Musculoskeletal exam Flashcards
What are articular structures?
- Joint capsule
- Articular cartilage
- Synovium and fluid
- Intra-articular ligaments
- Juxta-articular bones
What are extra-articular structures?
- Periarticular ligaments
- Tendons
- Bursae
- Muscle
- Fascia
- Bone
- Nerve
- Overlying skin
What are bursae?
Pouches of synovial fluid that cushion tendons from other structures
What types of joints are there?
- Synovial (movable; knee)
- Cartilaginous (slightly movable; intervertebral)
- Fribrous (immovable; skull)
What are the types of synovial joints?
- Spheroidal
- Hinge
- Condylar
What are spheroidal joints?
Wide range of movement; ball and socket
What are hinge joints?
Allow motion in a single plain
What are condylar joints?
Like spheroidal but not ball and socket; uses condyles instead
What are the steps for examining joints?
- Symmetry, alignment, deformities, swelling
- Skin changes, nodules, muscular atrophy, tenderness
- Range of motion, function, stability
- Inflammation
What are the two parts of the shoulder?
Shoulder girdle: 1. dynamic stabilizers 2. static stabilizers
What are the dynamic stabilizers of the shoulder?
Rotator cuff muscles
What are the static stabilizers of the shoulder?
Bony structures: 1. labrum 2. articular capsule 3. glenohumeral ligaments
What are 3 joints of the shoulder?
- Glenohumeral
- Sternoclavicular
- Acromioclavicular
How to conduct a shoulder inspection?
- Inspect anteriorly and posteriorly for atrophy for swelling, deformity, atrophy, fasciculations (twitch)
- Palpate: 1. sternoclavicular joint 2. acromioclavicular joint 3. coracoid process 4. greater tubercle of humerus
- Examine range of motion (flexion, extension, abduction, adduction, internal rotation, external rotation)
What are 3 wrist joints?
- Radiocarpal
- Distal radioulnar
- Intercarpal
What are 3 hand joints?
- Metacarpophalangeal
- Proximal interphalangeal
- Distal interphalangeal
How to conduct a hand and wrist inspection?
- Examine: joints (swelling or deformity), thenar and hypothenar eminence wasting; thickening of flexor tendons or flexion contractures (rigidity)
- Palpate for tenderness: radius, ulna, wrist joint grooves, radial styloid in snuff box, carpals, metacarpals, phalanges, joints
- Check range of motion of digits, thumb, and wrist
What are flexion contractures?
Rigidity and shortening of flexion tendons, causing rigidity and permanent semiflexion at joints of hand
What are habardon and bouchard nodes?
Indicative of osteoarthritis
Habardon: distal IP joint swelling
Bouchard: Proximal IP joint swelling
How to conduct a hip inspection?
Check range of motion
How to check for hip flexion?
- With patient supine, place your hand under lumbar spine
2. Ask patient to flex their knee to their chest and pull it firmly against the abdomen
How to check for hip extension?
- With patient prone, extend their thigh toward you
How to check for hip abduction?
- Stabilize pelvis by pushing down on the opposite hip
2. Grasp ankle and abduct their leg until you feel the iliac spine move
How to check for hip adduction?
- Stabilize the pelvis
2. Move the leg medially over the opposite extremity
