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Board Review - MSK > MSK Evaluation UE > Flashcards

MSK Evaluation UE Flashcards

1
Q

Degenerative Joint Disease (DJD)/ Osteoarthrosis/ Osteoarthritis (OA) S&S

A

pain, swelling, loss of ROM, and bony demformity

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2
Q

arthritis affects ______ more than ______ before age 50, then more _______ than ______ after age 50

A

men < 50 y/o

women > 50 y/o

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3
Q

ankylosing spondylitis affects ______ 3x more often than ________

A

men 3x more than women

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4
Q

Psoriatic arthritis affects ______ more often than _______

A

both sexes are affected =

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5
Q

RA affects _______ 2-4 x more than _______. What is the age range of onset?

A

women > men

40-60 y/o

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6
Q

Differential Diagnosis of Ankylosing Spondylitis and Spinal Stenosis: History

A

Ankylosing Spondylitis: morning stiffness, male predominance, sharp pain-ache, bilateral SI pain may refer to posterior thigh

Spinal Stenosis: intermittent aching pain, pain may refer to both legs w/ walking

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7
Q

Differential Diagnosis of Ankylosing Spondylitis and Spinal Stenosis: Active movements

A

Ankylosing Spondylitis: restricted

Spinal stenosis: may be normal

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8
Q

Differential Diagnosis of Ankylosing Spondylitis and Spinal Stenosis: Passive movements

A

Ankylosing Spondylitis: restricted

Spinal Stenosis: may be normal

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9
Q

Differential Diagnosis of Ankylosing Spondylitis and Spinal Stenosis: resisted isometric movements

A

Ankylosing Spondylitis: normal (in beginning of disorder)

Spinal Stenosis: normal

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10
Q

Differential Diagnosis of Ankylosing Spondylitis and Spinal Stenosis: Posture

A

Ankylosing Spondylitis: flexed posture of entire spine

Spinal stenosis: flexed posture of lumbar spine

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11
Q

Differential Diagnosis of Ankylosing Spondylitis and Spinal Stenosis: special tests

A

Ankylosing Spondylitis: Schober test (mobility less than 4 cm)

Spinal Stenosis: bicycle test of van Gelderen may be +; Stoop test may be + (walking w/ flexed posture)

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12
Q

Differential Diagnosis of Ankylosing Spondylitis and Spinal Stenosis: reflexes

A

Ankylosing Spondylitis: normal (in beginning)

Spinal Stenosis: may be affected in long-standing cases

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13
Q

Differential Diagnosis of Ankylosing Spondylitis and Spinal Stenosis: sensory deficit

A

Ankylosing Spondylitis: none (in beginning)

Spinal Stenosis: usually temporary

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14
Q

Differential Diagnosis of Ankylosing Spondylitis and Spinal Stenosis: diagnostic imaging

A

Ankylosing Spondylitis: plain films are diagnostic

Spinal Stenosis: CT scans are diagnostic

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15
Q

osteoporosis affects _____ 10x more frequently than ______

A

women > men

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16
Q

Osteomyelitis is more common in who?

A

children and immunosuppressed adults than healthy adults

more common in males than females

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17
Q

signs and symptoms of bursitis

A
  • pain w/ rest
  • PROM and AROM are limited due to pain, but not in a capsular pattern
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18
Q

What is abnormal calcification within a muscle belly?

A

myositis ossificans

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19
Q

What can induce myositis ossificans? What are the most frequent locations?

A

early mobilization and stretching, w/ aggressive PT following trauma to muscle

most frequent locations: quads, brachialis, and biceps

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20
Q

What should be avoided w/ myositis ossificans?

A

avoid aggressive soft tissue/massage techniques which may worsen condition

21
Q

CRPS I is associated w/ _______

CRPS II is associated w/ ________

A

CRPS I = frequently triggered by tissue injury

CRPS II = clearly associated w/ a nerve injury

22
Q

long term changes of CRPS

A
  • muscle wasting
  • trophic skin changes
  • decreased bone density
  • decreased proprioception
  • loss of muscle strength from disuse
  • joint contractions
23
Q

torticollis direction

A

side-bending toward and rotation away from affected SCM

24
Q

most shoulder dislocations occur in what direction

A

anterior-inferior when abducted UE is forcefully, externally rotated, causing tearing of inferior GH ligament, anterior capsule, and possible glenoid labrum

25
Hill-Sachs lesion
compression fx of the posterior humeral head
26
Bankart lesion
avulsion of the anterior-inferior capsule and glenoid labrum
27
axillary nerve injury
exam will demonstrate numbness and tingling in the lateral deltoid and weakness in shoulder ABD
28
SLAP tear
superior labrum, anterior to posterior - may also involve the biceps tendon
29
GH labrum tears S&S
- shoulder pain that cannot be localized to a specific point - pain made worse by OH or when the arm is held behind the back - weakness - instability in the shoulder - pain on resisted flexion of the biceps - tenderness over the front of the shoulder
30
spinal accessory nerve injury S&S
- inability to abduct arm beyond 90 deg - pain in shoulder ABD
31
long thoracic nerve injury S&S
- pain on flexing fully extended arm - inability to flex fully extended arm - winging starts at 90 deg fwd flexion
32
suprascapular nerve injury S&S
- increased pain on fwd shoulder flexion - shoulder weakness (partial loss of humeral control) - pain increases w/ scapular ABD - pain increases w/ cervical rotation to opposite side
33
axillary (circumflex) nerve injury S&S
inability to abduct arm w/ neutral rotation
34
common areas of compression for thoracic outlet syndrome
- superior thoracic outlet - scalene triangle - between clavicle and 1st rib - between pec minor and thoracic wall
35
What should be avoided in early stage of subacromial decompression
shoulder elevation > 90 deg
36
Who most commonly has proximal humeral fractures (greater tuberosity)? What is the usual MOI?
more common in middle-aged and elder adults usually related to a fall onto the shoulder does not require immobilization
37
What is commonly seen in associated w/ diabetes and thyroid disease?
adhesive capsulitis (frozen shoulder)
38
risk factors for adhesive capsulitits
- 40-65 y/o - female and previous episodes in contralateral arm - hx of diabetes and thyroid
39
Osteochondrosis of humeral capitellum is what? Who is it most common in?
- bone fragment becomes detached from articular surface, forming a loose body - caused by repetitive compressive forces between radial head and humeral capitulum - occurs in adolescents between 12-15 y/o
40
What is Panner's disease? Who does it occur in?
- localized avascuar necrosis of capitellum - occurs in children age 10 or younger
41
which direction are most elbow dislocations?
posterior
42
What is the most common wrist fx?
Colles fx - dinner fork - FOOSH onto hand
43
Colles vs Smith fx
Colles - dinner fork fall onto hand/palm Smith - garden spade fall onto back of hand
44
Boutonniere deformity
extension of MCP and distal IP (DIP) w/ flexion of PIP
45
Swan neck deformity
flexion of MCP and DIP w/ extension of PIP
46
mallet finger
flexion of DIP joint
47
Jersey Finger - which finger is most likely involved What is a key exam finding?
aka Flexor Digitorum profundus tendon rupture/avulsion - hyperextension of DIP w/ max finger flexion contraction - 75% of cases involve ring finger - key exam finding of inability to produce isolated flexion of the DIP
48
spinal stenosis S&S
- bilateral pain and paresthesia in back, butt, thighs, calves, and feet - pain decreases w/ spinal flexion and increases w/ ext - pain increases w/ walking - pain relieved w/ prolonged rest or activity modification (leaning on shopping cart)
49
spinal stenosis interventions
flexion based exercises and avoid extension

Board Review - MSK (13 decks)

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