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EPC II > MSK > Flashcards

MSK Flashcards

1
Q

how to characterize msk disorders

A
  1. articular vs extra articular
  2. acute (6- weeks) or chronic (12+ weeks)
  3. inflammatory or not
  4. localized (monoarticular) or diffuse (polyarticular)
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2
Q

clues about msk disorders if pt less than 60yo

A
  1. repetitive strain
  2. overuse
  3. arthritis (RA, psoriatic, infectious, reactive, crystalline, lyme disease, viral/bacterial)
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3
Q

clues about msk disorders if pt more than 60yo

A
  1. OA
  2. gout/pseudogout
  3. PMR
  4. osteoporosis and related fx
  5. septic bacterial arthritis
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4
Q

some causes of intra articular injury

A
  1. trauma, fx
  2. fibromyalgia
  3. polymyalgia rheumatica
  4. bursitis/tendinitis
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5
Q

what to think if msk is acute during H&P

A
  1. infectious arthritis
  2. gout
  3. reactive arthritis
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6
Q

what to ask about chronic msk

A
  1. morning stiffness
  2. soft tissue swelling
  3. systemic symptoms
  4. inflammation
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7
Q

what could it be if there is chronic msk pain without inflammation

A
  1. chronic noninflammatory arthritis
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8
Q

what could msk disorder be if the carpometacarpal or DIP, hip or knee is chronic noninflamed

A

OA

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9
Q

chronic joint pain plus inflammation

A

how many joints? symmetric? which joints

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10
Q

what is volar

A

palmar surface of hand (anterior)

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11
Q

what are articular structures?

A

joint capsule, articular cartilage, synovium and synovial fluid, intra-articular ligaments, and juxta-articular bone

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12
Q

what are extra-articular structures?

A

periarticular ligaments, tendons, bursae, muscle, fascia, bone, nerve, overlying skin

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13
Q

what are bursae

A

pouches of synovial fluid that cushion movement of tendons and muscles over bone or other joint structures - usually don’t feel unless they are enlarged

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14
Q

example of synovial joint

A

knee, shoulder

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15
Q

characteristic of synovial joint

A

articular cartilage, synovial membrane secretes synovial fluid that lubricates joint movement, separated by synovial cavity, FREELY MOVABLE

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16
Q

characteristics of cartilaginous joint

A

SLIGHTLY MOVABLE, bones separated by fibrocartilaginous discs, nucleus pulposus cushions movement

17
Q

example of cartilaginous joint

A

vertebral bodies of spine

18
Q

characteristics of fibrous joint

A

minimally appreciable gross movement, separated by fibrous tissue or cartilage

19
Q

example of fibrous joint

A

sutures of the skull

20
Q

which are synovial joints?

A
  1. spheroidal
  2. hinge
  3. condylar
21
Q

what are condylar joints

A

TMJ, knee

22
Q

what are hinge joints

A

interphalangeal joints of hand and food, elbow

23
Q

what are spheroidal joints

A

shoulder, hip

24
Q

what does joint stability depend on

A

shape of surfaces, ligaments and muscles

25
Q

what are common or concerning sx of msk?

A
  1. LBP
  2. neck pain
  3. monoarticular or polyarticular joint pain
  4. inflammatory or infectious joint pain
  5. joint pain with systemic features (fever, chills, rash, anorexia, wt loss, weakness
  6. joint pain with sx from other organ systems
26
Q

red flags age range

A

less than 20 and greater than 50

27
Q

what does proximal weakness indicate

A

myopathy

28
Q

what does distal weakness indicate

A

neuropathy

29
Q

what affects active movement against an examiner’s resistance?

A
  1. number of motor units firing
  2. number of joints crossed
  3. age, pain, fear
  4. misunderstanding
  5. sensory receptors
  6. substitution for weak muscles
30
Q

objective part of manual muscle testing?

A
  1. can pt complete available ROM
  2. can pt move against gravity?
  3. can pt hold a desired position
31
Q

what is a score 5 in MMT?

A

full available ROM against gravity with max resistance

32
Q

what is a score 4 in MMT

A

full available ROM against gravity with moderate resistance

33
Q

what is a score 3 in MMT

A

full available ROM against gravity but NO resistance

34
Q

what is a score 2 in MMT

A

full available ROM with gravity eliminated

35
Q

what is a score 1 in MMT

A

visible/palpable contraction but no joint movement

36
Q

what is a score 0 in MMT

A

no contraction

37
Q

tips for assessing joint pain

A
  1. point to the pain
  2. clarify and record mechanism of injury (esp if trauma)
  3. localized or diffuse
  4. acute or chronic
  5. inflammatory or noninflammatory
38
Q

how to assess joint stability

A
  1. pain with movement
  2. resistance with movement, type of motion barrier
  3. difference between active and passive ROM
  4. hyper or hypomobility

EPC II (2 decks)

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