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MBB > Physical exams and pathology > Flashcards

Physical exams and pathology Flashcards

1
Q

What is the anterior drawer test and what does it identify?

A

Bend the knee at a 90o angle, pull anteriorly

positive test indicates torn ACL

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2
Q

What is the Lachman test and what does it identify?

A

bend the knee at a 30o angle, pull anteriorly

positive test indicates torn ACL

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3
Q

What is the posterior drawer test and what does it indicate?

A

Bend the knee at a 90o angle, push posteriorly

positive test indicates torn PCL

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4
Q

What is the passive abduction test (putting a valgus stress on the knee) and what does it indicate?

A

Knee is extended, lateral (valgus) force

positive test indicates an MCL tear

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5
Q

What is the passive adduction (putting a varus stress on the knee) test and what does it indicate?

A

Knee is extended, medial (varus) force

positive test indicates an LCL tear

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6
Q

What is the McMurray test and what does it indicate?

A

During flexion and extension of knee with rotation of tibia/foot:

​Pain, “popping” on external rotation indicates medial miniscal tear

​Pain, “popping” on internal rotation indicates lateral miniscal tear

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7
Q

What are the muscles of the rotator cuff?

A

S.I.t.S,

Supraspinatous

Infraspinatous

Teres minor

Subscapularis

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8
Q

Describe general symptoms of osteoarthritic pain (when is it worse/better)? Are systemic symptoms present? Is the joint cool to the touch?

A

worsening with continued use

improves with rest

no systemic symptoms present

cool to the touch

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9
Q

What joints are typically affected in OA? Is joint involvement symmetrical or unilateral?

A

affects the DIPs, PIPs, 1st CMC, 1st MTP, hips, knee, cervical and lumbar spine

unilateral monoarticular joint involvement

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10
Q

What are Bouchard and Heberden nodes?

A

Bouchard - PIP

Heberden - DIP

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11
Q

Is osteoarthritis associated with inflammatory cells?

A

NO! Although it has -itis in the name, inflammatory cells are not involved in the pathophysiology of the disease

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12
Q

What are the effusion characteristics of OA? Is effusion always present?

A

Effusion:

​clarity: clear

color: straw

WBCs: <2000

PMN %: <25%

Effusion is not always present

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13
Q

What are typical fidings in OA imaging?

A

Focal joint narrowing (narrowing at one part of the joint)

osteophytes

subchondral cysts

subchondral sclerosis

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14
Q

What joint pathology is this?

A

osteoarthritis

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15
Q

Describe general symptoms of Rheumatoid arthritic pain (when is it worse/better)? Are systemic symptoms present? Is the joint cool to the touch?

A

morning stiffness and pain that improves with use

systemic symptoms are usually present (fever, fatigue, weght loss, subcutaneous nodules, uveitis, etc)

Joints are warm to the touch

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16
Q

What joints are typically involved in RA? Is joint involvement symmetrical or unilateral?

A

PIPs, MCPs, carpals, facets

symmetric polyarticular joint involvement

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17
Q

How does RA affect the hands?

A

Swan neck deformity

Ulnar deviation of fingers

Subluxation of fingers towards ulna

18
Q

What are the effusion characteristics of RA? Are inflammatory cells present?

A

effusion:
Clarity: translucent
Color: yellow
WBC: 2,000-75,000
PMNs: >50%

inflammatory cells are present (pannus formation)

19
Q

What are typical findings in RA imaging?

A

Concentric joint narrowing

symmetric marginal erosion of articular cartilage and bone

subluxation or dislocation of joints towards ulna

20
Q

What are the clinical findings in gout? Is it acute? Does is affect multiple joints at once?

A

Acute unilateral monarticular arthropathy

tophus formation is common

21
Q

What joints does gout typically effect?

A

1st metatarsal-phalangeal joint of the big toe, DIPs, knee, ankle

22
Q

What are the effusion characteristics of gout? What type of crystals are found in gout?

A

Effusion:
Clarity: translucent
Color: yellow
WBCs: 2,000-75,000
PMN %: >50%

birefringent crystals under polarized light

23
Q

What is a boutonniere deformity?

A

disruption of the rupture of the central slip at the base of the middle phalanx

24
Q

What is a swan neck deformity?

A

typically caused by a volar plate injury at the PIP, either caused by RA or trauma

25
Q

What is a mallet finger?

A

tear in the terminal slip located in the DIP

26
Q

What is a trigger finger?

A

caused by nodule or fusiform swelling of the superficial tendon at the MCP causing flexion at MCP, PIP, and DIP

27
Q

What is a colles fracture?

A

fracture of the distal radius and ulna causing a fall of the outstretched arm creating a “dinner fork” appearance

28
Q

What nerve could be damaged in a colles fracture?

A

median nerve

29
Q

What is a scaphoid fracture?

A

fracture of the scaphoid which typically occurs from falling on an outstretched arm

30
Q

What physical exam test can be performed to diagnose a scaphoid fracture?

A

snuffbox pain

31
Q

What complication can occur in scaphoid fractures?

A

avascular necrosis

32
Q

What is carpal tunnel syndrome?

A

narrowing or inflammation of the carpal tunnel causing compression of the median nerve

33
Q

What are the symptoms of carpal tunnel?

A

weakness, numbness, and thenar atrophy of the hand

34
Q

What is guyon’s syndrome?

A

Ulnar tunnel syndrome

Compression of the ulnar nerve in guyton’s canal

35
Q

If there is compression of zone I in guyton’s syndrome, what will the symtpoms be?

A
36
Q

If there is compression of zone II in guyton’s syndrome, what will the symtpoms be?

A
37
Q

If there is compression of zone III in guyton’s syndrome, what will the symtpoms be?

A
38
Q

What causes Erb palsy (waiter’s tip)?

A

injury to C5-6 roots

deltoid and supraspinatus deficit -> can’t abduct

infraspinatus deficit -> can’t lateral rotate (causes medial rotation)

biceps brachii deficit -> cant flex or supinate (arm extended and pronated)

39
Q

What causes Klumpke palsy (claw hand)?

A

damage to C8-T1

intrinsic hand muscle deficit

40
Q

What causes winged scapula

A

lesion of long thoracic nerve

MBB (24 decks)

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