Canadian Boards (Part C) Common Conditions

Low Back Differentials (Sprain/Strain)

-Sprain --> Not past knee // Pain w activity // Local tenderness, decr ROM, pain w passive ROM

-Strain --> pain w active or isometric ROM

Low Back Differentials (Facet)

-Facet --> Diffuse, dull ache, low back and butt // Incr pain with ROM, Decr pain w sitting, leaning forward, or changing positions

Low Back Differentials (Disc)

-Disc --> Possible radiation to feet // sharp shooting paresthesia // Decreased w standing, incr w flx ext // + orthos, asymm reflexes

Low Back Differentials (Degenerative)

-Degenerative --> bilateral ache into calves and feet // incr w extension, decr w flexion

Low Back Differentials (Spondylitis)

-Spondy --> local pain // increased w activity & w flexion // palpable step defect, anterior tilt, tight hamstrings

Low Back Differentials (Ankylosing Spondylosis)

-AS --> morning stiffness >30mins, relieved w exercise // Decreased ROM, SI tenderness

Low Back Differentials (Infection)

-Infection --> Sharp Pain // Fever, percussive tenderness // Possible neurologic abnormalities or decreased motion

Low Back Differentials (Malignancy)

-Malignancy --> Dull ache, throbbing, progressive // Increased with recumbency or cough // Night Sweats, weight loss etc

Headache Hx Location

Unilateral: migraine

Periorbital: glaucoma, CVT, optic neuritis, cluster

Facial/maxillary: trigeminal neuralgia, sinusitis

Temporal: GCA

Occipital: cerebellar stroke

Nuchal: meningitis

Headache Hx (migraine)

Unilateral

Hours to days

Throbbing

Photophobia, phonophobia

// Uncommon to see neurological findings

Headache Hx (Tension)

Tension

Bilateral

Minutes to days

Constricting feeling

Headache Hx (Cluster)

Cluster

Unilateral, periorbital

Minutes to hours

Throbbing

Conjunctival injection, lacrimation, rhinorrhea, miosis, eyelid edema

// Males 90%, triggered by EtOH

Headache Hx (Giant cell arteritis)

GCA

Boring, burning, or jabbing pain @ temples & around the ear, when chewing

Eyesight problems

Over 50

Neck Pain Ddx

-Vascular (stroke)

-Infection

-Malignancy

-Trigger Point

-Strain/Sprain

-Disc Herniation

-Facet

-TOS

-Fracture

-Arthritis

-Spondy

Neck Pain Exam

Compression Neutral/Maximal

Distraction

Upper limb tension test

Rhomberg position / test

Hautants Test

Anterior Shear Test

Headache Exam

Direct / Indirect Light

Fields of Gaze

Facial Expressions

SCM/Traps

Compression/Distraction

Swivel Chair Test

Thoracic Spine Exam

Slump Test

TOS Tests (costoclavicular maneuver, Wright's test, and supraclavicular pressure test)

Roos

Shepplemans Test

Low Back Exam

SLR + Braggards

Slump test

Valsalva

Piriformis Stretch

Bechterews

Kemps

Nachlas

Brudzinski / Kernig

Shoulder Exam

Apprehension

Hawkings-Kennedy (90-90 bring into IR)

Neer Test (AC Compression w/ arm flx)

Obriens Test

Horizontal Adduction

Speeds

Yergasons

Empty can test

Gerber Lift off test

Elbow Exam

Varus/Valgus

Cozens

Mills

Prayer

Golfers Elbow

Knee Exam

Varus / Valgus

Ant/Post Drawer

Apleys compression

McMurrays

Clarks test

Apprehension (fairbank) test

Nobles

Hip Exam

Scour

FABER (Patrick)

Nobles

Ober

Thomas

Trendelenberg

Hibbs

SI Exam

Positive SI w 3/5 tests positive

*Distraction*

Pt supine. Examiner applies posterolateral directed pressure to bilateral ASIS. (Reproduction of pain)

*Compression*

Pt sidelying. Examiner compresses pelvis with pressure applied over the iliac crest directed at the opposite iliac crest. (Reproduction of symptoms)

*Thigh Thrust*

Pt supine. Examiner places hip in 90 deg flexion and adduction. Examiner then applies posteriorly directed force through the femur at varying angles of abduction/adduction. (Reproduction of buttock pain)

*Sacral Thrust*

Pt prone. Examiner delivers an anteriorly directed thrust over the sacrum. (Reproduction of pain)

*Gaenslen's*

Pt supine with both legs extended. The test leg is passively brought into full knee flexion, while the opposite hip remains in extension. Overpressure is then applied to the flexed extremity. (Reproduction of pain)

SI Ddx

Ankylosing spondylitis

Sacroiliitis

Psoriasis

Reiter's syndrome

Septic arthritis

Gout

Osteoarthrosis

Sacroiliac joint syndrome

Tumours

Fractures of the sacrum

Pediatric Hx

A2

B5

MM

VW

APGAR Score

Age

Birth Details

Breast Feeding

Big Falls

Bowel/Bladder

Breating issues

Milestones

Medical Checkups

Vaccinations

Weight

Pediatric Reflexes

Moro (make baby fall while supine)

Plantar/Palmar Grasp

Babinski

Rooting

LORD FICARA (Hx Qs)

Location

Onset

Radiation

Duration

----

Frequency

Intensity

Character

Aggravation

Relieving

Associated symptoms

XYZ (Hx Qs)

X-rays / Labs

Anything else?

Sleep (zzz's)

PPM FLOATS (Hx Qs)

PMH

Psychosocial

Meds

------

Family Hx

Lifestyle

Occupation

Allergies

Trauma

Special Tests / Surgeries

Physical Exam

VIP PIR NOC

Vitals

Inspect

Palpate

Percuss

Instrumentation

ROM

Neuro

Ortho

Chiro Exam

Consent Points

Consent to discuss

Findings & Diagnosis

Treatment plan --> Services, frequency, length

Benefits

Risks

Alternatives

Prognosis

Cost

Quesions

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