MSK

Question 1

General Inspection of Spine Exam

Answer 1

• Body Habitus
• Scars
• Wasting
• Aids- walking/ wheelchair
• Prescriptions

Question 2

Assess gait

Answer 2

• gait cycle
• limp
• leg length
• turning speed
• footwear
• limping
• foot drop = high stepping gait

Question 3

What examinations involve you to assess gait?

Answer 3

• spine
• hip
• ankle/ foot
• Knee
• diabetic foot
• cerebellar
• lower limb

Question 4

Feel Spine

Answer 4

• spinal process
• paraspinal muscles
• sacroiliac joints

Question 5

Inspection of spine

Answer 5

• DWARF
• posture
• Pelvic tilt (lateral=scoliosis)
• asymmetry of shoulder girdle
• Cervical lordosis, thoracis kyphosis, lumbar lordosis (loss of LL= anylosing s.)
• iliac crest alignment
• bruising

Question 6

Movement of Cervical Spine

Answer 6

• chin to chest
• chin to sky
• rotate left
• rotate right
• left ear to shoulder
• right ear to shoulder

Question 7

Movement of Thoracic Spine

Answer 7

• flexion
• extension
• left rotate
• right rotate
• lateral left
• lateral right

Stabilise pelvis when rotating

Comment on ROM

Question 8

Special Test for Spine

Answer 8

Modified Schober’s
Straight leg raise
Femoral Nerve

Question 9

How to do Schober’s Test

Question 10

General Inspection of Hip Exam

Answer 10

• aids/ wheelchair/ sticks
• body habitus
• pain
• prescriptions

Question 11

Special Test for Hip Exam

Answer 11

Trendelenburg
Thomas test (NEVER IN HIP REPLACEMENT)

Question 12

Inspection Of Hip

Answer 12

• rotation of leg
• leg length
• DWARF
• pelvic tilt

Question 13

Feel Hip

Answer 13

• temperature
• greater trochanter (bursitis)

Question 14

How to measure Hip Length?

Answer 14

Umbilicus to the medial malleolus of each limb (there are other ways)

Question 15

Move Hip

Answer 15

• flexion
• extension
• adduction (feel opposite joint)
• abduction (feel opposite joint)
• internal rotation
• external rotation

PASSIVE AND ACTIVE

Question 16

General Inspection of Ankle and Foot Exam

Answer 16

• Body Habitus
• Scars
• Wasting
• Aids- walking/ wheelchair
• Prescriptions
• are they able to weight bear?

Question 17

Inspect/ Look in Ankle and Foot Exam:

Answer 17

• DWARF
• bruising
• swelling
• psoriasis plaques
• alignment of toes
• callouses
• wounds
• foot arch
• achilles tendon

Question 18

Feel Ankle and Foot Exam

Answer 18

Get the pt to lay on bed
Temperature
Pulses
Palpate Ankle and Foot:
* Metatarsal + Tarsal bones
* Tarsel joint
* Ankle joint
* calcaneum
* medial and lateral malleolus
* Phalanges
* squeeze MTP joints

Question 19

Move Ankle and Foot Exam

Answer 19

ACTIVE AND PASSIVE

• plantar flex
• dorsi flex
• eversion
• inversion
• big toe extension
• big toe flexion

Question 20

Special Test for Ankle and Foot Exam

Answer 20

• Thompson test (++ when no foot movement when squeezing the calf)

Question 21

General Inspection of Shoulder Exam

Answer 21

• Body Habitus
• Scars
• Wasting
• Aids- slings
• Prescriptions

Question 22

Shoulder Inspection LOOK

Answer 22

• DWARF
• scars
• bruising
• bony deformities

Question 23

FEEL Shoulder Exam

Answer 23

Temperature
Joints:
* SC joint
* clavical
* AC joint
* acromion
* coracoid process of scapula
* humerous head
* greater tubercule of humerous
* scapula spine
Muscles + Tendons
* supraspinatous
* infraspinaton
* teres minor
* Subscapularans

Question 24

Move Shoulder Exam

Answer 24

ACTIVE AND PASSIVE
* flex
* extend
* Abduct
* adduct
* internal rotation
* external rotation

Question 25

General Inspection of Elbow Exam?

Answer 25

* Body Habitus * Scars * Wasting * Aids- slings * Prescriptions

Question 25

Special Test Shoulder Exam

Answer 25

* empty can test * painful arc * apprehension test (ask if they have ever had a hx of shoulder dislocation and don't do)

Question 26

LOOK Elbow Exam

Answer 26

Anterior aspect: * DWARF * Scars * Bruising * swelling Lateral Aspect: * Fixed flexion deformity of arm * Cubitus valgus >15 degree * Cubitus varus <5 degree Posterior Aspect * Rheumatoid nodules * Psoriatic Plaques

Question 27

FEEL Elbow Exam

Answer 27

Temperature Joint * radial head * radiocapitellar joint * lateral epicondyle of humerus * medial epicondyle of humerus * olecranon Biceps + Tendon * Biceps tendon

Question 28

Move Elbow Exam

Answer 28

Active and Passive Flex Extend Pronation Supination

Question 29

Special Test for Elbow Exam

Answer 29

Resisted flexion Resisted extension

Question 30

Special Test for Golfers Elbow

Answer 30

Medial Epicondylitis Resisted flexion = pain

Question 31

Special Test for Tennis Elbow

Answer 31

Lateral Epicondylitis Resisted extension = pain

Question 32

General Inspection of Hand and Wrist Exam:

Answer 32

* scars * wasting * pain * comfy * body habitus = carpel tunnel if obese * Aids- splints * prescription

Question 33

Look/ Inspection of Hand and Wrist Exam

Answer 33

Dorsal Aspect: * Hand posture (ulnar deviation) * DWARF * Scars * swelling * Raynauds * Bouchard's nodes (OA of PIP) * Heberden's nodes (OA of DIP) * Swan neck deformity (RA) * Z thumb * Thin skin = long term steroids * Psoriatic plaques * Splinter haemorrhages * Nail pitting * nail onycholysis Palmar Aspect: * Dupytren's * DWARF * Thenar/ hypothena wasting * elbows * janeway lesions * Osler's nodes

Question 33

Feel/ Palpate in Hand and Wrist Exam

Answer 33

Temperature Radial/ Ulnar pulse Palmar Thickening Median and Ulnar nerve sensation Joint and bones: * MCP + DIP + PIP * wrist joint * middle to distal radius and ulnar bone * 20 carpal bones (LEARN MEMORY TOOL) * scaphoid

Question 34

Movement of Hand and Wrist Exam

Answer 34

* "any pain/ stiffness" * Active and passive * Wrist extension * wrist flexion * finger flexion * finger extension * "make a fist, open the fist"

Question 35

Motor assessment of Hand and Wrist Exam

Answer 35

Motor function of radial nerve: * wrist and finger extension on resistance Motor function of ulnar nerve: * Index finger abduction against resistance Motor function of median nerve: * thumb abduction against resistance

Question 36

Function assessment of Hand and Wrist Exam

Answer 36

Power grip: * squeeze my fingers Pincer grip: * pinch my finger Pick up a small object Do a button

Question 37

Special Tests of Hand and Wrist Exam

Answer 37

* Tinnel's * Phalen's * Finklesteins

Question 38

Inspection/ Look of the Knee:

Answer 38

Gait * limp * varus * valgus DWARF Swelling at the back of knees

Question 39

Feel Knees

Answer 39

* Temperature * Patella * joint lines (space) * popliteal fossae * testing for fluid (tap/sweep and bulge)

Question 40

Move Knee exam

Answer 40

* flexion * extension active and passive

Question 41

Special Test:

Answer 41

* Anterior Drawer * Posterior Drawer * MCL/ LCL ????