__________ and _________ will likely display crepitus Also common in trauma and is a common sign of ________

osteoarthritis rheumatoid arthritis bone fracture

MSK 3 Flashcards by Casey Hamilton

Temporomandibular Joint: Normal range of motion test

3 finger insert test

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__________ are hard, bony outgrowths or gelatinous cysts on the proximal interphalangeal joints (the middle joints of fingers or toes.)
Sign of ___________

Bouchard’s nodes=PIP

Osteoarthritis

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_________ are hard or bony swellings that can develop in the distal interphalangeal joints (DIP) (the joints closest to the end of the fingers and toes)
Sign of ___________

Heberden’s nodes=DIP
Osteoarthritis

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It results from hyperflexion of the extensor digitorum tendon
Injury of the extensor digitorum tendon of the fingers at the distal interphalangeal joint
Usually occurs when a ball, while being caught, hits an outstretched finger and jams it
Inability to extend finger

Mallet Finger

Hyperflexion at DIP (extensor digitorum tendon)

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Presents with flexion of the PIP and hyperextension of the DIP.
- PIP=flexion
- DIP=hyperextension
May affect one or more fingers, including the thumb.
Active flexion results in being “stuck” until person passively extends finger
PIP joint will not straightened under its own power (actively) but can be straightened by the other hand (passively). In addition the end joint of the finger (DIP joint) over straightens and will not bend (flex) fully.
Keyword: “POP”
Generally caused by a forceful blow to the top (dorsal) side of a bent (flexed) middle joint of a finger or a deep cut.
May also be caused by Rheumatoid arthritis

Boutonniere (“button hole”) deformity/Trigger finger

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Develops with hyperextension of the proximal interphalangeal (PIP) joint and flexion of the distal interphalangeal (DIP) joint.
- PIP=hyperextension
- DIP=flexion
May affect one or more fingers but not the thumb.
Occurs in about 50 per cent of rheumatoid arthritis (RA) cases

Swan-neck deformity

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“Squeeze-Test” (MTP/MCP)

Indicates Rheumatoid arthritis
Positive squeeze test – where squeezing the hand across the knuckle joints is unduly painful

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Signs of Rheumatoid arthritis

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grating, crackling or popping sounds and sensations experienced in the joints or a crackling sensation
Indication of lost cartilage (sound is bone on bone)

crepitus

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__________ and _________ will likely display crepitus
Also common in trauma and is a common sign of ________

osteoarthritis
rheumatoid arthritis
bone fracture

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Presence of increased intra-articular fluid (fluid in the joint)
Can be blood, synovial fluid, or gout fluid

Joint Effusion

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Palpate for warmth utilizing the ____ of the hand

dorsum

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Shoulder range of motion

flexion (180 degrees)
extension (50 degrees)
abduction (180 degrees)
adduction (50 degrees)
internal rotation (90 degrees)
external rotation (90 degrees)

(ball and socket joint)

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Degree of normal range of motion:

shoulder flexion

180 degrees

(same as abduction)

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Degree of normal range of motion:

shoulder hyperextension

50 degrees

(same as adduction)

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Degree of normal range of motion:

shoulder abduction

180 degrees

(same as flexion)

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Degree of normal range of motion:

shoulder adduction

50 degrees

(same as hyperextension)

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Degree of normal range of motion:

shoulder external rotation

90 degrees

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Elbow range of motion

Flexion (160 degrees)
Extension (180 degrees)
Pronation (90 degrees)
Supination (90 degrees)

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Degree of normal range of motion:

Elbow flexion

160 degrees

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Degree of normal range of motion:

Elbow extension

180 degrees

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Degree of normal range of motion:

Elbow supination

90 degrees

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Degree of normal range of motion:

Elbow pronation

90 degrees

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Degree of normal range of motion:

shoulder internal rotation

90 degrees

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Identify

* Olecranon bursitis * inflammation of the fluid filled sac of the elbow joint; NOT INFECTION * No actual effusion in the joint; only the bursa * Note that this is a mobile "ball" * Due to trauma * May get cellulitis

Wrist range of motion

1. Flexion (90 degrees) 2. Extension (70 degrees) 3. Radial deviation (toward thumb) (20 degrees) 4. Ulnar deviation (toward pinky) (55 degrees)

Degree of normal range of motion: * Wrist flexion

90 degrees

Degree of normal range of motion: * Wrist extension

70 degrees

Degree of normal range of motion: * Wrist radial deviation

20 degrees | (toward thumb)

Degree of normal range of motion: * Wrist ulnar deviation

55 degrees | (toward pinky)

Finger range of Motion

1. Flexion (MCPJ) (90 degrees) 2. Hyperextension (MCPJ) (30 degrees) 3. Abduction 4. Adduction 5. Opposition (thumb)

Degree of normal range of motion: * Finger (MCPJ) Flexion

90 degrees

Degree of normal range of motion: * Finger (MCPJ) hyperextension

30 degrees

Identify the thumb movement

flexion of thumb

Identify the thumb movement

extension of thumb

Identify the thumb movements

* Adduction of thumb (top arrow toward fingers) * Abduction of thumb (bottom arrow away from fingers)

Identify thumb movement

Opposition of thumb

Thumb range of motion

1. Flexion 2. Extension 3. Abduction 4. Adduction 5. Opposition

Identify * condition in which the knees angle in and touch each other when the legs are straightened

Genu Valgum "knock knees"

Identify * condition in which the knees of an affected individual are wide apart, while the ankles and feet are together when he/she stands up. * lower leg is angled inward (medially) in relation to the thigh's axis, giving the limb overall the appearance of an archer's bow. Usually medial angulation of both lower limb bones (femur and tibia) is involved.

Genu Varum "Bow Legged" * In most children under 2 years old, bowing of the legs is simply a normal variation in leg appearance. In children with physiologic genu varum, the bowing begins to slowly improve at approximately 18 months of age and continues as the child grows. By ages 3 to 4, the bowing has corrected and the legs typically have a normal appearance.

Hip range of motion

1. Flexion * Knee flexed: 120 degrees * Knee extended: 30 degrees 2. Extension (90 degrees) 3. Abduction (45 degrees) 4. Adduction (30 degrees) 5. Internal (medial) Rotation (40 degrees) 6. External (lateral) Rotation (45 degrees)

Degree of normal range of motion: * Hip flexion

* Flexion-knee flexed (120 degrees) * Flexion-knee extended (30 degrees)

Degree of normal range of motion: * Hip extension

90 degrees

Degree of normal range of motion: * Hip abduction

45 degrees

Degree of normal range of motion: * Hip adduction

30 degrees

Degree of normal range of motion: * Hip Internal rotation

40 degrees

Degree of normal range of motion: * Hip external rotation

45 degrees

Knee range of motion

1. Flexion (130 degrees) 2. Extension (15 degrees)

Degree of normal range of motion: * knee flexion

130 degrees

Degree of normal range of motion: * knee extension

15 degrees

Ankle range of motion

1. Plantar flexion (45 degrees) 2. Dorsiflexion (20 degrees) 3. Inversion (30 degrees) 4. Eversion (20 degrees)

Degree of normal range of motion: * Ankle plantar flexion

45 degrees

Degree of normal range of motion: * Ankle dorsiflexion

20 degrees | (same as ankle eversion)

Degree of normal range of motion: * Ankle inversion

30 degrees

Degree of normal range of motion: * Ankle eversion

20 degrees | (same as ankle dorsiflexion)

Toe range of motion

1. Flexion 2. Extension

Lordosis is a _______ or ______ concavity

* Cervical * Lumbar

* **Lateral inspection** * ___________ refers to an inward (concave) curvature of the cervical and lumbar regions of the human spine. * Can also refer to extreme curvature in those regions

Lordosis

* **Lateral inspection** * _________ refers to the normal outward (convex) curvature in the thoracic and sacral regions * Can also refer to extreme curvature in those regions

Kyphosis

Kyphosis is a _____ and _____ convexity

* Thoracic * Sacral

Lordosis is con\_\_\_\_

con**_CAVE_**

kyphosis is con\_\_\_\_

con**_VEX_**

**_Normal Spine_** * Cervical spinE is **\_\_\_\_\_\_\_\_\_** * Thoracic spine is **\_\_\_\_\_\_\_\_\_** * Lumbar spine is **\_\_\_\_\_\_\_\_\_** * Sacral spine is **\_\_\_\_\_\_\_\_\_**

* Cervical spinE is con**_CAVE_** * Thoracic spine is con**_VEX_** * Lumbar spine is con**_CAVE_** * Sacral spine is con**_VEX_**

**_POSTERIOR INSPECTION OF SPINE_** Symmetry of _______ and \_\_\_\_\_\_\_\_

* Shoulder height * Iliac crest

**_POSTERIOR INSPECTION OF SPINE_** When inspecting the spinal column, an upright spinal column should have an imaginary line from _____ through the \_\_\_\_\_\_\_

* C7 * gluteal cleft

\_\_\_\_\_\_\_\_\_\_ is defined as a decrease in the mass of the muscle

muscle atrophy

\_\_\_\_\_\_\_\_ involves an increase in size of skeletal muscle through a growth in size of its component cells

muscle hypertrophy

Identify * (posterior inspection) a spine that curves to the side

Scoliosis

* ____ is the top of the shoulder * _____ is the tip of the shoulder

* T1 * T7-T8

It's common to find a harmless deposit of fat under the skin on the back. This is called \_\_\_\_\_\_

lipoma

An abnormal tuft of hair of the back may indicate \_\_\_\_\_\_\_

spina bifida Spina bifida is a birth defect where there is incomplete closing of the backbone and membranes around the spinal cord.

\_\_\_\_\_\_\_\_\_ is a benign, flat, congenital birthmark with wavy borders and irregular shape. May appear on the backs of infants.

Mongolian spot (congenital dermal melanocytosis)

* ______ is a visible and palpable finding of the spine where the bones are not lined up properly which can be seen and felt by the examiner * Commonly due to trauma

"step-off"

Cervical spine range of motion

1. Flexion (45 degrees) 2. Extension (55 degrees) 3. Lateral Rotation (70 degrees right and left) 4. Lateral bending (40 degrees right and left)

Degree of normal range of motion: * Cervical spine flexion

45 degrees

Degree of normal range of motion: * Cervical spine extension

55 degrees

Degree of normal range of motion: * Cervical spine lateral rotation (right and left)

70 degrees

Degree of normal range of motion: * Cervical spine lateral bending (right and left)

40 degrees

When performing cervical spine range of motion, you may need to stabilize the \_\_\_\_\_\_

shoulders-prevents chest movement

Which cranial nerve? * As patient to **_rotate_** head to one side then apply resistance--\> compare to other side * Have patient shrug shoulders against resistance and compare