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Clerkship Prep > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

Shoulder examination, impingement signs: (4)

A

Supraspinatus sign (empty can test)
Hawkins sign
Neers sign
90/90 sign

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2
Q

Empty can test

A

Supraspinatus sign, position inhibits deltoid and mostly stresses the supraspinatus muscle, grade patients strength and pain

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3
Q

Hawkins sign

A

Compresses the rotator cuff, subacromial bursa, and biceps tendon. Helps evaluate for rotator cuff impingement

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4
Q

Assess the subscapularis with what test

A

Lift off test, eliminates the force of the larger muscles like pec major and lat dorsi

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5
Q

Scarf sign

A

Assesses AC joint stress by applying direct pressure to the articular surfaces of the joint

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6
Q

Testing the stability of the GH joint (shoulder)

A

Sulcus sign for laxity
Load and shift testing
Apprehension sign
Dislocation/relocation

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7
Q

Testing for tears of the shoulder labrum

A

Obriens test, arm out and thumb to the floor, apply downward pressure and look for pain and or clicking

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8
Q

Broken humerus can affect which nerves

A

Axillary, radial, or ulnar

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9
Q

Position for postural realignment

A

Bruggers position, sitting with the legs slightly apart, back arched back, head back, and arms pulled back.
Mountain pose.
Active scapular retraction

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10
Q

GH joint dislocation occurs in what two mechanisms

A

Apprehension position, and FOOSH

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11
Q

5 E’s of posterior GH dislocation

A

Electricity, epilepsy, elderly, ECT, ethanol

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12
Q

Bankart lesion

A

Avulsion of the anterior glenoid labrum from the glenoid

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13
Q

Hill Sachs lesion

A

Dent in the Humoral head

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14
Q

Mallet finger

A

Ruptured extensor tendon

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15
Q

Boutonnière deformity

A

Sprained pip with central slip disruption, needs splinting in complete extension. Can lead to flexion contracture otherwise.

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16
Q

Boxers fracture treatment

A

Ulnar gutter splint

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17
Q

Scaphoid fracture treatment

A

Thumb spica cast

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18
Q

MCP joint thumb dislocation

A

Thumb spica cast

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19
Q

Bennett’s fracture

A

Broken 1st metacarpal, referral fracture of orif

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20
Q

Muscles for supination

A

Biceps brachii and supinator

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21
Q

Muscles for pronation

A

Pronator teres, pronator quadratus

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22
Q

Allen’s test

A

Checks for occlusion of the ulnar or radial arteries

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23
Q

Tenderness over the anatomic snuffbox may be a sign of

A

Scaphoid fracture

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24
Q

Thenar innervation

A

Median

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25
Q

Hypothenar innervation

A

Ulnar

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26
Q

Hip dislocation can present clinically as

A

Internally rotated leg that appears shortened

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27
Q

Hip fracture can appear clinically as

A

Shortened leg and externally rotated

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28
Q

Third degree strain (complete tear) of the extensor mechanism of the knee

A

Will not recover spontaneously, test SLR, requires surgery

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29
Q

Feltys syndrome triad

A

RA, autoimmune leukopenia, splenomegaly

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30
Q

DDx lateral hip pain (3)

A

Greater trochanteric pain syndrome, SI joint disease, lumbar pain

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31
Q

If the patient is not able to continue sport or immediate swelling at the knee suspect

A

ACL issue

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32
Q

Inability to perform a straight leg raise indicative of what leg injury

A

Ruptured extensor mechanism

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33
Q

Positions of risk for the knee

A

Valgus, and pivot shift

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34
Q

ACL testing

A

Lachman, anterior drawer, pivot shift

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35
Q

MCL test

A

Medial stress at 0 and 30 degrees

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36
Q

PCL and LCL tests

A

Posterior drawer, lateral stress, palpation of the LCL, dial test

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37
Q

Patellar test

A

Patellar apprehension

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38
Q

Meniscal testing

A

Mcmurray test and apley

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39
Q

Ottawa ankle rules say you xray if any of:

A

Tenderness to medial or lateral malleolus, tenderness to 5th metatarsal, tenderness of navicular, inability to bear weight immediately and at the time of the assessment

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40
Q

Achilles rupture most commonly occurs at? How do we test for it?

A

5cm proximal to calcaneal attachment, test with Thompson’s test when patient is prone

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41
Q

Gout on microscopy

A

Aspiration shows negative strongly birefringement needle shaped crystals in keeping with gout

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42
Q

Achondroplasia occurs due to

A

Limited proliferation and function of chondrocytes

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43
Q

Patellar reflex nerves

A

L3-4

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44
Q

Achilles reflex nerves

A

L5-S1

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45
Q

Hamstrings reflex nerve

A

L5-S1

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46
Q

Dural tension signs

A

Straight leg raise and femoral stretch test

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47
Q

Quadriplegia indicates an injury in what spinal region

A

C spine

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48
Q

Paraplegia indicates an injury at what level of spine

A

Distal to the c7 vert `

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49
Q

Asia A

A

No motor or sensory

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50
Q

Asia E

A

Normal spinal cord function

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51
Q

Upper cervical segmental pain refers to

A

The head

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52
Q

Lower cervical segmental pain refers to

A

The shoulder girdle

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53
Q

Cellulitis organism and treatment

A

Staph aureus, cloxacillin

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54
Q

Necrotizing faciitis organism and treatment

A

Strep, penicillin or staph, clindamycin

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55
Q

Gas gangrene, organism and treatment

A

Clostridium perfringens, metronidazole or clindamycin

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56
Q

Tinels test

A

Tap at crease of effected wrist and note tingling in D1-3

Percuss the flexor retinaculum over the median nerve

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57
Q

Phalens test

A

Press backs of hands together 30-60s looking for symptoms in D1-3

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58
Q

Finklesteins test

A

Pt makes fist with thumb curled inside fingers, ulnar deviation, pain felt on radius means DeQuervains tenosynovitis

59
Q

Yergasons and speeds tests for

A

Bicipital tendinitis

60
Q

Yergasons description

A

Elbow 90 degrees hand neutral, hold hand while pt tries to supinate, + for BT if painful

61
Q

Speeds test

A

Patient flexes supinated arm against resistance, +BT if painful

62
Q

Distinguish AC joint pain from impingement with the

A

Scarf test

63
Q

Test the subscapularis with

A

Lift off test

64
Q

Perform lift off test by

A

Arm bent behind back, patient attempts to push hand away from the spine against resistance, +for rotator cuff injury if painful

65
Q

Test the infraspinatus with

A

Resisted external rotation

66
Q

Resisted eternal rotation

A

Pt has elbow against side, 90’, tries to externally rotate. Pain positive for RC injury to infraspinatus

67
Q

Subacromial impingement can be tested with

A

Neers test, Hawkins test

68
Q

Neers test

A

Impingement if there is pain with arm more tha. 90 degrees raised

69
Q

Hawkins test

A

Hold abducted arm in flexion 90/90, push up on elbow and down on wrist, look for pain

70
Q

Ataxic gait

A

Uncoordinated, due to intoxication, cerebellar disease

71
Q

Trendelenburg gait is a sign of

A

Abductor weakness

72
Q

Antalgic gait

A

Painful gait

73
Q

Valgus knee force tests the

A

MCL

74
Q

Varus knee force tests the

A

LCL

75
Q

Wrist injury - neurovascular assessment

A

Screen for radial, ulnar, and median nerve function in the hand.
Sensation to the back of hand, pointer, pinky
Muscular innervation

76
Q

Shoulder injury neurovascular exam

A

Screen for sensation of radial, median, and ulnar nerve distributions, axillary nerve at lower deltoid
Muscle innervation with various movements of hands, wrists, elbow, shoulder

77
Q

Ankle injury, neurovascular examination

A

Colour, temp, cap refill, pulses

Sensory: tibial (plantar), peroneal (1st dorsal web space), sapenous (medial ankle/foot), Sural (lateral foot)

78
Q

If a radiculopathy is suspected, what should be tested

A

Dermatomes, myotomes, and reflex examination

79
Q

Signs of cauda equina

A

Saddle anesthesia, bowel or bladder dysfunction, recent infection, night pain

80
Q

Neurovascular testing hip/lumbar

A

Motor: hip flex L2, knee extend L3, dorsiflex L4, extend big toe L5, plantar flex S1

81
Q

Achilles special test

A

Thompsons

82
Q

Ankle special tests

A

Anterior drawer, talar tilt

83
Q

Test axillary nerve C7 at

A

Lower deltoid

84
Q

Elbow inspection

A

Carrying angle valgus vs varus

85
Q

VaLgus

A

Distal limb too lateral

86
Q

Which muscles origainate at medial epicondyle

A

Flexors

87
Q

Which muscle originate at the lateral epicondyle

A

Extensors

88
Q

Special tests for the elbow

A

Lateral is resisted extension

Medial is resisted flexion

89
Q

Elbow stress testing

A

For the medial and lateral ligaments in varus and valgus positioning

90
Q

Biceps reflex root

A

C5 c6

91
Q

Triceps reflex root

A

C6 c7

92
Q

Radial nerve sensation

A

1st interosseus space

93
Q

Ulnar nerve sensation

A

Pinky

94
Q

Median nerve

A

Pointer distal

95
Q

Posterior butt pain

A

SI joint pathology

96
Q

Groin pain

A

Hip pathology

97
Q

Leg length discrepancy

A

True (ASIS to medial malleolus)

Apparent (umbilicus to medial malleolus)

98
Q

Faber test

A

Supine, figure 4 position, press down on flexed knee and opposite ASIS
Posterior pain = SI patho, groin pain = hip patho

99
Q

Thomas test hips

A

Supine, flex one hip with bend knee and extend the other one
Positive if increased lumbar lordosis, or hip cannot extend fully
Indicative of hip flexion contracture

100
Q

Hip OA ROM

A

Reduced PROM

101
Q

Hip fracture rotation

A

Internal

102
Q

Hamstring rupture

A

Weak knee flexion

103
Q

General MSK physical mnemonic

A

GALs: gait, arms, leg, spine

104
Q

Mcmurrays test is for the

A

Meniscus

105
Q

Perform mcmurrays by

A

Supine, knee flexed
Palpate the two sides of the joint line
Rotate the knee as you extend it, with the heel to the side you’re testing
Positive is pain or clicking

106
Q

Xray is required if pain and

A

Unable to bear weight for 4 steps (2 on each foot)

107
Q

“Sciatica” is really

A

Lumbosacral radiculopathy

108
Q

Most common cause of lumbosacral radiculopathy (sciatica)

A

Nerve root compression due to herniated disc

109
Q

First line treatment for lumbosacral radiculopathy (sciatica)

A

NSAIDs and acetaminophen

110
Q

Treating pes anserine bursitis

A

Quadriceps and hamstrings strengthening exercises

111
Q

Diagnostic imaging for rotator cuff tear

A

Xray to rule out fracture, MRI to see soft tissue in cuff tear

112
Q

Treatment of acute rotator cuff tear

A

Surgery

113
Q

Bone scans can help diagnose

A

Infectious or metastatic disease

114
Q

Injury mechanism for rotator cuff tears

A

FOOSH

115
Q

Greater trochanteric pain syndrome is due to

A

Overuse involving the tendons of the gluteus medius and minimus

116
Q

Adhesive capsulitis occurs due to contracture of

A

Glenohumeral capsule

117
Q

Treatment of adhesive capsulitits

A

ROM exercises, NSAIDS, corticosteroid injections

118
Q

Carpal tunnel can be diagnosed with

A

Nerve conduction studies

119
Q

Nerve affected in carpal tunnel syndome

A

Median nerve

120
Q

Chronic forefoot pain mechanically induced neuropathic degeneration of the interdigital nerves is called

A

Interdigital (Morton) neuroma

121
Q

Crepitus on lateral compression of the metatarsal heads

A

Mudler sign

122
Q

Female athlete triad

A

Excessive exercise, less periods, inadequate caloric intake, osteoporosis

123
Q

Spastic contraction of the anal sphincter

A

Proctalgia fugax

124
Q

Sub auricular systolic bruit is highly suggestive of

A

Fibromuscular dysplasia

125
Q

Treating olecranon bursitis

A

Rest, ice, NSAIDs, padding. Abx if septic. Treat underlying gout or RA if inflammatory.

126
Q

Within ten years of ACL injury most patients end up developing

A

Osteoarthritis

127
Q

Calcaneal apophysitis is also called

A

Sever disease

128
Q

Treating calcaneal apophysitis

A

Generally supportive - stretching, ice, NSAIDs, heel cup insert for cushioning

129
Q

Treatment for plantar fasciitis

A

Activity modification, stretching, heel pads/orthotics

130
Q

Degenerative condition of plantar aponeurosis at its insertion at the calcaneus caused by overuse

A

Plantar fasciitis

131
Q

Fluctuating and fatiguable proximal muscle weakness

A

Myasthenia gravis

132
Q

Treating myasthenia gravis

A

AChE inhibitors (pyridostigmine), immunotherapy, thymectomy

133
Q

First drug of choice for myasthenia gravis

A

Pyridostigmine, long acting oral AchE inhibitor

134
Q

Hallmark of ALS

A

Both upper (hyperreflexia, spasticity) and lower (atrophy, fasciculations) motor neuron signs

135
Q

Hip pain in a young child following a viral illness

A

Transient synovitis

136
Q

Diagnosing septic bursitis

A

Bursar fluid aspiration, xray

137
Q

Treating septic bursitis

A

Systemic antibiotics, drainage in select cases

138
Q

Low back pain radiating to thighs with posture dependent symptoms

A

Lumbar spinal stenosis

139
Q

Confirming diagnosis of lumbar spinal stenosis

A

MRI of the spine

140
Q

Acute back pain with unilateral radiation down the sciatic nerve to the foot, following an inciting event and worse with lumbar flexion

A

Lumbar disk herniation

141
Q

Back pain that is dull, non radiating, worse at night, not related to position or activity

A

Vertebral metastasis is suspected

142
Q

Distribution of pain in fibromyalgia

A

Chronic and widespread

143
Q

Distribution of symptoms in polymyositis

A

Proximal muscle weakness, pain mild/absent

144
Q

Characteristic symptoms of polymyalgia rheumatica

A

Stiffness>pain in shoulders, hip girdle, neck. Associated with giant cell arteritis

Clerkship Prep (34 decks)

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