Musculoskeletal Day 1

Question 1

what can be developed overtime according to your specific motion needs?

Answer 1

bursae

Question 2

what kind of liquid is synovial fluid similar to?

Answer 2

oil, very viscous

Question 3

what is a strain?

Answer 3

muscle injury

Question 4

what is a sprain?

Answer 4

ligamentous stretching-type injury

Question 5

how much movement do you have between your vertebral bodies?

Answer 5

2-5 degrees

Question 6

what do cartilaginous joints provide?

Answer 6

stability AND some flexibility

Question 7

what is a syndesmosis?

Answer 7

fibrous joint between two bones

• distal tibiofibula jt (allows leg to stay together)
• will not separate

Question 8

what are two examples of a pivot joint?

Answer 8

radio/ulna

atlas/axis

Question 9

how many movements does the TMJ have?

Answer 9

5 motions

it has a disc that divides it into 2 joint spaces

Question 10

what are signs of superior iliac spine dysfunction?

Answer 10

localized pain at SI space (skin dimples) and SI spaces that are offset

Question 11

what targeted history questions are important for musculoskeletal injuries?

Answer 11

related injury–have them describe exactly what happened
aggravating (standing = stenosis)
alleviating (sitting = stenosis)

Question 12

what is radicular pain?

Answer 12

referred pain that follows a nerve root

Question 13

what will skin creases tell you?

Answer 13

indicative of spine alignment

Question 14

what skin markings will you look for?

Answer 14

markings (spina bifida-hairy mole)
tags (benign growths)
edema
eccymosis
erythema
scars

Question 15

what is an inspection test for ankylosing spondylitis?

Answer 15

men <1in indicates the disease

Question 16

when should thoracic kyphosis be treated?

Answer 16

when children have it, it should be aggressively pursued

-in the elderly does not need treatment

Question 17

what conditions may be indicated with kyphosis?

Answer 17

osteoporosis

Question 18

what is scoliosis?

Answer 18

lateral and rotary curvature of the spine

-indicated by a rib hump when the person bends over

Question 19

when does scoliosis stop?

Answer 19

after puberty growth spurt, but starts again after menopause

Question 20

what is a treatment for severe scoliosis?

Answer 20

harington rods

Question 21

what is sprengel’s deformity?

Answer 21

born with a non descended scapula

Question 22

what may cause winging of the scapula?

Answer 22

• loss of innervation of the serratus anterior mm by the long thoracic nerve
• contralateral weakness of the trapezius

Question 23

what may cause unequal hts of iliac cresti?

Answer 23

1. leg length discrepancy (disappears with block placed under short leg
2. scoliosis, hip ab or ad duct
3. listing of trunk unilaterally sometimes with herniated lumbar disc open the foramina

Question 24

what do you note on palpating the spine?

Answer 24

1. spinous processes with thumb for step-offs
2. facet joints of C2 and C3
3. SI joints even and bilateral
4. percuss for tenderness with ulnar surface of fist
5. paravertebral mm’s for tenderness and spasm (common with muscle strain)
6. sciatic nerve
7. other areas that pt suggests

Question 25

what is spondylolisthesis?

Answer 25

step off of a vertebra-forward slippage, may cause compression

Question 26

what are indicated by pain with percussion?

Answer 26

compression fx,
osteoporosis
infection (hx of joint replacement-transverse myeloitis)
malignancy

Question 27

what does sciatic tenderness indicate?

Answer 27

herniated disc

mass lesion

Question 28

what are the AMA guidelines for cervical flexion?

Answer 28

50 deg

Question 29

what are the AMA guidelines for cervical extension?

Answer 29

60 deg

Question 30

what are teh AMA guidelines for cervical rotation?

Answer 30

look at symmetry

80 deg

Question 31

what are the AMA guidelines for cervical lateral ear bending?

Answer 31

50 deg

look at symmetry

Question 32

what would pain with hip flexion indicate?

Answer 32

disc herniation

Question 33

what would pain with hip extension indicate?

Answer 33

spinal stenosis,
lumbar facet athropathy
spondylosithesis

Question 34

what would be a positive straight leg raise?

Answer 34

pt has LBP that radiates down the leg (pinches the nerve)

Question 35

what is a positive spurling’s test?

Answer 35

have pain that radiates to the elbow

-tests cervical spine injury

Question 36

what is a positive trendelenburg?

Answer 36

sudden pelvic drop when pt is asked to stand on one leg

-tests strength of gluteus medius which is innervated by L5

Question 37

what is a positive fabere test?

Answer 37

figure 4

pain in stress maneuver or when you push against them

Question 38

what is a positive waddell sign?

Answer 38

if they are positive on 2 ore more tests, raises index of suspicion for magnification of pain

1. nonorganic tenderness
2. axial stimulation
3. seatedd straight leg raise test
4. sensory examination

Question 39

a lumbar lordosis that persists upon flexion would indicate what?

Answer 39

mm spasm

ankylosing spondylitis