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MM Test 3 > B6.043 MSK Exam > Flashcards

B6.043 MSK Exam Flashcards

(78 cards)

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1
Q

major components of MSK system with clinical relevance

A 
joint movements
ligaments
muscles
tendons
cartilage
synovial fluid
bursae
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2
Q

related history to injury

A 
sensation at time of injury
impairment
mechanism of injury
pain (qualifiers and quantifiers)
swelling (immediate or delayed)
bruising (temporal relationship to injury)
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3
Q

related PMH for MSK exam

A

trauma
surgery
chronic illness
congenital anomalies

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4
Q

related FH for MSK exam

A

congenital anomalies of hip/foot
scoliosis/back problems
arthritis
genetic disorders

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5
Q

goniometer

A

used to measure range of motion of a joint

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6
Q

characteristics of ROM on exam

A

PROM may exceed active ROM by 5 degrees

active ROM/passive ROM should be equal in contralateral joints

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7
Q

basics of exam for muscle strength

A

compare bilateral muscles (strength, symmetry, equality, resistance)
muscle function levels/grades

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8
Q

manual muscle testing grades w/ associated functions

A

0- no activation
1- trace activation, twitch
2- activation with gravity eliminated, achieving full ROM
3- activation against gravity, full ROM
4- activation against some resistance, full ROM
5- activation against examiners full resistance, full ROM

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9
Q

joint motions examined

A 
flexion/ extension/ hyperextension
internal/ external rotation
ABductoin/ADduction
lateral motions
special motions related to a specific joint
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10
Q

inspection of elbow

A

contour
carrying angle
-males = 5 deg
-females= 10-15 deg

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11
Q

palpation of elbow

A

landmarks for tenderness (head of radius, olecranon, epicondyles)
swelling
thickening

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12
Q

ROM of elbow

A

flexion
extension
pronation
supination

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13
Q

moving valgus stress test

A

shoulder at 90 degrees abduction and external rotation
apply valgus torque to elbow (pushing forward), elbow is flexed and extended
pain = positive test

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14
Q

function of moving valgus stress test

A

diagnosing UCL injuries

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15
Q

milking maneuver

A

shoulder at 90 degrees abduction and external rotation

apply valgus torque to elbow (pushing forward) and gently pull thumb in posterior direction

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16
Q

function of milking maneuver

A

additional info about possible UCL injurt

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17
Q

function of middle finger test

A

assess for lateral epicondylitis if isolated pain at lateral epicondyle

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18
Q

inspection of shoulder

A 
size
symmetry
contour
dislocation
winging of scap
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19
Q

palpation of shoulder

A

bone (acromion, coracoid)
joints (AC joint)
muscles

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20
Q

ROM assessment of shoulder

A 
forward flexion
hyperextension
abduction/adduction
internal/external rotation
shrug
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21
Q

internal rotation of shoulder

A

ROM through body plane and hand on back of L spine
reach up back with thumb
nondominant side has greater ROM

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22
Q

external rotation of shoulder

A

ROM normal 45-60 deg

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23
Q

position of arm when testing both internal and external shoulder rotation

A 
shoulder at 0 deg
elbow at 90 deg
OR 
shoulder at 90 deg
elbow at 90 deg
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24
Q

Yerguson test

A

place patients hand with palm facing up and grasp their hand in yours
instruct patient to hold and flat and not let you turn it over
attempt to pronate patients hand against their resistance

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25
function of Yerguson test
tenderness with supination of forearm against resistance is indicative of bicipital tendinitis
26
empty can test
extend elbows fully while you move their arms into a position of 70-80 deg of abduction and 30 deg of forward flexion turn thumbs down as if emptying a can pt cannot hold affected arm at 90 deg of abduction against resistance
27
function of empty can test
supraspinatus test | pain or inability to resist downward pressure
28
neer impingement sign
place hand on top of patient's acromion to stabilize scapula while you grasp the forearm with arm relaxed and palm facing down, passively flex the shoulder anteriorly, raising the arm overhead
29
function of neer impingement sign
compresses the greater tuberosity against the anterior undersurface of the acromion, compressing the superior rotator cuff (supraspinatus) near its insertion pain may indicate inflammation, overuse injury, or tear of rotator cuff
30
Hawkins Kennedy test
place one hand on top of patients acromion to stabilize scapula passively flex the shoulder to 90 deg of flexion with forearm parallel to the floor internally rotate the humerus by moving the hand toward the floor
31
function of Hawkins Kennedy test
compresses the greater tuberosity against the anterior undersurface of the coracoacromial ligament, compressing the superior rotator cuff (supraspinatus) near its insertion complementary to Neer test
32
drop arm test
arm is raised passively to 160 deg patient asked to slowly lower arm inability to lower = positive test
33
function of drop arm test
may indicate a large rotator cuff tear
34
infraspinatus/ teres minor test
hold arms at sides with elbows flexed 90 deg actively externally rotate against resistance positive test is weakness compared with contralateral side
35
lift off test
arm internally rotates behind the patients lower back | patient internally rotates against examiners hand
36
function of lift off test
inability to lift hand off back may indicate subscapularis tendinopathy or tear
37
cross body adduction test
arm is passively adducted across the patients body toward the contralateral shoulder
38
function of cross body adduction test
pain main indicate AC joint pathology, including chronic sprain or OA
39
hip inspection
symmetry (muscle mass, hip rotation and height) size gluteal folds ability to bear weight - gait assessment
40
hip palpation
stability | tenderness
41
hip ROM
flexion/extension hyperextension abduction/adduction internal/external rotation
42
hip muscle assessment
``` strength function symmetry ```
43
how can you increase hip flexion
by also flexing knee 90 deg without knee flexed 120 deg with knee flexed
44
how to test hip rotation
flex knee while seated | move foot inward and outward (foot inward = hip external rotation and vice versa)
45
FAB-ER test / Patrick test
flexion, abduction, external rotation examiner moves leg into 45 deg of flexion (while pt is laying down) and then externally rotates and abducts the leg so that the ankle is proximal to the knee of the contralateral leg
46
function of FAB-ER test
looks for labral tears
47
FAD-IR / impingement test
flexion, adduction, internal rotation | examiner passively moves leg into full flexion and then into adduction and internal rotation
48
function of FAD-IR
looks for labral tears
49
log roll test / Freiberg test
passive supine rotation | patients leg is extended and relaxed on exam table as the examiner internally and externally rotates the leg
50
function of log roll test
looks for slipped capital femoral epiphysis
51
knee inspection
landmarks concavities (loss = effusion) alignment
52
palpations of knee
swelling tenderness bogginess crepitus
53
ROM assessment of knee
flexion extension hyperextension
54
patellar tap test
press the patella against femoral condyles
55
function of patellar tap test
indicates fracture vs. inflammation
56
apprehension test
laterally displace patella | should be laxity in relaxed extension of the knee
57
function of apprehension test
in a positive test, patient will guard against movement | indicates potential instability or history of subluxation
58
anterior drawer test
place pts knee at 90 deg of flexion with hip flexed at 45 deg anchor foot to prevent forward movement (sit on it) relax hamstrings grasp superior aspect of lower leg and gently pull forward displacing tibia anteriorly evaluate for endpoint and forward motion
59
function of anterior drawer test
for ACL integrity | Lachman's test more sensitive
60
posterior drawer test
similar to anterior drawer but displace tibia posteriorly | for PCL integrity
61
Lachman test
flex knee at 20 deg, hamstrings relaxed | stabilize distal femur with one hand and pull forward using a short quick motion on the proximal tibia with the other
62
function of Lachman test
most sensitive test for ACL test | with torn ACL, translation is noted and end point is soft or mushy
63
MCL test
hold ankle with one hand while other hand support the leg at level of knee valgus stress applied at ankle (push knee medially and pull ankle laterally) test at both 30 and 0 deg of knee extension
64
LCL test
varus stress applied at ankle (push knee laterally and ankle medially) small motions test at both 30 and 0 deg of knee flexion
65
Apley grind test
``` patient lie prone on exam table flex knee 90 deg grasp foot in palm apply downward pressure on the sole of foot to axially load lower leg rotate leg in grinding motion ```
66
function of Apley grind test
pain indicates meniscal pathology (tear)
67
McMurray test
used to test medial and lateral meniscys
68
iliotibial bad syndrome
occurs frequently in runners or cyclists caused by a combo of overuse and biomechanical factors exam shows tenderness over the lateral aspect of the knee about 2 cm above the joint line
69
Ober test
patient lays on side w affected leg on top examiner stabilized the pelvis with one hand and moves the tested leg into knee flexion, hip abduction, and extension THEN lower the leg into adduction until it stops via soft tissue stretch, posterior rotation of the pelvis, or both
70
function of Ober test
positive if the tested leg fails to adduct parallel to the table in a neutral position
71
Osgood Schlatter
pain is elicited on palpation of anterior tibial tuberosity
72
ankle inspection
contour/position alignment weight bearing arch
73
ankle palpation
heat swelling tenderness
74
ankle ROM
flexion/extension | inversion/eversion
75
ligaments of ankle to palpate
anterio talofibular posterior talofibular calcaneofibular medial ligament of ankle (deltoid)
76
thompsons test
squeeze thigh and see if foot moves | tests integrity of achilles
77
anterior drawer test of ankle
tests anterior talofibular ligament
78
talar tilt test of ankle
``` invert foot (no endpoint = tear, pain = sprain) tests integrity of calcaneofibular ligament ```

MM Test 3 (31 decks)

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