MSK Flashcards
What is the convex-concave rule?
Convex-concave -
covex surface moves/glides OPPOSITE to proximal part/shaft of bone (ie. humerus on labrum in shoulder flexion or abd)
Concave-convex - concave surface moves/glides in the SAME direction to proximal part/shaft of bone (ie. ulna on humerus in elbow flexion)
What are normal end-feels?
Soft
Firm
Hard
What do the types of pathological end-feels feel like? Boggy? Firm? Rubbery? Empty? Hypermobility?
Boggy- edema, joint swelling
Firm with decreased elasticity- fibrosis of soft tissue
Rubbery- muscle spasm
Empty- losse, then hard, muscle guarding
Hypermobility- edn feel at later time than opp side
What are symptoms of DJD?
pain/stiffness on rising pain eases through morning 4-5 hours pain increases with repetition/bending constant awareness of discomfort with episodes of exacerbation soreness and nagging pain
What are symptoms of facet joint dysfunction?
stiff upon rising pain eases within 1 hour loss of motion sharp pain movement in pain-free range reduces symptoms stationary positions increase symptoms
What are symptoms of disc dysfunction with nerve root impingement?
no pain in reclined position
pain increases with increasing weight bearing activities
shoorting, burning, stabbing pain
altered strength and ability to perform ADLs
What are symptoms of spinal stenosis?
pain in related position flexed position decreases pain extended position increases pain numbness, tightness, cramping walking increases symptoms pain persists for hours after assuming resting position
What are symptoms of vascular clauditcation?
consistant pain in all spinal positions pain starts with physical exertion relieved with rest within 1-5 min numbness decreased/absent pulse
What are symptoms of neoplastic disease?
gnawing, intense, penetrating pain
pain will wake patient at night
pain not resloved by position change, time of day, or activity level
What are x-rays for?
bony tissues, dysfunction of bones
What is CT used for?
complex fractures, facet dysfunction, disc disease, stenosis, soft tissue structures
What is discography used for?
dye infected into disc to identify abnormalities in annulus or nucleus
What is MRI used for?
excellet visualization of tissue anatomy
T1 for bony anatomy
T2 for soft tissue
What is arthrography used for?
identifies abnormalities within joints ie. tendon ruptures
What are bone scans for?
RA, stress fracture, bone cancer, bone infection
detects ‘hot spots’ of increased metabolic activity
What is diagnostic US used for?
assesses soft tissue dysfunctions
uses high-frequency sound waves
subjective
What is myelography used for?
disc and stenosis
What is electrodiagnostic testing?
electroneuromyography ENMG and nerve conduction testing NCV used to assess and/or monitor MSK conditions
What are the phases of normal gait?
Stance - initial contact, foot flat, midstance, heel off, preswing
Swing - initial, midswing, terminal
How do you treat DJD?
joint protection strategies
maintain/improve joint mechanics and connective tissue functions
implement aerobic capacity/endurance conditioning
What is Ankylosing spondylitis and how do you treat it?
Progressive inflammatory disorder
First symptoms mid to low back pain, morning stiffness, sacroiliitis
Results in kyphotic deformity of Cx and Tx spine, decrease lordosis
PT - flexibility exs for trunk mobility, aerobic endurance, aquatic, relaxation to maintain resp
What is gout and how do you treat it?
Genetic disorder, uric acid forms into crystals and deposits into joints (knee, great toe)
PT – edu for injury prevention, early identification important
What is psoriatic arthritis and how do you treat it?
Chronic, erosive inflammatory disorder. degeneration usually occurs in joints of digits as well as axial skeleton.
PT - joint protectino, maintain/improve joint mechanics and connective tissue functions, implement aerobic/endurance conditioning
What is rheumetoid arthritis and how do you treat it?
Chronic systemic disorder. symmetrical pattern of dysfunction in synovial tissues and articular cartilage of joints in hands, wrists, elbows, shoulders, knees, ankles, feet
PT - joint protection, maintain/improve joint mechanics, aerobic/endurance conditioning
What is osteoporosis and how do you treat it?
Metabolic disease that depletes bone mineral density/mass, predisoping to fracture.
PT - joint protection, maintain/improve mechanics, aerobic endurance, aquatic
What is osteomalacia and how do you treat it?
decalcification of bones due to vit D deficiency.
PT - joint protection, maintain/improve mechanics, aerobic endurance, aquatic
What is osteomyelitis?
inflammation within bone due to infection
What is arthrogryposis multiplex congenita and how do you treat it?
Congenital deformity of skeleton and soft tissues, characterised by limitation in joint motion and a sausage=like appearance in limbs.
PT - joint protection, maintain mechanics, aerobic endurance, edu and equipment, flexibility exs
What is osteogenesis imperfecta and how do you treat it?
Inherited disorder transmitted by autosomal dominant gene. Characterised by abnormal collagen synthesis, leading to imbalance between bone deposition and reabsorption.
cortical and cancellous bones become thin, leadint to fractures and deformity of weight bearing bones.
PT - joint protection, maintain mechanics, aerobic endurance exs.
What is osteochondritis dissecans and how do you treat it?
separation of articular cartilage from underlying bone.
PT – joint protection, flexibility, aerobic endurance, strength, power exs
What is myofascial pain syndrome and how do you treat it?
trigger points
PT -
flexibility
manual Rx - soft tissue, joint mobs, spray and stretch, dry needling
Ice, heat, hydro, US, TENS, desensitization of trigger point with manual therapy,
Strength power and endurance exs
What is tendonosis and how do you treat it?
tendon dysfunction. often called tendonitis, but no inflammatory response.
PT -
flexibility, manual therapy, endurance and strengthening, thermal agents, edu and training in ADLs
What is bursitis? What are its signs and symptoms? How do you treat it?
inflammation of bursa secondary to overuse, trauma, gout, infection.
Signs - pain with rest, PROM and AROM limited due to pain but not in capsular pattern
PT - flexibility, manual therapy, aerobic endurance, thermal agents, edu and ADL training
What are muscle strains and how do you treat it?
Inflammatory response within muscle following traumatic event caused by microtearing of muscle tendon fibers
Pain and tenderness within that muscle.
PT - flexibility, manual therapy, aerobic endurance, thermal agents, edu and ADLs
What is myositis ossificans and how do you treat it?
abnormal calcification within muscle belly.
usually by direct trauma. sometimes induced by early mobilization and stretching with aggressive PT following trauma to muscle.
PT - flexibility, manual therapy, aerobic capacity
What is complex regional pain syndrome CRPS and how do you treat it?
Thought to be related to trauma
Results in dysfunction of sympathetic nervous system to include pain, circulation, vasomotor disturbances
Type 1 – triggered by tissue injury, no underlying nerve injury
Type 2 – associated with nerve injury
Long term changes – muscle wasting, trophic skin changes, decreased bone density, decreased proprioception, loss of muscle strength, joint contractures
PT – edu for injury prevention, desensitize activities focus on return to ADLs, flexibility, TENS
What is Paget’s disease and how do you treat it?
Metabolic bone disease involving abnormal osteoclastic and osteoblastic activity. Maybe linked to viral infection along with enviro factors.
Results in spinal stenosis, facet arthropathy, spinal fracture.
PT - joint protection, maintain mechanics, aerobic endurance
What is idiopathic scoliosis and how do you treat it?
Structural – irreversible lateral curvature of spine with rotational component
Nonstructural – reversible lateral curvature of spine without rotational component, and straightening as individual flexes spine
PT – flexibility, strength, e-stim for muscle performance, edu re orthosis
What is torticolis and how do you treat it?
Spasm and/or tightness of SCM
Dysfunction observed is sidebending toward and rotation away from affected SCM
PT – flexibility, manual therapy
