Musculoskeletal: Lower & Spine

Question 1

After introduction and hand washing, what is the first thing you do?

Answer 1

Perform general Inspection for gait, posture, skin color, rashes, masses and swelling; gross deformity, alignment, symmetry, muscle hypertophy/atrophy, fasciculations and spasms

Question 2

What are the four general areas you will be examining?

Answer 2

Spine, Hip, Knee, Foot

Question 3

What general procedures will you be checking in each area?

Answer 3

Palpation, Range of Motion, Nervous system (reflexes and sensation)

Question 4

What is the first step of the spine exam?

Answer 4

Check alignment and symmetry of patient in standing position, forward bending.

Question 5

After inspecting alignment/symmetry of spine, what do you do?

Answer 5

Palpate surface features: SI joints, spinal processes, paravertebral muscles, sacrum)

Question 6

What follows the spine palpation?

Answer 6

Check ROM of spine and neck and hip extension, making sure to support patient.

Question 7

You ask the patient to sit on the exam table following spine ROM. What do you do next?

Answer 7

Elicit deep tendon reflexes of patellar ligament and calcaneal tendon.

Question 8

You ask the patient to lay back on the exam table. What do you do next?

Answer 8

Straight leg raising test to test for sciatica, dorsiflexing the ankle at the 30 degree angle.

Question 9

What do you do after the leg raising test?

Answer 9

Palpate the surface features:from least invasie to most invasive: anterior superior iliac spine, greater trochanter, ischial tuberosity, pubic tubercle.

Question 10

While palpating, what do you ask the patient?

Answer 10

“Let me know if you feel any discomfort or unusual sensations”

Question 11

After Hip palpation, what do you do?

Answer 11

Check ROM: flexion, medial/lateral rotation, abduction/adduction

Question 12

Is hip ROM performed actively or passively?

Answer 12

Passively except for extension.

Question 13

After hip examination, we move to the knee. Where do you begin?

Answer 13

Ask patient to sit up, palpate surface features: patella, patellar tendon, head of fibula, medial and lateral joint lines.

Question 14

When palpating, what is the most critical thing to do?

Answer 14

Palpate bilaterally to check for symmetry.

Question 15

What are the tests that are performed on the knee joint?

Answer 15

McMurray: menisci test; Valgus and Varus stress tests: Collateral Ligaments; Drawer Tests: Cruciate ligaments; Lachman test:

Question 16

For the foot, what do you palpate?

Answer 16

plantar fascia, medial/lateral malleoli, achilles, posterior and anterior tibial tendons, peroneal tendon, toe extensors

Question 17

Foot ROM???

Answer 17

Dorsiflex, plantarflex, invert, evert.