Ortho Flashcards
impingement syndrome tests
neer and hawkins
carpal tunnel tests
compression of what nerve?
phalen and tinel
medial
mcl tear test
valgus
acl tests
anterior drawer, lachman
patella dislocation tests
apprehension test
achilles rupture test
thompson test (first 48 hours)
cervical compression test
sperling test
back pain tests
leg raise-pain less than 70 degrees involves SI greater than 70 lumbar
frozen shoulder risk factors
women over 40, diabetes, thyroid
frozen shoulder aka
PE
Dx
Tx
ADHESIVE CAPSULITIS-adhesion/scarring of joint capsule
PE: 50% limited ROM, pain, tenderness
Dx: xray (rule out fracture, osteophytes), MRI (rule out rotator tear)
Tx: NSAIDS, moist heat, injectins, PT
impingement syndrome - cause
PE
inflammation of bursa and rotator cuff
tenderness and crepitus with motion; pain against resistance; + Neer & Hawkins signs
rotator cuff occur from:
sx
PE
overuse, injury, trauma, repeated over the head motion
Pain, weakness, catching & grating when lifting the arm overhead
PE: sunken; active ROM limited; shrug & can not hold arm elevated
radial head disengaged from humerus=
nurse maid elbow
nurse maid elbow- how will patient hold arm?
tx
close to body with thumb pronated, avoids use
reduction, splint, NSAIDS, ice
biceps tendon rupture tx
Rest, ice, NSAIDS, intermittent splinting,
physical therapy
epicondylitis aka
1) - - pain with ____
2) - pain with ___
tx
golfers, bowlers- medial, pain with flexion
tennis elbow-lateral, pain with extension
BRACE*, Modify or eliminate activity causing symptoms, NSAIDS, ice, injections, physical therapy
olecranon bursitis PE
tx
Swelling, pain, limited ROM
Red and warm with infection
Aspiration, antibiotics, NSAIDs, elbow pads, activity modification
unable to grip or move thumb=
scaphoid fracture
jammed finger aka
mallet finger
boxer fracture
fx of what metatarsal?
sx
PE
tx
5th metatarsal
Pain, tenderness, swelling, deformity and/or decrease range of motion
may appear shortened or depressed; rotated especially with partial fist
Open reduction internal fixation (ORIF)
slipped capital femoral epiphyses PE presentation
one leg shorter, adolescent
trochanteric bursitis sx
Pain & tenderness over the greater trochanter**PALPATION
Pain may radiate to knee or ankle but not to foot nor buttock
Worsens when rising from seated position, walking stairs, from laying on side
trochanteric bursitis risk factors
PE (pain with ____)
tx
Obesity, Gait disturbance, women 50 and older
PAIN WITH ABDUCTION-
NSAIDs, activity modifications, short term use of assistive device when ambulating, injection
groin pull sx
pain with _____, _____, _____
refer?
pain with adduction, ecchymosis, swelling
if cant actively adduct, refer to ortho
osteoarthritis of hip
loose ___ rotation first and cant _______knee
tx
internal rotation, cant flex more than 90 degrees
Tx: Joint activity, NSAIDs, Physical therapy
ACL- tear from ___ force
MCL- tear from___ force
hyperextension or rotational - ACL
abduction force- MCL
ACL subjective:
MCL subjective:
pop, unable to ambulate
locking, able to ambulate
tx acl mcl
NSAIDs, ice, rest, protective weight
bearing, immobilize, & physical therapy
surgical repair
meniscal tear subjective
Swelling, stiffness, locking, catching, decrease motion with tightness sensation
mcmurray test positive
patella dislocation sx
Pain, swelling, deformity, impaired mobility
+apprehension test
osgood schlatter def
Rupture of the growth plate at the tibial tuberosity
sprain vs strain
Strain: stretching or tear of muscle; sudden stretch on actively contracting muscle
Sprain: stretching or tearing of a ligament***; sudden trauma
avulsion fx def
5th metatarsal of foot
plantar fascitis presentation
dx
pain with dorsiflexion:
Heel pain, tenderness; pain intense by rising from a resting position, standing & walking
X-ray: rule out heel spur or fracture
muscle contusion monitor for
compartment syndrome
6ps PAIN, PALLOR, PARESTHESIA, PULSELESSNESS, PRESSURE, TEMPERATURE-WARM TO TOUCH
shin splits def
dx- imaging?
tx
Inflammation of tibial periosteum secondary to repetitive muscle contraction; small muscle tears
xray rule out stress fx
Limit activity to soft surfaces, decrease activity, NSAIDs, ice massage, orthotics, stretching
treatment stress fracture (meds+ other)
dx imaging again at? other imaging?
NO NSAIDS, TYLENOL ONLY
Rest, activity modifications, splint/brace, protective weight bearing
xray again at 3-4 weeks, bone scan/MRI to confirm
arthritis types
osteo, rheumatoid, septic, gouty
burner and stingers
def
sx- describe sensation
PE
tx- return to sports?
Injury to nerve roots exiting the spinal cord
sx Electric shock or lightening bolt down arm into hand; burning; numbness; weakness
weakness, decrease sensation, reflexes
No return to contact sports until resolved; physical therapy
whiplash
dx- imaging?
Acceleration-deceleration of the neck with rapid flexion-extension; ligament/muscle injury
xray and mri
low back pain def acute vs chronic
Acute: fracture vs muscle/ligamentous injury
Chronic: pain for 3 months or longer
PE low back pain acute vs. chronic
Acute: tenderness, decrease forward flexion
Chronic: tenderness, exhibit side or forward stance, may have + straight-leg raise test; inconsistent actions → sensitivity to light touch, inappropriate pain behaviors, nonanatomic localization of symptoms
ligaments connect?
tendons connect?`
bone to bone
muscle to bone
vertebrae spine
Cervical- 7 Thoracic- 12 Lumbar- 5 Sacral- 5 Coccygeal Vertebrae- 3 - 4
musculoskeletal change with age - - - - -
tendons less elastic Decreased reaction time & ROM Increased bone resorption Decreased bone density Deterioration of cartilage around joints
parts of cerebral cortex and what they control
Frontal: Concerned with personality, behavior, emotions, and intellectual function Parietal: Primary center for sensation Occipital: Primary visual receptor center Temporal: Primary auditory reception center
wernickes
broca
basal ganglia
what do they control?
Wernicke’s Area: language, temporal
Broca’s Area: speech, frontal
Basal Ganglia: bands of gray matter, control automatic associated movements of the body, eg: arm swing alternating with the legs during walking.
thalmus
hypothalmus
sensory, movement
hypo- temp regulation, emotion, hunger, thirst, circadian rhythm
cerebelum located?
controls
occipital
movement, balance, posture
brain stem controls
Breathing
Heart Rate
Blood Pressure
where does spinal cord end
Cauda equina - a bundle of nerves occupying the spinal column below the spinal cord in most vertebrates that consists of nerve roots and rootlets attached to the spinal cord. It serves the legs.
peripheral nerve function
send ___ between ___ and ____
send messages between body and spinal cord
reflex normal
2+
cranial nerve function mneumonic
Some Say Marry Money; But My Brother Says Big Boobs Matter Most
cranial nerves
On (olf) old (optic) Olympus’s (oculomotor) towering (trochlear) top (trigeminal) a (abducens) Finn (facial) and (acoustic- vestibulo) German(glossopharyngeal) viewed (vagus) some (spinal) hops (hypoglossal)
chronic low back pain meds
imaging?
nsaid, opiate, topamax
do not unless suspect fracture, cauda
patellar tracking test
lie flat leg straight, hold patella on medial and lateral side
+= normal movement
mcmurray
meniscal tear
how to do reduction of nurse maid elbow
90 degrees in supination
