MSK- clinical skills Flashcards
visible angular deformity in the thoracic region
gibbus
lordotic region
areas of the spine that have a naturally inward curve
When palpating in the midline of the spine, from cranially to caudally (top to bottom), what structures are you palpating
spinous process
When palpating down each side of the midline of the spine, from cranially to caudally (top to bottom), what structures are you palpating
paraspinal muscles
What are the sacroiliac joints
the bony joints between the spine and pelvis
what types of movements are assessed when assessing the cervical spine
Flexion / extension
Lateral flexion (left and right)
Rotation (left and right)
what types of movements are assessed when assessing the lumbar spine
Flexion / extension
Lateral flexion (left and right)
Schober’s test distance should increase by what
the distance between these marks should increase to 20cms when the patient bends forward
marks made during Schober’s test
Identify the level of the sacroiliac joints; make a mark 10cms above this level and 5cms below
genu valgus
condition characterized by an inward angling of the knee joints
effusions
accumulation of fluid within joint space or cavity
test that confirms presence of large effusion
patellar tap test
test which confirms whether a small-to-medium effusion is present.
medial gutter sweep
patellar tap test
gently tap down on the patella (kneecap) with one or two fingers.
positive patellar tap test
patella moves easily or a sensation of “bounce” is felt, this suggests the presence of significant effusion in the knee joint
negative patellar tap test
If the patella does not move significantly and feels stable, this indicates that there is likely no significant effusion
medial gutter sweep
place one hand on the medial aspect (inner side) of the knee and gently sweeps downwards, pushing any accumulated fluid toward the lateral aspect (outer side) of the joint
positive gutter sweep
bulge of fluid is seen returning to the medial gutter after the sweep, it suggests the presence of effusion in the knee joint.
Steinmann’s test
suspect acute meniscal tear- <40yrs, history of twisting injury, focal tenderness on one joint line
meniscus
crescent shaped cartilage structure located in knee joint
trendelenburg test what are you assessing?
tests the integrity and strength of the abductor muscles
will you see an effusion within a hip joint
no- deep joint
true limb length
The anterior superior iliac spine (ASIS) to the tip of the medial malleolus
Apparent limb length
The xiphisternum to the tip of the medial malleolus
trendelenburg test
Ask the patient to put their hands on yours for balance and then to stand on each leg in turn. The leg in contact with the floor is the side being assessed. If the ABductors are weak, the standing leg will move into ADduction and the iliac crest on the contralateral side will move down
Clinical problem suggested by tenderness at the greater trochanter
Trochanteric bursitis
clinical problem suggested by tenderness at the mid-point of the groin
hip arthritis or fracture
Thomas test purpose
to look for a fixed flexion deformity of the hip, which is loss of hip extension
Thomas test
With the examiner standing on the side to be examined, a hand is placed between the patient’s lumbar lordosis and couch. The patient is asked to maximally flex the contralateral hip and knee. The examiner’s hand will feel the lumbar lordosis occluding. The examiner observes the ipsilateral thigh. If the thigh remains lying flat on the couch, there is no fixed flexion deformity and the test is negative. If the thigh leaves the couch as the lumbar lordosis is occluded, there is a fixed flexion of the hip joint
Jobe’s test
the patient is asked to raise their arms in the scapular plane (at about 30° forward of the coronal plane) with the thumbs pointing downward (as if emptying a can).
The examiner applies a downward force to the arms, and the patient is asked to resist this pressure.
