MSK Physical Exam

Question 1

What are possible areas of pain?

Answer 1

joint pain
soft tissue pain
nerve pain

Question 2

What are some causes of pain?

Answer 2

inflammation
infection
mechanical

Question 3

What are the types of synovial joints?

Answer 3

ball and socket
hinge
condylar

Question 4

What are the planes of movement?

Answer 4

abduction
adduction
flexion
extension
internal/external rotation

Question 5

What areas of the body have full ROM?

Answer 5

ball and socket joints
hinge joints

Question 6

What is an example of a ball and socket joint?

Answer 6

hip
shoulder

Question 7

What is an example of a hinge joint?

Answer 7

knee

Question 8

What is abduction?

Answer 8

movement away from midline

Question 9

What is adduction?

Answer 9

movement toward the midline

Question 10

What is dorsiflexion?

Answer 10

movement superiorly
only applies to foot and ankle

Question 11

What is extension?

Answer 11

lengthening of a muscle or joint (increase angle)

Question 12

What is flexion?

Answer 12

shortening of a muscle or joint (decrease angle)

Question 13

What to look for when assessing gait and general movement

Answer 13

is it abnormal watching it or abnormal when you are not

Question 14

What is normal anatomical position?

Answer 14

person standing upright facing forward, arms straight and hands held by the hips with palms facing forward. feet parallel and toes pointing forward.

Question 15

What is the purpose of normal anatomical position?

Answer 15

central concept behind all descriptions of location within the body

Question 16

What is important with anatomic difference?

Answer 16

there is different anatomy between males and females so consider how they make people more susceptible to certain injuries - in both upper and lower extremities

Question 17

How do changes in the bones and muscles change the exam?

Answer 17

posture
range of motion
strength
pain

Question 18

How do you evaluate the pain during a physical exam?

Answer 18

watch the pt during the entire visit, including walking into the exam room

Question 19

What should you notice when evaluating the pain?

Answer 19

how they are sitting
how they move towards the table
how they get off the table
do their movements correlate with their description of the pain

Question 20

What are possible mechanisms of injury?

Answer 20

sometimes its helpful to work backwards to discover the cause but a good hx and PE will help you evalulate

Question 21

What is the scale for assessing strength?

Answer 21

0: no movement
1: trave movement
2: movement and full PROM, but unable against gravity
3: full AROM, but not against resistance
4: full ROM against gravity & resistance, but weak
5: full ROM against gravity, full resistance

Question 22

What are the most common numbers to use when assessing strenght?

Answer 22

4 and 5

Question 23

Which numbers are considered profound weakness?

Answer 23

0-3

Question 24

What should you do when strength testing?

Answer 24

ROM of each joint - remember each plane of motion of each joint

Question 25

What should you do with the joint above and below the joint you are testing?

Answer 25

ALWAYS consider the them as there may be contributory factors effecting more than the joint of pain

Question 26

What are things to consider when assessing joints above and below the one being tested?

Answer 26

LBP is effected by knee problems Knee pain affected by foot problems biomechanics of posture on the neck pain elbow pain being effected by rotator cuff restriction

Question 27

What are some soft tissue clues when doing an MSK PE?

Answer 27

swelling bruising and lesions erythema nodules and tumors patterns of radiation

Question 28

How do circulation and sensation affect PE?

Answer 28

always check circulation and sensation distal to injury

Question 29

How do you determine a mechanism of injury?

Answer 29

consider which structures are most likely to be injured

Question 30

What are the components of a MSK PE?

Answer 30

IPRRSSSS-V and Joints above and below I: Inspection P: Palpation R: Range of Motion R: Reflexes S: Strength S: Sensation S: Stability S: Special Tests V: Vascular

Question 31

What should you do when testing ROM?

Answer 31

What is the normal ROM for the joint selected? Compare joints from side to side

Question 32

How to test strength?

Answer 32

peripheral nerve specific/nerve root specific

Question 33

How to test sensation?

Answer 33

think about nerve distribution. how would you check neurologic function related to the selected joint?

Question 34

How to test vascular?

Answer 34

check pulses distal to the joint and cap refill