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PCM 4 midterm > adult MSK > Flashcards

adult MSK Flashcards

1
Q

shoulder bones

A
  1. clavicle
  2. scapula
  3. proximal humerus
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2
Q

shoulder articulation

A
  1. glenohumeral
  2. sternoclavicular
  3. acromioclavicular
  4. scapulothoracic
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3
Q

shoulder mm

A 
deltoid
rotator cuff:
1. supraspinatus: abduction to 90 degrees
2. infraspinatus: ext rotation
3. subscapularis: int rotation
4. teres minor: ext rotation
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4
Q

cause of extrinsic shoulder pain

symptoms of extrinsic shoulder pain

A
  1. cause - referred pain

2. symptoms - poorly localized, no or minimal reproduction of pain

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5
Q

work up for shoulder problem

A
  1. X-ray
  2. US
  3. MRI
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6
Q

empty can test which mm?

A

supraspinatus

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7
Q

lift off test which mm?

A

subscapularis

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8
Q

complete tear of supraspinatus symptom

A

can’t keep arm up at 90 degree

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9
Q

rotator cuff tear

A
  1. chronic use problems - tendonopathy, tendonitis, bursitis
  2. injury to mm
  3. disuse atrophy
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10
Q

shoulder impingement symptoms

A
  1. night pain

2. localized pain, crepitus, or sudden pain while abducting the arm

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11
Q

shoulder impingement causes

A
  1. superior and posterior mm atrophy

2. bone spurs

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12
Q

shoulder impingement involve which mm?

A

supraspinatus

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13
Q

shoulder impingement exams

A

hawkins and near impingement signs

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14
Q

shoulder impingement definition

A

weakness of the rotator cuff -> superior sublaxation of the humeral head when the shoulder is abducted beyond 90 degrees

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15
Q

shoulder impingement tx

A

surgery

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16
Q

AC separation
cause?
diagnose with?
tx?

A
  1. injury associated problems
  2. dx by inspection
  3. tx: surgery, or can allow it to heal by itself (but can decrease function of shoulder)
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17
Q

shoulder arthritis hx

A
  1. significant shoulder use

2. other joints have arthritis

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18
Q

shoulder arthritis symptoms

A
  1. generalized tenderness
  2. decreased shoulder ROM
  3. disuse atrophy
  4. active or passive crepitus
  5. can be u/l
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19
Q

shoulder arthritis x-ray

A
  1. substantial lost of joint space
  2. a lot of sclerosis
  3. cartilage degen
  4. bone spur
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20
Q

shoulder arthritis tx

A
  1. non-narcotic meds for pain

2. therapy - hot or cold motion

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21
Q

adhesive capsulitis symptoms

A
  1. worst pain at night
  2. loss of active and passive ROM
  3. hear and feel active and passive crepitus
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22
Q

adhesive capsulitis risk factor

A

diabetes mellitus

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23
Q

adhesive capsulitis exams

A

MRI

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24
Q

adhesive capsulitis tx

A
  1. increase ROM with therapy or surgery if therapy doesn’t work
  2. pain med
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25
Q

bursitis onset

A

young

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26
Q

bursitis history

A
  1. trauma
  2. repeated trauma
  3. repetitive motion
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27
Q

bursitis physical finding

A
  1. active and passive ROM tenderness with abduction (tendonitis only have active ROM tenderness)
  2. no atrophy
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28
Q

bursitis diagnose with

how to differentiate it between bursitis, tear, frozen shoulder, and arthritis

A

lidocaine injection challenge - traumatic reduction in pain and improvement in shoulder function after injection

(tear - reduction in pain after injection but still have weakness)
(frozen shoulder and arthritis - does not have significant pain and shoulder function improvement)

29
Q

bursitis tx

A
  1. find underlying cause of inflamm
  2. restrengthen mm around rotator cuff with therapy
  3. lidocaine injection
30
Q

SLAP lesion definition

A

tear located superior labrum, extends anterior to posterior

31
Q

SLAP history

A
  1. athletes who throws a lot
  2. works overhead
  3. falling and grabbing something to break fall
32
Q

SLAP physical exam findings

A
  1. reproduce pain with click (abduction and external rotation and resist motion by coming back to normal position)
  2. no atrophy
  3. no reproduce pain with palpation
33
Q

SLAP exams

A

MRI

34
Q

SLAP tx

A
  1. allow it to sclerosis itself to heal (takes a long time to heal due to low vascular supply)
  2. surgery if severe
35
Q

lateral hip tenderness with palpation dx

A

bursitis

36
Q

trochanteric bursitis physical exam

A
  1. gait

2. reproduce pain

37
Q

trochanteric bursitis diagnose with and treatment

A

lidocaine injection

38
Q

laterla hip pain with paresthesia dx

A

meralgia paresthetica

39
Q

meralgia paresthetica pathogenesis

A

irritation of lateral femoral cutaneous nerve as it goes over inguinal area

40
Q

meral paresthetica physical exam findings

A
  1. sensory problems
  2. not map to one dermatome
  3. anterior-lateral around thigh and don’t go below the knee
41
Q

meral paresthetica caused by

A
  1. mechanical irritation

2. compression due to overweight person with abdominal fat

42
Q

posterior hip pain dx

A

SI, lumbar, unusual true hip joint problem

43
Q

osteoarthritis of hip joint history findings

A
  1. sport injury
  2. inisidious onset
  3. gelling pain (pain when first get up in the morning or after not moving for a period of time, pain improves as day goes on and move around)
44
Q

osteoarthritis of hip joint physical exam findings

A
  1. nonspecific pain
  2. restricted abduction
  3. referred pain
45
Q

anterior/groin pain dx

A

true hip pain

  1. osteonecrosis
  2. sepsis
  3. fracture
  4. synovitis
46
Q

osteonecrosis definition

A

compromise vascular supply to femoral head -> collapse of femoral head

47
Q

osteoncrosis history finding

A
  1. worst with weightbearing and motion

2. pain at rest and night

48
Q

hip fracture history finding

A
  1. worst with weightbearing

2. pain with rotation

49
Q

hip fracture diagnose with

A
  1. X-ray (can’t see occult fracture until it heals)
  2. MRI - if fracture near soft tissue
  3. CT with bone windows for long bone
50
Q

hip fracture tx

A
  1. non-weightbearing

2. pain control

51
Q

hip fracture onset

A

sudden onset in elderly

52
Q

low anterior thigh pain dx

A

referred hip pain from

  1. true hip pain
  2. upper femur
  3. femoral neck
  4. lumbar radiculopathy
53
Q

referred hip pain symptoms

A

direct pressure and ROM do not reproduce pain

54
Q

other types of arthritis

A
  1. Reactive: aseptic arising 1-6 weeks after extra- articular infection, most common from GI or GU infection.
  2. Septic: site of infection, warm, swollen, red, usually localized
  3. Psoriatic: more than one site, non-rheumatic and associated with rash
  4. Rheumatic: specific criteria for diagnosis, + RF or anti-CCP
55
Q

osteonecrosis risk factor

A
  1. excessive alcohol use

2. frequent steroid use

56
Q

hip special exams and what it tests

A

Faber - hip joint, SI, psoas

57
Q

significant pain at hip ROM end point is a strong indicator for

A
  1. osteonecrosis
  2. occult fracture
  3. acute synovitis
  4. metastasis
58
Q

Osgood-Schlatter definition

A

apophysitis of tibial tubercle at insertion of patellar tendon

59
Q

Osgood-Schlatter demographic

A

active kids (14-15y/o)

60
Q

Osgood-Schlatter physical exam findings

A
  1. pain

2. knot at tibial plateau

61
Q

Osgood-Schlatter diagnose with

A

clinical findings

62
Q

Osgood-Schlatter tx

A
  1. non-weightbearing
  2. casting
  3. follow-up to see how it is healing
  4. continue activity to help healing
  5. pain med
63
Q

Osgood-Schlatter other ddx

A
  1. stress fracture
  2. evulsion of quad tendon
  3. tumor
64
Q

plantar fasciitis caused by

A

abnormal gait -> over pronate foot -> stress on plantar fascia –> pain at anterior calcaneus

65
Q

plantar fasciitis symptoms

A
  1. foot hurts at heel when get up and step on it in the morning
  2. gets better with massage and as the day goes on
66
Q

plantar fascitis treatment

A
  1. find underlying cause
  2. counerstrain
  3. NSAIDs
  4. taping support
  5. massage arch or heel
  6. orthotics
  7. hip motion that might be affecting gait
67
Q

plantar fasciitis physical exam findngs

A

reproduce pain with palpation

68
Q

plantar fasciitis associated with

A

tarsal syndrome (due to plantar fasciitis affecting tibial nerve)

69
Q

plantar fasciitis radiograph finding

A

bone spurs but often not the cause of pain

PCM 4 midterm (6 decks)

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