msk review session 1/13 Flashcards
parts of a msk exam
- Detailed History/Review of Systems
- VisualObservation
- Range of Motion
- MMT’s
- NeurologicalTests- Dermatome/Myotome
- Special Tests
- Function Testing
- Psych Testing
C1/2 myotomes and muscles
neck flex/ext
rectus lateralis, rectus capitis ant
longus capitis, longus coli, longus cervicis, SCM
myotomes and muscles - C3
neck lateral flexion
longus capitis, longus cervicis
trapezius
scalenes
myotomes and muscles - C4
shoulder elevation trapezius levator scapulae scalenus anterior and medius diaphragm
myotomes and muscles - C5
shoulder abduction rhomboid major, minor deltoid, supraspinatus infraspinatus, teres minor biceps scalene anterior, scalenus medius
myotomes and muscles - C6
elbow flex, wrist extend serratus anterior, latissimus dorsi subscapularis, teres major pec major biceps, coracobrachialis, brachialis, brachioradialis supinator Extensor carpi radialis longus scalenus anterior, medius, and poserior
myotomes and muscles - C7
elbow extend, wrist flex serratus anterior, latissimus dorsi pec major, minor triceps pronator teres flexor carpi radialis, flexor digitorum superficialis extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi scalenus medius, scalneus posterior
myotomes and muscles - C8
thumb extension, thumb abduction, ulnar deviation
pec major, minor
triceps
FDS, FDP, FPL
pronator quadratus
FCU
abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis
extensor indicis, abductor pollicis brevis, flexor pollicis brevis, opponens pollicis
scalenus medius and posterior
myotomes and muscles - T1
intrinsic hand abduction, adduction
flexor digitorum profundus, intrinsic hand muscles, flexor pollicis brevis, opponens pollicis
myotomes and muscles - L1/L2
hip flexion
psoas, iliacus
sartorius, gracilis, pectineus, adductor longus, adductor brevis
myotomes and muscles - L3
knee extension
quads
adductor longus, magnus, brevis
myotomes and muscles - L4
ankle DF tibialis anterior quads tensor fasciae latae adductor magnus obturator externus tibialis posterior
myotomes and muscles - L5
toe extension extensor hallucis longus, extensor digitorum longus glute med, min obturator internus semimembranosus, semitendinosus peroneus tertius popliteus
myotomes and muscles - S1
ankle PF, eversion hip extension knee flexion gastroc, soleus glute max obturator internus, piriformis biceps fem, semitendinosus, semimembranosus popliteus peroneus longus, brevis extensor digitorum brevis
myotomes and muscles - S2
knee flexion biceps fem piriformis gastroc, soleus flexor dig longus, flexor hallucis longus intrinsic foot muscles
myotomes and muscles - S3
rectal sphincter tone
intrinsic foot muscles
flexor hallucis brevis, flex dig brevis, ext dig brevis
DTR biceps reflex - spinal level? normal response?
C5-6
contract biceps
DTR brachioradialis reflex - spinal level? normal response?
C5-6
elbow flex, forearm pronation
DTR triceps reflex - spinal level? normal response?
C7-8
elbow extension, contract triceps
DTR patellar reflex - spinal level? normal response?
L3-4
knee extension
DTR tib post reflex - spinal level? normal response?
L4-5
PF, inversion foot
DTR achilles reflex - spinal level? normal response?
S1-2
PF foot
DTR grading min to max? what is normal?
min 0 absent
max 4+ clonus, very brisk, hyperactive
normal 2+
shoulder ROM
Flexion = 0-180 Extension = 0-60 Abduction = 0-180 Internal rotation = 0-90 External rotation = 0-90
Elbow ROM
Flexion = 0-150 Extension = 0
Forearm ROM
Pronation = 0-80 Supination = 0-80
Wrist ROM
Flexion = 0-80
Extension = 0-70
Radial deviation = 0-20
Ulnar deviation = 0-30
hip ROM
Flexion = 0-120 Extension = 0-30 Abduction = 0-45 Adduction = 0-30 Internal rotation = 0-45 External rotation = 0-45
knee ROM
Flexion = 0-135 Extension = 0
subtalar ROM
Inversion = 0-5 Eversion = 0-5
ankle ROM
Dorsiflexion = 0-20
Plantar flexion = 0-50
Inversion = 0-35
Eversion = 0-15
MMT grade?
complete ROM, against gravity, no resistance
3/5 fair
MMT grade?
complete ROM, against gravity, moderate resistance
4/5 good
MMT grade?
complete ROM, against gravity, minimum resistance
3+/5 fair +
MMT grade?
>1/2 ROM not complete, against gravity, no resistance
3-/5 fair -
MMT grade?
initiates but <1/2 ROM, against gravity, no resistance
2+/5 poor+
MMT grade?
complete ROM, gravity eliminated, no resistance
2/5 poor
MMT grade?
contraction but no movement, gravity eliminated position
1/5 trace
MMT grade?
no contractions, gravity eliminated position
0/5 zero
glenohumeral jt
open pack? closed pack?
open: 55-70deg abduction, 30deg horizontal adduction, neutral rotation
closed: max abduction, ER
humeroulnar
open pack? closed pack?
open: 70deg flexion, 10deg supination
closed: full extension, supination
humeroradial
open pack? closed pack?
open: full extension, supination
closed: 90deg flexion, 5deg supination
proximal radioulnar
open pack? closed pack?
open: 70 deg flexion, 35deg supination
closed: full extension, 5 deg supination
distal radioulnar
open pack? closed pack?
open: 10deg supination
closed: 5 deg supination
radiocarpal
open pack? closed pack?
open: neutral
closed: full extension, radial deviation
vertebral
open pack? closed pack?
open: midway flexion and extension
closed: max extension
hip
open pack? closed pack?
open: 30deg flexion, 30 deg abduction, slight ER
closed:
- ligamentous: full extension, abduction, IR
- bony: 90 deg flexion, slight abduction, slight ER
knee
open pack? closed pack?
open: 25 deg flexion
closed: full extension, ER (screw home)
talocrural
open pack? closed pack?
open: 10deg PF
closed: full DF
Scapulohumeral rhythm for elevation
- First 30-60 elevation GH, then 2:1 ratio
* Total = 120 GH + 60 scapulothoracic
obrien test
what for? patient position? + result?
for SLAP lesion
position: standing, begin 90 flexion, max IR then max ER
+
Signs of what nerve entrapment?
- Tibialis anterior weakness, drop foot
- Sensory loss along the anterior leg below the knee
L4
outcome measures for functional ambulation status, determining function in a community ambulator
TUG or 6 MWT
