Musculoskeletal Exam 2 Flashcards
Tenderness associated with trauma or in rheumatoid arthritis suggests possible risk for what in palpation of the spine?
Subluxation and high cervical cord compression and needs prompt additional assessment
3 osteopathic spine tests
- Perform a pelvic side shift
2, Perform a standing and seated forward bend while assessing the position of the PSIS - Assess General Spinal Motion –AGR
Do we inspect gait for the hips as the patient enters the room?
Yes
What should width of hip base be?
2-4 inches
A wide hip base suggests what?
Cerebellar disease or foot problems
Normal gait has what?
Smooth, continuous rhythm
Abductor contraction stabilizes what?
Pelvis and helps maintain balance, raising the opposite hip
Lack of knee flexion and drop foot cause what?
Circumduction of the extremity
Leg shortening and external rotation suggest what?
Hip fracture
Tenderness in groin area could be due to what?
Synovitis of the hip joint, arthritis, bursitis, or possibly psoas abscess
Focal tenderness over trochanter confirms what?
Trochanteric bursitis
Iliotibial band tendinitis
Tenderness over the posterolateral surface of the greater trochanter
Do we look for tenderness in ischiogluteal bursitis or “weaver’s bottom”?
Yes
Normal anterior portion of hip ROM
Anterior portion of the thigh can almost touch the chest wall (when knee is also flexed relaxing the hamstrings)
What does restriction in hip ROM suggest?
Arthritis
Stumbling or “giving way” of the knee during heel strike suggests what?
Quadriceps weakness or abnormal patellar tracking
Do we check alignment and contour of knees?
Yes
Are Bowlegs (genu varum) and knock-knees (genu valgum) common?
Yes
When is Flexion contracture (inability to extend fully) seen?
Limb paralysis or hamstring tightness
Swelling over the patella suggests what?
Prepatellar bursitis.
Swelling over the tibial tubercle suggests what?
Infrapatellaror, if more medial, anserine bursitis
Do we palpate tibiofemoral joint?
Yes
How do we palpate medial meniscus?
Pressing on the medial soft-tissue depression along the upper edge of the tibial plateau
Will a medial meniscus tear have point tenderness?
Yes
What do we palpate when we place the knee in slight flexion?
Lateral meniscus along the lateral joint line.
How far do we palpate tibial tuberosity?
Until we hit tibial tuberosity
Tenderness over the tendon or inability to extend the knee suggests what?
Partial or complete tear of the patellar tendon
Pain with compression and with patellar movement during quadriceps contraction suggests what?
Chondromalacia, or degenerative patella (the patellofemoral syndrome)
What suggests Achilles tendinitis?
Tenderness and thickening of the tendon above the calcaneus, sometimes with a protuberant posterolateral bony process of the calcaneus
A defect in the muscles with tenderness and swelling suggests what?
A defect in the muscles with tenderness and swelling suggests
Absence of plantar flexion is a positive test indicating what?
Rupture of the Achilles tendon may be present
Detail of ingrown toenail
Tender, overhanging nail fold
Localized tenderness is often present in what in the foot?
Arthritis, ligamentous injury, or infection of the ankle
Localized tenderness is often present in what in the foot?
Arthritis, ligamentous injury, or infection of the ankle
Focal heel tenderness on palpation of the plantar fascia suggests what?
Plantar fasciitis
Tenderness along the posterior medial malleolus suggests what?
Posterior tibial tendonitis
What is suspicious for ankle fracture (known as the Ottawa ankle rule?
After trauma, inability to bear weight after four steps and tenderness over the posterior aspects of either malleolus, especially the medial malleolus
Is an arthritic joint painful when moving in any direction?
Yes
Ligamentous sprain produces maximal pain when?
When ligament is stretched
