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Flashcards in MSK Deck (50)
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1

looking at spine

look from side: curvatures of spine

behind: spinal alignment, symmetry,, scoliosis, abnormal hair growth

scars, bruising

2

feeling spine

paplate midline spinous processes from top downwards
feel sacroiliac joints: any ill-alignment, irregularities, tenderness

feel for paraspinal muscle tenderness or increased tone one side at a time

3

movement of cervical spine

active -
flexion: touch chin to chest
extension: tilt head backwards
-lateral flexion: touch ear to shoulder
-rotation: look over each shoulder

4

movement of lumbar spine

flexion: touch their toes, measure by placing fingers on 2 adjacent lumbar spinous processes

extension: lean back

lateral flexion: bend to side, running hand down their leg

5

neurological examination spine

straight leg raise: patient lying down, lift their leg up to their limit then dorsliflex foot: may exacerbate pain if nerve root entrapment or prolapsed disc

reflexes - upper and lower lumvs

-power and sensation upper and lower limbs

6

ankle and foot: looking

shoewear
nail changes, skin rashes, scars, wound, calluses

swelling or muscle wasting of calf muscles

toes for clawing or joint swelling or hallux valgus

sole for callus formation

toe alingment

standing: foot arch position, dropped/hihg arch, alignment if hind foot
varus or valgus deformity
achilles tendon swelling or thickening

7

ankle and foot: feel

temperature
pulses
MTP joint squeeze for tenderness

palpate for tenderness, swelling, irregularity

8

ankle and foot: move

active: dorsiflexion and plantar flexion ankle, flexion + extension big toe

passive; ankle plantar and dorsi flexiom, inversion and eversion subtalatr joint, mid tarsal and subtalar movements

9

ankle and foot function

assess gait

10

shoulder: look

asymmetry
deformity
scapula winging
muscle wasting - deltoid and infra-/supra-spinatous
scars
wounds
bruises
swelling

11

shoulder: feel

temp at joints (4 in shoulder)
bony landmarks for tenderness

sternoclavicular joint
spine scapula
greater tuberosity humerus
ant + pos joint lines humerus
3 muscles
axillary nerve sensation

12

shoulder: active movement

hands behind head: abduction and external rotation

hands behind back: internal rotation

full extension
full flexion
full abduction
external + internal rotation shoulder: elbows flexed 90d, tucked into sides and rotate

13

shoulder: passive movement

all those for active
extension, flexion, abduction, external rotation

14

elbow: look

scars
swellings
rashes
deformity
normal carrying angles
muscle wasting
bruising

15

elbow: feel

temp
tenderness over medial and lateral epicondyles, olecranon process, radial head

16

elbow: movement

active then passive

flex
extend
supination then pronation

17

elbow: function

check ability to put hand to mouth for feeding

18

phalen's test

detection carpal tunnel syndrome

wrist in full flexion for 60s

if +ive pts symptoms elicited by this manouvre

19

tinnel's test

detect carpal tunnel syndrome

tapping over median nerve as it passes through wrist
+ive if tingling in thimb, index and middle fingers

20

hand + wrist: look

scars
wounds
thinning skin
rash
clubbing
nail pitting
splinter haemorrhages
deformity
muscle wasting
fasical thickening on palm

21

hand + wrist: feel

temp
muscle bulk thenar + hypothenar
distal radius, ulnar, carpals and metacarpals
fingers
MCP and wrist joint

22

hand + wrist: move

straighten fingers fully then make fist

-finger flexion MCPJ, PIPJ and DIPJ
-wrist flexion and extension: prayer and reverse prayer sign (active then passive)

phalen's and tinnel's tests

23

hand + wrist: function

power grip: patient to grip your 2 fingers
pincer grip: patient to pick up small object

24

hand + wrist: neurological examination

sensation median, ulnar and radial nerves and then their power

25

trendelenburg sign

sign found in people with weak/paralysed hip abductor muscles

patient stand on one foot

test +ive if pelvis dips on side of non-weight bearing leg

26

true leg length

measured from anterrior superior iliac spine to just below the ipsilateral medial malleolus

27

apparent leg lenght

point in patient's midline (either umbilicus or xiphi-sternum) to medial malleolus of ankle of each leg

28

thomas' test

assessment of fixed flexion deformity

if fixed flexion deformity patient usually compensates by increasing lumbar lordosis - stop this by placing one hand under pt lumbar spine

flex normal hip until feel lumbar lordosis flatten on hand. if opposite leg is lifted off bed then there is fixed flexion deformity of that hip

29

hip: look

deformity
symmetry
scars
swellings
muscle wasting
leg length discrepency

30

hip: feel

tenderness over greater trochanter
apparent and true leg length