MUSCULOSKELETAL

Question 1

SYNOVIAL JOINTS (FJBA)

Answer 1

• Freely movable with ROM
• Jt. Capsule –> Synovial fluid
• Bones w/ articular cartilage

Question 2

Non-synovial (TNB)

Answer 2

• Immovable (ex. Skull sutures)
• No capsule
• Bones joined by fibrous tissue/cartilage

Question 3

Order of examination

Answer 3

Inspection

Palpation

Question 4

Color, masses, Swelling

Answer 4

• ↑ joint fluid (effusion)
• Thickened synovium
• Bursitis, tendonitis, tenosynovitis

Question 5

Deformities

Answer 5

• Dislocation (Humerus out of fossa)
• Subluxation (partial)
• Contracture
• Ankylosis (fusing)

Question 6

Palpable fluid is

Answer 6

abnormal. Pushing on one side of the capsule = fluid shift which causes visible bulging on the other side.

Question 7

• Jt. Capsule

Answer 7

• Not normally palpable
• Inflamed Synovial membrane
• Feels “doughy” or “boggy”

Question 8

Note any:
• localize to specific anatomic structure
•

Answer 8

heat, swelling, masses, pain

- Skin
• Muscle
• bursae/ligaments/tendons
• Fat pads
• Capsule

Question 9

Ask pt. move through full range

•

Answer 9

If see limitation, gently attempt passive motion
• Normal range of active & passive s/b same
• Note limitation/hyperflexion/hyperextension
• If any ↓ ↑ measure w/ goniometer

Question 10

Crepitation

Answer 10

• Audible/palpable crunching/grating
• Occurs when articular surfaces are roughened
• Ie. Rheumatoid arthritis

Question 11

Normal incisor space

Answer 11

3-6cm

Question 12

Normal lateral ROM

Answer 12

1-2cm

Question 13

Cervical spine

• Pt. should have minimum of

Answer 13

45° flexion; 55° extension

Question 14

Palpate with elbow flexed at

Answer 14

70 degrees
- Extensor surface
• Olecranon process
• Medial & lateral epicondyles of humerus
• Head of Radius
• Extensor tendons

Question 15

Common sites of inflammation & Tennis Elbow

Answer 15

Medial & lateral epicondyles of humerus
• Head of Radius
• Extensor tendons

Question 16

• Gout

Answer 16

• Consolidated deposits

Question 17

• Rheumatoid Nodules

Answer 17

Single or multiple nodules

Question 18

• Nodules
• Heberden’s nodes =
• Bouchard’s nodes =

Answer 18

OA

RA

Question 19

Phalen’s Test

•

Answer 19

Ask pt. hold hands back to back
• Flexing @ wrist 90 °
• Hold for 60 sec.
• *Pain, numbness, burning = carpal tunnel syndrome

Question 20

Tinel’s Sign

•

Answer 20

Direct percussion of Median N.

• Tingle, burning, “electrical shock” type pain = carpal tunnel

Question 21

Gait pattern s/b smooth & even

Answer 21

Trendeleburg Sign = weak or paralyzed hip abductors

• Damage to Superior Gluteal N. (L4, L5, S1)

Question 22

Palpation

Answer 22

• Symmetric

* No pain or crepitance

Question 23

Prepatellar bursa

Answer 23

• Swelling = prepatellar bursitis

Question 24

Suprapatellar pouch

Answer 24

• Swelling = effusion

Question 25

• Lesions

Answer 25

(ie. Psoriasis)

Question 26

Angulation deformities: • Genu varum • Genu valgum

Answer 26

(bow-legs) | knock knees

Question 27

Tibiofemoral articulation (jt.)

Answer 27

• Pain @ jt. Line / Irregular bony margins = OA | osteophytes

Question 28

Check patella for crepitance | •

Answer 28

Hand on patella during flexion/extension • Small crepitus in asymptomatic pt. usually ok •*** Pronounced crepitus = DJD***

Question 29

Knee sudden locking is

Answer 29

Sudden Locking = meniscus tear

Question 30

Audible or Palpable “click” = (

Answer 30

+) for torn meniscus

Question 31

Difference in shoulder level, ribs, scapulae & iliac crests =

Answer 31

scoliosis

Question 32

• Lateral tilting and forward bending =

Answer 32

herniated intervertebral disc

Question 33

LaSegue’s Test Straight LEG RAISE

Answer 33

• If sciatic pain reproduced = herniated disc

Question 34

LaSegue’s Test for

Answer 34

Herniated DISC

Question 35

• Sometimes true limb length is equal, but looks unequal. This is due to (PAF)

Answer 35

pelvic obliquity or adduction or flexion deformity of the HIP.

Question 36

For true length,

Answer 36

measure 2 fixed points

Question 37

For Leg discrepancy measure ______to _______crossing __________of _____

Answer 37

ASIS to Medial Malleolus crossing medial side of knee

Question 38

McMurray’s Test • Pt. supine • Stand on affected side • Hold heel; flex knee & hip)

Answer 38

MedExROpu-in-val

Question 39

In-Var-out-La

Answer 39

Internally rotate tibia & VARUS (OUT) stress on knees tests LATERAL meniscus (Va

Question 40

Ex-Valg-IN-Me

Answer 40

• Externally rotate Tibia & push valgus (inward) stress on knee (tests medial meniscus

Question 41

What is rotate in mcMurrays

Answer 41

Tibia

Question 42

Test Muscle Strengtht – ask seated pt. to maintain flexion while you pull forward (FF)

Answer 42

• Flexion test

Question 43

Test Muscle Strength– ask pt. to rise from seated position w/o hands______ test (RSE)

Answer 43

Extension test