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2b > Exam: MSK > Flashcards

Exam: MSK Flashcards

1
Q

What should you ask them before you start the examination

A

Do you have any pain

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2
Q

Shoulder: What do you look for

A

Scars, shoulder alignment, swelling, muscle wasting

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3
Q

What would deformity at the medial clavicle suggest

A

Previous clavicular fracture

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4
Q

What would distal clavicle deformity suggest

A

AC joint subluxation

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5
Q

Why would you ask the patient to press against the wall

A

Winged scapula from long thoracic nerve damaging the serratus anterior

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6
Q

Shoulder: What do you feel for

A 
Temperature
Sternoclavicular joint
Clavicle
Acromioclavicular joint
Coracoid process
Humerus
Spine of the scapula
Border of the scapula
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7
Q

Where is the coracoid process

A

2cm inferior and medial to the clavicle tip

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8
Q

Shoulder: How should the patient move (quick)

A

Press against the wall
Hands behind back high up
Hands behind head, elbow back

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9
Q

Shoulder: Full assessment of ROM

A

Active shoulder flexion and extension
Active shoulder abduction and adduction
Active external rotation (elbows tuck in, rotate out)
Active internal rotation (hand high up on spine)
Assess scapular movement during abduction
(repeat, passively)

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10
Q

How do you assess supraspinatus

A

Abduct against resistance

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11
Q

What does painful arc assessment (between 60-120 degrees) suggest

A

Impingement

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12
Q

How do you assess infraspinatus and teres minor

A

External rotation (pain, tendonitis, loss of power, tear)

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13
Q

Shoulder: What are the special tests for the shoulder

A

Gerbers lift off test

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14
Q

Gerbers lift off test

A

Lift back of hand off spine against resistance. Assesses subscapularis

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15
Q

Shoulder: How would you summarise

A

Today I examined x a x year old male. On inspection there were no obvious abnormalities. On palpation there was no tenderness. There was a full range of active and passive movement. There were no positive findings on any of the special tests.

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16
Q

Shoulder: How would you complete the examination

A

Examine cervical spine and elbow

Look at any appropriate imaging of the shoulder joint

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17
Q

Elbow: What are you looking for

A

Scars, swelling, erythema. Note the carrying angle (5-15 degrees). Rheumatoid or psoariatic lesions

18
Q

Elbow: What do you feel

A 
Temperature
Lateral epicondyle
Medial epicondyle
Olecranon
Biceps tendon (with elbow flexed at 90)
19
Q

Elbow: How should the patient move

A

Full flexion and extension
Pronation and suppination
(passively, feeling for crepitus)

20
Q

Elbow: special tests

A

Active wrist flexion against resistance

Active wrist extension against resistance

21
Q

What does active wrist flexion against resistance test for

A

Medial epidocondylitis

22
Q

What does active wrist flexion against resistance test for

A

Lateral epicondylitis

23
Q

Elbow: How would you summarise

A

On examination a x a x year old male. There were no abnormalities on inspection, palpation or active and passive movements of the elbow. In summary this was a normal elbow examination.

24
Q

Elbow: How would you complete the examination

A

Examine shoulder and wrist

Neurovascular examination of the upper limb

25
Q

Hand: How should you prepare the patient

A

Get them to place their hands on a pillow

26
Q

Hand: What are you looking for (on the backs)

A

Scars and swelling
Deformity
Skin and nail changes
Muscle wasting

27
Q

Hand: What are you looking for (on the front)

A

Scars and swelling
Thenar and hypothenar wasting
Dupuytrens contracture

28
Q

Hand: What are you looking at the elbows for

A

Psoriatic plaques

Rheumatoid noduels

29
Q

Hand: What are you feeling for

A 
Joint temperatures
Ulnar and radial pulses
Thenar and hypothenar muscle bulk 
Test sensation.
Squeeze all MTPs
Squeeze each joint individually (fingers and wrist)
Palpate anatomical snuffbox
Palpate ulnar border of each arm to the elbow
30
Q

Where do you touch to test median nerve

A

Base of thumb

31
Q

Where do you touch to test ulnar nerve

A

Base of little finger

32
Q

Where do you touch to test radial nerve

A

Back of base of thumb

33
Q

What does tender anatomical snuffbox suggest

A

Scaphoid fracture

34
Q

Hand: How should the patient move

A

Finger flexion and extension
Wrist extension and flexion
Passive wrist flexion and extension (checking for crepitus)
Passive finger extension (against resistance)
Passive finger abduction (against resistance)
Thumb abduction (to ceiling, against resistance)

35
Q

Which nerve causes finger extension

A

Radial nerve

36
Q

Which nerve causes finger abduction

A

Ulnar nerve

37
Q

Which nerve causes thumb abduction

A

Median nerve

38
Q

Hand: How do you test function

A 
Squeeze fingers
Pincer grip
Observe the patient picking up a coin
Tinels test
Phalens test
39
Q

What is tinels test

A

Tap wrist and test for tingling or pain

40
Q

What is phalens test

A

backs of hands together for 30s

41
Q

Hand: How to conclude the examination

A

On inspection of the hands they had a normal appearance with no evidence of scars, deformity or muscle wasting. On palpation there was a normal temperature and no tenderness. Sensation was entact and there was a normal range of movement.

42
Q

Hand: How to complete the examination

A

Full neurovascular assessment of the upper limb

Examine the elbow

2b (28 decks)

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