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Week 10 HA Flashcards

1
Q

What does OLDCARTS stand for?

A

Onset, Location, Duration, Character, Aggravating/Alleviating factors, Radiation, Timing, Severity

OLDCARTS is a mnemonic used to systematically assess pain.

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2
Q

What are the systemic/constitutional symptoms to ask about in a patient with joint pain?

A
  • Fever
  • Chills
  • Night sweats
  • Weight loss
  • Fatigue
  • Rash
  • Recent infections
  • History of cancer or autoimmune disease

These symptoms help rule in/out systemic causes like RA, lupus, septic arthritis, or malignancy.

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3
Q

List 5 red flags of low back pain.

A
  • History of cancer
  • Unexplained weight loss
  • Immunosuppression
  • History of intravenous drug use
  • Bladder or bowel dysfunction

Additional red flags include age >50, trauma, night pain, fever, or neurological deficits.

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4
Q

What does the mnemonic IPROMS stand for?

A

Inspection, Palpation, Range of Motion, Other (Special tests), Muscle Strength, Stability

IPROMS is a systematic approach to the musculoskeletal exam.

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5
Q

What are the 4 signs of inflammation?

A
  • Redness (rubor)
  • Swelling (tumor)
  • Heat (calor)
  • Pain (dolor)

Loss of function is also considered a 5th sign in some texts.

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6
Q

How do you evaluate neurovascular function?

A
  • Sensation
  • Motor
  • Reflexes
  • Pulses
  • Capillary Refill

Each component assesses different aspects of neurovascular integrity.

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7
Q

What does SITS refer to?

A
  • Supraspinatus
  • Infraspinatus
  • Teres Minor
  • Subscapularis

These are the four muscles of the rotator cuff.

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8
Q

What are the Ottawa Ankle Rules?

A

X-ray required if:
* Pain in malleolar zone with tenderness at lateral/medial malleolus
* Inability to bear weight
* Pain in midfoot zone with tenderness at base of 5th metatarsal/navicular

These rules help determine the necessity of imaging after ankle or foot injury.

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9
Q

What does the Crossover Test evaluate?

A

AC joint

A positive sign is pain at the AC joint, indicating AC arthritis.

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10
Q

What does the Apley Scratch Test assess?

A

Shoulder ROM

Limited ROM or pain suggests rotator cuff disorder.

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11
Q

What is the positive sign for the Neer Test?

A

Pain with forward flexion

This indicates rotator cuff tendinitis.

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12
Q

What is assessed in the Hawkins Test?

A

Impingement

A positive sign is pain with internal rotation, indicating subacromial impingement.

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13
Q

What does the External Rotation Lag Test evaluate?

A

Infraspinatus/supraspinatus function

A positive sign is arm rotating inward, indicating a rotator cuff tear.

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14
Q

What does the Internal Rotation Lag Test assess?

A

Subscapularis function

A positive sign is the hand falling to the back, indicating a subscapularis tear.

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15
Q

What is the Drop Arm Test used for?

A

Supraspinatus function

A positive sign is inability to lower the arm slowly, indicating a supraspinatus tear.

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16
Q

What does the Empty Can Test evaluate?

A

Supraspinatus function

A positive sign is pain/weakness, indicating a supraspinatus issue.

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17
Q

What is the Finkelstein Test used for?

A

Thumb tendons

A positive sign is pain with ulnar deviation, indicating De Quervain’s.

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18
Q

What does the McMurray Test assess?

A

Meniscus

A positive sign is a click or pain, indicating a meniscal tear.

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19
Q

What is tested with the Valgus Stress Test?

A

MCL

A positive sign is pain/laxity, indicating an MCL injury.

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20
Q

What does the Anterior Drawer Test evaluate?

A

ACL

A positive sign is tibial movement forward, indicating an ACL tear.

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21
Q

What does the Trendelenburg Test assess?

A

Hip abductors

A positive sign is pelvis dropping on the opposite side, indicating weakness in the gluteus medius.

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22
Q

What are the key components of a musculoskeletal history?

A
  • OLDCARTS
  • Mechanism of Injury (MOI)
  • Review of Systems (ROS)
  • Functional impact
  • Joint-specific questions
  • Red flags screening

Each component is crucial for a comprehensive musculoskeletal assessment.

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23
Q

What are the grading levels of muscle strength?

A
  • 0: No contraction
  • 1: Flicker
  • 2: Active movement without gravity
  • 3: Active movement against gravity
  • 4: Active movement against some resistance
  • 5: Normal strength

This grading system helps assess muscle function.

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24
Q

What are common anatomical landmarks to palpate in the hand and wrist?

A
  • Heberden nodes (DIP)
  • Bouchard nodes (PIP)
  • Anatomical snuffbox
  • MCP subluxation
  • Ulnar deviation

These landmarks are important for identifying pathologies.

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25
What is the significance of the Galeazzi or Allis Sign?
Testing for femoral length discrepancy or hip dislocation A positive sign shows one knee appears lower when hips and knees are flexed.
26
What does the assessment for scoliosis involve?
Testing spinal asymmetry ## Footnote A positive sign is asymmetric shoulder height or rib hump with forward bending.
27
What is the term for the movement of the wrist that involves flexion, extension, radial & ulnar deviation?
Wrist
28
What are the movements associated with the fingers?
Flexion, extension, abduction, adduction
29
What movements occur in the spine?
Flexion, extension, lateral bending, rotation
30
What are the movements of the hip joint?
Flexion, extension, abduction, adduction, internal & external rotation
31
What are the primary movements of the knee?
Flexion, extension
32
What movements are associated with the ankle?
Dorsiflexion, plantar flexion, inversion, eversion
33
What are the movements of the toes?
Flexion, extension
34
What does a muscle strength grade of 0 indicate?
No contraction
35
What does a muscle strength grade of 1 indicate?
Flicker or trace of contraction
36
What does a muscle strength grade of 2 signify?
Active movement with gravity eliminated
37
What does a muscle strength grade of 3 mean?
Active movement against gravity
38
What does a muscle strength grade of 4 indicate?
Active movement against gravity + some resistance
39
What is a muscle strength grade of 5 considered?
Normal strength
40
What does the Crossover Adduction test assess?
AC joint pathology
41
What does a positive result in the Crossover Adduction test indicate?
Pain over AC joint
42
What does the Apley Scratch Test evaluate?
Shoulder rotation and flexibility
43
What is indicated by pain or limited range of motion in the Apley Scratch Test?
Positive result
44
What condition does the Painful Arc test for?
Subacromial impingement
45
What is indicated by pain between 60°-120° in the Painful Arc test?
Positive result
46
What does the Neer test assess?
Impingement (supraspinatus/bursa)
47
What indicates a positive Neer test?
Pain with forward flexion
48
What does the Hawkins test evaluate?
Impingement (supraspinatus)
49
What does a positive Hawkins test indicate?
Pain with internal rotation
50
What condition does the Drop Arm test assess?
Rotator cuff tear
51
What indicates a positive Drop Arm test?
Inability to hold arm abducted
52
What does the Empty Can/Full Can test assess?
Supraspinatus strength
53
What indicates weakness or pain in the Empty Can/Full Can test?
Positive result
54
What does the External/Internal Rotation Lag test assess?
Rotator cuff tears
55
What indicates a positive External/Internal Rotation Lag test?
Inability to maintain rotation
56
What does the Finkelstein test evaluate?
de Quervain tenosynovitis
57
What indicates a positive Finkelstein test?
Pain over radial styloid with thumb grasp/flexion
58
What does Tinel’s Sign test for?
Carpal Tunnel
59
What indicates a positive Tinel’s Sign?
Tingling in median nerve distribution
60
What does Phalen’s Test evaluate?
Carpal Tunnel
61
What indicates a positive Phalen’s Test?
Numbness/tingling in median distribution
62
What does the Thumb Abduction test assess?
Median nerve/muscle weakness
63
What indicates a positive Thumb Abduction test?
Weakness against resistance
64
What does the McMurray test evaluate?
Meniscal tear
65
What indicates a positive McMurray test?
Click or pain with rotation
66
What does the Valgus (abduction) Stress test assess?
MCL
67
What indicates a positive Valgus Stress test?
Laxity/pain medial side
68
What does the Varus (adduction) Stress test evaluate?
LCL
69
What indicates a positive Varus Stress test?
Laxity/pain lateral side
70
What does the Anterior Drawer test assess?
ACL
71
What indicates a positive Anterior Drawer test?
Excessive forward tibial movement
72
What does the Lachman test evaluate?
ACL
73
What indicates a positive Lachman test?
Forward movement, soft endpoint
74
What does the Posterior Drawer test assess?
PCL
75
What indicates a positive Posterior Drawer test?
Posterior tibial movement
76
What does the Straight Leg Raise test evaluate?
Lumbar radiculopathy (L5/S1)
77
What indicates a positive Straight Leg Raise test?
Pain in leg between 30-70° elevation
78
What does the Crossed Straight Leg test assess?
Herniated disc
79
What indicates a positive Crossed Straight Leg test?
Pain in affected leg when opposite leg raised
80
What does the Spurling test evaluate?
Cervical radiculopathy
81
What indicates a positive Spurling test?
Reproduced arm pain/tingling
82
What does the Thompson Test assess?
Achilles tendon rupture
83
What indicates a positive Thompson Test?
No plantarflexion with calf squeeze
84
What does the Talar Tilt Test evaluate?
Lateral ankle ligaments
85
What indicates a positive Talar Tilt Test?
Excessive inversion
86
What does the Barlow-Ortolani test assess?
Congenital hip dislocation
87
What indicates a positive Barlow-Ortolani test?
"Clunk" with maneuver
88
What does the Galeazzi Sign evaluate?
Hip dislocation
89
What indicates a positive Galeazzi Sign?
Asymmetrical knee height when hips/knees flexed
90
What does the Trendelenburg test assess?
Gluteus medius weakness
91
What indicates a positive Trendelenburg test?
Pelvic drop on contralateral side when standing
92
What does the Scoliosis Screen evaluate?
Curvature of spine
93
What indicates a positive Scoliosis Screen?
Rib hump when bending forward
94
What does the IPROMS mnemonic stand for?
Inspection, Palpation, Range of motion, Other, Muscle strength, Sensory/motor/reflex/neurovascular assessment
95
What are the four signs of inflammation?
Redness, warmth, swelling, pain
96
What should be checked during a neurovascular assessment?
Motor, Sensation, Pulses
97
What is the normal finding for hip dysplasia screening in infants?
Positive sign = palpable clunk
98
What is Genu Varum?
Bowlegs, normal until ~18–24 months
99
What is Genu Valgum?
Knock-knees, common ages 3–5; should resolve by age 7–8
100
What is Tibial Torsion?
Common cause of in-toeing in toddlers
101
What is Nursemaid's Elbow?
Common subluxation of the radial head in toddlers from arm pulling
102
What does the Adams forward bend test assess?
Scoliosis screening
103
What are the key considerations for older adults during a musculoskeletal exam?
Decreased muscle mass and strength, reduced joint flexibility and ROM, increased kyphosis
104
What is a recommended screening for osteoporosis in women?
DEXA scans for women ≥65 years and younger postmenopausal women with risk factors
105
What are the key components of fall prevention?
Exercise, vision care, address home hazards
106
What does the OLDCARTS acronym stand for in history taking?
Onset, Location, Duration, Characteristics, Aggravating factors, Relieving factors, Timing, Severity
107
What is the significance of assessing gait and balance in older adults?
To evaluate fall risk
108
What dietary recommendations are made for osteoporosis prevention?
Calcium (1,000–1,200 mg/day) and Vitamin D (800–1,000 IU/day) intake
109
What is the importance of addressing modifiable risks in osteoporosis?
To prevent fractures and maintain bone health
110
What are common signs of joint pain in older adults?
Common in OA; morning stiffness that improves (RA, PMR)
111
What should be done if a patient presents with low back pain?
Identify red flags for serious underlying conditions

Health Assessment (8 decks)

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