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PD Exam 3 > MSK > Flashcards

MSK Flashcards

1
Q

Grade of muscle strength with no contraction/ paralysis

A

0- absent

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2
Q

Grade of muscle strength with slight contraction

A

1-trace

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3
Q

Grade of muscle strength: movement with gravity eliminated

A

2- weak

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4
Q

What would you grade joint with some muscle movement against gravity with little resistance

A

3- fair

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5
Q

What would you grade a muscle with movement against gravity with some resistance

A

4- good

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6
Q

What would you grade a muscle with movement against gravity with full resistance?

A

5- normal

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7
Q

What muscles are responsible for flexion of the shoulder joint?

A

Anterior deltoid
Pec major
Coracobrachialis
Biceps Brachii

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8
Q

What muscles are response for extension of the shoulder?

A

Lat Dorsi
Teres Major
Posterior delt
Triceps brachii

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9
Q

What muscles are responsible for abduction of the shoulder?

A

Supraspinatus
Middle deltoid
Serratus anterior

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10
Q

What muscles are responsible for adduction of the shoulder?

A

Pec major
Coracobrachialis
Lat Dorsi
Teres major
Subscapularis

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11
Q

What muscles are responsible for IR of the shoulder?

A

Subscapularis
Anterior Deltoid
Pec Major
Teres Major
Lat Dorsi

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12
Q

What muscles are responsible for external rotation of the shoulder?

A

Infraspinatus
Teres Major
Post delt

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13
Q

What is nurse maids elbow?

A

MOA: pulling action of forearm
Typically occurs in children
Subluxation of radial head from the annular ligament

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14
Q

What should the width of base of a normal patients gait, from heel to heel?

A

2”-4”

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15
Q

Lordosis typically affects which portions of the spine?

A

Cervical and lumbar

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16
Q

Kyphosis usually affects which portions of the spine?

A

Thoracic and sacrococcygeal

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17
Q

What is the most prominent spinous process that is palpable when a patient performs forward neck flexion?

A

C7- T1

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18
Q

What exam should you do if you suspect your patient has cauda equina syndrome?

A

Rectal exam- inspecting rectal tone

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19
Q

What is an early symptom of hip issues?

A

Difficulty putting on shoes

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20
Q

What are the typical complaints of a patient presenting with hip pain?

A

Pain
Stiffness
Deformity
Limp

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21
Q

Why are difficulty putting on shoes, typically the earliest sign of hip issues?

A

Motion requires ER of the hip which is the first motion to be lost with degenerative hip disease

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22
Q

What is the first motion lost with degenerative hip disease?

A

External rotation

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23
Q

List the order from first to last of the directions of motions lost with degenerative hip disease:

A

ER> Abduction> adduction> flexion

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24
Q

What muscle is responsible for flexion of the hip?

A

Iliopsoas

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25
Q

What muscle is responsible for extension of the hip?

A

Glute max

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26
Q

What muscles are responsible for Abd of the hip

A

Glute medius and minimus

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27
Q

What muscles are response for adduction of the hip?

A

Adductor brevis
Adductor longus
Adductor magnus
Pectineus

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28
Q

What muscle is responsible for IR of the hip?

A

Iliopsoas

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29
Q

What muscles are responsible for ER of the hip?

A

Internal and external obturator
Quadratus femoris
Sup/inf gemellus

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30
Q

What is the LARGEST hinge joint in the body?

A

Knee

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31
Q

What bones make up the knee joint?

A

Femur, tibia, patella

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32
Q

What 4 ligaments provide stability and are key in the maintenance of position of the knee joint relative to the femur?

A

ACL
PCL
MCL
LCL

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33
Q

What muscles are responsible for flexion of the knee?
(Be specific)

A

Hamstrings:
Biceps femoris
Semimembranosis
Semitendinosis

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34
Q

What muscles are responsible for extension of the knee joint?
(Be specific)

A

Quadriceps:
Rectus femoris
Vastus Medialis
Vastus Lateralis
Vastus intermedius

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35
Q

What muscles are responsible for internal rotation of the knee?

A

Satorius
Gracilis
Semitendinosis
Semimembranosis

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36
Q

What muscle is responsible for external rotation of the knee?

A

Biceps femoris

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37
Q

How much of total body weight is transmitted from the ankle to the foot?

A

1/2 total body weight

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38
Q

The ankle joint is what type of joint?

A

Hinge

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39
Q

What bones form overall ankle hinge joint?

A

Talus
Fibula
Tibia

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40
Q

What are the names of the primary joints of the ankle?

A

Tibiotalar joint
Subtalar (talocalcaneal)

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41
Q

What is the primary medial stabilizer of the ankle?

A

Deltoid ligament

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42
Q

What are the primary stabilizers of the lateral ankle?

A

ATFL
Calcaneofibular ligament
PTFL

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43
Q

What muscles are responsible for plantarflexion of the ankle joint?

A

Gastrocnemius
Soleus
Plantaris
Tib posteroir

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44
Q

What muscles are responsible for dorsiflexion of the ankle?

A

Tibialis anterior
Extensor Digitorum longus
Extensor Hallucis longus

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45
Q

At what specific ankle joint to dorsiflexion and plantarflexion occur at?

A

Tibiotalar joint

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46
Q

At what specific joint does ankle inversion and eversion occur at?

A

Subtalar joint

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47
Q

What muscles are responsible for inversion of the ankle?

A

Tibialis anterior and posterior

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48
Q

What muscles are responsible for ankle eversion?

A

Peroneal longus and brevis

49
Q

What time frame is an acute injury?

A

Within the past 2 weeks

50
Q

What is the time frame of a subacute injury?

A

Within the past 3-4 weeks

51
Q

What is the time frame for a chronic injury?

A

1-2 months

52
Q

What is an articular injury?

A

Condition within the joint capsule, articular surfaces, cartilages, synovium, synovial fluid, and intra-articular ligaments

53
Q

What sx do articular injuries typically present with?

A

Swelling and tenderness to the joint capsule
Crepitus
Instability
Locking
Snapping

54
Q

Are articular injuries typically limited in AROM, PROM, or both?

A

Both

55
Q

What is an extra articular injury?

A

Condition within periarticular ligaments, tendons, bursae, muscle, fascia, bone, nerve, and overlying skin

56
Q

What are the sx of an extraarticular condition?

A

Point tenderness in adjacent regions

57
Q

Are extraarticular conditions limited in AROM, PROM, or both?

A

AROM

58
Q

What are the 4 cardinal features of inflammation?

A

Swelling
Warmth
Redness
Pain

59
Q

What is the Mneumonic associated with infection?

A

SHARP

60
Q

What are the sx of an infectious MSK process (think of the pneumonic)

A

Swelling
Heat
Aching
Redness
Pus

61
Q

What are examples of MSK conditIons that are MONOARTICULAR?

A

Traumatic
Crystalline
Septic

62
Q

At are examples of OLIGOARTICULAR MSK conditions?

A

Gonorrhea
Rheumatic fever
CT disease
OA

63
Q

What are examples of POLYARTICULAR MSK conditions?

A

Lupus
RA
Psoriasis

64
Q

What are symptoms of a systemic MSK condition?

A

Fever
Chills
Rash
Fatigue
Anorexia
Weakness

65
Q

What is the primary referred sx of radioculopathy?

A

Foot pain

66
Q

What is the primary referred sx from a hip condition?

A

Knee pain

67
Q

What is the primary referred sx from intraabdominal processes?

A

Shoulder Pain

68
Q

Synovial spheroid joints

A

Ball and stocket
Wide ROM (F/E, Abd/Add, rotation, circumduction)
Convex surface in a concave cavity

69
Q

Synovial Hinge joint

A

Motion in 1 plane (F/E)
Flat, planar, articular surfaces

(Elbow/ IP Jts)

70
Q

Synovial Condylar Joits

A

“Egg in spoon”
Movment of 2 articular surfaces
Allows for F/E, rotation, coronal plane motion
Convex or concave

Knee, wrist, TMJ

71
Q

Cartilaginous joints

A

Slightly moveable

Vertebral bodies and symphysis pubis

72
Q

Fibrous joints

A

Intervening layers of fibrous tissue or cartilage
Immobile

Skull

73
Q

What is the primary special test to dx DeQuarvain’s Tenosynovitis?

A

Finklestein test

74
Q

What is a positive Finkelstein test?

A

Patient makes fist with thumb in
Deviation towards ulnar aspect
+= pain over the abd Pollicis longus and extensor Pollicis brevis

75
Q

What type of splint is indicated for someone with DeQuarvian’s Tenosynovitis?

A

SPICA

76
Q

What does Tinel’s test look for?

A

Carpel tunnel (median nerve entrapment)

77
Q

What type of split do we use for median nerve pain/ positive Tinel’s Test?

A

Volar splint or cock up[

78
Q

Tinel’s Test

A

Tap over the median nerve —> reproduction of pain and Parasthesia proximal and distal to the site

79
Q

What are the 2 carpel tunnel special tests?

A

Tinel’s
Phalen

80
Q

Phalen’s test

A

Patient holds both wrists flexed against each other (inverted prayer) for 30-60min
+ = reproduction of sx of carpel tunnel

81
Q

What are the 2 primary knee special tests?

A

Valgus/Varus stress test
Ant/Post Drawer

82
Q

What does varus/valgus stress test look for?

A

Tests integrity of the collateral ligaments of the knee

83
Q

What is a + varus/valgus stress test?

A

Pain or gap/laxity over the area being tested

84
Q

How is the patient positioned for valgus/varus test?

A

Knee slight flexed; abduct leg off the table about 30 degrees

85
Q

When you are testing for laxity of the MCL, do you place a valgus or varus stress?

A

Valgus

86
Q

when you are testing the LCL, do you place a valgus or varus stress?

A

Varus

87
Q

Describe how to perform a valgus stress test on the MCL

A

Stabilizing hand on the lateral knee
Movement hand on medial ankle

Place varus stress, pushing the ankle laterally

88
Q

Describe how you would perform a varus stress test on the LCL

A

Stabilizing hand on the medial knee
Movement hand on the lateral ankle

Push ankle medially

89
Q

What do the Anterior/Posterior Drawer test test for?

A

Test the integrity of the cruciate ligaments of the knee

90
Q

What is a + anterior/posterior drawer?

A

Pain or gap/laxity of the area being tested

91
Q

How should a patient be positioned for an ant/post drawer test?

A

Hip and knee flexed to 90 with feet flat on the table
Provider thumbs should be over the medial and lateral joint lines

92
Q

Testing the ACL

A

Anterior drawer
Draw the tibia forward, observing the degree of sliding (few degrees= normal)

93
Q

Testing the PCL

A

Posterior drawer
Push tibia posteriorly and observe degree of motion

94
Q

Back pain definition

A

6-12 weeks of pain between the costal angels and gluteal folds that may radiate down one or both legs

95
Q

Common presentation of back pain

A

Awaken with morning pain or develop pain after minor forward blinding, twisting, or lifting

96
Q

Are recurrent episodes of back pain typically more or less painful

A

More painful

97
Q

Red Flag Sx in back pain

A

<20 or >50
Hx of cancer
Unexplained weight loss, fever, or decline in general health
Pain lasting more than 1 month or non-responsive to treatment
Pain at night at rest
Hx of IVDU, addiction, immunosuppresion
Presence of active infection or HIV
Long term steroid therapy
Saddle anesthesia, bladder, or bowel incontinence
Neurologic sx or progressive neurological deficit

98
Q

Why is a red flag for back pain IVDU?

A

Patients with hx IVDU are susceptible to abscesses in the dorsal roots of the spine

Spinous processes will be painful on percussion

99
Q

What are the red flag sx associated with cauda equina syndrome?

A

Saddle anesthesia, bladder, and bowel incontinence

100
Q

What are the sx of lymes disease?

A

ERYTHEMA MIGRANS
Mental status changes
Facial weakness
Nuchal rigidity

101
Q

Sx of IBD

A

Diarrhea
Abd pain
Cramping
Scleritis

102
Q

Sx of rheumatoid arthritis

A

Scleritis
Oral ulcers
Pneumonitis
Interstitial lung disease

103
Q

Sx of Bechet Disease

A

Erythema nodosum
Oral ulcers
Conjunctivitis
Uveitis

104
Q

Sx of Rheumatic fever

A

Fever
Malaise
PRECEDING SORE THROAT
SUBCUTANEOUS NODULES

105
Q

Notable shoulder/ upper arm injuries

A

Anterior shoulder dislocation
AC joint separation
Biceps Tendon rupture

106
Q

Notable elbow issues

A

Olecranon Bursitis
Elbow dislocation
Supracondylar fracture - POSTERIOR SAIL SIGN

107
Q

Notable wrist deformity

A

Colles fracture
(Will see dinner fork deformity)
MOA: fish

108
Q

Hand issues

A

Boutonnière deformity
Swan Neck deformity
Herbeden Nodes
Bouchard Nodes
Mallet finger- they say they jammed it. No pain
Claw hand- usually nerve injury (stroke, congenital)
Trigger finger- gets stuck

109
Q

Sign of a hip fracture

A

Leg length discrepancy
( fx side is shortened in externally rotated)

110
Q

Patellar Tendon Rupture

A

Knee cap displaced upward with elongated area distal to knee cap

111
Q

Patient presents with hot, tender, swollen metatarsal that is PAINFUL ON LIGHT TOUCH. What do you suspect?

A

Gout

112
Q

Deformity where the sole of the foot touches the floor

A

Flat foot

113
Q

High arched feet

A

Cavus foot

114
Q

Patient presents with an MTP that his hyperextended and TIPJ flexed. What is this deformity?

A

Hammer toe

115
Q

Lateral deviation of the great toe
Possible enlargement of the head of the first metatarsal on media side forming a bunion

A

Hallux Valgus

116
Q

Injuries to the torsalmetatarsal (TMT) joint complex are commonly referred to ________________

A

Lisfranc injuries

117
Q

When Lisfran injuries go undetected (which is often) this leads to what?

A

OA
Long term disability

118
Q

Lisfranc injuries result from:

A

Indirect injuries as a result from an axial load placed on a platnar flexed foot that forcibly rotates, bends, or is compressed

119
Q

Common MOA for Lisfranc

A

Falling forward onto a plantar flexed foot

PD Exam 3 (3 decks)

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