Adult - Musculoskeletal II Flashcards
What condition does compression of the median nerve cause?
Carpal tunnel syndrome
Is carpal tunnel more common in men or women?
women
What is dorsiflexion of the wrist?
hand in “stop” position
Tinel’s sign
tapping the median nerve on the flexor surface of the wrist
+ for carpal tunnel if tingling sensation from wrist to hand is provoked
Phalen’s sign
opposite of Namaste hands
hold for 1 minute
+ if symptoms provoked
What type of splint is most effective for carpal tunnel syndrome?
“cock up” splint
Can corticosteroid injection be used in carpal tunnel?
yes
What test can be used to document motor involvement in carpal tunnel syndrome?
electromyography
What is the typical pain/complaint of carpal tunnel?
features?
timing?
exacerbation?
numbness tingling burning nocturnal pain excerbation with dorsiflexion
What is the leading cause of lost work days in the US?
low back pain
What is the typical pain/complaint of low back pain?
may be localized or radiating may include: numbness muscle weakness limp
What are two assessment maneuvers that may be done to assess low back pain?
straight leg raise test - one leg at a time
pelvic rock test
Which lumbar nerve root dysfunction results in diminished or absent patellar reflex?
L3 - L4
Which lumbar nerve root dysfunction results in diminished or absent achilles reflex?
L5 - S1
Which lumbar nerve root dysfunction results in pain along the buttocks?
L5 - S1
What type of X-ray would be helpful in evaluating low back pain?
AP and lateral
Beyond an X-ray what diagnostics might be helpful in low back pain?
CR or MRI
Management of low back pain (10)
rest heat/ice brace PT body mechanics ultrasound/TENS NSAIDs weight loss psychosocial refer
Morton’s neuroma
a benign neuroma of an intermetatarsal nerve
most commonly in 3rd or 4th intermetatarsal space
What is a common cause of Morton’s neuroma?
Wearing high heels shoes with closed toes
What is the common complaint of Morton’s neuroma?
feeling of “standing on a pebble”
What are the diagnostics for Morton’s neuroma?
ultrasound
MRI
Management of Morton’s neuroma?
orthotics
steroid injection
What is the plantar facsia?
o the thick tissue on the bottom of the foot
o connects the heel bone to the toes
o creates the arch of the foot
Who most commonly develops plantar fasciitis?
Men 40 - 70 years old
What is the common complaint of platar fasciitis?
heel pain and stiffness in the morning
pain can be dull or sharp
can radiate from the heel to the toes
What are the diagnostics for plantar fasciitis?
physical exam
X-ray to rule out other causes
Management of plantar fasciitis
NSAIDs corticosteriods orthotics night splints PT surgery (very painful)
“Tibial tubercle apophyseal traction injury”
Osgood-Schlatter
Treatment for Osgood-Schlatter
RICE
NSAIDs
surgery (rare)
Define costochondritis
inflammation of the cartilage that connects a rib to the sternum
What are the possible causes for costochondritis?
o injury o physical strain o URI o infection o fibromyalgia
An inflammatory disorder involving pain and stiffness in the shoulder and usually also the hip
Polymyalgia rheumatica
What are possible causes for polymyalgia rheumatica?
unknown
Who is typically afflicted by polymyalgia rheumatica?
those over 50 years
In 15% of cases, polymyalgia rheumatica is associated with what other condition?
temporal arteritis
What is temporal arteritis characterized by?
headache
high fever
Signs and symptoms of polymyalgia rheumatica?
o stiffness of neck, shoulders, and hips
o loss of ROM in affected areas
o fatigue, anemia, and mild fever
Is ESR increased in polymyalgia rheumatica?
yes
Management of polymyalgia rheumatica?
corticosteroids
symptomatic management
