MSK 2 Flashcards
C sign is indicative of
femoroacetabular impingement
labral tear tests
+FABER to EADIR
+Thomas test
+resisted SLR
+audible click
ligamentum teres rupture tests
+O’donnell test
+log roll test possible
what does…
+ SLS
+ resisted external derogation test … =?
GTPS
secondary OA
result of prior damage… usually under 40
CPR for hip OA
3/5 = 68% 4/5 = 91% squatting is painful active hip flex causes lateral pain scour with add causing lateral or groin pain passive IR less than 25 active hip ext. causing pain
Adults >50 y.o. with hip OA meet ≥ 1 of the following criteria:
- Moderate anterior or lateral hip pain with WB activities
- AM stiffness < 1 hr duration after waking
- Hip IR < 24° OR IR and hip flexion 15° less than nonpainful side
- Increased pain with PROM hip IR
what is FABER test for
FAI, SIJ
what is FABER to EADIR test for
internal snapping hip, labrum
what is FADIR test for
FAI
what is Flex + IR + axial load test for
posterior labrum tear
what is scour of the hip for
intra-articular pathology
what is over test for
ITB tightness or GTPS irritant
what is Thomas test for
hip flexor/rectus femoris tightness
what is resisted external derogation test for
GTPS
what is ely’s test for
rectus femoris length
tests for meniscus injury
- mcmurray
- apley compression
- thessaly’s
- joint line tenderness
most common avulsion fracture in pediatric knee
tibial eminence fractures
osgood-schlatter
traction on tibial tubercle
sinding Larson Johansson (SLJ)
irritation of growth plate at inferior pole of patella caused by repetitive traction
osteochondritis dessicans (OCD)
focal lesion or injury of the subchondral bone region
after how many weeks should pregnant patients avoid supine?
28 weeks, no more than 3 minutes
common numbness in pregnancy
called neuralgia parasthetica (lateral femoral cutaneus compressed under inguinal ligament)
pregnant women shouldn’t exercise with a BP over…
140/90
could be a sign of preeclampsia
gravida 3 means
pregnant 3 times
para 2 means
live birth 2 times
pelvic floor mm. anterior to posterior
puborectalis
pubococcygeus
iliococcygeus
coccygeus
oligohydramniosis
decreased amount of amniotic fluid
polyhydraminosis
increased amount of amniotic fluid
cervical incompetence
excessive dilation of the cervix
placenta previa
placenta implants low in the uterus
placenta abruptia
separation of he placenta from the uterine wall
scheuermann’s disease/ juvenile kyphosis
avascular necrosis of the vertebral endplate of T6-T12
12-15 y.o.
mid thoracic pain
ankylosing spondylitis
17-45 y.o. men
chronic inflammatory disease
reiter’s syndrome
reactive arthritis to a bacterial infection
white males ages 20-40
usually resolves in 12 months
inflammation of eyes, ulcers on penis, rashes, heart problems
4 subgroups of back pain patients
traction
directional preference
stabilization
mobilization/manipulation
lumbar traction classification
radicular symptoms
don’t centralize with movement tests or worsened
probably not effective treatment
SI mobilization syndrome tests
3 out of 4 tests
- PSIS asymmetry
- standing flexion test
- supine to long-sitting tees
- prone knee flexion test
lumbar manip CRP
-symptoms less than 16 days
- less than 35 deg IR for 1 hip
-hypomobility w./ spring test
-FABQ less than 19
-no symptoms distal to knee
4 or more 95%
3 or more 68%
lumbar CRP stabilization
- less than 40 y.o.
- average SLR more than 91
- aberrant motion with lumbar ARPM
- positive prone instability test
nutation
anterior sacral tilt and posterior iliac tilt
counternutation
posterior sacral tilt (flexion of sacrum cervix curves under) and anterior iliac tilt
abnormal findings of supine to sit
ALS: anterior goes long to short
posterior is opposite
prone knee flexion test
leg length test, if shorter/longer in prone but same in knee flexion, its innominate not tibia length
SIJ clusters
- compression
- distraction
- thigh thrust
- gaenslen’s test
- sacral thrust/faber
Bristow maneuver
align the pelvis by bridging up and straighten legs one at a time
pelvis fractures
Type A: girdle intact
Type B: not intact
Type C: SI joint not connected
muscle energy technique of pelvis
anterior rotation: hamstrings and glutei max
posterior rotation: iliacus and rectus femoris
inflare: adductors
outflare: glutes
autogenic inhibition
isometric contraction followed by a period of relative hypotonicity
reciprocal inhibition
during and following an isometric contraction, antagonist will be reciprocally inhibited
how do you appreciate inflare/outflare
location of umbilicus in relation to ASIS
Canadian c-spine rules
any high risk factor (over 65, dangerous mechanism, paresthesia in extremities)? yes –> X-ray
any low-risk factor (simple rearend, sitting in ED, ambulatory at any time, delayed onset of neck pain, absence of midline tenderness)? no –> X-ray
able to rotate neck 45 degrees each way? no –> x-ray
what to screen for cervical/shoulder pain?
cardiopulmonary, gastrointestinal
5 Ds and 3 Ns
Dizziness Diplopia Dysarthria Dysphagia Drop attacks Nausea Nystagmus Numbness
cervical special tests for instability
alar ligament test
sharp-purser test
transverse ligament stress test
cervical special tests for neurologic issues
spurlings
distraction
shoulder and test
Lhermitte’s sign
all rotation in c-spine comes from where?
C1-C2
lateral flexion comes from ___ c-spine
lower
what’s compressed in TOS
subclavian a. and v. and brachial plexus
what is schmorls node?
degeneration of the endplate, disc material can get in
discs are anistorophic what does that mean?
physical property that has a different value when measured in different directions
types of herniated discs
bulging/protruding: annulus intact
prolapsed/ruptured: annulus failed, but piece attached
extrusions: segment prolapsed AND separated from core
sequestered: like extrusion but farther out
most frequent levels of C-spine disc herniations
C6-C7 and then C5-C6
cervical radiculopathy predictors (4)
- ULTT A
- spurling
- distraction
- cervical rotation less than 60
vacuum phenomena
a collection of gas within the disc space, vertebral body, apophyseal joint or spinal canal
is it more likely to have a fusion in the lumbar or cervical region?
cervical spine
osteoporosis bone density level
2.5 SD below the young adult mean
why does smoking delay healing?
hemoglobin likes CO more then O2… less oxygen delivery
cervical classification categories
centralization mobility exercise/conditioning pain control headache
thoracic manip CPR
Clinical Prediction Rule:
Symptom duration <38 days
Positive expectation that manipulation would help
Side-to-side differences in cervical ROM > 10°
Pain with P/A spring testing of middle c-spine
what is a mulligan PILL respone
pain free, instant, long lasting
what does TNM mean in oncology
T= tumor size N= nodal involvement M= number of met sites
chemo drugs that cause pulmonary toxicity
bleomycin: antitumor antibiotic
chemo drugs that cause neurotoxicity
platinum agents
chemo drugs that cause rheumatic toxicity
almost any chemotherapeutic drug
restorative rehab in onco
minimal or no residual deficit
supportive rehab in onco
pt. will have persistent disability but can minimize this
when does fatigue peak for radiation and chemo
radiation: highest at end of treatment, builds up during
chemo: peaks just after
metabolic oncologic emergency
hypercalcemia (normal 9-11) caused by malignancy, immobilization, poor nutrition, vomiting
chvostek test for jaw
tests CN VII, tap parotid gland, + is twitch
cholecystitis
gallbladder, pain in scapula and T-spine after high fat meal
c sign when opening to R means
R hypomobility
S sign when opening means
hyper mobility
