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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
Q

Hill-Sachs lesion

A

compression fx of the posterior humeral head

26
Q

Bankart lesion

A

avulsion of the anterior-inferior capsule and glenoid labrum

27
Q

axillary nerve injury

A

exam will demonstrate numbness and tingling in the lateral deltoid and weakness in shoulder ABD

28
Q

SLAP tear

A

superior labrum, anterior to posterior
- may also involve the biceps tendon

29
Q

GH labrum tears S&S

A
  • 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
Q

spinal accessory nerve injury S&S

A
  • inability to abduct arm beyond 90 deg
  • pain in shoulder ABD
31
Q

long thoracic nerve injury S&S

A
  • pain on flexing fully extended arm
  • inability to flex fully extended arm
  • winging starts at 90 deg fwd flexion
32
Q

suprascapular nerve injury S&S

A
  • 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
Q

axillary (circumflex) nerve injury S&S

A

inability to abduct arm w/ neutral rotation

34
Q

common areas of compression for thoracic outlet syndrome

A
  • superior thoracic outlet
  • scalene triangle
  • between clavicle and 1st rib
  • between pec minor and thoracic wall
35
Q

What should be avoided in early stage of subacromial decompression

A

shoulder elevation > 90 deg

36
Q

Who most commonly has proximal humeral fractures (greater tuberosity)? What is the usual MOI?

A

more common in middle-aged and elder adults

usually related to a fall onto the shoulder

does not require immobilization

37
Q

What is commonly seen in associated w/ diabetes and thyroid disease?

A

adhesive capsulitis (frozen shoulder)

38
Q

risk factors for adhesive capsulitits

A
  • 40-65 y/o
  • female and previous episodes in contralateral arm
  • hx of diabetes and thyroid
39
Q

Osteochondrosis of humeral capitellum is what? Who is it most common in?

A
  • 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
Q

What is Panner’s disease? Who does it occur in?

A
  • localized avascuar necrosis of capitellum
  • occurs in children age 10 or younger
41
Q

which direction are most elbow dislocations?

A

posterior

42
Q

What is the most common wrist fx?

A

Colles fx
- dinner fork
- FOOSH onto hand

43
Q

Colles vs Smith fx

A

Colles - dinner fork fall onto hand/palm

Smith - garden spade fall onto back of hand

44
Q

Boutonniere deformity

A

extension of MCP and distal IP (DIP) w/ flexion of PIP

45
Q

Swan neck deformity

A

flexion of MCP and DIP w/ extension of PIP

46
Q

mallet finger

A

flexion of DIP joint

47
Q

Jersey Finger - which finger is most likely involved

What is a key exam finding?

A

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
Q

spinal stenosis S&S

A
  • 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
Q

spinal stenosis interventions

A

flexion based exercises and avoid extension

Board Review - MSK (13 decks)

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