Wk 3 MSK Lecture

Question 1

How is arthritis defined?

Answer 1

• Articular swelling/effusion OR
• 2 or more of the following signs:
• ROM limitation
• Joint tenderness on palpation
• Pain on joint movement
• Increased warmth over joint

Question 2

Synovitis

Answer 2

Inflammation of the synovial membrane, which lines the inside of the articular cartilage

Question 3

Joint effusion

Answer 3

increased synovial fluid in the synovial cavity of a joint

Question 4

crepitus

Answer 4

a grating/grinding/cracking sound of sensation from 2 rough surfaces rubbing together

Question 5

arthralgia

Answer 5

join pain

Question 6

myalgia

Answer 6

muscle pain

Question 7

Enthesis

Answer 7

insertion point of tendon or ligament to bone
- common: Achilles and tibial

Question 8

enthesitis

Answer 8

inflammation of the insertion site of ligament/tendon to bone

Question 9

Bursa

Answer 9

sacks lined w/ synovial membrane containing synovial fluid

Question 10

Bursitis

Answer 10

inflammation of the bursa

Question 11

MUSK Hx Qs

Answer 11

Where is the pain/swelling/redness?
How long?
Injury?
When is the pain worse?
Stiffness?
Meds? Helpful? Dose?

Question 12

5 tenents of MUSK exam

Answer 12

1. inspection - bare skin, state observations, note asymmetry
2. palpation (incl. T)
3. ROM
4. strength
5. Gait

Question 13

What is TUG?

Answer 13

Timed up & go
-fall risk

Question 14

What do we check w/ gait test?

Answer 14

1. tandem gait
2. toe walking
3. heel walking

Question 15

What do we palpate in the shoulder joint?

Answer 15

1. acromioclavicular joint
2. bicipital groove

Question 16

What 4 elbow ROMs are tested?

Answer 16

1. elbow flexion
2. extension
3. forearm pronation
4. forearm supination

Question 17

Hand and wrist MUSK inspection

Answer 17

plamar and dorsal surfaces

Question 18

Technique for PIP joint palpation

Answer 18

PIP = proximal interphalangeal joints
* 2 fingers of one hand on the medial and lateral joint lines
* 2 fingers from the opposite hand on the top and bottom of the joint.
* Pressure is applied from the top and bottom and then from the medial and lateral areas
* Alternating to feel for the fluid swish around your fingers like a water balloon

Question 19

MCP joint palpation

Answer 19

MCP = metacarpophalangeal joints
Technique
* Palpate the top of the MCP with thumbs of both hands
* Movefingersdownthe MCP into spaces between MCP
* Effusionsfeelslikea balloon

Question 20

Wrist palpation

Answer 20

Technique
* Groove of radiocarpal joint
* Distal radius
* Ulnar styloid process

Question 21

Causes of limited ROM in hands

Answer 21

1. RA
2. osteoarthritis

Question 22

What are diff hand deformities from late stage RA?

Answer 22

1. Boutonneire deformity of thumb (thumb pointed laterally)
2. Swan-neck deformity of fingers - bent laterally at distal joint
3. Ulnar deviation of metacarophalangeal joints

Question 23

What are 2 signs of late stage of osteoarthritis?

Answer 23

1. Heberden’s nodes - further on pinky, ring finger - distal DIPs
2. Bouchard’s nodes - close on pointer finger - proximal PIPs

*can’t have both at same time

Question 24

Knee palpation

Answer 24

1. Palpate Medial and Lateral Lines
   * 1 hand above and below and move fluid back and forth. Attempt to feel fluid hit your fingertip
2. palpate patella
3. tibial tuberosity

Question 25

Knee ROM

Answer 25

Question 26

Ankle joint palpation

Answer 26

Medial and lateral malleoli
* Anterior surface of ankle
* Achilles tendon
Technique:
* With thumbs, palpate the anterior aspect of each ankle
* Palpate tendons in center
* Palpate malleoli
* Palpate Achilles tendon down to insertion point (enthesis)

Question 27

Ankle ROM types

Answer 27

dorsiflexion
plantar flexion
inversion
eversion

Question 28

Documenting acronyms: LROM, POM, PIP, MCP

Answer 28

LROM= loss in range of motion POM= pain on motion
PIP= Proximal Interphalangeal MCP= metacarpophalangeal joints