Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK III & IV > MSK Exam > Flashcards

MSK Exam Flashcards

1
Q

Supraspinatus Tendinopathy pain motion

A

Flexion abduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Infraspinatus tendinopathy pain motion

A

ER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

PT interventions with Tendinopathy

A

-correct altered movement
-scapular taping
-functional training
-sports specific training

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Types of Full thickness RTC tear

A

Horizontal AP may involve more than 1 muscle
Longitudinal ML may involve just one muscle will do better with surgery and recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Rotator Cuff injury test item cluster

A
  1. Drop arm sign
  2. Painful arc + pain/catching between 60-120
  3. Infraspinatus with resisted ER at side + pain weakness lag
    3 tests positive and age greater than 60 positive LR of 28
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ideal pt for successful RTC repair

A

-<65 age
-non smoker
-non DM
-repair done within 3 months of MOI
-minimal fatty infiltrates into RTC muscles
-less than 2 tendons torn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why would you use an anatomical shoulder repair

A

-function RTC
-limited glenoid deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why would you use a reverse shoulder repair

A

major rotator cuff pathology
Glenoid deformity
functioning deltoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Do young athletes have good outcomes after TSA?

A

Yes near normal ranges for strength and function if rotator cuff was functioning prior to surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the most common age range for shoulder instability?

A

<20 yrs old 66-100%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Instability is defined as a clinical syndrome that occur when laxity produces____.

A

Symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

During end range of motion what is holding the glenoid/humerus complex

A

rotator cuff/biceps- dynamic
GH ligaments- static

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

At rest what is holding the glenoid/humerus complex in place

A

Negative pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

TUBS

A

Traumatic
Unilateral
Bankart
Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

AMBRI

A

Atraumatic
Multidirectional
Bilateral
Rehab effective
Inferior shift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Explain the onset of anterior instability and if its common

A

90% of instability anteriorly
unidirectional and traumatic onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Explain the onset of posterior instability and if it is common

A

2-10% most common with MVA or repetitive loading bench press

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Explain Multidirectional instability

A

not associated with traumatic episodes
more acquired laxity- may have a connective tissue disorder

Most common in young women with hypermobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Explain what the Rotator interval is and its relation to stability

A

interval between the subscapularis tendon and the supraspinatus tendon

related to stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Best test cluster for MDI

A

sulcus sign
load and shift
arc of pain
history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What specific Pt education is necessary with MDI patients and generalized laxity?

A

there needs to be constant time investment, compliance and maintenance to show improvement

need to include dynamic stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is a bony bankart?

A

labrum damage and glenoid damage after traumatic dislocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a soft bankart?

A

labrum damage only after traumatic dislocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is a hill sachs lesion?

A

when the posterior superior aspect of humeral head sustains a compression fracture after dislocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the most common sequela after traumatic anterior shoulder dislocation?

A

reoccurance up to 90% for 11 to 20 yrs of age
Bankart lesion

length of immobilization, avoidance of overhead activities and supervised pt had no effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the single best test for anterior shoulder instability?

A

apprehension/relocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the 4ps for PT treatment of GH dislocation

A
  1. GH protectors- supra, infra, teres
  2. Scapular pivoters- trap, rhomboids, serratus
  3. Humeral positoners- deltoid
  4. Humeral propellers- pec and latt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

A score of greater than 5 on the instability severity index puts a pt at a higher risk of dislocation what are these factors there are 6

A
  1. age
  2. loss of glenoid contour
  3. hill sachs lesion
  4. competitive sports individual
  5. contact sport/overhead
  6. shoulder hyperlaxity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the top 4 prognostic factors for surgery failure after dislocation.

A
  1. glenoid bone loss
  2. competitive sports participation
  3. hill sachs lesion
  4. age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What motion does the MGHL restrict

A

ER at 45 degrees of abduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What motion does the IGHL complex restrict

A

ER at 90 degrees of abduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the MOI for a superior glenoid labrum tear?

A

superior labrum can be torn from repetitive overhead activities, trauma, sudden avulsion, entrapment, hypermobility or instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Best cluster to determine a tension SLAP

A

biceps load II
resisted supination ER test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Best cluster to determine a compression SLAP

A

crank/clunk
compression rotation
dynamic sheer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Are SLAP tears manageable with conservative treatment?

A

Yes up to 85% successful with non-op care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What 3 things need to be avoided after a SLAP repair

A

avoid aggressive early exercise and ROM
NO forceful stretching into ABD/ER
NO resistance with biceps in SLAP lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

The following test cluster has a good ____ active compression test, throwers test, groove palpation to determine if a pt has biceps labrum pathology

A

sensitivity if negative good rule out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

The following test clusters have a good ____ speeds test, yergasons test to determine if a pt has biceps labrum pathology

A

Specificity if positive rule in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Explain the difference between tenodesis and tenotomy for the biceps

A

tenodesis- reattachment of the biceps
no resisted elbow flexion for 6-8 weeks

Tenotomy- resection of the biceps
no precautions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

With a grade 3 shoulder separation what ligaments are torn?

A

acromioclavicular
coracoclavicular- trapezoid and conoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the common features of adhesive capsulitis?

A

gradual onset
pain near the insertion of the deltoid
inability to sleep on affected side
painful and restrictive active and passive ROM
normal radiologic appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the Risk Factors for Adhesive Capsulitis

A

women>men
Diabetes
Thyroid dysfunction
age 40-65
previous episode of adhesive capsulitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the 4 stages and time frame for adhesive capsulitis

A

stage 1: 0-3 months
stage 2: 3-9 months freezing stage
stage 3: 9-15 months frozen stage
stage 4: 15-24 months thawing phase more stiff doesn’t hurt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Is passive stretching and mobilization good for individuals with frozen shoulder?

A

study showed that supervised neglect pt showed greater improvements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How should we rule in adhesive capsulitis

A
  1. age 40-65
  2. pt reports gradual onset
  3. pain and stiffness sleeping, ADLS
  4. GH PROM limited in multiple planes
  5. PROM to end range reproduce pt symptoms
  6. GH mobility glides limited in all direction

no radiological evidence of arthritis

46
Q

associated diagnosis shoulder pain with mobility deficits

A

subacromial pain syndrome
adhesive capsulitis

47
Q

associated diagnosis shoulder pain with radiating pain

A

TOS
Cervical radic

48
Q

Associated diagnosis shoulder pain with movement coordination

A

Subacromial pain syndrome
MDI: bankart
SLAP
Tendonosis

49
Q

Associated diagnosis shoulder pain with muscle force production deficits

A

rotator cuff tear
subacromial pain

50
Q

What is the primary muscle involved in lateral epicondyalgia?

A

extensor carpi radialis brevis

51
Q

Lateral epicondyalgia also known as ___

A

Tennis elbow
inflammation of the common extensor tendon

52
Q

If a younger patient is presenting with common sx of lateral epicondylalgia what do you think?

A

elbow Apophysitis is an inflammation or stress injury to the areas on or around growth plates in children and adolescents.
avoid heavy slow resistance

53
Q

What should be ruled out with lateral elbow pain?

A

Cervical radiculopthy
TOS
Radial tunnel syndrome
Radial head injury

54
Q

What muscles are involved in medial epicondylagia

A

flexor carpi ulnaris
flexor carpi radialis
pronator teres

55
Q

Medial epicondylagia is also known as ___.

A

Golfers elbow/pitchers elbow

56
Q

What needs to be ruled out in medial elbow pain

A

laxity in the ulnar collateral ligament
Cervical spine

57
Q

what is the risk factors for osteochondritis dessicans

A

-associated with gymnast and throwing
-trauma
-age 15-20
- Males>Females

58
Q

what are the signs and symptoms of Osteochondritis dessicans

A

joint effusion
pain with activity locking
constant pain, ADL impairment

59
Q

what is snapping elbow?

A

lateral elbow pain with palpable/audiable snapping during flexion/extension

60
Q

What should be ruled out in snapping elbow?

A

posteriorlateral instability
lateral epicondylagia
OCD with loose body

61
Q

what is the MOI and most common elbow dislocation direction

A

posterior due to a hyperextension force

62
Q

What should you do before you reduce an pts elbow dislocation?

A

get imaging to make sure that there are no additional fractures most common addition fracture is the coronoid fracture

63
Q

What are the ROM progressions based on age/tissue after elbow surgery?

A

younger-immobilize longer
older- earlier AAROM to prevent stiffness and contractures

64
Q

What are some common complications with elbow dislocations?

A

fracture
laceration of brachialis and biceps
ulnar/median nerve injuries
brachial artery injury
flexion contracture
myositis ossificans- calcium deposite in brachialis

65
Q

What is the MOI and risk factor group for biceps tendon rupture?

A

males
age 50
sudden contraction against a significant load

66
Q

During late cocking of acceleration for throwing what force is seen at the elbow joint and what ligament does this impact

A

valgus force
ulnar collateral ligament- provides stability at 20-130 degrees of motion

67
Q

If there is disruption of the UCL and medial instability what two other things occur at the elbow joint?

A
  1. posteriomedial compression injury
    -impingement of medial olecranon on trochlea and olecranon fossa
  2. lateral compression injury
    -impingement of the radial head on capitulum
68
Q

what can posterior medial compression and lateral compression lead too?

A

chondromalacia- breakdown of tissue cartilage
osteophyte formation
OCD
Loose bodies

69
Q

An xray is needed if a pt has elbow trauma and one of the following to rule out a fracture

A
  1. unable to fully extend elbow
  2. bony tenderness
    -raidal head
    -medial epicondyle
    -lateral epicondyle
    -olecranon process
  3. bruising ecchymosis around the elbow
70
Q

When is the volume of the cubital tunnel the largest?

A

when the elbow is in full extension

71
Q

What nerve runs through the cubital tunnel

A

Ulnar nerve

72
Q

In severe cases of cubital tunnel what observations may you see in the hand?

A
  1. atrophy of the ulnar intrinsic muscles on hypothenar eminence
  2. clawing of ring and small fingers
73
Q

Special test to test for Cubital Tunnel

A
  1. elbow flexion test
  2. shoulder IR test
  3. tinels sign
  4. froments sign
  5. wartenburgs
74
Q

What is the MOI and signs/symptoms of high radial nerve palsy

A

most common during midshaft humeral fracture
SS: loss of wrist extension (wrist drop)
loss of finger/thumb extension
loss of sensation in first dorsal web space

75
Q

What is the MOI and signs/symptoms of radial tunnel syndrome?

A

compression of deep radial nerve branch at the supinator
may mimic tennis elbow but 5cm distally

weakness, aching cramping
difficulty extending wrist, thumb fingers
difficulty grasping objects

76
Q

Special tests for radial tunnel

A

third finger sign at radial tunnel
reproduction of symptoms with direct pressure over nerve

77
Q

What is the MOI and signs and symptoms of pronator teres syndrome?

A

compression of median nerve between pronator teres insertions

paresthesis following a median nerve distribution
no nocturnal symptoms (unlike CTS)
associates with repetitive activities like car mechanic

78
Q

What is the MOI and signs and symptoms associated with anterior interosseous syndrome

A

compression of median nerve in the muscle bellies of the pronator teres
SS: pt will be unable to make the OKAY sign
sensory testing is normal
weakness is major complaint

79
Q

Explain positive and negative ulnar variance

A

positive ulnar variance creates more weight bearing in the ulnar portion of the wrist may be more likely to have compression injury

negative ulnar variance leads to increase load through the radius and creates lack of stability on the ulnar side of the wrist

80
Q

Explain the different functional arches in the hand

A

2 transverse arches
1 longitudinal arch
this allows for fingers and thumb to hold objects in hand

81
Q

Explain the extensor mechanism in the hand

A

complex tendon that creates a pulley system to extend the MCP and IPs allows intrinsics to assist in extension

82
Q

What happens if a pully tendon ruptures in the hand?

A

leads to a tendon bowstringing

83
Q

Explain the function of the flexor retinaculum

A

-roof of carpal tunnel
-protects the median nerve
-prevents bowstringing of flexor tendon
-helps preserve the transverse arch

84
Q

Explain the function of the extensor retinaculum

A

-prevents bowstringing of the extensor tendons
-creates the 6 extensor compartments

85
Q

What bones are attachments for the flexor retiaculum?

A

scaphoid
hamate
pisiform
trapezium

86
Q

What is in extensor compartment 1 and 3

A

compartment 1: abductor pollicis longus extensor pollicis brevis
compartment 3: extensor pollicis longus

87
Q

Describe the MOI of colles fracture

A

dorsal displacement of the distal radius
FOOSH

88
Q

Describe the MOI of a smith fracture

A

volar displacement of the distal radius
fall on the back of the hand

89
Q

What is the most common carpal fracture and how should it be managed?

A

scaphoid fracture
xray doesn’t show line for a few weeks
treat as if it is fractured and return to imaging in 2 weeks

90
Q

What are the clinical signs of a scaphoid fracture and what are we worried about? is it high sen or spec?

A
  1. tenderness in anatomic snuff box
  2. tenderness over scaphoid tubercle
  3. pain with a longitudinal compression of the thumb

high sensitivity if all three are negative rule out

91
Q

If a metacarpal is immobilized how is it casted and why?

A

casted at 60-70 degrees of flexion for the prevention of collateral ligament contractures

92
Q

What are some complications following a fracture in the hand?

A

-malunion
-non union
-avascular necrosis
-tendon injuries
-tendon ruptures
-nerve damage
-secondary OA
-stiffness
-loss of grip strength

93
Q

What is the prevalence of OA in the hand and is it more common in men or women?

A

women and over 80% in elderly population

94
Q

which joints are most affected with OA in the hand?

A

DIP—– 1st CMC & PIP—- MCP

95
Q

Where are heberden and bouchard nodes found

A

OA
heberden: DIP
bouchard: PIP

96
Q

what is the leading cause of pain in the hand? and what is the special test?

A

1 CMC OA
1st CMC grind test

97
Q

What is the difference between RA and OA?

A

RA is an inflammatory disease that destroys soft tissue, articular surface and bone most often affects the MCP and the PIP can result in Ulnar drift
often has fatigue and morning siffness longer than 1 hour

98
Q

name the location of a swan neck and a boutonnière deformity?

A

swan neck: extension of volar plate
boutonnière: flexion volar plate

99
Q

Describe the MOI and SS of De Quervains tenosynovitis?

A

MOI: progressive compression entrapment of Abductor pollicis longus and extensor pollicis brevis
special tests: ecchoffs and WHAT

100
Q

If a patient cannot actively flex or extend in the hand and you suspect a tendon laceration or rupture what should you do?

A

refer

101
Q

Explain MOI and SS for skiers thum

A

tear of ulnar collateral ligament of the thumb
pain in webspace pinch weak
grade 1-3 depending on laxity

102
Q

Explain the MOI and SS of TFCC

A

FOOSH or repetitive rotational loading
pain in ulnar region with grip and rotation

103
Q

If you get a positve scaphoid shift what should you do

A

refer to orthopedic because have potential to progress to OA and scapholunate advanced collapse

104
Q

Explain carpal tunnel MOI and SS

A

most common compression in UE
median nerve compression

105
Q

Who is at greater risk for carpal tunnel?

A

female>male
45-59
size of tunnel
obesity
smoking/alcohol use

106
Q

What are the special test for carpal tunnel and high spin or snout?

A

tinels
phalens
carpal compression
high spin specificity rule in

107
Q

What is the CPG for carpal tunnel

A

shaking hands for sx relief
wrist ratio >.67
hand severity scale >1.9
diminished sensation median nerve
age >45

108
Q

Acording to the new Carpal tunnel CPG what should you not do?

A

do not asses lateral pinch strength
do not asses grip strength <3 months post carpal tunnel release
do not use low level laser, iontophoresis

109
Q

What is the 6 item CTS symptom scale for Carpal tunnel

A
  1. numbness in median nerve distribution
  2. nocturnal numbness
  3. thenar muscular atrophy
  4. positive tinels sign
  5. positve phalans
  6. loss of 2 pt dicrimination
110
Q

What is Guyon canal syndrome?

A

ulnar nerve entrapment or compression
cause is pressure or trauma
decreased sensation in ulnar nerve distribution
froment sign
wartenberg sing
tinnels sing
grip strength

MSK III & IV (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions