Wk 3 MSK Lecture Flashcards
How is arthritis defined?
- Articular swelling/effusion OR
- 2 or more of the following signs:
- ROM limitation
- Joint tenderness on palpation
- Pain on joint movement
- Increased warmth over joint
Synovitis
Inflammation of the synovial membrane, which lines the inside of the articular cartilage
Joint effusion
increased synovial fluid in the synovial cavity of a joint
crepitus
a grating/grinding/cracking sound of sensation from 2 rough surfaces rubbing together
arthralgia
join pain
myalgia
muscle pain
Enthesis
insertion point of tendon or ligament to bone
- common: Achilles and tibial
enthesitis
inflammation of the insertion site of ligament/tendon to bone
Bursa
sacks lined w/ synovial membrane containing synovial fluid
Bursitis
inflammation of the bursa
MUSK Hx Qs
Where is the pain/swelling/redness?
How long?
Injury?
When is the pain worse?
Stiffness?
Meds? Helpful? Dose?
5 tenents of MUSK exam
- inspection - bare skin, state observations, note asymmetry
- palpation (incl. T)
- ROM
- strength
- Gait
What is TUG?
Timed up & go
-fall risk
What do we check w/ gait test?
- tandem gait
- toe walking
- heel walking
What do we palpate in the shoulder joint?
- acromioclavicular joint
- bicipital groove
What 4 elbow ROMs are tested?
- elbow flexion
- extension
- forearm pronation
- forearm supination
Hand and wrist MUSK inspection
plamar and dorsal surfaces
Technique for PIP joint palpation
PIP = proximal interphalangeal joints
* 2 fingers of one hand on the medial and lateral joint lines
* 2 fingers from the opposite hand on the top and bottom of the joint.
* Pressure is applied from the top and bottom and then from the medial and lateral areas
* Alternating to feel for the fluid swish around your fingers like a water balloon
MCP joint palpation
MCP = metacarpophalangeal joints
Technique
* Palpate the top of the MCP with thumbs of both hands
* Movefingersdownthe MCP into spaces between MCP
* Effusionsfeelslikea balloon
Wrist palpation
Technique
* Groove of radiocarpal joint
* Distal radius
* Ulnar styloid process
Causes of limited ROM in hands
- RA
- osteoarthritis
What are diff hand deformities from late stage RA?
- Boutonneire deformity of thumb (thumb pointed laterally)
- Swan-neck deformity of fingers - bent laterally at distal joint
- Ulnar deviation of metacarophalangeal joints
What are 2 signs of late stage of osteoarthritis?
- Heberden’s nodes - further on pinky, ring finger - distal DIPs
- Bouchard’s nodes - close on pointer finger - proximal PIPs
*can’t have both at same time
Knee palpation
- Palpate Medial and Lateral Lines
* 1 hand above and below and move fluid back and forth. Attempt to feel fluid hit your fingertip - palpate patella
- tibial tuberosity
Knee ROM
Ankle joint palpation
Medial and lateral malleoli
* Anterior surface of ankle
* Achilles tendon
Technique:
* With thumbs, palpate the anterior aspect of each ankle
* Palpate tendons in center
* Palpate malleoli
* Palpate Achilles tendon down to insertion point (enthesis)
Ankle ROM types
dorsiflexion
plantar flexion
inversion
eversion
Documenting acronyms: LROM, POM, PIP, MCP
LROM= loss in range of motion POM= pain on motion
PIP= Proximal Interphalangeal MCP= metacarpophalangeal joints
