Flashcards in musculoskeletal Deck (31):
wrist pain at snuffbox (loading of thumb)
splint write (thumb spica spling) and refer to hand surgeon
usually from a fall
most common WRIST fracture
"sudden" one sided hip pain.
elderly have 1 year mortality rate increased after
leg shortening with displacement
ecchymosis and swelling of lower abdomen, hips, groin, scrotum.
check ABC for internal hemorrhage
cauda equina syndrome
sudden bladder incontinence
LEG NUMBNESS (due to pressure o a sacral nerve root)
Surgical emergency, needs spinal decompression
low back pain from dissecting abdominal aneurysm
"tearing" of low back pain/abdominal pain.
s/s of shock
most common in elder, white male, smoker
connects muscle to bone
bone to bone
test for de quervain's tenosynovitis (base of thumb)
test is thumb in wrist and flex downwards
knee pain and "click"
medial mensicus= valgus pressure (knee in), foot out
lateral meniscus= varUS stress (knee out, feet in)
gold standard is MRI
knee joint laxity, more sensitive than drawer test
The examiner should place one hand behind the tibia and the other on the patient's thigh. It is important that the examiner's thumb be on the tibial tuberosity. On pulling anteriorly on the tibia, an intact ACL should prevent forward translational movement of the tibia on the femur ("firm endpoint").
soft endpoint= tear
test for "MEDIAL collateral ligament. which stress test.
test for "LATERAL collateral ligament. which stress test.
inflammation of the digital nerve of the foot between the 3rd and 4th metatarsal, > risk with high heels, tight shoes, dancers
test for morton's neuroma.
positive is click and pain when squeezing the forefoot
nodes of the DISTAL interphalangeal joint
bondy nodules of the proximal interphalangeal joint
RA versus OA
RA: symmetrical, > pain/stiffness, systemic systems (fever)
TREatement of RA
systemic steroids ( NOT for OA)
biologics (HUMIRA, Enbrel)
> AA, hispanic
affects skin, kidneys, heart, blood vessels
MACULOPAPULAR butterfly rash (malar rash)
DISCOID RASH ( non itchy rash)
tx for lupus
refer to rhemuatologist; plaquenil, methotrexate, biologics ( same as RA)
swan's neck deformity (50%), flexion of dip joint, hyperextension PIP joint
boutonnier deformity- hyperextion of the DIP with flexion of the PIP joint
rx for RA
DMARD- disease modifying agent for rheumatoid disease;
methotrexate, sulfasalazine, cyclosproine, hydroxychloroquine (antimalarial drug)
Gold salt compounds IM injections
anti TNF (humira, enbrel, remidade)
uric acid crystals inside joint and tendons due to genetic excess or low excretion of purine crystals (by product of protein metabolism).
LARGE JOINT OF FIRST TOE common, middle age males common
worse with alcohol, meat, seafood
Chronic gout has tophi (small white nodules full of urates on ears and joints)
rx for gout
nsaids (indocin, anaprox)
early 20's, > males
inflammation of seronegative arthritis effects spine (upper thoracic)
best for dsg herniated disc
cauda quina syndrome
acute pressure on the SACRAL nerve root (anal and bladder
Sprains grade (ottawa) to determine needs for radiographs
1- mild sprain, able to bear weight
2-partial tearing of ligament. painful ablution
3- complete rupture of ligaments. Can't ambulate 4 steps
bursitis behind the knee (bursae are synovial sacs located o certain joints)
if cyst ruptures, will cause reaction like celulitis (calf redness, swelling)