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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
what is a Superior Labrum Anterior Posterior (SLAP) lesion
lesion is superior labrum tearing or pulling away by the biceps insertion, which is under the subacromial arch
26
Repair of a SLAP Lesion w/ biceps - 2 weeks elevation
̶Limit passive or assisted elevation of UE to 60°
27
Repair of a SLAP Lesion w/ biceps - 3/4 weeks elevation
̶Limit passive or assisted elevation of UE to 90°
28
repair of SLAP with biceps - 2 weeks humeral rotation
̶Only perform passive humeral rotation with shoulder in scapular plane for first 2 weeks
29
repair of SLAP with biceps - 3/4 weeks IR and ER
30° ER & 60° IR
30
repair of SLAP with biceps - how long should we avoid biceps contraction
for 6 weeks
31
Rotator Cuff Rehabilitation - what do we start with
isometrics
32
Rotator Cuff Rehabilitation - what do we not want with resisted exercises
Resisted exercises should NOT cause pain
33
Rotator Cuff Rehabilitation - what muscle should we focus on first
Rotator cuff strength must be address before large primary movers
34
Rotator Cuff Rehabilitation - AROM Flexion and abduction
Flexion and abduction must be done AROM without shoulder hiking
35
Rotator Cuff Rehabilitation - closed kinetic chain exercises
No closed kinetic chain exercises x 6 weeks
36
Rotator Cuff Rehabilitation - Dynamic strengthening starts when
8 weeks for small tear 12 weeks for a large tear
37
Rotator Cuff Rehabilitation - functional activities
Light functional activities 6+ weeks
38
De Quervain’s tenosynovitis - presentation
Tenderness over lateral wrist and thumb Severe pain with wrist ulnar deviation and thumb flexion and adduction
39
De Quervain’s tenosynovitis - muscles
Abductor pollicis longus Extensor Pollicis Brevis
40
De Quervain’s tenosynovitis - special test
Finkelstein’s test
41
Carpal Tunnel Syndrome - presentation
Tingling/ numbness in the median nerve distribution of hand Thenar muscle atrophy seen in later stages Night pain
42
Carpal Tunnel Syndrome - MOI
Repetitive activities and sustained positioning of wrist aggravates pain
43
Carpal Tunnel Syndrome - special tests
Phalen’s test Tinel sign
44
Colle’s fracture- what is it
Dorsal displacement of the distal fragment of radius
45
Colle’s fracture- MOI
Due to FOOSH injury
46
Colle’s fracture- deformity
Leads to DINNER FORK DEFORMITY
47
Smith fracture- MOI
Due to fall on flexed wrist
48
Smith fracture- presentation
Volar displacement of distal fragment of radius
49
Smith fracture- deformity
Leads to GARDEN SPADE DEFORMITY
50
opening the mouth muscle
lateral pterygoid and gravity
51
closing of the mouth muscle
temporalis massester medial pterygoid MMT
52
protusion of the madible
lateral and medial pterygoid
53
retraction of the mandible
temproalis
54
lateral deviation of the mandible
lateral pterygoid (contralateral muscle) and medial pterygoid (contralateral muscle)
55
disc displacement with reduction - what is heard with opening and closing
pops and clicks
56
disc displacement with reduction - what does opening click represent
reduction of the disc
57
disc displacement with reduction - what does the closing click represent
the disc displacing anteriorly to the condyle
58
disc displacement with reduction - what is the reciprocal click
opening and closing click
59
TMJ - Hypomobility
Decreased mouth opening and deviation to same side
60
TMJ - Hypermobility
Increased mouth opening and deviation to opposite side KB is opposite of me
61
TMJ - Disc displacement with reduction
Clicking heard. No deviation, no difficulty with mouth opening
62
TMJ - Synovitis
Pain and limited mouth opening, no deviation
63
TMJ - Capsulitis
Pain, limited mouth opening and deviation to same side
64
Legg-Calve-Perthes age vs Slipped Capital Femoral Epiphysis age
Legg-Calve-Perthes: 2-13 Years Slipped Capital Femoral Epiphysis: Age = 10-17 Years - slipped icecream come later in the melting stage
65
Legg-Calve-Perthes - body and pop
Short: stature, males
66
Legg-Calve-Perthes - what is it
Deformity/flattening of femoral head due to loss of bloody supply Femoral head necrosis, fragments, and ossifies
67
Legg-Calve-Perthes - clinical presentation
Pain worsens with activity Limping Stiffness
68
Legg-Calve-Perthes - what hip movement are limited
Extension, abduction and IR limited AEI(OU) - spasity posiotion
69
Legg-Calve-Perthes - treatment
Conservative treatment, bracing
70
what is the hip capsular pattern
IR > abd > flexion IAF I am farty vs shoulder ER > ABD > IR
71
Slipped Capital Femoral Epiphysis - body
Overweight
72
Slipped Capital Femoral Epiphysis - what is it
Displacement of femoral head due to slippage from the growth plate
73
Slipped Capital Femoral Epiphysis - clinical presentation
Pain worsens with activity Limping Stiffness
74
Slipped Capital Femoral Epiphysis - motion limited
Flexion, abduction and IR limited
75
Slipped Capital Femoral Epiphysis - treatment
Surgical treatment to stabilize
76
what are the name of the braces used for Congenital hip dysplasia
Frejka pillow Pavlik harness
77
what is the name of the brace Used for Perthes disease
Scottish rite brace
78
ACL - primary restraint for what
anterior translation of tibia on femur medial rotation of the tibia on the femur
79
ACL - MOI
Hyperextension + valgus force + planted foot
80
ACL - Symptoms:
Deep pain, strong pop heard at injury, instability while descending stairs
81
ACL - Special test
Lachman’s, Anterior drawer, Pivot shift test
82
PCL - primary restriant
Primary restraint for posterior translation medial rotation of the tibia on the femur
83
PCL - MOI
Hyperflexion/Dashboard injury
84
PCL - sym
Deep pain, instability, mild pop heard at injury
85
PCL - special test
Posterior drawer test Posterior sag sign
86
Meniscus Injury
Popping, locking, catching sensation during movement joint line tenderness swelling, pain with knee hyperextension and full flexion
87
Patellofemoral pain syndrome
Peripatellar pain, lateral patellar tracking, pain with squatting, prolonged sitting (movie theatre sign), commonly seen in young females
88
Osgood Schlatter syndrome:
Pain at tibial tuberosity, enlarged tibial tubercle, excessive activity in adolescents and poor flexibility
89
Tarsal Tunnel Syndrome - presentation
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
Tarsal Tunnel Syndrome - aggregvated with what activities
Aggravated with excessive dynamic pronation in walking/ running
91
Tarsal Tunnel Syndrome - pain with what movements
passive extreme dorsiflexion and eversion active ankle plantarflexion and inversion
92
Tarsal Tunnel Syndrome - special test
Tinel sign
93
Medial Tibial Stress Syndrome (Posterior Shin Splints) - pain location
Posterior-medial lower leg pain Tenderness over posteromedial calf
94
Medial Tibial Stress Syndrome (Posterior Shin Splints) - aggravated with what
Aggravated with exercising over involved lower extremity
95
Medial Tibial Stress Syndrome (Posterior Shin Splints) - pain with what movements
Pain with active combined plantarflexion and inversion
96
Achilles Tendinitis - pain location
Posterior ankle pain Tenderness over posterior ankle
97
Achilles Tendinitis - aggravated with what activity
Aggravated with jumping, running
98
Achilles Tendinitis - what movement are painful
active PF (heel raises) passive overpressure to DF restricted range of DF
99
Plantar Fasciitis - pain location
Pain over sole of foot (under heel) Tenderness over plantar aspect of heel
100
Plantar Fasciitis- aggrevated with what activties
Aggravated with weight bearing especially first thing in the morning
101
Plantar Fasciitis - pain with what movements
Pain with passive overpressure to great toe extension
102
Plantar Fasciitis - special test
Windlass test
103
hornblower is used for what muscle
teres minor
104
what is normal mouth opening
35-55 mm
105
mouth opening glide and closing - direction
open - anterior closing - posterior
106
mouth closing glide - direction
posterior
107
OPP and CPP - TMJ
OPP - mouth slightly open CPP - teeth clenched
108
when is hip splica used
an orthodic used following hip manipulation
109
ACL open chain activities - what do we not want
full ext - 30 deg 0-45
110
ACL closed chain activities - what do we not want
do not go past 90-deg 60-90
111
ACL repair - weights
we do not want ankle weights distal to the tibia

FF: MSK content (13 decks)

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