Week 6 Musculoskeletal System Flashcards by Jade Ring

Screening tool used to test basic mobility in frail and elderly patients

Timed
Up &
Go

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TUG high risk =

> 13.5 sec

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Shoulder expected range

Arms forward and up
Arms behind back and hands up
Arms to side and up over head
_______

Touch hands behind head

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Elbow

Inspect joint in _____ and _____ posistions

Flexed & Extended

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The palm facing the ground

Pronation

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palm upward

Supination

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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

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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

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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

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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

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The McMurray test for….

torn meniscus

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McMurray test

Lateral meniscus
Medial meniscus

Lateral = internal rotation
Medial = external rotation

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Inversion =
Eversion =

Inversion = soles of foot towards body midline

Eversion = Sole of foot away from body midline

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Ankylosing spondylitis

An inflammatory arthritis affecting the spine and large joints.

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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

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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

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condition in which bones become weak and brittle

New bone creation doesn’t keep up with old bone removal.

Osteoporosis

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Inflammation of the fluid-filled that act as cushions at the joints.

occurs most often at joints that perform frequent repetitive motion.

Bursitis

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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

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Gout is associated with this disease

CAD (Coronary artery disease)

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Syndactyly

Fingers fused together

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Polydactyly

Extra finger

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_____ fracture is a break in the radius close to the wrist

A Colles

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______ 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

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_______ 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. 1. Trace muscle contraction is noted in the muscle by palpating the muscle while patient attempts to contract it. 2. ________ 3. The patient may move the muscle against gravity but not against resistance of the Examiner 4. 5. The patient moves the muscle group and overcomes the resistance of the Examiner. NORMAL MUSCLE STRENGTH

2. The patient is able to actively move the muscle when gravity is eliminated 4. 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 " Muscular weakness caused by nerve damage or disease; partial paralysis" 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

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