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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
Carpal Tunnel S/S, Dx, Tx
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
26
Tunnel of Guyon S/S, Dx, Tx
S/S: numbness and weakness of last two digits Dx: Tinels, muscle test, NCV, EMG, SSEP Tx: Adjust (ulnar nerve entrapment), PT
27
Dupuytren's (flexion contracture of last 2-3 fingers) S/S, DX, Tx
S/S: familial, related to alcoholism, post vascular accident Dx: palpation of fascia, MRI Tx: Surgery
28
Volkmann's Ischemic Contracture S/S, Dx, Tx
(last 2-3 digits) S/S: Post trauma usually (humerus fracture) Dx: History, MRI Tx: Adjust elbow, shoulder, spine, PT
29
Claw Hand S/S, Dx, Tx
PNE (last 2-3 digits) | Tx: adjust (ulnar nerve entrapment)
30
Benediction Hand S/S, Dx, Tx (cannot flex first 3 digits)
Dx: ROM, NCV, EMG Tx: adjust (median nerve entrapment), PT
31
TFL Syndrome AKA Iliotibial Band Syndrome
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
Trochanteric Bursitis S/S, Dx, Tx
S/S: clicking when climbing stairs and bicycling Tx: adjust and ice (assciated with TFL)
33
Age for congential hip dysplasia
0-1 yo
34
Age for LCP
4-8 yo
35
Age for SCFE
12-16 yo
36
Age for OA
> 40 yo
37
Age for Osteoporosis, Paget's, Mets
> 60 yo
38
Ischial Bursitis S/S, Dx, Tx
S/S: Pain on sitting (localized); Rider's bone (calcified bursa) Tx: Adjust, ice, PT, exercise
39
Congenital Dysplasia S/S, D/x, Tx
0-1 year old S/S: joint slips in and out Dx: Ortolani's, Barlow's, Telescoping, Xray Tx: Surgery, plantar support
40
LCP S/S, Dx, Tx
``` 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
SCFE AKA Type 1 Salter Harris Fracture
12-16 years old S/S: Hip pain, weight bearing, gait problems Dx: Xray, CT, MRI Tx: Surgery (pins)
42
Arthritis - young males bilateral
AS
43
Arthritis - over 40 yo unilateral
OA
44
Arthritis - over 60 yo bilateral
RA
45
Infection treatment
refer
46
Osgood Schlatter S/S, Dx, Tx
S/S: localized pain inferior to patella Dx: lateral xray Tx: decrease activity, brace 4-8 wks, heat, pain for several years anticipated
47
Osteochondritis Desiccans (AKA OCD and quiet necrosis) (no infection) S/S, Dx, Tx
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
Meniscus S/S, Dx, Tx
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
Pellegrini Stieda S/S, Dx, Tx
S/s: medial knee pain Dx: xray, calcified MCL Tx: do not massage (12 mo to never), may need surgery
50
Anterior Cruciate S/S, Dx, Tx
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
Posterior Cruciate S/S, Dx, Tx
Dx: sag sign, arthroscopy, MRI Tx: adjust, exercise without extreme end range
52
Chondromalacia Patella S/S, Dx, Tx
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
Patella Dislocation Tx
Refer
54
Bursae: Housemaid, Clergyman, Pes anserine
Housemaid: prepatella, adjust Clergyman's: infra patella Per anserine: medial tibia (sartorius, gracilis, semitendinosis)
55
Baker's cyst aka synovial cyst aka popliteal bursitis causes:
``` OA Trauma RA Hereditary Synovial Protrusion (post knee) Refer ```
56
Which artery in the knee can you find an aneurysm?
Popliteal artery (posterior knee), refer
57
Ankle Sprain S/S, Dx, Tx
``` 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
Shin Splints S/S, Dx, Tx
S/S: Pain during activity, relieved by rest Dx: exam, history Tx: adjust, warm-up, stretching, heat, evaluate shoes, exercise surface
59
Compartment Syndrome S/S, Dx, Tx
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
Cervical Disc S/S, Dx, Tx
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
Cervical injury damaging sympathetics, rotation aggravates Mimics Meniere's or VBAI Adjust and monitor
Barre-Lieou Syndrome
62
PICA mimics TIA, mostly motor involvement, weakness | Refer, rule out arterial disease
Wallenburg Syndrome
63
Whiplash S/S
HA, neck pain, dizziness, neurological symptoms, vascular compromise
64
Lab and special tests for whiplash
Bone panel, joint panel, inflammation tests, UA, MRI, CAT scan
65
Acute treatment for whiplash
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
PT for whiplash
Ice, collar, disability after inflammation reduces add: traction, ultrasound, exercises
67
Nutrition for whiplash
Collage synthesis, magnesium, chondroitin sulfate, C, B vitamins, stool softener
68
Rehab for whiplash
Rest (cervical pillow), disability, ADLs, isometric exercises, balloon, work hardening
69
Disc Prolapse
``` 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
Disc Protrusion
S/S: gradual, LBP leads to leg pain Ortho: +SLR Confirm: MRI (+Valsalva) Tx: Adjust, walk, L/S brace
71
Posterolateral Disc
S/S: Antalgia; away Ortho: +Kemp's toward, +SLR, -WLR, +Lindner's Confirm: MRI, +Valsalva Tx: Adjust, walk, L/S brace
72
Posteromedial Disc
S/S: Antalgia toward Ortho: +Kemp's away, + SLR, +WLR Confirm: MRI, + Valsalva Tx: Adjust, walk, L/S brace
73
Subrhizal disc posterior
S/S: Antalgia, forward Ortho: +Kemp's bilat., +traction Confirm: MRI, +Valsalva Tx: Adjust, walk, L/S brace
74
Central Disc
``` S/S: antalgia, forward Ortho: +Kemp's bilat., +traction Confirm: MRI, +Valsalva Bilateral leg pain; Cauda equina Tx: Adjust/refer, walk, LS brace ```
75
Tumor
``` S/S: Deep, boring, constant, nocturnal pain Ortho: Confirm: MRI, + Valsalva Miscellaneous: Varies Tx: Refer ```
76
Facet Problem for LB
``` 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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