SILVER Musculoskeletal Conditions Flashcards
What is the most common MOI for an intervertebral disc herniation?
Twisting and bending of the spine, often with the addition of an external load
What structures make up an intervertebral disc?
Annulus fibrosus = outer cartilaginous ring
Nucleus pulposus = inner jelly like material
What portion of the disc is most likely to be herniated? Why?
Posterolateral portion of the disc
Why?
- Posterior disc is narrower in height than anterior disc
- PLL is not as strong as the ALL
- Posterior lamellae of the annulus are thinner
What is a disc herniation?
Occurs when the nucleus pulposus bulges through the exterior wall of the annulus fibrosis
What is the most common cause of disc herniations?
Gradual age related changes which causes the disks to lose water content overtime resulting in greater likelihood of tearing/rupturing the annulus fibrosis
List 2 common sxs associated with lumbar disc herniations.
Low back pain Radicular pain (numbness, tingling and weakness in the affected nerve distribution)
What is the most common type of glenohumeral dislocation? MOI?
Anterior dislocation
MOI: External force or blow applied to the arm while it is in a position of abduction, external rotation, and extension (i.e. throwing a ball)
List 4 injuries that are associated with anterior GH dislocation.
- Hill Sachs lesion (compression fracture of the humeral head)
- SLAP lesion
- Bankart lesion (avulsion of the anterior-inferior capsule and glenoid labrum)
- Axillary nerve injury
List 3 signs and sxs associated with an anterior GH dislocation.
Visible deformity (palpable humeral head)
Severe pain
Significant ROM limitations
What is the most common cause of a meniscal tear?
Twisting of the knee when it is in a semiflexed position with the foot planted on the ground
Which meniscus is more susceptible to injury? Why?
Medial meniscus because it is more firmly attached to the tibia
List 5 signs and sxs associated with meniscal tears.
Joint line pain Tenderness Swelling Joint popping/clicking Feelings of instability
List 3 special tests used to asses the presence of a meniscal tear.
Thessaly’s test
McMurray’s test
Apley’s test
What is Osgood Schlatter disease?
Traction apophysitis at the tibial tuberosity
Describe the clinical presentation associated with Osgood Schlatter disease.
Localized pain and edema with point tenderness over the patellar tendon’s insertion at the tibial tubercle
What is piriformis syndrome?
Compression or irritation to the proximal sciatic nerve due to piriformis muscle inflammation, spasm or tightness
List 5 signs and symptoms associated with piriformis syndrome.
- Restriction in internal rotation
- Pain with palpation of piriformis muscle
- Referral of pain to posterior thigh
- Weakness in ER
- (+) Piriformis test
What is spinal stenosis?
Congenital narrowing of the spinal canal or intervertebral foramen, coupled with hypertrophy of the spinal lamina and ligamentum flavum or facets caused by age related changes or disease
List 4 signs and symptoms associated with spinal stenosis.
- Unilateral/Bilateral pain and paresthesia in back and LEs
- Pain decreases with spinal flexion and increases with extension
- Pain increases with walking
- Pain relieved with prolonged rest or activity modification
What 2 special tests may be performed to differentiate between spinal stenosis and intermittent claudication?
van Gelderen’s test
2 stage treadmill test
What is trochanteric bursitis?
Inflammation of the deep trochanteric bursa due to direct/repetitive microtrauma or irritation by ITB
Trochanteric bursitis is common in patients with ______.
Rheumatoid arthritis
List 4 symptoms associated with trochanteric bursitis.
- Pain at lateral hip which may radiate to lateral thigh
- Point tenderness
- Pain with passive ER and abduction
- Pain with resisted hip flexion and abduction
