Introduction to Musculoskeletal/Neuro Exam

Question 1

joints

Answer 1

cartilagenous, fibrinous, and synovial

Question 2

ligament

Answer 2

bone to bone

-poor blood supply

Question 3

tendon

Answer 3

muscle to bone

-good blood supply

Question 4

bursa

Answer 4

synovial pouch

• cushion and decrease friction at joint
• will stop motion with significant inflammation

Question 5

exam of major joints

Answer 5

inspect, palpation, range of motion, muscle strength

Question 6

inspection of joint?

Answer 6

symmetry, alignment, bony/tissue deformities, redness, swelling

Question 7

palpation of joint?

Answer 7

temperature, texture, crepitus, tenderness

Question 8

range of motion of joint

Answer 8

joint function and stability, integrity of ligaments, tendons, burs,a especially if pain or trauma

Question 9

active vs. passive range of motion

Answer 9

defined from patient’s action, not yours

Question 10

TMJ

Answer 10

temporomandibular joint

Question 11

TMJ exam?

Answer 11

inspect for symmetry, swelling, redness, lumps
observe resting and normal activity
palpate clicking, tenderness
strength - clench teeth
range of motion - open/close

Question 12

pain vs tenderness?

Answer 12

pain - what patient tells you

tenderness - pain that you create

Question 13

rotator cuff

Answer 13

supraspinatus, infraspinatus, teres minor, subscapularis

Question 14

shoulder exam

Answer 14

inspect symmetry of bones and muscles

• include anterior, side, and posterior
• normal walking and conversation

**do while sitting and standing

palpate for tenderness, masses, bony structure symmetry, crepitus

range of motion

Question 15

crepitus

Answer 15

like you are popping tiny bubbles under skin surface

-associated with some amount of swelling

Question 16

range of motion of shoulder

Answer 16

flexion, extension, abduction, adduction, internal rotation, external rotation, circumduction

Question 17

shoulder

Answer 17

rotator cuff and subacromial bursa

Question 18

most common rotator cuff injury?

Answer 18

supraspinatus

Question 19

test for supraspinatus

Answer 19

“empty can test”

arms out thumbs down
-put pressure downward against arm

Question 20

test for infraspinatus and teres minor

Answer 20

elbows in and resist external rotation

Question 21

test for subscapularis and pectoralis

Answer 21

elbows in and resist internal rotation

Question 22

test for subscapularis

Answer 22

bear hug

hand over opposite shoulder then attempt to pull it away

also lift off

• hand over lumbar
• resist lifting arm off back

Question 23

neer’s sign

Answer 23

sign of impingement

palpate acromion and bring arm into flexion

pain indicates impingement of rotator cuff

Question 24

hawkin’s sign

Answer 24

sign of impingement

rotate head of humerus internally to pinch ligaments into acromion by greater trochanter

Question 25

exam of elbow

Answer 25

inspect and palpate range of motion

Question 26

range of motion of elbow

Answer 26

flexion/extension pronation/supination radial/ulnar deviation

Question 27

golfers elbow

Answer 27

medial epicondyle

Question 28

tennis elbow

Answer 28

lateral epicondyle

Question 29

olecranon bursitis

Answer 29

trauma, overuse, infection, arthritic condition

Question 30

wrist and hand exam

Answer 30

inspect/observe | palpate skin, soft tissues, JOINTS, and masses

Question 31

range of motion of wrist

Answer 31

flexion/extension | ulnar/radial deviation

Question 32

range of motion of fingers

Answer 32

flexion/extension/abduction/adduction

Question 33

range of motion of thumb

Answer 33

flexion/extension/abduction/adduction also opposition**

Question 34

most common place of osteoarthritis?

Answer 34

carpometacarpal joint

Question 35

game-keepers thumb

Answer 35

ulnar collateral ligament (ski pole)

Question 36

synovial thickening

Answer 36

occurs in arthritis

Question 37

snuff box

Answer 37

scaphoid tender to direct palpation

Question 38

test for carpal tunnel

Answer 38

*patients complaining of dropping things tinels sign and phalens test

Question 39

tinels sign

Answer 39

tap on nerve for carpal tunnel

Question 40

phalens test

Answer 40

dorsum of hands (reverse prayer) test for carpal tunnel

Question 41

inspection of spine

Answer 41

from the side -normal curves from behind - upright spinal column - alignment - skin markings, tags, or masses

Question 42

sciatic nerve

Answer 42

through pelvis normal cause of pain

Question 43

range of motion of neck

Answer 43

flexion/extension rotation sidebending

Question 44

thoracic/lumbar range of motion

Answer 44

flexion/extension rotation sidebending

Question 45

sciatica

Answer 45

shooting pain down leg, constant or intermittent -straight leg raise can be a positive test (60 degree) central vs. peripheral impingement -positive test = central impingement

Question 46

true hip pain?

Answer 46

in the groin

Question 47

inspection of hip?

Answer 47

swing - foot moving when walking | stance - foot on the ground

Question 48

hip range of motion

Answer 48

flexion/extension abduction/adduction external/internal rotation

Question 49

NAVEL

Answer 49

nerve, artery, vein, empty space, lymph nodes

Question 50

medial ligament of ankle?

Answer 50

deltoid ligament

Question 51

lateral ligaments of ankle?

Answer 51

posterior talofibular anterior talofibular calcaneofibular ligament

Question 52

major muscle groups

Answer 52

``` upper arm flexor and extensor lower arm flexor and extensor upper leg flexors/extensors plantar flexors dorsiflexors ```

Question 53

muscle strength chart?

Answer 53

0 - no contraction 1 - barely detectable flicker of contraction 2 - active movement of body with gravity eliminated 3 - active movement against gravity 4 - active movement against gravity and some resistance 5 - active movement against full resistance without evident fatigue (normal muscle strength)

Question 54

paresis

Answer 54

weakness or imcomplete paralysis

Question 55

paralysis

Answer 55

loss of voluntary movement

Question 56

spasticity

Answer 56

increased muscle tone dependent on rate of movement

Question 57

rigididty

Answer 57

increased resistance that persists throughout movement

Question 58

flaccidity

Answer 58

loss of muscle tone

Question 59

bradykinesia

Answer 59

slow movement

Question 60

tremor

Answer 60

repetitive oscillatory movement resting (involuntary) and intention

Question 61

nystagmus

Answer 61

rhythmic oscillation of eyes

Question 62

ataxia

Answer 62

uncoordinated movement that isn't smooth in appearance

Question 63

involuntary movement

Answer 63

spontaneous movements that aren't intentional

Question 64

PNS sensory testing

Answer 64

soft and sharp testing of peripheral and dermatomes

Question 65

deep tendon reflexes

Answer 65

use reflex hammer | -strike with brisk direct movement

Question 66

biceps reflex?

Answer 66

C5-6

Question 67

triceps reflex?

Answer 67

C6-7

Question 68

Supinator or brachioradialis reflex?

Answer 68

C5-6

Question 69

Knee reflex?

Answer 69

L2-L4

Question 70

Ankle Reflex

Answer 70

S1

Question 71

Clonus

Answer 71

hyperactive response required for assigning a reflex grade of 4 (usually achilles)

Question 72

grading of reflex

Answer 72

0 - no response 1 - somewhat diminished, low normal 2 - average, normal 3 - brisker than average, not necessarily indicative of disease 4 - brisk, hyperactive, may have clonus (rhythmic oscillations between flexion and extension)

Question 73

anesthesia

Answer 73

loss of sensation

Question 74

paresthesia

Answer 74

abnormal sensation such as burning, prickling, or tingling

Question 75

dysesthesia

Answer 75

abnormal or disagreeable sensations produced without stimuli or with stimuli that generally don't cause such altered sensations