MSK 1 Flashcards
1
Q
greenstick fracture
A
only one side of the bone is broken, more common in long bones of children
2
Q
referral pattern for liver and lung
A
neck/shoulder
3
Q
boxer’s fracture
A
5th MC
4
Q
Maitland grades of mobilization
A
1, 2, 3, 4, 5 is thrust
basketball court
5
Q
anterior interosseous syndrome
A
median n.
motor only
pinch grip test
6
Q
nerve injury levels
A
- neuropraxia
- axonotmesis
- neurotomesis: full neuron and sheath
7
Q
biceps femoris reflex level
A
S1
8
Q
boyes test
A
for central tendon rupture
+ inability to flex DIP
boutonnière deformity
9
Q
cervical spinal manip screen
A
- signs of UMN lesion
- vertebral artery/ligament instability testing
- bilateral radicular symptoms
10
Q
MMT grading
A
0= no contraction 1= trace 2- = initiates movement gravity eliminated 2= full ROM in gravity eliminated 3= full ROM against gravity 3+ = minimal resistance 4= moderate resistance 5= max resistance
11
Q
myositis ossificans
A
atypical bone formation in elbow or thigh
12
Q
spaces where TOS can happen
A
- interscalene triangle
- costoclavicular space
- subpectoralis minor space
13
Q
what phase are patients in with dynamic splints for tendon repair?
A
repair phase
14
Q
biceps brachii reflex level
A
C5
15
Q
gangrene
A
death of tissue due to loss of vascularity
16
Q
beighten scale parts and score
A
- pinky (2)
- thumb (2)
- elbow (2)
- knee (2)
- hamstring (1)
4/9 is hyper mobility syndrome
17
Q
spiral groove syndrome
A
radial n.
wrist drop
radial n. sensory deficits
18
Q
symptoms of carpal tunnel
A
weakness and atrophy of thenar mm., sensory changes/pain, positive phalen’s and reverse phalen’s, tinel’s and direct compression
19
Q
ulnar collateral testing
A
moving valgus stress test
valgus stress test
milking maneuver
stand up test (posterior band)
20
Q
game keepers thumb
A
sprain of UCL at MCP
valgus stress test
21
Q
secondary bone healing
A
4 stages of healing
- hematoma formation (inflammation stage)
- soft callus formation (proliferative stage, 3-4 week formation)
- hard callus formation (maturing or modeling phase, 2-3 months) CLINICAL UNION
- bone remodeling (woven into stronger bone)
22
Q
secondary OA
A
specific cause (injury, obesity, genetics)
23
Q
claw finger
A
intrinsic mm. wasting, either ulnar or median n., occurs when asked to extend fingers
24
Q
chronic fatigue syndrome
A
general fatigue more than 6 months, reduction in activity ability, unrefreshing sleep AND cognitive impairment OR orthostatic hypotensin
25
pain location for dequervain's syndrome
radial styloid process
26
C-spine manip rules
- symptoms less than 38 days
- think it will help
- rotation difference 10 degrees or greater
- pain with spring testing
27
arthrodesis
fusion
28
DVT probability: wells criteria
+1 for...
- active cancer
- paralysis/paresis/immobilization
- bedridden recently
- localized tenderness along deep vein
- calf swelling 3cm
- pitting edema in painful leg
- collateral superficial veins
- previous DVT
-2 for alternative diagnosis
2 or more DVT likely
29
which is worse proximal, middle, or distal scaphoid fracture?
proximal takes longest to heal 12-23 weeks
30
special tests for lateral epicondylalgia
pain-free grip
Cozen's test
Mill's test
resistance of 3rd digit (maudsley's)
31
brachioradialis reflex level
C6
32
distal bicipital tendon rupture signs
swelling and bruising
tenderness over radial tubercle
pain with elbow flexion or supination
Popeye deformity
33
what muscles does the median n. innervate past the wrist
abductor pollicis brevis
flexor pollicis brevis
opponens pollicis
lumbricals 1 and 2
34
TFCC tests
piano key test on ulna
| supination lift test
35
body weight at water levels...
```
C7 = 10%
zyphoid = 30%
ASIS = 50%
```
36
grading scale for joint play
```
0 = no movement
1 = decrease in motion
2 = slight decrease
3 = normal
4 = slight increase
5 = increase in motion
6 = complete instability
```
37
lumbar spinal manip screen
- unexplained weight loss
- severe unremitting pain
- b/b dysfunction
- bilateral radicular symptoms
38
wartenberg syndrome
superficial radial n. entrapment...
pain/paresthesia over radial dorsal wrist, grip aggravates
differential: dequervain's
39
compound fracture
breaks through skin
40
triceps reflex level
C7
41
adhesive capsulitis stages
1: painful/pre-adhesive
2: freezing/adhesive
3: frozen/fibrotic
4: thawing stage
42
ape hand
thenar eminence wasting, median n. palsy
43
signs of TSA prosthetic loosening
- increased pain
- instability
- decreased ROM
44
insufficiency stress fracture
normal activity on poor bone quality
45
sweater finger
extended DIP, flexor profundus rupture
46
bunnel-littler test
test for capsule vs. intrinsic m. tightness
if PIP restricted w/ both then capsular tightness
if PIP only restricted with MCP ext., team intrinsic mm.
47
integumentary screening questions
- unusual or new moles
- fever or night sweats
- swelling or redness in any joint
- pregnancy
48
dx of knee OA
knee pain + radiograph charges + one of ...
- older than 50
- morning stiffness
- crepitus
49
dx of hip OA
older than 50
morning stiffness
15 degree difference in IR and flexion
50
colles fracture
distal radius
51
AC separation types
1: sprain of AC
2: ruptured AC, sprain of coracoclavicular
3: both sets ruptured
4: clavicle posterior
5: clavicle superior
6: clavicle inferior
52
indications for wrist arthroplasty
severe pain, instability, deformity
53
cyriax pain and inflammation with passive range
pain before resistance --> acute inflammation
pain with resistance --> subacute inflammation
resistance prior to pain (overpressure) --> mild or chronic inflammation
54
wartenburg's syndrome
superficial radial n.
sensory only/pain
mimics de quervian syndrome (pain with thumb flex and ulnar deviation)
55
BMD score osteoporosis
T score -2.5 or lower
| FRAX score
56
cancellous bone
ribs, pelvis, vertabrae
| -heal faster
57
psychological screening questions
- changes in mentation
- LOC
- attention
- orientation
- judgement
58
semitendinosus reflex level
S2
59
primary bone healing
approximation of bone fragments from surgery
60
radiographic healing
- callus size
- cortical continuity
- progressive loss of fracture line on x-ray
61
osteomyelitis
bone infection
62
kaltenborn's grades of mobilization
1: loosening, unweighting
2: tightening, taking up slack
3: stretching capsule
63
cardiovascular screening questions
- SOB
- dizziness
- heaviness in chest
- pulsating pain
- constant pain in lower leg
- discolored or painful feet
- swelling with MOI
64
carpel tunnel stages
- preclinical: symptoms only with prolonged activity
- mild: night N&T
- moderate: constant N&T, pain at night
- severe: constant, atrophy
65
zigzag deformity
flexion of CMC, hyperextension of MCP
66
tests for medial epicondylalgia
resisted elbow flexion
passive wrist extension
valgus stress test
67
allen test
circulatory testing
open and close hand
occlude radial and ulnar a.
let one go compare bth
68
cyriax lesion type
- painful and strong= minor lesion
- painful and weak= major lesion
- painless and weak= total rupture or neurologic lesion
- painless and strong= normal
69
pronator syndrome
median n.
sensory only
tests: resist pronation, extend elbow
70
mill's test
passive wrist flexion stretch
| + for lateral epicondylalgia
71
extrinsic primary RTC tendinopathy
mechanical compression of tissue and can result from loss of stability of shoulder
72
clinical healing
- absence of pain at site
- no pain on weight bearing
- return to normal limb function
73
tests for ulnar n. dysfunction in the hand
formet's sign (IP flexion while holding paper)
Jeanne's sign ( MCP extension in pinch grip)
wartenburg's sign (unable to adduct 5th digit)
74
synovitis
wrist, hand, fingers, tendon f the digits
75
extrinsic internal RTC tendinopathy
compression of supraspinatus between glenoid and humerus, usually in throwers
-20 degrees GIRD is risk factor
76
GI/GU screening questions
- frequent or severe abdominal pain
- frequent heartburn or indigestion
- nausea or vomiting
- change in B/B
- unusual menstrual irregularities
77
smith's fracture
distal segment displaced anteriorly
78
osteotomy
realigns joint surfaces
79
simple fracture
not breaking through skin
80
primary OA
wear and tear with time
81
what is important to remember about total elbow arthroplasty
protect tricep since it gets cut (10-12 weeks before isolated tricep work)
82
referral pattern for gallbladder and stomach
thoracic/rib
83
saltar harris fracture
fracture involving growth plate
84
radial tunnel syndrome
posterior interosseous n. --> radial n.
| mimics lateral epicondylitis
85
olecranon bursitis signs
pain with end range flexion
| student's elbow
86
contraindications of massage
- acute inflammatory disease
- infection of skin
- open wounds
- acute thrombophlebitis
- localized malignancy
- congestive heart failure
87
supracondylar process syndrome
ligament of strutters compression
| very rare
88
referral pattern for heart
men: L shoulder, throat, jaw, neck
women: R shoulder and R arm
89
Guyon tunnel compression
ulnar n.
sensory to hand
wartenberg's SIGN
often from longterm crutch use
90
what zone is bad for flexor tendon lacerations
zone 2
there are 5 for fingers and 3 for thumb
91
cubital tunnel syndrome
```
ulnar n.
positive tinel's
wartenberg's sign
elbow flexion test (provocation and weakness)
throwers
```
92
what is intrinsic RTC tendinopathy?
age-related degeneration
- very rare to have purely intrinsic, likely partly something else
- articular side
93
bishops hand
occurs when asked to make a fist
median nerve palsy
can't close the fingers 1-3
94
lateral collateral testing
varus stress test
95
cozen's test
resisted wrist extension
| + for lateral epicondylalgia
96
referral pattern for kidney and appendix
low back/flank
97
common avascular necrosis sites
proximal femur and humerus, and scaphoid neck
98
algometry
reliable pain measurement
99
colles fracture
distal segment displaced dorsally, more common
100
supinator syndrome
posterior interosseous n. --> radial n.
thumb and finger ext. weakness
motor only
101
types of wrist instability
volar/dorsal intercalated segmental instability (VISI/DISI)
| TFCC
102
patellar reflex level
L4
103
achilles reflex level
S1
104
Outerbridge classification for OA
```
0=normal cartilage
1=cartilage with softening and swelling
2=fragmentation of 1/2 in or smaller
3=fragmentation more than 1/2 in
4=erosion of cartilage down to bone
```
105
remodeling stage of healing
4-8 weeks, no inflammation
106
proliferation/repair stage of healing
5-28 days
| active scar formation from fibroblasts laying down collagen
107
extension test for elbow fracture
if they can get full extension its really unlikely that they have an elbow fracture
108
deep tendon reflex testing grading
```
0= absent
1= diminished
2= normal
3= exaggerated
4= clonus
```
109
fibromyalgia syndrome
chronic widespread muscle pain, fatigue, and multiple tender points
110
oncologic screening questions
- persistant night pain
- constant pain anywhere
- unexplained weight loss
- loss of appetite
- unusual lumps or bumps
111
joint mob contraindications/precautions
C:unstable/hypermobile joints (spondylolithesis)
P: joint effusion, inflammation, pregnancy, generalized hyper mobility, osteoporosis
112
neurologic screening question
- changes in hearing
- severe headaches
- swallowing or speech difficulties
- changes in vision
- balance or coordination probs
- fainting spells
- sudden weakness
- onset of saddle paresthesia
113
bennett's fracture
base of 1st MC
