MSK examination Flashcards
What is GALS screening?
Gait arms legs spine
HOw to differentiate inflammatory or degenerative symptoms/
Pain eases with use, stiffnes longer than hur in morning sweling syndovial younger with psoriasis famuly history respnds to NSAIDs joint didstribution hands and feet but OA is pain increases wiht use clicks clunks, stiffness not prolongues any time, not clinnically inflammed older or with sport injury, joint distributions 1CMCJ DIPJ knees hip
What is timeline of gout?
Intermittet arthritis severe and then comes back but can become cronic
What is the pattern of RA?
Rheumatoid arthritis can fluctuate but usually constant and increase
What are associated symptoms with joint issues?
Rash Raynaud’s mouth ulcers sicca symptoms dry eyes mouth,
Which conditions are important to ask about in family history of inflammatory disease?
Thyroid issues vitiligo T1DM pernicious anaemic MS CTD RA, Psoriasis crohn’s UC ankylosing spondylitis reactive arthritis
Where does RA not affect?
Distal interphalangeal joint
What to ask before GALS/
DO you have anypain or stiffenens in mucsled or jointsCan you walk up down stairs? Can you dress yourself
What to assess in gait?
Smoothness quick turn and
What to look at from back in GALS?
Look for muscle bulk alignment spine poopleteal fossa hingfood for deformity
What to look at in spine?
Look for curcature of spine, check lumbar spine movement.
What to look at in the front?
Anatomical possition then hands behind head then turning hands over look at skin changes on hands
What to check on hands?
Opposiont and squeezing joints and strength test
What to look at in knees and legs?
Knee hip and bip flexon and roattion look for effusion of knees by presing patella
How to report GALS?
NAD GALS if all fine then report specific isuse or not after
How to record findings of GALS?
do gris for GALS appearance movement for each one and then a small note
What are the rotator cuff muscles?
Inraspinatus, supraspinatu, subscapularis teres minor
What is action of supraspinatus?
initiates abduction below 90 degrees, after it is deltoid
What does infaspinatus do?
external rotation
What does teres minor do?
external rotation works with infraspinatus
What does subscapularis do?
Internal rotation of the shoulder?
What does deltoid do?
Abduction of shoulder above 90 degrees
What does trapezius do?
shrugs shoulders and controls scapular movement
For shoulder joint exam, what to do?
Look feel move
What to look at For shoulder joint exam?
posture muscle wasting scars skin changes swelling deformity
What to feel for shoulder joint exam?
feel temperature over joints, ternoclavicular acromioclavicular joint, anterior and posterior glemoheumoral, back of hand feel bonly landmarks walk along clavicle for swellings spine of scap medial border feel for bulk of muscle squeeze them to check for wasting
what to move For shoulder joint exam?
intitially put hands behind our back let them do active first then passive if can’t. put hands behind head
look at flexion extension externalrotation abduction pinful arc
What is rotator cuff pathology?
pain from 60-120 degrees in abduction 2 components glenohumeral scapuothoracic
What is acromioclavicular joint pathology indicated by?
120-180 degree pain
How to test supraspinatus?
resised abduction below 90 degrees
How to test infraspinatus?
Resist externa rotation
What is subscapularis test?
lift off test resisted internal rotation
How to test acromioclavicular joint?
Scarf test forced aduction
What to do at end of shoulder exam?
Assess cervical spine, assess neuroogical and cascular limb status if indicated
What is a frozen shoulder?
adhesive capsulitispainful restrction all movements especially of external rotation usually over 40 have RA diabetes post stroke minor trauma postoperative
What to look at cervical spine?
Look normal lordosis, feel spinous processes move flexion, extension lateral rotation lateral flexion lateral flexion is often first to go
What is radiculopathy?
nere root pain from impingement tingling pain and other symptoms in dermotomes
