Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Physiotherapy > MSK Assessment > Flashcards

MSK Assessment Flashcards

1
Q

What is a subjective assessment?

A
  • Initial assessment where we talk to our patients and gather information
  • Discussions with other clinicians, family or carers
  • Reading referrals or notes to gather initial information
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the aims of your subjective assessment?

A
  • Build rapport with your patient
  • Gather information (to plan our objective assessment)
  • Establish differential diagnoses
  • Establish the main problems and patient’s goals / expectations.
  • Evaluate patient awareness, knowledge and insight.
  • Establish baseline subjective markers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What areas of subjective assessment should be included in MSK?

A
  • History of present condition (HPC)
  • Past medical history (PMH)
  • Drug history (DH)
  • Social history (SH)
  • Patient goals / aims / expectations
  • Differential diagnoses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can interpersonal skills in a subjective assessment significantly contribute to?

A
  • Patient and healthcare provider satisfaction
  • Problem detection and diagnostic accuracy
  • Patient adjustment to stress and illness,
  • Patient recall of information and adherence to therapy plans
  • Patient health outcomes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What percentage of clinicians can obtain their diagnostic info in a good subjective history?

A

60-80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What percentage of subjective histories can lead to a final diagnosis?

A

76%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some expectations the patient may have from their assessment?

A
  • Diagnosis
  • Advice
  • Exercises to help manage pain
  • Reassurance
  • Cure or resolution of their pain
  • Reduction in their ain so they can self-manage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is discovered during the History of Present Condition (HPC) section of a subjective assessment?

A
  • Current symptoms
  • Timeline
  • Pattern of symptoms
  • Treatment/investigations
  • Mechanism of injury vs insidious onset
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is discovered during the Past Medical History (PMH) section of a subjective assessment?

A
  • Previous operations, accidents or significant illnesses (THREADS)
  • Relevant current medical conditions
  • Specific ‘red flag conditions’
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is discovered during the Drug History (DH) section of a subjective assessment?

A
  • Current medication (anticoagulation?, analgesics?)
  • Significant past medication
  • Specific ‘red flag’ medication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is discovered during the Social Health (SH) section of a subjective assessment?

A
  • Occupation
  • Relevant social or family situations
  • Hobbies & interests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can we record signs & symptoms (S&S) in a clear, detailed and succinct way?

A

Body Chart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some symptoms that mean extra caution is needed?

A
  • Excessive symptoms
  • Neurological symptoms (P&N / numbness)
  • Symptoms of instability
  • Symptoms not matching MOI / problem
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are examples of signs & symptoms (S&S)?

A
  • Pain
  • Pins and needles
  • Giving way
  • Locking
  • Stiffness
  • Swelling
  • Bruising
  • Numbness
  • Instability
  • Clicking/popping/clunking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What questions would you ask about pain location?

A
  • Exactly where is the pain?
  • Can they point with one finger or is it the whole hand?
  • Where does it start, where does it refer to?
  • If there are more than one pain locations are they related?
  • Is it deep or superficial (near the surface)?
  • Do they come together or separately?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What information might we want to get about a patient’s pain?

A
  • Severity
  • Duration (when it started, how long each episode lasts, constant?)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are non-verbal pain cues?

A
  • Facial expression (grimace, redness/pale, clench teeth, shut eyes0
  • Body language (deep breathing, withdraw from touch)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are examples of words used to describe pain?

A
  • Aching
  • Throbbing
  • Burning
  • Shooting
  • Prickling
  • Lancing
  • Stinging
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does night pain suggest in an assessment?

A

more severe pathologies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does 24-hour pain pattern show in an assessment?

A
  • Aids diagnosis
  • AM pain + stiffness (indicate inflammatory)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are (4) pain cautions to look out for?

A
  • Non-mechanical pain: No clear aggravating factors or easing factors
  • Unrelenting pain
  • No 24-hour pattern: pain through the day and night
  • Night pain: severe pain which prevents or wakes from sleep (Manageable night pain is not uncommon)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What do easing factors for pain show in an assessment?

A
  • Aids diagnosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What do aggravating factors for pain show in an assessment?

A
  • Aids diagnosis
  • Provides objective markers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are ‘special’ questions to ask in an assessment?

A

Questions that help diagnose
- Any P&N/numbness?
- Any swelling?
- Any feelings of instability / locking / giving way?
- Any audible pops / clicking?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are ‘red flag’ questions?

A

Questions that indicate more serious pathology
- Cauda equina symptoms
- PMH THREADS questions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is SIN (pain)?

A
  • Severity (low/moderate/high or VAS)
  • Irritability (low/moderate/high)
  • Nature (nociceptive (mechanical/inflammatory)/Neuropathic or peripheral neurogenic/central sensitisation))
  • OR the origin of the pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is irritability (pain)?

A

a disorder’s susceptibility to become painful, how painful it becomes and the length of time this pain takes to subside.
(low/moderate/high)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is nociceptive pain?

A
  • Pain derived from tissues by mechanical or chemical processes.
  • Most likely to be associated with an acute injury, with damaged and healing tissues and postural pain.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is neuropathic/peripheral neurogenic pain?

A
  • Pain derived from the nerve itself or its connective tissue by mechanical or chemical stimulation.
  • Has characteristic qualities typical of nerve irritation and involvement including the sensation and behaviour of the pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is nociplastic pain/central sensitisation?

A
  • Derived from a hyperactive and hypersensitised nervous system (where the stimulus would not normally trigger a pain response and can be strongly linked to stress and emotion).
  • Can be a feedforward response where thoughts and feelings can elicit a pain response.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How will the subjective assessment and SIN factor affect an objective assessment?

A
  • High impact MOI?
  • Positive red flag questions?
  • High pain score (severity)?
  • High irritability?
  • Pain nature?
    + Nociceptive
    + Neurogenic (peripheral neurogenic)
    + Nociplastic (central sensitisation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How does an objective assessment in MSK outpatients flow?

A
  • Observation
  • AROM
  • Clearing joints
  • PROM
  • Muscle tests
  • Palpation
  • Special tests to area
  • Functional testing
  • Nerve/Neuro tests (neuro integrity, neuro sensitivity)
  • Outcome measures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Why do we need to clear joints in an objective assessment?

A

to ensure the pain is coming from the joint/area we think it is (and not referred from another joint/area)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How do we clear joints in an objective assessment?

A
  • Verbally check for other areas of pain (e.g.: common referral areas)
  • AROM + PROM with over pressure of joint above + below
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are special tests in an objective assessment?

A

tests that can be helpful determining the absence or presence of a disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Why do we use special tests in an objective assessment?

A

to add another piece to the ‘diagnostic jigsaw’

37
Q

What are considerations required for special tests during an objective assessment?

A
  • Validity
  • Reliability
  • Sensitivity
  • Specificity
38
Q

What are neurological tests?

A

test the function or integrity of the peripheral nerves

39
Q

What are functional tests?

A

complex objective tests which replicate activities of daily living (e.g.: jump, squat)

40
Q

Outcome measures.

A
  • Can be subjective or objective
  • Need to consider reliability and validity
  • Give us a baseline
  • Monitor progress
  • Motivate patients
  • Justify onwards referrals or discharge decisions
41
Q

What does the ‘snOut’ rule mean for an objective test?

A

a negative ‘snOut’ rules it out
(sensitivity + they don’t have it)

42
Q

What does the ‘spIn’ rule mean for an objective test?

A

a positive ‘spIn’ rules it in
(specificity + they do have it)

43
Q

What are some knee specific special questions for a subjective assessment?

A

Does the patient have or have they experienced any….
- Locking
- Swelling
- Giving way
- Clicking/clunking
- Any sound on injury (e.g.: popping)
- Pins and needles

44
Q

What may true locking of the knee suggest about their injury?

A

suggests loose body or meniscal

45
Q

What is pseudo locking of the knee like?

A

knee feels ‘sticky’ and like it may lock (but it doesn’t)

46
Q

What is true locking of the knee like?

A

patient can’t physically move knee (have to move it with their hands for it to move again)

47
Q

What may the time taken for swelling of the knee tell us about the injury?

A

Within hours = ACL rupture (or similar)

Over several hours = Meniscal

48
Q

What does true giving way suggest about a patient’s knee injury?

A

Mechanical
- Meniscal tear

49
Q

What does pseudo giving way suggest about a patient’s knee injury?

A

Knee weakness
- Hyperextension

Pain
- Muscle inhibition

50
Q

What can a popping sound on injury tell us about the knee injury?

A

can indicate ACL rupture

51
Q

What can pins & needles/ numbness suggest about an injury

A

Indicates nerve involvement
- Is it peripheral nerve irritation perhaps a neuroma after trauma or following surgical incision or spinal referred pain?

52
Q

What are the main pathological features of osteoarthritis in the knee?

A
  • Joint space narrowing
  • Osteophyte formation
  • Sclerosis of the bone
  • Meniscal and articular cartilage degeneration
  • Exposure of subchondral bone
  • Muscle weakness
53
Q

What problems will patients with osteoarthritis of the knee present with?

A
  • Pain on walking and weightbearing activities.
  • Weakness and feelings on instability.
  • Inability to continue with normal or previous activities.
  • Stiffness in the morning and after rest signs on inflammation.
54
Q

What will be the findings on subjective assessment of an osteoarthritic knee?

A
  • Insidious onset
  • Gradually worsening though episodic.

Symptoms:
- Pain
- Stiffness
- Weakness
- Giving way
- Hot knee
- Clicking.

Functional limitations like a reduced ability to walk, kneel, squat.

55
Q

Where can pain be found in a patient with patellofemoral pain syndrome (PFPS)?

A
  • Retropatella
    OR
  • Around the patella
56
Q

What is patellofemoral pain syndrome (PFPS) often aggravated by?

A
  • Walking up stairs
  • Squatting
  • Prolonged flexion
57
Q

What are some common contributing factors to patellofemoral pain syndrome (PFPS)

A
  • Patella Alta (high)
  • Reduced quads flexibility
  • Increased knee valgus on landing
  • Trochlea morphology
  • Patella Baja (low)
  • Reduced Gastroc flexibility
  • Overload
  • Osteochondral defects
  • Quads weakness
  • Hip abductor weakness
  • Gluteal weakness
58
Q

What are the best diagnostic factors for patellofemoral pain syndrome (PFPS) following an objective assessment?

A
  • Muscle weakness
  • Muscle tightness
  • Functional tests
59
Q

What is patella tendinopathy pain aggravated by?

A

loading the tendon + quads activation

60
Q

Who is patella tendinopathy most commonly seen in?

A

young males with a high prevalence in jumping sports

61
Q

Where is the point of tenderness for patella tendinopathy?

A

over the proximal tendon on its attachment to the distal pole of the patella

62
Q

When do knee fractures occur?

A

result from high force sports trauma, falls or RTAs

63
Q

How to fractures of the patella occur?

A

usually a direct trauma or deceleration injury

64
Q

How do fractures of the tibial plateau occur?

A

usually a fall or high trauma event

65
Q

How do fractures of the fibula head occur?

A

usually lateral impact

66
Q

What are the Ottawa rules of the knee?

A

Knee X-ray only required when:
1. Age 55 or older
2. Isolated tenderness of patella
3. Tenderness at head of fibula
4. Inability to flex to 90 degrees
5. Inability to bear weight both immediately & in A&E

67
Q

How are the collateral ligaments (MCL/LCL) typically injured?

A

through lateral forces to the side of the knee, creating a valgus or varus stress

68
Q

Is the LCL or MCL more commonly injured and why?

A

MCL
- it’s less mobile (being partially attached to the medial meniscus)

69
Q

How are knee ligament injuries graded?

A

Grade 1= few fibres torn
Grade 2 = more fibres torn
Grade 3 = complete tear

70
Q

How do ACL ruptures most frequently occur?

A

Non-contact sports related injuries:
- Cutting
- Twisting
- Landing action
(where foot is plated on ground + knee pivots into adduction & medial rotation)

71
Q

What specific tests are used to aid the diagnosis of an ACL injury?

A
  • Anterior draw test
  • Lachman’s test
  • Positive sweep test (seen on examination due to intra-articular swelling)
72
Q

Why are PCL injuries less common?

A

strong + prevent posterior translation of the tibia

73
Q

How does PCL injury usually occur?

A

through hyperextension or a forceful AP translation of the tibia while in flexion

74
Q

What are red flag pathologies and findings of the knee?

A
  • Septic Osteoarthritis
  • Wound infection
  • Compartment syndrome
  • Bone tumours
  • Blocked movement
  • Gross instability
  • Non-mechanical pain
  • Calf redness/heat/pain
75
Q

How do you clear a joint?

A

Full AROM in all directions
- Helps to rule out other joints
- Helps to identify deficits which may be contributing to the patient’s symptoms.

If they have full pain free range of motion the clinician can apply overpressure.
(Do NOT apply over pressure if AROM is restricted/painful or condition is highly irritable.)

76
Q

Weight bearing lunge test.

A

a functional measure of ROM (ankle dorsiflexion)

Foot parallel to wall. Bend knee to touch wall. Move foot as far back as possible with knee still touching wall. Measure distance.

77
Q

What are some serious red flag pathologies?

A
  • Fracture
  • Infection
  • Malignant
  • Visceral
  • Cauda Equina Syndrome
  • Cervical Spine: Cervical artery dysfunction, cervical instability, cervical myleopathy
78
Q

What are some key questions to ask patients (in relation to suspected/diagnosed cancer)?

A
  • Over 50 years old
  • Unexplained weight loss (> 5% over 6 months).
  • Constant severe unremitting pain
  • Night pain that prevents or disturbs sleep
  • Thoracic pain
  • Previous history of cancer
79
Q

What questions do you need to ask your patient in relation to Cauda Equina Syndrome (CES)?

A
  • Do you have pain down both legs (sciatica)?
  • Have you noticed any changes in your bowel, bladder or sexual function?
  • Do you have difficulty controlling your bowel or bladder?
  • Can you feel your saddle area when you wipe?
  • Have you noticed any disturbances in your walking?
80
Q

What are some red flag questions when a patient has neurological symptoms?

A
  • Do you have any P&N or numbness?
  • Have you experienced any weakness or difficulty moving/controlling your body? (any loss of balance or coordination?)
  • Do you experience muscle cramps or spasms?
81
Q

What are some red flag questions when a patient has systemic symptoms?

A
  • Have you had unexplained weight loss recently?
  • Do you have a history of cancer?
  • Have you experienced pain waking you at night and stopping you from getting back to sleep?
82
Q

What is a red flag question for a patient who has had trauma or injury?

A

Have you recently experienced a significant trauma or injury?

83
Q

What are red flag questions for a patient who is at risk of infection?

A
  • Have you had a recent infection or operation?
  • Do you have a fever or night sweats?
84
Q

What are red flag questions for a patient who has had spinal trauma or injury?

A
  • Have you recently experienced a significant trauma or injury to your back?
  • Did your back pain start after a fall or accident?
85
Q

What are red flag questions for a patient who you suspect has Cauda Equina Syndrome (CES)?

A
  • Do you have severe pain down both legs?
  • Have you noticed any changes in your bowel, bladder or sexual function?
  • Do you have difficulty controlling your bowel or bladder?
  • Can you feel your saddle area when you wipe?
  • Have you noticed any disturbances in your walking?
86
Q

What are red flag questions for a patient who has history of spinal infection?

A
  • Have you had a recent infection or operation, especially one that involved the spine?
  • Do you have a fever along with back pain?
87
Q

What is a red flag question for a patient who has spinal inflammatory conditions?

A

Do you have any difficulty moving/stiffness in back or joints >30mins in the morning?

88
Q

What is a red flag question for pathological lower limb vascular symptoms?

A

Have you noticed any changes in skin colour or temperature in your legs?

89
Q

What are red flag questions for pathological lower limb joint swelling & deformity?

A
  • Have you experienced any sudden swelling or deformity in your joints?
  • Have you experienced any trauma?
  • Do you have a history of joint diseases such as rheumatoid arthritis?

Physiotherapy (48 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions