patrick test?
To test for reproducible pain in groin strain
What is assessed during the Finkelstein test?
De Quervain tenosynovitis
What is the initial sign of a Dupuytren contracture?
Inflammatory nodules
What is the purpose of the FABER (Flexion, Abduction, External Rotation) test?
To test for reproducible pain in suspected groin strain
Which test is used to test for Hip Flexion Deformity?
Kendall test
What happens when a positive Kendall test is observed?
The affected hip rises off the table
Which condition is characterized by swelling over the patella?
Prepatellar bursitis
What is the characteristic feature of Heberden nodes?
Painful nodules at the base of the fingers
What does the Patrick test assess for?
Hip joint pathology
What is the common trigger for prepatellar bursitis?
Excessive kneeling
What is the purpose of the bulge sign in the assessment of the knee joint?
To approximate the amount of fluid in the knee joint
What action is performed on the patient during the bulge sign test?
Patient extends their knee
What does a bulge on the medial side between the patella and the femur indicate during the bulge sign test?
A positive test for effusion
What does a positive Trendelenburg test indicate?
Weakness on the side of the pelvis drop
What is the characteristic gait associated with a positive Trendelenburg test?
Waddling gait
What does a positive Trendelenburg test indicate about hip strength?
Weakness of the hip abductor muscles
During the Anterior Drawer Test, how is the proximal tibia manipulated?
Pulled anteriorly (toward the examiner)
What does joint laxity indicate in the Posterior Drawer Test?
A positive test for a tear of the PCL
In the Posterior Drawer Test, how is the proximal tibia manipulated?
Pushed posteriorly (away from the examiner)
How is the Lachman test performed?
Flex the patient's knee to 30º, stabilize the distal femur, and pull the proximal tibia anteriorly
What does a positive Lachman test indicate?
Tear of the anterior cruciate ligament (ACL)
In the Lachman test, what does joint laxity indicate?
A positive test
During the McMurray test, what does pain or clicking during external tibial rotation, valgus stress, and knee extension indicate?
Medial meniscus dysfunction
In the McMurray test, what is the position of the hip and knee when assessing for dysfunction of the medial meniscus?
Hip flexed to 60–90º, knee flexed to 90º
During the Varus/Valgus test, what is assessed for when exerting a varus or valgus force on the knee?
Tear of the lateral collateral ligament (LCL) and/or medial collateral ligament (MCL)
During the Valgus (or Abduction) test, how is the thigh positioned?
Moved about 30° laterally to the side of the table
What is the purpose of the Valgus (or Abduction) test?
Assess for a tear of the medial collateral ligament (MCL)
What does gapping or laxity of the joint during the Valgus (or Abduction) test indicate?
A positive test for a tear of the medial collateral ligament (MCL)
During the Varus (or Adduction) test, what does gapping or laxity of the knee joint indicate?
A tear of the lateral collateral ligament (LCL)
What is the purpose of the Varus (or Adduction) test?
To assess for a tear of the lateral collateral ligament (LCL)
How is the Varus (or Adduction) test performed?
Push laterally against the knee and pull medially at the ankle
What is the purpose of the Anterior Drawer Test?
To assess for dysfunction of the anterior cruciate ligament
How should the knee respond during the Anterior Drawer Test if the ACL is intact?
It should have a firm endpoint with minimal movement
What does joint laxity indicate in the Anterior Drawer Test?
Dysfunction of the anterior cruciate ligament
What does excessive movement during the Posterior Drawer Test suggest?
Insufficient or torn PCL
What is the expected degree of movement in the femur during the Posterior Drawer Test?
Minimal posterior movement
What does absent plantar flexion indicate during testing integrity of the Achilles Tendon?
Achilles tendon rupture
What does pain during movements of the ankle and foot help to localize?
Possible arthritis
Test your knowledge of hand arthritis with this quiz on Heberden and Bouchard nodes, common bony overgrowths associated with osteoarthritis. Learn about their characteristics, associated symptoms, and related joint deformities.
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