MSK Flashcards
1
Q
What are the 3 main MSK symptoms?
A
Pain, Stifness, Joint swelling
2
Q
What are the first 3 Qs in a GALS screening?
A
- Any Pain, Swelling or Stiffness in your Muscles, Joints or Back?
- Can you dress yourself completely without difficulty?
- Can you walk up and down stairs without any difficulty?
3
Q
Outline Gait analysis in GALS screening
A
- Walk a few steps, turn, walk back. Look for Symmetry, Smoothness and Ability to Turn Quickly
- Look for Limb Alignment, Spine Alignment, Equal Iliac crest level, Shoulder+Glute+Quad+Calf muscle Bulk and Symmetry, Ability to fully extend limbs, Popliteal Swelling, Feet abnormalities
4
Q
Outline Arm analysis in GALS screening
A
- Put hands behind head. Straighten arms completely. Observe Dorsum: Joint swelling, Deformity, Nails, Skin
- Supinate hands. Observe Muscle Bulk.
- Make fist. Assess: Power grip, Hand and wrist function, RoM in fingers. Squeeze my fingers.
- Touch each finger to thumb. Squeegee across MTPJs (look for tenderness
5
Q
Outline Legs analysis in GALS screening
A
- Assess F+E of knees and Internal Rotation.
- Patellar Tap or Sweep/Bulge Test. (Small effusions may not be seen with Patellar Tap)
- Inspect feet: Swelling, Deformity. Squeeze across MTPJs
6
Q
Outline Spine analysis in GALS screening
A
- Scoliosis, Lordosis, Kyphosis. Aysmmetry.
- Assess Lateral neck flexion.
- Assess lumbar spine flexion: Ask to touch toes, Place fingers on Lumbar vertebrae. Fingers should move apart on flexion and together on extension
7
Q
After GALS, you do Regional Examinations.
What are the 4 stages of these
A
- Look
- Feel
- Move
- Special tests
8
Q
Outline the Hand+Wrist Regional Examination
A
- Look: Swell, Deformity, Wasting, Skin, Nails, Symmetry.
- Feel: Pulses, Eminences, Tendons, Sensation. Joint temps, Squeeze MCPJs. Nodes, Swellings, Palpate wrists, run hand up forearm to look for nodules/ plaques.
- Move: Straighten fingers against gravity, Make Fist. Assess Wrist F+E Actively and Passively. Phalen’s test if suspect Carpal Tunnel Syndrome. Assess muscle power.
- Function/ Special: Grip my 2 fingers, Pinch my finger, Pick up coin/ Undo button
9
Q
Outline the Elbow Regional Examination
A
- Look: From front for Carrying Angle, From side for Flexion Deformity
- Feel: 4arm + Joint Temp. Swelling, Nodule, Plaque, Scars. Palpate M+L Epicondyles and Olecranon (Tenderness or evidence of Bursitis)
- Move: Full F+E Actively and Passively. Pronation+Supination Actively and Passively.
- Special: Put hand to mouth/ behind head
10
Q
Outline the Shoulder Regional Examination
A
- Look: Symmetry, Posture, Wasting
- Feel: Front Joint temp. Palpate bony landmarks (tenderness), Glenohumeral joint line Ant and Post, Muscle bulk of Supraspiantus, Infraspinatus, Deltoids.
- Move: Put hands behind head then back. External rotation with elbow tucked to side. Raise arms behind and to front (F+E). Abduct arm Actively and Passively, looking from front and back
11
Q
Outline the Spine Regional Examination
A
- Look: Wasting, Asymmetry, Scolisis, Posture.
- Feel: Feel down SPs for Alignment and Tenderness. Palpate Paraspinal muscles.
- Move: Run each hand down lateral leg (Lat Flexion). Cervical movements (Rotation, F+E, Lat Flexion). Sitting: Thoracic rotation with arms crossed. Supine: Straight leg raise with DFlexion.
- Special: U+L Limb Reflexes, Pulses, Full Neurovascular exam
12
Q
Outline the Knee Regional Examination
A
- Look: Deformity,Alignment, Valgus/Varus, Wasting, Redness, Swelling, Psoriasis rash (extensor)
- Feel: Skin + Knee Temp, Tenderness around Patella, Baker’s Cyst, Effusion.
- Move: Full F+E Actively and Passively, Anterior Drawer Test (Pull upper tibia towards). Assess M+L Collateral Ligaments (with knee slightly flexed, apply force towards ligament)
- Special: Stand + walk, looking for Valgus/Varus deformity
13
Q
Outline the Hip Regional Exam
A
- Look: Wasting, Deformity when Supine, Leg Lengths (Ant Sup Iliac Crest to Medial Malleosus)
- Feel: Palpate over Greater Trochanter (Tenderness-Trochanteric Bursitis) and Groin
- Move: Full flexion, Thomas Test, I+E Rotation with H+K flexed.
- Special: Trendelenburg Sign. Antalgic or Trendelenburg Gait (waddling
14
Q
Outline Ankle+Foot Regional Exam
A
- Look: Sitting- Symmetry, Nails, Skin. Toe alignment/ subluxation/ Deformity/ Swelling/ Callus. Standing- Foot arch, Achilles’ tendon thickening or swelling, Hindfoot alignment.
- Feel: Forefoot, Midfoot, Ankle Temps. DP Pulse. Squeeze MTPJs. Palpate Midfoot, ankle and Subtalar Joints for tenderness.
- Move: Active + Passive Inversion+Eversion, D+PFlexion at the Ankle and Big Toe
15
Q
What are 3 common causes of Synovitis
A
RA, OA, Gout
