MSK Flashcards
lateral epicondylitis tests
cozens and mills
medial epicondylitis tests
reverse cozens
valgus stress test of elbow indicates
medial or ulnar pain
laxity of ulnar collateral ligament
varus stress test of elbow indicates
lateral pain
laxity of radial collateral ligament
how long do you hold phalens and reverse phalens
60 sec
what are features of adhesive capsulitis
thickening and contraction
abduction and external rotation most limited
end feel may be soft
what ROM is limited the most in adhesive capsulitis
abduction and ER
what is neer classification of impingement syndrome
1 - edema and hemorrhage
2 - thickening and fibrosis
3 - tears and ruptures
what are features of supraspinatus lesion
painful arc
tenderness on AC and greater tub
weakness of AB and ER
difficult sleeping on side
what are positive signs of painful arc
crepitus
apprehension
pain
what are positive signs of empty can
weakness or pain
with or without resistance!
crepitus and apprehension may be present
what does yergasons test indicate
bicipital tendonitis
transverse humeral ligament
SLAP tears grading
1 - degenerated labrum and biceps intact
2 - detached labrum and bicep anchor from superior glenoid
3 - bucket handle tear
4 - bucket handle tear extending into bicep anchor
what does cross arm test indicate
AC
sprain
OA
what does apprehension and relocation test indicates what
anterior instability
what does sulcus sign indicate
inferior or multidirectional instability
what are the characteristics of fibromyalgia
chronic pain - widespread pain and stiffness
affects neck, back, shoulders, pelvis, and hands MC
11-18 multiple tender points
deep muscular tone and throbbing
numbness tingling burning
worse in the morning
cold and humid conditions worsen
IBD and bladder dysfunction
headache
anxiety stress
impaired memory
sleep disturbances - abnormal phase 4 (REM) sleep
fatigue / exhaustion
what is the new criteria for fibromyalgia
old 1990 criteria - 11-18 tender points
found to be a barrier for primary care setting
new 2010 criteria - perceived cognitive impairment, fatigue, sleep disturbance
what is the WPI
what is used for
what is criteria
widespread pain index
fibromyalgia
0-19 tender points
must have felt pain in the tender point in the past week!!!!
what is the criteria for DX of fibromyalgia
1a. WPI score greater than 7
AND
Symptom severity score is greater than 5
OR
1b. WPI score is between 3 and 6
AND
Symptoms severity score is greater than 9
- symptoms have been present for at least 3 months
- you dont have a disorder that would otherwise explain the pain
what are the common symptoms of cervical myelopathy
what are the common signs
symptoms - clumsy/weak hands, stiff or heavy legs, neck stiffness, pain in shoulders and arms, unsteady gait, cant walk at brisk pace, deterioation of fine motor skills (writing or buttoning shirt), intermittent shooting pains down the arm like electric shock, arm pain
signs - atrophy of the hands, hyperreflexia, hypertonic LE, Lhermittes sign, sensory loss, inability to tandem walk
what does the neuro exam look like with cervical myelopathy at C5-C6 level
biceps and supinator (C5/6) may be absent
brisk triceps reflex (C7) - pathognomonic of cord compression at C5-C6 interspace
ankle clonus and babinski present
hoffmans sign is indicator of spinal cord dysfunction
stiff or spastic gait - seen in later stages
what are the MSK findings in polymyalgia rheumatica
morning stiffness for more than 1 hour
proximal muscle weakness
muscle stiffness after inactivity
carpal tunnel syndrome - 15% of people
distal extremity swelling
arthalgia or myalgia up to 6 months after systemic symptoms
cervical distraction
increases ligamentous pain
decreases nerve root and facet pain
adsons test is used for what causes
scalenes
cervical rib
what is allens test used for
obstruction of vasculature to the hand
what is T4 syndrome
symptoms - paresthesia, numbness, UE pain, with or without upper back stiffness
no neuro signs
upper thoracic joint dysfunction around T4
how do you treat T4 syndrome
joint manip, stretching, strengthening excercises directed at upper back
C5 root
or
C4-C5 disc
deltoid
biceps reflex