Musculoskeletal Exam 1

Question 1

PE Question

Answer 1

Any discomfort or problems with your extremities or back?

Question 2

How should our examination for musculoskeletal be?

Answer 2

Systematic

Question 3

What should we look for on inspection?

Answer 3

Looking for symmetry, deformities, malalignments, skin changes, subcutaneous nodules, and muscle atrophy

Question 4

What do we look for in palpation?

Answer 4

For crepitus (an audible or palpable crunching during movement of tendons or ligaments over bone or areas of cartilage loss) or tenderness, bogginess, warmth, etc

Question 5

What do we assess for?

Answer 5

Range of motion and special maneuvers to test specific movements.

Question 6

What is range of motion in terms of fold?

Answer 6

3 fold

Question 7

How many fingers can normally be inserted into the mouth?

Answer 7

3

Question 8

Can bottom teeth normally be placed in front of upper t

Answer 8

Yes

Question 9

How does it appear in anterior dislocation of the shoulder?

Answer 9

The rounded lateral aspect of the shoulder appears flattened.

Question 10

What 7 things do we palpate in the shoulder?

Answer 10

1. Sternoclavicular joint
2. Spine of the scapula
3. Acromion
4. Acromioclavicular joint
5. Coracoid process
6. Greater tubercle
7. Biceps tendon in the intertubercular groove

Question 11

Do we examine the subacromial and subdeltoid bursae and the SITS muscles?

Answer 11

Yes

Question 12

Is the subscapularis palpable?

Answer 12

No

Question 13

What does localized tenderness in the shoulder arise from?

Answer 13

Subacromial or subdeltoid bursitis, degenerative changes, or calcific deposits in the rotator cuff

Question 14

When is tenderness over the SITS muscle insertions and inability to abduct the arm above shoulder level are seen?

Answer 14

Sprains, tears, and tendon rupture of the rotator cuff, most commonly the supraspinatus

Question 15

What does tenderness and effusion suggest?

Answer 15

Synovitis of the glenohumeral joint

Question 16

What are the 6 motions of the shoulder girdle?

Answer 16

Flexion, extension, abduction, adduction, and internal and external rotation

Question 17

What 4 things does shoulder restricted ROM occur in?

Answer 17

Bursitis, capsulitis, rotator cuff tears or sprains, and tendinitis

Question 18

What is the most common cause of shoulder pain?

Answer 18

Rotator cuff

Question 19

What does compression of the rotator cuff muscles and tendons between the head of the humerus and the acromion cause?

Answer 19

“Impingement signs” or pain during maneuvers such as Neer’s, Hawkin’s, and the empty-can tests, described below

Question 20

What 3 things cause swelling over the olecranon process?

Answer 20

Olecranon bursitis; inflammation or synovial fluid occurs in arthritis

Question 21

Tenderness distal to epicondyle is common in what and not common in what?

Answer 21

Lateral epicondylitis (tennis elbow)and less common in medial epicondylitis (pitcher’s or golfer’s elbow)

Question 22

When is the olecranon displaced posteriorly?

Answer 22

Posterior dislocation of the elbow and supracondylar fracture

Question 23

Do we palpate grooves between epicondyles?

Answer 23

Yes

Question 24

What does ROM include?

Answer 24

Fexion and extension at the elbow and pronation and supination of the forearm

Question 25

How should the wrist and hands be when the fingers are relaxed?

Answer 25

Slightly flexed; the fingernail edges should be in parallel

Question 26

When is diffuse swelling in the hands and fingers common? Local swelling?

Answer 26

Arthritis or infection; local swelling suggests a ganglion

Question 27

What do we palpate at the wrist?

Answer 27

Distal radius and ulna

Question 28

Do we palpate the groove of each wrist joint with your thumbs on the dorsum of the wrist?

Answer 28

Yes

Question 29

Do we palpate the radial styloid bone and the anatomical snuffbox?

Answer 29

Yes

Question 30

Colles Fracture

Answer 30

Tenderness over the distal radius

Question 31

De Quervain’s tenosynovitis and gonococcal tenosynovitis

Answer 31

Tenderness over the extensor and abductor tendons of the thumb at the radial styloid

Question 32

How do we test thumb function if there is wrist pain? What is it commonly called?

Answer 32

Grasp the thumb against the palm and then move the wrist toward the midline in ulnar deviation (commonly called Finkelstein’s test)

Question 33

What does tenderness over the snuffbox suggest?

Answer 33

Scaphoid fracture

Question 34

3 tests for Carpel Tunnel

Answer 34

1. Abduction of thumb 2. Tinel's Sign 3. Phalen's Sign

Question 35

Positive Abduction of Thumb Test

Answer 35

Weakness

Question 36

Abductus Pollicis Longus Innervation

Answer 36

Only by median nerve

Question 37

Tinel's Sign process

Answer 37

Median nerve compression by tapping lightly over the course of the median nerve in the carpal tunnel as shown

Question 38

What is a positive Tinel?

Answer 38

Aching and numbness in the median nerve distribution

Question 39

Phalen's Sign Process

Answer 39

Median nerve compression by asking the patient to hold the wrists in flexion for 60 seconds

Question 40

Positive Phalen

Answer 40

Numbness and tingling in the median nerve distribution within 60 seconds is a positive test.

Question 41

How do we compress the MCP joint?

Answer 41

Squeezing the hand from each side between the thumb and fingers

Question 42

Do we palpate the medial and lateral aspects of each PIP joint?

Answer 42

Yes

Question 43

PIP changes are seen in what?

Answer 43

Rheumatoid arthritis; Bouchard’s nodes in osteoarthritis

Question 44

What are Heberden’s nodes? Common in?

Answer 44

Hard dorsolateral nodules on the DIP joints; osteoarthritis

Question 45

Do we palpate along tendons in areas of swelling and inflammation?

Answer 45

Yes

Question 46

Tenosynovitis

Answer 46

Tenderness and swelling in tendon sheaths

Question 47

What ROM do we test in fingers?

Answer 47

Flexion, extension, abduction, and adduction