extra MSK exam Flashcards
__% of patients have IDIOPATHIC back pain
85%
what is one thing you want to evaluate for when a patient has neck pain?
see if it radiates (radicular pain)
hip joint pain is deceptive because it can manifest in what four areas?
groin, buttock, anterior thigh, knee
what is important to know for an accidental injury (from an orthopedic standpoint)?
mechanism of injury
If there’s an intra-articular problem, what type of ROM is affected?
passive AND active
what is stiffness?
perceived tightness or resistance to movement
what “inflammatory” symptom is least indicative of inflammation?
redness
what are some constitutional symptoms sometimes associated with joint problems?
fever, chills, rash, fatigue, anorexia, weight loss, weakness
what are some systemic conditions that can occur with joint problems?
skin conditions- malar rash, scaly plaques, bull's eye, palpable purpura, hives, capillary changes, clubbing scleritis sore throat oral ulcers urethritis pneumonitis
physical activity recommendations (per week)
at least 2.5 hrs of moderate intensity OR 1.25 hrs of vigorous activity
2 or more days/week do moderate or high intensity muscle strengthening
osteoporosis: __% of adults over 50
9%
___% of postmenopausal women have 1 osteo related fracture
50%
screening guidelines for osteoporosis
women 65 yrs or older or younger people whose 10 yr fracture risk is equal or greater than a 65 yr old
osteoporosis vs osteopenia T score
osteopenia: -1 to -2.5
osteoporosis: greater than -2.5
what supplementation is given to prevent fractures from osteoporosis?
ca and vitamin D
prevention of falls guidelines
exercise/PT and/or vitamin D supplementation for at risk adults over 65 yrs old
risk factors for falls
increasing age impaired gait and balance postural hypotension loss of strength medication use comorbid illness depression cognitive impairment visual deficits
what makes up the condylar synovial joint?
articular disc between zygomatic arch and mandibular condyle
what makes up the shoulder girdle?
3 joints- AC, SC, glenohumoral
3 large bones- scapula, clavicle, humerus
3 principal muscle groups- SITS, axioscapular, axiohumeral
what are the SITS muscles?
supraspinatus, infraspinatus, teres minor, subscapularis
what is the “shoulder’s” anchor to axial skeleton?
scapula at sternoclavicular joint (also called scapulothoracic articulation)
supraspinatus- runs _____ glenohumoral joint, attaches where?
above, greater tubercle
infraspinatus/teres minor- crosses glenohumoral joint ________, attaches where?
posteriorly, greater tubercle
subscapularis- originates on ________ surface of scapula and crosses joint _________; attaches where?
anterior, anteriorly; LESSER tubercle
crossover test detects?
arthritis or problem with AC joint
neer’s impingement test detects?
subacromial impingement or RC tendinitis
hawkin’s impingement test detects?
supraspinatus impingement or RC tendinitis
empty can test detects what?
supraspinatus rotator cuff tear
drop arm test detects?
supraspinatus tear or bicipital tendinitis
radial nerve is located where at elbow?
anterior lateral aspect
median nerve hand distribution
palm side- thumb, index, middle, half ring finger
other side- end of index, middle and ring fingers to DIP
radial nerve hand distribution
top of hand- thumb, up to DIP of index, and half of middle (up to DIP joint)
ulnar nerve hand distribution
palm side- pinky and half of ring finger
top of hand- pinky, half of ring finger, up to DIP of middle
what movements does the intervertebral discs allow for?
allow column to curve, flex and bend
line between posterior iliac crests is at what level of the spinal cord?
L4
how do you palpate sciatic nerve?
hip flexed and patient lying on opposite side (midway between greater trochanter and ischial tuberosity)
line between PSIS lies at what spinal cord level?
S2
what is 60% of walking cycle?
when foot is on the ground and bears weight
how far should feet be when walking?
2-4 inches
NV in the hip?
NAVEL (lateral to medial)
patella slides in what groove?
trochlear groove
what is bulge sign?
minor effusion
knee extended, milk fluid downward
force medial fluid laterally
what is balloon sign?
major effusion
thumb and index finger of right hand on each side of patella
left hand compresses suprapatellar pouch
palpate for fluid under thumb and finger
what is balloting patella?
large effusion
compress suprapatellar pouch and push patella against femur
watch for fluid returning to that pouch
what is McMurray’s test used for? how to do it
lateral and medial meniscus
left foot- left hand on knee and right on ankle; externally rotate lower leg and push on knee from lateral side (VALGUS- medial joint stress)
VARUS- internally rotate foot and apply medial pressure (laterally stress joint)
what is valgus vs varus stress used for? how to do it
MCL/LCL
valgus- medial stress (pushing knee medially and pulling ankle laterally)
varus- lateral stress (push knee laterally and pulling ankle medially)
what is Lachman’s used for? how to do it
ACL
knee flexed and externally rotated
pull tibia forward and femur back
what is the longitudinal arch of the foot?
imaginary line spanning foot from calcaneus along tarsals to forefoot
what does Morton’s neuroma affect?
3rd and 4th plantar metatarsal heads
