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Physical Diagnostics > Musculoskeletal System > Flashcards

Musculoskeletal System Flashcards

1
Q

What is the 5th leading cause of all doctor office visits in the US? What is another popular complaint?

A

LBP

knee pain

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2
Q

Define tendon

A

connects muscle to bone

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3
Q

Define ligament

A

connects bone to bone

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4
Q

T/F

The 2 ends of bones should never touch in a normal pt

A

true

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5
Q

What are the 6 types of synovial joints (freely movable)?

A

1) ball and socket
2) hinge
3) plane
4) condyloid
5) saddle
6) pivot

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6
Q

What is another name for immovable joints? Give an example

A

fibrous joints

ex: skull sutures such as coronal suture, lambdoid suture, or squamous suture

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7
Q

What is another name for slightly movable joints? Give an example

A

cartilaginous or symphysis joints

ex: pubis joints

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8
Q

What is a ball and socket joint? Give an example

A

type of synovial joint

convex bone sitting in a concave bone

wide range of motion

ex: shoulder joint

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9
Q

What is a hinge joint? Give an example

A

type of synovial joint that hinges

range of motion in one axis

ex: elbow joint

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10
Q

What is an example of a plane joint (type of synovial joint)?

A

patellofemoral joint

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11
Q

What type of joint is a condyloid joint? What is its ROM? Give an example

A

type of synovial joint

motion in 2 axises

ex: wrist joint or TMJ

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12
Q

What is an example of a saddle joint (synovial joint)?

A

thumb joint

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13
Q

What is an example of a pivot joint (type of synovial joint)?

A

Proximal radioulnar joint

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14
Q

What is a synovial joint?

A

a joint sitting in a synovial cavity filled with fluid (the synovial fluid is there to keep the bones from touching)

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15
Q

What is anatomical position?

A

body standing upright and facing forward with each arm hanging on either side of the body, and the palms facing forward

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16
Q

What is the most common cause of LBP?

A

idiopathic

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17
Q

What is the most common cause of neck pain?

A

mostly idiopathic, but can also be from a spinal nerve compression

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18
Q

If there is pain in only one joint, what does this typically mean?

A

trauma or injury

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19
Q

What is the #1 cause of limited ROM?

A

arthritis

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20
Q

Define median plane

A

Also called mid-sagittal plane

plane passing vertically through the midline

Splits body left/right (evenly)

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21
Q

Define coronal plane

A

vertical plane running from side to side

Splits your front/back side

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22
Q

Define sagittal plane

A

vertical plane running from front to back

Splits body into left/right pieces (unequal)

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23
Q

Define anterior

A

the front

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24
Q

Define posterior

A

the back

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25
Q

Define medial

A

toward the middle or center

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26
Q

Define lateral

A

to the side of, or away from, the middle of the body

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27
Q

Define proximal

A

a part of the body that is closer to the center of the body than another part

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28
Q

Define distal

A

a part of the body that is farther away from the center of the body than another part

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29
Q

What are the 4 signs of inflammation?

A

1) edema
2) erythema
3) warmth localization
4) pain localization

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30
Q

You should always evaluate a pt symmetrically. What is this called?

A

bilateral comparison

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31
Q

What is the medical term for “joint clicking”? What does this mean?

A

crepitus

bone rubbing against bone, due to loss of cartilage

common with arthritis (osteoarthritis and wear/tear arthritis)

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32
Q

Define myasthenia gravis

A

severe muscle weakness

If its not affecting distal portion of body and only proximal that is a key indicator

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33
Q

What does TMJ stand for?

A

temporomandibular joint

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34
Q

How do you assess TMJ?

A

Place the pad of each index or 3rd finger in front of the tragus and have the pt open/close mouth

Palpate for clicking or popping that can indicate TMJ dysfunction

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35
Q

What are the 2 most common problems with dysfunctional TMJ?

A

crepitus and trigeminal neuralgia

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36
Q

What is trigeminal neuralgia?

A

painful sensations similar to an electric shock on one side of the face

chronic pain that affects the trigeminal nerve, which carries sensation from your face to your brain.

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37
Q

What ROM should you be looking at when assessing the neck?

A

flexion
extension
rotation
lateral flexion

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38
Q

How do you assess extension of the neck ROM?

A

take your hand on ulnar side and place at the back-side of the base of the pt neck

If pt fully extends neck, your hand should be trapped

If you can easily remove your hand then then they have limited ROM

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39
Q

What are the 2 bony landmarks you should pay attention to in the shoulder region?

A

clavicle and acromion

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40
Q

What are the 4 rotator cuff muscles?

A

supraspinatus, infraspinatus, teres minor, and subscapularis

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41
Q

What is a common injury in the upper extremities?

A

rotator cuff injury

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42
Q

Where is the supraspinatus muscle?

A

superior to the spine of the scapula

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43
Q

Where is the infraspinatus muscle?

A

inferior to the spine of the scapula

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44
Q

What ROM should you be looking at when assessing the shoulders?

A 
abduction
adduction
extension
flexion
internal rotation
external rotation
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45
Q

What should you do if a pt has limited AROM?

A

try PROM and see how far they can go

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46
Q

What is the Appley Scratch Test? Describe it

A

assesses adduction and internal rotation of the shoulder

see how far the pt can reach back to their scapula

they should be able to at least reach the lower handle of scapula with full ROM

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47
Q

Shoulder pain is indicative of….

A

heart attack, nerve damage, tendinitis, etc.

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48
Q

What is the best diagnostic tool for joint problems?

A

MRI

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49
Q

If you perform an Appley Scratch Test and the pt cannot reach their scapula for one/both sides, then this is indicative of….

A

cervical spine injury or DJD if there’s crepitus

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50
Q

What is the most common muscle that gets damaged in rotator cuff injuries?

A

supraspinatus muscle

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51
Q

If a pt suffers from crepitus in their shoulder(s), then this most often is indicative of….

A

Degenerative Joint Disease (DJD)

52
Q

What ROM should you be looking at when assessing the elbows?

A

flexion
extension
pronation and supination of the forearm at the elbow

53
Q

What is the most complicated joint in the upper extremity?

A

the elbow joint

54
Q

What is tennis elbow?

A

lateral epicondylitis

swelling of the tendons that bend your wrist backward away from your palm

painful upon palpation and certain movements

55
Q

What is olecranon bursitis?

A

excessive fluid behind the elbow due to trauma. infection, etc,

edema, ROM not affected/no limitations

56
Q

What should you be inspecting ALL joints for?

A

pain, lesions/masses, deformities, symmetry, etc.

57
Q

What ROM should you be looking at when assessing the wrists?

A

extension
flexion
pronation
supination

58
Q

What fingers should you be using when palpating the wrist joints on a pt?

A

your thumbs and forefingers

59
Q

What is the difference between the ulnar and median nerve?

A

ulnar nerve passes over the transverse carpal ligament

median nerve passes under the transverse carpal ligament

60
Q

What is it called when the median nerve gets trapped under the transverse carpal ligament?

A

carpal tunnel

61
Q

Define paresthesia. Where is this common?

A

Pain, numbness, tingling

sometimes referred to as “pins and needles”

burning or prickling sensation that is usually felt in the hands, arms, legs, or feet

62
Q

What are the 2 tests for carpal tunnel?

A

Tinel’s test and Phelan’s test

63
Q

What is the tinel’s test?

A

tap on the median nerve, while the pt holds out hand in supination

if they have carpal tunnel, they will feel paresthesia

64
Q

What is the phelan’s test?

A

forcefully flex the patient’s wrist and hold it in that position for approx 1 min

If the pt has carpal tunnel they will feel paresthesia

65
Q

What is another name for radial fossa?

A

anatomic snuffbox

66
Q

Radial fossa (snuffbox) is bounded by 4 tendons. What are they?

A

1) extensor pollicis longus
3) extensor pollicis brevis
3) abductor pollicis longus
4) styloid process of radius

67
Q

How can you see the snuffbox?

A

stretch fingers, specifically the thumb and you should see an indentation

68
Q

The floor of the radial fossa is made up of 2 bones. What are they?

A

trapezium bone and scaphoid bone

69
Q

Which bone is the most commonly fractured carpal bone?

A

scaphoid bone

70
Q

Which joints in the fingers should you be palpating when assessing a pt? What fingers should you be using for palpation of these joints?

A

metacarpophalangeal joints and interphalangeal joints

only used your thumbs and forefingers

71
Q

What are the 2 nodes you should look out for on the fingers? These nodes are common with which medical problem?

A

heberden nodes and bouchard nodes

both common with arthritis (especially with osteoarthritis)

72
Q

Where are heberden nodes found?

A

on the distal interphalangeal joints

73
Q

Where are bouchard nodes found?

A

on the proximal interphalangeal joints

74
Q

When assessing pt hips, knees, feet, and ankles should they be sitting, standing, or walking for proper evaluation?

A

standing and walking

75
Q

What is the largest joint?

A

the hip joint

76
Q

What ROM should you be looking at when assessing the hips?

A 
extension
flexion
abduction
adduction
internal rotation
external rotation
77
Q

What is a common problem with the hips?

A

DJD (degenerative joint disease)

78
Q

What is trochanteric bursitis?

A

inflammation of the bursa (fluid-filled sac near a joint) at the part of the hip called the greater trochanter

When this bursa becomes irritated/inflamed, it causes pain in the hip (common cause of hip pain)

79
Q

DJD of the medial aspect of knee leads to what type of deformity?

A

varus deformity

80
Q

Define valgus deformity

A

the bone segment distal to a joint is angled outward, that is, angled laterally, away from the body’s midline

opposite of varus deformity

81
Q

Define varus deformity

A

the twist or angulation is directed medially, toward the center of the body

opposite of valgus deformity

82
Q

What ROM should you be looking at when assessing the knees?

A

hyperextension

active/passive flexion and extension

83
Q

What should you be feeling for when doing passive ROM on the knee for pt?

A

ROM, obviously

but also feel for crepitus

84
Q

Swollen knee is most commonly….

hint: there is 2 options

A

baker cyst or effusion of the knee

85
Q

What is a baker cyst?

A

cyst that causes a bulge and feeling of tightness behind the knee

problem with your knee joint, often seen with arthritis or a cartilage tear

86
Q

What is effusion of the knee?

A

swelling and edema of the knee

87
Q

What is a test you can do to see if a pt has effusion of the knee?

A

ballottement test (testing for fluid in joint)

88
Q

Describe a ballottement test

A

pt is supine

one hand above the patient’s patella, push down and towards the knee

if the patella feels like it’s floating then there is fluid in the joint

89
Q

What is the drawer test used for?

A

to test for rupture of the cruciate ligaments

90
Q

What is a super common athletic injury in LE?

A

cruciate ligament tears

91
Q

Describe the anterior and posterior drawer test

A

anterior drawer test= have pt flex knee and you will sit partially on their foot, place your thumbs underneath their patella and pull forward –> if you can pull more than 2 cm there is a rupture

posterior drawer test= same thing but push back, if you can push more than 2 cm then there is a rupture

If either anterior/posterior drawer test come back positive then confirm diagnosis with MRI

92
Q

What ROM should you be looking at when assessing the feet/ankles?

A

dorsiflexion
plantar flexion
eversion
inversion

93
Q

When palpating a patient’s ankles and feet, look for painful areas, but also palpate which joints+tendon?

A

medial and lateral malleolus joint (ankle joint), and achilles tendon

94
Q

When examining a patient’s arches how should they be situated? Standing or sitting?

A

standing

95
Q

What are the 3 types of foot arches?

A

1) normal arch
2) cavus arch (also called “pes cavus”) = high arch
3) flat foot (also called “pes planus”)

96
Q

What ROM should you be looking at when assessing the spine?

A

flexion
extension
rotation
lateral extension

97
Q

What is lordosis?

A

excessive inward curvature of the spine, “sway back”

98
Q

What is kyphosis?

A

curvature of the spine that causes the top of the back to appear more rounded than normal, “hump back”

99
Q

What is scoliosis?

A

sideways curvature of the spine

100
Q

Pain from sciatica radiates where?

A

from the buttock, down the leg

can travel as far as the feet and toes

101
Q

Define sciatica

A

inflammation of the sciatic nerve

102
Q

What are the 2 tests you can do in office if you suspect a pt has sciatica?

A

1) straight leg raising test

2) sitting knee extension test

103
Q

Describe the straight leg raising test

A

ask pt to raise their leg and you will dorsiflex/flex their foot

if this is painful = sciatica

104
Q

Describe the sitting knee extension test

A

a f/u test to the straight leg raising test (only do if 1st test was positive result)

have pt sit and flex their neck, you will place one hand on their thigh and raise that same leg up

if this is painful = sciatica

105
Q

What are the 2 types of bone softening?

A

1) rickets (children)

2) osteomalacia (adults)

106
Q

ankyl(o)-

A

pertaining to: stiff

ex: ankylosis
def: immobility or stiffness of a joint

107
Q

arthr(o)-

A

pertaining to: joint

ex: arthrogram
def: radiograph of a joint

108
Q

chir(o)-

A

pertaining to: hand

ex: chirospasm
def: writer’s cramp

109
Q

dactyl(o)-

A

pertaining to: finger or toe

ex: dactylospasm
def: cramping of a digit

110
Q

myo-

A

pertaining to: muscle

ex: myopathy
def: disease of muscle

111
Q

oste(o)

A

bone

osteomalacia- a condition marked by softening of the bones

112
Q

pod-

A

foot

podiatrist- specialist in conditions of the foot

113
Q

scolio-

A

twisted

scoliosis- lateral deviation of the spine

114
Q

spondyl(o)-

A

vertebrae

spondylitis- inflammation of vertebrae

115
Q

teno-

A

tendon

tenotomy- surgical cutting of a tendon

116
Q

Define flexion

A

motion away from the zero position

117
Q

Define extension

A

return motion to the position

extension that goes beyond the zero position is called hyperextension

118
Q

Define dorsiflexion

A

movement in the direction of the dorsal surface

119
Q

Define plantar (or palmar) flexion

A

movement in the direction of the plantar (or palmar) surface

120
Q

Define adduction

A

movement toward the midline

121
Q

Define abduction

A

movement away from the midline

122
Q

Define inversion

A

turning of the plantar surface of the foot inward

123
Q

Define eversion

A

turning of the plantar surface of the foot outward

124
Q

Define internal rotation

A

turning of the anterior surface of a limb inward

125
Q

Define external rotation

A

turning of the anterior surface of a limb outward

126
Q

Define pronation

A

rotation so that the plantar surface of the hand is directed downward

127
Q

Define supination

A

rotation so that the plantar surface of the hand is directed upward

Physical Diagnostics (13 decks)

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