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MM Test 3 > B6.043 MSK Exam > Flashcards

B6.043 MSK Exam Flashcards

1
Q

major components of MSK system with clinical relevance

A 
joint movements
ligaments
muscles
tendons
cartilage
synovial fluid
bursae
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2
Q

related history to injury

A 
sensation at time of injury
impairment
mechanism of injury
pain (qualifiers and quantifiers)
swelling (immediate or delayed)
bruising (temporal relationship to injury)
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3
Q

related PMH for MSK exam

A

trauma
surgery
chronic illness
congenital anomalies

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4
Q

related FH for MSK exam

A

congenital anomalies of hip/foot
scoliosis/back problems
arthritis
genetic disorders

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5
Q

goniometer

A

used to measure range of motion of a joint

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6
Q

characteristics of ROM on exam

A

PROM may exceed active ROM by 5 degrees

active ROM/passive ROM should be equal in contralateral joints

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7
Q

basics of exam for muscle strength

A

compare bilateral muscles (strength, symmetry, equality, resistance)
muscle function levels/grades

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8
Q

manual muscle testing grades w/ associated functions

A

0- no activation
1- trace activation, twitch
2- activation with gravity eliminated, achieving full ROM
3- activation against gravity, full ROM
4- activation against some resistance, full ROM
5- activation against examiners full resistance, full ROM

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9
Q

joint motions examined

A 
flexion/ extension/ hyperextension
internal/ external rotation
ABductoin/ADduction
lateral motions
special motions related to a specific joint
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10
Q

inspection of elbow

A

contour
carrying angle
-males = 5 deg
-females= 10-15 deg

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11
Q

palpation of elbow

A

landmarks for tenderness (head of radius, olecranon, epicondyles)
swelling
thickening

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12
Q

ROM of elbow

A

flexion
extension
pronation
supination

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13
Q

moving valgus stress test

A

shoulder at 90 degrees abduction and external rotation
apply valgus torque to elbow (pushing forward), elbow is flexed and extended
pain = positive test

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14
Q

function of moving valgus stress test

A

diagnosing UCL injuries

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15
Q

milking maneuver

A

shoulder at 90 degrees abduction and external rotation

apply valgus torque to elbow (pushing forward) and gently pull thumb in posterior direction

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16
Q

function of milking maneuver

A

additional info about possible UCL injurt

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17
Q

function of middle finger test

A

assess for lateral epicondylitis if isolated pain at lateral epicondyle

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18
Q

inspection of shoulder

A 
size
symmetry
contour
dislocation
winging of scap
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19
Q

palpation of shoulder

A

bone (acromion, coracoid)
joints (AC joint)
muscles

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20
Q

ROM assessment of shoulder

A 
forward flexion
hyperextension
abduction/adduction
internal/external rotation
shrug
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21
Q

internal rotation of shoulder

A

ROM through body plane and hand on back of L spine
reach up back with thumb
nondominant side has greater ROM

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22
Q

external rotation of shoulder

A

ROM normal 45-60 deg

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23
Q

position of arm when testing both internal and external shoulder rotation

A 
shoulder at 0 deg
elbow at 90 deg
OR 
shoulder at 90 deg
elbow at 90 deg
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24
Q

Yerguson test

A

place patients hand with palm facing up and grasp their hand in yours
instruct patient to hold and flat and not let you turn it over
attempt to pronate patients hand against their resistance

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25
Q

function of Yerguson test

A

tenderness with supination of forearm against resistance is indicative of bicipital tendinitis

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26
Q

empty can test

A

extend elbows fully while you move their arms into a position of 70-80 deg of abduction and 30 deg of forward flexion
turn thumbs down as if emptying a can
pt cannot hold affected arm at 90 deg of abduction against resistance

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27
Q

function of empty can test

A

supraspinatus test

pain or inability to resist downward pressure

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28
Q

neer impingement sign

A

place hand on top of patient’s acromion to stabilize scapula while you grasp the forearm
with arm relaxed and palm facing down, passively flex the shoulder anteriorly, raising the arm overhead

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29
Q

function of neer impingement sign

A

compresses the greater tuberosity against the anterior undersurface of the acromion, compressing the superior rotator cuff (supraspinatus) near its insertion
pain may indicate inflammation, overuse injury, or tear of rotator cuff

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30
Q

Hawkins Kennedy test

A

place one hand on top of patients acromion to stabilize scapula
passively flex the shoulder to 90 deg of flexion with forearm parallel to the floor
internally rotate the humerus by moving the hand toward the floor

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31
Q

function of Hawkins Kennedy test

A

compresses the greater tuberosity against the anterior undersurface of the coracoacromial ligament, compressing the superior rotator cuff (supraspinatus) near its insertion
complementary to Neer test

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32
Q

drop arm test

A

arm is raised passively to 160 deg
patient asked to slowly lower arm
inability to lower = positive test

33
Q

function of drop arm test

A

may indicate a large rotator cuff tear

34
Q

infraspinatus/ teres minor test

A

hold arms at sides with elbows flexed 90 deg
actively externally rotate against resistance
positive test is weakness compared with contralateral side

35
Q

lift off test

A

arm internally rotates behind the patients lower back

patient internally rotates against examiners hand

36
Q

function of lift off test

A

inability to lift hand off back may indicate subscapularis tendinopathy or tear

37
Q

cross body adduction test

A

arm is passively adducted across the patients body toward the contralateral shoulder

38
Q

function of cross body adduction test

A

pain main indicate AC joint pathology, including chronic sprain or OA

39
Q

hip inspection

A

symmetry (muscle mass, hip rotation and height)
size
gluteal folds
ability to bear weight - gait assessment

40
Q

hip palpation

A

stability

tenderness

41
Q

hip ROM

A

flexion/extension
hyperextension
abduction/adduction
internal/external rotation

42
Q

hip muscle assessment

A 
strength
function
symmetry
43
Q

how can you increase hip flexion

A

by also flexing knee
90 deg without knee flexed
120 deg with knee flexed

44
Q

how to test hip rotation

A

flex knee while seated

move foot inward and outward (foot inward = hip external rotation and vice versa)

45
Q

FAB-ER test / Patrick test

A

flexion, abduction, external rotation
examiner moves leg into 45 deg of flexion (while pt is laying down) and then externally rotates and abducts the leg so that the ankle is proximal to the knee of the contralateral leg

46
Q

function of FAB-ER test

A

looks for labral tears

47
Q

FAD-IR / impingement test

A

flexion, adduction, internal rotation

examiner passively moves leg into full flexion and then into adduction and internal rotation

48
Q

function of FAD-IR

A

looks for labral tears

49
Q

log roll test / Freiberg test

A

passive supine rotation

patients leg is extended and relaxed on exam table as the examiner internally and externally rotates the leg

50
Q

function of log roll test

A

looks for slipped capital femoral epiphysis

51
Q

knee inspection

A

landmarks
concavities (loss = effusion)
alignment

52
Q

palpations of knee

A

swelling
tenderness
bogginess
crepitus

53
Q

ROM assessment of knee

A

flexion
extension
hyperextension

54
Q

patellar tap test

A

press the patella against femoral condyles

55
Q

function of patellar tap test

A

indicates fracture vs. inflammation

56
Q

apprehension test

A

laterally displace patella

should be laxity in relaxed extension of the knee

57
Q

function of apprehension test

A

in a positive test, patient will guard against movement

indicates potential instability or history of subluxation

58
Q

anterior drawer test

A

place pts knee at 90 deg of flexion with hip flexed at 45 deg
anchor foot to prevent forward movement (sit on it)
relax hamstrings
grasp superior aspect of lower leg and gently pull forward displacing tibia anteriorly
evaluate for endpoint and forward motion

59
Q

function of anterior drawer test

A

for ACL integrity

Lachman’s test more sensitive

60
Q

posterior drawer test

A

similar to anterior drawer but displace tibia posteriorly

for PCL integrity

61
Q

Lachman test

A

flex knee at 20 deg, hamstrings relaxed

stabilize distal femur with one hand and pull forward using a short quick motion on the proximal tibia with the other

62
Q

function of Lachman test

A

most sensitive test for ACL test

with torn ACL, translation is noted and end point is soft or mushy

63
Q

MCL test

A

hold ankle with one hand while other hand support the leg at level of knee
valgus stress applied at ankle (push knee medially and pull ankle laterally)
test at both 30 and 0 deg of knee extension

64
Q

LCL test

A

varus stress applied at ankle (push knee laterally and ankle medially)
small motions
test at both 30 and 0 deg of knee flexion

65
Q

Apley grind test

A 
patient lie prone on exam table
flex knee 90 deg
grasp foot in palm
apply downward pressure on the sole of foot to axially load lower leg
rotate leg in grinding motion
66
Q

function of Apley grind test

A

pain indicates meniscal pathology (tear)

67
Q

McMurray test

A

used to test medial and lateral meniscys

68
Q

iliotibial bad syndrome

A

occurs frequently in runners or cyclists
caused by a combo of overuse and biomechanical factors
exam shows tenderness over the lateral aspect of the knee about 2 cm above the joint line

69
Q

Ober test

A

patient lays on side w affected leg on top
examiner stabilized the pelvis with one hand and moves the tested leg into knee flexion, hip abduction, and extension
THEN lower the leg into adduction until it stops via soft tissue stretch, posterior rotation of the pelvis, or both

70
Q

function of Ober test

A

positive if the tested leg fails to adduct parallel to the table in a neutral position

71
Q

Osgood Schlatter

A

pain is elicited on palpation of anterior tibial tuberosity

72
Q

ankle inspection

A

contour/position
alignment
weight bearing
arch

73
Q

ankle palpation

A

heat
swelling
tenderness

74
Q

ankle ROM

A

flexion/extension

inversion/eversion

75
Q

ligaments of ankle to palpate

A

anterio talofibular
posterior talofibular
calcaneofibular
medial ligament of ankle (deltoid)

76
Q

thompsons test

A

squeeze thigh and see if foot moves

tests integrity of achilles

77
Q

anterior drawer test of ankle

A

tests anterior talofibular ligament

78
Q

talar tilt test of ankle

A 
invert foot (no endpoint = tear, pain = sprain)
tests integrity of calcaneofibular ligament

MM Test 3 (31 decks)

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