Objective

Question 1

physical exam items are most likely to be in an MSK objective

Answer 1

observation
palpation
functional screen
clearing related joints
PROM/AROM
joint mobility
muscle performance

Question 2

what are we looking for in observation during an exam

Answer 2

gait
transfers
posture
visible atrophy or tone differences
malformations / deformities

Question 3

in a functional screen, what are we looking for?

Answer 3

we are hoping to localize / find the origin of pain, but looking for

symptom reproduction
hesitancy to complete the movement
changes in motion

Question 4

what are some functional screens for UEs

Answer 4

arms overhead
reaching behind head/back
lifting a weight / carrying a weight

Question 5

functional tests for the spine

Answer 5

flexion/bending to pick up
extending
lifting / carrying a load

Question 6

functional tests for LE

Answer 6

squats
walking
sit to stand
stairs

Question 7

what is something to keep in mind when “clearing” a joint

Answer 7

joint above and below
UE - cervical/thoracic
LE - lumbar spine/SI jt

Question 8

what are the criteria for “clearing” a joint

Answer 8

able to actively move through ROM in a normal movement pattern

application of overpressure

• both without reproduction of symptoms

Question 9

joint clearing is an example of

Answer 9

screening

Question 10

criteria for AROM

Answer 10

quality
quantity
reactivity

• of motion

Question 11

what is quality of motion

Answer 11

“fluidity” of motion
compensatory or lack of compensatory patterns

Question 12

what is used for quantity of movement

Answer 12

goni

Question 13

normative shoulder motion degrees

Answer 13

flex - 180
ext - 60
abd - 180
IR - 70
ER - 90

Question 14

normative elbow motion degrees

Answer 14

flex - 150
ext - 0
pro - 80
sup - 80

Question 15

normative wrist motion degrees

Answer 15

ext - 70
flex - 80
radial dev - 20
ulnar dev - 30

Question 16

what is important to keep in mind when doing PROM on a painful joint

Answer 16

pain may be opposite of the painful active motion due to muscle stretch

Question 17

how to minimize gaurding

Answer 17

body contact
bed set up
patient position

Question 18

steps to ROM assessment

Answer 18

active or passive to first point of pain/resistance
– assess response

repeat to max point of pain/resistance
– assess response

repeat motion to determine if pain or ROM changes

full motion and painless = overpressure

Question 19

what can cause adaptive shortening

Answer 19

restricted mobility
tissue damage
prolonged immobilization
disease
neuro involvement

Question 20

what is morphological muscle shortening

Answer 20

contracture

Question 21

what is physiological muscle shortening

Answer 21

spasmodic

Question 22

what is neurological muscle shortening

Answer 22

hypertonicity

Question 23

normal end feels? what makes each occur

Answer 23

soft - soft tissue approximation
firm - joint tissue, capsule, ligaments
hard - bone on bone

Question 24

joint mobility grading and description

Answer 24

0 - no mvmt
1 - mvmt

hypo / normal / hypermobile

Question 25

difference between capsular and joint stiffness

Answer 25

capsular - multiple plane of mvmt
joint stiff - singular plane

Question 26

Grade 1 maitland oscillations

Answer 26

small amplitude
beginning of range
- for pain

Question 27

grade 2 maitland oscillation

Answer 27

large amplitude
within available range, up to tissue resistance
- for pain

Question 28

grade 3 maitland oscillation

Answer 28

large amplitude
into tissue resistance
- for mobility

Question 29

grade 4 maitland oscillation

Answer 29

small amplitude within tissue resistance
- for mobility

Question 30

what are resisted isometrics used for

Answer 30

if pain/weakness is present during muscle activation

Question 31

are resisted isometrics break or make tests? how come?

Answer 31

make - match resistance of pt

“break” will hurt the patient and decrease self-efficacy

Question 32

at what portion of ROM are resisted isometrics completed

Answer 32

mid-range position

Question 33

indications of strong but painful resisted isometrics

Answer 33

muscle tendon issue
joint pathology

Question 34

indication of weak but painless resisted isometrics

Answer 34

nerve palsy
complete tendon tear

Question 35

indication of weak and painful resisted isometric

Answer 35

major lesion

Question 36

what are used to measure muscle performance in nonpainful situations

Answer 36

MMT
dynamometry

Question 37

uses of palpation

Answer 37

skin temp / inflammation
swelling / jt effusion
anatomical structure tenderness
muscle tone or abnormalities
distal pulses

Question 38

what can palpation tell you about a muscle

Answer 38

trigger points
tonic changes
fasciculations

Question 39

when is neuro screen indicated

Answer 39

radiating pain / paresthesia
referred pain in dermatomal dist
weakness without pain during function, resistance or MMT

Question 40

what is in a neuro screen

Answer 40

sensation
muscle strength
reflexes
neural dynamic testing

Question 41

upper extremity performance based measures examples

Answer 41

CKCUEST
TFAST
Shelf Taps

Question 42

spine performance based measures examples

Answer 42

multifidi leg raise
biofeedback cuff (C/T Spine)
trunk extension hold

Question 43

lower extremity performance based measures examples

Answer 43

5xSTS
6 MWT
TUG
13 Steps

Question 44

how can 5xSTS be adapted based upon population

Answer 44

stronger/more able pts can do a kickstand version with one leg out and one leg back

– back leg does most of work