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Osce - Learn Bitch > MSK > Flashcards

MSK Flashcards

1
Q

The 6 phases of gait cycle?

A
  1. Heel stroke
  2. Foot flat
  3. Mid-stance
  4. Heel- off
  5. Toe -off
  6. Swing
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2
Q

Simmond’s test

A

Used to assess achilles tendon rupture

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3
Q

Further assessments and investigations after a foot/ankle exam?

A
  • Neurovasuclar examination of both lower limbs
  • Examination of the knee and hip joint
  • Further imaging if indicated (eg. x-ray and MRI)
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4
Q

Things to feel in ankle/foot exam?

A
  • Temperature
  • Pulses
  • MTP joint squeeze
  • Ankle and foot palpation
  • Achilles tendon palpation
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5
Q

Anterior inspection of the foot and ankle?

A
  • Scars
  • Bruising
  • Swelling
  • Psoriasis plaques
  • Fixed flexion deformity of the toes
  • Big toe misalignment
  • Calluses
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6
Q

Lateral inspection of the foot and ankle?

A
  • foot arch
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7
Q

Posterior inspection of the foot and ankle?

A
  • Scars
  • Muscle wasting
  • Heel misalignment
  • Achilles tendon
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8
Q

Anterior inspection of the elbow joint?

A
  • Carrying angle
  • Cubitus valgus
  • Cubitus varus
  • Scars
  • Bruising
  • Swelling
  • Abnormal bony prominence
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9
Q

Lateral inspection of the elbow joint?

A
  • Scars
  • Fixed flexion deformity of the arm
  • Muscle wasting
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10
Q

Posterior inspection of the elbow joint?

A
  • Scars
  • Rheumatoid nodules
  • Psoriatic plaques
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11
Q

What to feel for in the elbow exam?

A
  • Temperature
  • Elbow joint palpation
  • Biceps tendon palpation
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12
Q

Special tests in elbow exam?

A
  • Medial epicondylitis: active wrist flexion against resistance
  • Lateral epicondylitis: active wrist extension against resistance
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13
Q

Further assessments and investigations after an elbow exam?

A
  • Examination of the joint above (shoulder) and below (wrist)
  • Full neuromuscular examination of the upper limbs
  • Further imaging if indicated (eg. x-ray and MRI)
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14
Q

Screening questions GALS?

A
  • Do you have any pain or stiffness in your muscles, joints or back?
  • Do you have any difficulty getting yourself dressed without any help?
  • Do you have any problem going up and down the stairs?
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15
Q

GALS - anterior inspection?

A
  • Posture
  • Scars
  • Joint swelling
  • Joint erythema
  • Muscle bulk
  • Elbow extension
  • Valgus/varus deformity
  • Pelvic tilt
  • Fixed flexion deformity of the toes
  • Big toe
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16
Q

GALS - lateral inspection?

A
  • Cervical lordosis
  • Thoracic kyphosis
  • Lumbar lordosis
  • Knee joint hyperextension
  • Foot arch
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17
Q

GALS - posterior inspection?

A
  • Muscle bulk
  • Spinal alignment
  • Iliac crest alignment
  • Popliteal swelling
  • Achilles tendon thickening
  • Valgus/varus deformity
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18
Q

Compound movements in GALS?

A
  • Hands behind head
  • Hands held out in front with palms facing down
  • Hands held out in front with palms facing up
  • Making a fist
  • Grip stength
  • Precision grip
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19
Q

Further assessment after GALS?

A
  • Focussed examination of joints with suspected pathology
  • Further imaging if indicated (eg. X-ray and MRI)
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20
Q

Things to do in legs - GALS

A
  • Passive movement: Knee flexion, extension and passive internal rotation of hip
  • MTP squeeze
  • Patellar tap
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21
Q

Things to do in spine - GALS

A
  • Cervical lateral flexion
  • Lumbar flexion
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22
Q

Dorsum of the hand - inspection

A
  • Hand posture
  • Scars
  • Swelling
  • Skin colour
  • Bouchards nodes, Heberdens nodes
  • Swan neck deformity
  • Z thumb
  • Boutonieres deformity
  • Skin thinning or bruising (steroid use)
  • Psoriatic plaques
  • Muscle wasting
  • Splinter haemorrhages
  • Nail pitting and onycholysis
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23
Q

Swan neck deformity?

A

DIPJ flexion with PIPJ hyperextension

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24
Q

Boutonieres deformity?

A

PIPJ flexion with DIPJ hyperextension

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25
Q

Risk factors for carpal tunnel syndrome?

A
  • Fluid retention (pregnancy, obesity, menopause)
  • inflammation in the area (repetitive strain, athropathy)
  • Space occupying lesion (ganglion cyst, osteophyte, previous fracture)
  • Other (diabetes, Hypothyroidism, smoking)
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26
Q

De Quervain’s tenosynovitis?

A
  • pain on movement of thumb and/or wrist
  • Worsens on heavy lifting
27
Q

Management of Carpal tunnel syndrome?

A
  • Conservative: splinting, activity change, analgesia
  • Medical: corticosteroid injection
  • Surgical: open release, endoscopic release
28
Q

Which nerve is compressed in carpal tunnel?

A

median nerve

29
Q

Main findings on carpal tunnel exam?

A
  • Isolated sensory changes in median nerve distribution with sparing of thenar eminence
  • Weakness in thumb abduction
30
Q

Palmar aspect of the hand - inspection MSK

A
  • Hand posture
  • Scars + Swelling
  • Duptyrens contracture
  • Thenar/hypothenar wasting
  • Elbows
  • Janeway lesions
  • Osler’s nodes
31
Q

Phalen’s test?

A

Ask patient to hold their wrists in maximum forced flexion for 60 seconds
Suggestive of carpal tunnel syndrome

32
Q

Further assessments and investigations after hand and wrist exam?

A
  • Neurovascular examination of upper limbs
  • Examination of elbow joint
  • Further imaging if indicated (x-ray and MRI)
33
Q

Close inspection of the Knee - anterior?

A
  • Scars, bruising, swelling
  • Psoriasis plaques
  • Patellar position
  • Valgus/varus deformity
  • Quadriceps wasting
34
Q

Close inspection of the Knee - Lateral?

A
  • Extension abnormalities
  • Flexion abnormalities
35
Q

Close inspection of the Knee - Posterior?

A
  • Scars
  • Muscle wasting
  • Popliteal swellings
36
Q

Where to measure quadriceps bulk?

A

20cm above tibial tuberosity

37
Q

What causes joint effusion?

A
  • Ligament rupture
  • Septic arthritis
  • Inflammatory arthritis
  • Osteoarthritis
38
Q

Posterior sag sign?

A
  • PCL rupture
39
Q

Anterior drawer test?

A

Anterior cruciate ligament laxity/rupture

40
Q

Posterior drawer test?

A

Posterior cruciate ligament laxity/rupture

41
Q

Lachman’s test?

A

Test for laxity or rupture of the anterior cruciate ligament
Pull tibia onto the femur at 30 degree flexion

42
Q

VaRus stress test?

A

Lateral collateral ligament assessment

43
Q

ValGus stress test?

A

Medial collateral ligament assessment

44
Q

McMurray’s test?

A

Tests for the meniscus tears

45
Q

Further assessments and investigations - knee exam?

A
  • Neuromuscular examination of both lower limbs
  • Examination of the joints above and below (eg. ankle and hip)
  • Further imaging if indicated (eg. x ray/MRI)
46
Q

Anterior inspection of the shoulder?

A
  • Scars, bruising, swelling
  • Asymmetry
  • Abnormal bony prominence
  • Deltoid wasting
47
Q

Lateral inspection of the shoulder?

A
  • Scars
  • Deltoid wasting
48
Q

Posterior inspection of the shoulder?

A
  • Scars
  • Trapezius muscle asymmetry
  • Supraspinatus and infraspinatus asymmetry
  • Scoliosis
  • Winged scapula
49
Q

Empty can test?

A

Supraspinatus

50
Q

Painful arc?

A

Impingement of supraspinatus

51
Q

Lift off test?

A

Subscapularis

52
Q

Scarf test?

A

Acromioclavicular joint function

53
Q

Further assessments and investigations at end of shoulder exam?

A
  • Neurovascular examination of the upper limb
  • Examination of the joints above and below (cervical spine and elbow joint)
  • Further imaging if indicated (x-ray/ MRI)
54
Q

Anterior inspection of the hip?

A
  • Scars, bruising, swelling
  • Quadriceps wasting
  • Leg lenght discrepancy
  • Pelvic tilt
55
Q

Lateral inspection of the hip?

A
  • Flexion abnormalities
56
Q

Posterior inspection of the hip?

A
  • Scars
  • Muscle wasting
57
Q

Trendelenburg gait - pathology

A

Unilateral hip abductor weakness

58
Q

Waddling gait - pathology?

A

Bilateral hip abductor weakness

59
Q

Palpation of the hip joint for?

A
  • Greater trochanter - trochanteric bursitis
  • Temperature
  • Leg length assessment
60
Q

Apparent leg length?

A

Umbilicus and the tip of the medial malleolus of each limb

61
Q

True leg length?

A

Anterior superior iliac spine to the tip of the medial malleolus

62
Q

Further assessments and investigations - hip exam?

A
  • Neurovascular examination of both lower limbs
  • Examination of the joints above and below (lumbar spine and knee joint)
  • Further imaging of indicated (eg. x ray/MRI)
63
Q

Special tests of hip?

A

Thomas
Trendelendburg

Osce - Learn Bitch (7 decks)

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