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Clin Skills > Musculoskeletal > Flashcards

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
Q

What’s the normal range for adduction of shoulder?

A

75
“Cross your arm in front of your body keeping arm straight”

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26
Q

What’s the MCC of shoulder pain?

A

RTC tear

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27
Q

What’s the best predictor of RTC tear?

A

supraspinatus weakness on abduction, infraspinatus weakness on external rotation
positive impingement

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28
Q

What’s Neer’s impingement?

A

Pain with forward flexion and stabilizing the scapula

Near to the ear !!!

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29
Q

What is Hawkin’s impingement?

A

Flex shoulder-elbow to 90 w/ palm down - rotate internally and see if there is pain

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30
Q

What’s the empty can test?

A

internal rotation arms with thumbs down, push down
Weakness = positive

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31
Q

What’s the drop arm test?

A

Help patient abduct arm to 90, if patient can’t hold it, positive

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32
Q

What is the elbow made of?

A

troclea, capitulum, ulna, radius with ulnar, radial and median nerves

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33
Q

What does tenderness distal to epicondyle indicate?

A

epicondylitis
medial = pitcher’s
lateral = tennis

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34
Q

What do nodules on the extensor surface of the ulnar indicate?

A

rheumatoid nodules

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35
Q

What do grooves between the epicondyles and olecranon indicate?

A

arthiritis

36
Q

What’s the elbow’s normal flexion range?

A

140 degrees

37
Q

What nerve supplies the majority of your palm?

A

median

38
Q

What does tenderness of the snuff box indicate?

A

scaphoid fx

39
Q

What does bilateral swelling/tenderness indicate?

A

RA

40
Q

where are your Heberden’s nodes in OA?

A

distal finger joint

41
Q

where are your Bouchard’s nodes in OA?

A

proximal finger joint

42
Q

Why are you inspecting the thenar and hypothenar eminences?

A

for carpal tunnel

43
Q

Is wrist flexion towards the floor or the ceiling?

A

Floor

44
Q

What should you remember with wrist ROM?

A

stay in anatomical position for abduction and adduction!

45
Q

What’s the Finkelstein test?

A

Patient grasps thumb in fist and flexes wrist joint
pain = positive

46
Q

What does decreased grip strength indicate?

A

weakness of finger flexors, intrisnic hand muscles

47
Q

What is Tinel’s sign?

A

tap lightly over median nerve at volar wrist with aching, tingling, and numbness in 2nd, 3rd, 4th fingers = + sign

48
Q

What is Phalen’s sign?

A

patient flexes wrists for 60 seconds (put tops of hands against each other)
aching, tingling, + numbness in 2nd, 3rd, 4th = + sign

49
Q

How else can you test for carpal tunnel testing?

A

thumb adduction against resistance
weakness specific to median nerve = + sign

50
Q

In what views do you need to observe the spine?

A

side and back

51
Q

What are you looking for in a spine inspection?

A

asymmetric heights of shoulders, iliac crests, buttocks

52
Q

What do tender spinous processes indicate?

A

trauma, infection, “step-offs” in spondylolisthesis

53
Q

What does tenderness in sacroiliac joints indicate?

A

sacroiliitis, ankylosing spondylitis

54
Q

What do issues with paravertebral muscles indicate?

A

spasms, degenerative and inflammatory muscle disorders, overuse

55
Q

What could issues with the sciatic nerve indicate?

A

herniated disc or nerve root compression

56
Q

What should you check with low back pain?

A

check for bladder or bowel dysfunction

57
Q

What should you ask with neck pain?

A

location, radiation, arm/leg weakness, bladder/bowel dysfunction

58
Q

What’s more common than disc herniation with C6 or C7 spinal nerve compression?

A

foraminal impingement

59
Q

What is the CVAT?

A

pylelonephritis test

60
Q

What test should you do with cauda equina issues, S2-S4?

A

MRI

61
Q

What is the straight leg raise?

A

testing for lumbar herniated disc

lift patient’s leg while the knee is straight
pain = positive

62
Q

What is the Spurling’s test?

A

Cervical radiculopathy

Turn patient’s head to affected side and apply downward pressure
pain radiating = positive

63
Q

What are you palpating for in the hip?

A

Inguinal structures, trochanteric bursa, ischiogluteal bursa

64
Q

What’s in the medial section of the knee?

A

adductor tubercle, medial epicondyle of femur/tibia

65
Q

What’s in the anterior portion of the knee?

A

patella, patella/quad, tibia tuberosity

66
Q

What’s in the lateral portion of the knee?

A

lateral epicondyle of femur/tibia, fibula

67
Q

How can you test the cruciate ligaments?

A

anterior and posterior drawer tests
fix foot and pull and push

68
Q

How can you test the ACL?

A

anterior drawer test with knee flexed 90 degrees, pull tibia forward

69
Q

What’s the Lachman’s test?

A

knee flexed 15 degrees, grasp femur in one hand, tibia in the other, move femur back and pull tibia forward

70
Q

What’s the valgus test?

A

MCL – push medially against lateral surface of knee with one and pull laterally at ankle with other

71
Q

What’s the varus test?

A

LCL – pull laterally along medial surface of knee and push medially at ankle with another

72
Q

How do you test the PCL?

A

posterior drawer – knee at 90 degrees, push tibia back

73
Q

What’s the McMurray test?

A

Meniscus!
Grasp heel and flex knee with external/internal rotation
Click, popping, locking = positive

74
Q

What’s the Apley’s grind test?

A

testing MENISCUS – patient is prone, and knee is flexed, with compression force applied with rotation

75
Q

What are you palpating in the foot and ankle?

A

ankle joint, achilles, heel, medial/laeral malleous, MTP joints

76
Q

What’s the anterior drawer of the foot?

A

pulling ankle and pushing on tibia

testing ATFL

77
Q

What’s the talar tilt?

A

testing CFL

grasping tibia, turning ankle inwards

78
Q

What’s the Thompson test?

A

Testing achilles – prone patinet, squeeze tendon in calf, if no movement = tendon rupture

79
Q

When do you screen for osteoporosis?

A

> 65
postmenopausal women

80
Q

What are risks for osteoporosis?

A
  • post menopause
  • > 50
  • <70kg
  • lower dietary calcium
  • vitamin D defiecency
  • tobacco and alcohol use
  • family history of fracture
  • corticosteroid use
    *comorbidities
81
Q

What is the cross over test for?

A

testing AC joint –> pain = AC arthritis

82
Q

What could bowel/bladder dysfunction indicate?

A

cauda equina damage, S2-S4, disc herniation

83
Q

In what illness do you have a spastic/scissor-like gait?

A

cerebral palsy

84
Q

In what illness do you have a propulsive gait?

A

Parkinson’s, back problems

85
Q

In what illness do you have a steppage gait?

A

weakness of anterior tibial muscles

Clin Skills (9 decks)

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