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Physical Diagnosis > MSK > Flashcards

MSK Flashcards

1
Q

lateral epicondylitis tests

A

cozens and mills

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2
Q

medial epicondylitis tests

A

reverse cozens

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3
Q

valgus stress test of elbow indicates

A

medial or ulnar pain

laxity of ulnar collateral ligament

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4
Q

varus stress test of elbow indicates

A

lateral pain

laxity of radial collateral ligament

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5
Q

how long do you hold phalens and reverse phalens

A

60 sec

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6
Q

what are features of adhesive capsulitis

A

thickening and contraction

abduction and external rotation most limited

end feel may be soft

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7
Q

what ROM is limited the most in adhesive capsulitis

A

abduction and ER

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8
Q

what is neer classification of impingement syndrome

A

1 - edema and hemorrhage

2 - thickening and fibrosis

3 - tears and ruptures

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9
Q

what are features of supraspinatus lesion

A

painful arc
tenderness on AC and greater tub
weakness of AB and ER
difficult sleeping on side

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10
Q

what are positive signs of painful arc

A

crepitus
apprehension
pain

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11
Q

what are positive signs of empty can

A

weakness or pain

with or without resistance!
crepitus and apprehension may be present

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12
Q

what does yergasons test indicate

A

bicipital tendonitis

transverse humeral ligament

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13
Q

SLAP tears grading

A

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

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14
Q

what does cross arm test indicate

A

AC
sprain
OA

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15
Q

what does apprehension and relocation test indicates what

A

anterior instability

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16
Q

what does sulcus sign indicate

A

inferior or multidirectional instability

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17
Q

what are the characteristics of fibromyalgia

A

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

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18
Q

what is the new criteria for fibromyalgia

A

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

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19
Q

what is the WPI

what is used for

what is criteria

A

widespread pain index

fibromyalgia

0-19 tender points

must have felt pain in the tender point in the past week!!!!

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20
Q

what is the criteria for DX of fibromyalgia

A

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

  1. symptoms have been present for at least 3 months
  2. you dont have a disorder that would otherwise explain the pain
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21
Q

what are the common symptoms of cervical myelopathy

what are the common signs

A

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

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22
Q

what does the neuro exam look like with cervical myelopathy at C5-C6 level

A

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

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23
Q

what are the MSK findings in polymyalgia rheumatica

A

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

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24
Q

cervical distraction

A

increases ligamentous pain

decreases nerve root and facet pain

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25
Q

adsons test is used for what causes

A

scalenes

cervical rib

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26
Q

what is allens test used for

A

obstruction of vasculature to the hand

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27
Q

what is T4 syndrome

A

symptoms - paresthesia, numbness, UE pain, with or without upper back stiffness

no neuro signs

upper thoracic joint dysfunction around T4

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28
Q

how do you treat T4 syndrome

A

joint manip, stretching, strengthening excercises directed at upper back

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29
Q

C5 root
or
C4-C5 disc

A

deltoid

biceps reflex

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30
Q

C6 root
or
C5-C6 disc

A

biceps
wrist extension
brachiradialis reflex

31
Q

C7 root
or
C6-C7 disc

A

triceps
wrist flexion
finger extensors
triceps reflex

32
Q

C8 root
or
C7-T1

A

finger flexion

no reflex

33
Q

T1 root
or
T1-T2 disc

A

interossei

34
Q

L4 root
or
L3-L4 disc

A

tibialis anterior

patellar reflex

35
Q

L5 root
or
L4-L5 disc

A

extensor hallucis longus

no reflex

36
Q

S1 root
or
L5-S1 disc

A

peroneus longus

achilles reflex

37
Q

what are the tight muscles in upper cross syndrome

A

tight - pecs, ant deltoid, levator scapulae, upper trap, subscap, lats, SCM, scalenes

weak - rhomboids, post deltoid, serratus anterior, lower trap, longus coli, capitus

38
Q

what are the mechanical factors in cervical myelopathy in flexion and extension

A

flexion (anterior) - herniated discs and osteophytic ridges

extension (posterior) - ligamentum flavum buckling and hypertrophy

39
Q

correct hip firing patterns

explain

A

hamstrings
glut max
contra erector
ipsi erector

40
Q

what are the different grades of spondylolisthesis

A 
normal 
1 - <25% 
2 - 25-50% 
3 - 50-75% 
4- >75%
41
Q

what are characteristics of lumbar disc syndrome

A 
dejerines triad 
minor sign 
flexion is more painful 
more painful in AM 
improve with mobilization
better with activity 
sitting more painful - tripod sign 
antalgia 
sciatic pain
42
Q

bechterews test is + for

A

lumbar disc

sciatica

43
Q

kemps test is + for

A

lumbar sprain
facet
disc
sciatica

44
Q

SLR is + for

A

sciatica
lumbar sprain
SI sprain
tight hamstrings

45
Q

braggards tests is + for

A

sciatica

tight hamstrings

46
Q

well leg raise is + for

A

sciatica

lumbar disc

47
Q

patricks test is + for

A

hip pathology

SI lesion

48
Q

yeomans test is + for

A

SI lesion

49
Q

elys test is + for

A

SI lesion

50
Q

hibbs test is + for

A

SI lesion

hip pathology

51
Q

what is the most specific SI test

A

gaenslens test

52
Q

what is a positive hip extension sign

A

ipsi erector fires first

53
Q

neri bowstring sign is + for

A

sciatica
lumbar disc
hamstring

54
Q

what does retrolisthesis mean

A

disc narrowing is greater than posterior joint degeneration

55
Q

what does anterolisthesis mean

A

posterior joints are more degenerated than the disc

56
Q

what is the difference in neurogenic and vascular pain

A

neuro - thighs, calves, back, (buttocks is rare), burning and cramping, erect posture/ambulation/extension make worse, squatting/bending forward/sitting make better, pulses normal, no skin changes, bladder incontinence

vascular - buttocks and calves, cramping, any leg exercise makes worse, rest makes it better, decrease pulses, skin and nail changes, impotence

57
Q

osgood schlatters occurs when and due to what

A

11-14 years old

growth spurts and overuse

58
Q

what is the most sensitive and specific test for meniscus

A

thessaly 20*

59
Q

what is patella tendonitis

A

aka jumpers knee or sinding larsen johansson syndrome

inflammation of inferior border of patella

anterior knee pain over patella

pain worse when jumping, landing, or running

gradual onset due to overuse

sitff first thing in the morning or after sitting

60
Q

what is pes anserine bursitis

A

inflammation of pes anserine

located anterior medial knee below the tibial tub

61
Q

what is a synovial plica

A

snapping sensation or pain along the medial epicondyle

1-2 fingers away from patella

pain with knee flexed and then extended

62
Q

what does pivot shift test for

A

acl and rotatory instability

63
Q

what does apleys compression and distraction test for

A

compression - meniscus

distraction - cruciates and collateral sprain

64
Q

patellar mobility

displaced less than one quadrant medially =

displaced more than 3 quadrants medially =

A

displaced less than one quadrant medially = tight lateral structures

displaced more than 3 quadrants medially = hypermobile

65
Q

what is patellar inhibition or grind test for

A

patellar femoral syndrome

66
Q

anterior drawer of ankle indicates what

A

anterior talofibular instability

67
Q

varus stress, talar tilt, and inversion stress indicates what

valgus stress, talar tilt, and eversion stress indicates what

A

calcaneofibular lig

deltoid lig

68
Q

how does avulsion of 5th metatarsal occur

A

inversion sprain

69
Q

how does jones fracture occur

A

stress or acute fracture

difficult to heal

70
Q

what are the different osteochondral defects of the ankle

A

lateral talar dome - inversion sprain

medial talar dome - unclear maybe trauma

71
Q

how does a high ankle sprain occur

A

tibiofibular syndesmosis

dorsiflexion and eversion of the ankle
internal rotation of tibia

72
Q

what are the tests used to diagnose high ankle sprain

A

squeeze test
external rotation test
cross leg test

73
Q

what is a march fracture

A

stress fracture of a metatarsal

74
Q

what is homans sign indicate

A

thrombophlebitis

Physical Diagnosis (18 decks)

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