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DOOS 2 > MSK1-Table 1 > Flashcards

MSK1-Table 1 Flashcards

1
Q

what are some important observations in msk?

A

gait, carrying angle, pain, function, atrophy, asymmetry, deformity, footwear, color.

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2
Q

why is medication important? Esp steroids?

A

osteoporosis

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3
Q

what about sexual hx?

A

gonorrhea reactive arthritis

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4
Q

if your patient has a score of 3 on motor examination they can…?

A

active full ROM against gravity (no resistance)

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5
Q

what is HLA-B27 antigen used for?

A

spondylomyopathy

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6
Q

are x-rays useful in OA or RA?

A

OA in early dg and dz progression

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7
Q

what should you order if you suspect spondyloarthropathy?

A

sacroiliac films!

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8
Q

most common cause of neck pain?

A

mechanical!

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9
Q

where does trapiezus pain refer to?

A

temporal lobe, jaw, mastoid,

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10
Q

SCM pain may refer where and cause what automonic dysfunction?

A

above the eye, back of head, top of head. Auditory, corryza, lactorrhea, lactimation.

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11
Q

scalene pain moves where?

A

shoulder, upper arm, chest

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12
Q

when is the soonest time you can do an EMG/NCV nerve conduction study after neck injury?

A

1 month post onset

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13
Q

where are your C5, C6, C7, C8, T1, T2 dermatomes???

A

C5 shoulder, 6-top forearm/thumb/1st digit. 7- middle digit/hand, 8-4th and 5th digits/wrist, T1- forearm to elbow, T2-upper arm

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14
Q

what view is needed on x-ray to see C-7?

A

swimmer’s view

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15
Q

what kind of curve should be seen on cervical x-ray?

A

lordotic

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16
Q

when do you order an MRI for degenerative disc disease?

A

neuro compromise is apparent

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17
Q

what are the main tx options for neck pain?

A

PT, NSAIDs, muscle relaxants, trigger point (trapezius)

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18
Q

pt has chronic arm and shoulder pain with unknown cause, and weakness/wasting of hand muscles, plus sensory disturbance of palmar 5th digit?

A

thoracic outlet syndrome (TOS)

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19
Q

Dg? Tx?

A

cervical x-ray and electrodiagnostics. EMG w/ slow conduction. Tx surgical resection of band.

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20
Q

what nerve roots are compressed in TOS

A

C8 or T1

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21
Q

where does sciatica occur?

A

buttock, posterior thigh, posterolateral leg including malleolus, dorsum and sole

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22
Q

where do discs bulge?

A

posterior lateral

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23
Q

what test do you use for low back pain w/radiation?

A

straight leg raise

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24
Q

u/l LBP and buttock pain worse with standing in one position?

A

SI joint. Do compression test! Dg/tx- injection

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25
Q

elderly pt with low back pain that increases with walking and is relieved by leaning forward?

A

spinal stenosis

26
Q

what are red flag sx for low back pain?

A

Fever, Wt. loss, morning stiffness, hx. of IV drug/steroid abuse, trauma, hx. of CA, saddle anesthesia, bowel/bladder function loss, major motor weakness

27
Q

when do you get an MRI in LBP?

A

cord, neural tumor, stenosis, disc infections

28
Q

colitis pain may refer where?

A

low back!

29
Q

where does the sciatic nerve refer pain to?

A

posterior calf.

30
Q

what should you measure in a back pain w/u?

A

leg length!

31
Q

what degrees are considered positive for sciatica in SLR?

A

30-70 degrees elict pain

32
Q

what else should you check for in back pain w/u?

A

fever, breast mass, pleural effusion, prostate dz, skin abscess, lipoma.

33
Q

elevated ESR may raise suspicion for?

A

malignancy or inflamm condition (polymyalgia)

34
Q

post menopausal female w/ back pain should get what?

A

DXA w/ VFA view for compression fx

35
Q

what are your leg dermatomes?

A

refer to slide 70. L5 heal, S1 outer leg/5th digit, S5- anus/inner thigh, L-4 knee, big toe. L5 and S1 important.

36
Q

what is spondylolisthesis?

A

vertebra slips onto bone below it

37
Q

how many signs do you need for Waddel’s? what does it test?

A

3 or more. Suggestive malingering. Tenderness, simulation, distraction, regional disturbances, overreaction.

38
Q

what are red flags for emergency investigation of back pain?

A

loss of bowel or bladder, saddle anesthesia, loss sphincter tone, sensory level on neuro exam, B/L leg pain w/ B/L neuro deficit.

39
Q

what should you encourage your mechanical chronic low back pn pt do to?

A

exercise, keep moving, lose wt.

40
Q

medical mngmt of LBP?

A

NSAIDs: Ibuprofen 600mg TID . Flexeril 5-10mg TID. Tx depression.

41
Q

how do you dg disc herniation?

A

MRI w/ focal and neuro sx.

42
Q

what curvature is significant in scoliosis?

A

greater than 15 degrees. Commonly right thoracic T7 or T8.

43
Q

what degree do you refer? When do you x-ray?

A

refer over 20. x-ray q3-4 mo in 15-20 degrees.

44
Q

leg pain, numbness, saddle anesthesia and/or paralysis, with loss of bowel or bladder?

A

cauda equina. Sg emergency

45
Q

what is the difference in perarticular vs articular disorder?

A

articular- limited ROM w/active and passive; swelling. Periarticular- pain with active ROM only, tender to adjacent structure, pain w/ specific movement.

46
Q

what is bursistis associated with?

A

rotator cuff tendinitis

47
Q

tx of bursitis?

A

NSAID, rest, occ steroid inj.

48
Q

where is the most common location of tendinitis?

A

supraspinatus

49
Q

dull aching, worse at night, interferes w/ sleep, severe w/ abduction and overhead reach, tender lateral humeral head?

A

supraspinatus tendinitis. Tx: NSAID, PT, steroid inj, surg decompression.

50
Q

painful ROM esp resisted supination?

A

bicipital tendinitis.

51
Q

inflammation at lateral epicondyle, possible weak hand extension, pt types a lot.

A

lateral epicondylitis- tennis elbow. Tx- counterforce tennis elbow brace.

52
Q

Taut band, tender spot, referred pn, motor dysfunction and autonomic phenomena…

A

trigger point (MTrPs)

53
Q

what are the 3 components in Motor Endplate Hypothesis?

A
  1. motor componenet (contraction knot). 2. sensory (allodynia and hyperalgesia). 3. autonomic (lacrimation, coryxa, salivation, dizzy)
54
Q

MTrPs is the result of…

A

mechanical, chemical and neuro dyf in mscle and CNS. Chronicity-> recruit additional mscle and sensory regions resulting in hyperalgesia, allodynia and widespread stimulus.

55
Q

tx?

A

get blood to it, diet, posture, vitamins.

56
Q

Local or regional pain syndrome (usually aching and poorly localized) with spasm, tightness, referral along well established pattern, with possible autonomic symptoms and articular dysfunction.

A

myofascial pain

57
Q

what is main dg for myofascial pain?

A

palpation! Tight band!

58
Q

where should you NEVER inject on neck?

A

high and right= vertebral artery

59
Q

what is the goal of dry needling or 0.5% lidocaine?

A

elicit LTR spinal reflex to contract fibers in taut band. Then vapocoolant spray, stretch and heat.

60
Q

what is never indicated in myofascial pain?

A

opiods!

61
Q

what are some important observations in msk?

A

gait, carrying angle, pain, function, atrophy, asymmetry, deformity, footwear, color.

62
Q

why is medication important? Esp steroids?

A

osteoporosis

DOOS 2 (14 decks)

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