MSK exam

Question 1

bones of shoulder girdle

Answer 1

clavicle
scapula
proximal humerus

Question 2

4 articulations of shoulder

Answer 2

glenohumeral
sternoclavicualr
acromioclavicular
scapulothoracic

Question 3

mm of shoulder

Answer 3

deltoid
supraspinatus
infraspinatus
subscapularis
teres minor

Question 4

mm of rotator cuff

Answer 4

supraspinatus
infraspinatus
subscapularis
teres minor

Question 5

deltoid action

Answer 5

abduction

Question 6

supraspinatus action

Answer 6

abduction

Question 7

infraspinatus action

Answer 7

external rotation

Question 8

subscaupularis action

Answer 8

internal rotation

Question 9

teres minor action

Answer 9

external rotation

Question 10

intrinsic causes of shoulder pain

Answer 10

glenohumeral ligaments sprain or tear
mm or tendon inflammation, tear, strain
bones- fracutres, inflamed capsule

Question 11

neurological external causes of shoulder pain

Answer 11

cercial nn root compression
supraspinatus nn compression
brachial plexus lesions
herpes zoster
spinal cord lesion
cervical spine disease

Question 12

abdominal causes of shoulder pain

Answer 12

hepatobiliary diseases
diaphragm irritation (spleen, ectopic, perforated)

Question 13

CV causes of shoulder pain

Answer 13

MI
axiallary vv thrombosis
thoracic outlet syndrome

Question 14

thoracic causes of shoulder pain

Answer 14

upper lobe pneumonia
apical lung tumor
PE

Question 15

intrinsic pathologies

Answer 15

impingment
tendinopathy
tendon tear
AC separation
osteoarthritis
adhesive capsulitis bursitis
instability
SLAP lesion

Question 16

testing infraspinatus and teres minor

Answer 16

pt rotates forearm laterally against resistance

Question 17

supraspinatus

Answer 17

most common cause of tendon or mm source pain
susceptible to repetitive motion injuries: baseball, house painters
only protected by subacromial bursa

Question 18

supraspinatus attachments

Answer 18

sup scapular
greater tubercle of humerus
passes thru narrow area btwn acromion and head of humerus

Question 19

tendinitis

Answer 19

weakness of cuff mm allow upward migration of humeral head -> irritates supraspinatus tendon and/or mm from impingment on acromion
can lead to tear

Question 20

drop arm test

Answer 20

supraspinatus tear

Question 21

impingement

Answer 21

weakness of rotator cuff can lead to superior subluxation of humeral head when shoulder is abducted beyond 90 degrees, predisposing to impingment syndromes
Sx may be necessary

Question 22

AC seperation

Answer 22

fall on tip of shoulder typical
involves both AC and coracoclavicular ligs
5 grades
tender over AC joint, visual inspection at 3+
usually conservative Tx

Question 23

osteoarthritis

Answer 23

atrophy, significant loss of both active and passive ROM, tender, crepitus
x-ray loss of joint space

Question 24

adhesive capsulitis

Answer 24

aka frozen shoulder
any reason there is long standing loss of ROM
mm atrophy, significant loss of both active and passive ROM, tender, but major complaint is stiffness
DM SIGNIFICANT risk factor
MRI to Dx

Question 25

bursistis

Answer 25

trauma, repetitive motion , tender pain with both active and passive ROM inject with lidocaine to Dx

Question 26

rotator cuff tear

Answer 26

persistent weakness despite pain relief w/injection

Question 27

rotator cuff tendonpathy

Answer 27

normal strength with pain relief

Question 28

SLAP lesion

Answer 28

superior labrum anterior to posterior most common in throwing athletes and those who do lots of work overhead acutely can be d/t grabbing onto something while falling or lifting something heavy suddenly

Question 29

signs of SLAP

Answer 29

clicking | ant pain, especially on abduction and external rotation

Question 30

shoulder workup

Answer 30

x-ray US MRI

Question 31

trochanteric bursitis

Answer 31

exaggerated or abnormal movement of gluteus medius and TFL over greater trochanter lat hip apin

Question 32

chronic trochanteric bursitis

Answer 32

bursa fibrose and lose its ability to provide frictionless surface of movement

Question 33

what do you want to know if trochanteric bursitis is suspected

Answer 33

``` lumbar mm tightness leg length discrepancy knee or ankle arthritis varus/vlagus stance or gait orthotics? gait symmetry ```

Question 34

osteoarthritis

Answer 34

activity pain, occuring at night or fist thing in am groin pain aggrevated by movement restricted abduction and internal rotation

Question 35

meralgia pareshetica

Answer 35

lat femoral cuteanoue nn impinged as it courses underneath inguinal lig sensory only

Question 36

osteonecrosis

Answer 36

aka aseptic necorsis avascular necrosis or osteochrondritis dissecans joint collapse in 3-5yrs

Question 37

occult fracture

Answer 37

severe pain on light weight bearing intolerable hip roation MRI needed, plan xray not sensitive enough

Question 38

referred pain

Answer 38

from lumber and SI joint common suspect when: -whenever groin pain accompanied by back pain - symptoms extend beyond knee pareshesia present direct exam of hip is

Question 39

osgood-schlatter

Answer 39

aka tibial tuberosity avulsion osteochondritis of tibial tubercle apophystitis of tibial tubercle at insertion of patellar tendon do not limit kids activity