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Musculoskeletal Flashcards

1
Q

What do articular structures include?

A

joint capsule + articular cartilage, synovium, fluid, intra-articular ligaments, and juxta-articular bone

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2
Q

What do extra-articular structures include?

A

periarticular ligaments, tendons, bursae, muscle, fascia, bone, nerve, skin

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3
Q

What are the ropelike bundles of collagen fibrils that connect bone to bone?

A

ligaments

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4
Q

What connects muscles to bone?

A

tendons

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5
Q

What are the pouches of synovial fluid that cushion the movement of tendons and muscles over bone?

A

bursae

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6
Q

What are common/concerning symptoms of MSK?

A
  • low back pain
  • neck pain
  • mono/poly joint pain
  • systemic features + joint pain
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7
Q

With MSK pain what should you always ask of your patient?

A

point to the pain

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8
Q

What are you inspecting for in the MSK?

A
  • swelling
  • skin changes
  • adjacent structures
  • deformity
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9
Q

What are you palpating for in the MSK?

A
  • Swelling
  • erythema
  • tenderness
  • temp
  • crepitus
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10
Q

What type of joint pain is trauma, tendonitis, or bursitis?

A

monoarticular

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11
Q

What type of joint pain is rheumatic fever, gonococcal arthritis, rheumatoid arthritis?

A

polyarticular

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12
Q

What type of joint pain is bursitis, tendonitis, tenosynovitis?

A

extra-articular

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13
Q

What are inflammatory symptoms of joint pain?

A

fever, chills, warmth, redness

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14
Q

What are systemic symptoms of joint pain?

A

fever, chills, rash, anorexia, weight loss, weakness
high fever and chills = infectious cause

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15
Q

What is dynamic in the shoulder?

A

SITS

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16
Q

What is static in the shoulder?

A

labrium, capsule, glenohumeral ligaments

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17
Q

What joints are in the shoulder?

A

glenohumeral, sternocalvicular, acromioclavicular

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18
Q

What does asymmetrical shoulder heights indicate?

A

scoliosis

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19
Q

What does atrophy of supraspinatus and infraspinatus indicate?

A

RTC tear

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20
Q

What’s the normal shoulder flexion range?

A

180

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21
Q

What’s the normal range of the shoulder extension?

A

60 degrees

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22
Q

What’s the normal range of shoulder internal rotation?

A

70 degrees
Place your arm behind your back and touch your shoulder blade

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23
Q

What’s the normal range for shoulder’s external rotation?

A

100 degrees
“Raise your arm to shoulder level and rotate your forearm to the ceiling”

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24
Q

What’s the normal shoulder range for abduction?

A

180 degrees

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25
What's the normal range for adduction of shoulder?
75 "Cross your arm in front of your body keeping arm straight"
26
What's the MCC of shoulder pain?
RTC tear
27
What's the best predictor of RTC tear?
supraspinatus weakness on abduction, infraspinatus weakness on external rotation positive impingement
28
What's Neer's impingement?
Pain with forward flexion and stabilizing the scapula Near to the ear !!!
29
What is Hawkin's impingement?
Flex shoulder-elbow to 90 w/ palm down - rotate internally and see if there is pain
30
What's the empty can test?
internal rotation arms with thumbs down, push down Weakness = positive
31
What's the drop arm test?
Help patient abduct arm to 90, if patient can't hold it, positive
32
What is the elbow made of?
troclea, capitulum, ulna, radius with ulnar, radial and median nerves
33
What does tenderness distal to epicondyle indicate?
epicondylitis medial = pitcher's lateral = tennis
34
What do nodules on the extensor surface of the ulnar indicate?
rheumatoid nodules
35
What do grooves between the epicondyles and olecranon indicate?
arthiritis
36
What's the elbow's normal flexion range?
140 degrees
37
What nerve supplies the majority of your palm?
median
38
What does tenderness of the snuff box indicate?
scaphoid fx
39
What does bilateral swelling/tenderness indicate?
RA
40
where are your Heberden's nodes in OA?
distal finger joint
41
where are your Bouchard's nodes in OA?
proximal finger joint
42
Why are you inspecting the thenar and hypothenar eminences?
for carpal tunnel
43
Is wrist flexion towards the floor or the ceiling?
Floor
44
What should you remember with wrist ROM?
stay in anatomical position for abduction and adduction!
45
What's the Finkelstein test?
Patient grasps thumb in fist and flexes wrist joint pain = positive
46
What does decreased grip strength indicate?
weakness of finger flexors, intrisnic hand muscles
47
What is Tinel's sign?
tap lightly over median nerve at volar wrist with aching, tingling, and numbness in 2nd, 3rd, 4th fingers = + sign
48
What is Phalen's sign?
patient flexes wrists for 60 seconds (put tops of hands against each other) aching, tingling, + numbness in 2nd, 3rd, 4th = + sign
49
How else can you test for carpal tunnel testing?
thumb adduction against resistance weakness specific to median nerve = + sign
50
In what views do you need to observe the spine?
side and back
51
What are you looking for in a spine inspection?
asymmetric heights of shoulders, iliac crests, buttocks
52
What do tender spinous processes indicate?
trauma, infection, "step-offs" in spondylolisthesis
53
What does tenderness in sacroiliac joints indicate?
sacroiliitis, ankylosing spondylitis
54
What do issues with paravertebral muscles indicate?
spasms, degenerative and inflammatory muscle disorders, overuse
55
What could issues with the sciatic nerve indicate?
herniated disc or nerve root compression
56
What should you check with low back pain?
check for bladder or bowel dysfunction
57
What should you ask with neck pain?
location, radiation, arm/leg weakness, bladder/bowel dysfunction
58
What's more common than disc herniation with C6 or C7 spinal nerve compression?
foraminal impingement
59
What is the CVAT?
pylelonephritis test
60
What test should you do with cauda equina issues, S2-S4?
MRI
61
What is the straight leg raise?
testing for lumbar herniated disc lift patient's leg while the knee is straight pain = positive
62
What is the Spurling's test?
Cervical radiculopathy Turn patient's head to affected side and apply downward pressure pain radiating = positive
63
What are you palpating for in the hip?
Inguinal structures, trochanteric bursa, ischiogluteal bursa
64
What's in the medial section of the knee?
adductor tubercle, medial epicondyle of femur/tibia
65
What's in the anterior portion of the knee?
patella, patella/quad, tibia tuberosity
66
What's in the lateral portion of the knee?
lateral epicondyle of femur/tibia, fibula
67
How can you test the cruciate ligaments?
anterior and posterior drawer tests fix foot and pull and push
68
How can you test the ACL?
anterior drawer test with knee flexed 90 degrees, pull tibia forward
69
What's the Lachman's test?
knee flexed 15 degrees, grasp femur in one hand, tibia in the other, move femur back and pull tibia forward
70
What's the valgus test?
MCL -- push medially against lateral surface of knee with one and pull laterally at ankle with other
71
What's the varus test?
LCL -- pull laterally along medial surface of knee and push medially at ankle with another
72
How do you test the PCL?
posterior drawer -- knee at 90 degrees, push tibia back
73
What's the McMurray test?
Meniscus! Grasp heel and flex knee with external/internal rotation Click, popping, locking = positive
74
What's the Apley's grind test?
testing MENISCUS -- patient is prone, and knee is flexed, with compression force applied with rotation
75
What are you palpating in the foot and ankle?
ankle joint, achilles, heel, medial/laeral malleous, MTP joints
76
What's the anterior drawer of the foot?
pulling ankle and pushing on tibia testing ATFL
77
What's the talar tilt?
testing CFL grasping tibia, turning ankle inwards
78
What's the Thompson test?
Testing achilles -- prone patinet, squeeze tendon in calf, if no movement = tendon rupture
79
When do you screen for osteoporosis?
>65 postmenopausal women
80
What are risks for osteoporosis?
* post menopause * >50 * <70kg * lower dietary calcium * vitamin D defiecency * tobacco and alcohol use * family history of fracture * corticosteroid use *comorbidities
81
What is the cross over test for?
testing AC joint --> pain = AC arthritis
82
What could bowel/bladder dysfunction indicate?
cauda equina damage, S2-S4, disc herniation
83
In what illness do you have a spastic/scissor-like gait?
cerebral palsy
84
In what illness do you have a propulsive gait?
Parkinson's, back problems
85
In what illness do you have a steppage gait?
weakness of anterior tibial muscles

Clin Skills (14 decks)

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