MSK tutorial - solo learning Flashcards
1
Q
What three questions are asked in GALS?
A
- Do you have any pain or stiffness in any of your joints, muscles or back?
- Are you able to dress yourself without any difficulty?
- Can you walk up and down the stairs without any difficulty?
2
Q
What is involved in gait?
A
Smoothness, symmetry and ability to turn quickly
3
Q
What else to assess when patient stood up?
A
- Muscle bulk - trapezius, shoulder girdle
- Spine straight?
- Iliac crests level?
- Gluteal muscle bulk and size?
- Popliteal fossa swelling?
- Hindfoot deformities
4
Q
What to assess in spine?
A
- From side of patient
- Normal cervical lordosis?
- Normal thoracic kyphosis?
- Normal lumbar lordosis?
- Bend forward and touch toes, assess lumbar spine movement with fingers, fingers should come together when pt comes up
5
Q
What to check in arms?
A
- Normal anatomical position - normal elbow exension
- Symmetry
- Muscle bulk - pectoralis and shoulder
- Jaw side to side - TMJ related to RA
- Elbows back and behind head - glenohumoural, elbow flexion, function assessment
- Hands out infront - pronate
- Inspect hands - swelling, skin changes, deformity
- Palms - muscle bulk, tendon thickening
- Fist -
- Touch each finger together
- Grip strength
- Squeeze MCPJ
6
Q
What is involved in leg assessment?
A
- Knee flexion
- Hip flexion
- Internal rotation hip - push leg outwards
- Both sides
- Patella tap - fluid?
- Sweep test?
- Inspect feet - callous? squeeze MTPJ and look for pain
7
Q
If no problem with gals…
A
Record GALS NAD
8
Q
What does GALS stand for?
A
- Gait
- Arm
- Legs
- Spine
9
Q
Function of GALS
A
- Screening for function of joints
- Used to identify problems which require more focused assessment
10
Q
OA of the knee exam findings
A
- Complain of - pain on walking, grinding sensation
- Muscle wasting
- Inability to fully extend knee
- Normal temp joint
- Normal patella tap
- Positive sweep test?
- Limited knee flexion
- Crepitus felt on full ROM
- Tenderness when flexed knee palpated
- Normal anterior drawer test
- Normal collateral ligament tests - maybe uncomfy
- Varus deformity on standing?
- Stick to mobilise?
- Slow walk - antalgic?
11
Q
Inflammatory arthiritis of feet findings
A
- Antalgic gait
- Symmetrical deformities feet
- Clawing toes
- Normal temp and foot pulses
- Squeeze MTPJ - some tenderness
- Palpate painful joints - tender
- Normal midfoot, ankle and subtalar palpation
- Normal dorsi/plantar flexion, inversion and eversion
- Stiffness on individual IPJ
- Loss ROM ankle joint and toes
- Flat foot walk - inability to stand on toes
12
Q
Rheumatoid arthirits findings - hands
A
- Bilateral, symmetrical
- Polyartropathy
- Ulnar deviation
- Subluxation
- Z deformity thumb
- Boutonierre deformity
- Good power and pincer grip
- If no pain/tenderness - disease may be inactive currrently
13
Q
What is synovitis?
A
- Inflammation (swelling, pain and warmth) of synvoial membrane
- Feature of arthirits when there ois active inflammation
- Causes inc RA and gout
- Can occur in OA if degen process causes inflammation
14
Q
What is stiffness and early morning stiffness?
A
- Difficulty moving one or more joints
- Early morning = stiffness on getting out of bed/staying in one position
- Indicates inflammatory arthritis
- Usually lasts more than 30 mins on waking to be RA
15
Q
Likely causes of limited or painful active movement but with full, pain free passive movement
A
- Passive movement does not require pt to use own nerves, muscles and tendons to produce movement
- Reduction in passive range/pain on passive indicates joint problem (foreign body, deformity, inflam)
- Problem with muscles, tendons etc would cause pain on active movement but not passive
