Physical Assessment 2 > MSK > Flashcards

MSK Flashcards

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1
Q

Osteoartrhtisit is MC in:
M or W?
and what anatomical location

A

women

knee

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2
Q

tenderness of the entire joint, crepitus, instability, locking and deformity limiting both active and passive ROM due to pain or stiffness explains?

A

articular disease

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3
Q

point or focal tenderness in regions adjacent to articular strucutres and limits ROM explains?

A

extra-articular dz

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4
Q

which rarely causes swelling, instability or joints deformity:
-extra articular dz
or
-articular dz

A

extra articular dz

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5
Q

__ cervical
__ thoracic
___ lumbar

vertebrae are stacked on?

A

7 cervical
12 thoracic
5 lumbar

*stacked on sacrum and coccyx

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6
Q

bringing chin to chest is?

A

flexion of neck

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7
Q

looking up to the ceiling is

A

extension of neck

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8
Q

looking over the right and left shoulder is

A

rotation of neck

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9
Q

bringing right ear to shoulder and then same with the left is

A

lateral bending of neck

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10
Q

spine ROM

A

flexion–bend forward and touch toes
extension–bend as far back as poss
rotation–rotate side to side
lateral bending–bend side to side

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11
Q

list the articular strucutures (6)

A
  1. joint capsule
  2. articular cartilage
  3. synovium
  4. synovial fluid
  5. intra-articular ligaments
  6. juxta-articular bone
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12
Q

list extra articular strucs (8)

A
  1. periarticular ligaments
  2. tendons
  3. bursae
  4. muscle
  5. fascia
  6. bone
  7. nerve
  8. overlying skin
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13
Q

ropelike bundles of collagen fibrils that connect bone-bone

A

ligaments

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14
Q

collagen fibers that connect muscle-bone

A

tendons

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15
Q

collagen matrix overlying bony surfaces

A

cartilage

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16
Q

pouches of synovial fluid that cushion the movement of tendons and muscles over bone or other joint structures

A

bursae

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17
Q

synovial joints:

  • move freely?
  • what is bone covered by?
  • what are bones separatd by?
  • what lurbicates joint movement
  • ex 5
A

moves freely
bones are covered by articular cartilage
bones are separated by synovial cavity
synovial membrane secreted synovial fluid that lubricates joint movement

EX: shoulder, knee, hip, tmj, interphalangeal joints of hand/foot

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18
Q

cartilaginous joints

  • move freely?
  • what is bone covered by?
  • what lurbicates joint movement
  • ex 2
A

slightly movable
bones sep by fibrocartilaginous discs
discs contain nucleus pulposus that cushions bony movement

EX: vertebral bodies of spine

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19
Q

fibrous joint

  • movement?
  • bones are separated by?
  • ex
A

joints have no movement
-bones sep by fibrous tissue or catilage

ex: sutures of skull

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20
Q

spheroidal joint

  • also called
  • articular shape
  • movement
  • ex
A

ball and socket
articular shape=convex surface in concave cavity
-movement: wide range flexion, extension, abduction, adduction, rotation, circumduction

ex: shoulder, hip

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21
Q

Hinge joint

  • articular shape
  • movement
  • ex
A

shape=flat, plantar

movement: motion is one plane…flexion and extension
ex: interphalangeal joints of hand and foot, elbow

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22
Q

condylar joint

  • articular shape
  • movement
  • ex
A

shape= convex or concave

movenet: movement of two articulating surfaces.. not dissociable
ex: knee, TMJ

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23
Q

how does the knee joint move

A

its a condylar joint (type of synovial joint)

movement of two articulating surfaces— not dissociable

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24
Q

list the common or concerning symps

A
  1. low back pain
  2. neck pain
  3. joint pain
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25
how do we categorize patient complaints? (4)
1. articular vs extra-articular 2. acute (<6 wks) or chronic (>12wks) 3. inflammatory vs noninflammatory 4. localized (monoarticular) vs diffuse (polyarticular)
26
list the features of inflammation (4)
swelling warmth redness pain
27
ex of single joint injuries
tendinitis | bursitis
28
what can migratory pattern of pain indicate?
rheumatic fever | gonococcal arthritis
29
additive/progressive pattern + symmetric involvement=?
RA
30
cause inflamamtory joint disorders (5)
1. infectious: N. gonorrhea, TB 2. crystal induced--gout 3. immune related--lupus, RA 4. reactive--- reactive arthritis 5. idiopathic
31
pain in single joint suggests
monoarthritis injury extra articular dz-- tendinitis or bursitis
32
lateral hip pain with focal tenderness over the greater trochanter is suggestive of
trochanteric bursitis
33
inflammatory arthritis is more comon in?
women
34
caues of extra articular pain
bursitis tendinitis tenosynovitis--tendon sheaths sprains from stretching or tearing of ligaments
35
decrease active and passive ROM | +morning stiffness or gelling
articular joint pain
36
decrease active ROM and normal passive ROM
extra-articular joint pain
37
myalgias
"aches and pains" muscle is the pain -extra articular
38
arthralgias
joint pain but no evidence of artritis | -extra articular
39
tendonitis
inflamation of tendon | -extra articular
40
bursitis
infalmmatino of bursae | -extra articular
41
inflamm of tendon sheaths
tenosynovitis | -extra articular
42
sprains
stretching/tearing of ligaments | -extra articular
43
joint pain + butterfly rash on cheeks
lupus
44
joint pain + scaly plaques on extensor surfaces
Psoriasis
45
Joint pain + stiffness especially in morning, better throughoug the day with movemnt
RA
46
joint pain + bulls eye rash
lyme
47
12 red flag s/s for low back pain
1. Age <20 yrs or >50 yrs 2. History of cancer 3. Unexplained weight loss, fever, or decline in general health 4. Pain lasting more than 1 mo or not responding to treatment 5. Pain at night or present at rest 6. History of intravenous drug use, addiction, or immunosuppression 7. Presence of active infection or human immunodeficiency virus (HIV) infection 8. Long-term steroid therapy 9. Saddle anesthesia 10. Bladder or bowel incontinence 11. Neurologic symptoms or progressive neurologic deficit 12. Lower extremity weakness
48
where is location of biceps tendon | what movement does it do
bicipital groove runs medial to greater tubercle *flexion of elbow*
49
pain with adduction of arm or pain with crossover tests suggests
AC joint disorder
50
pain during apley scratch test suggests
rotator cuff disorder or adhesive capsulitis
51
MCC of shoulder pain ?
rotator cuff disorder
52
list the pain provocation tests for the shoulder ---3
painful arc test neer impingement sign hawkins impingement sign
53
strength tests for the shoulder ---3
external rotation lag test internal rotation lag test drop-arm test
54
composite tests for the shoulder--2
external rotation resistance test | empty can test
55
symmetric involvement --list the disorders (3)
- RA - SLE--- lups - ankylosing spondylitis
56
asymmetric involvement-list the disorders (3)
-psoriatic, reactive and IBD assoc arthritis
57
radicular pain signals?
spinal nerve compression | MC at C7 or C6
58
MC site for spinal nerve compression
C6 C7
59
how to perform painful arc test | + sign means?
Full abduct the patients arm from 0 to 180 degrees *shoulder pain from 60-120 is a positive test for subacrominal impigement/rotator cuff tendinitis disorder
60
positive painful impinegment test means?
subacrominal impingement/rotator cuff teninditis disorder
61
how to do the near impingement test | -positive test means?
press on scapula while raising patients arm + test=pain during test means: subacrominal impingement/rotator cuff tendonitis
62
how to do hawkins test | -pos test means?
flex shoulder and elbow to 90 degrees with palm down -next rotate arm interally postive test=pain during test means: supraspinatus impingement/rotator cuff tendonitis
63
drop arm test-how to do | + means?
abduct arm to shoulder level and lower it slowly | -Weakness is a + test
64
+ finding for external rotation resistance test means
infraspinatus disorder---weakness/pain=pos
65
positive finding for empty can test means?
supraspinatus rotator cuff tear | + test= inability for pt to hold up arm
66
ROM for elbow
flexion--bend elbow extension--straighten elbow pronation--turn palm down supination--turn palm up
67
location of ulnar nerve
b/w olecranon process and medial epicondyle
68
finkelstein test--what does it show
tests for thumb dequervains tenosynovitis
69
what muscles are part of the hamstring
semimembranous gracilis sartorius semitendinosus
70
scoliosis
deformity of the thorax on forward bending | -esp when the height of the scapulae is unequal
71
height of scapulae are unequal suggests?
scoliosis
72
elevation of one shoulder, lateral and rotatory curvature of spine brings head back t midline
scoliosis
73
___ can cause unequal leg lengths
scoliosis
74
deformity of throax on forward bending
scoliosis
75
persistence of lumbar lordosis suggests?
muscle spasm or ankylosing spondylitis
76
inward curvature of spine
lordosis
77
hunchback... can occur with age
kyphosis
78
what is the largest joint in the body?
knee joint
79
type of joint for knee?
hinge
80
how m any ligaments support the knee
four
81
deeply embeded in pelvis and noted for strenght, stability and wide ROM
hip joint
82
what is the hip joint noted for?
strength stability wide ROM
83
what provides stability in hip joint
deep fit of femur head into acetabulum
84
what provides hip joint strength
strong fibrous articular capsule and power muscles
85
what type of joint is the hip
ball in socket--wide ROM
86
can you readily palpate hip joint?
no
87
nocturnal hand or arm numbness
carpal tunnel
88
droping objects (decr grip strenght) or inability to twist lids off jars?
carptal tunnel
89
aching at wrist or forearm
carpal tunnel
90
numbness of the first 3 digits
carptal tunnel
91
carpal tunnel involves what nerve | -what causes it
compression of median nerve causes: foreceful repeptitive handwork with wrist flexion like--- keyboarding, mail, sorting, virbation, or cold envir
92
RF for carpal tunnel (5)
``` pregnancy RA wrist anatomy DM hyPOthyroidism ```
93
what tests do we use to diagnose carpal tunnel
phalen test | tinnel test
94
explain median nerve teritory
VOLAR (palm) surface of - thumb, - secnod finger - half of ring finger DORSAL surface: -inner aspect of thumb -PIP and up of second third fingers half of the fourth
95
osgood schlatter dz --what is it | -who gets it
tibial tubercle tenderness -knee pain in adolescents from inflammation of the tendon from kneecap to tibial tuberosity *repeptitve use injury so MC in kids who play sports--running, jumping,
96
colles fracture affects what nerve
median
97
tenderness over the distal radius after a fall is suscious for?
colles fracture
98
palpable click or pop along the medial or lateral joint line of the knee? what + sign would this be?
+ test for medical meniscal tear | +mcmurry sign
99
pain or a gap in the medial joint line of the knee is a positive?
+ test for MCL injury
100
pain or a gap in the lateral joint line of the knee?
+ test for LCL injury
101
degenerative joint dz +degeneration +progressive loss of joint cartilage
osteoarthritis
102
causes of osteoarthritis
mechanical stress w damage to underlying bone, formation of new bone at the cartilage margin
103
crepitus over inflammed joints?
osteoarthritis
104
heberden nodes over DIP joints
osteoarthritis
105
Bouchard nodes over PIP joints?
osteoarthritis
106
what nodes are over DIP joints with osteoarthritis
heberden
107
what nodes are over the PIP joints with osteoarthritis
Bouchard
108
degree with ROM for the wrist - extension? - flexion? - radial deviation - ulnar deviation
extension= 70 degrees flexion=80 degrees 20 degrees radial deviation 30 degrees ulnar deviation
109
adhesive capsulitis
aka frozen shoulder -pain with overall shoulder rotation +diffuse, dull aching progressive restriction of active and passive ROM +apley scratch test
110
+ apley scratch test?
adhesive capsulitis aka frozen shoulder
111
diffuse dull aching progressive restriction of active and passive ROM and pain with overall shoulder rotation
adhesive capsulitis aka frozen shoulder
112
what nerves innervate the wrist and hands
median radial ulnar
113
mcmurry tests?
medial and lateral menisci
114
Valgus tests?
MCL | *also called abduction test
115
Varus tests?
LCL | *also called Adduction test
116
anterior drawer sign or Lachman tests what anatomical structure?
ACL
117
posterior drawer sign tests?
PCL
118
+ bulge sign?
minor effusion
119
+ balloon sign?
major effusion
Physical Assessment 2
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