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Physical Diagnosis > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

When inspecting a musculoskeletal region of the body, what should be noted?

A 
Size
Symmetry
Swelling
Deformity
Color
Skin Texture
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2
Q

Musculoskeletal joints to be inspected?

A

Shoulder
Upper Arm/Forearm
Elbow
Wrist/Hand

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3
Q

Unique things to observe on the upper arm/forearm?

A

Venous Pattern

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4
Q

When inspecting the wrist/hand, one should specifically look for

A

Thenar+Hypothenar eminence for atrophy/asymmetry
Joints for Swelling/Erythema
Snuffbox
Color and Texture of Nails

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5
Q

When palpating the shoulder, be sure to check…

A
  1. Anterior to acromion+over subacromial/deltoid bursa
  2. Head of the humerus for tenderness at insertion points
  3. Bicipital groove
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6
Q

What are you feeling for when you palpate the shoulder

A

Sweet MC

Swelling
Warmth
Effusions
Edema
Tenderness
Masses
Crepitus
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7
Q

What are you feeling for in the upper arm/forearm?

A

Masses
Warmth
Edema
Tenderness

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8
Q

When examining the elbow you should palpate?

A
  1. Olecranon process, M and L epicondyle, Extensor surface of ulna, grooves overlying the elbow joint
  2. Bilateral brachial pulse - compare the two
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9
Q

What do you palpate in the wrist/hand?

A
  1. Thenar/Hypothenar
  2. Joints
  3. Anatomical Snuffbox
  4. Radial Pulse Bilaterally
  5. Capillary Refill Time (Blanch Nail Bed)
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10
Q

Normal time for capillary refill?

A

2 seconds

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11
Q

What happens when you assess shoulder motion

A
  1. Arms to shoulder level, palms down
  2. Arms over head, palms face eachother (diving)
  3. Hands behind neck, elbows out
  4. Put hands behind small of back
  5. Adduct each arm across chest
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12
Q

What do you call when you put hands behind the neck, elbows out

A

Apley scratch test

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13
Q

What do you call it when you adduct each arm across chest

A

Crossover Test

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14
Q

When assessing Elbow ROM

A

Flex and extend elbows

Turn palms up and down

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15
Q

Wrist and Hand ROM test

A

Flex and extend wrists
Move the hand toward the radial and ulnar sides
Flex and extend at the MCP joint w/ straight and fist

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16
Q

How to assess carpal tunnel?

A

Thumb abduction
Tinel’s Sign
Phalen’s Test

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17
Q

How do you inspect spinal curvatures

A

Upright spinal column from behind and the side (imaginary line from C& into your butt)

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18
Q

When palpating the spine..

A

Palpate spinous processes

Palpate Sacroiliac joint (ID w/ dimple over posterior Illiac spine)

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19
Q

How to assess spinal ROM?

A

Flexion - bend ova to the front touch ya toes
Extension - Bend back as par as possible
Rotation - wag yo ass back and forth
Lat bending - side to the waist

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20
Q

How to inspect a hip?

A

Patient Lies on Side

Observe Size, Symmetry, swelling, deformity, color, texture

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21
Q

What do you inspect on the leg

A

The same shit as the arm.

dumb ass.

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22
Q

How to inspect the knee

A

With patient supine

Size, symmetry, swelling, color, texture

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23
Q

How to inspect ankle/foot

A

Observe size, swelling, deformity, color, skin
Venous pattern
Color and Texture (Skin, Hair, Nails)

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24
Q

How to palpate the hip

A
  1. Inguinal Ligament (location of the iliopectineal bursa)
    , trochanteric bursa, and ischiogluteal bursa
  2. Femoral pulse bilaterally
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25
Q

What should you be looking up specific to the upper/lower leg

A

Great and Small Saphenous Veins
Dorsal Venous Arch of the Foot
Pitting Edema

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26
Q

What should you specifically look for when palpating the knee?

A
  1. Patellar Tendon
  2. Patellar Crepitus
  3. Clench quads and feel for smooth glide of the patella
  4. When flexed, M and L menisci
  5. Popliteal Pulse
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27
Q

Special Maneuvers for Knee Joint Effusions

A

Bulge Sign
Balloon Sign
Ballotting the Patella

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28
Q

What parts of the foot should you check for swelling, effusions, warmth, or tenderness

A

Ankle Joint/Ligaments
Achiles Tendon
Compress MTP joints and palpate btw thumb and forefinger
Dorsalis pedis and posterior tibal pulses

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29
Q

How to assess hip ROM

A

Flex, Extend, ab/dduct, internally and externally rotate

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30
Q

How to assess ankle and foot ROM

A

Dorsiflex and plantarflex each foot (tibiotalar joint)
Internally rotate and externally rotate (subtalar+talocalcaneal)
Flex toes at MTP joints

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31
Q

How to do the straight leg raise

A

Supine patient raises leg until discomfort
Then dorsiflex the foot
Eval. for pain down the back of the leg, pain on dorsiflexion of ankle

32
Q

Mediolateral instability assessment?

A

Flex knee to 30 degrees

Apply varus and valgus pressure to knee while assessing for emdial and lateral instability

33
Q

Lachman Test?

A

Flex knee to 20-30 degrees
Grasp the distal thigh just above the patella and the proximal tibia
Pull tibia anteriorly

34
Q

Anterior/Posterior Drawer Test?

A

Flex to 90 degrees
Stabilize the patient’s foot on the table (sit on it)
Pull tibia anteriorly and posterior for drawer tests.

35
Q

What should you look for on MS general inspection?

A

Guarded Movement

36
Q

On inspection of hand/wrist, poor finger allignment implies

A

Flexor Tendon damage

37
Q

On inspection of hand/wrist, deformed contours of wrist or hand

A

From RA, arthritic swelling, ganglia, flexor tendon damage

38
Q

On inspection of hand/wrist, thenar atrophy indicates…

A

Median nerve compression (carpal tunnel)

39
Q

On inspection of hand/wrist, hypothenar atrophy indicates…

A

Ulnar nerve compression

40
Q

On inspection of hand/wrist, swollen joints indicate…

A

RA, Gonococcal infection (extensor sheaths)

41
Q

On inspection of knee, stumbling/pushing knee to extension indicates…

A

Quadriceps Weakness

42
Q

On inspection of knee, bowlegs indicate

A

Flexion contractures

43
Q

On inspection of knee, quad atrophy above knee indicates…

A

Patellofemoral Disorder

44
Q

On inspection of knee, swollen prepatellar bursa indicates…

A

Housemaid’s Knee

45
Q

On inspection of knee, swollen suprapatellar pouch indicates…

A

Synovitis, Arthritis

46
Q

On inspection of knee, swollen infrapatellar pouch indicates…

A

arthritis

47
Q

On inspection of knee, swollen medial tibial condyle indicates…

A

pes anserine bursitis

48
Q

On inspection of knee, popliteal swelling indicates…

A

Baker’s cyst

49
Q

On inspection of foot/ankle, what does chronic arterial insufficiency look like?

A
  • Pale or dusky red on dependency, cool, minimal to no edema
  • Thin, shiny, strophic skin
  • Hair loss over foot
  • Ridged nails, gangrene
50
Q

On inspection of knee, what does chronic venous deficiency look like?

A 
Cyanotic on dependency
Marked Edema
Petechiae
Brown Pigment
Thick Skin
Possible ulcer, but no gangrene
51
Q

What does a diabetic neuropathic ulcer look like?

A 
Ulcer on pressure point
Calloused skin
Decreased sensation (no pain, no gangrene)
52
Q

Tender ligaments indicate…

A

sprain

53
Q

Tender joints indicate…

A

arthritis, gout

54
Q

Loss of radial pulse…

A

thromboangitis obliterans
acute arterial occlusion
Cardiac Failure

55
Q

Loss of epitrochlear node enlagement indicates…

A

from lymphadenopathy from local injury or infection

56
Q

Loss of lower extremity pulses indicates…

A

Acute arterial occlusion
Arteriosclerosis obliterans
cardiac failure

57
Q

Bilateral edema is caused by…

A

CHF, Chronic Venous Insufficiency, Pulmonary HTN, Drug induced

58
Q

Unilateral edema is caused by…

A

Deep vein thrombosis
Baker’s cyst
Cellulitis
Cancer/Cancer treatment

59
Q

Pitting edema is caused by…

A

Venous edema due to cardiac, pulmonary, liver disease, nephrosis, chronic venous insuffciency, medications

60
Q

Non-pitting edema is caused by…

A

Lymphedema from congenital abnormality, cellulitis, breast cancer, metastatic prostate cancer, lymphoma, or cancer treatment

61
Q

Pain on palpation of the anterior acromion subdeltoid bursa indicates…

A

Subacromial or subdeltoid bursitis

62
Q

Tenderness of humerus head or tendon insertions indicates…

A

rotator cuff tendonitis

63
Q

Tenderness of olecranon process indicates…

A

Olecran. bursitis
Posterior dislocation
Supracondylar frxure

64
Q

Tenderness of epicondyles

A

Epicondylitis

65
Q

Tenderness in elbow grooves

A

From arthritis

66
Q

Nodular on palpation of extensor surface f the ulna

A

Rheumatoid Nodules

67
Q

Tenderness of the snuffbox indicates…

A

scaphoid frxure

68
Q

Tenderness of the MCPs

A

RA bilateral

69
Q

Bulges or inguinal ligament indicate…

A

hernia, aneurysm

70
Q

Tender lateral to femoral pulse indicates

A

Synovitis, bursitis, iliopsoas abscess

71
Q

Tender superficial to ischial tuberosity

A

Weaver’s bottom bursitis

72
Q

Tenderness of the patellar tendon/inability to extend leg indicates…

A

partial or complete patellar tendor tear

73
Q

Pain/crepitus/Hx of knee pain when pressing patella against femur

A

Patellofemoral disorder

74
Q

Click or pop along medial knee joint with valgus/external/extension

A

Medial meniscal tear in posterior position

75
Q

Pain or gap in medial joint line of knee upon abductive stress

A

Partial or complete MCL tear

76
Q

Pain or gap in lateral joint line of knee upon adductive stress

A

LCL tear

Physical Diagnosis (2 decks)

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