Chapter 22 Musculoskeletal System Flashcards
McMurray Test
1. Assessing for?
2. Steps to do?
3. Abnormal findings
Exam done to assess the stability of the lateral and medial meniscuses.
Done by having the patient lay in a supine position. Bring the leg into flexion. Rotate the tibia medially. Bring the leg into full extension. Repeat the process.
This test is considered positive if there is clicking, locking, or pain in the knee.
Ballottement Test
1. What does it assess?
2. Steps to do?
3. Abnormal findings?
Exam done to assess for knee effusion (fluid behind the knee).
Patient in supine position. Extend the leg. Bunch up the knee anterior and distal to the knee joint. Take a finger and tap the knee cap to see if it is floating.
Evidence that the patella is floating. This is seen with knee joint swelling.
Barlow-Ortolani Maneuver
1. What does it assess?
2. Steps to complete?
3. Abnormal findings?
Exam done to assess for subluxation or dysplasia of the hip in infants
Done by having the infant lay flat. Push down on the infants hips to feel and hear for a clicking sound. The other half is relocating the femur in the acetabulum.
Bulge Sign
1. What does this assess/
2. Steps to complete?
3. Abnormal findings?
Exam done looking for knee effusion.
Done by brushing the medial portion of the knee pouch. This is to displace any fluid present to the lateral portion. With eyes observing the medial portion that was just brushed, stroke the lateral portion.
A positive test would show movement of fluid back into the medial portion of the pouch. This indicates the presence of a knee effusion.
Drawer Test
1. What does this assess for?
2. Steps to complete?
3. Abnormal findings?
Exam done to assess for anterior circuiting ligament stability.
Have the patient lay supine, flex the knee about 45 degrees. The practitioner will grab behind the patients knee and tub stoutly to attempt separation of the tibia and femur.
The exam is positive if the tibia moves anteriorly 6mm during the movement.
Femoral Stretch Test
1. What does this assess for?
2. Steps to complete?
3. Abnormal findings?
Exam is done to assess for L1 to L4 lesion.
Patient is positioned in prone position. Their leg is fully flexed behind them and held in that position until symptoms become present or for 45 seconds.
A positive test would be seen if the patient complained of pain or stiffness during the positioning of the movement.
Lachman Test
1. What does this test for?
2. Steps to complete?
3. Abnormal findings?
Exam done to assess for anterior cruciate ligament instability.
Patient is supine. Flex the leg 30 degrees. Try to translocate the tibia. If there is a soft or mushy feel or the tibia translocate 3mm or more when compared to the unaffected leg there is a positive test.
Neer Test
1. What is this test used to assess?
2. How is it performed?
3. Abnormal findings?
Exam done to assess rotator cuff injuries.
Patient is in sitting position. The clinician rotates the affected arm inward and then maximally forward flexes the patient affected arm at the glenalhumoral joint.
Pain or discomfort while raising their arm in this manner is a positive test.
Thomas Test
1. What does this test assess?
2. How is the test done?
3. Abnormal findings?
Exam is done to assess for hip contractures.
The patient is placed in the supine position. The affected leg is drawn up toward the patient for maximal flexion. The patient is asked to hold the flex. The clinician looks at the extended limb noting the hips degree of movement off the bench.
If there is a large degree of hip not touching the bench then this indicates hip contractures.
Herbenden Nodes
Bony enlargement nodules located on the distal tips of the fingers. Seen in osteoarthritis. Caused by degeneration of cartilage and inflammation that results in new bone formation.
Bouchard Nodes
Bony enlargements that are often seen alongside Herbenden nodes in cases of osteoarthritis.
Lumbosacral radiculopathy
1. AKA
2. Signs and Symptoms
AKA as herniated disc and sciatica.
Characterized by pain that begins in the lower back region and travels along down the posterior hamstring. Tenderness over the spine.
How does gout differ from arthritis?
Gout is a form of joint inflammation that is seen in people with an accumulation of uric acid. It typically affects the great toes. Pain comes on suddenly with associated inflammation, redness, swelling, warmth.
Arthritis is a form of joint inflammation that can affect many different joints at the same time. Typically not experiencing warmth.
What are rheumatoid nodules? Where do they typically occur?
Rheumatoid nodules are nodules that are seen with RA. They typically occur on joint areas where there is a lot of trauma or use.
Radial Head Subluxation
A possible reason a child would be reluctant to use affected arm and wrist. Pain.
Thumb abduction test
1. What does it assess?
2. How is it done?
An exam that is used to assess for carpal tunnel syndrome. The hand is held palm side up with the thumb perpendicular. Downward pressure is applied to the thumb. Trying to reproduce the signs and symptoms the patient was experiencing.
Phalen Test
1. What does this assess?
2. How is it done?
The Phalen test is done to assess for medial nerve entrapment, or carpal tunnel syndrome.
Done by having the patient place their dorsal surfaces of both hands together and holding that pose.
Tinel Sign
1. What does this assess?
2. How is the exam performed?
Tap test to assess for carpal tunnel syndrome.
RA VS osteoarthritis
RA is a more severe disease. that has a gradual onset. Symptoms occur several hours and can occur at anytime, even waking the patient from sleep. Weakness, depression, fatigue, tenderness and swelling, heat and erythema.
Osteoarthritis has a insidious onset, taking many years to form. Symptoms are mild when compared to RA. Come and go quicker.
