Musculoskeletal System

Question 1

Symptom consistent with an inflammatory process

Answer 1

tenderness along with increased temperature

Question 2

Lupus

Answer 2

• systemic disease
• one symptom may be joint pain
• important to consider the presence of a systemic illness when a patient presents with arthritis

Question 3

Lyme disease

Answer 3

• characterized by target-shaped red spot at the site of the bite, which disappears, then reappears and starts spreading (erythema migrans)
• lyme disease can also result in joint pain as well as cardiac and neurologic manifestations

Question 4

stance phase of gait

Answer 4

• when the foot is on the ground and bears weight (60% of the walking cycle)
• foot when flat is part of stance phase of gait

Question 5

Test for herniated disc

Answer 5

Straight leg raise

• involves having the patient lie supine with the examiner raising the leg
• if patient experiences a sharp pain radiating from the back down the leg in an L5 or S1 distribution, that suggest the presence of a herniated disc

Question 6

Indication for fibromyalgia

Answer 6

• pain in specific trigger point areas on the muscles

- normal strength and ROM

Question 7

Rotator cuff tendinitis

Answer 7

• typically precipitated by repetitive motions (such as occurs with throwing or swimming)
• crepitus/grating is noted in the shoulder with ROM

Question 8

Extra-articular structure

Answer 8

include

• periarticular ligament
• tendons
• bursae
• muscle
• fascia
• bone
• nerve
• and overlying skin

Question 9

atricular structures include

Answer 9

• joint capsule and articular cartilage
• synovium and synovial fluid
• intra-articular ligaments
• juxta-articular bone

Question 10

Extra-articular disease

Answer 10

Example- physical job and notes pain when attempts to lift arm over his head. When move shoulder passively, he has full ROM without pain and there is no gross swelling or tenderness.

• articular disease typically involves swelling and tenderness of the entire joint and limits both active and passive ROM
• extra-articular affects a certain portion of ROM, is not painful with passive ROM and is not associated with gross swelling or tenderness

Question 11

Vertebral bodies of the spine

Answer 11

-connected by cartilaginous joints involving the discs

Question 12

Condylar Joint

Answer 12

-TMJ because it involves the movement of 2 surfaces which are not dissociable.

Question 13

Red flags with back pain

Answer 13

• > 50 years
• history of ca
• unexplained weight loss
• pain > 1 month or not responding to treatment
• pain at night or increasing with rest
• h/o iv drug use
• presence of infection

Question 14

Cauda equina

Answer 14

• presence of bowel and bladder symptoms

- suggest impingement of nerve roots S2-S4

Question 15

Consistent with articular joint pain

Answer 15

• pain
• swelling
• loss of both active and passive motion
• locking
• deformity

Question 16

rheumatoid arthritis

Answer 16

• systemic disease and accounts for multiple symmetrically involved joints
• septic arthritis is usually monoarticular, as are gout and trauma-related joint pain

Question 17

TMJ syndrom

Answer 17

-Very common cause of pain with chewing

Question 18

Adduction of the patient’s arm across his chest can cause pain if…

Answer 18

the acromioclavicular joint is involved

Question 19

Median nerve innervates

Answer 19

pulp of the index finger

Question 20

Tinel’s sign

Answer 20

• use to assess for carpal tunnel syndrome

- tingling with tapping over the median nerve as it enters the carpal tunnel

Question 21

Phalen’s sign

Answer 21

numbness or tingling with pressing back of hands together in acute flexion for 60 second.