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C21 Phase 1 > MSK Examination > Flashcards

MSK Examination Flashcards

1
Q

Questions before knee exam

A

Which knee is sore?
Where is the pain?
Can I expose both knees, I would like to compare them?

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2
Q

What are you looking for in a knee examination

A

Mobility aids
Symmetry of knees
Redness/swelling
Thigh circumference of both legs above knee

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3
Q

What are you feeling for in a knee examination

A

Temperature
Joint lines and tendon insertion (knee at 90*)
Patellar border, behind knee (leg straight)
Patellar tap
Sweep test

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4
Q

What active movement do you ask the patient to perform in a knee examination

A

Flexion (heel into bottom)
Extension (straighten again)
Hyperextension (push knee into the bed)
Straight leg raise (keep leg straight and raise off bed)

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5
Q

What passive movement do you perform on the patient in a knee examination

A 
Flexion and extension (with hand on patella)
Anterior and posterior drawer tests
McMurray's test
Collateral ligament stress test
Patellar apprehension test
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6
Q

What can be done to complete a knee examination

A

Examine the other knee
Examine hip and ankle
Perform full MSK assessment
X-ray, MRI, aspiration of any effusion

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7
Q

What can you assess in a standing patient in a knee examination

A 
Inspect for deformity, wasting etc...
Gait
Sensation in feet
Foot pulses
Big toe cap refill
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8
Q

What is fixed flexion of the knee indicative of

A

Osteoarthritis

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9
Q

What is thigh circumference indicative of

A

Reduced indicates wasting of hamstrings or quadriceps

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10
Q

What does palpation of the joint tendons indicate

A

Patients may flinch if tender - inflammation

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11
Q

What does palpation behind the knee indicate

A

Baker’s cyst

Popliteal aneurysm

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12
Q

What does a patellar tap indicate

A

Large knee effusion

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13
Q

What does a sweep test indicate

A

Small knee effusion

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14
Q

Why ask a patient to perform active movements in a knee exam

A

To assess ROM

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15
Q

Why perform passive movements on the patient in a knee exam

A

Feel for crepitus and observe patient’s discomfort

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16
Q

What do the anterior and posterior drawers indicate

A

ACL and PCL integrity

17
Q

What does McMurray’s test for

A

Meniscal tear

18
Q

What does the collateral ligament stress test test for

A

MCL and LCL weakness

19
Q

What does the patellar apprehension test test for

A

Previous patellar dislocation

20
Q

What knee deformities can be observed

A 
Varus deformity (bow-legged)
Valgus deformity (knock-kneed)
21
Q

What is a varus deformity indicative of

A

osteoarthritis, rickets

22
Q

What is a valgus deformity indicative of

A

osteoarthritis, rheumatoid arthritis

23
Q

Questions for a hand exam

A

Are you in any pain in your hands or arms

24
Q

What do you look for on the nails in a hand exam (with causes)

A

Pitting (psoriasis)
Nailfold infarcts (Vasculitis, lupus)
Clubbing (other systems)

25
Q

What do you look for on the fingers in a hand exam (with causes)

A

Scars (surgery)
Swelling (Synovitis, infection)
Swan-neck deformity (Rheumatoid)
Heberdens and Bouchards nodes (osteoarthritis)

26
Q

What do you look for on the MCP joints in a hand exam (with causes)

A

Ulnar deviation (Rheumatoid)
Sublux/dislocation (rheumatoid)
Swelling (infection)

27
Q

What do you look for on the dorsum in a hand exam (with causes)

A 
Tight, cold, waxy skin (scleroderma)
Interossei wasting (Rheumatoid, ulnar nerve palsy)
28
Q

What do you look for on the wrists in a hand exam (with causes)

A 
Radiocarpal subluxation (rheumatoid)
Prominent ulnar styloid (rheumatoid)
29
Q

What do you look for on the palms in a hand exam (with causes)

A 
Scars (Duputryns release surgery)
Wasting of thenar/hypothenar eminence (median/ulnar nerve palsy)
Palmar erythema (Rheumatoid, liver disease, hyperthyroidism, pregnancy)
30
Q

What do you look for with the hands in a praying position in a hand exam (with causes)

A

Flexion deformity (RA, OA, Duputryns)

31
Q

What do you look for with the hands clenched in a hand exam (with causes)

A

Loss of valleys between metacarpals (swelling)

32
Q

What do you look for with the hands up to the chin in a hand exam (with causes)

A 
Rheumatoid nodules (RA)
Psoriatic plaques (psoriasis)
33
Q

What do you feel for in a hand exam (causes)

A 
Temperature  (increased due to inflammation)
Squeeze across wrists, MCP and interphalangeal joints (tenderness due to inflammation)
Palmar thickening (Duputryns)
34
Q

What active movement do you ask the patient to perform in a hand exam

A 
Finger flexion and extension (Make fists)
Finger abduction and adduction 
Wrist flexion/extension
Wrist radial/ulnar deviation
Pronation/supination
35
Q

What passive movement do you perform on a patient in a hand exam

A

Any movements patient struggled with actively

Any joint with an abnormality

36
Q

How do you assess function in a hand exam

A

Pinch grip
Power grip
Fine motor control

37
Q

How do you assess neurovascular integrity

A

Test median, ulnar and radial nerve sensitivity
Radial pulse
CRT in both hands

38
Q

Further investigations after hand exam

A

Examine elbow/shoulder joint
Rheumatoid serology
Joint aspiration
X-ray

C21 Phase 1 (45 decks)

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