MSK

Question 1

Format for MSK?

Answer 1

Subjective-history
Objective-exam
Analysis-diagnosis
Plan-Do what?

Question 2

Subjective Examination AIM

Answer 2

To determine primary concern
To assist in the determination of a diagnosis and prognosis
To identify any precautions or contraindications
To determine any yellow, red or blue flags

Question 3

Format of History

Answer 3

Introduction
Patient Profile
Social History
History of Present Illness
Past Medical History
Aggravating and Easing factors
Previous interventions
Medications
Investigations
General Health Screening (red, yellow, blue flags)
Opinion of patient

Question 4

Flag meaning

Answer 4

Red flag-NIFTI (neurological, infection, fracture, tumour, inflammation-serious medical pathology)
Yellow flags-Psychological issues (anxiety)
Blue-litigation (sueing) involved

Question 5

A scan exam?

Answer 5

A quick scan of the upper or lower part of the body involving the spine and extremities
Used to rule out symptoms that may be originating from the spine and referring to another part of the body
Cervical or lumbar assessment and active movements and neurological exam (dermatomes and myotomes)

Question 6

When do we use the scan exam?

Answer 6

When neurological signs and symptoms are present or when it is not clear what is causing the symptoms

Question 7

What is an example of neurological pain?

Answer 7

Neuro=sharp, burning, stabbing pain

Question 8

Objective Examination

Answer 8

Posture
Alignment
Bony and soft tissue symmetry
Skin texture, tone, colour, and temp
Patient’s attitude and willigness tomove

Question 9

Examination of Movement

Answer 9

willingness to move
when and where pain occurs
intensity and quality of the patient in pain
the ROM available and is it symmetrical
The pattern of movement (trick movement)
The movement of associated

Question 10

Spinal Joint movement

Answer 10

flexion
extension
rotation
SB

Question 11

Peripheral Joints

Answer 11

Upper-TMJ, shoulder, elbow and wrist/hand
Lower-hip, kneww, ankle/foot

Question 12

How do you examine peripheral joint upper (TMJ)

Answer 12

TMJ
place index fingers over tragus (ear flap)
Test for open, close, retraction, protraction, lateral deviation
Note any pattern f restriction, pain or assymmetry

Question 13

Examination of movement-peripheral joint-upper (shoulder)

Answer 13

elevation tests to include-abduction and flexion
medial and lateral rotation

Question 14

Examination of movement-peripheral joint-upper-elbow

Answer 14

flexion
extension
supination
pronation

Question 15

Examination of movement-peripheral joints (upper) hand and wrist

Answer 15

Wrist-flexion, extension, radial deviation, ulnar deviation
Hand-flexion, extension, abduction, adduction, opposition

Question 16

Examination of movement-lower-hip joint

Answer 16

flexion
extension
abduction
adduction
medial rotation
lateral rotation

Question 17

Examination of movement-peripheral lower

Answer 17

knee joint-flexion and extension

Question 18

Examination of movement-peripheral joints-ankle and foot

Answer 18

ankle-plantarflexion
dorsiflexion
inversion
eversion

foot-toe flexion
toe extension

Question 19

What is a myotomes

Answer 19

Myotomes-a muscle or a group of muscles supplied by a single nerve root

Question 20

Dermatomes

Answer 20

The sensory distribution of an area of skin supplied by a single nerve root

Question 21

Reflexes

Answer 21

An involuntary muscle contraction in response to a quick stretch of that same muscle

Question 22

How do you test for myotomes

Answer 22

Have the patient seated comfortably
place the tested joint in its resting position
“don’t let me move you”
test with force

Question 23

How do you test dermatomes

Answer 23

test the whole dermatome
do both sides at once
light touch
(if impaired do sharp/dull)

Question 24

Reflexes

Answer 24

used to determine the integrity of the nerve or nerve roots supplying the reflex
patient must be relaxed
tendon is put on a slight stretch
apprpriate stimulus is applied by the reflex hammer onto the tendon
Jendrassik maneuver

Question 25

Deep Tendon reflexes

Answer 25

biceps/brachioradialis
triceps
patellar tendon
achilles tendon

Question 26

Upper Motor Neuron (UMN)

Answer 26

Babinski
clonus
hoffman

Question 27

Deep Tendon Refle (LMN) Grading

Answer 27

0=absent
1=hypo
2=normal
3=hyper/brisk
4=clonus

Question 28

Special Tests for an Upper Scan

Answer 28

Foraminal Compression (Spurling) axial load to the top of head directed downwards (positive test is pain down the side the head is directed towards)
Distraction Test-upward pull on neck (positive test is if the pain is relieved or decreased when the head is tractioned)

Question 29

Lower Scan exam

Answer 29

Straight leg raise (SLR) life and lower leg
Prone knee bend (positive is shooting pain down the front of the thigh)

Question 30

Regional Examination

Answer 30

Observation
Range of Motion
Strength
Special Tests
Palpation

Question 31

Strength testing in a regional examination

Answer 31

0=no contraction
1=slight contraction
2=full passive ROM, no gravity
3=full ROM, with gravity
4=normal, active ROM, full resistance

Question 32

Special tests in a regional examination

Answer 32

This is to confirm your potential diagnosis and to identify the key structures and tissues at fault
Diffrentiates between structures (Contractile vs noncontractile)

Question 33

Special Tests-do they rule out disease?

Answer 33

They are suggestive of a particular disease but do not necessary rule out the disease when negative
positive also is also not conclusive

Question 34

Regional Exam-palpation

Answer 34

Reserved to the end of the exam due to the provocative nature

Question 35

Analysis

Answer 35

Brief statement that includes patients age, sex, purpose of visit and onset of presenting symptoms
Diagnosis-structure at fault
Cause-underlying cause of dysfunction
Stage-actube/chronic

Question 36

Plan

Answer 36

Treatment goals