Musculoskeletal Flashcards
1
Q
42% of people who have osteoporosis are
A
men
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
3
Q
When you’re examining a joint, it has to be
A
at rest
4
Q
Joints should not be tender to
A
palpation
5
Q
active ROM should equal
A
passive ROM
6
Q
Boggy joints
A
When the joint lining begins to grow abnormally, it may give a joint a mushy, doughy texture
7
Q
If the patient can only move against gravity, assign Grade
A
3
8
Q
Ask the patient to move actively against your opposing resistance; assign Grade ___ if the patient overcomes your opposing movement
A
5
9
Q
3 movements of the TMJ
A
- hinge action which opens and closes the jaws
- gliding action for protrusion and retraction
- gliding for side-to-side movement of the lower jaw
10
Q
swelling, tenderness, decreased ROM of TMJ indicates
A
some kind of inflammation or arthritis
11
Q
The TMJ opens and closes about ____ times a day
A
2,000
12
Q
2 tests for carpal tunnel:
A
- Phalen’s test
2. Tinel’s sign
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
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
15
Q
osteoarthritis (degenerative joint disease)
A
arthritis of aging
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.
17
Q
depression
A
lowering a body part
18
Q
elevation
A
raising a body part
19
Q
retraction
A
moving a body part backwards and parallel to the ground
20
Q
protraction
A
moving a body part forward and parallel to the ground
21
Q
rotation
A
moving the head around a central axis
22
Q
eversion
A
moving the sole of the foot outward at the ankle
23
Q
inversion
A
moving the sole of the foot inward at the ankle
24
Q
circumduction
A
moving the arm in a circle around the shoulder
25
supination
turning the forearm so that the palm is up
26
pronation
turning the forearm so that the palm is down
27
adduction
moving a limb towards the center/the midline
28
abduction
moving a limb away from the midline of the moving
29
extension
straightening a limb at a joint
30
flexion
bending a limb at a joint
31
muscles account for how much of our body weight?
40-50%
32
3 types of muscle
1. skeletal
2. smooth
3. cardiac
33
skeletal muscle
voluntary, under our conscious control
each skeletal muscle is composed of bundles of muscle fibers and is attached to bones by tendons
34
bursae
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.
35
ligaments
fibrous connective tissue that connects bones to other bones
36
tendons
tough bands of fibrous connective tissue that connects muscle to bone and is capable of withstanding tension
37
cartilage
firm but flexible connective tissue that is softer and much more flexible than bone
38
non-synovial joints
bones are united by fibrous tissue or cartilage and are either immovable or slightly moveable
39
example of slightly moveable non-synovial joints
vertebrae
40
example of fibrous non-synovial joints
sutures in our skull that close off after 2-3 years of age
41
2 kinds of non-synovial joints
fibrous joints
| cartilaginous joints
42
avascular cartilage
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
43
3 types of synovial joints
ball and socket joints
hinge joints
condylar joints
44
2 main examples of ball and socket joints
hip
| shoulder
45
3 main examples of hinge joints
hand, feet, elbows
46
2 main examples of condylar joints
knee and TMJ
47
joint (articulation)
union of two or more bones
functional units of the musculoskeletal system b/c they allow us to be mobile
48
4 functions of the musculoskeletal system
- 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
49
skeleton
bony framework of the body with 206 bones
50
bone characteristics
hard, rigid, very dense
cells are continually turning over and remodeling
51
3 kinds of interphalangeal joints
distal (DIP)
proximal (PIP)
metacarpophalangeal joints (MCP)
52
Over half the bones of the body are in
the hands and feet
53
swelling, heat, and redness are signs of
acute inflammation
54
What do we call pain that goes away when you rest?
intermittent claudification
55
myalgia
muscle aches
56
arthralgia
bone/joint pain
57
issues that are present bilaterally in arms could be
compression of the spinal column
58
example of a one joint (monoarticular) problem
gout
59
Order of musculoskeletal exam
Inspect, Palpate, Range of Motion, Muscle Tension
60
steps for ROM portion of physical exam
stabilize joint and ask for active range of motion
if you see any limitation, do passive ROM
active ROM should equal passive ROM
61
crepitation
a crackling or rattling sound
62
the Glenohumeral joint is surrounded by
the rotator cuff muscles
63
Heberden’s nodules
occur on the DIP
64
Bouchard’s nodes
occur on the PIP
65
Rheumatoid arthritis
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
Boutonniere deformity
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
Swan Neck Deformity
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
Ulnar deviation
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
the knee joint is the articulation of which 3 bones?
femur, tibia, and the patellar (kneecap) bone
70
True or false: the knee joint is the largest in the body
True
71
suprapatellar pouch
the extension of the knee joint cavity above the patella, extends up as much as 6 cm behind the quadriceps muscle
72
2 landmarks of the ankle joint
medial malleolus and lateral malleolus
73
temporomandibular joint (TMJ)
articulation of the mandible and the temporal bone
74
You can feel the TMJ in
the depression that’s anterior to the tragus of the ear
75
spine has how many vertebrae?
33:
7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 3-4 in our coccyx
76
C7 and T1 are prominent at
the base of the neck
77
inferior or bottom angle of the scapula is normally between
T7 and T8
78
the imaginary line at the iliac crests is around
L4
79
intervertebral discs
elastic, fibrocartilaginous plates that constitutes about ¼ of the length of the column
80
each intervertebral disc center has a ____ made of soft mucoid material that has the consistency of toothpaste
nucleus pulposus
81
if compression is too great, disc can
rupture, and nucleus pulposus can herniate -- this causes a great deal of pain
82
4 motions of vertebral column
flexion (bending forward)
extension (bending backwards)
abduction to either side
rotation
83
the large subacromial bursa helps during
abduction of the arms
84
Glenohumeral Joint is the articulation of the
humerus with the glenoid fossa of the scapula
85
3 bony articulations of the elbow joint
humerus bone, radius, and ulna of the forearm
86
olecranon bursa lies
between the olecranon process and the skin - can lead to a golf ball-size swelling on the elbow
87
palpable landmarks of the elbow joint
medial and lateral epicondyle of the humerus and then the large olecranon process of the ulna in between them
88
sensitive ulnar nerve runs between the
olecranon process and the medial epicondyle -- when we bang on it, we get tingling down our hand
89
radius and ulna articulate with each other at the
radioulnar joints, one at the elbow and one at the wrist
90
midcarpal joint
articulation between the two parallel bones of carpal bones
91
flexor tendons of the wrists and hands are enclosed in
synovial sheaths coming up towards the fingers
92
hip joint
ball and socket joint that's the articulation between the acetabulum and the head of the femur
93
you should be able to feel the entire ___ during the hip exam
iliac crest
94
ischial tuberosity lies under the ____ and is palpable when ____
gluteus maximus; the hip is flexed
95
greater trochanter of the femur is normally the width of
the person's palm
96
where is the greater trochanter of the femur located?
below the iliac crest and halfway between the anterior superior iliac spine and the ischial tuberosity
97
medial and lateral meniscus
two wedge-shaped cartilages that cushion the tibia and the femur
98
knee joint is stabilized by which 2 sets of ligaments
cruciate ligaments
collateral ligaments
99
cruciate ligaments
crisscross within the knee and give anterior and posterior stability and help control rotation
100
collateral ligaments
connect the joint at both sides, give medial and lateral stability and prevent dislocation
101
infrapatellar fat pad
small triangular fat pad below the patella and behind the patella ligaments
102
ankle joint
tibiotalar joint, is the articulation of the tibia, fibula and talis
103
the ankle joint is a hinge joint that's limited to
dorsiflexion and plantarflexion
104
eversion or inversion sprains of the angle can tear the
strong, tight medial and lateral ligaments that extend from each malleolus onto the foot
105
subtalar joint
joint distal to the ankle that permits inversion and eversion of the foot
106
foot has a very long longitudinal arch with weight bearing that’s distributed between
the two parts that touch the ground (metatarsals and calcaneus which is the heel)
107
toddlers have a ___ spine, which means
Lordotic ; belly is pushed forward
108
At birth, babies have a ___ shaped spine
C
109
In young childhood: Rate of muscle growth speeds up around __ years
2
110
In infancy, muscles are about __% of body weight
25
111
Scoliosis is a lateral curve of the spine that can be screened with a
scholiometer
112
Scoliosis is more dangerous if child is
pre-pubescent
113
3 ways to check for Hip Dysplasia in babies
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
Genu Valgum: “Knock-need” is a normal finding until ___ years
7
115
Genu Valgum: “Knock-need” is correctable until age
9
116
Genu Varum: “Bowlegged” is a normal finding until age
2.5-3
117
For Genu Varum “Bowlegged” refer if
the angle is acute
| if there is 15cm between knees
118
3 causes of intoeing
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
Disappearing baby reflexes
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
3 main Abnormal Childhood Reflexes
1. Oppenheimer
2. Chaddock’s
3. Snouting
121
Oppenheimer Abnormal Childhood Reflex
Reflex hammer down interior calf
| Positive (abnormal): Big toe fans out
122
Chaddock’s Abnormal Childhood Reflex
Reflex hammer moved distally along outer foot
| Positive (abnormal): Big toe fans out
123
Snouting Abnormal Childhood Reflex
Reflex hammer placed on philtrum (upper lip)
| Positive (abnormal): Lips and nose scrunch up
