Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PCM IV Exam II > MSK CIS Handout > Flashcards

MSK CIS Handout Flashcards

1
Q

Increased uric acid level is necessary, but not sufficient for onset of gout. There is a known multifactorial inheritance, which is _________, and has polymorphisms at ______ and ______

A

X-linked; URAT1; GLUT9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

_______ toxicity increases risk of saturnine gout

A

Lead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Use of _____ diuretics impedes excretion of urate, thus increasing risk for gout

A

Thiazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Elevated _______ fit with alcohol abuse, which can predispose to gout

A

LFTs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The number of co-morbidities in gout patients is related to disease severity. What co-morbidities are highly prevalent in gout patients?

A 
Hypertension
Diabetes mellitus
CV disease
Renal disease
Dyslipidemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Gout is an independent risk factor for ______ and _____ mortality, and is associated with increased co-morbidity, thus an EKG is often performed on pts presenting with gout

A

Cardiovascular; all-cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Patients with recurrent hospital admissions for gout have a higher number of comorbid medical conditions, particularly higher rates of _____ disease

A

Heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Uric acid crystals can form ____ in heart valves

A

Tophi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

T/F: Pts hospitalized for gout have higher rates of tophaceous disease and higher serum urate concentrations

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T/F: Pts hospitalized for gout are more likely to be on high doses of allopurinol

A

False — hospitalized cases are less likely to be on allopurinol, and those on allopurinol areon lower doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Rotator cuff muscles

A

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anterior deltoid and coracobrachialis are responsible for GH joint _______ with a normal ROM of ______

A

Flexion; 180

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Latissimus dorsi and teres major are responsible for GH joint _______ with a ROM of ______

A

Extension; 60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pec major and latissimus dorsi are responsible for GH joint ________ with ROM of ______

A

Horizontal adduction; 40-50 (or 130-140)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Supraspinatus and mid-deltoid are responsible for GH joint _________ with ROM of _______

A

Horizontal abduction; 40-55 (or 130-145)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Infraspinatus and teres minor are responsible for GH joint _________ with ROM of _____

A

ER; 90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Subscapularis and pec minor are responsible for GH joint ______ with ROM of ____

A

IR; 90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ROM for axial rotation at the AC joint

A

~10 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Rhomboid major and minor mm. are responsible for scapular ______

A

Retraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Serratus anterior is responsible for scapular _____

A

Protraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Upper trapezius and levator scapulae are responsible for scapular _____

A

Elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Lower trapezius and lower rhomboids are responsible for ______ of the scapula

A

Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

2 tests for GH instability

A

Apprehension test

Sulcus sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Apprehension test

A

Pt seated or supine. Shoulder abducted to 90 and elbow flexed to 90. Stabilize shoulder with 1 hand and force arm into ER with other hand

+ test = pt apprehensive of repeat dislocation

Indicates GH instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Sulcus sign

A

Grasp pts elbow and apply inferior traction

+ test = indentation in area beneath acromion

Indicates GH instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

2 tests for long head of the bicep

A

Yergason’s

Speed’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Yergasons test

A

Pts arm at side with elbow flexed at 90. Examiner uses one hand to palpate bicipital groove and monitors there, while other hand grasps the pts wrist. Have pt supinate and ER against resistance

+ test = pain and/or tendon subluxation out of groove

Indicates unstable bicipital tendon/subluxation bicipital tendonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Speeds test

A

Pts arm forward flexed (50-90 deg) at the shoulder with hand supinated. Slightly flex pts elbow. Resist at forearm while pt forward flexes shoulder (resistance to cephalad/superior motion)

+ test = pain in bicipital groove

Indicates bicipital tendonitis of longhead biceps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

2 rotator cuff tests indicative of supraspinatus pathology

A

Empty can test

Drop-arm test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Empty can test

A

Flex pt shoulders/arms to 90 while horizontally abducting to 45 deg. Then IR both arms so thumbs point down. Press down on forearms while pt resists

+ test = pain or weakness

Indicates rotator cuff pathology of supraspinatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Drop-arm test

A

Pt abducts arms to 90 deg then slowly drop arms

+ test = arm will drop or gentle tap on wrist will cause arm to drop

Indicates full thickness tear of supraspinatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

2 tests for rotator cuff impingement

A

Neer impingement

Hawkins test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Neer impingement test

A

Stabilize pts shoulder, forearm is pronated, passively flex shoulder to fully flexed position

+ test = pain

Indicates subacromial bursa or rotator cuff impingement

34
Q

Hawkins test

A

Flex shoulder to 90, flex elbow to 90, and passively rotate the humerus into IR. This opposes rotator cuff against coracoacromial ligament and acromion

+ test= pain

Indicates rotator cuff or subacromial bursa impingement

35
Q

Ortho test for subscapularis pathology

A

Lift off test

36
Q

Lift off test

A

Place pts arm into internal rotation and extension. Pt pushes arm into further IR as doc resists

+ test = weakness (inability to resist)

Indicates subscapularis weakness

37
Q

Ortho test for AC joint pathology

A

Cross arm test

38
Q

Cross arm test

A

Doc passively adducts pts arm across their chest and rests pts hand on opposite shoulder

+ test = pain in AC joint with end range adduction

Indicates AC joint pathology

39
Q

2 maneuvers for apley scratch test

A

Upper — pt abducts arm placing palm of hand behind their neck with palm facing toward the body. Pt should attempt to scratch the lowest possible vertebrae (coupled ER and abduction)

Lower — pt places arm behind their back with palm facing outward and dorsum of hand resting on their mid-back. Pt should attempt to scratch highest possible vertebrae (coupled IR and adduction)

40
Q

Normal elbow carrying angle in males vs females

A

Males = 5 degrees

Females = 10-15 degrees

41
Q

Cubitus varus = _____ degrees

Cubitus valgus = _____

A

<5 degrees

> 15 degrees

42
Q

Biceps brachii, brachialis, brachioradialis, and coracobrachialis are responsible for elbow _____ with ROM of _______

A

Flexion; 140-150

43
Q

Triceps brachii and anconeus are responsible for elbow _______ with ROM of ______

A

Extension; 0 to -5

44
Q

Supinator m. and biceps brachii are responsible for elbow _______ with ROM of ______

A

Supination; 90

45
Q

Pronator teres and pronator quadratus mm. are responsible for elbow _______ with ROM of ______

A

Pronation; 90

46
Q

What nerve roots are tested with biceps, brachioradialis, and triceps reflexes?

A

Biceps = C5

Brachioradialis = C6

Triceps = C7

47
Q

Valgus stress test for elbow

A

Arm slightly abducted and ER. Forearm supinated and flexed to 30 degrees. Slight medial directed valgus stress applied

+test = pain/tenderness with palpation and valgus stress; increased laxity

Indicates sprained medial (ulnar) collateral ligament

48
Q

Varus stress test

A

Arm slightly abducted and IR. Elbow flexed to approx 15 degrees. A slight lateral directed varus stress is applied to elbow

+ test = pain/tenderness with palpation; increased laxity

Indicates sprained lateral (radial) collateral ligament

49
Q

Tinel test for ulnar nerve entrapment

A

Tap between olecranon and medial epicondyle in ulnar groove

+ test elicits tingling sensation don forearm within ulnar nerve distribution

Indicates ulnar nerve entrapment/cubital tunnel syndrome

50
Q

Golfer’s elbow test

A

[anterior forearm/flexor compartment]

Pts elbow flexed to 90 and forearm placed in supination with wrist neutral and palm facing up. Examiner places one hand under proximal forearm for stabilization and the other hand over the pts wrist to resist movement. Instruct pt to FLEX the wrist

+ test = pain/tenderness around medial epicondyle

Indicates medial epicondylitis

51
Q

Tennis elbow (Cozen’s) test

A

[posterior forearm/extensor compartment]

Pts elbow flexed to 90 and forearm placed in pronation with wrist neutral and palm down. Examiner places one hand under proximal forearm for stabilization and the other hand over pts hand to resist movement. Instruct pt to EXTEND the wrist

+ test = pain around lateral epicondyle, may radiate down lateral forearm

Indicates lateral epicondylitis

52
Q

Clinical presentation of olecranon bursitis in terms of pain and ROM

A

Region is often painless and ROM is normal

53
Q

Little league elbow refers to a group of problems related to stress of throwing in young athletes. How does the pathology change from childhood to adolescence to young adulthood?

A

Childhood = medial apophysitis

Adolescence = medial epicondyle avulsion fracture

Young adulthood = medial collateral ligament tear

[as bone development matures, the most common injury evolves from apophysitis to avulsion to ligament injury]

54
Q

Little league elbow presents as pain over the _____ epicondyle, initially after throwing (repetitive ______ distraction forces), progresses to persistent pain

A

Medial; valgus

55
Q

Injury that is often the result from trauma by tractioning the child’s extended arm

A

Radial head instability “nursemaid’s elbow”

[Annular ligament tear and/or radial head subluxation from annular ligament]

56
Q

Radial head instability due to annular ligament tear presents with pain with palpation of radial head with _____ displacement of radial head, and restriction to _____ glide

A

Anterior; posterior

57
Q

Ulnar _______ is coupled with supination at the elbow

Ulnar ______ is coupled with pronation at the elbow

A

Adduction

Abduction

58
Q

Radial head ______ glide is paired with supination at the elbow

Radial head ______ glide is paired with pronation at the elbow

A

Anterior

Posterior

59
Q

Medial, lateral, and proximal borders of anatomic snuffbox

A

Medial border — extensor pollicis longus

Lateral border — extensor pollicis brevis, abductor pollicus longus

Proximal border — radial styloid process

60
Q

Name the carpal bones

A 
Scaphoid
Lunate
Triquetrum
Pisiform
Trapezium
Trapezoid
Capitate
Hamate
61
Q

Flexor carpi radialis, flexor carpi ulnaris, and palmaris longus are responsible for wrist ______ with ROM of ______

A

Flexion; 80-90

62
Q

Extensor carpi radialis longus and brevis along with extensor carpi ulnaris are responsible for wrist ______ with ROM of ______

A

Extension; 70

63
Q

Flexor carpi ulnaris and extensor carpi ulnaris are responsible for wrist ______ with ROM of ______

A

Adduction; 30-40

64
Q

Flexor carpi radialis, extensor carpi radialis longus and brevis are responsible for wrist ______ with ROM of ______

A

Abduction; 20-30

65
Q

_______ of the wrist is coupled with dorsal/posterior carpal glide

A

Flexion

66
Q

Adduction of the wrist is coupled with ulnar _______

Abduction of the wrist is coupled with ulnar ______

A

Abduction

Adduction

67
Q

Motor branch of median nerve that innervates flexor pollicis longus, deep flexors of digits 2 and 3, and pronator quadratus (responsible for making “ok” sign)

A

Anterior interosseous nerve

68
Q

Tinel’s sign of the wrist is elicited by tapping over the _________ ligament with wrist held in extension

A

Transverse carpal

69
Q

What is the Allen test?

A

Evaluates functioning of radial and ulnar aa.

Occlude both aa. while pt makes a fist. Have pt open and close fist; palm should be pale

Release pressure on ulnar a. and observe for color return to hand w/i 5-10seconds. Repeat with radial a.

70
Q

A positive Allen test indicates lack of dual blood supply to the hand and would be a contraindication for what procedure?

A

Radial catheterization

71
Q

3 possible inflammation sites in DeQuervain’s tenosynovitis

A

Tendon sheath

Abductor pollicis longus

Extensor pollicis brevis

72
Q

Test used to detect dequervains tenosynovitis

A

Finkelstein test

73
Q

It is important to diagnose and treat a scaphoid fracture due to risk of ________ _______ secondary to blood supply. Treatment is with thumb spica cast/splint. Note that immediate radiographic evidence is not always visible and may require repeat imaging. CT or MRI to confirm if necessary

A

Avascular necrosis

74
Q

Fracture of the distal radius in the forearm with dorsal (posterior) and radial displacement of the wrist and hand; classic “dinner fork” deformity with bony stepoff

A

Colle’s fracture

75
Q

Fracture of proximal ulna + dislocation of radial head

A

Monteggia fracture

76
Q

Fracture of the distal radius + dislocation of the ulna

A

Galeazzi fracture

77
Q

Isolated fracture of the midshaft/distal ulna from a direct blow

A

Nightstick fracture

78
Q

Biomechanical OMT considerations in acute gout of the elbow

A

Avoid direct treatments to the elbow during acute flare

Consider treating any areas that may be compensating for limited use of elbow — opposite shoulder, lumbar spine, sacrum, innominates

79
Q

Respiratory circulatory OMT considerations in acute gout of the elbow

A

Consider use of lymphatics to assist with clearing of uric acid crystal deposition; may also help with inflammation

Treat zink patterns

Do effleurage/petrissage proximal to elbow as tolerated

Check for restrictions of lymph drainage by treating fascial restrictions in the axilla and hypertonicity of the pec minor m (can use pec minor CS therapy or pectoral traction)

80
Q

Sequence of treatment for successful lymphatic treatment

A
  1. Open pathways to remove restriction to flow — transverse myofascial restrictors: thoracic inlet, myofascial restrictors, broad fluid movement
  2. Maximize diaphragmatic functions — abdominal and pelvic diaphragms
  3. Increase pressure differentials or transmit motion using fluid pumps
  4. Mobilize targeted tissue fluids (localized to specific SDs)
81
Q

Neurologic OMT considerations for acute gout of the elbow

A

Restore homeostasis for sympathetics for UE by targeting T2-T7

Restore homeostasis for parasympathetics for UE by targeting OA, AA

82
Q

Behavioral model OMT considerations for acute gout of the elbow

A

Educate pt on aspects leading to development of gout flares

Reduce alcohol and other dietary purine consumption

Encourage weight loss which will complement dietary purine reduction

Encourage increased hydration, especially if on a thiazide

PCM IV Exam II (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions