Musculoskeletal Table Flashcards
Scoliosis, Lordosis, Kyphosis: Curvatures
Bend forward at waist without bending the knees, shoes off and inspect for a rib hump or nonsymmetrical scapula (scoliosis), sway lumbar back (lordosis), hump to thoracic spine (kyphosis).
Cervical Instability: Assess cervical ligamentous stability
Complaints of pain, weakness and a “locking” sensation of the neck.
Cervical radiculopathy: Impairment of upper extremity neurological function due to abnormal process in neck—pressure on spinal nerve
- Para cervical tenderness
- Decreased ROM neck
- Positive Spurling’s test
- Pain with resisted ROM - strain
- Pain with passive ROM - sprain
TMJ
- Open and close mouth
- Crepitus
Frozen shoulder: Stiff glenonumeral joint from adhesion, rotator tendinitis, bursitis
- Apley scratch test
- Reduced abduction and external rotation
Shoulder Instability (glenohumeral instability): Assess integrity of anterior rotator cuff which holds humerus in glenoid cavity
- Shoulder out of normal position
- Arm raise that causes pain
- Complaints of shoulder slipping out of place.
- Apprehension test
- Relocation
- Load and Shift
Rotator cuff tendonitis: May occur from underlying tendinitis. Fall with outstretched arm. Vigorous pulling in lawnmower curve
- Supraspinatus test
- Apley scratch test
- Unable to life arm over head
Torn rotator cuff: May occur from underlying tendinitis. Fall with outstretched arm. Vigorous pulling in lawnmower curve
- Drop Arm Test
- Push button test
- Weakness or pain on midarch abduction or external rotation
- Loss of smooth over head reach
Impingement: Compression of the tissue
- Neer’s Sign
- Hawkins-Kennedy
- Excessive rubbing of the rotator cuff and the acromion
Lateral Epicondylitis (Tennis Elbow): Injury of lateral extensor tendon at the lateral epicondyle
- Tenderness at the medial epicondyle
- Cozen’s test (force extended wrist into flexion)
- Mill’s test (supinate against resistance)
- Resistance of Third finger extension
Medical Epicondylitis (Golfer’s Elbow): Injury of flexor tendon
-Golfer’s elbow test (resistance against flexed hand)
Olecranon Bursitis: Inflammation of the bursal sac (gout or staph). Frequently from pressure (draftman’s elbow)
-Inspect and palpate for swelling, redness and heat
Carpal Tunnel Syndrome: Compression of median nerve
- Sensory loss of first 3 fingers
- Loss of thumb opposition
- Tinel’s test
- Phalen’s test
- Reverse Phalen’s test
- Carpal compression test
DeQuervain Tenosynovitis: Inflammation of extensor and abductor tendons of the thumb. Overuse of repetitive gripping and grasping.
- Positive finkelestein (thumb in fist)
- Local tenderness at tip of radial tubercle
Lunate Dislocation
-Murphy’s sign
Ulnar Tunnel Syndrome: Ulnar nerve compression
- Ulnar tunnel triad
- Tenderness over ulnar tunnel with pressure
- Clawing of ring finger
- Hypothenar wasting
Rheumatoid arthritis (RA): RA is a chronic inflammatory disorder that affects small joints in the hands and feet.
- Ulnar deviation and swan neck deformity which is a deformed position of the finger
- Complaints of pain most pronounced after periods of exertion.
Gluteus Medius Weakness
-Trendelenberg Sign
Gluteus Medius Bursitis: Inflammation of bursa sac
- Observe gait
- Perform ROM
- Palpate joint
- Hip pain or difficulty walking
- Pain above the trochanteric process
Hip Trochanteric Bursitis: Inflammation of the lubricating sac
- Hip pain over the outer thigh or difficulty walking
- Pain lying on the affected side
- Tenderness to palpation
- Aggravation of pain with hip rotation
- Normal ROM
- Midtrochanteric tenderness
Lumbar nerve root irritation (Lumbar Radiculopathy): Pain associated with abnormal function of the LS nerve roots from pressure on the nerve.
- Straight leg test (Lasegue Sign)
- Heel and toe walking
- Rectal tone
- ROM/gait
- Shooting, sharp pain associated with foot and leg pain and worsens with valsalva maneuver
- Paresthesias
- Associated deep tendon reflexes depressed or absent
- Muscular weakness or atrophy may result
- Cauda equina involvement may cause rectal or perineal pain with decreased perineal sensation and loss of sphincter control of bowel or bladder
- Signs of LS sprain
Lumbosacral Strain: Spasm and irritation of the supporting muscles of the lumbar spine
- Minimal discomfort during or after the injury with pain and stiffness 12-36 hours after
- Pain in back, buttocks or thighs and aggravated by standing or flexion
- Tenderness and spasm in paraspinal muscles
- “Straightened” LS curve
- Normal neurologic exam
Osteoarthritis of the hip: “Wear-and-tear” of the articular cartilage
- Patrick-faber test (which may indicate hip joint, SI joint or iliopsoas pathology).
- Complain of groin or thigh pain or loss of mobility
- Morning stiffness
- May have crepitus
- Loss of normal gait
- Decreased internal/external rotation
Unstable Knee due to anterior/
posterior cruciate ligament tears: Disruption of cruciate ligaments of knee
- Lachman test
- Anterior drawer sign
- Complaints of pain and swelling
- May have an audible “pop” or “giving way”
- Tenderness over ligament
Medial collateral ligament strain: Irritation, inflammatory or partial separation of ligament
- Pain with valgus stress
- Perform ROM
- Observe gait
- Drawer test
- Pain along inner aspect of the knee joint
- Difficulty walking, pivoting and twisting
- Tenderness over medial joint line
- Edema
Lateral Collateral Ligament Strain
Varus Test
Meniscal tear of the knee: Disruption of fibrocartilage pads
- McMurray’s sign
- Apley Sign
- Observe gait
- Perform ROM
- C/O pain as “popping,” “locking” or “giving out”
- Swelling and pain
Patellofemoral Pathology: Many conditions: subluxation, degenerative charges, arthritis (including chondromalaxia).
- Normal ROM
- Assess gait
- Patella apprehension test
- Clarke’s Sign
- Anterior knee pain
- “Noise” from the knee
- Painful crepitation over patella
- Patella may not glide smoothly
Patellofemoral Stress Syndrome: Mild malalignment of the exterior mechanism of the knee. May be from repetitive microtrauma from overuse.
- Abnormal Q angle
- Dull, achey knee pain and may be associated with clicking or popping of the knee
- Pain increases with prolonged sitting activity involving knee fusion
- No swelling
- Tenderness with compression of patella in femoral groove
Prepatellar Bursitis: Inflammation of bursal sac overlying the patella
- Knee pain
- Swelling over patella
- Tenderness over patella
- Normal ROM of knee
Osgood-Schlatter’s Disease: Degeneration of the tibial tubercle at the insertion site of the quadriceps ligament
- Drawer test
- Varus/valgus pain
- Perform ROM
- Observe gait
- Painful swelling of the anterior aspect of the tibial tubercle
- Point tenderness over tibial tubercle
- Pain with strenuous activity over quadriceps muscles
Ankle Clonus
-Ankle Flexion
Gait: Assess for balance and gait
General deviation from standards
