MS Exam Flashcards
Review of Systems Main Questions?
Back pain (is it more middle or on the sides) Midline or off midline
Neck pain
Hip pain
Muscle pain (myalgia)
Joint pain (arthralgia) or stiffness
Previous problem/trauma
History of: Arthritis Gout Back pain/disc disease Bursitis/tendonitis Fractures Osteoporosis Surgeries/treatments
Review of Systems Injury Questions ?
“Point to the pain”
Mechanism of injury (MOI)
Tenderness/pain
Inflammation
Hx of repetitive motion
Swelling (edema, effusion)
Discoloration (erythema, ecchymosis
Review of Systems More specific questions ?
Weakness – guarding or true
Limitation of motion/activities
Hand dominance
Nocturnal pain - wake you up at night, generally more severe like malignancy
Systemic features:
Fever/chills, rash, anorexia, weight loss, weakness
help you with differential
systemic features versus not
Review of Systems Main Questions: Back Pain ?
Midline or off midline
Radiation
Bowel/bladder dysfunction
compression of the spinal cord
Review of Systems Main Questions: Neck Pain ?
Radiation to shoulders, arms
more nerve related
Review of Systems Main Questions: Hip Pain ?
Typically groin or buttocks area
Can be anterior thigh or solely in the knee
knee but it can be hip
Review of Systems Main Questions: Joint pain (arthralgia) or stiffness ?
Mono or polyarticular
one or many
Pattern of involvement
symmetrical
Associated symptoms
F, fatigue or malaise
Review of Systems Main Questions: Previous problem/trauma
?
previous trauma or problems with same joint
Review of System s Injury Questions: “Point to the pain” ?
can you point to it - narrow down anatomy
muscle stuff is so close to the surface so they can usually pinpoint the pain
Review of Systems Injury Questions: MOI ?
how did you do it? which angle did you get hit at?
outside of knee impact - then think medial collateral ligament damage
Review of Systems Injury Questions: tenderness / pain ?
Timing – duration, sudden/gradual, steady/intermittent
Quality, severity
Aggravating/alleviating
Review of Systems Injury Questions: Inflammation ?
Tenderness, warmth, redness of areas
inflammation think more infection or trauma
Review of Systems Injury Questions: Hx of repetitive motion ?
elbow hurts and they a cashier
Review of Systems Injury Questions: Swelling (edema, effusion) ?
effusion - inside the joint
edema id the soft tissues around the joint swelling
Review of Systems Injury Questions: Discoloration ?
erythema, ecchymosis
red or blue
Review of Systems More specific questions: Weakness ?
guarding or true
true cause no strength
or weak and cant cause it hurts
Review of Systems More specific questions: Limitation of motion / activities ?
can u brush you hair or teeth, can you eat with that arm
Review of Systems More specific questions: Hand dominance ?
are you R or L handed ( dont care if back pain)
Review of Systems More specific questions: Nocturnal pain ?
wake you up at night, generally more severe like malignancy
Review of Systems More specific questions: Systemic features ?
Fever/chills, rash, anorexia,
weight loss, weakness
help you with differential
systemic features versus not
Physical Exam: Need to recall ?
Need to recall anatomy
Bony landmarks
Soft tissue structures
Reviewed in Bates -
Chapter 16
Three types of joints ?
Fibrous
Synovial
Cartilaginous
Fibrous joints are ?
Immovable
Fibrous joints examples ?
skull
**no range of motion to it **
Synovial joints are ?
freely movable
Synovial joints are comprised of ?
Ligaments – bone to bone
Joint capsule
Synovial cavity
Synovial membrane
Articular cartilage
- *a lot of parts to them
- more prone to injury**
Synovial joints own notes ?
loss of artclar cartilgae is bone on bone
synovial fluid provides a cushion
Synovial membrane- secrete synovial fluid and the membranee is pouched
Synovial joints examples ?
Spheroidal
Hinge
Condylar
Synovial Joint: Spheroidal example ?
ball and socket
hip, shoulder ( like a cup) wide ROM
Synovial Joint: Hinge example ?
one plane f
fingers
Synovial Joint: Condylar example ?
convex/concave surfaces
knee, epicondylas , tempomandibular joint
Cartilaginous Joints have ?
less movement
Cartilaginous Joints examples ?
vertebrae
No synovial cavity, but a fibrocartilaginous disc
disc instead of synovial cavity
Disc: Outer ?
annulus fibrosis
Disc: Inner ?
nucleus pulposus
**herniated disc - stuff can leak out and then FB reaction to it **
Bursae: ____ shaped, _____ filled sac
disc
fluid
160 of em!
Bursae: where do they lie ?
point of friction
Point of friction examples ?
Between skin and convex surface
Where tendon or muscle rub against bone, ligament or other muscle
**help provide a cushion
over olecranon**
Bursae facilitate ?
movement
Musculoskeletal Exam: be systematic like ?
Inspection - edema, erythema, symmetric
Palpation
ROM
Special maneuvers
Can be thorough in a few minutes
If problems noted – do a more detailed exam
Physical Exam General Assessment: General appearance ?
watch gait when they dont know you watching
Physical Exam General Assessment: Posturing/splinting ?
arm supporting or guarding