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OSCE > Joints > Flashcards

Joints Flashcards

1
Q

SHOULDER JOINT

look - front

A

head and neck posture
symmetry of shoulders

shoulder girdle alignment
deltoid wasting
scars

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2
Q

SHOULDER JOINT

look - side

A

scars

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3
Q

SHOULDER JOINT

look - back

A

trapezius wasting
paravertebral muscle wasting
scoliosis
winged scapula

shoulder girdle alignment
deltoid wasting
scars

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4
Q

SHOULDER JOINT

what happens after looking at front, side, and back?

A

inspect for winged scapula - long thoracic nerve injury

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5
Q

SHOULDER JOINT

what to feel on the front?

A

joint temperature bilaterally

shoulder girdle:
sternoclavicular joint
acromioclavicular joint
acromion
coracoid process
clavicle
head of humerus
greater tuberosity of humerus

repeat on other shoulder

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6
Q

SHOULDER JOINT

what to feel on the back?

A

borders and spine of scapula

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7
Q

SHOULDER JOINT

movements?

A

compound:
- shoulder abd and ext rotation with elbow flexion
- shoulder int rotation

active:
- shoulder flexion/extension
- shoulder abduction/adduction
- shoulder int/ext rotation
- degree and smoothness of scapular movement

passive: same as active (feel for crepitus)

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8
Q

SHOULDER JOINT

normal angle: shoulder flexion?

A

150-180

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9
Q

SHOULDER JOINT

normal angle: shoulder extension?

A

~40

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10
Q

SHOULDER JOINT

normal angle: shoulder abduction

A

up to 180

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11
Q

SHOULDER JOINT

normal angle: shoudler adduction

A

30-40

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12
Q

SHOULDER JOINT

normal angle: ext rotation

A

80-90

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13
Q

SHOULDER JOINT

normal angle: int rotation

A

80-90

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14
Q

SHOULDER JOINT

normal angle: int rotation

A

80-90

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15
Q

SHOULDER JOINT

special tests?

A

empty can - weakness/impingment of supraspinatus

painful arc - impingement of supraspinatus

ext rotation against resistance - tendonitis or tear of infraspinatus

int rotation against resistance - tendonitis or tear of subscapularis

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16
Q

SHOULDER JOINT

how to complete exam?

A

examine joint above - cspine
examine joint below - elbow
assess nv status of both upper limbs
look at any available xrays

17
Q

HAND AND WRIST JOINT

what are you looking for?

A

scars/swelling
deformities
skin and nail changes
muscle wasting

palmar:
dupuytren’s
thenar/hypothenar wasting

elbow:
psoriatic plaques
rheumatoid nodules

18
Q

HAND AND WRIST JOINT

feeling?

A

temp
pulse - radial and ulnar
hypothenar and thenar + palmar fascia
sensation - median and ulnar

turn over hands
sensation - radius
temperature

squeeze MCP joints
bimanually palpate each joint
anatomical snuffbox

medial border of upper arm

19
Q

HAND AND WRIST JOINT

what to do when doing the MCP joint squeeze?

A

observe any signs of pain or discomfort

20
Q

HAND AND WRIST JOINT

what to do when bimanually palpating each joint?

A

check for tenderness or asymmetry

21
Q

HAND AND WRIST JOINT

order of bimanual joint palpation?

A

MCP
PIP
DIP
thumb
wrist

22
Q

HAND AND WRIST JOINT

movements?

A

passive hand flexion/extension
passive wrist hyperextension/hyeprflexion
active extension and flexion

resisted:
- resisted finger adduction/extension
- resisted thumb abduction

23
Q

HAND AND WRIST JOINT

special tests?

A

power grip
pincher
pick up small item
tinel’s
phalen’s

24
Q

SHOULDER JOINT

what does intact ext rotation suggest?

A

infrapinsatus and teres minor are intact

25
Q

SHOULDER JOINT

what does intact int rotation suggest?

A

subscapularis is intact

26
Q

SHOULDER JOINT

what does difficulty in abduction suggest?

A

deltoid and/or supraspinatus lesion

27
Q

what would poor empty can test/jobe test and drop arm test suggest?

A

supraspinatus lesion

28
Q

mx of supraspinatus tear?

A

analgesia - paracetamol + nsaids (ppi)
xr to rule out bony injury
further imaging like uss/mri to confirm diagnosis

physio referral
senior review
potential surgery

OSCE (5 decks)

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