Adult - Musculoskeletal II

Question 1

What condition does compression of the median nerve cause?

Answer 1

Carpal tunnel syndrome

Question 2

Is carpal tunnel more common in men or women?

Answer 2

women

Question 3

What is dorsiflexion of the wrist?

Answer 3

hand in “stop” position

Question 4

Tinel’s sign

Answer 4

tapping the median nerve on the flexor surface of the wrist

+ for carpal tunnel if tingling sensation from wrist to hand is provoked

Question 5

Phalen’s sign

Answer 5

opposite of Namaste hands
hold for 1 minute
+ if symptoms provoked

Question 6

What type of splint is most effective for carpal tunnel syndrome?

Answer 6

“cock up” splint

Question 7

Can corticosteroid injection be used in carpal tunnel?

Answer 7

yes

Question 8

What test can be used to document motor involvement in carpal tunnel syndrome?

Answer 8

electromyography

Question 9

What is the typical pain/complaint of carpal tunnel?
features?
timing?
exacerbation?

Answer 9

numbness
tingling
burning
nocturnal pain
excerbation with dorsiflexion

Question 10

What is the leading cause of lost work days in the US?

Answer 10

low back pain

Question 11

What is the typical pain/complaint of low back pain?

Answer 11

may be localized or radiating
may include: 
numbness
muscle weakness
limp

Question 12

What are two assessment maneuvers that may be done to assess low back pain?

Answer 12

straight leg raise test - one leg at a time

pelvic rock test

Question 13

Which lumbar nerve root dysfunction results in diminished or absent patellar reflex?

Answer 13

L3 - L4

Question 14

Which lumbar nerve root dysfunction results in diminished or absent achilles reflex?

Answer 14

L5 - S1

Question 15

Which lumbar nerve root dysfunction results in pain along the buttocks?

Answer 15

L5 - S1

Question 16

What type of X-ray would be helpful in evaluating low back pain?

Answer 16

AP and lateral

Question 17

Beyond an X-ray what diagnostics might be helpful in low back pain?

Answer 17

CR or MRI

Question 18

Management of low back pain (10)

Answer 18

rest
heat/ice
brace
PT
body mechanics
ultrasound/TENS
NSAIDs 
weight loss
psychosocial
refer

Question 19

Morton’s neuroma

Answer 19

a benign neuroma of an intermetatarsal nerve

most commonly in 3rd or 4th intermetatarsal space

Question 20

What is a common cause of Morton’s neuroma?

Answer 20

Wearing high heels shoes with closed toes

Question 21

What is the common complaint of Morton’s neuroma?

Answer 21

feeling of “standing on a pebble”

Question 22

What are the diagnostics for Morton’s neuroma?

Answer 22

ultrasound

MRI

Question 23

Management of Morton’s neuroma?

Answer 23

orthotics

steroid injection

Question 24

What is the plantar facsia?

Answer 24

o the thick tissue on the bottom of the foot
o connects the heel bone to the toes
o creates the arch of the foot

Question 25

Who most commonly develops plantar fasciitis?

Answer 25

Men 40 - 70 years old

Question 26

What is the common complaint of platar fasciitis?

Answer 26

heel pain and stiffness in the morning pain can be dull or sharp can radiate from the heel to the toes

Question 27

What are the diagnostics for plantar fasciitis?

Answer 27

physical exam | X-ray to rule out other causes

Question 28

Management of plantar fasciitis

Answer 28

``` NSAIDs corticosteriods orthotics night splints PT surgery (very painful) ```

Question 29

"Tibial tubercle apophyseal traction injury"

Answer 29

Osgood-Schlatter

Question 30

Treatment for Osgood-Schlatter

Answer 30

RICE NSAIDs surgery (rare)

Question 31

Define costochondritis

Answer 31

inflammation of the cartilage that connects a rib to the sternum

Question 32

What are the possible causes for costochondritis?

Answer 32

``` o injury o physical strain o URI o infection o fibromyalgia ```

Question 33

An inflammatory disorder involving pain and stiffness in the shoulder and usually also the hip

Answer 33

Polymyalgia rheumatica

Question 34

What are possible causes for polymyalgia rheumatica?

Answer 34

unknown

Question 35

Who is typically afflicted by polymyalgia rheumatica?

Answer 35

those over 50 years

Question 36

In 15% of cases, polymyalgia rheumatica is associated with what other condition?

Answer 36

temporal arteritis

Question 37

What is temporal arteritis characterized by?

Answer 37

headache | high fever

Question 38

Signs and symptoms of polymyalgia rheumatica?

Answer 38

o stiffness of neck, shoulders, and hips o loss of ROM in affected areas o fatigue, anemia, and mild fever

Question 39

Is ESR increased in polymyalgia rheumatica?

Answer 39

yes

Question 40

Management of polymyalgia rheumatica?

Answer 40

corticosteroids | symptomatic management