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Clinical Skills: Unit 3 > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

Structures that include the joint capsule and articular cartilage, synovium, and synovial fluid, intra-articular ligaments, and juxta-articular bones.

A

Articular

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2
Q

Structures include periarticular ligaments, tendons, bursae, muscle, fascia, bone, nerve, and overlying skin.

A

Extra-Articular

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3
Q

Rope-like bundles of collagen fibril that connect BONE to BONE.

A

Ligaments
(injury = sprain)

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4
Q

Collagen fibers that connect MUSCLE to BONE

A

Tendons
(Injury = sTrain)

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5
Q

Pouches of synovial fluid that cushion the movement of tendons and muscles over bone or other joint structures.

A

Bursae

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6
Q

FREELY MOVEABLE within limits of surrounding ligaments. Separated by articular cartilage and a synovial cavity. Lubricated by synovial fluid and surrounded by a joint capsule.

A

Synovial Joint
(Knee and Shoulder)

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7
Q

SLIGHTLY MOVEABLE. Contain fibrocartilaginous discs that separate bony surfaces. Have a central nucleus pulposus of discs that cushions bony contact.

A

Cartilaginous Joint
(Vertebral Bodies)

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8
Q

IMMOVABLE. Consists of fibrous tissue or cartilage. Lack joint cavity.

A

Fibrous Joint
(Skull Sutures)

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9
Q

CONVEX SURFACE IN A CONCAVE CAVITY. Wide-ranging flexion and extension, abduction and adduction, rotation and circumduction.
- Synovial Joint

A

Spheroidal (Ball and Socket)
(Shoulder and Hip)

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10
Q

FLAT or PLANTAR. Motion in one plane that allows for flexion and extension.
- Synovial Joint

A

Hinge
(Elbow and Fingers)

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11
Q

CONVEX OR CONCAVE. Movement of 2 articulating surfaces that are not dissociable.
- Synovial Joint

A

Condylar
(TMJ, Wrist, and Knee)

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12
Q

Asking your patient to do this may save considerable time because the patient’s verbal description is often imprecise.

A

“Point to the Pain”

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13
Q

Internal rotation of the knees that causes them to be close together.
“Knock Knee”

A

Valgus

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14
Q

External rotation of the knees that cause them to be far apart.
“Bow-Legged”

A

Varus

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15
Q

Motion where the patient moves on their own.

A

Active Motion

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16
Q

Motion where the examiner moves the patient. If movement is impeded painful, it can help identify the cause.

A

Passive Motion

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17
Q

What are the muscles of the rotator cuff?

A

Supraspinatus
Infraspinatus
Teres Minor
Subscapularis

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18
Q

What muscle is most commonly injured with a rotator cuff tear?

A

Supraspinatus

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19
Q

Raising your arm in front and overhead.

A

Flexion

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20
Q

Normal range of flexion

A

180°

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21
Q

Move your arm behind you

A

Extension

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22
Q

Normal range of extension

A

60°

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23
Q

Raise your arms to to the side and overhead

A

Abduction

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24
Q

Normal range of abduction

A

180°

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25
Q

Weakness on abduction of the shoulder would indicate what?

A

Rotator Cuff Tear

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26
Q

What is the primary muscle of shoulder abduction?

A

Supraspinatus

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27
Q

Cross your arm in from of your body, keeping the arm straight.

A

Adduction

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28
Q

Normal range of adduction

A

75°

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29
Q

Cross-over test is performed when asking the patient to adduct the shoulder. Pain caused by this action would indicate what?

A

Acromioclavicular Joint Arthritis

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30
Q

Place your arm behind your back and touch your shoulder blades

A

Internal Rotation

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31
Q

Normal range of internal shoulder rotation

A

70°

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32
Q

Limited internal shoulder rotation could indicate what?

A

Rotator Cuff Tear
Adhesive Capsulitis

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33
Q

Raise your arm to shoulder level and rotate your forearm to the ceiling

A

External Rotation

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34
Q

Normal range of external rotation

A

100°

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35
Q

What is the primary muscle involved with external rotation

A

Infraspinatus

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36
Q

Limited external rotation could indicate what?

A

Rotator Cuff Tear
Adhesive Capsulitis

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37
Q

What is the most common cause of shoulder pain?

A

Rotator Cuff Tear

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38
Q

What is the best predictor of a torn rotator cuff?

A

Supraspinatus weakness on abduction

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39
Q

Pain with forward flexion and stabilizing the scapula.

A

Neer’s Impingement
(Neer to the Ear)

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40
Q

What does pain with Neer’s Test indicate?

A

Rotator Cuff Tear

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41
Q

Flex shoulder and elbow to 90° with palm down and internally rotate.

A

Hawkins Impingement

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42
Q

What does pain with Hawkins Impingement indicate?

A

Rotator Cuff Tear

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43
Q

Internally rotate arms with thumbs down as if holding a can. Push down on patients arm.

A

Empty Can Test

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44
Q

What does weakness during an Empty Can Test indicate?

A

Rotator Cuff Tear

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45
Q

Abduct arm to 90° and see if the patient is able to hold their arm at shoulder level.

A

Drop Arm Test

46
Q

What does the inability to hold arm at shoulder level during a Drop Arm Test indicate?

A

Rotator Cuff Tear

47
Q

Adduct the patients arm across their chest. “Touch Shoulder”

A

Acromioclavicular Joint Test
(Cross over or Crossed Body Adduction Test)

48
Q

What does pain during an Acromioclavicular Joint Test indicate?

A

Rotator Cuff Tear
Adhesive Capsulitis

49
Q

Test where you ask the patient to touch the opposite scapula using (abduction and external rotation) and (adduction and internal rotation)

A

Apley Scratch Test
(Over Shoulder Rotation)

50
Q

What does pain during an Apley Scratch Test indicate?

A

Rotator Cuff Tear
Adhesive Capsulitis

51
Q

What is the technical term for the boney part of your elbow?

A

Olecranon Process

52
Q

Pain or tenderness of the Medial Epicondyle.

A

Pitcher’s Elbow

53
Q

Pain or tenderness of the Lateral Epicondyle

A

Tennis Elbow

54
Q

What should you be looking for when assessing the extensor surface of the ulna?

A

Rheumatoid Nodules

55
Q

What does pain in the grooves between the epicondyles and olecranon indicate?

A

Arthritis

56
Q

What is considered the normal range of motion when you bend (flex) your elbows?

A

140°

57
Q

Boney growths seen in osteoarthritis that occur at the distal interphalangeal joint (DIP)

A

Heberden’s Node

58
Q

Boney growths seen in osteoarthritis that occur at the proximal interphalangeal joint (PIP)

A

Bouchard’s Node

59
Q

Cutaneous Innervation of the Hand

A
60
Q

Bones of the Hand

A
61
Q

Atrophy of the Thenar and Hypothenar eminences may indicate what?

A

Carpal Tunnel Syndrome

62
Q

Tenderness when palpating the snuff box would suggest?

A

Scaphoid Fracture

63
Q

Boggy metacarpals may indicate what?

A

Rheumatoid Arthritis
(Rarely involved in Osteoarthritis)

64
Q

Pain with thumb movement

A

De Quervain’s Tenosynovitis
(Gamer’s Thumb)

65
Q

Have patient grasp their own thumb and ulnar deviate. (adduction)

A

Finkelstein Test

66
Q

Radial pain during a Finkelstein Test would indicate what?

A

Tenosynovitis

67
Q

Movements of the Thumb

A
68
Q

Tap lightly over median nerve at volar wrist.

A

Tinel’s Sign
(Discomfort in 2nd, 3rd, or 4th finger is positive test)

69
Q

Patient flexes wrist for 60 seconds.

A

Phalen’s Sign
(Discomfort in 2nd, 3rd, or 4th volar finger is positive)

70
Q

Used specifically to test for weakness of the median nerve.

A

Thumb aBduction Test

71
Q

Number of Vertebrae in each region of the spine.

A

7 - Cervical
12 - Thoracic
5 - Lumbar
5 - Sacral
4 - Coccyx

72
Q

When palpating the Spinous Processes you feel a “step off” what might this indicate?

A

Spondylolisthesis

73
Q

When palpating the Sciatic Nerve (midway between greater trochanter and ischial tuberosity) you note discomfort. What might be wrong?

A

Herniated Disc
Nerve Root Compression

74
Q

What is the 2nd most common reason for office visits?

A

Low Back Pain

75
Q

Where does most lower back pain occur?

A

L5 - S1

76
Q

Bladder or Bowel Dysfunction with lower back pain or “saddle anesthesia” from perianal numbness may be caused by what two things?

A

Cauda Equina Syndrome from S2 - S4 Tumor
Disc Herniation
(S2-S4 keeps your shit and dick off the floor)

77
Q

Most common cause of C6 or C7 spinal nerve compression.

A

Foraminal Impingement

78
Q

Lateral curvature of the spine typically affecting adolescents

A

Scoliosis

79
Q

Type of Scoliosis that disappears with forward flexion of the spine.

A

Postural Scoliosis

80
Q

Type of Scoliosis that persists with forward flexion of the spin or a RIB HUMP presents.

A

Structural Scoliosis

81
Q

What does the Costovertebral Angle Tendeness test assess?

A

Pyelonephritis

82
Q

What type of imaging should be done if you suspect Cauda Equina Syndrome?

A

MRI

83
Q

Lift the patient’s leg while the knee is straight.

A

Straight Leg Test
(Pain = Lumbar Herniated Disc)

84
Q

Turn patient’s head to affected side and apply downward pressure to the top of the head.

A

Spurling’s Test
(Pain Radiating = Cervical Radiculopathy)

85
Q

Bone disease that causes bones to become less dense and more porous.

A

Osteoporosis

86
Q

Who has the greatest risk for developing osteoporosis?

A

Postmenopausal Women
Age 65+

87
Q

When your foot is on the ground and bearing weight.

A

Stance

88
Q

When your foot moves forward and doesn’t bear any weight.

A

Swing

89
Q

Most hip problem arise from weight bearing during what phase?

A

Stance Phase

90
Q

What are the four phases seen during gait analysis

A

Heelstrike
Foot Flat
Midstance
Push-Off

91
Q

Type of gait with a stiff, foot dragging walk caused by a long muscle contraction on one side.

A

Spastic Gait

92
Q

Type of gait where legs are flexed slightly at the hips and knees like crouching, with the knees and thighs hitting or crossing in a scissor like movement.

A

Scissor Gait
(Cerebral Palsy)

93
Q

Type of gait where the person is stooped with a stiff posture and the head and neck are bent forward.

A

Propulsive Gait
(Parkinson’s and Back Problems)

94
Q

Type of gait where the foot hangs with the toes pointing down, causing the toes to scrape the ground while walk, requiring them to lift the leg higher than normal when walking.

A

Steppage Gait
(Weakness of Anterior Tibial Muscles)

95
Q

Type of gait where the person has a duck-like walk that may appear in childhood or later.

A

Waddling Gait
(Childhood or Dislocation)

96
Q

When palpating inguinal structures, what should you be assessing for?

A

Bulges in Inguinal Hernia
Aneurysm
Lymphadenopathy
Arthritis or Infection

97
Q

When palpating Trochanteric Bursa, what should you be assessing for?

A

Focal Tenderness in Trochanteric Bursitis
(Described as “Low Back Pain”)

98
Q

When palpating the Ischiogluteal Bursa what should you be assessing for?

A

Tenderness from prolonged sitting
(Weaver’s Bottom)

99
Q

Bending your knee

A

Knee Flexion

100
Q

Straightening your knee

A

Knee Extension

101
Q

Knee flexed 90° and sit on the patient’s foot. Place thumbs on medial and lateral joint Lin and place fingers on hamstrings insertions. PULL TIBIA FORWARD and OBSERVE IF TIBIA SLIDES FORWARD

A

Anterior Drawer Test
(ACL)
Anterior Movement = Positive Test

102
Q

Knee flexed 15° Grab the distal femur with one hand and the proximal tibia with the other. PULL TIBIA FORWARD AND PUSH FEMUR BACK.

A

Lachman Test
(ACL)
Movement = Positive Test

103
Q

PUSH MEDIALLY ON LATERAL KNEE & PULL LATERALLY AT ANKLE.

A

Valgus (ABduction)
(MCL)
Pain or Gap = Positive Test

104
Q

PUSH LATERALLY ON MEDIAL KNEE and PULL MEDIALLY AT ANKLE

A

Varus (Adduction)
(LCL)
Pain or Gap = Positive Test

105
Q

Knee flexed at 90° and sit on the patient’s foot. Place thumb on medial and lateral joint lines with fingers on the hamstrings. PUSH TIBIA PACK and OBSERVE IF TIBIA SLIDES POSTERIORLY

A

Posterior Drawer Test
(PCL)
Posterior Movement = Positive Test

106
Q

Patient prone and knee flexed at 90° then apply compression force.

A

Apley’s Grind Test
(Meniscus)
Pain = Positive Test

107
Q

Grasp the heel and rotate it internally and externally while flexing the knee with internal and external rotation. (Like you’re giving some an Indian Burn)

A

McMurray Test
(Meniscus)
Clicking, Popping, Locking = Positive Test

108
Q

Grab the heel of the foot and pull forward.

A

Anterior Drawer
(Anterior Talofibular Ligament Injury)

109
Q

Grab talus and invert it.

A

Talar Tilt
(Calcaneofibular Ligament Injury)

110
Q

Grab the calf muscle and squeeze.

A

Thompson Test
(Achilles Rupture)
NO MOVEMENT with SQUEEZE = Positive Test

Clinical Skills: Unit 3 (3 decks)

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