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Physical Assessment 2 > MSK > Flashcards

MSK Flashcards

1
Q

Osteoartrhtisit is MC in:
M or W?
and what anatomical location

A

women

knee

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2
Q

tenderness of the entire joint, crepitus, instability, locking and deformity limiting both active and passive ROM due to pain or stiffness explains?

A

articular disease

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3
Q

point or focal tenderness in regions adjacent to articular strucutres and limits ROM explains?

A

extra-articular dz

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4
Q

which rarely causes swelling, instability or joints deformity:
-extra articular dz
or
-articular dz

A

extra articular dz

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5
Q

__ cervical
__ thoracic
___ lumbar

vertebrae are stacked on?

A

7 cervical
12 thoracic
5 lumbar

*stacked on sacrum and coccyx

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6
Q

bringing chin to chest is?

A

flexion of neck

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7
Q

looking up to the ceiling is

A

extension of neck

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8
Q

looking over the right and left shoulder is

A

rotation of neck

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9
Q

bringing right ear to shoulder and then same with the left is

A

lateral bending of neck

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10
Q

spine ROM

A

flexion–bend forward and touch toes
extension–bend as far back as poss
rotation–rotate side to side
lateral bending–bend side to side

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11
Q

list the articular strucutures (6)

A
  1. joint capsule
  2. articular cartilage
  3. synovium
  4. synovial fluid
  5. intra-articular ligaments
  6. juxta-articular bone
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12
Q

list extra articular strucs (8)

A
  1. periarticular ligaments
  2. tendons
  3. bursae
  4. muscle
  5. fascia
  6. bone
  7. nerve
  8. overlying skin
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13
Q

ropelike bundles of collagen fibrils that connect bone-bone

A

ligaments

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14
Q

collagen fibers that connect muscle-bone

A

tendons

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15
Q

collagen matrix overlying bony surfaces

A

cartilage

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16
Q

pouches of synovial fluid that cushion the movement of tendons and muscles over bone or other joint structures

A

bursae

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17
Q

synovial joints:

  • move freely?
  • what is bone covered by?
  • what are bones separatd by?
  • what lurbicates joint movement
  • ex 5
A

moves freely
bones are covered by articular cartilage
bones are separated by synovial cavity
synovial membrane secreted synovial fluid that lubricates joint movement

EX: shoulder, knee, hip, tmj, interphalangeal joints of hand/foot

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18
Q

cartilaginous joints

  • move freely?
  • what is bone covered by?
  • what lurbicates joint movement
  • ex 2
A

slightly movable
bones sep by fibrocartilaginous discs
discs contain nucleus pulposus that cushions bony movement

EX: vertebral bodies of spine

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19
Q

fibrous joint

  • movement?
  • bones are separated by?
  • ex
A

joints have no movement
-bones sep by fibrous tissue or catilage

ex: sutures of skull

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20
Q

spheroidal joint

  • also called
  • articular shape
  • movement
  • ex
A

ball and socket
articular shape=convex surface in concave cavity
-movement: wide range flexion, extension, abduction, adduction, rotation, circumduction

ex: shoulder, hip

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21
Q

Hinge joint

  • articular shape
  • movement
  • ex
A

shape=flat, plantar

movement: motion is one plane…flexion and extension
ex: interphalangeal joints of hand and foot, elbow

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22
Q

condylar joint

  • articular shape
  • movement
  • ex
A

shape= convex or concave

movenet: movement of two articulating surfaces.. not dissociable
ex: knee, TMJ

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23
Q

how does the knee joint move

A

its a condylar joint (type of synovial joint)

movement of two articulating surfaces— not dissociable

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24
Q

list the common or concerning symps

A
  1. low back pain
  2. neck pain
  3. joint pain
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25
Q

how do we categorize patient complaints? (4)

A
  1. articular vs extra-articular
  2. acute (<6 wks) or chronic (>12wks)
  3. inflammatory vs noninflammatory
  4. localized (monoarticular) vs diffuse (polyarticular)
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26
Q

list the features of inflammation (4)

A

swelling
warmth
redness
pain

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27
Q

ex of single joint injuries

A

tendinitis

bursitis

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28
Q

what can migratory pattern of pain indicate?

A

rheumatic fever

gonococcal arthritis

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29
Q

additive/progressive pattern + symmetric involvement=?

A

RA

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30
Q

cause inflamamtory joint disorders (5)

A
  1. infectious: N. gonorrhea, TB
  2. crystal induced–gout
  3. immune related–lupus, RA
  4. reactive— reactive arthritis
  5. idiopathic
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31
Q

pain in single joint suggests

A

monoarthritis
injury
extra articular dz– tendinitis or bursitis

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32
Q

lateral hip pain with focal tenderness over the greater trochanter is suggestive of

A

trochanteric bursitis

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33
Q

inflammatory arthritis is more comon in?

A

women

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34
Q

caues of extra articular pain

A

bursitis
tendinitis
tenosynovitis–tendon sheaths
sprains from stretching or tearing of ligaments

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35
Q

decrease active and passive ROM

+morning stiffness or gelling

A

articular joint pain

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36
Q

decrease active ROM and normal passive ROM

A

extra-articular joint pain

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37
Q

myalgias

A

“aches and pains”

muscle is the pain

-extra articular

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38
Q

arthralgias

A

joint pain but no evidence of artritis

-extra articular

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39
Q

tendonitis

A

inflamation of tendon

-extra articular

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40
Q

bursitis

A

infalmmatino of bursae

-extra articular

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41
Q

inflamm of tendon sheaths

A

tenosynovitis

-extra articular

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42
Q

sprains

A

stretching/tearing of ligaments

-extra articular

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43
Q

joint pain + butterfly rash on cheeks

A

lupus

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44
Q

joint pain + scaly plaques on extensor surfaces

A

Psoriasis

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45
Q

Joint pain + stiffness especially in morning, better throughoug the day with movemnt

A

RA

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46
Q

joint pain + bulls eye rash

A

lyme

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47
Q

12 red flag s/s for low back pain

A
  1. Age <20 yrs or >50 yrs
  2. History of cancer
  3. Unexplained weight loss, fever, or decline in general health
  4. Pain lasting more than 1 mo or not responding to treatment
  5. Pain at night or present at rest
  6. History of intravenous drug use, addiction, or immunosuppression
  7. Presence of active infection or human immunodeficiency virus (HIV) infection
  8. Long-term steroid therapy
  9. Saddle anesthesia
  10. Bladder or bowel incontinence
  11. Neurologic symptoms or progressive neurologic deficit
  12. Lower extremity weakness
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48
Q

where is location of biceps tendon

what movement does it do

A

bicipital groove
runs medial to greater tubercle
flexion of elbow

49
Q

pain with adduction of arm or pain with crossover tests suggests

A

AC joint disorder

50
Q

pain during apley scratch test suggests

A

rotator cuff disorder or adhesive capsulitis

51
Q

MCC of shoulder pain ?

A

rotator cuff disorder

52
Q

list the pain provocation tests for the shoulder —3

A

painful arc test
neer impingement sign
hawkins impingement sign

53
Q

strength tests for the shoulder —3

A

external rotation lag test
internal rotation lag test
drop-arm test

54
Q

composite tests for the shoulder–2

A

external rotation resistance test

empty can test

55
Q

symmetric involvement –list the disorders (3)

A
  • RA
  • SLE— lups
  • ankylosing spondylitis
56
Q

asymmetric involvement-list the disorders (3)

A

-psoriatic, reactive and IBD assoc arthritis

57
Q

radicular pain signals?

A

spinal nerve compression

MC at C7 or C6

58
Q

MC site for spinal nerve compression

A

C6 C7

59
Q

how to perform painful arc test

+ sign means?

A

Full abduct the patients arm from 0 to 180 degrees

*shoulder pain from 60-120 is a positive test for subacrominal impigement/rotator cuff tendinitis disorder

60
Q

positive painful impinegment test means?

A

subacrominal impingement/rotator cuff teninditis disorder

61
Q

how to do the near impingement test

-positive test means?

A

press on scapula while raising patients arm
+ test=pain during test
means: subacrominal impingement/rotator cuff tendonitis

62
Q

how to do hawkins test

-pos test means?

A

flex shoulder and elbow to 90 degrees with palm down
-next rotate arm interally

postive test=pain during test
means: supraspinatus impingement/rotator cuff tendonitis

63
Q

drop arm test-how to do

+ means?

A

abduct arm to shoulder level and lower it slowly

-Weakness is a + test

64
Q

+ finding for external rotation resistance test means

A

infraspinatus disorder—weakness/pain=pos

65
Q

positive finding for empty can test means?

A

supraspinatus rotator cuff tear

+ test= inability for pt to hold up arm

66
Q

ROM for elbow

A

flexion–bend elbow
extension–straighten elbow
pronation–turn palm down
supination–turn palm up

67
Q

location of ulnar nerve

A

b/w olecranon process and medial epicondyle

68
Q

finkelstein test–what does it show

A

tests for thumb dequervains tenosynovitis

69
Q

what muscles are part of the hamstring

A

semimembranous
gracilis
sartorius
semitendinosus

70
Q

scoliosis

A

deformity of the thorax on forward bending

-esp when the height of the scapulae is unequal

71
Q

height of scapulae are unequal suggests?

A

scoliosis

72
Q

elevation of one shoulder, lateral and rotatory curvature of spine brings head back t midline

A

scoliosis

73
Q

___ can cause unequal leg lengths

A

scoliosis

74
Q

deformity of throax on forward bending

A

scoliosis

75
Q

persistence of lumbar lordosis suggests?

A

muscle spasm or ankylosing spondylitis

76
Q

inward curvature of spine

A

lordosis

77
Q

hunchback… can occur with age

A

kyphosis

78
Q

what is the largest joint in the body?

A

knee joint

79
Q

type of joint for knee?

A

hinge

80
Q

how m any ligaments support the knee

A

four

81
Q

deeply embeded in pelvis and noted for strenght, stability and wide ROM

A

hip joint

82
Q

what is the hip joint noted for?

A

strength
stability
wide ROM

83
Q

what provides stability in hip joint

A

deep fit of femur head into acetabulum

84
Q

what provides hip joint strength

A

strong fibrous articular capsule and power muscles

85
Q

what type of joint is the hip

A

ball in socket–wide ROM

86
Q

can you readily palpate hip joint?

A

no

87
Q

nocturnal hand or arm numbness

A

carpal tunnel

88
Q

droping objects (decr grip strenght) or inability to twist lids off jars?

A

carptal tunnel

89
Q

aching at wrist or forearm

A

carpal tunnel

90
Q

numbness of the first 3 digits

A

carptal tunnel

91
Q

carpal tunnel involves what nerve

-what causes it

A

compression of median nerve

causes: foreceful repeptitive handwork with wrist flexion like— keyboarding, mail, sorting, virbation, or cold envir

92
Q

RF for carpal tunnel (5)

A 
pregnancy 
RA
wrist anatomy 
DM 
hyPOthyroidism
93
Q

what tests do we use to diagnose carpal tunnel

A

phalen test

tinnel test

94
Q

explain median nerve teritory

A

VOLAR (palm) surface of

  • thumb,
  • secnod finger
  • half of ring finger

DORSAL surface:
-inner aspect of thumb
-PIP and up of second third fingers
half of the fourth

95
Q

osgood schlatter dz –what is it

-who gets it

A

tibial tubercle tenderness
-knee pain in adolescents from inflammation of the tendon from kneecap to tibial tuberosity

*repeptitve use injury so MC in kids who play sports–running, jumping,

96
Q

colles fracture affects what nerve

A

median

97
Q

tenderness over the distal radius after a fall is suscious for?

A

colles fracture

98
Q

palpable click or pop along the medial or lateral joint line of the knee?
what + sign would this be?

A

+ test for medical meniscal tear

+mcmurry sign

99
Q

pain or a gap in the medial joint line of the knee is a positive?

A

+ test for MCL injury

100
Q

pain or a gap in the lateral joint line of the knee?

A

+ test for LCL injury

101
Q

degenerative joint dz
+degeneration
+progressive loss of joint cartilage

A

osteoarthritis

102
Q

causes of osteoarthritis

A

mechanical stress w damage to underlying bone, formation of new bone at the cartilage margin

103
Q

crepitus over inflammed joints?

A

osteoarthritis

104
Q

heberden nodes over DIP joints

A

osteoarthritis

105
Q

Bouchard nodes over PIP joints?

A

osteoarthritis

106
Q

what nodes are over DIP joints with osteoarthritis

A

heberden

107
Q

what nodes are over the PIP joints with osteoarthritis

A

Bouchard

108
Q

degree with ROM for the wrist

  • extension?
  • flexion?
  • radial deviation
  • ulnar deviation
A

extension= 70 degrees
flexion=80 degrees

20 degrees radial deviation
30 degrees ulnar deviation

109
Q

adhesive capsulitis

A

aka frozen shoulder
-pain with overall shoulder rotation
+diffuse, dull aching progressive restriction of active and passive ROM
+apley scratch test

110
Q

+ apley scratch test?

A

adhesive capsulitis aka frozen shoulder

111
Q

diffuse dull aching progressive restriction of active and passive ROM and pain with overall shoulder rotation

A

adhesive capsulitis aka frozen shoulder

112
Q

what nerves innervate the wrist and hands

A

median
radial
ulnar

113
Q

mcmurry tests?

A

medial and lateral menisci

114
Q

Valgus tests?

A

MCL

*also called abduction test

115
Q

Varus tests?

A

LCL

*also called Adduction test

116
Q

anterior drawer sign or Lachman tests what anatomical structure?

A

ACL

117
Q

posterior drawer sign tests?

A

PCL

118
Q

+ bulge sign?

A

minor effusion

119
Q

+ balloon sign?

A

major effusion

Physical Assessment 2 (6 decks)

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