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Bates Reviews > Musculoskeletal > Flashcards

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
Q

ROM shoulder: abduction

A

raise arms out to the side and overhead

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26
Q

ROM shoulder: adduction

A

cross arm in front of body. “crossover test”. tests ac joint. localized tenderness or pain suggests inflammation or arthritis

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27
Q

ROM shoulder: internal rotation

A

place one hand behind your back and touch your shoulder blade: pain =rotator cuff

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28
Q

ROM shoulder: external rotation

A
  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
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29
Q

Neer’s impingement sign- rotator cuff

A

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

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30
Q

hawkin’s impingement sign-rotator cuff

A

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

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31
Q

supraspinatus strength- rotator cuff

A

empty the can test-rotate the arms internally and place downward pressure

32
Q

infraspinatus strength- rotator cuff

A

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
Q

forearm supination- rotator cuff or inflamed long head of biceps tendon

A

flex oatient forearm to 90 deg at the elbow and pronate the patient’s wrist. provide resistance when the patient supinates the forearm

34
Q

drop arm sign- rotator cuff

A

if the patient cannot hold the arm fully abducted at shoulder level, the test positive

35
Q

ELBOW: Bony structures

A 
Humerus
medial epicondyle (ulnar side)
lateral epicondyle (radial side)
ulna
radius
olecranon process-bursa is between process and skin
36
Q

ELBOW: ROM/maneuvers

A

Flexion: “bend elbow

extension: straighten elbow
supination: turn palm up as if carrying bowl
pronation: turn palms down

37
Q

WRIST AND HANDS: Bony structures

A 
distal interphalangeal joint: DIP
Proximal interphalangeal joint: PIP
metacardophalangeal joint: MCP
carpals
metacarpals
phalanges
padius
ulna
38
Q

Flexor retinaculum

A

transverse ligament holding the tendons and tendon sheath in place. the median nerve lies between the flexor retinaculum and the tendon sheath.

39
Q

Wrists and hands exam

A

Inspection: poor finger alignment seen in flexor tendon injury
-thenar/hypothenar eminences:atrophy=median nerve compresion

palpation-joints

40
Q

anatomical snuffbox

A

hollowed depression just distal to the radial styloid process-tenderness in scaphoid fracture

41
Q

wrists: ROM and maneuvers

A
  • 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
Q

carpal tunnel syndrome testing

A

test sensation:
pulp of index finger (median nerve)
pulp of 5th finger (ulnar)
dorsal web space of the thumb and index finger (radial)

43
Q

hand grip

A

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
Q

thumb movement

A

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
Q

Carpel tunnel-thumb abduction

A

rasie thumb straight up as you apply downward pressure-weakness is positive test

46
Q

carpel tunnel-Tinel’s sign

A

median nerve compression by tapping lightly over the course of the median nerve. aching and numbness =positive

47
Q

carpel tunnel-Phalen’s sign

A

hold wrists in flexion for 60 sec. numbness and tingling w/in 60 sec =positive

48
Q

Fingers and thumbs: flexion and extension

A

flexion: tight fist with each hand, thumb across the knuckles
extension: extend and spread the fingers

49
Q

Fingers and thumbs: abduction and adduction

A

spread fingers apart dorsal (abduction) and back together palmar (adduction)

50
Q

thumb: flexion, extension

A

flexion: thumb across hand to fifth digit
extension: away from fingers

51
Q

thumb: abduction, adduction, opposition

A

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
Q

spine muscle groups

A

trapezius
deltoid
gluteus maximus
latissimus dorsi

53
Q

exam: inspection

A

posterior superior iliac spine
iliac crest
ischial tuberosity
sciatic nerves

54
Q

side view

A

cervical concavity
thoracic convexity
lumbar concavity

55
Q

behind view

A

alignment of the shoulders, iliac crest, skin creases below buttocks

56
Q

Neck: ROM

A

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
Q

Spinal column ROM

A

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
Q

the hip structures

A 
iliac crest level of L4
iliac tubercle
abt superior iliac spine
greater trochanter
pubic sympysis
59
Q

hip muscle groups

A

flexor: iliopsoas
extensor: gluteus maximus
adductor
abductor

60
Q

inspection: stance

A

heelstrike
foot flat
midstance
push-off

61
Q

Hip : ROM

A

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
Q

Knee structures

A 
medial epicondyle
lateral epicondyle
ant cruciate lig
post cruciate ligament
medial meniscus
lateral meniscus
tibia
tibial tuberosity
63
Q

knee muscles

A

quadriceps: extends leg
hamstrings: flex knee
gastrocnemius muscle in calf

64
Q

knee ROM

A

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
Q

meniscus exam

A

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
Q

MCL: medial cruciate lig-most injuries on medial

A

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
Q

Lateral collateral ligament

A

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
Q

ant cruciate ligament

A

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
Q

post cruciate ligament

A

post drawer sign: same as ant push tibia posteriorly under femur

70
Q

ankle and foot structures

A

achilles

tibia: inside
calcaneous: heel

71
Q

ankle

A 
lateral malleolus
first metatarsal
metatarsophalangeal joint
proximal phalanx
distal phalanx
72
Q

exam ankle

A

inspect, palpate

73
Q

ankle ROM

A

ankle plantar flexion: point foot toward floor

dorsiflexion: point foot toward ceiling
inversion: bend heel inward
eversion: bend heel outward

74
Q

Attempting to open knee at medial side. Tests MCL

A

Valgus stress

75
Q

Placing pressure on LCL. Opens lateral side of knee.

A

Varus stress

Bates Reviews (22 decks)

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