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Physical Exam Midterm & Final > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

How do you grade muscle strength (MS) and what does each grade mean

A 
0 = no muscle contraction
1 = flicker/trace of contraction
2 = Active movement possible with gravity eliminated
3 = Active movement possible against gravity
4 = active movement possible against gravity & resistance
5 = normal muscle power
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2
Q

What is proximal muscle weakness more suggestive of

A

Myopathy

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3
Q

What is distal muscle weakness more suggestive of

A

Polyneuropathy of disorder of peripheral nerve

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4
Q

What are the 3 types of joints

A

Synovial
Cartilaginous
Fibrous (immovable)

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5
Q

What is active ROM

A

Pt does the motion on their own

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6
Q

What is passive ROM

A

The examiner does/provides the motion for the pt

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7
Q

What is the degree of active flexion for the hea/neck? What about active extension?

A

Active flexion = 40 degrees

Active extension = 30 degrees

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8
Q

What is the degree of active lateral flexion of head/neck

A

Active lateral flexion = 30 degrees

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9
Q

What is the degree of passive roatation of the head/neck

A

60 degrees

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10
Q

What is radicular pain?

A

Pain caused by spinal nerve root compression

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11
Q

What is the usual cause of radicular pain? What nerve roots are most commonly involved?

A

Usual cause = foraminal impingement from degenerative joint changes
Most commonly involves C6 &C7

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12
Q

Which muscle is paralyzed in “winged scapula”

A

Serratus anterior

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13
Q

What nerve is paralyzed in “winged scapula”

A

Long thoracic nerve

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14
Q

What is torticollis

A

Lateral deviation and rotation of the head due to SCM contraction

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15
Q

What can cause torticolis

A

Hematoma, tear, or dystonic reaction from pheothiazines

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16
Q

What are the SxS of TMJ syndrome

A

Unilateral TMJ/jaw pain, bruxism, HA, creptius

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17
Q

Whan muscle opens the mouth? What muscles close the mouth?

A 
Open = pyerygoids
Close = masseter & temporalis
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18
Q

What part of the spine is most mobile

A

Cervical spine

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19
Q

What may unequal height of the iliac crests or pelvic tilt suggest

A

Leg length discrepancy, scoliosis, or hip abduction

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20
Q

What is the degree of spinal flexion?

A

90 degrees

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21
Q

What is the degree of spinal extension

A

30 degrees

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22
Q

What is the degree of lateral flexion of spine

A

30 degrees

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23
Q

Radicular symptoms with spinal flexion, extension, or lateral flexion warrant you to do what?

A

A thorough neuro exam

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24
Q

Step offs in the spine upon palpation suggest

A

Spondylolisthesis

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25
Q

TTP of SI joints suggests

A

Sacroillitis

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26
Q

TTP of spine suggests

A

Fx, infection, arthritis

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27
Q

Which region of the spine is particularly susceptible to compression fractures

A

Thoracic spine

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28
Q

What are the muscles of the rotator cuff

A

Subscapularis
Infraspinatous
Supraspinatous
Teres minor

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29
Q

Pt presents with inability to abduct arm and TTP over bicipital grove. What do they have?

A

Rotator cuff tear

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30
Q

Restricted range of motion of the shoulder may indicate…

A

Bursitis, adhesive capsulitis, tendonitis, cuff injuries, or Fx

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31
Q

Localized pain of the shoulder may suggest…

A

Subacromial bursitis, subdeltoid bursitis, or arthritis

32
Q

What are possible causes of bursitis

A

Impingement
Rotator cuff tendonitis
Rotator cuff strain
Inflammation

33
Q

The “cross over test” tests for….

A

AC separation

34
Q

Which rotator cuff muscle is most commonly injured

A

Supraspinatous

35
Q

What is the diagnostic modality of choice for rotator cuff injury

A

MRI

36
Q

How does an anterior shoulder dislocation occur?

A

FOOS arm causes humerus dislocation anteriorly and inferiorly

37
Q

What is the apprehension test

A

Pt lies on their back and you pull their arm back & over head; positive test illicits pain

38
Q

What is Neer’s sign

A

Press scapula and push head of humerus against the acromion

39
Q

What is Hawkin’s sign

A

Raising the arm forward and above head causes impingement with rotator cuff injury

40
Q

What is Yergason’s test

A

Palpate the bicipital groove of the elbow while it is flexed at 90 and pt attempts to supinate the forearm against resistance

41
Q

What is a positive Yergason’s test

A

Pain/popping; sign of biceps tendonitis

42
Q

What are the major joints of the elbow

A

Radiohumeral, humeroulnar, radioulnar

43
Q

What muscles are affected in lateral epicondylitis (tennis elbow)

A

Tendonitis of the wrist extensors

44
Q

Medial epicondylitis is AKA

A

Golfers elbow

45
Q

TTP over the snuff box indicates

A

Scaphoid Fx

46
Q

Complication of scaphoid Fx is…

A

Avascular necrosis

47
Q

PIP inflammation is seen with what condition

A

Acute RA

48
Q

What deformities/clinical findings are seen with chronic RA

A

Ulnar deviation
Swan neck deformity
Boutonniere deformity

49
Q

What deformities are seen with OA

A

Herberden’s nodes (DIP)

Bouchard’s nodes (PIP)

50
Q

Condition where forcible hyperflexion at the DIP causes tearing of the tendon sheath

A

Mallet finger

51
Q

What is the Finkelstein test

A

Test for DeQuervain’s Tenosynovitis; pt grasps thumb in hand and adducts wrist; positive sign is pain in the wrist

52
Q

What tendons/muscles are involved in DeQuervain’s

A

Extensor pollicis brevis and abductor pollicis longus

53
Q

What is dupuytren’s contracture

A

Palmar fascia hyperplasia with nodules & contractures

54
Q

What are the RFs for Dupuytren’s

A

Men > 50 y/o, EtOH, & fibrosing diseases

55
Q

What is the Trendelenburg Test

A

Pt asked to stand on one hip and the opposite hip (one off the ground) should point upward

56
Q

What is an antalgic gait

A

Slow, shuffling gait (think zombies lol)

57
Q

What is genu varum and when is it normal

A

Bowlegged; normal from infancy - 3 y/o

Abnormal with tibial rotation

58
Q

What is genu valgus and when is it normal

A

Knock-knee; normal until ~ 8 y/o

Abnormal with skeletal dysplasia or rickets

59
Q

What is the Lachman Test

A

Tests ACL integrity; flex knee 20-30 degrees while stabilizing the femur and displacing the tibia anteriorly

60
Q

Pt presents with inflammation at the front of the knee and pain what is it

A

Prepatellar bursitis

61
Q

What is the anterior drawer test

A

Tests ACL integrity (laxity of ACL)

62
Q

What is the posterior drawer test

A

Tests PCL integrity (laxity of PCL)

63
Q

What is mechanism of injury for meniscus injury

A

Forceful internal femur rotation on WB leg

64
Q

What are SxS of meniscus injury

A

Joint line pain in flexion, clicking, locking, effusion

65
Q

What is the McMurray Test

A

Test for meniscal injury; knee flexed at 90 then rotate external/internal and extend knee listening for click or pain

66
Q

How do you get a MCL injury and what test do you use to check it

A

Blow to lateral side of knee during weight bearing; test with valgus stress

67
Q

How do you get an LCL injury and what test do you use to check it

A

Blow to medial side of knee during weight bearing; test with varus stress test

68
Q

What is the patellar grind test

A

Place downward pressure on patella compressing it against the patellofemoral groove; grinding suggestive of patellofemoral syndrome

69
Q

What are common joint findings of OA

A

Effusion, crepitus, deformities, narrowing of joint space

70
Q

What is the most common ankle injury? What ligament is involved

A

Lateral sprain; ATF ligament is damaged

71
Q

What are the 3 lateral ligaments of the ankle

A

ATFL, CFL, an PTFL

72
Q

What are the rules/criteria for use of x-rays in ankle injuries

A

Ottawa ankle rules

73
Q

What is pes planus

A

Flat feet due to valgus heel while standing

74
Q

What does pes planus make you more susceptible to

A

Plantar fascitis

75
Q

What is the Thompson test

A

Test for achilles tendon integrity

76
Q

What causes achilles tendon injury

A

Sudden acceleration or jumping

Older pt attempting unusual vigorous exercise

77
Q

What are SxS of achilles tendon injury

A

Immediate pain, inability to walk, inability to dorsiflex

Physical Exam Midterm & Final (11 decks)

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