MSK Physical Exam Flashcards
What are possible areas of pain?
joint pain
soft tissue pain
nerve pain
What are some causes of pain?
inflammation
infection
mechanical
What are the types of synovial joints?
ball and socket
hinge
condylar
What are the planes of movement?
abduction
adduction
flexion
extension
internal/external rotation
What areas of the body have full ROM?
ball and socket joints
hinge joints
What is an example of a ball and socket joint?
hip
shoulder
What is an example of a hinge joint?
knee
What is abduction?
movement away from midline
What is adduction?
movement toward the midline
What is dorsiflexion?
movement superiorly
only applies to foot and ankle
What is extension?
lengthening of a muscle or joint (increase angle)
What is flexion?
shortening of a muscle or joint (decrease angle)
What to look for when assessing gait and general movement
is it abnormal watching it or abnormal when you are not
What is normal anatomical position?
person standing upright facing forward, arms straight and hands held by the hips with palms facing forward. feet parallel and toes pointing forward.
What is the purpose of normal anatomical position?
central concept behind all descriptions of location within the body
What is important with anatomic difference?
there is different anatomy between males and females so consider how they make people more susceptible to certain injuries - in both upper and lower extremities
How do changes in the bones and muscles change the exam?
posture
range of motion
strength
pain
How do you evaluate the pain during a physical exam?
watch the pt during the entire visit, including walking into the exam room
What should you notice when evaluating the pain?
how they are sitting
how they move towards the table
how they get off the table
do their movements correlate with their description of the pain
What are possible mechanisms of injury?
sometimes its helpful to work backwards to discover the cause but a good hx and PE will help you evalulate
What is the scale for assessing strength?
0: no movement
1: trave movement
2: movement and full PROM, but unable against gravity
3: full AROM, but not against resistance
4: full ROM against gravity & resistance, but weak
5: full ROM against gravity, full resistance
What are the most common numbers to use when assessing strenght?
4 and 5
Which numbers are considered profound weakness?
0-3
What should you do when strength testing?
ROM of each joint - remember each plane of motion of each joint
What should you do with the joint above and below the joint you are testing?
ALWAYS consider the them as there may be contributory factors effecting more than the joint of pain
What are things to consider when assessing joints above and below the one being tested?
LBP is effected by knee problems
Knee pain affected by foot problems
biomechanics of posture on the neck pain
elbow pain being effected by rotator cuff restriction
What are some soft tissue clues when doing an MSK PE?
swelling
bruising and lesions
erythema
nodules and tumors
patterns of radiation
How do circulation and sensation affect PE?
always check circulation and sensation distal to injury
How do you determine a mechanism of injury?
consider which structures are most likely to be injured
What are the components of a MSK PE?
IPRRSSSS-V and Joints above and below
I: Inspection
P: Palpation
R: Range of Motion
R: Reflexes
S: Strength
S: Sensation
S: Stability
S: Special Tests
V: Vascular
What should you do when testing ROM?
What is the normal ROM for the joint selected?
Compare joints from side to side
How to test strength?
peripheral nerve specific/nerve root specific
How to test sensation?
think about nerve distribution. how would you check neurologic function related to the selected joint?
How to test vascular?
check pulses distal to the joint and cap refill
