Week 6 Musculoskeletal System Flashcards
Screening tool used to test basic mobility in frail and elderly patients
Timed
Up &
Go
TUG high risk =
> 13.5 sec
Shoulder expected range
Arms forward and up
Arms behind back and hands up
Arms to side and up over head
_______
Touch hands behind head
Elbow
Inspect joint in _____ and _____ posistions
Flexed & Extended
The palm facing the ground
Pronation
palm upward
Supination
Series of hand motions and posistions that will make your hands or fingers feel numb or tingle if you have carpal tunnel syndrome
Phalens test
Tap over the carpal tunnel of the wrist.
Test is positive if tingling is felt in the thumb, index, middle, and lateral half of the ring finger
Tinel’s test
Pressing upwards medially near the knee than Pressing downwards laterally on the knee
Describes this test
What is a positive sign
What does a positive sign suggest (Disease)
Bulge sign
A Bulge will appear on the medial side
Knee osteoarthritis
Push down on knee with a finger
If effusion moves to either side of the knee it is a positive sign for this test
Ballottement
The McMurray test for….
torn meniscus
McMurray test
Lateral meniscus
Medial meniscus
Lateral = internal rotation
Medial = external rotation
Inversion =
Eversion =
Inversion = soles of foot towards body midline
Eversion = Sole of foot away from body midline
Ankylosing spondylitis
An inflammatory arthritis affecting the spine and large joints.
A chronic inflammatory disorder affecting many joints, including those in the hands and feet.
the body’s immune system attacks its own tissue, including joints. In severe cases, it attacks internal organs.
Rheumatoid arthritis
A degenerative joint disease
type of arthritis that occurs when flexible tissue at the ends of bones wears down.
The wearing down of the protective tissue at the ends of bones (cartilage) occurs gradually and worsens over time.
Osteoarthritis
condition in which bones become weak and brittle
New bone creation doesn’t keep up with old bone removal.
Osteoporosis
Inflammation of the fluid-filled that act as cushions at the joints.
occurs most often at joints that perform frequent repetitive motion.
Bursitis
An irritation of the tissue connecting the forearm muscle to the elbow.
can be caused by repetitive wrist and arm motions.
Tennis elbow/ Lateral epicondylitis
Gout is associated with this disease
CAD (Coronary artery disease)
Syndactyly
Fingers fused together
Polydactyly
Extra finger
_____ fracture is a break in the radius close to the wrist
A Colles
______ occurs when inflammation in your hand, wrist, or fingers leads to your fingers bending toward your pinky.
Associated with which disease
Ulnar deviation shift
Rheumatoid arthritis
_______ are a typical symptom of osteoarthritis of the hands. They are small bony growths that appear on the middle joint of the finger.
Bouchard’s nodes
This type of cyst can be on a nerve
Ganglion cyst
deformity of the finger characterized by hyperextension of the proximal interphalangeal joint (PIP) and flexion of the distal interphalangeal joint (DIP)
Name of these findings
Name of disease associated
Swan neck
Rheumatoid arthritis
The result is that the middle joint (PIP joint) of the injured finger will not straighten and remains flexed, while the fingertip bends back (hyperextends).
Name of findings
Name of disease
boutonnière
Rheumatoid arthritis
ankylosis
Cause
stiffness or fixation of a joint by disease or surgery
From disuse
____ is the normal response to disuse
Flexion
Medial collateral ligament (MCL) tear is associated with (2)
Mild synovitis (an inflammation of the tissues that line a joint)
Prepatellar bursitis
(Prepatellar bursitis is an inflammation of the bursa in the front of the kneecap (patella). It occurs when the bursa becomes irritated and produces too much fluid)
form of arthritis characterized by severe pain, redness, and tenderness in joints.
Pain and inflammation occur when too much uric acid crystallizes and deposits in the joints.
Gout
A sideways curvature of the spine.
occurs most often during the growth spurt just before puberty.
Scoliosis
condition which refers to a problem with a rubbery disc between the spinal bones.
This condition occurs when the soft center of a spinal disc pushes through a crack in the tougher exterior casing.
Herniated nucleus pulposus
(Herniated Disc)
abnormal stiffening and immobility of a joint due to fusion of the bones
Ankylosis
One or more bones in a joint being out of posistion
Dislocation
Partial dislocation of a joint
Subluxation
Shortening of a muscle leading to limited range of motion of the joint
Contraction
Access strength test (Areas)
Upper
Lower
Bi, Tri, Grip
Quad, Hamstrings, Dorsiflexon / plantar flexon
0 No muscle contraction is noted in the muscle by Palpating the muscle while the patient attempts to contract it.
- Trace muscle contraction is noted in the muscle by palpating the muscle while patient attempts to contract it.
- ________
- The patient may move the muscle against gravity but not against resistance of the Examiner
- The patient moves the muscle group and overcomes the resistance of the Examiner. NORMAL MUSCLE STRENGTH
- The patient is able to actively move the muscle when gravity is eliminated
- The patient may move the muscle group against some resistance from the examiner
Test strength of _______ by holding the patient’s wrist from above
Instruct to Flex arm to shoulder
Provide resistance at wrist
Repeat and compare arm
Lower arm flexion
Extend forearm against the examiners resistance
Measures
Triceps
Iliopsoas group
Supine posistion
Raise each leg while the Examiner resists
Is this type of test
Hip Flexion
Hold knee from side
Apply resistance under ankle
Instruct paitent to pull lower leg to buttock
Test this muscle
Hamstring
Test extension at the knee
Place one hand under knee and other on top of lower leg for resistance.
Ask patient to “kick out” or extend lower leg at the knee
Test this muscle
Quadriceps
Test _____ of the ankle by holding the top of the ankle
Have the patient pull their foot towards their face as hard as possible
Dorsiflexion
Holding the bottom of the foot
Ask patient to Press down on the Gas Pedal as hard as possible
Describes this test
Plantar flexion
Damaged neurovascular finding: 6 (P)s
Pulselessness, (ischemic)
Pain
Pallor
Paresthesia “pins-and-needles”
Paralysis or
Paresis “ Muscularweaknesscaused bynervedamage or disease; partialparalysis”
Poikilothermia: “the inability to regulate core body temperature(as by sweating to cool off or by putting on clothes to warm up”
Neurovascular assessment of the extremities assessment:
(6)
Pulses
Capillary refill
Skin color
Temperature
Sensation
Motor funciona
Pressure, increased swelling, crush injuries, extreme exercise all can all affect this Assessment
Neurovascular
painful and dangerous condition caused by pressure buildup from internal bleeding or swelling of tissues.
The pressure decreases blood flow, depriving muscles and nerves of needed nourishment.
Compartment syndrome
Compartment syndrome
painful and dangerous condition caused by pressure buildup from internal bleeding or swelling of tissues.
The pressure (increases /decreases) blood flow, depriving muscles and nerves of needed nourishment.
Decreases
Procedure to correct Compartment Syndrome?
Fasciotomy
Neck exam
Strength of (2) muscles
Rotation against resistance
Sternocleidomastoid
Trapezius
ROM: Shoulders (2)
Abduction / Adduction
Internal rotation / Adduction
ROM hand and wrist
Flexion & hyperextension
Joint pain and swelling triggered by an infection in another part of the body.
The infection that causes reactive arthritis usually occurs days to weeks before the onset of joint pain.
Name disease
Name sign associated with it
Name 2 test to detect
Reiters syndrome
Effusion of knee
Bulge sign & Ballottement
Polyarthritis is a term used when at least _____ joints are affected with arthritis
five
ROM of Ankle (3)
Dorsiflexion and plantar flexion
Inversion & eversion
Abduction & Adduction
Straight leg raising test
Measure limb from ______ to the _______
Anterior superior iliac - medial malleolus
Types of Inflammatory Arthritis (4)
Ankylosing spondylitis
Rheumatoid Arthritis
Gout
Reactive arthritis
Dupuytren’s contracture
gradual thickening and tightening of tissue under the skin in the hand.
The condition most often affects the 4th (ring) and 5th (little) fingers.
Bicep muscle is innervated by the ____ nerve roots via the musculocutaneous nerve
C5 & C6
bursae
fluid-filled pads in joints
Balance
Ease of stride
Length of stride
Overall Steadiness
Are all concerned with
Gait
Sits, walks ___ meters, turns around , walks back to chair and sits.
Risk for fall >13.5 seconds
Name of test
3 meters
Timed
Up &
Go
Diet and Nutrition: Emphasize calcium and vitamin D-rich foods.
Weight-Bearing Exercise:
Fall Prevention:
Medication Adherence:
Smoking and Alcohol Reduction:
Bone Density Testing:
Posture and Body Mechanics:
Supplemental Support: Discuss the potential need for calcium and vitamin D supplements.
Regular Follow-Up:
Emotional Support:
Describe teachings for what
Osteoporosis
Assess Neurovascular of extremities
Check sensation by asking the patient to report any tingling, numbness, or changes in sensation.
Assess motor function by observing the patient’s ability to move the extremity and checking for any weakness or paralysis.
Evaluate proprioception and coordination, asking the patient to perform simple movements.
Neurological Assessment: (3)
Neurovascular Assessment
Assess pulses (radial, ulnar, brachial, femoral, popliteal, dorsalis pedis, and posterior tibial).
Evaluate capillary refill time by pressing on a nail bed and observing the time it takes for color to return.
Check skin color, temperature, and moisture for signs of adequate blood flow.
Assess for any swelling, discoloration, or abnormalities.
Vascular Assessment
Neurovascular Assessment (2) Parts
Inquire about any pain or discomfort in the extremity.
Ask the patient to describe the nature, location, and intensity of pain.
Evaluate the patient’s ability to perform daily activities using the extremity.
Pain Assessment:
Functional Assessment:
For first 5 years after menopause women lose about ___ % of bone mass each year
2%
Adhesive Capsulitis is aka….
Frozen Shoulder
Order of exam
Inspection
Palpation
ROM
Muscle testing
Muscle ____ is more important than overall strength
Equalness
Describe Gait for nusing
Steady or Unsteady
Balance (Dynamic / Static)
Ease of stride
Length of stride
Steadiness (Overall)
Describes what
PT evaluation of Gait
Give an example of a
Moderate
Maximum
Intervention for an unsteady gait
Mod. Gait Belt
Max. Sara steady
T- score measure what?
What ate the value ranges and findings for each
-1 - 0 = normal
-1 - - 2.5 = osteopenia
-2.5 or below = osteoporosis
Paresis
Partial paralysis
Cause: nerve damage or disease
A goniometer is an instrument that
Measures an angle of a joint
The shoulders preform this type of movement
(Rotation / circumduction)
Circumduction
The head / neck preform this type of movement
(Circumduction / Rotation)
Rotation
