TBL Dec 6 MSK

Question 1

When re-examine injury later and why?

Answer 1

3-5 days later

- allow pain and swelling to decrease

Question 2

Why do empty can test?

Answer 2

Suprapinatus

- beer is super and it makes you fall over at your spine

Question 3

Elbows 90, external rotation?

Answer 3

Infraspinatus + teres minor

Question 4

Lift-off test - dorm on lumbar back and lift off?

Answer 4

Subscapularis

Question 5

Drop arm test

Answer 5

Large rotator cuff tears

Question 6

What does anterior drawer test test?

Answer 6

Anterior talofibular ligament

Question 7

Tibia/fibula squeeze test

Answer 7

Syndesmosis - high ankle injury

Question 8

Anterior cruciate ligament test?

Answer 8

Lachman test: knee 20 degree flexion, pull forward on upper tibial while stabilize lower leg

Question 9

Ottawa knee rule?

Answer 9

Need 1 of 5 criteria:

• isolated patella tender
• head of fibula tender
• can’t flex knee to 90
• can’t bear wt 4 steps
• older than 55

Question 10

Ottawa ankle rule?

Answer 10

• medial/lateral malleolus edge/tip tender
• 5th metatarsal
• navicular
• unable to bear wt

Question 11

when get MRI?

Answer 11

Get two view X-ray first

- MRI when suspect ligament/tendon injury

Question 12

What is PRICE?

Answer 12

Protection
Rest
Ice
Compression
Elevation

Question 13

What drugs for knee/ankle pain control?

Answer 13

NSAIDs

Acetaminophen

Question 14

Early mobilization promotes healing. When start ROM?

Answer 14

48-72 hours after injury

Question 15

Most common cause stiff, painful, unstable joint after sprain?

Answer 15

inadequate rehabilitation

Question 16

What is Grade 1 sprain?

Answer 16

Ligament stretch

Question 17

What is Grade 2 sprain?

Answer 17

Partial ligament tear

Question 18

What is Grade 3 sprain?

Answer 18

Complete ligament tear

Question 19

How treat lumbosacral strain?

Answer 19

NSAIDs

Muscle relaxant

Question 20

Red flag symptoms lower back pain:

Answer 20

Pain at night/rest
> 6 weeks, > 70yo
Loss bowel/bladder
Trauma
Fever
Ankylosing spondylitis
Progressive focal neuro deficits
Alcohol abuse
IV drug use
IS
Corticosteroid
Osteoporosis

Question 21

Top 5 DDX lower back pain - mechanical

Answer 21

Lumbar strain/sprain
Degenerative faets/disks
Herniated disk
Compression fracture
Spinal stenosis

Question 22

Nonmechanical spinal conditions:

Answer 22

Cancer
Inflammatory arthritis
Infection
 - abscess
 - discitis

Question 23

Cauda Equina symptoms

Answer 23

Reduced anal sphincter tone
Decreased ankle reflexes
Bowel/bladder incontinence
Saddle paresthesia

Question 24

Cauda Equina treatment

Answer 24

Immediate MRI
Corticosteroids
Surgical decompression

Question 25

Cancer symptoms: lower back pain

Answer 25

``` Hx cancer Unexplained weight loss Worse pain at night Conservative therapy fails after 1 month Age > 50 ```

Question 26

Labs/tests for Possible Cancer of lower back pain?

Answer 26

``` CBC ESR Radiographs = if abnormal, evaluate with - bone scan - MRI ```