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Medicine: Data Interpretation > MSK > Flashcards

MSK Flashcards

1
Q

What are you assessing for in gait as the patient is walking ?

A
  • smoothness
  • symmetry
  • turning ability/speed
  • armswing
  • stride length
  • pelvic tilt
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2
Q

What do you inspect for from the back during GALS exam ?

A
  • muscle bulk and symmetry: shoulders, paraspinals, gluteal, calf
  • bones: level shoulders and iliac crests
  • abnormalities: popliteal swellings, hind foot abnormalities
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3
Q

What are you inspecting for from the side in a GALS exam ?

A
  • Normal cervical and lumbar lordosis
  • Normal thoracic kyphosis
  • knee flexion/hyperextension
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4
Q

What movements are tested for the spine part of GALS ?

A
  • cervical lateral flexion (ear to shoulder)
  • TMJ - jaw side to side
  • hip and lumbar flexion (touch toes)
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5
Q

What do you inspect for from the from in a GALS exam ?

A
  • Muscle bulk and symmetry: shoulders, quadriceps
  • elbow flexion & look for rheumatoid nodules
  • knee swelling/deformity (varus, valgum), foot arches, fore and mid foot abnormalities
  • hands - ulnar deviation, heberdons nodes etc
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6
Q

Which movements are tested in the arms part of GALS ?

A
  • shoulder abduction and external rotation (hands behind head)
  • shoulder internal rotation (hands behind back)
  • elbow extension (elbow down and straighten arm)
  • wrist and finger extension (prayer sign)
  • wrist flexion (reverse prayer)
  • power grip
  • precise grip
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7
Q

What are the 3 questions to be asked at the start of a GALS screening exam ?

A
  1. Any pain or stiffness in muscles, joints or back
  2. Can you dress yourself completely without difficulty
  3. Can you walk up and down the stairs without difficulty
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8
Q

What movements are tested in the legs during a GALS exam?

A
  • knee flexion & internal rotation if the hip

- ankle Dorsi and plantar flexion

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9
Q

What drugs may cause adverse MSK effects ?

A
  • statins - myalgia, myopathy
  • ACEi - myalgia
  • anticonvulsants - osteomalacia
  • quinolone - tendonopathy
  • diuretics, aspirin, alcohol: gout
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10
Q

Why may it be appropriate to take a sexual history in a MSK history ?

A

Reactive arthritis and Reiter’s syndrome caused by chlamydia and gonorrhoea

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11
Q

What psoriatic changes may be seen in the nails ?

A

Pitting, Oncholysis

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12
Q

Where is sensory innervation if radial nerve best tested ?

A

Thumb or index webbing

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13
Q

Where would you test sensory supply of median nerve

A

Index finger

Or thenar eminence

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14
Q

Where would you test ulnar nerve sensory supply ?

A

Little finger

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15
Q

What movements are tested in a focused hand exam ?

A
  • straighten fingers against gravity
  • make fist
  • prayer and reverse prayer
  • thumb abduction
  • finger spread
  • power grip
  • pincer grip
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16
Q

How do you test power if median nerve ?.

A

Thumb abduction against resistance

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17
Q

How do you test power of ulnar nerve ?

A

Finger spread against resistance

18
Q

Special test for carpel tunnel ?

A

Phalens

19
Q

What are the characteristics of bone pain ?

A

Boring, penetrating pain often worse at night

20
Q

Which type of joint disease has characteristic early morning stiffness ?

A

Inflammatory joint disease

21
Q

Which type of joint pain gets worse as the day goes on ?

A

Mechanical e.g. Osteoarthritis

22
Q

What is valgus joint deformity ?

A

The bone or part of limb distal to joint is displaced laterally
E.g, valgus deformity of knee = knock knee

23
Q

What is varus joint deformity ?

A

Bone or part of limb distal to joint is deviated medially

E.g. Varus knee deformity = bow leg

24
Q

Limitation of active movement of a joint only reflects what ?

A

Underlying pathology of tendons and muscles surrounding joint

25
Q

Limitation of both active and passive movements suggest what ?

A

An intrinsic joint problem

26
Q

What are you inspecting for on the elbow ?

A
  • scars
  • swellings
  • rashes
  • olecranon bursitis
  • rheumatoid nodules
  • psoriatic plaques
27
Q

What movements should be assessed in an elbow exam ?

A
  • full extension and flexion
  • pronation and supination

*actively and passively

28
Q

Which epicondyle is affected in golfers elbow ?

A

Medial

29
Q

How would you assess the function of the elbow joint ?.

A

Ask patient to pour glass of water and out on a jacket

30
Q

What movements are tested in a shoulder exam ?

A
  • hands behind head
  • hands behind back
  • extension - in front
  • flexion - behind
  • abduction - out to side (assess scapula)
  • addiction - by side
31
Q

Limited external rotation if the shoulder with elbow flexed at 90 degrees suggests which condition ?

A

Frozen shoulder

32
Q

What movements of the spine are assessed in a regional spine exam ?

A
  • lumbar flexion and extension
  • lateral flexion (run hand down side of leg)
  • cervical - lat flexion, rotation (look over side), flexion (chin to chest), extension
  • thoracic rotation
  • straight leg raise with dorsiflexion
33
Q

What is included in the brief neuro vascular exam in a regional spine exam ?

A
  • limb reflexes
  • dorsiflex big toe against resistance
  • peripheral pulses
34
Q

What would you palpate for in a regional spine exam ?

A

Tenderness in: spinous processes, sacroiliac joint, paraspinals

35
Q

What is the classic appearance of the spine in ankylosing spondylitis ?

A

Question mark spine wi exaggerated thoracic kyphosis and loss of lumbar lordosis

36
Q

What is palpated for in a regional hip exam ?.

A

Greater trochanter and surround area for tenderness

Temperature

37
Q

What movements are assessed actively in a regional hip exam ?

A

Full flexion

Abduction, adduction

38
Q

Which movements are assessed passively in a regional exam of the hip?

A

Flexion (and actively)
Internal and external rotation
Extension (prone position)

39
Q

What is done in palpation on a regional exam of the knee ?

A
  • temp (from mid thigh down)
  • border of patella for tenderness
  • behind knee for popliteal swellings
  • patella Tap/bulge sign
  • patella tendon (knee at 90 degrees)
40
Q

What movements are assessed in a regional exam of the knee

A

Flexion and extension (actively and passively)

*lift feet with straight leg to look for hyperextension)

Medicine: Data Interpretation (6 decks)

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