more msk Flashcards
the Ortolani test is for
hip dysplasia
Wells Clinical Decision Rule for Deep Vein Thrombosis
previously diagnosed DVT (1)
active cancer (1)
paralysis, paresis, or recent immobilization of LE (1)
bedridden for more than 3 days or major surgery
within the previous 12 wks (1)
localized tenderness in the center of the posterior calf , the popliteal space, or along the femoral vein in the anterior thigh/groin (1)
entire LE swelling (1)
u/l calf swelling (more than 3cm than other side) (1)
u/l pitting edema (1)
collateral superficial veins (1)
an alternative dx is as likely (or more likely) than DVT like cellulitis, postoperative swelling, calf strain (-2)
a score greater or equal to ____ means a DVT is likely
2
what are the Ottawa Ankle Rules used for?
determines if a pt needs imaging
and ankle radiograph should be performed if there is pain in the malleolar region with any of the following (3 things):
- bone tenderness at the posterior edge of the distal 6cm/tip of lateral malleolus
- bone tenderness at the posterior edge of the distal 6cm/tip of medial malleolus
- inability to WB for at least 4 steps immediately after injury at the time of eval
ottawa ankle rules
a foot radiograph should be performed if there is pain in the mid foot region with any one of the following (2 things):
- bone tenderness at navicular bone
- bone tenderness at the base of the 5th metatarsal
ottawa ankle rules
name the TOS special tests
CHARAW
costoclavicular / military brace
halstead
adsons
roos
allens
wright
toe in, subtalar pronation, medial femoral and tibial torsion are all associated with what at the hip?
anteversion
what is the normal range for anteversion in adults?
8-15 degrees
what test determines the angle of anteversion
Craig’s test
which shoulder diagnosis is most commonly characterized by painful arc 60-120 degrees, and pain at night?
shoulder impingement
you have tingling into 4th and 5th digits and muscle wasting over the hypothenar eminence. what test would best assess integrity of the nerve?
froment’s sign
will show weak adductor pollicis, innervated by ulnar nerve
What does Finklestein’s test look for?
deQuervain’s
make a fist around the thumb, ulnar deviation
what is the special test for lateral epicondylitis, where the patient extends third digits against examiner resistance?
Maudsleys’s
what mob should I do to improve wrist extension?
volar (palmar) glide of carpal bones
what special test identifies tightness of hip flexors?
thomas test
a + Froment’s sign will mean (pinching paper with thumb and thumb flexes)
ulnar nerve palsy
name the shoulder impingement special tests
hawkins
neers
jobes empty can
yocum
name the RTC special tests
ER lag
belly press (subscap)
lift off sign (subscap)
drop arm
IR lag
hornblowers test (teres minor)
SLAP special tests?
biceps load II
crank
clunk test
active obriens
AC joint injury special tests
horizonal add
paxinos (press AC joint and pain)
AC sheer test
following a bankart repair, what shoulder movements should you avoid?
abduction and ER
for TMJ, is popping/clicking a sign of disc displacement with reduction or without reduction?
with
what muscle opens the mouth?
lateral pterygoid
what muscles close the mouth?
masseter
medial pterygoid
temporalis
what muscles protrude the mandible?
lateral pterygoid
medial pterygoid
what muscles retract the mandible
temporalis
what muscles perform lateral deviation of the mandible
lateral ptery
medial ptery
if a patient cannot open their mouth that much and there is deviation to the same side, what is the diff dx?
hypomobility
if a patient has increased mouth opening and deviating to the opposite side, what is the diff dx?
hypermobility
TMJ: if clicking is heard, but there is no deviation or difficulty with mouth opening, what is the diff dx?
disc displacement with reduction
TMJ: if a pt has pain and limited mouth opening, no deviation, what is the diff dx?
synovitis
if a patient has pain, limited mouth opening, and deviation to the same side, what is the diff dx?
capsulitis
a 5 year old m patient has worsening hip pain with activity and limited extension, abd, and IR. what is the likely dx and how would you treat it?
legg-calve-perthes
conservative treatment and bracing (scottish rite brace)
a 13 year old overweight pt has worsening hip pain with activity, limping, and limited flexion, abduction, and IR. what is the likely dx and how would you treat it?
slipped capital femoral epiphysis
surgical treatment to stabilize
what two braces can be used for congenital hip dysplagia?
frejka pillow and pavlik harness
list the post ACLR precautions
graft is most vulnerable at 6-8 wks
no knees over toes with CKC/squats
avoid CKC 60-90
no ankle weights distal to tibia
no OKC 0-45*
name the knee diff dx: a patient has popping, locking, catching of the knee during movement with joint line tenderness, as well as pain with knee hyperextension and full flexion
meniscus
name the knee diff dx: a 25 y/o f patient has peripatellar pain, lateral patellar tracking, pain with squatting, prolonged sitting
PFPS
name the knee diff dx: pain at tibial tuberosity, due to excessive activity in adolescents and poor flexibility
osgood schlatter
if my patient had an achilles tendon repair surgery, i need to avoid __________ stretching for _____ weeks
plantarflexion
12
diff dx: pt has heel pain that is worse with the first steps in the morning and after periods of inactivity. medial calcaneal tubercle TTP and pain with DF of great toe
plantar fasciitis
what movements should you avoid with osteoporosis?
rotation and flexion
what is the T-score range for osteoporosis and osteopenia?
osteoporosis: below -2.5
osteopenia betwen -1.1 and -2.5
-1 or higher is normal bone density
what are the loose packed positions for:
hip
GH joint
elbow
knee
hip: 30 degrees of flexion
GH joint: 55 degrees abduction
elbow: 70 degrees flexion
knee: 25 degrees of flexion
