MSK

Question 1

what are you looking for during inspection

Answer 1

scars (suggestive of previous surgery eg knee replacement if scar down the middle or trauma to the joint) wasting of muscle bulk (due to disuse, especially if there is chronic pain such as arthritis. Muscle atrophy LMN lesion (peripheral neuropathy) perform neurological exam ). Knee deformities: valgus (knock knees- genu valgum-gum stick together-genetic ) valrus (bow legged- genu varum-rum makes you spread your knees-osteomalacia )

Question 2

what do you feel

Answer 2

: for temp (use banck of your hands, feel for temperature at patellar, above and below joint and compare left to right hand side). Warmth (inflammatory conditions (OA/ septic A this can cause irreplaceable damge to joints). Feel around patella, medial and lateral joint line, tibial tuberosity, head of fibula and popliteal fossa

Question 3

what is swelling in popliteal fossa

Answer 3

baker’s cyst

Question 4

what are effusions

Answer 4

excess synovial fluid caused by arthritis or damage to internal structures of the knee such as meniscus

Question 5

what is the tap method

Answer 5

pt knee extended, slide non dominant hand done thigh to empty suprapatellar pouch, then press firmly over patella with your dominant hand (moderate effusion- feel tap as patella hits femur).

Question 6

when is the tap method used

Answer 6

big effusion

Question 7

what is the sweep method

Answer 7

knee extended, non dominant hand sweep upward on medial side of knee to empty medial compartment , keep non dominant hand there and then use right hand to sweep downward on lateral side of knee to empty lateral compartment. Small effusions: see ripple/ bulge of fluid on medial side of knee

Question 8

why could there be reduced ROM

Answer 8

due to arthiritis

Question 9

what could cause anterior draw

Answer 9

dammage to MCL, signficant movement compared to other leg=laxity of ACL

Question 10

when should you not interpret anterior draw as positive

Answer 10

when there is a posterior sag (PCL tear)

Question 11

what is the ROM of leg

Answer 11

0 (full extension)–> 135. can be -10 and normal if both sides are -10

Question 12

What are the 4 quadricep muscles

Answer 12

(rectus femoris, vastus lateralis, vastus intermedius, vastus medialis)

Question 13

What type of bone is patella

Answer 13

sesamoid

Question 14

Which nerve near to fibula is at risk of damage

Answer 14

(common peroneal nerve)

Question 15

What lig prevents tibia from sliding backwards

Answer 15

PCL-posterior cruciate ligameent

Question 16

What is the correct exposure for MSK:

Answer 16

enough to see knee joint, quadriceps and calf muscles.

Question 17

Knock kneed?

Answer 17

Genu valgum

Question 18

What side do you sweep upwards when performing sweep test for small effusions

Answer 18

medial side)

Question 19

Where must practitioner’s hand be placed when assessing hyperextension?

Answer 19

At ankle (hold achilles/ calconeal tendon)

Question 20

How does arthirits affect ROM?

Answer 20

Dec

Question 21

When providing varus stress on knee, which lig is tested?

Answer 21

LCl

Question 22

What position must patients legs be when looking for post sag sign?

Answer 22

Feet falt on couch, knees bent at 90 degrees

Question 23

osteoarthirits

Answer 23

: pain worse on movement, Hx trauma to knees, joint space narrowing, osteophytes, subchondral sclerosis, subchondral cysts on x ray, dec ROM, middle-old age, warm on flare up

Question 24

septic arthirits

Answer 24

knee tender and hot, positive tap test, dec ROM, (reactive A or RA flare up) tenderness

Question 25

rheumatid arthiritis

Answer 25

female, pain better with movement, Hx of autoimmune disease.

Question 26

sports

Answer 26

open medial joint line, positive ant draw, pain on passive flexion (MCL and ACL both attached to medial meniscus so due to damage to medial meniscus

Question 27

where does acl attach

Answer 27

bottom attach on tibia, and tip attach behind femur

Question 28

how to tell left or right

Answer 28

fibula- always lateral. and from that should be able to orientate

Question 29

different parts of knee

Answer 29

bones (femur, tibia, fibula), menisci (medial, lateral), ligaments (ACL/PCL/MCL/LCL) muscles (quadriceps, hamstrings, gastroconemius, popliteus, plantaris.) tibial nerve, common fibular nerve, popliteal artery and vein

Question 30

what level is patella

Answer 30

level of femur