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clinical exam and diagnosis > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

What comprises the musculoskeletal system?

A 
muscles
bones
tendons
ligaments
joints
cartilage
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2
Q

What are potential presenting complaints for musculoskeletal system?

A
  1. lameness
  2. recumbancy
  3. syncope
  4. weakness
  5. wobbly
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3
Q

What are to non-exclusive types of problems with the musculoskeletal system?

A
  1. generalized

2. localized

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4
Q

What are two points of confusion that may make an issue seem muskuloskeletal when it isn’t?

A
  1. neurological disorders

2. pain

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5
Q

What are important points in a history?

A
  1. get full history
  2. ask specifics:
    a. problem,
    b. progression,
    c. previous treatments and response
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6
Q

What are important points in a history?

A
  1. get full history
  2. ask specifics:
    a. problem,
    b. progression,
    c. previous treatments and response
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7
Q

Why do you need to do a general physical exam?

A
  1. to rule out other body systems

2. to look for problems to support differentials

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8
Q

What are two problems with gait evaluation?

A
  1. requires experience

2. need to reproduce the problem–it may not be apparent at a walk–can be subtle

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9
Q

What two things need to be done in a specific physical exam?

A
  1. palpation

2. manipulation

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10
Q

What must you know and look for with palpation

A
  1. must know normal
  2. must look for
    a. pain
    b. different morphology
    c. changes in tone
    d. swelling
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11
Q

What do you have to manipulate? What do you look for?

A
  1. manipulate every joint
  2. check:
    a. range of motion
    b. smoothness of motion
    c. pain
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12
Q

Is a neurological exam always done? Why is it done?

A
  1. not always done

2. need to rule out possibility of neuro cause

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13
Q

How can you localize discomfort?

A
  1. nerve blocks

3. joint blocks

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14
Q

What direction do you work with nerve/joint blocks?

A

distal to proximal

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15
Q

What can be run on the blood?

A
  1. CBC–infectious?

2. chemistry panel–Ca/P; Ck/AST for muscle damage

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16
Q

What are disadvantages of imaging?

A
  1. expensive
  2. time consuming
  3. potentially dangerous
  4. difficult to interpret
  5. need to know where you are looking
  6. need to have some idea what looking for
17
Q

What are disadvantages of imaging?

A
  1. expensive
  2. time consuming
  3. potentially dangerous
  4. difficult to interpret
  5. need to know where you are looking
  6. need to have some idea what looking for
18
Q

What are 3 special tests that can be done?

A
  1. Biopsy (muscle, bone, joint)
  2. EMG
  3. Myasthenia gravis testing
  4. Genotyping
19
Q

What is signalment?

A
  1. species
  2. age
  3. breed
  4. sex
  5. activity
  6. environment
20
Q

Why is signalment important?

A

Some of the disease are very specific to the species, age, breed, sex, activity, environment

21
Q

Radiography is good for seeing what 4 things in bones?

A
  1. fractures
  2. density
  3. irregularity of growth
  4. can help with joints (but can’t see cartilage)
22
Q

What is ultrasound good for?

A
  1. soft tissue (tendon, joint capsule, abnormalities in muscle)
  2. can image surface of bone (e.g. pelvic fracture)
23
Q

What is CT good for?

A
  1. can get a 3D image so can get a better view of complex lesions
  2. can see some soft tissue lesions
24
Q

What is MRI good for?

A
  1. very good for soft tissue
  2. can image cartilage
  3. limited use for bone
25
Q

What is scintigraphy and what can it be used for?

A
  1. dynamic imaging

2. can be used to look for lesions in soft tissue and bone

26
Q

What are problems with scintigraphy?

A
  1. have to give a radioactive
27
Q

What are problems with scintigraphy?

A
  1. have to give a radioactive compound and that goes into urine and stall
  2. usually doesn’t help much?
28
Q

What is scintigraphy mostly used for?

A

spine lesions in horses (kissing spines)

29
Q

What is arthrocentesis and what can it diagnose?

A

sample synovial fluid of joint. Can diagnose inflammation (potentially infeciton, can help ID cause of inflammation)–however remember fluid is often negative for bacteria b/c in synovial membrane

30
Q

What are the advantages and disadvantages of muscle biopsy?

A

advantages

  1. relatively easy to do
  2. many options beyond simple histopath

disadvantages

  1. samples need to be handled carefully
  2. may need specialized lab services
31
Q

What are the advantages and disadvantages of bone biopsy?

A

advantages
1. can be a good tool for diagnosis

disadvantages

  1. need specialized tools (very specific needles)
  2. results delayed while sample is decalcificied
32
Q

What can EMG be used to do?

A
  1. generally more of a neurology test

2. can ID certain muscle disorders due to abnormal electrical activity (e.g. myotonia)

33
Q

What is an example of a muscle disorder that has a genetic basis?

A

Hyperkalemic periodic paralysis

34
Q

What does GIN AND TONIC stand for?

A 
G-genetic
I-infectious
N-non known cause
A-allergic/autoimmune
N-nutritional
D-degenerative
T-traumatic
O-oncologic
N-endocrine
I-intoxication
C-congenital
35
Q

What is a toxicology example that involves the musculoskeletal system?

A

monensin

36
Q

what are miconutrients that might be involved with muscle pathology?

A

Vit E and Se

clinical exam and diagnosis (10 decks)

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