Musculoskeletal assessment and diagnostics

Question 1

Scoliosis

Answer 1

Abnormal lateral curvature to the spine

Question 2

Kyphosis

Answer 2

Abnormal curvature of the thoracic spine

Question 3

Lordosis

Answer 3

abnormal curvature of the lumbar spine

Question 4

Ligaments

Answer 4

bone to bone

Question 5

Tendons

Answer 5

muscle to bone

Question 6

5 Ps of Neurovasc Assessment

Answer 6

Pain, Pulse, Pallor, Paresthesia, Paralysis (also edema, cap refill, nailbeds and skin)

Question 7

Crepitus

Answer 7

cracking or grating sound due to abnormal joint motion; TMJ, dislocation, fracture

Question 8

Contracture

Answer 8

resistance of movement of joint or muscle, results from fibrosis of supporting soft tissue, immobilized extremity

Question 9

Effusion

Answer 9

excessive fluid collection in joint, arthritis, injury, infection

Question 10

Dislocation

Answer 10

separation of 2 bones from normal position within a joint

Question 11

Subluxation

Answer 11

partial dislocation of joint

Question 12

Ankylosis

Answer 12

stiffness and fixation of the joint, chronic joint inflammation (RA)

Question 13

Atrophy

Answer 13

flabby appearance of muscle with decreased tone- prolonged disuse, chronic immobilization

Question 14

Xray

Answer 14

1d- front to back, 2d- lateral, evaluates structure and functional changes of bone, excessive exposure to radiation

Question 15

CT scan

Answer 15

3d, IDs soft tissue and bony abnormalities, claustrophobia, injection of IV contrast

Question 16

MRI

Answer 16

view soft tissue w/ magnetic field (tumors, osteomyelitis, ligament and cartilage tears)

consider claustrophobia, no metal, open v closed, can inject gadolinium to enhance visualization

Question 17

DXA scan indications

Answer 17

Measure bone mass density
* of spine, femur, forearm, total body
– Diagnose & monitor osteoporosis
– Predict fracture risk
– Diagnose presence of bone disease
* minimal exposure to radiation
* no discomfort

Question 18

Bone scan

Answer 18

Indications:
– detect metastatic & primary tumors
– detect osteomyelitis
– diagnose stress fracture not evident on x-ray
– May take up to 1 hour to perform
* Requires IV injection of Radioisotope
– a.k.a. “tracer”
– 2-4 hrs. before scan
– May “sting” when injected
– Encourage oral fluids afterward to eliminate radioisotope
* Results:
– Increased bone uptake of radioisotope = skeletal disease, metastasis, osteomyelitis,
fracture

Question 19

Arthroscopy

Answer 19

visualization of joint with fiberoptic endoscope, sterile technique in OR w/ general or local anesthesia

Question 20

Arthroscopy complications

Answer 20

infection, thrombophlebitis, neurovascular compromise, effusions

Question 21

Arthroscopy post op

Answer 21

compression dressing, ice packs, elevate leg, check pulses, color, sensation, temperature, assess for pain and administer analgesics, assess for infection and bleeding

Question 22

Arthrocentesis

Answer 22

to obtain synovial fluid for testing, to relieve pain due to effusion, can inject NSAIDs and steroids into joint for temporary pain relief

Question 23

Arthrocentesis post op

Answer 23

sterile dressing applied, ice packs to decrease swelling, may require antibiotics after procedure, assess for s/s of infection, effusion, bleeding, assess pain

Question 24

Myelogram

Answer 24

to detect nerve impingement within spinal canal, injection of radiopaque contrast into sac around nerve roots, NPO 4-6 hrs. before test

Question 25

EMG

Answer 25

test to diagnose muscle weakness

Question 26

CK

Answer 26

enzyme found in skeletal muscle (heart muscle as well), serum levels elevated with muscle damage: rhabdo, MI, traumatic injury, myositis
M- 20-200 F-20-180

Question 27

Myoglobin

Answer 27

protein found in striated muscle (h&s), serum and urine levels elevate with muscle injury, N- <90

Question 28

Alkaline phosphatase

Answer 28

Enzyme produced by osteoblasts and liver, elevated levels found in healing fractures, bone cancer, osteoporosis, Paget’s disease, liver disease (also during normal periods of growth) N- 38-126

Question 29

Uric acid

Answer 29

Forms as a result of purine metabolism, elevated amounts indicate gout or uric acid kidney stones

M-4.5-8.0 F- 2.5-6.2