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OMS Peripheral > Principles of orthopaedic medicine > Flashcards

Principles of orthopaedic medicine Flashcards

1
Q

What are the two main categories of pain?

A

Nociceptive and Non-nociceptive

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2
Q

What types of pain are in nociceptive and non-nociceptive?

A

Nociceptive:
1- Somatic: skin pain, tissue pain, muscle pain
2- Visceral: internal organs

Non-nociceptive:
1- Neurogenic: caused by damage or disease
2- Psychogenic

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3
Q

What are the four different sources of pain?

A

1- Local: inert or contractile tissue
2- Referred: from where?
3- Systemic: what disease?
4- Psychosocial: combined with somatic causes?

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4
Q

How to test contractile tissue?

A

1- Isometric contraction in mid-range

2- Passive stretching

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5
Q

What does an isometric contraction test?

A

The muscle belly, musculo-tendinous junction, body of the tendon, teno-osseous junction

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6
Q

How to test inert tissues?

A

Passive stretching or by squeezing

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7
Q

What are the inert tissues?

A

Bone, cartilage, capsule, ligament, bursa, fascia, neural and vascular tissue

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8
Q

What are the four rules of referred pain from unilateral structures?

A

1- It does not cross midline
2- It refers distally (except at a distal site of injury)
3- It refers segmentally (according to the nerve supply of the structure)
4- It occupies part or all of its dermatome

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9
Q

Capsular pattern of the elbow joint?

A

Flexion > extension

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10
Q

Capsular pattern of the proximal radioulnar joint?

A

Supination > Pronation

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11
Q

Capsular pattern of the distal radioulnar joint?

A

Pain at the extremes of rotation

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12
Q

Capsular pattern of the wrist joint?

A

Flexion = Extension

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13
Q

Capsular pattern of the trapeziofirst-metacarpal joint?

A

Abduction > Extension

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14
Q

Capsular pattern of the MCP and IP joints?

A

Flexion > Extension

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15
Q

What is a capsular pattern?

A

When a joint capsule is irritated by irritation/degeneration/disease/trauma

The inflamed capsule contracts, producing a loss of range in a set pattern

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16
Q

What are normal and pathological end feels?

A

Normal:
1- Elastic: capsular/ligamentous tightening
2- Hard: bone to bone or tough ligamentous tension
3- Soft: tissue approximation

Pathological:
1- Empty: Pain limits movement, no end point
2- Springy: intra-articular block, loose body
3- Spasm: hard twang of protective muscle spasm

17
Q

During Clinical Exam what are the three observations?

A

1- Face: ill, tired, anxious, angry, excessively bright
2- Posture: slumped, exaggerated, tense, consistent with Hx
3- Gait: exaggerated, consistent with Hx

18
Q

What are the nine categories in taking a History?

“ASOS DOBS”

A 
1- Age
2- Occupation
3- Site
4- Spread
5- Duration
6- Onset
7- Behaviour
8- Symptoms
9 - PMH
19
Q

During the clinical examination what are the four things to inspect?

A

1- Deformity
2- Wasting
3- Colour
4- Swelling

20
Q

What is the capsular pattern of the hip?

A

Medial rotation > Flexion + Abduction > Extension

21
Q

What is the capsular pattern of the knee?

A

Flexion > Extension

22
Q

What is the capsular pattern of the tibiofibular joint?

A

Pain when joint is stressed

23
Q

What is the capsular pattern of the talocrural joint?

A

Plantar flexion > Dorsi flexion

24
Q

What is the capsular pattern of the subtalar joint?

A

Increasing limitation of supination, eventual fixation of the joint in pronation

25
Q

What is the capsular pattern of the midtarsal joint?

A

Limitation of adduction and inversion

26
Q

What is the capsular pattern of the first MTP joint?

A

Extension > Flexion

27
Q

What is the capsular pattern of the 2nd to 5th MTP joints?

A

Variable

28
Q

What is the capsular pattern of the feet’s IP joints?

A

Joints fix in flexion

29
Q

What do passive movements test?

A

1- Pain
2- End-feel
3- ROM

30
Q

What do resisted movements test?

A

1- Pain

2- Power

OMS Peripheral (8 decks)

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