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Basic LL MSK Exam Flashcards

1
Q

ROM: adduction

A
  1. adductor longus, a brevis, a magnus, gracilis
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2
Q

ROM: abduction

A
  1. glut medius, glut minimus, TFL
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3
Q

ROM: flexion

A
  1. iliopsoas, rectus femoris, sartorius
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4
Q

ROM: extension

A
  1. glut max, biceps femoris, semimembranosus, semitendinosus
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5
Q

ROM: internal rotation (medial)

A
  1. a longus, a brevis, a magnus, TFL, glut medius, glut minimus
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6
Q

ROM: external rotation (lateral)

A
  1. glut max, piriformis, gemellus, obturator internus, glut inferior, quadratus femoris, obturator externus
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7
Q

basic knee exam: appearance

A

popeye deformities, muscle wasting, prepatellar bursa

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8
Q

basic knee exam: palpation

A

effusion, quad & patellar tendons, tibial tubercle, joint line

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9
Q

basic knee exam: ROM

A

flexion 130. functional 0-110 extension

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10
Q

basic knee exam: joint stability

A

LCL (varus) and MCL (valgus) stress, ACL, PCL

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11
Q

basic ankle exam: x rays for?

A

bony point tenderness at posterior edge w/wo tip of either malleolus. bony point tenderness at navicular and base of 5th metatarsal, inability to walk (4+ steps) immediately after injury/in ER

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12
Q

squeeze test

A

to rule out fibular head fracture (maisonneuve fracture) and syndesmotic/high ankle sprain

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13
Q

slipped capital femoral epiphysis (SCFE) history

A

classically overweight early adolescent w history of groin or knee pain, may be referred to anteromedial thigh. often bilaterally.

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14
Q

slipped capital femoral epiphysis (SCFE) etiology + presentation + exam

A

repetitive overload. vague stx, worst w activity. limitation of internal rotation on exam.

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15
Q

slipped capital femoral epiphysis (SCFE) tests + treatments

A

plain x-rays. surgical fixation.

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16
Q

transient synovitis of the hip: etiology

A

3-10 yo. usually viral, post-vaccine or drug-induced.

17
Q

transient synovitis of the hip: examination

A

usually hold hip slightly flexed & externally rotated. resistance to abduction and internal rotation. any motion causes pain, can’t bear weight.

18
Q

transient synovitis of the hip: tests + treatment

A

sed rate elevated, mild leukocytosis. NSAIDs 1-3 wks.

19
Q

septic joint etiology + exam

A

gonorrhea or skin flora. swollen and painful knee, passive & active ROM painful. red, hot. usually has systemic signs UNLESS diabetic or immunosuppressed

20
Q

septic joint treatment + compilcation

A

often requires surgical incision and drainage followed by IV antibiotics. can cause articular surface destruction

21
Q

patellar dislocation epidemiology + history

A

usually lateral dislocation. cutting w active quad contraction. immediate pain & swelling.

22
Q

patellar dislocation exam + treatment

A

ecchymosis, effusion. w/ positive apprehension test. PT (surgery if recurrent)

23
Q

ACL sprain etiology + exam

A

twisting non-contact, deceleration or hyperextension. + lachmann test (knee at 20-30 degree flexion, stabilize femur; check anterior translation and endpoint of tibia)

24
Q

ACL sprain history

A

acute: pop and rapid effusion. chronic: instability

25
Q

meniscal tear etiology + history

A

usually d/t twisting on a loaded knee. or degenerative tear. locking & effusion.

26
Q

meniscal tear exam + treatment

A

pain over joint line, pain w circumduction tests. if locked, needs reduction (surgery). if no locking, PT and relative test.

27
Q

compartment syndrome pathology

A

elevation of pressures in muscular compartment high enough to interfere with perfusion

28
Q

compartment syndrome etiology

A

acute: severe bleed, d/t fracture
chronic exertional: from hypertrophied muscle in tight compartment w exercise (increases muscle bulk up to 20%). leg»forearm.

29
Q

compartment syndrome presentation

A
  1. pain out of proportion (early)
  2. paresthesia (early)
  3. poikilothermia (coolness)
  4. paralysis (late)
  5. pallor (late)
    pulselessness (late and rare)
30
Q

compartment syndrome pressures (acute injury)

A

0-10 = normal
10-30 = elevated, not dangerous
30-40 = potentially dangerous in acute compartment syndrome
40-60 = usually dangerous, usually requires compartment release
> 60 = consistently dangerous, requires urgent release

31
Q

ankle sprains etiology + exam

A

forced inversion. anterior drawer test: 3-5 mm more than uninjured. squeeze test. external rotation test + = suspicious for high ankle

32
Q

achilles tendon rupture history+ exam

A

hear pop, feels like someone hit them in back of ankle. difficulty walking. defect in achilles on exam- pain and weakness with plantar flexion.

33
Q

achilles tendon rupture treatment

A

acute immobilization or surgery

MSS (28 decks)

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