derm/ MSK Flashcards
(44 cards)
what are the general steps of an MSK examination
introduction
look
feel
move
special test
closure
what are you looking for in a hip examination
Quadricep/hamstring/gluteal muscle mass
gait: pace, symmetry, trendeleburg test
erythema, swelling, bruising, scar
what are you feeling for in a hip examination
Greater trochanter
Groin (mid-point and medially)
what is the patient moving in a hip examination
Flexion 100-130degrees
Internal rotation 15 degrees External rotation 40 degrees Adduction 15 degrees
Abduction 45 degrees
(only flexion is active)
what is the trendelenburgh test for in hip examination
assesses hip abductor muscle strength (gluteus medius, gluteus minimus and tensor fascia lata
how is trendelenburg test conducted
hold patient hands, tell them to balance on one feet, if hips tilt, abductor muscle on standing feet is weak
what is Thomas’s test for in hip examination?
identifies a fixed flexion deformity (incomplete extension) at the hip, when flexing, other leg raise on the bed= positive
what are the areas being looked at during shoulder examination
anterior, lateral, posterior, axilla
muscle wasting, asymmetry, scars, bruising, swelling
what are you feeling for in a shoulder examination
Sterno-clavicular joint, clavicle acromio-clavicular joint, acromion,
Long head of biceps Scapula (spine and body)
what is the move step of a shoulder examination
flexion
abduction
Internal rotation (record vertebral level reached)
external rotation
(do active, if abnormal do passive)
what does active/ passive movement reduce mean
active only: muscle weakness
active and passive: arthritis, capsulitis
what are the 2 routes of a shoulder examination
- arthritic, rotator cuff, impingement
- instability, subluxation, disclocation
what is the scarf test?
acromioclavicular joint
ask to patient to chock them self position, push their arm see if it hurts
what are the 3 tests for suspected rotator cuff problems
Supraspinatus Jobe’s test
Infraspinatus (arms on side push out)
Subscapularis (arm behind)
(muscle weakness= positive )
how is Supraspinatus Jobe’s test done?
shoulder abducted and slightly flexed forward, point thumb towards the floor.
you push down on their forearms
how is Infraspinatus test done
test power of external rotation against the resistance of your hand pushing against the patient’s forearm.
how is Subscapularis test done
test power of internal rotation patient to put their hands behind their back push their palm, tell them to resist
what are the tests for Suspected shoulder instability
Test for the sulcus sign
Anterior and posterior drawer tests
Anterior apprehension and relocation test
how is the sulcus sign test done
on hand stabilize shoulder, other pull down on arm
if femur head translate inferiorly= positive sign
how is the anteior and posterior drawer tests done
patient in bed, one hand stabilize shoulder, other pull arm anterior and posterior (up and down)
how is the anterior relocation test done
patient lay down, abduct arm and bend elbow, push arm, if it hurts, push humeral head aswell. (imaging guy through a shot put)
what are you looking for in spine examination
behind: head, neck, shoulder posture
side: cervical lordosis, thoracic kyphosis, lumbar lordosis
ask patient to bend forward
deviation? asymmetry? gibbus?
what are you feeling for in spine examination
supraclavicular: cervical ribs, lymph
spinous process & para-spinal muscles
iliac crest heights & sacroiliac joints
chest expansion for ankylosing spondylitis
what movements are necessary for spine examination (patient should sit down for the first part)
cervical: head to chest and back, head left and right, lateral flexion
lumbar: schooner’s test, back bridge, lateral flexion
