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MSK Exam 1 > Advanced MSK Exam > Flashcards

Advanced MSK Exam Flashcards

1
Q

What is included if the injury is Articular?

A

INERT tissue damage
(doesn’t move)
* Ligament
* Cartilage
* Bone
* Connective tissue
* Monoarticular
* Polyarticular

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2
Q

What is included if the injury is Non-Articular?

A

Dynamic tissue damage (moves)
* Tendons
* Muscles
* Localized
* Limited, focal
* Widespread
* Regional, systemic

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3
Q

Traumatic vs. Atraumatic

A
  • Traumatic = acute, defined moment
  • Atraumatic = chronic, insidious onset
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4
Q

Referred vs. radiating pain

A

Referred
* Pain felt in a part of the body remote from source of the pain
* Left shoulder pain with myocardial infarction

Radiating pain
* Usually neuropathic
* Felt along a particular nerve innervation
* Ulnar nerve trauma (funny bone)

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5
Q

Nociceptive pain

A

Stimulation of pain receptors
(Nociceptors)
stabbing, stinging, sharp
* Traumatic injury
* Burns
* Infection
* Tissue degeneration

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6
Q

Somatic pain

A

Constant, achy pain:
* Cutaneous - Well localized in the superficial tissues
* Deep - Poorly localized the deeper tissues
Bone fracture
* Incision in the skin
* Arthritis
* Peripheral Vascular Disease (PAD)

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7
Q

Visceral Pain

A

Poorly localized, deep & diffuse pain sensation emanating
from internal organs or cavity linings
* Described as cramping
* Distention of a hollow viscous (ie bladder, bowel)

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8
Q

Neuropathic Pain

A

Poorly localized sensation of pain resulting from injury nerves
in the CNS or PNS.
* Described as shooting, electric shock, or burning
* Diabetic Neuropathy
* Post-herpetic neuralgia
* Nerve compression

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9
Q

Phantom Pain

A

Sensation of pain in a region of the extremity now amputated.
* Experienced by 30-81% of amputees, often described as:
* Aching, cramping, burning, tearing, squeezing

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10
Q

Calor

A

↑ heat = vascular permeability/blood flow

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11
Q

Rubor

A

redness = vascular permeability/blood flow

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12
Q

Tumor

A

swelling = accumulation of exudate
(↑ vascular permeability, 2° ischemic injury, cellular lysis)

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13
Q

Dolor

A

pain = chemical mediators of inflammation

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14
Q

Inflammatory Arthritides

A

Rheumatoid arthritis (RA)
Seronegative
spondyloarthropathies
Crystalline deposition
diseases (ex/ gout)
Septic arthritis
Bursitis
Tenosynovitis
Trauma

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15
Q

Laboratory markers for inflammatory conditions

A

Erythrocyte Sedimentation Rate (ESR)
C-Reactive Protein (CRP)*
Rheumatoid Factor (RF) (autoantibody)
Cyclic Citrullinated Peptide Antibody, IgG (CCP)

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16
Q

Erythrocyte Sedimentation Rate (ESR)

A

Blood in a tall, thin tube
Inflammation causes cells to
clump
more dense than individual
cells
settle to the bottom
more quickly
Non-specific test used to
detect inflammation

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17
Q

C-Reactive Protein (CRP)

A

Acute phase
inflammation

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18
Q

What is Rheumatoid Factor (RF)?

A
  • Aids in the workup of suspected RA or
    undifferentiated inflammatory arthritides
  • Order with Cyclic Citrullinated Peptide
    Antibody, IgG
  • ↑specificity
  • ↑sensitivity
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19
Q

What is Cyclic Citrullinated Peptide
Antibody, IgG (CCP)?

A

(+) ~69-83% of patients with RA
* Together with (+) RF
* Specificity = 93-95% for RA

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20
Q

Non-inflammatory Musculoskeletal Conditions

A

Painful conditions that, typically, are NOT accompanied by
the OVERT cardinal signs of inflammation:
* Osteoarthritis (OA)
* Neoplasm
* Pain amplification
* Fibromyalgia

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21
Q

Musculoskeletal Physical Exam (H.I.P.S.)

A

History
Inspection
Palpation
Special Tests

22
Q

Warmth + joint effusion (& soft tissue swelling) =

A

synovitis

23
Q

Special Tests - MSK exam

A

Range of motion tests (AROM, PROM, RROM)

24
Q

Pronation

A

palmar surface
toward posterior or plantar
surface toward midline

25
Q

Supination

A

palmar surface
toward anterior or plantar
surface away from midline*

26
Q

Dorsiflexion

A

↓ angle between dorsum of the
foot & tibia (sagittal plane)

27
Q

Plantar flexion

A

↑ angle between dorsum of the
foot & tibia (sagittal plane)

28
Q

Protraction

A

ant. movement
(transverse/sagittal plane)

29
Q

Retraction

A

post. movement
(transverse/sagittal plane)

30
Q

Circumduction

A

conical shaped moved of the segment
centered on the joint involved

31
Q

Convex vs concave gliding

A
  • Glide = One joint surface translates/slides over another
  • Convex: gliding is in the OPPOSITE direction of the angular movement of the bone.
  • Concave: gliding is in the SAME direction as the angular movement of the bone.
32
Q

↓ AROM + Normal PROM =

A

Dynamic tissue disorders
* Eg. tendinitis, or muscle injury (possible bursitis)
* ↓ RROM = tendinitis or muscle injury

33
Q

AROM + ↓ PROM =

A

INERT tissue disorder
* Eg. soft tissue contracture, synovitis,
and/or joint structural abnormality

34
Q

Goniometry

A

Tool used for Measurement of ROM

35
Q

How does goniometry work?

A
  1. “0°” starting position
  2. Varies for each joint
  3. Typically, the extended anatomical position
  4. Center axis of the goniometer with the center
    axis of the joint (depends on the plane)
  5. Align arms with proximal (fixed) & distal
    (movable) segments
  6. Degree of joint motion is read off the distal arm
    of the goniometer
36
Q

Flexion

A

Ant. sagittal plane*
↓ angle between segments

37
Q

Extension

A

= Post. sagittal plane*
↑ angle between segments

38
Q

Manual Muscle Testing - basic principles

A
  1. Place the muscle in a lengthened position
  2. Examiner resists movement through ROM
  3. Semi-quantitative measurement of muscle strength
    * Brake Test vs. Full Range of Motion?
39
Q

Sensory/Motor Pathways: SAME and DAVE

A

S-Sensory D-Dorsal
A-Afferent A-Afferent
M-Motor V-Ventral
E-Efferent E-Efferent

40
Q

If you want to text the Axillary n.

A

(Deltoid)
shoulder abduction
sensory area: lateral aspect of the arm)

41
Q

If you want to text the Musculocutaneous n.

A

(Biceps)
elbow flexion
Sensory area: Lateral proximal forearm

42
Q

If you want to test the median n.

A

Flexor pollicis longus
some flexion
sensory area: Tip of thumb, Volar aspect

43
Q

If you want to test the ulnar n

A

First Dorsal interosseous
abduction
Sensory area: Tip of little finger, volar aspect

44
Q

If you want to test the radial n.

A

Extensor pollicis longus
thumb extension
Sensory area: Dorsum thumb web space

45
Q

If you want to test the Obturator n.

A

Adductors hip
adduction
Sensory area: Medial aspect, mid-thigh

46
Q

If you want to test the Femoral n.

A

Quadriceps
knee extension
Sensory area: Proximal to medial malleolus

47
Q

If you want to test the Peroneal Deep
branch n.

A

Extensor hallucis longus
great toe extension
Sensory area: Dorsum first web space

48
Q

If you want to test the Peroneal Superficial
branch n.

A

Peroneus brevis
foot eversion
Sensory area: Dorsum lateral foot

49
Q

If you want to test the Tibial n.

A

Flexor hallucis
great toe flexion
Sensory area: Plantar aspect foot

50
Q

____ Tests exacerbate pain or contractures of
injured/deformed structures

A

Tension Stress

51
Q

What is Diagnostic joint aspiration
(arthrocentesis) used for?

A
  1. Evaluation for a septic
    joint
  2. Initial confirmation of
    gouty arthritis

MSK Exam 1 (5 decks)

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