Musculoskeletal System Flashcards
(88 cards)
1
Q
Order of MSK exam
A
- Inspection
- ROM
- Muscle strength
- Reflexes/neuro
- Special tests
- Palpation
2
Q
Joint locking or crepitus suggests…
A
Meniscal injury
3
Q
Give-way injury suggests…
A
Ligamentous or meniscal injury
4
Q
Weakness suggests…
A
Neurological, myopathy, tendinopathy, muscle injury
5
Q
Clicking, popping, tearing sensation suggests…
A
Soft tissue injury or tear
6
Q
Tremor, spasm, weakness suggests…
A
Neurological or muscle injury
7
Q
MSK ROS
A
- -Numbness, tingling, weakness
- -Incontinence or changes in bowel or bladder function
- -Weight loss
- -Night time pain
8
Q
Tendonitis
A
Inflammation of the tendon
9
Q
Tendonosis
A
Degeneration of a tendon
10
Q
Tenosynovitis
A
Inflammation of the sheath of a tendon
11
Q
Tendinopathy
A
Disease of a tendon, often painful overuse tendon condition
12
Q
Tremor
A
Involuntary, somewhat rhythmic, muscle movement involving oscillations of one or more body parts
13
Q
Spasticity
A
Velocity dependent resistance to muscle stretch
Neurological impairment
14
Q
Strain
A
Trauma to a muscle
15
Q
Sprain
A
Trauma to a ligament
16
Q
Arthritis
A
Joint inflammation
17
Q
Arthrosis
A
Joint degeneration
18
Q
Arthralgia
A
Joint pain
19
Q
Arthropathy
A
Disease of a joint
20
Q
Bursitis
A
Inflammation of the bursa
21
Q
Crepitus
A
- -Crunching or grating sound
- -Degenerative bony changes
- -“Bone on bone”
- -Inflammation of tendon sheaths
22
Q
When testing ROM, which is first?
A
- -Assess active (patient-controlled) first
- -Assess passive (physician-controlled) second
23
Q
What are the two red flags in resistance testing?
A
- Pain
2. Weakness
24
Q
What kinds of weakness are there and what do they suggest?
A
Smooth weakness - neurological
Break-away weakness - MSK problem
25
MSK exam for C5
Elbow flexion and shoulder abductors
26
MSK exam for C6
Wrist extensors
27
MSK exam for C7
Elbow extensors
28
MSK exam for C8
Long finger flexor
29
MSK exam for T1
Finger abductors
30
MSK exam for L2
Hip flexors
31
MSK exam for L3
Knee extensors
32
MSK exam for L4
Ankle dorsiflexors
33
MSK exam for L5
Long toe extensors
34
MSK exam for S1
Ankle plantar flexors
35
Muscle strength grade 0
No evidence of movement
36
Muscle strength grade 1
Trace movement
37
Muscle strength grade 2
Full ROM with gravity eliminated
38
Muscle strength grade 3
Full ROM against gravity, but not against resistance
39
Muscle strength grade 4
Full ROM against gravity and against resistance, but weak
40
Muscle strength grade 5
Full ROM against gravity and against resistance, full strength
41
Special tests for MSK evaluation
Ligaments -- elongate and push/pull bones
Joint surfaces -- rub them against each other to assess for pain
Cartilages -- gently squeeze them between bones, look at ROM
42
Trendelenburg sign
- -Unaffected hip drops down with gait
| - -Other hip held up as a result of weakness in hip abductors
43
Signs indicating osteoarthritis
Heberden's node
| Bouchard's node
44
Signs indicating rheumatoid arthritis
Swan-neck deformity
| Boutonniera deformity
45
Straight leg raise
Flex pt's hip to see if there is any impinging on a nerve
46
Bragard's test
If straight leg raise is positive, lower the leg until pain goes away, then dorsiflex foot
If this causes pain, then it's a nerve impinging problem
47
Gibbus
Sharp, angular deformity associated with collapsed vertebra due to atherosclerosis
48
Goniometer
Apparatus to measure joint movements and angles
49
Spurling's test and distraction maneuver
Tests for nerve root compression -- positive Spurling's is pain past mid-humerus
50
Apley Scratch Test
Quick active ROM assessment using usually both arms at the same time -- evaluates abduction and external rotation as they reach up, adduction and internal rotation as they hug themselves, and internal rotation and adduction as they reach back up their spine
51
Neer's test
Internally rotate shoulder, fully extend arm, assess for pain
52
Hawkins test
Abduct shoulder, flex arm, internally rotate forcibly
53
Lift off test
Wing scapula, stabilize elbow, have patient push hand against you to test subscapularis
54
Arm drop test
Abduct patient's arm, ask patient to lower slowly to see if the rotator cuff is damaged (arm would suddenly drop at a little higher than 90 degrees)
55
Apprehension test
Abduct shoulder, flex elbow, apply external rotation to test for shoulder dislocations
56
Yergason's test
Palpate interturbicular groove, have pt supinate against resistance
57
Speed's test
Arm is supinated, shoulder is flexed, have patient press arm down against resistance to test for biceps tendinitis
58
Empty can test
Abduct shoulder, palm facing back, have patient push arm down against resistance
59
How is the patient situated during elbow MSK exam?
Elbows held in close to body
60
What valgus angle would be abnormal?
Greater than 20 degrees
61
Varus and valgus tests
Flex arm about 20-30 degrees, apply varus or valgus force
| Assessing RCL and UCL, respectively
62
Tinel sign
Tapping between medial epicondyle and olecranon causes symptoms
63
Lateral epicondylitis
"Tennis elbow"
Inflammation at the origin of the wrist extensors and supinator muscle
Repetitive wrist extension and supination
64
Cozen's test
Pronation of pt forearm, wrist extension, radial deviation, assess resistance
65
Maudsley's test
Have pt resist pushing their 3rd finger down, assessing for pain
66
Phalen's test
Flex the pt's wrist, positive if pt gets symptoms in
67
Tinel's sign for CTS
Tapping at base of thumb, assessing for pain
68
de Quervain's tenosynovitis
Swelling or stenosis of the sheath around the APL and EPB
69
Finkelstein's test
- -Thumb flexed and fingers fisted around it
- -Ulnar deviation
- -Positive if pain produced over radial wrist
70
Assess for scaphoid fracture
Assess tenderness in the snuff box
71
Thumb grind test
(1st CMC) Carpo-metacarpal joint and joint and metacarpo-phalangeal joint for OA
72
Causes of osteoarthritis in the hand
- -Cartilage degeneration, trauma
| - -Progressive destruction of PIP and DIP, especially DIP and CMC of thumb
73
Heberden's nodes
DIP bony nodules
74
Bouchard's nodes
PIP abnormal enlargements, synovitis
75
RA inspection
Look for swan neck deformity, Boutonniere deformity, Ulnar deviation, MCP swelling/thickening
76
Dupuytren's contracture
Painless, flexion contractures of ring finger and pinky
77
Mallet finger
"Baseball finger," forced DIP flexion of finger
78
Thumb grind test
- -Pushing/twisting thumb metacarpal against the trapezium
| - -Positive with pain/grinding
79
Thomas' sign
Hyperflex one leg, and positive if the other leg lifts up (tightness of hip flexors on the other side)
80
Ober test
Pt lays on their side, extend hip and leg pt's leg fall, positive if the leg stays up (IT band tightness)
81
Ballottement
Compress thigh down towards knee, then tap patella to see if it's floating in excess fluid
82
Apley's compression
Pt is prone, knee is flexed, push on heel and twisting to test menisci
83
Apley's distraction
Pt prone, flex knee, pull ankle up and rotate, to assess collateral ligaments
84
McMurray's test
Flex hip, flex knee, externally/internally rotate tibia, exaggerate hip flexion, apply valgus/varus stress, then return leg to neutral position to assess for MCL/LCL, respectively
85
Anterior drawer test (ankle)
Support calcaneus and apply posterior pressure to assess ATFL
86
Talar tilt
Support calcaneus, slight plantar flexion, invert and evert the foot to assess for AFTL and CFL
87
Squeeze test
Squeeze at the distal part of the knee joint, looking for fractures
88
External rotation stress
Fully dorsiflex, rotate the ankle
