MSK Evaluation LE/Spine

Question 1

hip ROM loss w/ AVN

Answer 1

decreased in flexion, IR, and ABD

Question 2

what hip condition is common in patients w/ rheumatoid arthritis

Answer 2

trochanteric bursitis

Question 3

piriformis muscle is an ER of hip at ________ and becomes an IR and ABD of hip at _______

Answer 3

ER at hip flexion < 60

IR at hip flexion > 90

Question 4

CAM vs Pincer femoroacetabular impingement (FAI)

Answer 4

CAM - large aspherical femoral head in constrained acetabulum

Pincer - over-coverage of femoral head by prominent acetabular rim

Question 5

unhappy knee triad

Answer 5

injury to MCL, ACL, and medial meniscus
- results from a valgum, flexion, and ER forces on knee when foot is planted

Question 6

ACL prevention training schedule and type

Answer 6

• train multiple times per wk, > 20 min per session, >30 min per wk
• combo of strength/plyometric exercises, incorporate multiple components, proximal control exercises

Question 7

T/F: Should use dry needling w. PFPS?

Answer 7

false - according to CPG

Question 8

What presents as injury to adolescents where an ACL injury would occur in adults?

Answer 8

injury to epiphyseal plate

Question 9

6 “P”s of compartment syndromes

Answer 9

• pain
• palpable tenderness
• paresthesia
• paresis
• pallor
• pulselessness

Question 10

Ottawa Knee Rules

Answer 10

• age > 55
• isolated patellar tenderness w/o other bone tenderness OR
• tenderness of the fibular head OR
• inability to flex to 90 OR
• inability to weight bear immediately after injury and in ER

Question 11

Ottawa Foot and Ankle Rules

Answer 11

Ankle
- bone tenderness from posterior tip of lateral OR medial malleolus extending 6mm proximally OR
- inability to take 4 steps immediately or in ER

Foot
- bone tenderness in base of 5th metatarsal OR
- bone tenderness of navicular oR
- inability to take 4 steps immediately or in ER

Question 12

What is commonly seen in ballet performers?

Answer 12

flexor hallucis tendonopathy

Question 13

best intervention for achilles tendinopathy

Answer 13

mechanical loading (eccentric or heavy loading, slow velocity) exercise to decrease pain and increase function

Question 14

S&S of spine stenosis

Answer 14

• bilateral pain and paresthesia in back, buttocks, thighs, calves and feet
• pain decreases in spinal flexion, increases in extension
• pain increases w/ walking
• pain relieved w/ prolonged rest or activity modification, such as leaning on a shopping cart

Question 15

interventions for spinal stenosis

Answer 15

• flexion based exercises and exercises that promote dynamic stability throughout the trunk and pelvis
• avoid extension

Question 16

What is the most common observed disc disorder of lumbar spine due to its structural deficiencies?

Answer 16

posterolateral bulge/herniation

Question 17

What is the most common observed disc disorder of cervical spine?

Answer 17

central posterior bulge/herniation

Question 18

canadian c-spine rules to determine if they need raadiography

Answer 18

• Have high-risk factor (age >= 65, dangerous mechanism, OR paresthesias in extremities
• not low risk factor injury (simple rear end MVA, sitting in ER, delayed onset of pain, OR absence of midline cervical spine tenderness)
• not able to rotate neck actively 45 deg L or R

Question 19

How to rule in SIJ conditions?

Answer 19

2 of 4 tests must be +

• SI gapping
• SI compression test
• Sacral thrust
• thigh thrust

3 of 5 must be + if Gaenslen’s test included

Question 20

What compensation can be associated w/ rapid hyperextension of knee during stance?

Answer 20

forward trunk lean - body wants to anteriorly shift weight fwd