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FF: MSK content > class 9: MSK Advanced Differential Diagnosis > Flashcards

class 9: MSK Advanced Differential Diagnosis Flashcards

1
Q

ULTT1 what nerve

A

Median, Anterior
interosseous

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2
Q

ULTT2 what nerve

A

Median, Axillary,
Musculocutaneous

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3
Q

ULTT3 what nerve

A

Radial

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4
Q

ULTT4 what nerve

A

Ulnar, C8 & T1 nerve roots

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5
Q

ULTT1 actions

A

shoulder - Depression and Abd (110°)

elb - Extension

forearm - Supination

wrist/finger - Extension

C-spine - Contralateral side flexion

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6
Q

ULTT2

A

what is the only difference between 1 - shoulder ER

shoulder - Depression and Abd (110°), ER

elb - Extension

forearm- Supination

wrist/finger - Extension

C-spine - Contralateral side flexion

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7
Q

ULTT3

A

shoulder - Depression and Abd (40°), Ext (25°), IR

elb - Extension

forearms - Pronation

wrist/finger - Flexion and ulnar deviation

C-spine - Contralateral side flexion

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8
Q

ULTT4

A

shoulder - Depression and Abd (10° to 90°), LR

elb - Flexion

forearm - Supination

wrist - Extension and radial deviation

finger - Extension

C-spine - Contralateral side flexion

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9
Q

SUBACROMIAL
IMPINGEMENT - pain

A
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10
Q

SUBACROMIAL
IMPINGEMENT - special tests

A

Impingement signs:
Neer

Hawkins

Yocum,

Jobe [EmptyCan])

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11
Q

SUBACROMIAL
IMPINGEMENT - painful arc

A

Painful arc (60-120°)

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12
Q

what is a another name for empty can

A

jobe

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13
Q

ROTATOR CUFF TEAR - population

A

Age >40 (overuse cases) or
traumatic

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14
Q

ROTATOR CUFF TEAR - presentation

A

Anterior/posterior/superior shoulder pain, with loss of strength

Pain that wakes the patient during sleep, worse at night

Weakness and atrophy

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15
Q

ROTATOR CUFF TEAR -special tests

A

ER lag sign and IR lag sign,

belly press and Lift off sign

drop arm

Hornblower’s sign,

bear hug

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16
Q

SLAP- LABRUM TEAR - onset

A

Traumatic sudden onset

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17
Q

SLAP- LABRUM TEAR - presentation

A

Deep anterior shoulder pain

Clicking/clunking/joint locking,

pain with throwing or biceps loading (shoulder flexion and arm supination)

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18
Q

SLAP- LABRUM TEAR - special tests

A

Active O’Brien Test

Biceps load

Clunk test

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19
Q

AC JOINT INJURY - MOI

A

Trauma that displaces the
shoulder girdle inferiorly or heavy
weightlifting

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20
Q

AC JOINT INJURY - pain location and presentation

A

Pain at top of the shoulder

Step deformity

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21
Q

AC JOINT INJURY - special tests

A

Horizontal adduction

Paxinos sign

AC sheer test

Painful arc

pain with horizontal adduction

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22
Q

AC JOINT INJURY - painful arc

A

Painful arc (170-180°)

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23
Q

what is a step deformity

A

visibly raised point of the. shoulder where the collar bone and shoulder blade has separated due to a ligament tear

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24
Q

what makes up the Coracoacromial Arch

A

acromion

coracoid process

coracoacromial ligament (CAL)

roof of the GH joint

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25
Q

what is a Superior Labrum Anterior Posterior (SLAP) lesion

A

lesion is superior
labrum tearing or pulling away by the biceps insertion, which is
under the subacromial arch

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26
Q

Repair of a SLAP Lesion w/ biceps - 2 weeks elevation

A

̶Limit passive or assisted elevation of UE to
60°

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27
Q

Repair of a SLAP Lesion w/ biceps - 3/4 weeks elevation

A

̶Limit passive or assisted elevation of UE to 90°

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28
Q

repair of SLAP with biceps - 2 weeks humeral rotation

A

̶Only perform passive humeral rotation with
shoulder in scapular plane for first 2 weeks

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29
Q

repair of SLAP with biceps - 3/4 weeks IR and ER

A

30° ER & 60° IR

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30
Q

repair of SLAP with biceps - how long should we avoid biceps contraction

A

for 6 weeks

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31
Q

Rotator Cuff Rehabilitation - what do we start with

A

isometrics

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32
Q

Rotator Cuff Rehabilitation - what do we not want with resisted exercises

A

Resisted exercises should NOT cause pain

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33
Q

Rotator Cuff Rehabilitation - what muscle should we focus on first

A

Rotator cuff strength must be address before large primary movers

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34
Q

Rotator Cuff Rehabilitation - AROM Flexion and abduction

A

Flexion and abduction must be done AROM without shoulder hiking

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35
Q

Rotator Cuff Rehabilitation - closed kinetic chain exercises

A

No closed kinetic chain exercises x 6 weeks

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36
Q

Rotator Cuff Rehabilitation - Dynamic strengthening starts when

A

8 weeks for small tear

12 weeks for a large tear

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37
Q

Rotator Cuff Rehabilitation - functional activities

A

Light functional activities 6+ weeks

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38
Q

De Quervain’s tenosynovitis - presentation

A

Tenderness over lateral wrist
and thumb

Severe pain with wrist ulnar
deviation and thumb flexion
and adduction

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39
Q

De Quervain’s tenosynovitis - muscles

A

Abductor pollicis longus

Extensor Pollicis Brevis

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40
Q

De Quervain’s tenosynovitis - special test

A

Finkelstein’s test

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41
Q

Carpal Tunnel Syndrome - presentation

A

Tingling/ numbness in the median nerve distribution of hand

Thenar muscle atrophy seen
in later stages

Night pain

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42
Q

Carpal Tunnel Syndrome - MOI

A

Repetitive activities and
sustained positioning of wrist
aggravates pain

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43
Q

Carpal Tunnel Syndrome - special tests

A

Phalen’s test

Tinel sign

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44
Q

Colle’s fracture- what is it

A

Dorsal displacement of
the distal fragment of radius

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45
Q

Colle’s fracture- MOI

A

Due to FOOSH injury

46
Q

Colle’s fracture- deformity

A

Leads to DINNER
FORK DEFORMITY

47
Q

Smith fracture- MOI

A

Due to fall on flexed wrist

48
Q

Smith fracture- presentation

A

Volar displacement of distal fragment of
radius

49
Q

Smith fracture- deformity

A

Leads to GARDEN
SPADE DEFORMITY

50
Q

opening the mouth muscle

A

lateral pterygoid

and

gravity

51
Q

closing of the mouth muscle

A

temporalis

massester

medial pterygoid

MMT

52
Q

protusion of the madible

A

lateral and medial pterygoid

53
Q

retraction of the mandible

A

temproalis

54
Q

lateral deviation of the mandible

A

lateral pterygoid (contralateral muscle)

and

medial pterygoid (contralateral muscle)

55
Q

disc displacement with reduction - what is heard with opening and closing

A

pops and clicks

56
Q

disc displacement with reduction - what does opening click represent

A

reduction of the disc

57
Q

disc displacement with reduction - what does the closing click represent

A

the disc displacing anteriorly to the condyle

58
Q

disc displacement with reduction - what is the reciprocal click

A

opening and closing click

59
Q

TMJ - Hypomobility

A

Decreased mouth opening and deviation to same side

60
Q

TMJ - Hypermobility

A

Increased mouth opening and deviation to opposite side

KB is opposite of me

61
Q

TMJ - Disc displacement with reduction

A

Clicking heard. No deviation, no difficulty
with mouth opening

62
Q

TMJ - Synovitis

A

Pain and limited mouth opening, no deviation

63
Q

TMJ - Capsulitis

A

Pain, limited mouth opening and deviation to same side

64
Q

Legg-Calve-Perthes age vs Slipped Capital Femoral Epiphysis age

A

Legg-Calve-Perthes: 2-13 Years

Slipped Capital Femoral Epiphysis: Age = 10-17 Years
- slipped icecream come later in the melting stage

65
Q

Legg-Calve-Perthes - body and pop

A

Short: stature, males

66
Q

Legg-Calve-Perthes - what is it

A

Deformity/flattening of femoral head due to
loss of bloody supply

Femoral head necrosis, fragments, and ossifies

67
Q

Legg-Calve-Perthes - clinical presentation

A

Pain worsens with activity

Limping

Stiffness

68
Q

Legg-Calve-Perthes - what hip movement are limited

A

Extension, abduction and IR limited

AEI(OU) - spasity posiotion

69
Q

Legg-Calve-Perthes - treatment

A

Conservative treatment, bracing

70
Q

what is the hip capsular pattern

A

IR > abd > flexion

IAF
I am farty

vs shoulder ER > ABD > IR

71
Q

Slipped Capital Femoral Epiphysis - body

A

Overweight

72
Q

Slipped Capital Femoral Epiphysis - what is it

A

Displacement of femoral head due
to slippage from the growth plate

73
Q

Slipped Capital Femoral Epiphysis - clinical presentation

A

Pain worsens with activity

Limping

Stiffness

74
Q

Slipped Capital Femoral Epiphysis - motion limited

A

Flexion, abduction and IR limited

75
Q

Slipped Capital Femoral Epiphysis - treatment

A

Surgical treatment to stabilize

76
Q

what are the name of the braces used for Congenital hip dysplasia

A

Frejka pillow

Pavlik harness

77
Q

what is the name of the brace Used for Perthes disease

A

Scottish rite brace

78
Q

ACL - primary restraint for what

A

anterior translation of tibia on femur

medial rotation of the tibia on the
femur

79
Q

ACL - MOI

A

Hyperextension + valgus force + planted
foot

80
Q

ACL - Symptoms:

A

Deep pain,

strong pop heard at injury,

instability while descending stairs

81
Q

ACL - Special test

A

Lachman’s,

Anterior drawer,

Pivot shift test

82
Q

PCL - primary restriant

A

Primary restraint for posterior translation

medial rotation of the tibia on the
femur

83
Q

PCL - MOI

A

Hyperflexion/Dashboard injury

84
Q

PCL - sym

A

Deep pain, instability, mild
pop heard at injury

85
Q

PCL - special test

A

Posterior drawer test

Posterior sag sign

86
Q

Meniscus Injury

A

Popping, locking, catching sensation during movement

joint line tenderness
swelling,

pain with knee hyperextension and full flexion

87
Q

Patellofemoral pain syndrome

A

Peripatellar pain,

lateral patellar tracking,

pain with squatting,

prolonged sitting (movie theatre sign),

commonly seen in young females

88
Q

Osgood Schlatter syndrome:

A

Pain at tibial tuberosity, enlarged tibial
tubercle, excessive activity in adolescents and poor flexibility

89
Q

Tarsal Tunnel Syndrome - presentation

A

Pain, numbness and tingling
over medial malleolus,
distribution of posterior tibial
nerve- up the leg, or down into
the medial arch, plantar
surface of the foot and toes

90
Q

Tarsal Tunnel Syndrome - aggregvated with what activities

A

Aggravated with excessive
dynamic pronation in walking/
running

91
Q

Tarsal Tunnel Syndrome - pain with what movements

A

passive extreme dorsiflexion and eversion

active ankle plantarflexion and inversion

92
Q

Tarsal Tunnel Syndrome - special test

A

Tinel sign

93
Q

Medial Tibial Stress
Syndrome
(Posterior Shin Splints) - pain location

A

Posterior-medial lower leg pain

Tenderness over posteromedial
calf

94
Q

Medial Tibial Stress
Syndrome
(Posterior Shin Splints) - aggravated with what

A

Aggravated with exercising over
involved lower extremity

95
Q

Medial Tibial Stress
Syndrome
(Posterior Shin Splints) - pain with what movements

A

Pain with active combined
plantarflexion and inversion

96
Q

Achilles Tendinitis - pain location

A

Posterior ankle pain

Tenderness over posterior
ankle

97
Q

Achilles Tendinitis - aggravated with what activity

A

Aggravated with jumping,
running

98
Q

Achilles Tendinitis - what movement are painful

A

active PF (heel raises)

passive overpressure to DF

restricted range of DF

99
Q

Plantar Fasciitis - pain location

A

Pain over sole of foot (under
heel)

Tenderness over plantar aspect
of heel

100
Q

Plantar Fasciitis- aggrevated with what activties

A

Aggravated with weight
bearing especially first thing in
the morning

101
Q

Plantar Fasciitis - pain with what movements

A

Pain with passive overpressure
to great toe extension

102
Q

Plantar Fasciitis - special test

A

Windlass test

103
Q

hornblower is used for what muscle

A

teres minor

104
Q

what is normal mouth opening

105
Q

mouth opening glide and closing - direction

A

open - anterior
closing - posterior

106
Q

mouth closing glide - direction

107
Q

OPP and CPP - TMJ

A

OPP - mouth slightly open

CPP - teeth clenched

108
Q

when is hip splica used

A

an orthodic used following hip manipulation

109
Q

ACL open chain activities - what do we not want

A

full ext - 30 deg

0-45

110
Q

ACL closed chain activities - what do we not want

A

do not go past 90-deg

60-90

111
Q

ACL repair - weights

A

we do not want ankle weights distal to the tibia

FF: MSK content (13 decks)

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