MS Flashcards
What are appropriate questions to ask a pt during a MS exam?
Joint/ neuro
Functionality
What is the order of the MSK exam? (6)
- Inspection
- AROM /PROM
- Strength
- Reflexes
- Special tests
- Palpation
Why is palpation left to last?
avoid TTP
What does joint locking suggest?
Meniscal injury
What does give-way suggest?
Ligamentous ir meniscal injury
What does weakness suggest?
Neurological, myopatyh, tendinopathy, muscle injury
What does a clicking, popping/tearing sensation suggest?
Soft tissue injury/tear
What does tremor suggest?
Neuro issue
True or false: numbness/tingling always prompts concern
True
Why is night time pain concerning?
CA
Broken stuffs
What is tendonitis?
INflammation of a tendon
What is tendinosis?
Degeneration of a tendon
What is tenosynovitis?
Inflammation of a sheath of a tendon
What is tendinopathy?
Disease of a tendon–often painful overuse condition
What is a tremor?
an involuntary, somewhat rhythmic, muscle movement involving oscillations of one or more body parts
What is spasticity?
Velocity dependent resistance to muscle stretch
What is a strain?
Trauma to a muscle
What is arthritis?
Joint inflammation
What is arthrosis?
joint degeneration
What is arthropathy?
Disease of the joint
What is a sprain?
Trauma to a ligament
What is bursitis?
Inflammation of a bursa
What are landmarks used for in inspection?
Assessment of symmetry
What does ROM assess? (3)
Function
Muscle tone
Joint problems
What is the tool used to assess ROM?
Goniometer
Which should be tested first- AROM or PROM?
AROM
What do resistance test evaluate?
muscles/tendons
Smooth weakness indicates what type of cause?
Neurologic cause
Painless weakness indicates what type of cause?
Neurologic cause
Shoulder abduction and elbow flexion = what spinal level?
C5
Wrist extension = what spinal level?
C6
Elbow extension = what spinal level?
C7
Middle finger flexor = what spinal level?
C8
Abduction of the fingers = what spinal level?
T1
Hip flexors = what spinal level?
L2
Knee extension = what spinal level?
L3
Ankle dorsiflexion
L4
Extensor hallucis longus = what spinal level?
L5
Plantar flexion = what spinal level?
S1
Hoffman’s sign = what?
Flicking on the finger looking for extra motion in the index or thumb flicking into felxion
What is the Biceps brachialis reflex testing?
C5
What is the Brachioradialis reflex testing?
C6
What is the triceps reflex testing?
C7
What is the Patellar reflex testing?
L4
What is the medial hamstring reflex testing?
L5
What is the achilles reflex testing?
S1
Babinski’s sign looks for what?
Upper motor lesion
No evidence of movement = what grade of strength?
0/5
Trace movement = what grade of strength?
1/5
FROM with gravity eliminated = what grade of strength?
2/5
FROM against gravity but not against resistance = what grade of strength?
3/5
FROM against gravity, and with some resistance, but weak = what grade of strength?
4/5
FROM against gravity and full strength
5/5
How do you evaluate a ligament?
Elongating them by pushing or pulling on the bones they stabilize to assess for partial or complete tears
How do you evaluate joint surfaces?
Rubbing them against each other to assess for pain d/t trauma/arthritis/degeneration
How do you assess cartilage?
Gently squeezing them between bones or trying to find movements of the menisci that are excessive/painful/limited
What is trendelenburg’s sign?
Falling of the hip d/t damage to the superior gluteal nerve (on the opposite side the falls)
What is genu valgum?
Knock knees
What is genu varus?
Bow legged
What is pes planus?
Flat foot
What is pes cavus?
high arches
Bouchard nodes/Heberden nodes + ?
Osteoarthritis
Swan neck or Ulnar deviation of the wrist = ?
RA
What are heberden’s nodes?
Knobby knuckles caused by osteoarthritis
What is the swan neck deformity?
Flexed DIP + hyper extended PIP indicative of RA
What is boutonniere deformity?
flexed MIP + extended DIP
What is ankylosing spondylitis?
Chronic, inflammatory disease of the spine and sacroiliac joints when sacroiliac joints fuse
Loss of spinal curves can be seen in what two conditions?
Whiplash
Spinal stenosis
What is a Spurling’s test, and when is it positive? What does it test for?
Extension and rotation of the neck. Positive if pain is past the mid humerus
Tests for C5 compression
What is the distraction test for Spurling’s test?
Positive if radicular symptoms are lessened or relieved by pulling up on the head
What does the straight leg raise test for?
Sciatic nerve irritation (L4, L5, S1)
What is Bragard’s / Lasegue’s test? What is it used to confirm
When SLR is +, limb is lowered just until pain is relieved, then ankle is dorsiflexed.
Confirms SLR
What is the Apley scratch test?
Assessment for ROM of the shoulder
Test int rotation, external rotation
What is neer’s test? What does it test for?
raising arm above head, externally rotating
Tests for impingement
What is Hawkin’s test? What does it test for?
Bring arm into plane, then internally rotate
What is the lift off test? What does it test for?
flex at the shoulder and internally rotate to wing scapular, then push back.
Tests for subscapularis
What is the arm drop test? What does it test for?
Drop the arm from an elevated position. Positive if the arm falls past 20ish degrees since deltoid cannot lift above that point
What is the apprehension test? What does it test for?
Flex forearm, abduct the arm with external rotation. If pain, then may be tear
What is Yergason’s test? What does it test for?
Supinate forearm against resistance. Tests for biceps tendon
What is Speed’s test?
Tests the biceps tendon
Arm is straight, palm up. Flex against resistance.
pain in anterior shoulder indicated biceps tendonopathy
What is the empty can test?
Tests the supraspinatus tendon
Arm abducted, internally rotated
What are the three things to inspect at the elbow?
Cubitus valgus
Cubitus varus
Atrophy
Bursitis
What is the appropriate way to test ROM of the elbow?
Elbows against the body to avoid shoulder involvement
What is Tennis elbow?
Lateral epicondylitis
What is Golfer’s elbow?
Medial epicondylitis
What is carry angle?
The normal valgus angle between the upper arm and forearm with the elbow extended
What is the normal carry angle?
less than 20 degrees
What does the varus stress test, test for?
Radial collateral ligament instability
What does the valgus stress test, test for?
Ulnar collateral ligament instability
What does the tinel’s sign, test for?
Cubital tunnel syndrome (ulnar entrapment neuropathy)
What is Cozen’s test test for?
Lateral epicondylitis
What does the Maudsley’s test, test for?
Lateral epicondylitis
What angle should the elbow be in to perform the varus and valgus stress test?
20 degrees
Where is Tinel’s sign done to test for ulnar neuropathy?
Between the medial epicondyle and the olecronon
When does Tennis elbow (lateral epicondylitis) occur?
After repetitive wrist extension and supination
What is Cozen’s test?
Resistance of wrist extension
Tests for lateral epicondylitis
What is Maudsley (3rd finger) test?
REsist the extension of the 3rd digit PIP joint
Tests for lateral epicondylitis
What is phalen’s test?
Test for carpal tunnel
resist wrist extension
What is tinel’s sign?
Tapping at the base of the thumb to assess for carpal tunnel
What is de Quervain’s Tenosynovitis?
Swelling or stenosis of the sheath that surrounds the abductor pollicis longus and extensor pollicis brevis
What causes de Quervain’s Tenosynovitis?
Direct injury or repetitive activity
What are the symptoms of de Quervain’s Tenosynovitis?
Pinching, gripping wrist and thumb movements associated with pai
What is Finkelstein’s test?
Tests for de Quervain’s Tenosynovitis.
Thumb flexed and fingers”fisted” over thumb. Examiner twists wrist into ulnar deviation
TTP at the snuff box is indicative of what?
Scaphoid fracture
Palpable nodule at the DIP joint = ?
Herberden’s node (for osteoarthritis)
Palpable nodule at the PIP joint = ?
Bouchard’s nodes (for osteoarthritis)
Swelling at the MCPs, ulnar deviation of the fingers, and boutonniere deformities =?
RA
What is Dupuytren’s contracture?
Fibrosis of palmar fascia with flexion contraction of the MCP and PIP joints.
Unable to extend 4th or 5th digits
What is trigger finger?
Ligamentous sheath swelling
Pain with flexion of the finger
Rupture of the palmar PIP ligament, synovitis - ?
Swan neck deformitiy
Rupture of central extensor tendon at its insertion into the middle phalanx = ?
Boutonniere’s deformity
What is mallet finger?
Avulsion of extensor tendon at DIP joint
What does the APB test (I hope you know this muscle after anatomy, cause I sure as hell don’t now)?
Median n
What does the ADM test?
Ulnar nerve
What is the grind test?
Pushing thumb and wiggling it. Tests for OA
What is the FABER (patrick) test?
Figure four position, tests sacroiliac joint vs hip cause of pain
Pain lateral in FABER test = ?
Hip
Pain medial/posterior with FABER test = ?
Sacroiliac cause of pain
What is Thmoas test?
That runner’s stretch you never do
Test hip flexors
What is Ober test?
Flex leg at the knee, let fall. If falls, then tight IT band
What is the ballottement test?
Tests for joint effusion
Push fluid down, then patella down
What does McMurray’s test test for?
Medial and lateral meniscus injury
Flex hip, apply, varus/valgus stress, then bring back down
(whichever way you point the heel, is the meniscus you’re testing)
What does Apley’s compression test test for?
Meniscal tearing
Compress a flexed leg and rotate it
What does Apley’s distraction test test for?
Tests collateral ligaments
Lifting a flexed leg and rotation, while pressing down on the posterior thigh, just above the knee
What does the anterior drawer test test in the ankle?
Lateral instability, ATF ligament tear
What does the talar tilt test test for?
Lateral instability in the ATF or CF
Tilt foot toward midline while applying anterior force on ankle
What does the ankle squeeze test test for?
High ankle sprain/ syndesmotic sprain/fracture
What does the ankle external rotation test test for?
Syndesmotic injury
