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CSB521 - PM1 > wk 4- musculoskeletal > Flashcards

wk 4- musculoskeletal Flashcards

1
Q

principles of MSK
the 4 domains.

A

Domain A- person centred approaches
B- Assessment, investigations and diagnosis
C- condition management, interventions and prevention
D- service and professional development

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2
Q

what is the process of determining a diagnosis with a patient in general terms

A

use knowledge about other cases and the patients history to find a clinical prediction by comparing what is similar and not similar between the cases and the symptoms/history. if sinister differential diagnosis are yet to be eliminated or where no clinical test powerful enough to confirm a condition, then a highly sensitive/specific investigations are required.

  1. clinical prediction
  2. clinical tests
  3. investigations
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3
Q

indications of MSK 4

A

joint pain
regional or general pain or stiffness
muscle weakness or injury
systematic problems

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4
Q

common MSK conditions

A
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5
Q

rare MSK conditions

A
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6
Q

signals/symptoms that indicate the need for specialists

A
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7
Q

signals/symptoms that indicate the need for specialists

A
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8
Q

signals/symptoms that indicate the need for specialists

A
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9
Q

how to screen red flags

A
  1. musculoskeletal history
  2. symptoms from joint or soft tissue
  3. chronic or acute
  4. always exclude a potential systemic disease
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10
Q

aims of musculoskeletal assessment 5

A
  • Identify site of the primary problem
  • Identify secondary problems and relate them to the primary problem
  • Identify the cause of the primary problem e.g. poor posture
  • Devise an appropriate treatment plan based on the assessment data
  • Monitor the progress of the condition using subsequent assessment
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11
Q

where is the location of the COG and how much

A

55% of body height which is anterior to S2 vertebra

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12
Q

determinants of gait 9

A
  • Pelvic rotation
  • Pelvic tilting
  • Lateral displacement of
    the body
  • Knee flexion
  • Knee mechanism
  • Ankle mechanism
  • Trunk, neck, arm swing
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13
Q

what determines pelvic oblique tilt and what does the tilt do for the COG and gait

A

The magnitude of tilt is controlled by the hip abductors on the stance side.

  • Pelvis tilt reduces the apex of the
    COG trajectory
  • Pelvis tilt introduces the need for
    knee flexion during swing (so the foot
    can clear the ground)
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14
Q

position of a body part in the 3 planes, what directions are they in

A

Sagittal Plane
ØMedial vs lateral (towards vs away from midline)
* Frontal Plane
ØAnterior vs posterior (in front vs behind)
* Transverse Plane
ØDistal vs proximal (away vs towards centre)* Dorsal vs plantar (foot)

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15
Q

joint motion in the planes what movements occur (4 planes)

A

Sagittal Plane
ØFlexion
ØExtension
§Dorsiflexion
§Plantarflexion

Frontal plane
ØThigh & leg
§Abduction & adduction
ØFoot
§Inversion & eversion

  • Transverse plane
    ØThigh & leg
    §Internal and external rotation
    ØFoot
    §Adduction & abduction
  • Triplanar motion
    ØPronation
    §Dorsiflexion, eversion, abduction
    ØSupination
    §Plantarflexion, inversion, adduction
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16
Q

position of a joint in the planes

A

Sagittal Plane
ØHip & thigh
§Extended & flexed
ØFoot
§Dorsiflexed & plantarflexed

Frontal Plane
ØHip & thigh
§Abducted & adducted
ØFoot
§Inverted & everted

17
Q

deformities in these planes

A

Sagittal Plane
ØEquinus deformity if part is in plantarflexed position
ØExtensus deformity if part is in dorsiflexed position

  • Frontal Plane
    ØVarus & valgus
  • Transverse Plane
    ØAdductus & abductus
18
Q

what is equinus

A

Limitation of normal ankle joint dorsiflexion with the STJ in its neutral position
* Can be present with the knee joint flexed or extended
* Gastrocnemius muscle originates above the knee joint
* Origin of the soleus in below the knee joint
* Clinically differentiate tightness of two structures

19
Q

what is varus

A

inverted position of one part relative to the next
* Positional or structural deformity
* Example
ØForefoot varus, where the forefoot is invertedin relation to the rearfoot

20
Q

what is valgus

A

algus position is an everted position of one part relative to the next
* Positional or structural deformity
* Example
ØForefoot valgus, where the forefoot is evertedin relation to the rearfoot

21
Q

knee positions 4

A
  • Genu Varum (bow legged) - outward leg in relation to thigh
  • Genu Valgum (knock kneed) - knees touch and thighs angled inwards
  • Genu Recurvatum- knee hyperextension, bends backwards
  • Flexed deformity- inability to straighten the knee
22
Q

explain joint axes

A

oints of the foot function like hinges
* All joint motion occurs perpendicular to the joint axis (the pin)
* The arm of the hinge moves in the plane of motion
* The axis of motion or joint axis can be parallel to the
* Transverse and sagittal planes
* Motion in the frontal plane
* Transverse and frontal planes
* Motion in the sagittal plane
* Sagittal and frontal planes
* Motion in the transverse plane

23
Q

what is open/closed kinetic chain motion and what is kinetic and kinematics briefly

A
  • Joint motion can occur in non weight bearing
    ØOpen kinetic chain motion (OKC)* Or weight bearing
    ØClosed kinetic chain motion (CKC)* Kinetics
    ØUnderstanding the forces of movement* Kinematics
    ØThe understanding of movement
24
Q

process of muscolosletal assessment 7 steps

A

General observation
* Specific joint observation
* Palpation
* Examination of movement
* Muscle assessment
* Special tests
* Further investigation

25
Q

what body parts do you do a non weightbearing examination on

A
  • Hip
  • Knee
  • Ankle and rearfoot
  • Midtarsal
  • MTPJ’s
  • Digits
  • Alignment
26
Q

assessment of joints include 4 things

A
  1. Signs of inflammation
    ØErythema, heat, pain , swelling & loss of function
    ØPain
  2. Characteristics
    ØRange and direction of motion
    ØWarm up of muscles, ligaments and synovial fluid
  3. Range of motion (ROM)ØMeasured versus observed
    ØCompared to normal
    ØDirection of motion (DOM)
    ØSymmetry of motion (SOM)
    ØQuality of motion (QOM)
  4. Dislocation and subluxation
27
Q

classifying muscles

A

Local stabilizers maintain low continuous activation in all joint
positions and become inhibited when dysfunctional (e.g. VMO)

uGlobal stabilizers are activated in specific directions of joint
movement and tend to become long and weak with dysfunction
(e.g. gluteus medius)

uGlobal mobilisers produce joint movement in specific directions
and become short and overactive when dysfunctional (e.g.
hamstrings)

CSB521 - PM1 (10 decks)

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