MSK Rubric Flashcards
Intro
Name, PA-S, obtain consent, wash hands
Inspection
All muscle groups for tone, symmetry, and atrophy
Joints for swelling, deformity, and erythema
Palpate - Shoulder
I’m palpating for tenderness and deformity.
I’ll start with the scapula, clavicle to the AC joint, coracoid process, greater/less tubercle, bicipetal tendon grove.
Move down to the humerus, bicep, and tricep.
Palpate - elbow
At the elbow, the medial and lateral epicondyle, the olceranon.
Tricep/bicep insertion and the flexor and extensor origins.
Palpate- forearm
Radius, Ulna, flexors, and extensors
Palpate - wrist
Palpate carpals, distal radius and ulna
Check radial pulses
Palpate - hand
Metacarpals, interosseous muscles
Palpate - fingers
MCP joints, phalanges, PIP joints, DIP joints, tendons and ligaments
Palpate - Spine
Spinous processes, paravertebral musculature, for tenderness or spasms. Bilateral SIJ for tenderness
At this point I will also check the dermatomes of the BUE
ROM - Shoulder
Flexion, extension, abduction, adduction, internal rotation, external rotation
ROM - Elbow
Flexion, extension, pronation, supination
ROM - Wrist
Flexion, extension, radial deviation, ulnar deviation
ROM - Fingers
Flexion, extension, adduction, abduction, thumb opposition
ROM - C Spine
Flexion, extension, R and L rotation, R and L lateral bend
ROM- T spine/L spine
Flexion, extension, lateral bend, rotation
Strength - Shoulder
Flexion, extension, abduction, adduction, internal rotation, external rotation
Strength - Elbow
Flexion, extension, pronation, supination
Resisted pronation also tests for lateral epicondylitis
Strength - Wrist
Flexion, extension, radial deviation, ulnar deviation
Strength - Fingers
Flexion, extension, adduction, abduction, thumb opposition
Strength - C spine
Flexion, extension, R and L rotation
Special Tests - Shoulder
Speeds - Bicipital tendonitis Empty Can - rotator cuff weakness Neers - impingement Drop arm - rotator cuff tear Hawkins - impingement
Special Tests - wrist
Tinels - tap for median nerve irritation
Phalens - wrist flexion for medial nerve entrapment
Finkelstein - 1st dorsal extensor compartment tendonitis
Palpation - Pelvis
Again, palpating for tenderness or deformity.
Anterior sacroiliac spine, posterior sacroiliac spine, sacrum, and greater trochanter
Palpation - Thigh
Femur, quadriceps, bicep femoris
Palpation - Knee
Patella, femoral condyles, tibial plateau, tibial tuberosity, fibular head, and medial/lateral joint lines
Palpation - leg
Tibia, fibula, gastrocnemius
Palpation - ankle
Medial and lateral malleolus, tibial/talar joint, ATF ligament, deltoid ligament, achilles
I will also check the PT and DP pulses while I’m here
Palpation - foot
Calcaneus, tarsals, metatarsals, digits, flexor and extensor tendons.
Now I will do a BLE dermatomal check
ROM - Hip
Flexion, extension, abduction, adduction, internal rotation, external rotation
ROM - Knee
Flexion, extension
ROM - Ankle
Flexion, extension, inversion, eversion
Strength - Hip
Flexion, extension, abduction, adduction
Strength - Knee
Flexion, extension
Strength - Ankle
Flexion, extension, inversion, eversion
Special tests - Hip/pelvis
Thomas - tightness of the psoas
Special tests - Knee
Bulge - Knee effusion Anterior/posterior drawer - for ACL laxity Lachmans - ACL laxity Varus/Valgus stress - MCL/LCL laxity McMurray - for meniscal cartilage tear
Special tests - ankle
Anterior drawer - ligamentous stability
Talar tilt - ankle stability
Thompson - achilles tendon
Special tests - Spine
Supine straight leg raise - pain at 60 degrees or below positive for L4 L5 S1 nerve root irritation
Have patient sit up and do Hoffmans test for cervical stenosis
Have patient stand and do Trendelenburg for hip abductor weakness
Scoliosis check
