Clinical Examination and Differential Diagnosis Flashcards
6 cards from real MPT practice questions. Tap to flip, then mark Knew It or Still Learning โ missed cards come back until you master them.
Read the first 6 Clinical Examination and Differential Diagnosis flashcards as text
The straight leg raise (SLR) test becomes positive (radicular symptoms reproduced) at 30-70 degrees of hip flexion. This finding most specifically indicates:
Answer: L4-S1 nerve root tension or compression
The SLR test tensions the L4, L5, and S1 nerve roots. Reproduction of radicular pain into the leg between 30-70 degrees indicates nerve root compression or irritation (disc herniation, stenosis) at these levels.
The slump test is used to assess neural tension in the spine and lower extremities. Which position maximally sensitizes this test?
Answer: Cervical flexion, thoracic flexion, knee extension, and ankle dorsiflexion
The slump test is maximally sensitized by cervical and thoracic flexion (to tension the dura), combined with knee extension and ankle dorsiflexion (to tension the sciatic nerve).
Which manual muscle testing grade indicates the patient can move through full ROM against gravity but cannot tolerate any additional resistance?
Answer: Grade 3
Grade 3 (Fair) indicates the muscle can move the limb through full ROM against gravity only, with no additional external resistance tolerated.
A patient presents with deep buttock pain that worsens with sitting, tenderness to palpation in the sciatic notch region, and positive FAIR test. This presentation is most consistent with:
Answer: Piriformis syndrome
Piriformis syndrome presents with deep buttock pain, sciatic nerve symptoms (from piriformis compressing the sciatic nerve), tenderness at the sciatic notch, and positive FAIR test (Flexion, Adduction, Internal Rotation).
Which cluster of signs is most characteristic of complex regional pain syndrome type I (CRPS-I)?
Answer: Allodynia, autonomic changes (skin temperature and color), edema, and trophic changes in the absence of nerve injury
CRPS-I is diagnosed by the Budapest Criteria: allodynia or hyperalgesia, autonomic dysfunction (temperature asymmetry, skin color changes, sweating), edema, and trophic changes (hair, nail, skin), with no definable nerve injury.
A patient with diabetes mellitus presents with decreased vibration sense and absent Achilles tendon reflexes bilaterally. This is most consistent with:
Answer: Distal symmetric sensorimotor polyneuropathy
Diabetic peripheral neuropathy characteristically presents as a distal symmetric sensorimotor polyneuropathy with length-dependent sensory loss (vibration, proprioception) and diminished distal reflexes.