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PCM Spring 2015 Exam 1 > MSK Exam - Pitcher > Flashcards

MSK Exam - Pitcher Flashcards

1
Q

3 bones of shoulder

A

clavicle
scapula
proximal humerus

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2
Q

rotator cuff

A

supraspinatus
infraspinatus
subscapularis
teres minor

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3
Q

articular surfaces of shoulder

A

glenohumeral
sternoclavicular
acromioclavicular
scapulothoracic

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4
Q

teres minor action

A

external rotation

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5
Q

injury to shoulder

A

intrinsic - problem in shoulder

extrinsic - referred to shoulder

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6
Q

intrinsic injury to shoulder

A

ligaments, muscle or tendon, bones

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7
Q

muscle

A

strain

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8
Q

ligament

A

sprain

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9
Q

extrinsic injury to shoulder

A

neuro - nerve compression, brachial plexion lesion, herpes zoster

abdomen - hepatobiliary, diaphragm irritation, ruptured ectopic pregnancy

cardio - MI, axillary vein thrombosis, thoracic outlet syndrome

thorax - pneumonia, lung tumor, PE

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10
Q

reproduction of pain

A

should not happen with extrinsic shoulder pain

also - pain is more poorly localized if extrinsic

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11
Q

tendinopathy

A

long standing tendinitis

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12
Q

frozen shoulder

A

adhesive capsulitis

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13
Q

pain with specific movement, stiff, weak, instability

A

intrinsic shoulder issue

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14
Q

intrinsic issue

A

can reproduce pain usually on exam

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15
Q

always test with shoulder

A

strength

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16
Q

patient abduct against resitance

A

supraspinatus test

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17
Q

empty can test

A

exam for supraspinatus

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18
Q

patient rotate forearm medially against resistance

A

subscapularis

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19
Q

lift off test

A

for subscapularis

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20
Q

patient rotates forearm laterally against resistance

A

infraspinatus

teres minor

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21
Q

most common rotator cuff issue

A

with supraspinatus

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22
Q

supraspinatus

A

superior aspect of scapula to greater tubercle of humerus

susceptible to repetitive motion - baseball, house painter

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23
Q

UPS

A

pinched supraspinatus in abduction

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24
Q

protection of supraspinatus

A

subacromial bursa

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25
weakness of rotator cuff
allows upward movement of humeral head -irritates supraspinatus tendon - and impingement can occur acute tear - forceful injury mechanism
26
positive drop arm test
inability to hold arm 90 degree abduction when arm released complete supraspinatus tear
27
night pain, gradual onset, pain in shoulder while abductiong arm
impingement of supraspinatus
28
hawkins test
shoulder impingement test flex arm and elbow internally rotate looks at supraspinatus tendon
29
drop arm test
supraspinatus
30
AC separation
almost always traumatic problem strain, partial tear, complete tear
31
visualized on inspection for AC separation
grade 3 there are 5 grades of separation
32
surgery for AC separation
usually type 4-6 conservative therapy - PT
33
arthritis
loss of joint space**
34
loss of passive and active ROM of shoulder
arthritis**
35
adhesive capsulitis
inflammation in capsule - frozen shoulder hard to tell from arthritis MRI useful**
36
bursitis
repetitive motion option to inject - steroid
37
when to avoid epinephrine/lidocaine
small capillaries
38
lidocaine vs. marcaine
lido - short term | marc - long term
39
strength and pain recover after numbing meds
bursitis
40
therapeutic challenge
lidocaine to bursa to diagnose it ROM and strength recover with bursitis after injection
41
rotator cuff tear
persistant weakness despite injection
42
rotator cuff tendinopathy
normal strength in association with pain relief
43
frozen shoulder
persistent loss of ROM
44
lidocaine injection test
subacromial bursa when physical exam cannot exclude cuff tear, frozen shoulder, or AC joint involvement
45
SLAP lesion
superior labrum tear anterior to posterior biceps tendon anchors to labrum
46
fall and grab something and flex bicep against lots of resistance
SLAP lesion
47
O'briens test
test for slap lesion labrum tear
48
work up for trauma to shoulder
Xray US helpful for experienced hands MRI arthrography - contrast injection into joint with serial x-rays of fluoroscopy largely replaced by MRI
49
shoulder pain algorithm
traumatic vs. non-traumatic intrinsic vs. extrinsic
50
no difference active vs. passive
bursitis
51
lateral pain
rarely hip more bursa issues with paresthesia - meralgia paresthetica**
52
true hip pain
groin - anterior osteonecrosis, sepsis, fx, synovitis of hip joint
53
neither direct pressure or ROM reproduces hip pain
think hernia, lower abdominal pathology, referred pain from lumbar area
54
lower anterior thigh pain
referred true hip issue upper femur femoral neck lumbar radiculopathy
55
true hip joint pain
often arthritis
56
trochanteric bursitis
lateral bursa abnormal movement of glut medius and tensor fascia lata over greater trochanter investigate - posteior superior to point of trochanter chronic - fibrosis
57
leg length discrepancy
trochanteric bursitis
58
activity pain at night
osteoarthritis located in groin**
59
restricted abduction, morning stiffness, internal rotation limitation and pain, limited flexion
osteoarthritis of hip
60
key feature for osteoarthritis
restricted abduction
61
key physical exam for hip
internal/external rotation movements
62
lateral femoral cutaneous nerve impingement
meralgia paresthetica as couses under inguinal ligament
63
burning/paresthsia upper lateral thigh, weakness or DTR changes
meralgia paresthetica aka beer gut nerve or truckers nerve pinch
64
anterior and lateral thigh to the knee
meralgia paresthetica **not below knee**
65
osteonecrosis
aka aspectic necrosis, avascular necrosis, osteochondritis dissecans decreased vascular supply to femoral head joint destroyed within 3-5 years
66
dislocated hip
look for osteonecrosis
67
steroids and excessive alcohol
osteonecrosis
68
severe pain with light weight bearing
occult fracture intolerable hip rotation ROM MRI needed, Xray not sensitive enough **
69
groin and back pain, sx beyond knee, paresthesia
referred pain | -lumbar and SI joint
70
bone scan
Tc-99, sensitive, but not specific about 40% for occult fracture lots of false positives
71
duck walk quick screen
good screening for hip issues better for kids
72
significant pain at ROM end point of hip
osteonecrosis occult fx acute synovitis mets
73
fabere test
flex, abduct, external rotation extend to figure 4 gently push knee
74
positive fabere test
hips, psoas, SI problem
75
tibial tuberosity avulsion
osgood schlatter osteochondritis of tibial tubercle apophysitis of tibial tubercle at insertion of patellar tendon
76
young person doing sports with knee pain, tender area that is palpable
osgood schlatter tx - pain control, continue activity, leg strengthening through PS
77
osteoporotic fractures
older, female, fair, thin, smoker, minor trauma
78
strain vs. sprain
muscle - strain | ligament - sprain
79
3 major signs MRI needed for impingement
pain, weak, atrophy

PCM Spring 2015 Exam 1 (6 decks)

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