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MSK Flashcards

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1
Q

lateral epicondylitis tests

A

cozens and mills

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2
Q

medial epicondylitis tests

A

reverse cozens

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3
Q

valgus stress test of elbow indicates

A

medial or ulnar pain

laxity of ulnar collateral ligament

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4
Q

varus stress test of elbow indicates

A

lateral pain

laxity of radial collateral ligament

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5
Q

how long do you hold phalens and reverse phalens

A

60 sec

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6
Q

what are features of adhesive capsulitis

A

thickening and contraction

abduction and external rotation most limited

end feel may be soft

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7
Q

what ROM is limited the most in adhesive capsulitis

A

abduction and ER

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8
Q

what is neer classification of impingement syndrome

A

1 - edema and hemorrhage

2 - thickening and fibrosis

3 - tears and ruptures

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9
Q

what are features of supraspinatus lesion

A

painful arc
tenderness on AC and greater tub
weakness of AB and ER
difficult sleeping on side

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10
Q

what are positive signs of painful arc

A

crepitus
apprehension
pain

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11
Q

what are positive signs of empty can

A

weakness or pain

with or without resistance!
crepitus and apprehension may be present

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12
Q

what does yergasons test indicate

A

bicipital tendonitis

transverse humeral ligament

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13
Q

SLAP tears grading

A

1 - degenerated labrum and biceps intact

2 - detached labrum and bicep anchor from superior glenoid

3 - bucket handle tear

4 - bucket handle tear extending into bicep anchor

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14
Q

what does cross arm test indicate

A

AC
sprain
OA

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15
Q

what does apprehension and relocation test indicates what

A

anterior instability

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16
Q

what does sulcus sign indicate

A

inferior or multidirectional instability

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17
Q

what are the characteristics of fibromyalgia

A

chronic pain - widespread pain and stiffness

affects neck, back, shoulders, pelvis, and hands MC

11-18 multiple tender points

deep muscular tone and throbbing

numbness tingling burning

worse in the morning

cold and humid conditions worsen

IBD and bladder dysfunction

headache

anxiety stress

impaired memory

sleep disturbances - abnormal phase 4 (REM) sleep

fatigue / exhaustion

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18
Q

what is the new criteria for fibromyalgia

A

old 1990 criteria - 11-18 tender points

found to be a barrier for primary care setting

new 2010 criteria - perceived cognitive impairment, fatigue, sleep disturbance

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19
Q

what is the WPI

what is used for

what is criteria

A

widespread pain index

fibromyalgia

0-19 tender points

must have felt pain in the tender point in the past week!!!!

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20
Q

what is the criteria for DX of fibromyalgia

A

1a. WPI score greater than 7
AND
Symptom severity score is greater than 5

OR

1b. WPI score is between 3 and 6
AND
Symptoms severity score is greater than 9

  1. symptoms have been present for at least 3 months
  2. you dont have a disorder that would otherwise explain the pain
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21
Q

what are the common symptoms of cervical myelopathy

what are the common signs

A

symptoms - clumsy/weak hands, stiff or heavy legs, neck stiffness, pain in shoulders and arms, unsteady gait, cant walk at brisk pace, deterioation of fine motor skills (writing or buttoning shirt), intermittent shooting pains down the arm like electric shock, arm pain

signs - atrophy of the hands, hyperreflexia, hypertonic LE, Lhermittes sign, sensory loss, inability to tandem walk

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22
Q

what does the neuro exam look like with cervical myelopathy at C5-C6 level

A

biceps and supinator (C5/6) may be absent

brisk triceps reflex (C7) - pathognomonic of cord compression at C5-C6 interspace

ankle clonus and babinski present

hoffmans sign is indicator of spinal cord dysfunction

stiff or spastic gait - seen in later stages

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23
Q

what are the MSK findings in polymyalgia rheumatica

A

morning stiffness for more than 1 hour

proximal muscle weakness
muscle stiffness after inactivity

carpal tunnel syndrome - 15% of people

distal extremity swelling

arthalgia or myalgia up to 6 months after systemic symptoms

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24
Q

cervical distraction

A

increases ligamentous pain

decreases nerve root and facet pain

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25
adsons test is used for what causes
scalenes cervical rib
26
what is allens test used for
obstruction of vasculature to the hand
27
what is T4 syndrome
symptoms - paresthesia, numbness, UE pain, with or without upper back stiffness no neuro signs upper thoracic joint dysfunction around T4
28
how do you treat T4 syndrome
joint manip, stretching, strengthening excercises directed at upper back
29
C5 root or C4-C5 disc
deltoid | biceps reflex
30
C6 root or C5-C6 disc
biceps wrist extension brachiradialis reflex
31
C7 root or C6-C7 disc
triceps wrist flexion finger extensors triceps reflex
32
C8 root or C7-T1
finger flexion | no reflex
33
T1 root or T1-T2 disc
interossei
34
L4 root or L3-L4 disc
tibialis anterior | patellar reflex
35
L5 root or L4-L5 disc
extensor hallucis longus | no reflex
36
S1 root or L5-S1 disc
peroneus longus | achilles reflex
37
what are the tight muscles in upper cross syndrome
tight - pecs, ant deltoid, levator scapulae, upper trap, subscap, lats, SCM, scalenes weak - rhomboids, post deltoid, serratus anterior, lower trap, longus coli, capitus
38
what are the mechanical factors in cervical myelopathy in flexion and extension
flexion (anterior) - herniated discs and osteophytic ridges extension (posterior) - ligamentum flavum buckling and hypertrophy
39
correct hip firing patterns explain
hamstrings glut max contra erector ipsi erector
40
what are the different grades of spondylolisthesis
``` normal 1 - <25% 2 - 25-50% 3 - 50-75% 4- >75% ```
41
what are characteristics of lumbar disc syndrome
``` dejerines triad minor sign flexion is more painful more painful in AM improve with mobilization better with activity sitting more painful - tripod sign antalgia sciatic pain ```
42
bechterews test is + for
lumbar disc | sciatica
43
kemps test is + for
lumbar sprain facet disc sciatica
44
SLR is + for
sciatica lumbar sprain SI sprain tight hamstrings
45
braggards tests is + for
sciatica | tight hamstrings
46
well leg raise is + for
sciatica | lumbar disc
47
patricks test is + for
hip pathology | SI lesion
48
yeomans test is + for
SI lesion
49
elys test is + for
SI lesion
50
hibbs test is + for
SI lesion | hip pathology
51
what is the most specific SI test
gaenslens test
52
what is a positive hip extension sign
ipsi erector fires first
53
neri bowstring sign is + for
sciatica lumbar disc hamstring
54
what does retrolisthesis mean
disc narrowing is greater than posterior joint degeneration
55
what does anterolisthesis mean
posterior joints are more degenerated than the disc
56
what is the difference in neurogenic and vascular pain
neuro - thighs, calves, back, (buttocks is rare), burning and cramping, erect posture/ambulation/extension make worse, squatting/bending forward/sitting make better, pulses normal, no skin changes, bladder incontinence vascular - buttocks and calves, cramping, any leg exercise makes worse, rest makes it better, decrease pulses, skin and nail changes, impotence
57
osgood schlatters occurs when and due to what
11-14 years old | growth spurts and overuse
58
what is the most sensitive and specific test for meniscus
thessaly 20*
59
what is patella tendonitis
aka jumpers knee or sinding larsen johansson syndrome inflammation of inferior border of patella anterior knee pain over patella pain worse when jumping, landing, or running gradual onset due to overuse sitff first thing in the morning or after sitting
60
what is pes anserine bursitis
inflammation of pes anserine located anterior medial knee below the tibial tub
61
what is a synovial plica
snapping sensation or pain along the medial epicondyle 1-2 fingers away from patella pain with knee flexed and then extended
62
what does pivot shift test for
acl and rotatory instability
63
what does apleys compression and distraction test for
compression - meniscus distraction - cruciates and collateral sprain
64
patellar mobility displaced less than one quadrant medially = displaced more than 3 quadrants medially =
displaced less than one quadrant medially = tight lateral structures displaced more than 3 quadrants medially = hypermobile
65
what is patellar inhibition or grind test for
patellar femoral syndrome
66
anterior drawer of ankle indicates what
anterior talofibular instability
67
varus stress, talar tilt, and inversion stress indicates what valgus stress, talar tilt, and eversion stress indicates what
calcaneofibular lig deltoid lig
68
how does avulsion of 5th metatarsal occur
inversion sprain
69
how does jones fracture occur
stress or acute fracture difficult to heal
70
what are the different osteochondral defects of the ankle
lateral talar dome - inversion sprain medial talar dome - unclear maybe trauma
71
how does a high ankle sprain occur
tibiofibular syndesmosis dorsiflexion and eversion of the ankle internal rotation of tibia
72
what are the tests used to diagnose high ankle sprain
squeeze test external rotation test cross leg test
73
what is a march fracture
stress fracture of a metatarsal
74
what is homans sign indicate
thrombophlebitis

Physical Diagnosis (18 decks)

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