Basic UL MSK Exam Flashcards
sprain = ?
ligament injury
strain = ?
muscle injury
tedonitis/tendinosis = ?
tendon injury
strength grading scale?
0-5, 5 is normal. 3 = only against gravity; 2= not against gravity
reflex grading scale?
0-4, 4 = clonus, 1 = hypoactive
normal capillary refill time?
< 2 seconds = normal
pulse intensity grading?
0 = absent, 4 = bounding, 3 = normal
abduction?
- mid-deltoid, supraspinatus
adduction?
- pec major, lats
flexion?
- anterior deltoid, coracobrachialis
extension?
- lats, teres major, posterior deltoid
external rotation?
- infraspinatus, teres minor
internal rotation
- pec major, lats, teres major, subscapularis
scapular elevation
traps, levator scauplae
scapular retraction
rhomboids
scapular protraction
serratus anterior
functional = ?
120 abduction
painful arc of abduction 80-150?
c/w rotator cuff problems
painful arc of abduction > 150
c/w AC pathology
rotator cuff muscle tests?
supraspinatus. infraspinatus & teres minor. subscapularis
supraspinatus test?
full can test
subscapularis test?
liftoff test
joint stability test?
apprehension test
areas of sensation to test for shoulder probs?
axillary nerve (lateral shoulder), musculocutaneous nerve (lateral forearm)
functional elbow ROM?
30-130 extension/flexion; 50 pronation/supination.
UCL test?
valgus stress
valgus = ?
part of the body distal to the deformed part is deviated away from the body/midline
varus = ?
part of the body distal to the deformed part is deviated toward the body/midline
tinel’s sign?
tapping over median nerve in carpal tunnel
phalen’s sign?
holding wrists back to back in full flexion
AC sprain etiology
fall directly onto shoulder
AC sprain presentation
pain with overhead motions, deformity of superior shoulder
AC sprain exam:
pain and deformity at AC joint, pain with cross body adduction of arm, painful arc of abduction over 150.
AC injury grading? Grades I-IV
grade I: AC lig stretch
grade II: AC lig tear, CC lig stretch
grade III: AC and CC complete tears
grade IV: complete AC and CC tears + clavicular displacement
shoulder dislocation etiology
usually anterior. forced extension, abduction, external rotation of arm OR direct blow to post shoulder
shoulder dislocation exam?
arm held in slight abduction and external rotation. resistance to abduction and internal rotation. prominent acromion. humeral head anterior to acromion, adjacent to coracoid. positive apprehension test. anterior laxity.
initial treatment for acute dislocation
non-operative. immobilize with sling. or surgical for athlete.
rotator cuff history?
pain with overhead motions
rotator cuff impingement signs? (+)
neer’s test (pain when arm is elevated thru forward flexion); empty can test, hawkins test (pain with resisted external rotation w elbow flexed and across body)
rotator cuff weakness sign?
weakness to abduction (if complete tear) (drop arm test)
painful abduction between what degrees and why?
80-120. below 30 = supraspinatus.
adhesive capsulitis (frozen shoulder) etiology
complication of injuries (dislocation, rotator cuff tendinitis, reflex sympathetic dystrophy and fractures
medial epicondylitis (golfer’s) etiology
overuse of wrist flexors (esp pronator teres and flexor carpi radialis)
medial epicondylitis (golfer’s) exam
tenderness over medial epicondyle, pain with resisted wrist flexion and forearm pronation
lateral epicondylitis (tennis)
overuse from repetitive extension (esp extensor carpi radialis brevis)
lateral epicondylitis (tennis) stx?
pain over lateral elbow, radiating into forearm. later weakness.
lateral epicondylitis (tennis) signs
tenderness over lateral epicondyle, pain with resisted wrist dorsiflexion & middle finger extension
scaphoid fracture etiology, exam?
FOOSH. tenderness in anatomic snuffbox.
carpal tunnel syndrome etiology + stx
irritation of median nerve in carpal tunnel. tingling & pain in median nerve distribution, esp at night
carpal tunnel syndrome exam findings
tinel’s sign, phalen’s sign, sensory loss of radial 3.5 fingers, thenar eminence atrophy (late), loss of 2-pt discrimination (late, most sensitive)
wrist ganglion etiology, stx
overproduction of fluid by joint of tendon sheath (filled w thick gelatinous material). lump firm & mobile (wrist, hand, foot & ankle). pain (if any) from compression