Ch 21 muscoskeletal Flashcards
Shoulder rotator cuff impingement or tear
Neer Test and Hawkins Test
Median nerve integrity
thumb abduction test, tinel sign, phalen test
L2, L3, L4 nerve root irritation
femoral test
L4, L5, S1 nerve root irritation
straight leg raising
Effusion or excess fluid in knee
ballottement
Excess fluid in knee
Bulge Sign
Torn meniscus in knee
McMurray Test
Anterior and posterior cruciate ligament integrity
Anterior & Posterior Drawer Test
Mediolateral collateral ligament instability in knee
Varus/Valgus Stress Test
Anterior Cruciate ligament integrity
Pivot Shift Test
Anterior Cruciate ligament integrity
Lachman Test
Torn meniscus in knee
Apley test
Flexion contracture of hip
Thomas Test
Weak hip abductor muscles
Trendelenburg sign
TO check vascular status in upper extremities what do you check?
radial pulses on both side, if absent or weak check the brachial pulse
TO check vascular status in lower extremities what do you check?
Check the posterior tibial and dorsalis pedis pulses on both sides - if these pulses are absent or weak, check the popliteal and femoral pulses
When do you percuss nerves?
for symptoms of inflammation and CVA when looking at back
What is active ROM
patients moves joints
What is passive ROM?
you move patient
What should you palpate for that is crackly?
crepitus
What is a zero on the strength scale
0 (no evidence of movement)
What is a one on the strength scale
1 (muscle twitch apparent)
What is a two on the strength scale
2 (FROM but not against gravity)
What is a three on the strength scale
3 (FROM but not against resistance)
What is a four on the strength scale
4 (FROM but weak with resistance)
What is a five on the strength scale
5 (FROM and full strength)
When you are inspecting what are you inspecting for?
swelling, erythema (redness), posture/position, asymmetry, deformity or atrophy
What are the signs of musculoskeletal disease?
Pain, Redness (erythema), Swelling (edema), Increased warmth (calor), Deformity, Loss of function
What do you ask above motor vehicle accidents?
driver/passenger
belted/non-belted
location of impact and severity of crash (required jaws of life,
if anyone died in the crash, thrown from the car, etc)
speed at impact
position of the patient and the limb in question at impact
Moving a limb away from the body is (blank) while moving a limb toward the body is (blank)
abduction
adduction
(blank) is the result of a wrench or twist of the ligaments of a joint
sprain
What is the typical number of vertebrae?
24
(blank) is a flexible but inelastic cord of strong fibrous collagen tissue attaching a muscle to a bone.
tendon
(blank) is a firm, whitish, flexible connective tissue found in various forms in the larynx and respiratory tract, in structures such as the external ear, and in the articulating surfaces of joints.
cartilage
(blank) a short band of tough, flexible, fibrous connective tissue that connects two bones or cartilages or holds together a joint
ligament
(blank) is a structure in the human or animal body at which two parts of the skeleton are fitted together
jjoint
What type of joint is this:
no movement
Cranial sutures
synarthrosis
What type of joint is this:
slightly movable
Radius/ulna
Acromioclavicular joint
Amphiarthrosis
What type of joint is this:
freely movable
Knee
Shoulder
Diarthrosis
(blank) is a thin sac that allows gliding between surfaces
bursae
What are in a diarthrosic joint?
synovial fluid, articular cartilage and joint, bursae
What are the steps of the musculoskeletal exam?
inspect, palpate, ROM, muscle strength, specific tests for each joint
When inspecting posture what do you look for?
Erectness
Symmetry
Alignment
When inspecting skin and subcutaeous tissue what do you look for?
Swelling
Redness
Masses
When inspecting extremities what do you look for?
Size Deformities Enlargement Alignment Symmetry Atrophy Hypertrophy
Palpate bones, joints and surrounding muscles for what?
Heat Tenderness Swelling Fluctuation Crepitus Resistance to pressure Muscle tone
What are the three parts to assessing rom?
flexion, extension, rotation
What are the tests for checking the spine?
straight leg raise
What are the four tests for carpal tunnel assessment?
flick test, thumb abduction, tinel test, and phalen test
What test for carpal tunnel has you place the backs of your hands together?
phalen
What test for carpel tunnel has you place your index finger on your wrist?
tinel test
What test do you use to look for a meniscus tear?
McMurray or Apley test
What test do you use for ACL?
lachman test
What does the drawer test look at?
knee ligament eval
do kids get fractures or sprains more?
fractures
Menopausal women need calcium and estrogen why?
because lack of these causes bone resorption
Does not having kids increase you chance of osteoporosis?
yes
bony overgrowths in distal interphalangeal joints 2-3 mm is considered a sign of what?
osteoarthritis
swellings of interphalangeal joints is associated with what?
rheumatoid arthritis
outward curvation of the spine is called what?
kyphosis
What is inward curvation of the spine called?
lordosis
What is a sharp angular deformity associated with a collapsed vertebra from osteoporosis?
gibbus
A lateral curvature or rib hump shoud mae you suspect (blank)
scoliosis
What is the ottawa ankle rule?
used to identify if patients need ankle radiography
tenderness on fibula/tibia and pain in malleolar zone.
If you have weakened thumb abduction, probable distribution of symptoms on the katx hand diagram, hypalgesia (decreased pain along thumb and median nerve distribution compared to little finger on same hand) and weak thumb abduction then you have what.
Carpal tunnel
If you are older than 55, have tenderness at head of fibula, isolated tenderness of the platella, and inability to flex the knee to 90 degrees then what?
you have passed the ottawa knee rules and you need a knee radiograph
a single crease along a babies hand can indicate what?
down syndrome
What should be performed for the first year of the babies life to inspect the hips?
barlow-orolani maneuver
If an infant has unequal upper leg length this would give them a positive (blank) sign
allis
What is a quick way to differentiate between osteoarthritis and rheumatoid arthritis?
rheumatoid has a quick onset and osteoarthritis has an insidious onset (long time coming)
