NPTE Study Practice > MSK Patho UE > Flashcards

MSK Patho UE Flashcards

(95 cards)

Study These Flashcards
1
Q

DJD/OA are characterized by

A
  • Degeneration of articular cartilage with hypertrophy of subchondral bone & joint capsule of weight bearing joints
  • Most common form of arthritis affecting men more than women before age 50 and women more than men after age 50
  • Slowly progressive condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs and symptoms of DJD/OA

A
  • Pain
  • Swelling
  • Loss of ROM
  • Bony deformity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Radiographic findings indicating OA

A
  • Diminished joint space
  • Decreased height of articular cartilage
  • Presence of osteophytes
  • Subchondral cysts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Primary medications used for management of DJD/OA

A
  • Oral analgesics
  • NSAIDs
  • Corticosteroid injections
  • Viscosupplementation or intra-articular injections of the knee with a form of hyaluronic acid can be used
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pathology of Ankylosing spondylitis

A
  • Progressive inflammatory disorder of unknown etiology that initially affects axial skeleton
  • HLA-B27 biomarker indicating disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Timeline of symptoms for Ankylosing spondylitis

A
  • Mid to LBP for ≥3 months before the 4th decade of life
  • Morning stiffness and sacroiliitis
  • Results in kyphotic deformity of cervical/thoracic spine & decreased lumbar lordosis
  • Men affected 3x more than women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Medications used for management of Ankylosing spondylitis

A
  • NSAIDs to reduce inflammation & pain
  • Corticosteroids to suppress immune system to control various sx
  • Cytotoxic drugs (drugs that block cell growth) for those that don’t respond well to other treatments
  • Tumor necrosis factor (TNF) inhibitors to improve some sx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pathology of Gout

A
  • Genetic disorder of purine metabolism
  • Characterized by elevated serum uric acid (hyperuricemia)
  • Uric acid changes into crystals & deposits into peripheral joints & other tissues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What joints is Gout most frequently observed

A
  • Knee
  • Great toe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Medications for management of Gout

A
  • NSAIDs
  • COX-2 inhibitors
  • Colchicine
  • Corticosteroids
  • Adrenocorticotropic hormone (ATCH)
  • Allopurinol
  • Probenecid
  • Sulfinpyrazone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pathology of Psoriatic arthritis

A
  • Chronic, erosive inflammatory disorder of unknown etiology, associated with psoriasis
  • Both sexes affected equally
  • Erosive degeneration typically of the digits and axial skeleton joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Medications for management of Psoriatic arthritis

A
  • Acetaminophen for pain
  • NSAIDs
  • Corticosteroids
  • DMARDs (disease modifying anti rheumatic drugs) to slow progression
  • Biological response modifiers (BRM) like Enbrel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pathology of RA

A
  • Chronic systemic autoimmune disorder of unknown etiology thought to have a genetic basis
  • Pts produce antibodies to their own immunoglobulins (RF and ACPA)
  • Characterized by periods of exacerbation and remission
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Who does RA affect

A
  • Women affect 2-4x more than men
  • Age of onset ~40-60
  • Onset may be gradual or abrupt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is RA characterized

A
  • Bilateral and symmetrical synovial joint involvement
  • Most common joints include hands, feet, and cervical spine
  • Systemic features may include weight loss, fever, and extreme fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Diagnostic testing for RA

A
  • Radiographs
  • Increased white blood cell count
  • Increased erythrocyte sedimentation rate
  • Elevated rheumatoid factor
  • Hemoglobin and hematocrit will show anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Medications for management of RA

A
  • Golds and DMARDs in early stages
  • NSAIDs and immunosuppressive agents
  • Corticosteroids for acute flare-ups or long term management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pathology of osteoporosis

A
  • Metabolic disease that depletes bone mineral density/mass, predisposing individual to fracture
  • Affects women 10x more than men
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Common fracture site for osteoporosis

A
  • Thoracic and lumbar spine
  • Femoral neck
  • Proximal humerus
  • Proximal tibia
  • Pelvis
  • Distal radius
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is primary/postemenopausal versus senile osteoporosis

A
  • Primary: directly related to a decrease in estrogen production
  • Senile: occurs due to a decrease in bone cell activity secondary to genetics or acquired abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Medications for management of osteoporosis

A
  • Calcium
  • Vitamin D
  • Estrogen
  • Calcitonin
  • Biophosphonates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Pathology of osteomalacia

A
  • Decalcification of bones due to vitamin D deficiency
  • Sx: severe pain, fractures, weakness, deformities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Medications for management of osteomalacia

A
  • Calcium
  • Vitamin D
  • Vitamin D injections in the form of calciferol (vitamin D2)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Diagnostic tests for osteomalacia

A
  • Radiographs
  • Urinalysis and blood tests
  • Bone scan
  • Bone biopsy if warranted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Pathology of osteomyelitis
- Inflammatory response within bone caused by an infection - Usually caused by Staphylococcus aureus - More common in children and immunosuppressed adults - More common in men than women
26
Treatment for osteomyelitis
- Antibiotics - Proper nutrition - Surgery if infection spreads to joints
27
Pathology of myofascial pain syndrome
- Characterized by "trigger point" which is a focal point of irritability found within a muscle - Trigger point can be identified as a taut, palpable band within the muscle
28
Difference between an active versus latent trigger point
- Active: tender to palpate & have a characteristic referral pattern of pain when provoked - Latent: palpable taut bands that are not tender to palpate but can be converted into an active trigger point
29
Medical intervention for trigger points
- Dry needling - Analgesic injection - Can be combined with a corticosteroid
30
Pathology of tendonosis/tendonopathy
- Dysfunction caused by an imbalance between tendon loading and recovery which leads to tendon failure an a microscopic and eventually macroscopic level
31
Histological characteristics of tendonosis/tendonopathy
- Hypercellularity - Hypervascularity - No indication of inflammatory infiltrates - Poor organization and loosening of collagen fibrils
32
Pathology of bursitis
- Inflammation of bursa secondary to overuse, trauma, gout, or infection
33
Signs and symptoms of bursitis
- Pain with rest - PROM and AROM are limited due to pain but not in a capsular pattern
34
Medications for management of bursitis
- Acetaminophen - NSAIDs - Steroid injections
35
Pathology for muscle strains
- Inflammatory response within a muscle following a traumatic event that caused microtearing of the musculotendinous fibers - Pain and tenderness within that muscle - Pain with active contraction and passive stretch of the muscle
36
Pathology of myositis ossificans
- Painful condition of abnormal calcification within a muscle belly - Usually precipitated by direct trauma that results in hematoma and calcification of the muscle
37
What are the most frequent locations for myositis ossificans
- Quadriceps - Brachialis - Biceps brachii
38
When is surgery warranted for management of myositis ossificans
- Only in pts with non-hereditary form - Only after maturation of the lesion (6-24 months) - Indicated when lesion mechanically interferes with joint movement or impinge on nerves
39
Pathology of complex regional pain syndrome (CRPS)
- Etiology unknown but thought to be related to trauma or precipitating event - Results in dysfunction of sympathetic nervous system to include pain, circulation, and vasomotor disturbances
40
What are the 2 types of CRPS
- CRPS I: frequently triggered by tissue injury; no underlying nerve injury - CRPS II: experience the same symptoms but their cases are clearly associated with a nerve injury
41
Medical interventions for CRPS
- Sympathetic nerve block - Surgical sympathectomy - Spinal cord stimulation - Intrathecal drug pumps
42
Medications for management of CRPS
- Topical analgesics - Antidepressants - Corticosteroids - Opioids
43
Long term changes associated with CRPS
- Muscle wasting - Trophic skin changes - Decreased bone density - Decreased proprioception - Loss of muscle strength from disuse - Joint contractures
44
Pathology of Paget's disease (osteitis deformans)
- Etiology unknown but thought to be linked to a type of viral infection along with environmental factors - Consider a metabolic bone disease involving abnormal osteoclastic and osteoblastic activity - Results in spinal stenosis, facet arthropathy, & possible spinal fracture
45
Medications for management of Paget's disease
- Acetaminophen for pain control - Calcitonin & etidronate disodium to limit osteoclast activity
46
Pathology of torticollis
- Spasm and/or tightness of SCM muscle with varied etiology - Dysfunction observed is sidebending toward & rotation way from the affected SCM
47
What position do anterior-inferior GHJ dislocations occurs in
- Occurs when abducted upper extremity if forcefully ER causing tearing of inferior glenohumeral ligament, anterior capsule, and possibly the glenoid labrum
48
What position do posterior GHJ dislocations occur in
- Rare and occur with horizontal adduction and IR of the GHJ
49
What is a Hills-Sachs lesion
- Compression fracture of the posterior humeral head - Associated with an anterior-inferior dislocation of the humerus
50
What is a Bankart lesion
- Avulsion of the anterior-inferior capsule and glenoid labrum - Associated with an anterior-inferior dislocation of the humerus
51
Presentation of an axillary nerve injury due to GHJ dislocation
- Exam will demonstrate numbness and tingling in the lateral deltoid and weakness in shoulder abduction - Inability to abduct arm with neutral rotation
52
Signs and symptoms of possible spinal accessory nerve involvement in the shoulder
- Inability to abduct arm beyond 90º - Pain in shoulder on abduction
53
Signs and symptoms of possible long thoracic nerve involvement in the shoulder
- Pain on flexing fully extended arm - Inability to flex fully extended arm - Winging starts at 90º forward flexion
54
Signs and symptoms of possible suprascapular nerve involvement in the shoulder
- Increased pain on forward shoulder flexion - Shoulder weakness (partial loss of humeral control) - Pain increases with scapular abduction - Pain increases with cervical rotation to opposite side
55
Characteristics of atraumatic shoulder instability
- Global hypermobility - Throwing athletes - Characterized by popping/clicking in the joint
56
Signs and symptoms of a glenoid labrum tear
- Should pain that cannot be localized to a specific point - Pain is made worse by overhead activities or when the arm is held behind the back - Weakness - Instability in the shoulder - Pain on resisted flexion of the biceps (bending the elbow against resistance) - Tenderness over the front of the shoulder
57
Physical therapy guidelines following a glenoid labrum surgery
- Avoid apprehension position (90/90º abduction/ER) for 12 wks post-op - Shoulder is usually kept in a sling for 3-4 wks - After 6 wks more sports specific training can be done although full fitness may take 3-4 months
58
Common areas of compression for TOS (thoracic outlet syndrome)
- Superior thoracic outlet - Scalene triangle - Between clavicle and first rib - Between pectorals minor and thoracic wall
59
Special tests useful in making a TOS diagnosis
- Adson's test (anatomical position of arm with head ipsi turn) - Roos test (90-90 with pumping fists) - Wright test (90-90 position no head turn) - Costoclavicular test (depress/retract shoulder in neutral0
60
MOI for AC/SC joint disorders
- Fall onto shoulder with upper extremity adducted or a collision with another individual during a sporting event
61
Tendons of rotator cuff are susceptible to tendonitis and tears due to relatively
- Poor blood supply near insertion of muscles
62
Common symptoms of rotator cuff disorders
- Pain (night pain is common) - Weakness - Loss of shoulder ROM (active > passive)
63
Common MOIs for rotator cuff disorders
- Compression/impingement: mechanical impingement of distal attachment of rotator cuff on the anterior acromion and/or coracoacromial ligament with repetitive overhead activity - Tensile overload: repetitive resistance to horizontal adduction, IR, anterior translation, & distraction - Macrotrauma (RTC tear): forces generated by trauma exceed tendon tensile strength
64
Characteristics of internal (posterior) shoulder impingement
- Characterized by an irritation between the rotator cuff and greater tuberosity or posterior glenoid and labrum - Often seen in athletes performing overhead activities - Pain commonly noted in posterior shoudler
65
MOI and population typically affected by proximal humeral fractures
- Humeral neck fracture: occur with a FOOSH (fall on outstretched hand) among older osteoporotic women; generally does NOT require immobilization/surgical repair since it is a fairly stable fx - Greater tuberosity fracture: more common in middle aged and elder adults; usually related to a fall onto the shoulder & does NOT require immobilization for healing
66
Pathology of adhesive capsulitis (frozen shoulder)
- Characterized by restriction in shoulder motion as a result of inflammation & fibrosis of the shoulder capsule usually due to disuse following injury or repetitive microtrauma - Commonly seen in association with DM and thyroid disease
67
Loss of motion in non-capsular pattern (extension > flexion) of the elbow can be the result of
- A loose body in the joint - Ligamentous sprain - Complex region pain syndrome (CRPS)
68
Pathology of lateral epicondylalgia/epicondylitis (tennis elbow)
- Most often a chronic degenerative condition of the the extensor carpi radiialis brevis tendon (ECRB) at its proximal attachment at the lateral epicondyle - Gradual onset usually the result of sports or occupations requiring repetitive wrist extension or strong grip with wrist extended resulting in overload of the ECRB
69
Pathology of medial epicondylitis/epicondylalgia (golfer's elbow)
- Usually a degenerative condition of the pronator teres & flexor carpi radialis tendons at their attachment to the medial epicondyle - Occurs with overuse sports (pitching, golf swings, swimming) or occupations requiring a strong hand grip & excessive pronation of the forearm
70
Pathology of osteochondritis dissecans
- Affects central/lateral aspect of capitellum/radial head - Osteochondral bone fragment becomes detached from articular surface forming a loose body in joint - Caused by repetitive compressive forces between radial head and humeral capitellum - Occurs in 12-15 year olds
71
Pathology of Panner's disease
- Localized AVN of capitellum leading to loss of subchondral bone with fissuring & softening of articular surfaces of radiocapitellar joint - Etiology unknown but occurs in children age 10 or younger
72
Clinical signs of a UCL injury
- Pain along medial elbow at distal insertion of ligament - Paresthesias in some cases reported in ulnar nerve distribution with positive Tingel's sign
73
Possible causes of ulnar nerve entrapment
- Direct trauma at the cubital tunnel - Traction due to laxity at medial aspect of elbow - Compression due to thickened retinaculum or hypertrophy of flexor carpi ulnaris muscle - Recurrent subluxation - DJD that affects the cubital tunnel
74
Possible causes of median nerve entrapment
- Occurs within pronator teres muscle and under superficial head of flexor digitorum superficialis with repetitive gripping activities
75
Clinical signs of median nerve entrapment
- Aching pain with weakness of forearm muscles - Positive Tinel's sign with paresthesias in median nerve distribution
76
Possible causes of radial nerve entrapment
- Entrapment of distal branches (posterior interosseous nerve) occurs within radial tunnel (radial tunnel syndrome) as result of overhead activities & throwing
77
Clinical signs of radial nerve entrapment
- Lateral elbow pain that can be confused with lateral epicondylitis/epicondylopathy - Pain over supinator muscle - Paresthesias in a radial nerve distribution - Tinel's sign may be positive
78
Clinical signs of an elbow dislocation
- Rapid swelling - Severe pain at the elbow - Deformity with the olecranon pushed posteriorly
79
What structures are impacted by a posterior/posterior-lateral dislocation of the elbow
- Occurs as a result of elbow hyperextension from a fall on the outstretched hand - Can cause avulsion fractures of medial epicondyle secondary to traction pull of medial collateral ligament
80
Pathology of carpal tunnel syndrome
- Compression of median nerve at the carpal tunnel of the wrist due to inflammation of the flexor tendons and/or median nerve - Commonly occurs as result of repetitive motions/gripping with pregnancy, DM, & RA
81
Common clinical findings of carpal tunnel syndrome
- Exacerbation of burning, tingling, pins and needles, and numbness into median nerve distribution at night - Positive Tinel's sign and/or Phalen's test - long term compression causes atrophy & weakness of thenar muscles & lateral 2 lumbricals
82
Pathology of de Quervain's tenosynovitis
- Inflammation/degeneration of extensor pollicis brevis & abductor pollicis longus tendons at 1st dorsal compartment - Results from repetitive microtrauma or as a complication of swelling during pregnancy
83
Clinical signs of de Quervain's tenosynovitis
- Pain at anatomical snuffbox - Swelling - Decreased grip & pinch strength - Positive Finkelstein's test (which places tendons on a stretch)
84
MOI of a Colles' fracture
- FOOSH - Fracture is immobilized for 5-8 wks - Complication of median nerve compression can occur with excessive edema - Characteristic "dinner fork" deformity of wrist/hand results from dorsal/posterior displacement of distal fragment of radius with a radial shift of wrist/hand
85
Possible complications with a Colles fracture
- Loss of motion - Decreased grip strength - CRPS - Carpal tunnel syndrome
86
What is a Smith's fracture
- Similar to Colles fracture except distal fragment of radius dislocates in a volar direction causing characteristic "garden spade" deformity
87
Possible complications with a scaphoid fracture
- High incidence of AVN of the proximal fragment of the scaphoid secondary to poor vascular supply - Carpals are immobilized for 4-8 wks
88
Pathology of Dupuytren's contracture
- Observed as banding on palm & digit flexion contractures resulting from contracture of palmar fascia that adheres to skin - Affects men more than women - Contracture usually affects MCP & PIP joints of 4th/5th digits in nondiabetic individuals & affects 3rd/4th digits most often in individuals with DM
89
Pathology of Boutonnière deformity
- Results from rupture of central tendinous slip of extensor hood - Observed deformity is MCP and DIP extension with PIP flexion - Commonly occurs following trauma or in RA with degeneration of the central extensor tendon
90
Pathology of Swan neck deformity
- Results from contracture of intrinsic muscles with dorsal subluxation of lateral extensor tendons - Observed deformity is MCP & DIP flexion with PIP extension - Commonly occurs following trauma or with RA following degeneration of lateral extensor tendons
91
Pathology of Ape hand deformity
- Observed as thenar muscle wasting with 1st digit moving dorsally until it is in line with 2nd digit - Results from median nerve dysfunction
92
Pathology of Mallet finger
- Rupture or avulsion of extensor tendon at its insertion into distal phalanx of digit - Observed deformity is DIP flexion - Usually occurs from trauma forcing distal phalanx into a flexed position
93
Pathology of Jersey finger (flexor digitorum profundus tendon rupture/avulsion)
- MOI forced hyperextension of DIP with maximal finger flexion contraction - Ring finger involved in 75% of cases - May rupture directly from insertion, avulse from bone, or rupture at musculotendinous junction - Key exam finding of inability to produce isolated DIP flexion
94
Pathology of Gamekeeper's thumb
- Sprain/rupture of ulnar collateral ligament of MCP of 1st digit - Results in medial instability of thumb - Frequently occurs during a fall while skiing when increasing forces ar replaced on thumb through ski pole - Immobilized for 6 wks
95
Pathology of a Boxer's fracture
- Fracture of neck of 5th metacarpal - Frequently sustained during a fight or from punching a wall in anger or frustration - Casted for 2-4 wks
NPTE Study Practice
flashcards
Decks in class (31)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions