Chapter 17 muscularskeletal

Question 1

common disorders

Answer 1

bursitis: inflammation of bursa-knee, shdldr, elbow; pain and swelling at joint d/t kneeling, repetitive motion
carpal tunnel syndrome: pressure on nerves up the wrist; numbness, tingling thumbs and fingers esp. at night; repetitive work with bent wrist or vibrating tools
ganglion: cyst at joint, usually at back of hand or wrist; hard, small, painless; repetitive movements
tendonitis: inflammation of area where muscle and tendons join; pain, swelling, redness, difficulty using; repetitive movements
tenosynovitis: inflammation of tendon and tendon sheath; aching, tenderness, swelling; repetitive nonstrenous movements
trigger finger: inflammation of tendon/tendon sheaths of fingers; unable to move fingers smoothly or without pain; caused by repetative movements, gripping too long or tightly

Question 2

types of joints

Answer 2

hinge: movement of flexion and extension, elbow
pivotal: rotation along long shaft, proximal radialulnar joint
condyloid: “egg and spoon”, movement on 2 axis, wrist joint
saddle: aka biaxial joint, carpometacarpal joint of thumb (similar to condyloid)
ball-and-socket: hip, shoulder
plane: flat, one bone slides on top of other, patellofemoral joint

Question 3

common symptoms

Answer 3

pain-disorders of bone, muscles, or joints
weakness: differentiate from fatigue, distal or proximal muscle groups?
deformity-congenital vs. recent
limited ROM-d/t changes in articular cartilage, scarring of joint capsule, muscle contracture
stiffness-most common complaint
joint clicking-associated with certain movements

Question 4

primary movements of shoulder

Answer 4

forward flexion
extension
abduction
internal and external rotation

Question 5

common shoulder problems

Answer 5

impingement: usually rotator cuff problems, tendonitis, bursitis
instability: glenohumeral joint-including ligaments and muscles
rotator cuff tear v tendonitis

Question 6

Impingement of shoulder

Answer 6

Most common complaint
Normal wear and tear of rotator cuff tendons and tissue
-primary site is subacromial area
-can start as edema or hemorrhage d/t overuse or to more severe-full thickness rotator tear

Question 7

Elbow disorders

Answer 7

-usually soft tissue disorders including lateral and medial epicondylitis

Question 8

Lateral epicondylitis

Answer 8

-tennis elbow
Common in dominant arm
-caused by repetitive movements
-partial tearing of tendon
-symptoms: dull ache, worsening by grasping, localized, may radiate down forearm

Question 9

primary movements of shoulder

Answer 9

forward flexion
extension
abduction
internal and external rotation

Question 10

common shoulder problems

Answer 10

impingement: usually rotator cuff problems, tendonitis, bursitis
instability: glenohumeral joint-including ligaments and muscles
rotator cuff tear v tendonitis

Question 11

Carpal tunnel syndrome

Answer 11

• entrapment/compression of medial nerve in carpal canal

- idiopathic, associated with diabetes, hypothyroidism, alcoholism, RA, repetitive motion

Question 12

Trigger finger

Answer 12

• formation of scar tissue around flexor tendon

- finger catches or locks in flexed position

Question 13

Fracture of hip

Answer 13

• common in patients over 50
• usually s/p fall
• most cur I proximal femur

Question 14

Bursitis of hip

Answer 14

• trauma most common cause
• 40-60 yo men and women
• localized pain extending to knees or lower back

Question 15

Anterior cruciate ligament tear of knee

Answer 15

• injured by direct blow or indirect stress of ligament
• sudden pop of knee, unable to straighten leg
• sudden onset
• positive Lachman’s or drawer test

Question 16

Posterior cruciate ligament tear

Answer 16

Less common than all

-use posterior drawer test

Question 17

Ankle sprains

Answer 17

Most common ankle injury
Grade I: stretching of ligament, no tear
II: some tearing(bruising) some functional limitations
III: severe, complete disruption of ligaments, joint instability

Question 18

Achilles’ tendon rupture

Answer 18

• sudden sharp pain
• sudden swelling
• weakness in ankle
• thompsons test

Question 19

test for achilles tendon

Answer 19

thompson test: squeeze calf while patient prone will cause plantar flexion of foot-intact achilles

Question 20

Tests for ankle lateral sprains

Answer 20

anterior drawer tests: tests integrity of talofibular ligament
inversion stress test: tests integrity of calcaneo-fibular ligament

Question 21

tests for syndesmotic ankle injury

Answer 21

squeeze test

external rotation test

Question 22

yergason’s test

Answer 22

shoulder evaluation

detects long head bicep irritation or transverse humeral ligament issues

Question 23

speed’s test

Answer 23

shoulder evaluation

long head bicep tendon

Question 24

drop arm test

Answer 24

shoulder evaluation

problems with supraspinatus tendon

Question 25

apprehension/relocation test

Answer 25

shoulder evaluation | potential resubluxating or dislocated-instability

Question 26

thrower's tests

Answer 26

shoulder eval | anterior capsular laxity

Question 27

sulcus test

Answer 27

instability of shoulder | sulcus sign

Question 28

empty can test

Answer 28

shoulder eval | specific trauma to supraspinatus muscls: tendon irritation, impingement/tear

Question 29

ottawa ankle rules

Answer 29

- guidelines for xray - presents within 10 days of injury - unable to bear weight at time of injury or in office - tenderness of distal 6 cm of malleoli on posterior - tenderness over base of 5th met or navicular bone