MSK review Flashcards
Grade this ankle sprain:
mild joint instability, moderate intra- capsular swelling and tenderness, and some loss of ROM and joint function
Grade II lateral ankle sprain
Grade?
Complete rupture of the anterior talofibular ligament, calcaneofibular ligament, and capsule with mechanical joint instability; severe intra/extra-capsular swelling, ecchymosis, tenderness and inability to weight-bear.
a severe or Grade III lateral ak sprain
Grade?
Stretch of the lateral ligament complex with no macroscopic tear or joint instability, little swelling or tenderness
Grade I lateral ankle sprain (mild)
Syndesmosis sprain ankle sprain looks like?
inability to bear weight, severe ecchymosis (a discoloration of the skin resulting from bleeding underneath), mortise widening
medical term for a dark purple spot when blood leaks into top layer of skin.
ecchymosis - from greek “to pour out”
What test?
Lie the patient supine on the bed. Place the patient’s knee in about 20-30 degrees flexion. According to Bates’ Guide to Physical Examination, the leg should also be externally rotated slightly. The examiner should place one hand behind the tibia and the other on the patient’s thigh. It is important that the examiner’s thumb be on the tibial tuberosity.
Lachman’s test for ACL
Anterior translation of the tibia associated with a soft or a mushy end-feel indicates a positive test
Tibialis anterior weakness and sensory loss along the anterior leg below the knee are the most common signs of x nerve root entrapment.
L4
a childhood condition that occurs when blood supply to the ball part (femoral head) of the hip joint is temporarily interrupted and the bone begins to die.
Legg-Calvé-Perthes’ disease
Constant pain without any relation to position is a key indicator of
spinal cancer.
What deformity?
digit has a hyperextended metacarpophalangeal joint, flexed proximal interphalangeal joint, and a hyperextended distal interphalangeal joint.
Boutonniere deformity
Mallet finger involves
just flexion of the DIP joint
The O’Brien’s test is MOST indicative of
SLAP tears.
Extension activities will exacerbate any pain from
spondylolisthesis, stenosis of the spinal canal
for hypomobility of the neck, thrust manipulation of the x spine can provide short-term improvements in patients with mechanical neck pain.
thoracic
precautions to avoid dislocation with a THA that used a posterior surgical approach
flexion, medial rotation, and adduction.
Shoulder rotation, especially x, is the MOST helpful at strengthening the rotator cuff, which will be the MOST helpful at treating subacromial bursitis.
external rotation
Numerous studies indicate that maintaining x function after knee surgery speeds recovery.
quadricep
Forward head posture impacted by ___ tightness and ___ weakness
pec minor tightness
Sh retractor weakness
ligament located just inferior to the medial malleolus and is commonly injured in eversion sprains.
Deltoid
A patient reports pain in the knee while descending stairs. The pain increases with knee flexion, especially at approximately 30 degrees of flexion.
Which disorder likely present?
pain at approximately 30 degrees of flexion with eccentric loading, the point of the greatest compression of the patella into the femur = PFPS
Patrick’s Test (or the FABER Test) is used to test for
hip or SI joint pathology
Straight Leg Raising Tests for what?
Herniated discs
dark line is caused by increased melanocyte-stimulating hormone occurs in what?
Linea nigra, pregnancy
Supine; placing pillows under the x side of the body will help offload the inferior vena cava during treatment.
good for?
right
good for pregnancy
??, characterized by excessive collagen production and adhesions that result in restricted joint motion and pain, is the MOST common complication of surgical joint repair
List examples ^
Arthrofibrosis - characterized by excessive collagen production and adhesions that result in restricted joint motion and pain.
frozen shoulder, adhesive capsulitis,
joint contracture
stiff knee and stiff elbow.
anterior shoulder dislocation which creates a divot in the cortex of the humeral head.
what is this called?
Hill-Sach’s lesion
Difference between primary vs secondary shoulder impingement
secondary causes (2)= pinching of the rotator cuff in the shoulder joint itself; OR overuse d/t rotator cuff from attempting to stabilize an unstable GHJ
primary = pain in the shoulder is caused by direct (or primary) mechanical rubbing of the rotator cuff tendon by surrounding bony structures
MOST important consideration during rehab for meniscus repair? How long to limit?
Avoid full knee flexion - will shift the menisci posteriorly and disturb the repair site. Most protocols call for limited weight bearing and flexion for about 6-10 weeks.
The most dangerous point of rehabilitation is approximately x weeks when the graft is remodeling
6-8
Steps of gioniometric measurement
1) estimate
2) Locate landmarks
3) align
4) read
Joint Mob Grade X is large amplitude oscillation to the limits of available motion.
3
Grade X is large amplitude oscillations, but not to end of range.
2
Grade ?? is small amplitude oscillations at the end of range.
4
Grade ?? is high velocity, low amplitude thrust past the end of range.
5
correct landmarks for plumb line
posterior to the coronal suture
anterior of the lateral malleolus.
posterior to the iliofemoral joint
@ Vertebral bodies of the lumbar spine
A patient with an above knee prosthetic limb is displaying lateral trunk bending toward the involved lower extremity while ambulating. What is MOST likely cause of this gait abnormality?
Medial wall too high
If prosthetic is too long, what is likely?
Circumducted gt
Poor suspension leads to what type of gt?
vaulting in order to keep residual limb inside socket (approximate gap via gastroc)
When the capsule shrinks and sticks, the end-feel becomes
very firm.
Best test for anterior talofibular ligament integrity
Anterior drawer
Talar tilt test will indicate a torn x ligament.
calcaneofibular
x is a test for Achilles tendon rupture.
Thompson
Ottowa 2-step test rules out ?
fx
A patient is asked to flex their shoulder to 90 degrees with the forearm in full supination. The examiner places resistance downward against the flexed arm.
Name? Rules out?
Speed’s Test for bicep tendon pathology.
Rotator cuff pathology can be tested with resisted
external/internal rotation
Ratio of GH to scapulothoracic movement?
there is typically a 2:1 glenohumeral:scapulothoracic ratio of movement that will achieve full shoulder flexion.
120;60
Capsular pattern for T spine?
Equal lateral flexion and rotation inhibited, less so for extension