what can be developed overtime according to your specific motion needs?
bursae
what kind of liquid is synovial fluid similar to?
oil, very viscous
what is a strain?
muscle injury
what is a sprain?
ligamentous stretching-type injury
how much movement do you have between your vertebral bodies?
2-5 degrees
what do cartilaginous joints provide?
stability AND some flexibility
what is a syndesmosis?
fibrous joint between two bones
- distal tibiofibula jt (allows leg to stay together)
- will not separate
what are two examples of a pivot joint?
radio/ulna
atlas/axis
how many movements does the TMJ have?
5 motions
it has a disc that divides it into 2 joint spaces
what are signs of superior iliac spine dysfunction?
localized pain at SI space (skin dimples) and SI spaces that are offset
what targeted history questions are important for musculoskeletal injuries?
related injury–have them describe exactly what happened
aggravating (standing = stenosis)
alleviating (sitting = stenosis)
what is radicular pain?
referred pain that follows a nerve root
what will skin creases tell you?
indicative of spine alignment
what skin markings will you look for?
markings (spina bifida-hairy mole) tags (benign growths) edema eccymosis erythema scars
what is an inspection test for ankylosing spondylitis?
men <1in indicates the disease
when should thoracic kyphosis be treated?
when children have it, it should be aggressively pursued
-in the elderly does not need treatment
what conditions may be indicated with kyphosis?
osteoporosis
what is scoliosis?
lateral and rotary curvature of the spine
-indicated by a rib hump when the person bends over
when does scoliosis stop?
after puberty growth spurt, but starts again after menopause
what is a treatment for severe scoliosis?
harington rods
what is sprengel’s deformity?
born with a non descended scapula
what may cause winging of the scapula?
- loss of innervation of the serratus anterior mm by the long thoracic nerve
- contralateral weakness of the trapezius
what may cause unequal hts of iliac cresti?
- leg length discrepancy (disappears with block placed under short leg
- scoliosis, hip ab or ad duct
- listing of trunk unilaterally sometimes with herniated lumbar disc open the foramina
what do you note on palpating the spine?
- spinous processes with thumb for step-offs
- facet joints of C2 and C3
- SI joints even and bilateral
- percuss for tenderness with ulnar surface of fist
- paravertebral mm’s for tenderness and spasm (common with muscle strain)
- sciatic nerve
- other areas that pt suggests
what is spondylolisthesis?
step off of a vertebra-forward slippage, may cause compression
what are indicated by pain with percussion?
compression fx,
osteoporosis
infection (hx of joint replacement-transverse myeloitis)
malignancy
what does sciatic tenderness indicate?
herniated disc
mass lesion
what are the AMA guidelines for cervical flexion?
50 deg
what are the AMA guidelines for cervical extension?
60 deg
what are teh AMA guidelines for cervical rotation?
look at symmetry
80 deg
what are the AMA guidelines for cervical lateral ear bending?
50 deg
look at symmetry
what would pain with hip flexion indicate?
disc herniation
what would pain with hip extension indicate?
spinal stenosis,
lumbar facet athropathy
spondylosithesis
what would be a positive straight leg raise?
pt has LBP that radiates down the leg (pinches the nerve)
what is a positive spurling’s test?
have pain that radiates to the elbow
-tests cervical spine injury
what is a positive trendelenburg?
sudden pelvic drop when pt is asked to stand on one leg
-tests strength of gluteus medius which is innervated by L5
what is a positive fabere test?
figure 4
pain in stress maneuver or when you push against them
what is a positive waddell sign?
if they are positive on 2 ore more tests, raises index of suspicion for magnification of pain
- nonorganic tenderness
- axial stimulation
- seatedd straight leg raise test
- sensory examination
a lumbar lordosis that persists upon flexion would indicate what?
mm spasm
ankylosing spondylitis
