Physical Diagnosis Exam 3 Flashcards
articular structures
joint capsules articular cartilage synovium and synovial fluid intra articular ligaments juxta articular bone
Extra articular structures
periartiular ligaments tendons bursae muscle fascia bone nerve overlying skin
Ligaments
ropelike bundles of collagen fibrils that connect bone to bone
Tendons
Collagen fibers connecting muscle to bone
Cartilage
Collagen matrix overlying bony surfaces
Bursae
Pouches of synovial fluid that cushion the movement of tendons and muscles over bone or other joint structures
Synovial Joint
Freely movable
Bones are covered by articular cartilage
bones are seperated synovial cavity
synovial membrane secretes synovial fluid that lubricates joint movment
(shoulder, Knee)
Cartilaginous joint
Joint is lightly movable
Bones seperated by fibrocartilaginous discs
Discs contain nucleus pulposus that cushions bony movement
(vertebral bodies of the spine)
Fibrous Joint
Joints have no appreciable movement
Bones are seperated by fibrous tissue or cartilage
(suture of skull)
3 types of synovial joints
Spheroidal (ball & socket)
Hinge
Condylar
Spheroidal (ball and socket joint)
Synovial Joints
Shape: concex surface in concave cavity
Movement: Wide ranging flexion, extension, abduction, adduction, rotation, circumduction
(shoulder, hip)
Hinge joint
Synonial joints
Shape: flat, planar
Movement: Motion in one plane, flexioin or extension
(interphalangeal joints of hand and foot, elbow)
Condylar Joint
Synovial joint
Shape: Convex or concave
Movement: movement of two articulating surfaces not dissociable
(knee, temporal-mandibular joint)
General inspection of spine
Note gait
Look at patient from side
Look at patient form behind
Kyphosis
posterior curve of thoracic spine at level of ribs- seen from lateral view
A small amount of curvature in kyphosis and lordosis is normal
Lordotic
anterior curve of lumbar spine just above buttock- seen from lateral view
A small amount of curvature in kyphosis and lordosis is normal
Scoliosis
lateral curve of spine (always abnormal)
best seen from posterior view with patient leaning forward
Spondylolisthesis
step off
forward slippage of a vertebrae
most common at L4, L5, S1
(backache, nherniated disc, pain down legs)
Adams test
Forward bend test
Scoliosis
Palpates spinous process while patient is bending forward
routine scoliosis screening for adolescents not recommended
Two phases of gait
Swing: foot moves forward, non-weight bearing-40% walking cycle
Stance: foot on ground, weight bearing-60% walking cycle
Assess width of base (2-4 in. heel to heel), shift of the pelvis (smooth and continuous), and flexion of the knee (flexed throughout stance phase)
