Pitcher_MSK

Question 1

supraspinatus tests

Answer 1

1) empty can

2) with shoulder adducted and elbow at 90, patient tries to abduct against resistance

Question 2

Subscap tests

Answer 2

1) Lift off

2) with shoulder adducted and arm at 90 the patient tries to IR shoulder (move forearm medially against resistance)

Question 3

Infraspinatus and teres minor test

Answer 3

Patient tries to ER against resistance

Question 4

What protects the supraspinatus

Answer 4

subacromial bursa

Question 5

mechanism of injury to supra

Answer 5

weakness of the other mm causes an elevation of the humerus in the glenoid, which irritates the tendon
predisposes to impingement under the acromion

Question 6

signs of complete supraspinatus tear

Answer 6

shoulder shrugs upward during abduction d/t efforts of the deltoid
+drop arm test

Question 7

AC separation

Answer 7

Fall on tip of shoulder typical; involve both AC and coracoclavicular ligaments. 5 grades of separations.

Tenderness over AC joint above type 3

Question 8

shoulder arthritis

Answer 8

loss of both active and passive ROM
tender, crepitis
loss of joint space and loss of cartilage on XRAY

Question 9

Adhesivve capsulitis

Answer 9

longstanding loss of ROM
loss of both active and passive ROM
tender MORE crepitus and stiffness
DM is risk *****
night pain 
MRI is best

Question 10

Bursitis

Answer 10

trauma or repetitive motion

often presents first

differ from tendinitis w/ active and passive ROM

can inject !!! (use lido- help for dx)
Strength will return!! IF it does not return, then it is likely tendinitis

Question 11

SLAP lesion

Answer 11

superior labrum tear from anterior to posterior

from repetitive motion (i.e. throwing) or acute damage from falling and trying to gram something

Question 12

Lidocaine injection test-shouilder

Answer 12

1) RC tear will have persistent weakness
2) tendonopathy will have normal strength
3) Frozen shoulder will have persistent loss of ROM

Question 13

inflammation of LH biceps-test

Answer 13

adduct shoulder, flext arms to 90
Pronate
have patient supinate against resistance

or Speed’s test

Question 14

Speed’s test

Answer 14

flex arm to 90, parallel to flore while palm is supinated
ask patient to resist your effort to push arm back into extension
indicates bicep tendonitis

Question 15

Obrein’s test

Answer 15

flex arm to 90 and adduct across chest while IR the shoulder (point thumbs down)
then push down
pain= SLAP

Question 16

Cross-over test

Answer 16

adduct arm over chest

Pain= AC dysfunction

Question 17

lateral hip pain

Answer 17

Bursitis or meralgia paresthetica

Question 18

Posterior

Answer 18

SI, lumbar, unusual true hip joint

Question 19

anterior hip pain/ groin

Answer 19

ostenecrosis, sepsis, fx, synovitis

Question 20

lower anterior thigh pain

Answer 20

ref true hip, upper femur, femoral neck lumbar radiculopathy

Question 21

Trochanteric bursitis

Answer 21

abnormal movement of gluteus medius and TFL over greater trochanter.
need to ask them about their gate, lumbar mm tightness, LLD, knee pain, varus/valgus
bursa may fibrose

Question 22

Osteoarthritis

Answer 22

activity pain, occur at night only when advanced
occurs d/t low grade inflammation
painful in the morning, better later in day
restricted abduction
IR is very painful
insidious onset .

Question 23

Meralgia Paresthetica

Answer 23

LFC is sensory above the knee

Paresthesia ONLY

Question 24

Osteonecrosis

Answer 24

anything that causes decreased circulation into fovea
Groin pain, weight bearing and motion induced pain
**Steroid use and exs ETOH use
True groin pain

Question 25

Referred pain to hip

Answer 25

from lunbar or SI 
when there is also LBP 
sx extend beyone knee
parenthesis present 
unremarkable exam of hip

Question 26

Occult fx of hip

Answer 26

seen in older patients or acutely d/t sheer forces
severe pain to light weight bearing
need MRI**

Question 27

Fabere

Answer 27

flex, abduct, externally rotates, extends the leg in a figure 4, then gently push knee to table. If painful, indicates hip, psoas or SI problem.

Question 28

Osgood Schlatter

Answer 28

tibial tuberosity avulsion
osteochondritis of tibial tuberosity

young, active pain, focal tenderness
clinical dx
pain control, CONTINUED ACTIVITY, PT 
knee knob may be permanent but not painful 
increases risk for future avulsion fx

Question 29

lumbar radiculopathy

Answer 29

shooting pain down below the foot

use straight leg raise

Question 30

Strain

Answer 30

A sprain is a stretch and/or tear of a ligament, Ligaments stabilize and support the body’s joints.

Question 31

Sprain

Answer 31

A strain is an injury of a muscle and/or tendon. Tendons are fibrous cords of tissue that attach muscles to bone.