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Musculoskeletal Flashcards

1
Q

Lateral Epicodylitis

A

Radial side. Remember anatomical position. Tennis elbow.

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2
Q

Medial Epicondylitis

A

Golfer elbow. Ulnar side.

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3
Q

synovial joint

A

freely movable; knee-shoulder

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4
Q

cartilaginous joint

A

slightly movable; vertebral bodies of the spine

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5
Q

fibrous joint

A

immovable; skull sutures

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6
Q

spheroidal joint

A

synovial joint-ball and socket

  • convex surface in concave cavity; wide ranging flexion, extension, abduction, adduction, rotation, circumduction
    example: shoulder, hip
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7
Q

hinge joint

A

synovial joint

  • flat, planar
  • motion in one plane; flexion and extension
  • interphalangeal joints of hand and foot, elbow
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8
Q

condylar joint

A

synovial joint
-covex or concave
movement of two articulating surfaces not discernible
-knee, temporomandibular joint

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9
Q

bursae

A

disc-shaped synovial sacs that allow adjacent muscles or muscles and tendons to glide over each other during movement

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10
Q

exam specifics

A
  • inspection: symmetry
  • inspection and palpation: assess the surrounding tissues
  • test range of motion and maneuvers to demonstrate limitations in rom or joint instability from excess mobility of joint ligaments
  • test muscle strength
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11
Q

signs of inflammation and arthritis

A

swelling: 1. synovial membrane (boggy or doughy
2. effusion from excess synovial fluid within the joint space
3. soft-tissue structures such as bursae, tendons, tendon sheaths

-warmth, tenderness, redness

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12
Q

TMJ joint structures

A 
Temporal bone
zygomatic arch
articular disc
ext auditory meatus
condyle of mandible
articular tubercle
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13
Q

TMJ ROM and maneuvers

A

Glide and hinge motions.

ROM: opening and closing; protrusion and retraction(jutting jaw forward); lateral

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14
Q

Shoulder: bony structures

A 
Acromioclavicular joint
Acromion
Scapula
Clavicle
Glenohumeral joint
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15
Q

Glenohumeral joint

A

glenohumeral joint: head of the humerus articulates with the shallow glenoid fossa of the scapula. deeply situated and not normally palpable. Ball-and-spocket joint. wide range of motion-flexion, extension, abduction, adduction, rotation, circumduction

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16
Q

Sternoclavicular joint

A

the convex medial end of the clavicle articulates with the concave hollow in the upper sternum

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17
Q

Acromioclavicular joint

A

lateral end of the clavicle articulates with the acromion process of the scapula

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18
Q

Scapulohumeral muscle group

A

“SITS” muscles of rotator cuff:rotates shoulder laterally. depresses and rotates the head of the humerus

  • supraspinatus: runs above the glenohumeral joint-inserts on greater tubercle
  • infraspinatus and teres minor cross the glenohumeral joint posteriorly; insert on greater tubercle
  • subscapularis
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19
Q

axioscapular group

A

attaches the trunk to the scapula and includes the trapezius, rhomboids, seratus anterior, levator scapulae–rotate the scapula

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20
Q

axiohumeral group

A

attaches the trunk to the humerus and incldes the pectoralis major and minor and the latissimus dorsi. produce internal rotation of the shoulder

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21
Q

Exam shoulder: Inspection

A

inspection: note any swelling, deformity, atrophy/fasiculations, abnormal positioning
- look for swelling of the joint capsule anteriorly or a bulge in the subacromial bursa under the deltoid muscle

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22
Q

Exam shoulder: palpation

A

bony landmarks-page 592
-tenderness over the “SITS” muscle insertions and inability to lift arm above shoulder level are seen in sprains, tears, and tendon rupture of the rotator cuff

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23
Q

ROM: Shoulder flexion

A

raise arm in front of and overhead

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24
Q

ROM shoulder: extension

A

raise arms behind you

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25
ROM shoulder: abduction
raise arms out to the side and overhead
26
ROM shoulder: adduction
cross arm in front of body. "crossover test". tests ac joint. localized tenderness or pain suggests inflammation or arthritis
27
ROM shoulder: internal rotation
place one hand behind your back and touch your shoulder blade: pain =rotator cuff
28
ROM shoulder: external rotation
1. raise your arm to shouldder level, bend elbow and rotate forearm toward the ceiling 2. place one hand behind neck or head as if you are brushing hair. Pain=rotator cuff
29
Neer's impingement sign- rotator cuff
press on the scapula to prevent scapular motion with one hand, and raise the patient's arm with the other-compresses greater tuberosity of humerus against acromion
30
hawkin's impingement sign-rotator cuff
flex pt shoulder and elbow to 90 degrees with the palm facing down. then with one hand on the forearm and one on the arm, rotate the arm internally. compresses the greater tuberosity against the coracoacromial ligament
31
supraspinatus strength- rotator cuff
empty the can test-rotate the arms internally and place downward pressure
32
infraspinatus strength- rotator cuff
arms at side and flex the elbow to 90 deg with the thumns turned up. provide resistance as the patient presses the forearms outward
33
forearm supination- rotator cuff or inflamed long head of biceps tendon
flex oatient forearm to 90 deg at the elbow and pronate the patient's wrist. provide resistance when the patient supinates the forearm
34
drop arm sign- rotator cuff
if the patient cannot hold the arm fully abducted at shoulder level, the test positive
35
ELBOW: Bony structures
``` Humerus medial epicondyle (ulnar side) lateral epicondyle (radial side) ulna radius olecranon process-bursa is between process and skin ```
36
ELBOW: ROM/maneuvers
Flexion: "bend elbow extension: straighten elbow supination: turn palm up as if carrying bowl pronation: turn palms down
37
WRIST AND HANDS: Bony structures
``` distal interphalangeal joint: DIP Proximal interphalangeal joint: PIP metacardophalangeal joint: MCP carpals metacarpals phalanges padius ulna ```
38
Flexor retinaculum
transverse ligament holding the tendons and tendon sheath in place. the median nerve lies between the flexor retinaculum and the tendon sheath.
39
Wrists and hands exam
Inspection: poor finger alignment seen in flexor tendon injury -thenar/hypothenar eminences:atrophy=median nerve compresion palpation-joints
40
anatomical snuffbox
hollowed depression just distal to the radial styloid process-tenderness in scaphoid fracture
41
wrists: ROM and maneuvers
- flexion: palms down point finger toward the floor - extension: palms down point fingers at the ceiling - adduction: palms down bring fingers to the midline(radial deviation) - abduction: palms down bring fingers away from midline (ulnar deviation)
42
carpal tunnel syndrome testing
test sensation: pulp of index finger (median nerve) pulp of 5th finger (ulnar) dorsal web space of the thumb and index finger (radial)
43
hand grip
have patient grasp your fingers: decreased grip strength is a positive test for weakness of the finger flexors and intrinsic muscles of the hand -wrist pain and grip weakness in deQuervain's tenosynovitis, arthritis, carpel tunnel, epicodylitis, cervical radiculopathy
44
thumb movement
patient grasp thum against palm and them move the wrist toward the midline in ulnar deviation -pain identifies de Quervain's tenosynovitis from inflammation of the tendons
45
Carpel tunnel-thumb abduction
rasie thumb straight up as you apply downward pressure-weakness is positive test
46
carpel tunnel-Tinel's sign
median nerve compression by tapping lightly over the course of the median nerve. aching and numbness =positive
47
carpel tunnel-Phalen's sign
hold wrists in flexion for 60 sec. numbness and tingling w/in 60 sec =positive
48
Fingers and thumbs: flexion and extension
flexion: tight fist with each hand, thumb across the knuckles extension: extend and spread the fingers
49
Fingers and thumbs: abduction and adduction
spread fingers apart dorsal (abduction) and back together palmar (adduction)
50
thumb: flexion, extension
flexion: thumb across hand to fifth digit extension: away from fingers
51
thumb: abduction, adduction, opposition
abduction: fingers and thumb in neutral position w palm up, then have the patient move the thumb anteriorly away from the palm to assess abduction and back down for adduction. opposition: touch thumb to each of the fingers
52
spine muscle groups
trapezius deltoid gluteus maximus latissimus dorsi
53
exam: inspection
posterior superior iliac spine iliac crest ischial tuberosity sciatic nerves
54
side view
cervical concavity thoracic convexity lumbar concavity
55
behind view
alignment of the shoulders, iliac crest, skin creases below buttocks
56
Neck: ROM
flexion: chin to chest extension: look up at ceiling' rotation: look over one shoulder and then the other lateral bending: bring ear to shoulder
57
Spinal column ROM
flexion: bend forward and try to touch toes. note smoothness and symmetry of move, range of motion extension: bend back as far as possible rotation: rotate from side to side lateral bending: bend to the side from the waist
58
the hip structures
``` iliac crest level of L4 iliac tubercle abt superior iliac spine greater trochanter pubic sympysis ```
59
hip muscle groups
flexor: iliopsoas extensor: gluteus maximus adductor abductor
60
inspection: stance
heelstrike foot flat midstance push-off
61
Hip : ROM
flexion: bend knee to chest and pull to abd extension: lie face down, bend knee and lift it up abduction: laying flat move lower leg away from midline adduction: laying flat, bend knee and move lower leg toward midline external rotation: laying flat prone bend knee and turn lower leg and foot across midline internal rotation: laying flat prone bend your knee and turn lower leg and foot away from midline
62
Knee structures
``` medial epicondyle lateral epicondyle ant cruciate lig post cruciate ligament medial meniscus lateral meniscus tibia tibial tuberosity ```
63
knee muscles
quadriceps: extends leg hamstrings: flex knee gastrocnemius muscle in calf
64
knee ROM
flexion: bend or flex knee extension: straighten internal rotation: while sitting swing lower leg toward midline external rotation: while sitting swing lower leg away from midline
65
meniscus exam
McMurray test: if a click with flexion or extension in knee or tenderness in joint: patient supine: grasp heel and flex knee. cup other hand over the knee joint with fingers and thumb along the medial and lateral joint line. from the heel, rotate the lower leg internally and externally. then push on the lateral side to apply a valgus stress on the medial side of the joint. at the same time rotate the leg externally and slowly extend it
66
MCL: medial cruciate lig-most injuries on medial
abduction or valgus stress: patient supine and the knee slightly flexed, move the thigh about 30 degrees laterally to table. place one hand against the lateral knee to stabilize the femur and the other hand around the medial ankle. push medially agaiinst the knee and pull laterally at the ankle to open the knee joint on the medial side
67
Lateral collateral ligament
adduction/varus stress: hand against medial surface of knee and the other around the lateral ankle. push medially against the knee and pull laterally at the ankle to open knee joint on lateral side
68
ant cruciate ligament
ant drawer sign: knees flexed to 90-feet flat on table. draw tibia forward and observe if it slides forward like a drawer under the femur
69
post cruciate ligament
post drawer sign: same as ant push tibia posteriorly under femur
70
ankle and foot structures
achilles tibia: inside calcaneous: heel
71
ankle
``` lateral malleolus first metatarsal metatarsophalangeal joint proximal phalanx distal phalanx ```
72
exam ankle
inspect, palpate
73
ankle ROM
ankle plantar flexion: point foot toward floor dorsiflexion: point foot toward ceiling inversion: bend heel inward eversion: bend heel outward
74
Attempting to open knee at medial side. Tests MCL
Valgus stress
75
Placing pressure on LCL. Opens lateral side of knee.
Varus stress

Bates Reviews (22 decks)

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