MSK Examination Flashcards
Shoulder Joint ROM: flexion // extension // abduction // internal rotation // external rotation
flexion 0-180 // extension 0-60 // abduction 0-180 // internal rotation 0-90 // external rotation 0-90
Elbow Joint ROM: flexion // extension
flexion 0-150 // extension 0
Forearm Joint ROM: pronation // supination
pronation 0-80 // supination 0-80
Wrist Joint ROM: flexion // extension // radial deviation // ulnar deviation
flexion 0-80 // extension 0-70 // radial deviation 0-20 // ulnar deviation 0-30
Hip Joint ROM: flexion // extension // abduction // adduction // internal rotation // external rotation
flexion 0-120 // extension 0-30 // abduction 0-45 // adduction 0-30 // internal rotation 0-45 // external rotation 0-45
Knee Joint ROM: flexion // extension
flexion 0-135 // extension 0
Subtalar Joint ROM: inversion // eversion
inversion 0-5 // eversion 0-5
Ankle Joint ROM: dorsiflexion // plantar flexion // inversion // eversion
dorsiflexion 0-20 // plantar flexion 0-50 // inversion 0-35 // eversion 0-15
Describe a 1/5 MMT (gravity, ROM, resistance)
Gravity: none
ROM: contraction only
Resistance: none
Describe a 2/5 MMT (gravity, ROM, resistance)
Gravity: none
ROM: full
Resistance: none
Describe a 3/5 MMT (gravity, ROM, resistance)
Gravity: against
ROM: full
Resistance: none
Describe a 4/5 MMT (gravity, ROM, resistance)
Gravity: against
ROM: full
Resistance: moderate
Describe a 5/5 MMT (gravity, ROM, resistance)
Gravity: against
ROM: full
Resistance: max
GH Joint Open vs Closed Packed positions
55-70 abduction, 30 horizontal adduction, neutral rotation
vs
maximal abduction and external rotation
Humeroulnar Joint Open vs Closed Packed positions
70 flexion, 10 supination
vs
full extension and supination
Humeroradial Joint Open vs Closed Packed positions
full extension and supination
vs
90 flexion, 5 supination
Proximal Radioulnar Joint Open vs Closed Packed positions
70 flexion, 35 supination
vs
5 supination, full extension
Distal Radioulnar Joint Open vs Closed Packed positions
10 supination
vs
5 supination
Radiocarpal Joint Open vs Closed Packed positions
neutral
vs
full extension, radial deviation
Vertebral Joint Open vs Closed Packed positions
midway between flexion and extension
vs
maximal extension
Hip Joint Open vs Closed Packed positions
30 flexion, 30 abduction, slight ER
vs
ligamentous: full extension, abduction, IR
bony: 90 flexion, slight sbduction, slight ER
Knee Joint Open vs Closed Packed positions
25 flexion
(take stress of MCL and hamstrings during Lachman’s test)
vs
full extension, external rotation
Talocrural Joint Open vs Closed Packed positions
10 plantarflexion
vs
full dorsiflexion
Scapulohumeral rhythm
ratio:
total GH vs just scapulothoracic:
first 30-60 elevation is GH, then 2:1 ratio
total = 120 GH + 60 scapulothoracic
to improve GH ER which glide would you do?
what about on someone with adhesive capsulitis?
anterior;
posterior
upward rotators of the scapula:
upper traps.
lower traps. serratus anterior.,
downward rotators of the scapula:
levator scapulae.
pectoralis minor.
rhomboids.
O’Brien Active Compression Test
patient position?
testing what?
+
patient position: standing, begin with 90 flexion + max IR then repeat with max ER
SLAP tear, labral issue
(+) if pain or painful clicking during IR and no pain during ER
Speed’s Test
patient position?
testing what?
+
upright, 90 flexion with elbow fully extended and forearm supinated; examiner pushes towards extension
superior labral tear or bicipital tendinitis
(+) pain or tenderness in the bicipital groove
Yergason’s
patient position?
testing what?
+
sitting, with a flexed elbow patient supinates against resistance which turns on the biceps
mostly bicipital tendinitis or torn transverse ligament
(+) tenderness in bicipital groove
Crank Test
patient position?
testing what?
+
supine, arm elevated to 160, max ER or IR; examiner provides axial load to the humerus
used for labral instability
(+) painful click reproduction
Clunk Test
patient position?
testing what?
+
supine, abduction with anterior glide on humerus
feeling for surface defect in labrum
(+) painful clunk
Name some special tests to check the labrum?
- O’Brien (SLAP)
- Speeds (superior labrum/ biceps)
- Yergasons (transverse ligament/biceps)
- Crank (using axial load to check for labral instability/clicking)
- Clunk ( using anterior glide to detect labrum deficiencies/clicking)
- Biceps Load Tests at 90* and 120* abduction while in supine; loading biceps in max ER
Impingement Tests?
Hawkins Kennedy: chicken wing chicken wing checking for impingement
Neer: full shoulder flexion; overuse of supreaspinatus or biceps tendon
Painful Arc: impingement in the middle of the arc; AC joint at the top of the arc
Supraspinatus special test where patient is abducted in full IR
Empty Can/Jobe
pain severity reflects injury severity (indirect relationshp- completely torn isn’t painful)
Thoracic Outlet Syndrome Tests (3)
Adson: head towards arm extended; see if pulse disappears
Roos: chicken dance for 3 min; see if can keep arms in starting position or familiar sxs occur
Allen: football player position away; pulse disappears
Goal: checking for thoracic outlet syndrome secondary to neurovascular compromise
Ely’s Test used for:
Hip flexion contracture; in supine flex the patient’s knee and see if hip starts to come off the table
Ober’s Test used for:
IT band tightness; done in sidelying with hip extended
Thomas Test used for:
hip flexor tightness tested in supine; after you perform check the knee to see if a ROM restriction at the knee
Lachman Test used for
ACL/posterior oblique ligament/ arcuate popliteus complex injury; knee flexed to ~20-30* applying anterior translation force to tibia in order to stress ACL
Lachman tests ACL better anatomically. Why?
because due to patient positioning you can limit the joint capsule, MCL, and hamstrings. All of which could give a false negative, providing a firm end feel.
Anterior Drawer psychometric properties
good specificity; not good sensitivity
(if it’s positive we can rule in, but if it’s negative we can’t confidently rule out)
knee is flexed higher and you sit on the patient’s foot to stabilize
Pivot Shift tests what?
ACL stability; supine medial knee rotation while examiner flexes and extends the knee;
tibia subluxed then relocates
McMurray’s tests what?
meniscal tear; in supine flex knee/hip + bias meniscus based on IR/ER
(+) clicking/pain
During McMurray’s test: medial rotation is for ______ meniscus.
And vice versa.
lateral meniscus
SPINE ROM
Cervical
flex/ext, sidebending, rotation
80-90/70
20-45
70-90
SPINE ROM
Thoracic
flex/ext, sidebending, rotation
20-45/25-45
20-40
35-50
SPINE ROM
Lumbar
flex/ext, sidebending, rotation
40-60/20-35
15-20
3-18
Foraminal Compression.
what’s being treated?
patient position?
(+) finding?
cervical radiculitis
sitting
pain radiates in arm in direction head is side-flexed during compression
Distraction Test.
what’s being treated?
patient position?
(+) finding?
nerve root compression
sitting
decreased familiar sxs with head lifted
Shoulder Abduction Test.
what’s being treated?
patient position?
(+) finding?
cervical extradural compression
sitting or supine
decreased/relief of sxs
Valsava Test.
what’s being treated?
patient position?
(+) finding?
increased spinal cord pressure
sitting
increased pain
Vertebral Artery Test.
what’s being treated?
patient position?
(+) finding?
vertebrobasilar artery problem
supine
sxs when opposite artery is affected; dizzy/visual disturbances/disorientation
Vertebral Artery Test.
what’s being treated?
patient position?
(+) finding?
vertebrobasilar artery problem
supine, full extension and rotation of the neck
sxs when opposite artery is affected; dizzy/visual disturbances/disorientation
5D’s 3 N’s
dizzy drop attack dysphagia dysarthria diplopia
nystagmus numbness nausea
What’s the theory behind how TENS works to block pain?
Gate Control Theory
non noxious stimulus “noise”
goes up spinal cord to brain, blocks pain signals like a soccer goalie
gives an opportunity for muscles that are guarding to relax as well
usually pre-mod setting to prevent desensitization/ “getting used to it”
