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Patient Assessment > MSK Assessment > Flashcards

MSK Assessment Flashcards

1
Q

Wrist/Hand Physiology

A
  • carpels, metacarpels, phalangees, scaphoid
  • always consider FOOSH
  • there are so many nerves, blood vessels
  • any trauma concerns go to hospitals due to complexity of hand anatomy
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2
Q

Inspection of Hand/Wrist

A
  • Check for symmetry
  • Check for redness, swelling , deformity, bruising, muscle wastage (thenar eminence), rashes, discolouration
  • dupuyentrens contracture? = diabetes
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3
Q

Movement of Wrist/Hand

A
  • test pts full ROM
  • flexion, + extension
  • abduction + adduction
  • ask pt to do a fist, spread out, an okay sign (peace sign for report)
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4
Q

Palpation of Hand/Wrist

A
  • palpate the head of the radius
  • palpate the scaphoid
  • palpate the phalanges
  • systematically palpate the carpels and metacarpals
  • palpate the wrist joint
  • palpate anatomical snuffbox (pain=fractures)
  • check strength on both sides
  • check radial pulse
  • compare temp
  • check distal sensation
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5
Q

Shoulder Physiology

A
  • 3 bones, scapula, humerus, clavicle
  • it has 3 joints
  • due to increases ROM, usually anteriorly dislocates
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6
Q

Shoulder Special Test

A

Drop arm test - pt abducts to 90° then slowly lowers it. Pain/weakness is positive test for torn rotator cuff

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7
Q

Palpation of Shoulder

A
  • palpate bony structures
  • any pain?
  • check CRT
  • check radial and brachial pulse
  • again, looking for SLIPDUCT signs
  • palpate muscle tone
  • feel for normal temp
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8
Q

Inspection of Shoulder

A
  • check for symmetry
  • check for signs of trauma, bruising, swelling, redness
  • check for ‘step’ over AC joint, the SC and sub-aceomegaly joint
  • deformity, scarring, muscle wastage, rashes
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9
Q

Shoulder Movement

A
  • Test all ROM
  • flexion + extension
  • abduction + adduction
  • internal + external rotation
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10
Q

Elbow Inspection

A
  • check for symmetry
  • check for signs of trauma, redness, swelling, bruising, deformity
  • any scarring, muscle wastage, rashes
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11
Q

Palpation of Elbow

A
  • palpate the bony landmarks
  • palpate the decreased for swelling and pain
  • assess perfusion, limb temp, CRT
  • feel for pulses
  • feel for peripheral sensation and axillary nerve function at deltoid
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12
Q

Elbow Physiology

A
  • it’s a synovial joint
  • 3 bones; humerus and ulnar
  • joint is susceptible to 3 fractures; radial head, olecranon and a humerus fracture
  • Tennis elbow (lateral epicondylitis) = pain from where forearm tendons connect to a OUTSIDE bony lump in the elbow. Pain/weakness causes difficulty gripping
  • Golfers Elbow (medial epicondylitis) = pain where the tendons in forearm connect to the INSIDE of the bony lump in the elbow. Pain/weakness cause difficulty gripping
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13
Q

Movement of Elbow

A
  • flex the elbow to 90°, apply downward pressure to palm while supporting elbow
    -flexion + extension
  • Supination + pronation
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14
Q

Hips Pathophysiology

A
  • significant trauma is needed to fracture the pelvic bone itself
  • A fracture to the femoral head is more common
  • any suspicion of pelvic trauma should lead to anaelgesia and binding for haemorrhaging control
  • incontinence is a sign of nerve dmg
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15
Q

Palpation of Hips

A
  • feel the hips for pain and tenderness
  • would feel for femoral pulse if indicated
  • palpate bony prominences
  • compare leg temp, colour, sensation and strength
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16
Q

Inspection of Hip

A
  • look for symmetry
  • look for deformity, swelling, redness, rashes, bruising, muscle wastage, scarring, discolouration
  • look for evidence of a NOF - shortening and rotation and unable to move leg
  • look out for a do distension (haemorrhage)
  • assess mobility and gait
17
Q

Movement of Hip

A
  • test full ROM
  • flexion + extension
  • abduction + adduction
  • lateral and medial rotation
  • don’t move if suspected NOF
18
Q

Knee Pathophysiology

A
  • a complex joint that’s a popular source of pain, swelling and locking
  • ligaments, tendons, cartalidge (meniscus) can all produce pain
19
Q

Palpation of Knee

A
  • palpate the knee and bony prominences
  • palpate the head of the fibula
  • feel for the popliteal pulse (just behind the knee)
  • assess distal sensation and temp
20
Q

Inspection of Knee

A
  • check for symmetry
  • check for redness, swelling, bruising, deformity, muscle wastage, rashes, scarring, discolouration
  • look for symmetry in quads (ruptured ACL)
  • assess mobility/gait (limp = minor or major injury eg fracture or arthritis)
  • abnormal guilt = injury, something neuro or foot problems
21
Q

Ottawa Knee Rules

A
  • aged 55 and over
  • inability to weight bear/4 steps immediately after injury
  • inability to flex the knee to 90°
  • tenderness isolated at the patella
  • tenderness at the head of the fibula
  • exclusion criteria = chronic, >18, pregnancy, burn/lac
  • any of them indicate an x-ray is needed
22
Q

Movement of Knee

A
  • use passive, active and resisted movements to take the knee through its full ROM
  • flexion + extension
  • observe pt walking, standing and sitting
23
Q

Movement of the Foot

A
  • in the absence of pain/swelling, carry out passive, active, resisted movement to test full ROM
  • flexion + extension
  • inversion + eversion
  • toe flexion and extension (active and passive)
24
Q

Ottawa Ankle Rules

A
  • inability to weight bear/take 4 steps immediately after injury
  • bony tenderness in posterior edge or tip of lateral malleolus
  • bony tenderness at the base of the 5th metatarcel
    Bony tenderness at the navicular bone
25
Q

Inspection of the Foot/Ankle

A
  • compare both sides for symmetry
  • check for endless, swelling, bruising, deformity, muscle wastage, discolouration, rashes, scarring
  • assess mobility and gait
26
Q

Palpation of Foot/Ankle

A
  • palpate the bones in lower leg/ankle/foot
  • palpate for Achilles tendon, fibula, calf and 5th metatarcel
  • palpate Ottawa landmarks
  • feel the pedal pulse
  • test peripheral sensation and temp
    Simmonds Test= pt is kneeling on chair, squeeze calf to test for Achilles function

Patient Assessment (11 decks)

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