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Part 4 > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

Amount of motions, pain level, and modality for Tendinitis

A

One motion
General pain
Brace, ice

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2
Q

Motions, Pain, and Modalities for Bursitis

A

Several motions
Pinpoint pain
Adjust, heat, ice

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3
Q

Motions, Pain and Modalities for Capsulitis

A

Most motions
Adhesions
Adjust, heat, massage

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4
Q

Motions, Pain and Modalities for Calcification

A

No motions
Ankylosis (rare)
Yes till “bone on bone”

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5
Q

Kienbock’s

A

Carpal lunate

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6
Q

Prissier’s

A

Scaphoid

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7
Q

Legg Calve Perthes

A

Hip (2 years)

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8
Q

Osteochondritis Desiccans

A

Medial femoral condyle

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9
Q

Blounts

A

Medial tibial condyle

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10
Q

Osgood Schlatter

A

anterior tibial tuberosity

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11
Q

Kohler’s

A

Tarsal - navicular

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12
Q

Freiberg’s

A

Second metatarsal

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13
Q

Scheuermann’s

A

Disc end plates (1 year)

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14
Q

Treatment for Scheuermann’s

A

Brace, support, rest, heat on initial presentation

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15
Q

Rotator Cuff S/S, Hx, Dx, Tx

A

S/S: Night pain, usually above elbow, abduction and rotation painful
Hx: Pain for 1 year, 6 months gradually lack of use; supraspinatus and infraspinatus atrophy
Dx: Drop arm, MRI, US, CAT Scan, arthroscopy
Tx: Sling (10-14 days), ice, TENS, exercise (Codmans)

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16
Q

Adhesive Capsulitis (AKA Frozen Shoulder, adhesions) S/S, Dx, Tx

A

S/S: Persistent pain (night too), dull, nagging, progressive restriction of motion (active and passive)
Dx: ROM exam
Tx: Adjust, massage, exercise, TENS, moist hot packs

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17
Q

Bursitis S/S, Dx, Tx

A

S/S: Pinpoint pain, pain in multiple directions
Dx: Xray (calcification), MRI of joint
Tx: Adjust, PT, exercises

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18
Q

Dislocation S/S, Dx, Tx

A

S/S: (MOI) 90 abduct / external rotation (acute) forceful overhead motions (chronic); sudden sharp paralyzing pain while abducting indicates instability; “dead arm syndrome”
Dx: Anterior inferior deformity, axillary nerve entrapment, xray, hill sach’s (chronic)
Tx: Milch or Kocher’s method, sling and ice (3-6 wks) (<2 wks over 40 yo), hot packs, exercise (tubing, wand, very slow for 6 months), TENS, microcurrent

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19
Q

Reflex Sympathetic Dystrophy Syndrome (RSDS) aka Complex Regional Pain Syndrome (CRPS) S/S, Dx, Tx

A

S/S: Post trauma (6-8 wks usually), hyperpathia (sensory) swollen, color changes, sweaty and/or dry, burning pain (causalgia)
Dx: Plethysmograph (blood flow to extremity increased); Thermography (usually cold); Xray (spotty demineralization); three phase radionucleotide scintigraphy (most sensitive test)
Tx: Touch and motion, fluidotherapy, massage (light, deep, light), adjustments, exercise (scrub brush, crutch walking for lower ext.), acupuncture, US, TENS

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20
Q

Impingement AKA Swimmer’s Shoulder S/S, Dx, Tx

A

Rotator cuff and/or subacromial bursa, entrapment between humerus and coracoacromial arch resulting in rotator cuff lesions; caused by overhead sports activities and occupations
S/S: Diffuse lateral shoulder pain
1. achy, painful
2. night pain, rest doesn’t help, overhead sports 25-40 yo
3. loss range of motion, rotator rupture, bicipital tendon pain 40 years old
Dx: 1. Pain: 60-120 degrees abduction and 70-120 flexion and decreased ROM
2. Speed’s, Yergason’s and Codman’s tests
3. Xray: AC and shoulder DJD, HADD; MRI: Spurs, bursa, tendon tears
Tx: Adjust, rest, ice/heat, stretch, tape in ext rot, warm up, US, TENS, “rowing”

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21
Q

Tennis Elbow AKA Lateral Epicondylitis S/S, Dx, Tx

A

S/S: wrist extensors, weak grip, forearm atrophy, painful resisted extension, painful hyperflexion stretch (posterior radial head)
Dx: Mill’s Cozen’s, dynamometer
Tx: Adjust , TFM (transverse friction massage), US, brace, microcurrent, exercise (PNF, rope, weight)

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22
Q

Little Leaguer’s Elbow AKA Medial Epicondylitis

A

wrist flexors, adjust

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23
Q

Intra-articular effusion

A

Posterior fat pad - refer

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24
Q

Dislocation

A

posterior (m/c) refer

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25
Q

Carpal Tunnel S/S, Dx, Tx

A

S/S: Pain radiates into hand, arm, neck, tingling, numbness, weakness, cool hands, night pain relieved by shaking hand, effect first three digits
Dx: Tinels, Phalen’s Compression Test, NCV, EMG, SSEP, Tourniquet test (cuff diminishes arterial flow flow 30-60 sec)
Tx: Eliminate cause (change job, endocrine, pregnancy, PMS, etc), adjust wrist, elbow, neck, vitamin B6, ice and HVG, moist heat, diathermy for chronic, exercise (putty), cock up or plaster splint, modify job, breaks, stretch

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26
Q

Tunnel of Guyon S/S, Dx, Tx

A

S/S: numbness and weakness of last two digits
Dx: Tinels, muscle test, NCV, EMG, SSEP
Tx: Adjust (ulnar nerve entrapment), PT

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27
Q

Dupuytren’s (flexion contracture of last 2-3 fingers) S/S, DX, Tx

A

S/S: familial, related to alcoholism, post vascular accident
Dx: palpation of fascia, MRI
Tx: Surgery

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28
Q

Volkmann’s Ischemic Contracture S/S, Dx, Tx

A

(last 2-3 digits)
S/S: Post trauma usually (humerus fracture)
Dx: History, MRI
Tx: Adjust elbow, shoulder, spine, PT

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29
Q

Claw Hand S/S, Dx, Tx

A

PNE (last 2-3 digits)

Tx: adjust (ulnar nerve entrapment)

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30
Q

Benediction Hand S/S, Dx, Tx (cannot flex first 3 digits)

A

Dx: ROM, NCV, EMG
Tx: adjust (median nerve entrapment), PT

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31
Q

TFL Syndrome AKA Iliotibial Band Syndrome

A

S/S: ASIS (pain clicking), lat knee pain clicking, bicycling, running, stairs, painful
Dx: Ober’s and noble’s test, antalgia (coxa varus, genu valgus, toe out)
Tx: Adjust and stretch abductors

32
Q

Trochanteric Bursitis S/S, Dx, Tx

A

S/S: clicking when climbing stairs and bicycling
Tx: adjust and ice
(assciated with TFL)

33
Q

Age for congential hip dysplasia

A

0-1 yo

34
Q

Age for LCP

A

4-8 yo

35
Q

Age for SCFE

A

12-16 yo

36
Q

Age for OA

A

> 40 yo

37
Q

Age for Osteoporosis, Paget’s, Mets

A

> 60 yo

38
Q

Ischial Bursitis S/S, Dx, Tx

A

S/S: Pain on sitting (localized); Rider’s bone (calcified bursa)
Tx: Adjust, ice, PT, exercise

39
Q

Congenital Dysplasia S/S, D/x, Tx

A

0-1 year old
S/S: joint slips in and out
Dx: Ortolani’s, Barlow’s, Telescoping, Xray
Tx: Surgery, plantar support

40
Q

LCP S/S, Dx, Tx

A 
Cause unknown
4-8 yo
Early stage: crest sign, snowcap (1-2 years)
Healed: epiphyseal closure, deformity
S/S: Limping, "painless limp", 
Dx: Xray, MRI
Tx: Brace, heat, adjust in late stages
Associated with 80% develop DJD; differentiate from transient synovitis
41
Q

SCFE AKA Type 1 Salter Harris Fracture

A

12-16 years old
S/S: Hip pain, weight bearing, gait problems
Dx: Xray, CT, MRI
Tx: Surgery (pins)

42
Q

Arthritis - young males bilateral

A

AS

43
Q

Arthritis - over 40 yo unilateral

A

OA

44
Q

Arthritis - over 60 yo bilateral

A

RA

45
Q

Infection treatment

A

refer

46
Q

Osgood Schlatter S/S, Dx, Tx

A

S/S: localized pain inferior to patella
Dx: lateral xray
Tx: decrease activity, brace 4-8 wks, heat, pain for several years anticipated

47
Q

Osteochondritis Desiccans (AKA OCD and quiet necrosis) (no infection) S/S, Dx, Tx

A

Medial femoral condyle (posterior, lateral border)
S/S: Vague subpatellar pain, stiffness, swelling, weight bearing instability, catching, lock, giving away
Dx: Xray (joint mouse), MRI
Tx: No weight (6-12 wks), heat, splint brace and crutches, swimming, monitor with MRI and bone scan

48
Q

Meniscus S/S, Dx, Tx

A

Twisting injuries while foot is planted
S/S: locking, clicking, pain
Dx: Computed tomography, arthroscopy, MRI, scintigraphy (best for lat meniscus)
Tx: Adjust, exercise vastus medialis and lateralis, diathermy deep heat, decrease activity for 6 mo, surgery not usually successful

49
Q

Pellegrini Stieda S/S, Dx, Tx

A

S/s: medial knee pain
Dx: xray, calcified MCL
Tx: do not massage (12 mo to never), may need surgery

50
Q

Anterior Cruciate S/S, Dx, Tx

A

Prevents hyperextension
Associated with hemarthrosis with tears, fragments with fractures
S/S: pain, instability
Dx: MRI, arthroscopy
Tx: Non-weight bearing, brace, exercise 6-9 mo, build to full extension

51
Q

Posterior Cruciate S/S, Dx, Tx

A

Dx: sag sign, arthroscopy, MRI
Tx: adjust, exercise without extreme end range

52
Q

Chondromalacia Patella S/S, Dx, Tx

A

S/S: weakness about knee, aching, flexion and load aggravates, crepitus, catching, locking; associated with increase Q angle, medial femoral torsion, pronated feet, patella alta, TFL
Dx: sunrise view, MRI
Tx: adjust, rest, ice, anti-inflammatory, HVG, cho-pat strap below knee, orthotics, heel lifts, delorme exercises, vastus medialis

53
Q

Patella Dislocation Tx

A

Refer

54
Q

Bursae: Housemaid, Clergyman, Pes anserine

A

Housemaid: prepatella, adjust
Clergyman’s: infra patella
Per anserine: medial tibia (sartorius, gracilis, semitendinosis)

55
Q

Baker’s cyst aka synovial cyst aka popliteal bursitis causes:

A 
OA
Trauma
RA
Hereditary Synovial Protrusion (post knee)
Refer
56
Q

Which artery in the knee can you find an aneurysm?

A

Popliteal artery (posterior knee), refer

57
Q

Ankle Sprain S/S, Dx, Tx

A 
S/S: Pain, swelling, bruise, instability, deformity
Dx: Xray, MRI
Tx: 
1 - (mild); wrap (PRICE), adjust, ice
2 - (moderate); wrap / crutch (cast)
3 - (severe); cast / surgery (referral)
58
Q

Shin Splints S/S, Dx, Tx

A

S/S: Pain during activity, relieved by rest
Dx: exam, history
Tx: adjust, warm-up, stretching, heat, evaluate shoes, exercise surface

59
Q

Compartment Syndrome S/S, Dx, Tx

A

NVE; upper and lower ext., post trauma or activity
S/S: Pain with activity, not relieved by rest, swollen, shiny calf, numb foot
Dx: from S/S and associate with a history of decreased lower extremity pulses
Tx: surgery (fasciotomy)

60
Q

Cervical Disc S/S, Dx, Tx

A

S/S: aggravated by dejerine’s triad, cord or nerve compression with neck flexion
Dx: xray, MRI, positive valsalva
Tx: hard braces, then soft brace, rest, ice, traction, hot packs, gentle adjustments

61
Q

Cervical injury damaging sympathetics, rotation aggravates
Mimics Meniere’s or VBAI
Adjust and monitor

A

Barre-Lieou Syndrome

62
Q

PICA mimics TIA, mostly motor involvement, weakness

Refer, rule out arterial disease

A

Wallenburg Syndrome

63
Q

Whiplash S/S

A

HA, neck pain, dizziness, neurological symptoms, vascular compromise

64
Q

Lab and special tests for whiplash

A

Bone panel, joint panel, inflammation tests, UA, MRI, CAT scan

65
Q

Acute treatment for whiplash

A

Rest collar with slight flexion 3-5 days maximum begin adjusting low force when inflammation is reduced and patient allows set up, monitor neurological compression signs every visit; Re-evaluate within 2 weeks

66
Q

PT for whiplash

A

Ice, collar, disability after inflammation reduces add: traction, ultrasound, exercises

67
Q

Nutrition for whiplash

A

Collage synthesis, magnesium, chondroitin sulfate, C, B vitamins, stool softener

68
Q

Rehab for whiplash

A

Rest (cervical pillow), disability, ADLs, isometric exercises, balloon, work hardening

69
Q

Disc Prolapse

A 
S/S: Immediate, snap, leg pain leads to LBP
Ortho: +SLR
Confirm: MRI (- Valsalva)
Miscellaneous: Wandering Fragment
Tx: Adjust/refer, walk, L/S brace
70
Q

Disc Protrusion

A

S/S: gradual, LBP leads to leg pain
Ortho: +SLR
Confirm: MRI (+Valsalva)
Tx: Adjust, walk, L/S brace

71
Q

Posterolateral Disc

A

S/S: Antalgia; away
Ortho: +Kemp’s toward, +SLR, -WLR, +Lindner’s
Confirm: MRI, +Valsalva
Tx: Adjust, walk, L/S brace

72
Q

Posteromedial Disc

A

S/S: Antalgia toward
Ortho: +Kemp’s away, + SLR, +WLR
Confirm: MRI, + Valsalva
Tx: Adjust, walk, L/S brace

73
Q

Subrhizal disc posterior

A

S/S: Antalgia, forward
Ortho: +Kemp’s bilat., +traction
Confirm: MRI, +Valsalva
Tx: Adjust, walk, L/S brace

74
Q

Central Disc

A 
S/S: antalgia, forward
Ortho: +Kemp's bilat., +traction
Confirm: MRI, +Valsalva
Bilateral leg pain; Cauda equina
Tx: Adjust/refer, walk, LS brace
75
Q

Tumor

A 
S/S: Deep, boring, constant, nocturnal pain
Ortho:
Confirm: MRI, + Valsalva
Miscellaneous: Varies
Tx: Refer
76
Q

Facet Problem for LB

A 
S/S: extension painful; scleratogenous
Ortho: + Kemps
Confirm: Xray - lat, oblique
Misc: McNab's
Tx: Adjust, William's exercises

Part 4 (19 decks)

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