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PA > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

42% of people who have osteoporosis are

A

men

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2
Q

Why is it a good idea to start osteoporosis screening and prevention in adolescence?

A

because women gain their greatest bone before they start their menstrual cycle

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3
Q

When you’re examining a joint, it has to be

A

at rest

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4
Q

Joints should not be tender to

A

palpation

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5
Q

active ROM should equal

A

passive ROM

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6
Q

Boggy joints

A

When the joint lining begins to grow abnormally, it may give a joint a mushy, doughy texture

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7
Q

If the patient can only move against gravity, assign Grade

A

3

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8
Q

Ask the patient to move actively against your opposing resistance; assign Grade ___ if the patient overcomes your opposing movement

A

5

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9
Q

3 movements of the TMJ

A
  1. hinge action which opens and closes the jaws
  2. gliding action for protrusion and retraction
  3. gliding for side-to-side movement of the lower jaw
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10
Q

swelling, tenderness, decreased ROM of TMJ indicates

A

some kind of inflammation or arthritis

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11
Q

The TMJ opens and closes about ____ times a day

A

2,000

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12
Q

2 tests for carpal tunnel:

A
  1. Phalen’s test

2. Tinel’s sign

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13
Q

median nerve provides sensation to

A

the palm of the hand, the palmar surface of the thumb, the 2nd and 3rd fingers and ½ of the 4th finger

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14
Q

carpal tunnel

A

sheath through the wrist where all of the extensor and flexor tendons come through – if you have carpal tunnel, you get numbness and tingling in all these areas

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15
Q

osteoarthritis (degenerative joint disease)

A

arthritis of aging

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16
Q

A patient who presents to clinic complaining of hand pain says she was told by a friend that it is most likely carpal tunnel syndrome. Upon assessing the patient, you note the following findings. Which would be suggestive of carpal tunnel syndrome?

A. Hand pain when holding both hands in acute extension
B. Numbness and tingling when tapping over the course of the radial nerve
C. Symptoms related to compression are evident in all of the fingers
D. None of the above

A

D.

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17
Q

depression

A

lowering a body part

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18
Q

elevation

A

raising a body part

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19
Q

retraction

A

moving a body part backwards and parallel to the ground

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20
Q

protraction

A

moving a body part forward and parallel to the ground

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21
Q

rotation

A

moving the head around a central axis

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22
Q

eversion

A

moving the sole of the foot outward at the ankle

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23
Q

inversion

A

moving the sole of the foot inward at the ankle

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24
Q

circumduction

A

moving the arm in a circle around the shoulder

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25
Q

supination

A

turning the forearm so that the palm is up

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26
Q

pronation

A

turning the forearm so that the palm is down

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27
Q

adduction

A

moving a limb towards the center/the midline

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28
Q

abduction

A

moving a limb away from the midline of the moving

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29
Q

extension

A

straightening a limb at a joint

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30
Q

flexion

A

bending a limb at a joint

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31
Q

muscles account for how much of our body weight?

A

40-50%

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32
Q

3 types of muscle

A
  1. skeletal
  2. smooth
  3. cardiac
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33
Q

skeletal muscle

A

voluntary, under our conscious control

each skeletal muscle is composed of bundles of muscle fibers and is attached to bones by tendons

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34
Q

bursae

A

small fluid-filled sacs lined by synovial membrane with an inner capillary layer of viscous fluid that provides a cushion between bones and tendons and/or muscles around a joint.

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35
Q

ligaments

A

fibrous connective tissue that connects bones to other bones

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36
Q

tendons

A

tough bands of fibrous connective tissue that connects muscle to bone and is capable of withstanding tension

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37
Q

cartilage

A

firm but flexible connective tissue that is softer and much more flexible than bone

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38
Q

non-synovial joints

A

bones are united by fibrous tissue or cartilage and are either immovable or slightly moveable

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39
Q

example of slightly moveable non-synovial joints

A

vertebrae

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40
Q

example of fibrous non-synovial joints

A

sutures in our skull that close off after 2-3 years of age

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41
Q

2 kinds of non-synovial joints

A

fibrous joints

cartilaginous joints

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42
Q

avascular cartilage

A

layer of resilient cartilage that covers the surface of opposite bone - avascular means it has no blood supply- gets nourishment from synovial fluid that circulates during the joint movement

very stable with slow cell turnover

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43
Q

3 types of synovial joints

A

ball and socket joints
hinge joints
condylar joints

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44
Q

2 main examples of ball and socket joints

A

hip

shoulder

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45
Q

3 main examples of hinge joints

A

hand, feet, elbows

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46
Q

2 main examples of condylar joints

A

knee and TMJ

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47
Q

joint (articulation)

A

union of two or more bones

functional units of the musculoskeletal system b/c they allow us to be mobile

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48
Q

4 functions of the musculoskeletal system

A
  • supports the body and allows for movement
  • encases and protects vital organs
  • produces red blood cells in the bone marrow
  • reservoir for storage of essential minerals like calcium and phosphorus
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49
Q

skeleton

A

bony framework of the body with 206 bones

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50
Q

bone characteristics

A

hard, rigid, very dense

cells are continually turning over and remodeling

51
Q

3 kinds of interphalangeal joints

A

distal (DIP)
proximal (PIP)
metacarpophalangeal joints (MCP)

52
Q

Over half the bones of the body are in

A

the hands and feet

53
Q

swelling, heat, and redness are signs of

A

acute inflammation

54
Q

What do we call pain that goes away when you rest?

A

intermittent claudification

55
Q

myalgia

A

muscle aches

56
Q

arthralgia

A

bone/joint pain

57
Q

issues that are present bilaterally in arms could be

A

compression of the spinal column

58
Q

example of a one joint (monoarticular) problem

A

gout

59
Q

Order of musculoskeletal exam

A

Inspect, Palpate, Range of Motion, Muscle Tension

60
Q

steps for ROM portion of physical exam

A

stabilize joint and ask for active range of motion
if you see any limitation, do passive ROM
active ROM should equal passive ROM

61
Q

crepitation

A

a crackling or rattling sound

62
Q

the Glenohumeral joint is surrounded by

A

the rotator cuff muscles

63
Q

Heberden’s nodules

A

occur on the DIP

64
Q

Bouchard’s nodes

A

occur on the PIP

65
Q

Rheumatoid arthritis

A

autoimmune disease

Tender, painful, stiff joints (can affect any joint in the body)

symmetric involvement

Proximal interphalangeal (PIP) and metacarpophalangeal joints (MCP) involvement – DIPS are usually not involved

66
Q

Boutonniere deformity

A

a deformed position of the fingers or toes, in which the joint nearest the knuckle (PIP) is permanently bent toward the palm while the farthest joint (DIP) is bent back away

67
Q

Swan Neck Deformity

A

deformed position of the finger, in which the joint closest to the fingertip is permanently bent toward the palm while the nearest joint to the palm is bent away from it (DIP hyperflexion with PIP hyperextension)

68
Q

Ulnar deviation

A

a hand deformity in which the swelling of the metacarpophalangeal joints (the big knuckles at the base of the fingers) causes the fingers to become displaced, tending towards the little finger

69
Q

the knee joint is the articulation of which 3 bones?

A

femur, tibia, and the patellar (kneecap) bone

70
Q

True or false: the knee joint is the largest in the body

A

True

71
Q

suprapatellar pouch

A

the extension of the knee joint cavity above the patella, extends up as much as 6 cm behind the quadriceps muscle

72
Q

2 landmarks of the ankle joint

A

medial malleolus and lateral malleolus

73
Q

temporomandibular joint (TMJ)

A

articulation of the mandible and the temporal bone

74
Q

You can feel the TMJ in

A

the depression that’s anterior to the tragus of the ear

75
Q

spine has how many vertebrae?

A

33:

7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 3-4 in our coccyx

76
Q

C7 and T1 are prominent at

A

the base of the neck

77
Q

inferior or bottom angle of the scapula is normally between

A

T7 and T8

78
Q

the imaginary line at the iliac crests is around

A

L4

79
Q

intervertebral discs

A

elastic, fibrocartilaginous plates that constitutes about ¼ of the length of the column

80
Q

each intervertebral disc center has a ____ made of soft mucoid material that has the consistency of toothpaste

A

nucleus pulposus

81
Q

if compression is too great, disc can

A

rupture, and nucleus pulposus can herniate – this causes a great deal of pain

82
Q

4 motions of vertebral column

A

flexion (bending forward)
extension (bending backwards)
abduction to either side
rotation

83
Q

the large subacromial bursa helps during

A

abduction of the arms

84
Q

Glenohumeral Joint is the articulation of the

A

humerus with the glenoid fossa of the scapula

85
Q

3 bony articulations of the elbow joint

A

humerus bone, radius, and ulna of the forearm

86
Q

olecranon bursa lies

A

between the olecranon process and the skin - can lead to a golf ball-size swelling on the elbow

87
Q

palpable landmarks of the elbow joint

A

medial and lateral epicondyle of the humerus and then the large olecranon process of the ulna in between them

88
Q

sensitive ulnar nerve runs between the

A

olecranon process and the medial epicondyle – when we bang on it, we get tingling down our hand

89
Q

radius and ulna articulate with each other at the

A

radioulnar joints, one at the elbow and one at the wrist

90
Q

midcarpal joint

A

articulation between the two parallel bones of carpal bones

91
Q

flexor tendons of the wrists and hands are enclosed in

A

synovial sheaths coming up towards the fingers

92
Q

hip joint

A

ball and socket joint that’s the articulation between the acetabulum and the head of the femur

93
Q

you should be able to feel the entire ___ during the hip exam

A

iliac crest

94
Q

ischial tuberosity lies under the ____ and is palpable when ____

A

gluteus maximus; the hip is flexed

95
Q

greater trochanter of the femur is normally the width of

A

the person’s palm

96
Q

where is the greater trochanter of the femur located?

A

below the iliac crest and halfway between the anterior superior iliac spine and the ischial tuberosity

97
Q

medial and lateral meniscus

A

two wedge-shaped cartilages that cushion the tibia and the femur

98
Q

knee joint is stabilized by which 2 sets of ligaments

A

cruciate ligaments

collateral ligaments

99
Q

cruciate ligaments

A

crisscross within the knee and give anterior and posterior stability and help control rotation

100
Q

collateral ligaments

A

connect the joint at both sides, give medial and lateral stability and prevent dislocation

101
Q

infrapatellar fat pad

A

small triangular fat pad below the patella and behind the patella ligaments

102
Q

ankle joint

A

tibiotalar joint, is the articulation of the tibia, fibula and talis

103
Q

the ankle joint is a hinge joint that’s limited to

A

dorsiflexion and plantarflexion

104
Q

eversion or inversion sprains of the angle can tear the

A

strong, tight medial and lateral ligaments that extend from each malleolus onto the foot

105
Q

subtalar joint

A

joint distal to the ankle that permits inversion and eversion of the foot

106
Q

foot has a very long longitudinal arch with weight bearing that’s distributed between

A

the two parts that touch the ground (metatarsals and calcaneus which is the heel)

107
Q

toddlers have a ___ spine, which means

A

Lordotic ; belly is pushed forward

108
Q

At birth, babies have a ___ shaped spine

A

C

109
Q

In young childhood: Rate of muscle growth speeds up around __ years

A

2

110
Q

In infancy, muscles are about __% of body weight

A

25

111
Q

Scoliosis is a lateral curve of the spine that can be screened with a

A

scholiometer

112
Q

Scoliosis is more dangerous if child is

A

pre-pubescent

113
Q

3 ways to check for Hip Dysplasia in babies

A

Barlow maneuver (adduct hip, push thigh posteriorly) – if positive, hip goes out of socket

Ortolani maneuver (abduct thighs and apply downward measure) - if positive, “clunk” means unstable and that the hip has been reduced

Trendelenburg Gait - colateral side drops

114
Q

Genu Valgum: “Knock-need” is a normal finding until ___ years

A

7

115
Q

Genu Valgum: “Knock-need” is correctable until age

A

9

116
Q

Genu Varum: “Bowlegged” is a normal finding until age

A

2.5-3

117
Q

For Genu Varum “Bowlegged” refer if

A

the angle is acute

if there is 15cm between knees

118
Q

3 causes of intoeing

A
  1. From the hip
    (Femoral ante version - Caution on child’s seated position)
  2. From the tibia
    (Tibial tortion, Knees still face forward)
  3. From the foot
    (Metatarsus Adductus, Distal half of the foot points in)
119
Q

Disappearing baby reflexes

A

Palmar grasp (disappears at two months)

Placing / stepping (disappears at 2-4 months)

Rooting / Sucking (disappears at 3-4 month)

Moro (disappears at 3-6 months)

Tonic Neck (disappears at 7-8 months)

Plantar Reflex (disappears at 8-10 months)

Babinski (disappears as baby beings walking, ~ 12 months

120
Q

3 main Abnormal Childhood Reflexes

A
  1. Oppenheimer
  2. Chaddock’s
  3. Snouting
121
Q

Oppenheimer Abnormal Childhood Reflex

A

Reflex hammer down interior calf

Positive (abnormal): Big toe fans out

122
Q

Chaddock’s Abnormal Childhood Reflex

A

Reflex hammer moved distally along outer foot

Positive (abnormal): Big toe fans out

123
Q

Snouting Abnormal Childhood Reflex

A

Reflex hammer placed on philtrum (upper lip)

Positive (abnormal): Lips and nose scrunch up

PA (10 decks)

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