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Year 2 PCM IV midterm > MSK Exam 10? > Flashcards

MSK Exam 10? Flashcards

1
Q

3 bones in shoulder

A

clavicle
scapula
proximal humerus

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2
Q

articular surfaces in shoulder

A

glenohumeral
sternoclavicular
acrocioclavicular
scapulothoracic

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3
Q

5 main mm of shoulder

A 
deltoid- abduction
supra- abduction
infra- ext rotation
subscap- internal rotation
teres minor- external

Rotator cuff

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4
Q

intrinsic injury of shoulder

A

glenohumeral ligaments- sprain or tear
muscle or tendon inflammation, tear, strain: rotator cuff and deltoid
bones: fracture, inflamed capsule

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5
Q

extrinsic causes shoulder pain

A

referred

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6
Q

neuro causes shoulder pain

A 
Cervical nerve root compression
supraspinatus nerve compression
brachial plexus
herpes zoster
spinal cord lesion
cervical spine disease
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7
Q

abdominal cause shoulder pain

A

hepatobiliary disease

diaphragm irritation

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8
Q

CV causes shoulder pain

A

MI
axillary vein thrombosis
thoracic outlet syndrome

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9
Q

thoracic causes shoulder pain

A

upper lobe pneumonia
apical lung tumor
pulmonary embolus

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10
Q

common causes of intrinsic shoulder path

A 
impingement
tendinopathy
tendon tear
AC separation
OA
adhesive capsulitis (frozen shoulder)
bursitis
instability
SLAP lesion
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11
Q

characterisitic of intrinsic shoulder issue

A

pain can be positional

more easily localized with palpation and movement

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12
Q

way to test suprascap

A

empty can

or 90 degree and resist their AB duction

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13
Q

way to test subscap

A

lift off

or tuck elbow in, 90 degrees and have them push medially against R with their wrist

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14
Q

infraspinatus teres minor test

A

forearm laterally against R

90 degrees

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15
Q

most intrinsic shoulder pain

A

supraspinatus

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16
Q

what protects supraspinatus

A

sub acromial bursa

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17
Q

what space can compress supraspinatus

A

head of humerus and acromion

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18
Q

night pain in shulder
atrophy sup and post mm
pain crepitus while abducting arm

A

impingment

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19
Q

tests for impingment

A

hawkins and near impingement

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20
Q

weakness of rotator cuff can lead to what

A

superior subluxation humeral head when should abduct beyond 90 degrees
predisposing to impingement

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21
Q

what ligaments can be affected when falling on tip of shoulder

A

AC and corcaoclavicular

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22
Q

what is Tx for grade 1-3 AC separation

4-5

A

1-3 conservative

4+ surgical

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23
Q

lost active and passive ROM inshoulder

A

arthritis!

24
Q

loss of joint space

A

arthritis

25
Q

imaging to distinguish soft tissue path

A

MRI

26
Q

risk factor frozen shoulder

A

DM

27
Q

limit of steroid injections each year

A

4

28
Q

differentiate between bursitis and tendonitis

A

pain with active vs passive ROM
tendon hurst with active
bursa with passive too

29
Q

Dx bursitis

A

clinical exam and inject then test ROM and strength again after

30
Q

What is SLAP lesion

A

superior labrum anterior to posterior

where biceps anchors to labrum

31
Q

acute SLAP lesion

A

falling and grab something

32
Q

MRI definition of SLAP lesion

A

O’Brians

33
Q

what is new imaging for joint problems instead of MRI

A

contrast injection into joint with serial XR or fluoroscopy

34
Q

posterior pain aroun dhip could be

A

SI
lumbar
unusual true hip pain

35
Q

lateral hip pain ddx

A

bursitis

36
Q

lateral hip pain with paresthesia

A

meralgia paresthetica

37
Q

anterior/groin pain ddx

A

hip pain
osteonecrosis
sepsis, fracture
synovitis

38
Q

lower anterior thigh pain

A

referred true hip
upper femur
femoral neck
lumbar radiculopathy

39
Q

if neither direct P not ROM reproduces “hip pain”

what is ddx

A

hernia, lower abdominal pathology

referred pain from lumbar area

40
Q

trochanteric bursitis

A

exaggerated or abnormal movement of gluteus medius and TFL over greater trochanter

41
Q

what type of pain with trochanteric bursitis

A

lateral hip pain, just posterior superior to point of trochanter

42
Q

important part of PE with hip pain cc

A

gait analysis

43
Q

key exam feature in OA hip

A

restricted abduction and internal rotation
pain
limited flexion and morning stiffness

44
Q

in OA of hip the groin is aggravated by what

A

movement more than palpation

45
Q

when will OA pain hurt the most

A

morning and end of the day

46
Q

what is meralgia paresthetica

A

lateral femoral cutaneous nerve susceptible to impingement

especially when course under inguinal lig

47
Q

burning of lateral thigh

no weakness of DTR changes

A

meralgia paresthetica

48
Q

if burning lateral thigh and with weakness and DTR changes

A

not! meralgia paresthetica

because involving more than sensory

49
Q

osteonecrosis

A

compromised vascular supply to femoral head
joint collapse in 3-5 years
groin pain, weight bearing and motion induced

50
Q

steroids and excessive alcohol intake can cause what hip path

A

osteonecrosis

51
Q

occult fracture imaging

A

MRI

XR not enough

52
Q

presentation of referred pain of hip

A

lumbar ans SI joint
whenever groin pain with back pain
Sx extend beyond knee
paresthesia present

53
Q

fabere test

A

hip, psoas or SI problem
flex abduct externally rotate then extend
if painful then +

54
Q

osgood- schlatter

A

tibial tuberosity avulsion
osteochondritis of tibial tubercle
apophysitis of tibial tubercle at insertion of patellar tendon

55
Q

Tx osgood schlatter

A

pain contro;
continnue activity
leg strengthening with physical therapy

56
Q

76 u.o L shoulder pain
burning and radiates to back of shoulder low neck area
ddx?

A

ruptured supraspinatus
cervical n compression/radiculopathy (5, 6)
OA

Year 2 PCM IV midterm (6 decks)

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