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Review Flashcards

1
Q

How long does morning stiffness last for OA?

A

< 30 minutes

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2
Q

How long does morning stiffness last for RA?

A

> 30 minutes

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3
Q

What nodes are seen in OA?

A

Heberden’s (DIP) and Bouchard (PIP) nodes

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4
Q

What is the age of onset for OA?

A

Older >65

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5
Q

What is the age of onset for RA?

A

20-40

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6
Q

What is the speed of onset for OA?

A

Many yrs

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7
Q

What is the speed of onset for RA?

A

Rapid, weeks to months

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8
Q

What joints are affected by OA?

A

Often begins unilateral and limited to one set of joints (ie fingers)

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9
Q

What joints are affected by RA?

A

Symmetrical polyarticular (small (MCPs) and large joints)

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10
Q

When does joint pain occurs with OA?

A

Worsens w/ usage of joint

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11
Q

When does joint pain occurs with RA?

A

At rest, may improve w/ usage of joint

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12
Q

Do systemic sxs occur with OA, if so what are the sxs?

A

No

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13
Q

Do systemic sxs occur with RA, if so what are the sxs?

A

Yes, fatigue and malaise

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14
Q

What is seen on an spine XR for RA?

A

Atlantoaxial subluxation and insatiably (c-spine)

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15
Q

What is seen on an chest XR in a RA pt w/ exposure to silica dust, asbestos fibers, and other pneumoconiosis?

A

Caplan syndrome: multiple rheumatoid nodules w/ possible cavitation.

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16
Q

What is seen on a hand XR in a pt with Psoriatic arthritis?

A
  • Pencil in a cup deformity d/t erosion of distal end and one phalanx and expansion of the base of the proximal portion of the next phalanx
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17
Q

What is seen on a spine XR in a pt w/ ankylosing spondylosis?

A
  • Sacroiliitis: sclerotic changes of sacroiliac area (SI joint fusion)
  • Bamboo spine
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18
Q

What is seen on an XR in a pt w/gout?

A

Rat-bite erosions

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19
Q

What labs are used to diagnose RA?

A
  • RF

- Anti-CCP (anti-cyclic citrullinated peptides/protome antibody - ACPA)

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20
Q

What is the crystal composition of gout?

A

Monosodium urate monohydrate (needle like)

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21
Q

What is the crystal composition of pseudogout?

A

Calcium pyrophosphate (rhomboid like)

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22
Q

What is stage 1 of gout?

A

Asymptomatic hyperuricemia

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23
Q

What is stage 2 of gout?

A

Acute gouty arthritis: Podagra (big toe at the first MTP)

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24
Q

What is stage 3 of gout?

A

Intercritical gout: asymptomatic period after initial attack.

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25
Q

What is stage 4 of gout?

A

Chronic tophaceous gout - Tophi (conglomerations of urate crystals surrounded by giant cells in an inflammatory rxn

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26
Q

Infections involving GI and GU tracts (campylobacter and chlamydia), staph areus is causes to what disease?

A

Reactive arthritis

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27
Q

What dx would you think of if a young male comes in complaining of decreased ROM in is back?

A

Ankylosing spondylosis

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28
Q

Pt comes in with a rash on their leg and joint pain. You do an XR of their hands and you see “pencil in cup”. What do you diagnose pt with?

A

Psoriatic arthritis

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29
Q

What is the indications for Arthrocentesis?

A
  • Painful joint effusions
  • Monoarticular inflammation of joint
  • Systemic rheumatoid disorder of unknown etiology
  • Articular inflammation of unknown causes
  • Bursal aspiration- indicated when there is a painful bursal swelling despite conserving treatment or when olecranon bursitis is aggregated by normal activities
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30
Q

What are the contraindications of Arthrocentesis?

A
  • Total joint replacement

- Burns, infected skin, infected subcutaneous tissue

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31
Q

What is the causes of OA?

A
  • Degenerative condition (wear and tear of cartilage)
  • Age
  • Obesity
  • Excessive joint loading
  • Repeated microtrauma
  • Macrotruama
  • Genetic predisposing
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32
Q

What is the cause of RA?

A
  • Unknown

- may be caused by infxn or series of infxn (most likely viral), and genetically predisposition

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33
Q

What is the cause of Psoriatic Arthritis?

A

Genetics, +HLA-B27

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34
Q

What is the cause of Reactive arthritis?

A

Infections involving GI and GU tracts (campylobacter, chlamydia, staph areus)

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35
Q

What lab is + for CREST?

A

Anti-centromere

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36
Q

What lab is + for drug induced lupus?

A

Anti-histone antibodies

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37
Q

What labs are + for Sjögrens?

A

Ro=SS-A and La= SS-B

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38
Q

A positive HLA-B27 would make you think of which 3 disease?

A
  • Ankylosing spondylosis
  • Reactive arthritis
  • Psoriatic arthritis
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39
Q

What is the COD for drug induced lupus?

A

Death usually related to cardiac or pulmonary complications.

  • 5 yr survival w/o tx
  • 10 yr survival w/treatment
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40
Q

What are the general characteristics associated with Polymyalgia rheumatica?

A
  • Temporal arthritis
  • Stiffness and subjective weakness of shoulder and hip regions after a period of inactivity
  • ESR > 50
  • Age >50
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41
Q

What are the SICCA sxs associated with Sjögrens?

A

SICCA symptoms: dry mouth (xerostomia), dry eyes (xerophthalmia)
Decreases production of saliva and tears

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42
Q

What is the MC non-sicca sx associated with Sjögrens?

A

Chronic fatigue

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43
Q

What are the general characteristics of Behçet disease?

A
  • Middle eastern descent
  • Relapsing uveitis
  • Recurring genital ulcers
  • Recurring oral ulcers
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44
Q

What are the general characteristics of Takaysau?

A
  • Asian women
  • 10-20 yrs old
  • Granulomatous vasculitis of aortic arch and its major branches
  • Absent peripheral pulses, discrepancies in blood pressure, arterial bruits
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45
Q

What are the general characteristics Granulomatosis with polyangiitis?

A
  • Vasculitis involving the kidneys and upper and lower respiratory tract.
  • URI sxs: purulent/bloody nasal discharge, oral ulcerations, hemoptysis, dyspnea, tracheal stenosis
  • Saddle nose
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46
Q

What lab is + for Granulomatosis with polyangiitis?

A

c-ANCA

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47
Q

What is the MCC of death in a pt w/ Granulomatosis with polyangiitis?

A

Renal failure

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48
Q

What are the general characteristics of SLE?

A
  • Malar butterfly rash
  • Photosensitivity
  • Discoid lesions
  • Oral ulcers
  • Alopecia
  • Reynaud phenomenon
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49
Q

What are the general characteristics of Dermatomyositis?

A
  • Heliotrope rash: around eyes
  • Gottron papules: purplish, papular, erythematous, scaly lesion over the knuckles
  • V sign: rash on face, neck and anterior chest
  • Shawl sign: rash on shoulder, upper back, elbows and knees
  • Increased incidence of malignancy in adults
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50
Q

What does CREST stand for?

A 
C: calcinosis cutis
R: reynaud's phenomenon (1st and MC) 
E: esophageal dysmotility 
S: sclerodactyly (claw like appearance of hands)
T: telangiectasias
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51
Q

What drugs cause drug induced lupus?

A
  • Procainamide
  • Hydralazine
  • Isoniazide
  • Quinidine
  • Carbamazepine
  • Phenytoin
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52
Q

Is Takayasu large medium or small vasculitis?

A

Large

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53
Q

Is Behçet disease large medium or small vasculitis?

A

Medium

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54
Q

Is granulomatosis with polyangiitis large medium or small vasculitis?

A

Small

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55
Q

What are characteristic findings in a pt with SCFE?

A
  • Risk for AVN
  • Obese, adolescent male (13 yrs old)
  • Limp
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56
Q

What is the Salter Harris classification?

A
  • S: separated (physis alone)
  • A: above (physis and metaphysis)
  • L: below (physis and epiphysis)
  • TE: through everything (physis, metaphysis, and epiphysis)
  • R: cRush (physis)
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57
Q

Where is the pain located with trochanteric bursitis?

A

Point tenderness over bursa-pain to lateral aspect of the hip that is made worse w/ direct pressure

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58
Q

What are common sxs of trochanteric bursitis?

A
  • Increased pain in the AM, pain at night, and difficulty laying on the affected side.
  • Increased Q angle
  • “Snapping” hip syndrome
  • +/- warmth
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59
Q

What is the largest Sesamoid bone?

A

Patella w/quadriceps tendons

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60
Q

What are the types of knee XRs?

A
  • AP
  • Lateral
  • Sunrise/skyline (axial patellofemoral) - imaging device at 15 degrees and knee at 115 degrees
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61
Q

What zone is a jones fx?

A

Zone 2

- Fx at 5th MT at the metaphysis/diaphysis junction

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62
Q

Pt with a jones fx is at risk for what?

A
  • Risk for nonunion

- Surgical intervention recommended

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63
Q

What is a common presentation in a pt with RC tendonitis?

A
  • Pain w/ raising the arm overhead
  • Age: 40s
  • Chronic shoulder pain for months
  • Pain worse at night, difficulty sleeping on affected side
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64
Q

Where is the location of pain in a pt with RC tendonitis?

A
  • Localized to the lateral shoulder and radiates to the deltoid muscle
  • Tears generally originate in the supraspinatus tendon.
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65
Q

What ligaments are involved with an inversion ankle sprain?

A
  • anterior talofibular ligament
  • calceneofibular ligament
  • posterior talofibular ligament
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66
Q

What ligaments and structure are involved with an eversion ankle sprain?

A

deltoid ligament

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67
Q

What are PE findings in a pt with De Quervains?

A
  • Tenderness over the first dorsal compartment of the distal radius
  • Swelling over radial styloid
  • Crepitus when pt flexes and extends the thumb
  • Gripping/making a fist causes pain
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68
Q

What test is used to dx De Quervains?

A
  • Finkelstein test: Full flexion of the thumb into the palm followed by ulnar deviation of the wrist
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69
Q

What is the the tx for De Quervains?

A

RICE, spica splint, NSAIDs

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70
Q

What is Osgood Schlatter disease?

A
  • Overuse injury in a growing child that results from receptive stress when quadriceps pull on the apophysis of the tibial tubercle during a time of rapid growth
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71
Q

Who is Osgood Schlatter disease seen in more commonly?

A
  • 11-15 yr olds: more common in boys than girls

- Pts who are active in sports

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72
Q

Pain from Osgood Schlatter disease is typically exacerbated when doing what?

A

Running, jumping, climbing stairs, and squatting.

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73
Q

Why should you get a comparison view in pediatric pts?

A

Helpful in differentiating a true fracture from a growth plate.

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74
Q

What is the MC cause of compartment syndrome?

A

Tibial fracture (injury to lower extremities)

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75
Q

What is the hallmark sx of compartment syndrome?

A

Severe leg pain out of proportion to what would be expected

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76
Q

What are PE findings of a pt with compartment syndrome?

A

Unwilling to flex and extend extremities

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77
Q

How many compartments in in your thigh and lower leg?

A

3 in thigh and 4 in lower leg

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78
Q

What is the tx for compartment syndrome?

A

Immediate fasciotomy within 4-6 hrs

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79
Q

What PE test are used to determine the stability of the knee and what ligament is it testing?

A
  • Varus stress test: LCL
  • Valgus stress test: MCL
  • Anterior drawer test: ACL
  • Posterior drawer test: PCL
  • McMurrys: meniscus
  • Lachmans: ACL and PCL
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80
Q

What PE test are used to determine the stability of the ankle and what ligament is it testing?

A
  • Anterior drawer test: talofibular ligament
  • Varus stress test: calcaneofibular ligament
  • Thompson: Achilles tendon
  • Talar tilt test: anterior talofibular ligament and calcaneofibular ligament
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81
Q

What are indications to look for a talar dome fx?

A

Chronic swelling and or locking of the ankle 4-5wks post injury

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82
Q

What is the MC cause of a talar dome fx?

A

Inversion ankle injuries

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83
Q

What structures are involved in a Lisfranc fx?

A

Midfoot: tarsometatarsal joint

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84
Q

What would you see on an XR in a pt with a Lisfranc fx?

A
  • Displaced laterally

- Widening between big toe and 2nd toe

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85
Q

A critical injury causing a Lisfranc fx involves what?

A
  • 2nd metatarsal joint, it wedges into a slot in the cuneiforms
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86
Q

What structures are associated with a deltoid injury?

A

Tear to deltoid ligament usually occurs with a fracture to medial malleolus and distal tibia

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87
Q

Where does the deltoid ligament originate from?

A

Medial malleolus and spreads to attached to the medial border of the talus

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88
Q

What is a bimalleolar fx?

A

Torn deltoid ligament and fx of fib and tib

89
Q

What deformity is a result of deltoid ligament insufficiency?

A

Ankle valgus deformity

90
Q

What does the sunrise/skyline view of the knee show?

A

Location of the patella in the femoral groove and the thickness of the articular cartilage

91
Q

What is the C1 dermatome?

A

top of head

92
Q

What is the C2 dermatome?

A

temporal

93
Q

What is the C3 dermatome?

A

side of jaw/neck

94
Q

What is the C4 dermatome?

A

top of shoulders

95
Q

What is the C5 dermatome?

A

lateral arm

96
Q

What is the C6 dermatome?

A

lateral forearm, thumb, index finger

97
Q

What is the C7 dermatome?

A

posterior forearm, middle finger

98
Q

What is the C8 dermatome?

A

medial forearm, ring and little finger

99
Q

What is the T1 dermatome?

A

medial arm

100
Q

What are the symptoms L4-5 disc herniation?

A
  • pain over sacroiliac joint, hip, lateral thigh and leg
  • numbness lateral leg and first 3 toes
  • weakness with dorsiflexion of great toe, difficulty walking on heels, foot drop may occur
  • minor atrophy
101
Q

What are the symptoms L5-S1 disc herniation?

A
  • pain over sacroiliac joint, hip, posterolateral thigh and leg to heel
  • numbness back of calf, lateral heel, foot to toe
  • weakness with plantar flexion and great toe may be affected, difficulty walking on toes
  • ankle jerk diminished or absent
102
Q

What is the NEXUS criteria?

A
  • no midline cervical tenderness
  • no focal neuro deficits
  • normal alertness
  • no intoxication
  • no painful distracting injury
103
Q

How do you diagnose drug induced lupus?

A
  • anti-histone antibodies - always present

- absence of anti-dsDNA and Anti-Sm Ab

104
Q

How do you diagnose spinal stenosis?

A
  • degenerative narrowed spinal canal
  • neurogenic claudication - back and butt pain with standing and walking
  • reduced with flexed spinal positions
  • can have BL leg symptoms
  • pain worse walking, better sitting
105
Q

What are the red flags for Cauda Equina?

A
  • saddle anesthesia
  • recent onset of bladder dysfunction such as urinary retention, increased frequency, or overflow incontinence
  • minor trauma
  • strenuous lifting, especially in the older or osteoporotic patient
  • corticosteroid use
  • severe or progressive neurology deficit in the lower extremity such as “foot drop” or weakening of the lower extremity muscles
  • unexpected laxity of the anal sphincter, perianal/perineal sensory loss
106
Q

What are the red flags for HNP?

A

-significant numbness and weakness with plantar flexion of foot (L5/S1) or dorsiflexion (L4/L5)

107
Q

What is SCFE?

A

“sciffy”

-increased in obesity

108
Q

What is the MC age in boys for SCFE?

A

12-15 years

109
Q

What is the MC age in girls for SCFE?

A

10-13 years

110
Q

What are the s/s of SCFE?

A

limp, pain

111
Q

What is the PE of SCFE?

A

decreased internal rotation, abduction, flexion

112
Q

What is the immediate management of SCFE?

A

stop weight-bearing and refer immediately

113
Q

What is the treatment for SCFE?

A

surgical pinning

114
Q

What is the prognosis for SCFE?

A
  • may interrupt blood supply (AVN)

- damage to joint cartilage, later osteoarthritis

115
Q

The Salter-Harris classification

A 
Straight Across 
Above
Lower or Below
Through 
Crushed
116
Q

What makes you suspicious of compartment syndrome?

A
  • severe swelling
  • orthopedic emergency (>40 mmHg)
  • pain, parestesia, paralysis, pulselessness
  • increased presses in closed muscle compartment
  • surgical fasciotomy within 4-6 hours
117
Q

What is the problem with scaphoid fractures?

A

AVN

118
Q

What are the physical exam findings of scoliosis?

A
  • uneven shoulders
  • curve in spine
  • uneven hips
119
Q

What is the apley scratch test looking at?

A

rotator cuff and adhesive capsulitis

120
Q

What is Neer’s impingement sign looking at?

A

rotator cuff disorder

121
Q

What is Hawkin’s impingement test looking at?

A

rotator cuff disorder

122
Q

What is Empty can test looking at?

A

supraspinatus strength

123
Q

What are tinel’s sign and phalen’s test looking for?

A

carpel tunnel syndrome

124
Q

What is patella balloting looking for?

A

assess for effusion with bulge and balloon sign

125
Q

What is valgus laxity looking at?

A

MCL

126
Q

What is varus laxity looking at?

A

LCL

127
Q

What is anterior drawer and Lachman’s test looking at?

A

ACL

128
Q

What is posterior drawer looking at?

A

PCL

129
Q

What is McMurray test looking at?

A

meniscus injury

130
Q

What is Talor Tilt test looking at?

A

ankle instability

131
Q

What are the intra-articular conditions?

A
  • acute arthritis
  • infectious arthritis
  • reactive arthritis
  • gout
  • pseudogout
132
Q

Gout

A
  • monosodium urate monhydrate
  • negatively birefringent, needle-like crystals
  • monoarticualar 60%, polyarticular 40%
  • warmth and erythema of 1st MTP joint (podagra)
  • nodular deposits of uric acid (Tophi)
133
Q

Developmental dysplasia

A
  • breech delivery - increased risk of DD of hips
  • do no rely on leg creases
  • 25% of infants with normal hips will have asymmetric leg creases
134
Q

What are the physical exam maneuvers of developmental dysplasia?

A

Barlo and Ortolani testing

Older Infants: galeazzi sign and decreased range of motion

135
Q

What is the pathogenesis of developmental dysplasia?

A

spontaneous dislocation due to lax hip ligaments - improper development of femoral head and acetabulum

136
Q

What is the diagnostic evaluation for developmental dysplasia?

A
  • ultrasound recommended

- femoral head ossification starts at 4-6 months

137
Q

What is the treatment for developmental dysplasia?

A
  • pavlik harness (in 1st 4 months)
  • casting +/- traction
  • surgery (open reduction)
138
Q

Legg-Calvé-Perthes

A

avascular necrosis of the femoral head

-boys&raquo_space; girls

139
Q

What is the peak age for Legg-Calvé-Perthes to occur?

A

4-8 years

140
Q

What are the s/s of Legg-Calvé-Perthes?

A

2-3 week history of limp, +/- aching

141
Q

What are the PE findings of Legg-Calvé-Perthes?

A

limited abduction

142
Q

What are the hip films you would get with Legg-Calvé-Perthes?

A

AP and frog

143
Q

What is the treatment for Legg-Calvé-Perthes?

A

containment and limit weight-bearing

144
Q

What is the treatment for club foot?

A
  • serial casting (Ponseti) followed by bracing to prevent relapse
  • may require achilles tenotomy
145
Q

Osteosarcoma

A
  • malignant, most high grade

- metaphyses long bones - distal femur, proximal tibia, proximal humerus

146
Q

Who is osteosarcoma most common to occur in?

A

children and adolescents

147
Q

What are the s/s of osteosarcoma?

A

pain and swelling of affected are

148
Q

What does the x-ray of osteosarcoma show?

A

destructive lesion, moth eaten appearance, sunburst appearance

149
Q

What is the treatment of osteosarcoma?

A
  • core-needle or open biopsy
  • chemotherapy - preoperatively and post-operatively
  • limb sparing surgery
  • no role for radiation therapy
150
Q

Osteoma

A
  • low prevalence
  • new piece of bone, usually growing on another piece of bone
  • benign tumor, slow growing
151
Q

What are the s/s of osteoma?

A
  • vary on location
  • cranial nerve or visual/hearing issues
  • round, hard Smoot mass
  • can be painful or not
152
Q

What is the treatment for osteoma?

A
  • many will disappear on their own

- surgery with tumor removal

153
Q

Osteoblastoma

A
  • relatively benign, can become aggressive and malignant

- diaphysis of long bones

154
Q

Who do osteoblastoma most often occur in?

A

males

155
Q

When do osteoblastoma most often occur?

A

2nd - 3rd decades of life

156
Q

What are the s/s of osteoblastoma?

A
  • painful, night pain

- swelling and tenderness

157
Q

What does the x-ray of osteoblastoma show?

A
  • Lucent defect with various degrees of density

- well circumscribed

158
Q

What is the treatment of osteoblatsoma?

A

surgical curettage

159
Q

What is the most common benign bone tumor?

A

osteochondromas

160
Q

When do osteochondromas occur?

A

1st to 3rd decades

161
Q

Osteochondromas

A
  • 15% of all primary bone lesions

- metaphysis of long bones, sometimes small hand/foot bones

162
Q

What are the s/s of osteochondromas?

A

non painful, slow growing mass

163
Q

What are the x-ray findings of osteochondromas?

A

bony protuberances usually grow away from near joint

164
Q

What are is the treatment of osteochondromas?

A

usually none required

165
Q

Chondromas

A
  • benign cartilaginous tumor

- small bones in hands and feet, humerus and femur

166
Q

What are the s/s of chondromas?

A
  • asymptomatic
  • pain (dull)
  • swelling
  • endocondromas can cause fractures
167
Q

What is the treatment of chondromas?

A

surgical removal

168
Q

Chondroblastoma

A
  • rare, benign bone tumor

- epiphysis of long bones

169
Q

Who and when do chondroblastoma occur?

A

males younger than 25

170
Q

What are the s/s of chondroblastoma?

A
  • pain (joint)
  • joint stiffness
  • muscle atrophy
  • limp
171
Q

What is the treatment of chondroblastoma?

A

curettage, bone graft, resection

172
Q

Ewing Sarcoma

A
  • malignant, very aggressive
  • lesions below elbow and below mid-calf with no mets = 80% 5-year survival rate with treatment
  • diaphysis region long bones and flat bones
173
Q

When do Ewing sarcoma occur?

A

adolescence, 2nd decade of life

174
Q

What are the s/s of Ewing sarcoma?

A
  • pain and palpable mass
  • pathologic fracture
  • fever and weight loss
175
Q

What are the x-ray finding of Ewing sarcoma?

A

“onion peel” periosteal reaction, soft tissue mass

176
Q

What is the treatment for Ewing sarcoma?

A
  • chemotherapy-systemic = mainstay

- surgery-local resection, limb salvage

177
Q

What are some wound complications?

A
  • Open tibia fx worst for Osteomyelitis
  • Puncture wound through sneaker- pseudomonas (get hib and tetanus vaccine)
  • Puncture wound can cause septic arthritis
  • Pt w/ DM has open sores = risk for osteomyelitis
178
Q

What cancers metastasis to the bone?

A

prostate, breast, lung

179
Q

T-score

A
  • 0=0 BMD is equal to normal

- lower score the more porous bone

180
Q

DEXA scan

A

dual-energy X-ray absorptiometry

-measures the hip, spine, and wrist

181
Q

Z-score

A
  • comparison to the age matched normal
  • the number of SD a pts BMD differs from the average BMD of their age, sex, and ethnicity
  • used for severe cases of osteoporosis
182
Q

Osteopenia

A

BMD is between 1 and 2.5 SD below mean

T-score: -1 to -2.5

183
Q

Osteoporosis

A

BMD >2.5 SD below mean

T-score: -2.5 or less

184
Q

What are the s/s of osteoporosis?

A
  • usually none
  • progressive dorsal kyphosis
  • skeletal pain: often due to fracture
185
Q

What is the work-up for osteoporosis?

A
  • X-ray and DEXA

- BMP, CBC, TSH, Vit D level

186
Q

What is the treatment for osteoporosis?

A
  • estrogen replacement therapy
  • bisphosphonates
  • SERMs
  • Calcium/Vitamin D
187
Q

Osteopenia

A
  • essentially early stages of osteoporosis
  • really no sings or symptoms unless fracture occurs
  • prevention is key
188
Q

What do you do if osteopenia is caught early and want to stop progression to osteoporosis?

A
  • exercise an nutrition

- at this stage estrogen therapy and other specific therapies not recommended

189
Q

What is the criteria for a septic joint?

A
  • Labs: increased WBC, ESR, CRP
  • joint aspiration: WBC >50,000 bacteria
  • unable to bear weight
190
Q

How would the pt be laying if they had a hip dislocation?

A

Internal rotation, adduction

191
Q

How would the pt be laying if they had a hip fracture?

A

External rotation, abduction

192
Q

What is the S/Sxs of brachial plexus?

A
  • Burning, achy, radiating pain
  • Muscle weakness/dropped shoulder
  • Point tenderness
  • Mechanism of injury (overly extended or compressed)
    (commonly seen in football players)
193
Q

What are the PE test fo brachial plexus?

A
  • Spurlings
  • Brachial plexus traction test
  • Tinels sign
  • Cervical distraction
194
Q

Pain with a cervical strain (tendon injury) is most painful during what?

A

AROM

- NO peripheral pain or paresthesia

195
Q

Pain with a cervical sprain (whiplash) is most painful during what?

A

PROM and AROM

- NO peripheral pain or paresthesia

196
Q

Torticollis (WryNeck) is caused by a shortened SCM causes what sxs?

A
  • Muscle spasms

- Facet irritation

197
Q

During PROM of the cervical spine, what should you be sure to palpate?

A

Intersegmental motion

198
Q

What does vertebral artery impingement causes?

A

Hearing loss, vertigo, nystagmus, confusion

199
Q

A compression force brachial plexus injury is causing what?

A

Pitching of nerve roots between adjacent vertebra

- increased risk for spinal stenosis

200
Q

A distraction force brachial plexus injury is causing what?

A

Tension or stretching force on nerve roots

- MC at C5/C6

201
Q

Where is Erbs point located?

A

2-3 cm above clavicle anterior to C6 transverse process

202
Q

What is Erbs point?

A

Most superficial passage of brachial plexus

203
Q

Severe cervical sprains (dislocations) will present with what?

A

Postural changes d/t joint disassociation

204
Q

What is the return to play criteria?

A

Full pain free ROM and strength

- need Drs approval

205
Q

Thoracic outlet syndrome is commonly seen in what profession

A

Hairdressers

206
Q

What are S/Sx of thoracic outlet syndrome?

A
  • Tingling 4th and 5th digit

- Ulnar and median weakness

207
Q

What is syringomyelia?

A

Cyst in the spinal cord that elongates over time

208
Q

What are S/Sxs of syringomyelia?

A
  • Progressive arm and leg weakness
  • HA and cold sensation of hands
  • Loss of bladder function
  • MRI: Chiari malformations
209
Q

What is cervical spondylosis?

A

Degenerative disorder of the disc with ingrowth of the bone with side spurs and thickening of the ligament Flavum

210
Q

What are S/Sx of cervical spondylosis?

A
  • Pain
  • Radiculopathy
  • Limited mobility in an upright position
  • paresthesia in hands and hand dexterity
211
Q

What are PE findings that would indicate cervical spondylosis?

A

Loss of vibratory and position sense in feet and legs

212
Q

Visible or palpable step-off is indicative of what?

A

Spondylolisthesis

213
Q

What ROM is preserved with disc disease?

A

Lateral flexion is preserved where forward flexion is not

214
Q

Single squat and rise test the quadriceps and is innervated by what nerve?

A

L4 nerve root

215
Q

What test is a strong indication of nerve root compression d/t herniated disc?

A

Crossover straight leg test

216
Q

Sciatica is defined as?

A

Pain radiating below the knee

217
Q

Pt w/ LBP has paresthesias in the lateral foot, decreased toe-raise strength, diminished sensation lateral foot, and normal Achilles reflex. Suggestive of what dysfunction of which nerve root?

A

L5

218
Q

What is felty syndrome?

A

RA, Splenomegaly, Neutropenia

MSK (11 decks)

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