Musculoskeletal - power points Flashcards
What is MMT?
Manual muscle testing
What are the systems involved in pain assessment for musculoskeletal disorders?
1) Vascular
2) Neuro
3) Musculoskeletal
4) Psych (emotional)
What are some of the descriptors used that indicate vascular pain?
Throbbing, pounding, pulsing, beating
What are some of the descriptors used that indicate neurogenic pain?
Sharp, crushing, pinching, burning, hot, searing itchy, stinging, pulling, jumping, pricking, gnawing and electrical
What are some of the descriptors used that indicate musculoskeletal pain?
Aching, sore, heavy, hurting, dull, cramping and deep
What are some of the descriptors used that indicate emotional pain?
Tiring, miserable, viscious, agonizing, nauseating frightful, piercing, dreadful, torturing, punishing, killing, unbearable, annoying, cruel, sickening, and exhausting
What are some systemic pain patterns?
1) recent or sudden onset
2) vascular or neurogenic descriptors
3) usually more constant
4) may have pain at night (oncological)
5) unilateral or bilateral
6) other s/sx
What are some musculoskeletal pain patterns?
1) sudden or gradual
2) musculoskeletal descriptors
3) may be constant or intermittent
4) normally unilateral
5) rarely may have sweating, nausea or blanching
Superficial pain sources include:
1) skin
2) fascia
3) tendon sheaths
4) periosteum
Sources of deep pain include:
1) bones
2) nerves
3) muscles
4) tendons
5) ligaments
6) blood vessels
7) deep fascia
8) joint capsules
Common hip complaints are?
1) pain increased with weight bearing
2) Pain present with active or passive ROM
3) pain in buttocks or radiating to anterior thigh
What is the term that means outward from the center of the body?
Valgus
What is the term that means inward toward the center of the body?
Varus
Golfers elbow typically causes pain in what location?
Medial epicondyle
Tennis elbow typically causes pain in what location?
Lateral epicondyle
The reflex measurement scale ranges from what to what?
0-4
What reflex measurement is considered normal?
2/4
Who does active ROM?
The patient
Who does passive ROM?
The provider
Inert structures are non-contractile. Give some examples.
Ligaments, bursae, nerves, cartilege
Pain with passive ROM indicates a problem with what structures?
Inert structures
Pain with active ROM indicates a problem with what structures?
Muscles or tendons
Examples of normal end feels are:
1) bony
2) soft tissue
3) stretch
Examples of abnormal end feels are:
1) spasm
2) empty
3) bony
4) capsular (fibrosis)
5) springy
What is the normal range of flexion in the shoulder?
0-180 degrees
What is the normal range of extension in the shoulder?
0-60 degrees
What is the normal range of abduction in the shoulder?
0-180 degrees
What is the normal range of adduction in the shoulder?
0-90 degrees
When recording ROM measurements, always record what two things?
The starting and ending points in terms of degrees of motion
What is the normal range of flexion in the elbow?
0-145 degrees
What is the normal range of extension in the elbow?
0-10 degrees
What is the normal range of flexion in the wrist?
0-60 degrees
What is the normal range of extension in the wrist?
0-70 degrees
What is the normal range of pronation and supination in the wrist?
0-90 degrees
What is the normal range of radial deviation in the wrist?
0-20 degrees
What is the normal range of ulnar deviation in the wrist?
0-30 degrees
What is the normal range of flexion in the hip?
0-125 degrees
What is the normal range of extension in the hip?
0-30 degrees
What is the normal range of abduction in the hip?
0-45 degrees
What is the normal range of adduction in the hip?
0-25 degrees
What is the normal range of external rotation in the hip?
0-40 degrees
What is the normal range of internal rotation in the hip?
0-60 degrees
What is the normal range of flexion in the knee?
0-140 degrees
What is the normal range of extension in the knee?
0-5 degrees
What is the normal range of dorsiflexion in the ankle?
0-20 degrees
What is the normal range of plantar flexion in the ankle?
0-45 degrees
What is the normal range of inversion (supination) in the ankle?
0-30 degrees
What is the normal range of eversion (pronation) in the ankle?
0-20 degrees
What is the name of the test?
Active elbow extension
Elbow extension test
elbow trauma if +
What is the name of the test?
Make a relaxed fist with thumb tucked and go into ulnar deviation
Finkelstein
checks for tenosynovitis of thumb
+ if pain (DeQuervain’s)
What is the name of the test?
With hand flat, extend thumb to create dimple beside carpals
Snuffbox test
Tests for scaphoid fx
+ if pain on compression
What is the name of the test?
Supine, unaffected leg straight, other knee bent at 90 degrees and rest ankle on other leg. Passive downward and lateral force
Patrick’s Test
arthritis in hip if + pain in anterior hip or in
sacroiliac joint if + in SI
What is the name of the test?
Weight on on leg
Trendelenberg
Checks strength of GM
+ if lack of elevation on supporting side
What is the name of the test?
Patient on unaffected side, lift leg, bend knee, take into abduction then extension
Obre test
Checks for IT band stiffness
+ if remains abducted
What is the name of the test?
Nobel’s Compression Test
checks IT friction
+ if pain to lateral epicondyle
What is the name of the test?
Prone with knee at 90 degrees, palpate trochanter, rotate externally and interally until trochanter parallel with table
Craig’s Test
femoral torsion
What is the name of the test?
Supine, one leg straight, one knee flexed into chest
Thomas Test
hip contracture
+ if thigh off the table
What is the name of the test?
Patient prone, one leg out, other knee flexed and bring toward buttock, should be able to touch and leave pelvis on mat
Ely’s Test
femoral nerve irritation
+ if anterior/medial thigh pain
What is the name of the test?
Joint line tenderness
checks meniscus, + if pain
What is the name of the test?
Have patient squat while palpating meniscus
Inward feet for lateral tears and outward feet for medial tears
Ege’s test
checks meniscus, + if clicking
What is the name of the test?
Compress tibia and fibula above ankle
Squeeze Test
checks for tibiofibular syndesmosis
+ if pain
What is the name of the test?
Grasp the medial border of the foot and stabilize, support lateral tib/fib with other hand, externally rotate foot
External Rotation Stress Test
checks for tibiofibular syndesmosis injury
+ if pain at distal syndesmosis
What is the name of the test?
Crossed Leg Test
Checks for syndesmotic injury
+ if pain
What is the name of the test?
Squeeze calf
Thompson Test
Checks for achilles tear
+ if lack of plantar flexion
What is the name of the test?
Tap around the ankle
Tinel sign
Checks for nerve compression
+ if reproduction of pain or sensory symptoms
What is the name of the test?
patient seated, move foot into inversion.
Talar tilt
Checks for calcaneofibular ligament injury
+ if instability or empty end