Term
| Synarthoidal/Fibrous joints, define and give examples: |
|
Definition
- immovable
- sutures in skull, sternocleidmastoid
- fusions b/w tibia and fibula, and radius and ulna |
|
|
Term
| Amphiarthroidal/Cartilaginous, define and give examples: |
|
Definition
- slightly moveable
- nose
- symphisis pubis
- intervertebral discs |
|
|
Term
|
Definition
- freely movable
- elbow, knee, finger
- lined by and surrounded by synovium |
|
|
Term
| Synarthroidal, Amphiarthroidal, and Diarthroidal are ____ classifications based on what the joint can do. |
|
Definition
|
|
Term
| Fibous, Cartilaginous, and Synovial are ___ classifications. |
|
Definition
|
|
Term
| classifications of diarthroidal joints: |
|
Definition
Be Happy Camper So Good Parties
- Ball and socket
- Hinge
- Condyloid aka Ellipsoid
- Saddle
- Gliding
- Pivot |
|
|
Term
| examples and define ball and socket joint: |
|
Definition
- can move along indefinite number of axes
- type of diarthroidal
- hip joint
- glenohumeral joint |
|
|
Term
| Hinge joint, define, give example: |
|
Definition
- can move only in one plane
- elbow
- type of diarthroidal joint |
|
|
Term
| define and give examples of a condyloid joint: |
|
Definition
- rounded end of one bone inserts into the shallow cavity of another bone
- movement allowed in two planes
- carpals to radius
- carpals to metacarpals |
|
|
Term
| give example of Saddle joint: |
|
Definition
| - thumb at the carpometacarpal |
|
|
Term
| example of gliding joints: |
|
Definition
|
|
Term
|
Definition
- atlantoaxial
- radial head on ulna |
|
|
Term
| Inspection/Palpation in Musculoskeletal exam should include: |
|
Definition
- Alighment
- Symmetry
- Size of joint/surrounding structures
- Deformity |
|
|
Term
| Always check to joint above and below the area where pain is. |
|
Definition
|
|
Term
| goniometer is used for what? |
|
Definition
| - measure range of motion of a joint |
|
|
Term
| when walking why would someone slap their feet down? |
|
Definition
| Diabetics may have loss of sensation in feet, so they can't feel their feet touch the floor, so they slap them down on the ground so they can hear it |
|
|
Term
|
Definition
|
|
Term
| during palpation check this: |
|
Definition
- temperature
- tenderness
- swelling
- effusion
- tenderness |
|
|
Term
| passive ROM is motion performed by the ___. |
|
Definition
|
|
Term
| Active ROM is ___ driven. |
|
Definition
|
|
Term
|
Definition
| - hands always flexed down and no matter how hard you pull up the hand stays flexed |
|
|
Term
| number scale of muscle strength: |
|
Definition
No Contractility 0
Slight Contractility, no movement by pt 1
Full ROM, gravity eliminated (passive) 2
Full ROM vs gravity 3
Full ROM vs gravity, some resistance 4
Full ROM vs gravity, full resistance 5 |
|
|
Term
|
Definition
- audible palpable snapping and clicking is OK
- true TMJ dysfunction is accompanied by pain, crepitus, locking, or popping |
|
|
Term
| range of motion of jaw should be about __ to __ cm, or about __ fingers width. |
|
Definition
|
|
Term
| lateral movement of jaw should be about __ to __ cm. |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| inferior angles of scapula |
|
|
Term
|
Definition
| umbilicus (dermatome of T10) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Flexion and extension of the cervical spine should be ___ degrees, lateral bending should be ___ degrees, and lateral rotation should be ___ degrees. |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| stick out butt, increased concavity of lumbar spine |
|
|
Term
| dowager hump is seen with ___ |
|
Definition
|
|
Term
| your hammer is useful in diagnosis of ___ ___. Hit the hammer and place the base over the spinous processes of each lumbar segment. The patient will experience severe pain where the fracture is. |
|
Definition
|
|
Term
| Thoracic and lumbar spine range of motion, flexion should be __ to __ degrees, extension should be __ degrees, lateral flexion should be __degrees, and rotation should be __ degrees. |
|
Definition
- flexion 75 to 90 degrees
- extension 30 degrees
- lateral bending 35 degrees
- rotation 30 degrees |
|
|
Term
| Supine Straight leg raise test does what: |
|
Definition
- tests for nerve root irration/herniated disc
- tests L4, L5, S1
- could also try this while patient is sitting with legs of table, if it hurts in one position but not in the other, then they might be faking it |
|
|
Term
| positive straight leg test: |
|
Definition
- examiner flexes hip with knee extended
- positive if pain below the knee area when hip extended past 30 degrees
- bending the knee aleviates the pain |
|
|
Term
| Sitting Straight Leg Test and Flip Sign: |
|
Definition
- patient seating leaning slightly foward
- extend leg at knee against resistance
- positive test if patient leans back (flip sign), has radicular pain with extension/ resistance |
|
|
Term
|
Definition
- patient supine with neck slightly flexed
- examiner holds lower leg/ankle
- LE raised until pain felt, then lower slightly
- briskly dorsiflex foot and internally rotate LE simultaneously
- pain in leg indicates herniated lumbar disc |
|
|
Term
| The Bragard stretch test and straight leg raise test both test what nerve roots: |
|
Definition
|
|
Term
| Femoral stretch test is also known as the __ __ __. |
|
Definition
|
|
Term
|
Definition
- tests L1, L2, L3, maybe L4
- patient prone, extend hip and flex knee, then have them extend hip and knee in air
- positive if pain is in anterior thigh with hip extension |
|
|
Term
|
Definition
- tests L1, L2, L3, maybe L4
- patient prone, extend hip and flex knee, then have them extend hip and knee in air
- positive if pain is in anterior thigh with hip extension |
|
|
Term
|
Definition
| - herniated nucleus pulposus |
|
|
Term
| what are the five muscles that make up the shoulder? |
|
Definition
- supraspinatus
- infraspinatus
- Teres minor
- Subscapularis
- Deltoid |
|
|
Term
| what are the rotator cuff muscles? |
|
Definition
- supraspinatus
- infraspinatus
- teres minor
- subscapularis |
|
|
Term
Shoulder ROM:
- flexion
- extension
- abduction
- adduction
- internal rotation
- external rotation |
|
Definition
flexion= 180 degrees
extension= 50 degrees
abduction= 180 degrees
adduction= 50 degrees
internal rotation= 90 degrees
external rotation= 90 degrees |
|
|
Term
| which rotator cuff muscles are responsible for external rotation: |
|
Definition
- supraspinatus
- infraspinatus
- teres minor |
|
|
Term
| which rotator cuff muscles are responsible for internal rotation? |
|
Definition
|
|
Term
| with rotator cuff there should be no pain when abducting up to 180 degrees, indicators of a cuff tear would be: |
|
Definition
| - pain and/or disability between 60 and 120 degrees of abduction |
|
|
Term
| problems brushing hair or buckling bra means there are __ __ problems. |
|
Definition
|
|
Term
|
Definition
- flex shoulder and elbow to 90 degrees
- internally rotate the shoulder
- positive if pain in rotator cuff region |
|
|
Term
| O-Brien's active compression test was developed for assessment of _____ joint pathology following a patient's demonstration of what reproduced shoulder pain. O'Brien found it was also good for detecint ___ pathology- |
|
Definition
|
|
Term
|
Definition
- patient flexes arm to 90degrees with elbow fully extended, and then adduct arm 10 to 15 degrees medial to the sagital plane
- then arm is maximally internally rotated and the patient resists the physician's downward force. Test is repeated in supination.
- this test maximally loads the AC joint and labrum, for maximaly results the patient has to resist the examiner's downward force |
|
|
Term
|
Definition
- biceps tendinitis
- labral pathology |
|
|
Term
|
Definition
- patient's arm relaxed and by there side, seated
- palpate bicipital groove, hold on to patient' wrist
- have them attempt shoulder flexion while you resist it |
|
|
Term
|
Definition
- rotator cuff integrity
- raise patients arm to 150 degrees of shoulder flexion and internally rotate the arm
- push supraspinatus into antero-inferior subacromial area
- positive test if pain
- also checks serratus anterior integrity and winged scapula |
|
|
Term
| injury to what nerve causes a winged scapula? |
|
Definition
|
|
Term
| winged scapula is accentuated by: |
|
Definition
| - extending arm or pushing against wall |
|
|
Term
| supraspinatus stress test; |
|
Definition
- abduct to 90 degrees, flex anteriorly to 30 degrees, put thumb to floor (pronate forearm)
- apply mild resistance downward on forearm
- positive test if pain or weakness is elicited
- empty can test |
|
|
Term
| drop arm test, examines what? |
|
Definition
- rotator cuff integrity, specificly the supraspinatus
- passivley abduct shoulder to 90 degrees,tell patient you are going to let go of arm, and they should lower it slowly
- positive if patient cannot lower slowly in a fluid motion
- sign of supraspinatus injury |
|
|
Term
| complete rupture of supraspinatus: |
|
Definition
- most common between ages 55 and 65
- active abduction is very limited
- further abduction accomplished by elevation of scapula and shoulder shrugging or assistance from opposite hand |
|
|
Term
| Impingement syndrome and subacromial bursitis: |
|
Definition
- repetive activity with the arm above horizontal
- compresses structures between the humeral head and coracoacromial arch |
|
|
Term
| AC joint evaluation cross over test: |
|
Definition
| - arm horizontally across chest, examiner presses against arm to stress joint |
|
|
Term
| carpel tunnel gives you atrophy of what? |
|
Definition
|
|
Term
| volar surface of hand is the __ surface. |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| - swelling of joint right before fingernail (DIP) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| if a joint is red, swollen, and hot to touch, its probably ___. |
|
Definition
|
|
Term
| ROM and strength of fingers, hands, and wrists: |
|
Definition
Flexion of fingers at DIPs, PIPs, and MCPs – each 90° (DIPs at about 45°)
Hyperextension of fingers at MCPs – up to 30°
Thumb opposition ability and strength
Finger(s) and thumb adduction and abduction ability and strength
Wrist flexion ( 90°) and extension ( 70°)
Grip ability and strength
Test radial motion ( 20°) and ulnar motion ( 55°) with palms down |
|
|
Term
|
Definition
- light percussion over flexor retinaculum
- tingling and numbness> positive test for carpel tunnel
- with carpel tunnel, the flexor retinaculum hypertrophys so it compresses nerve |
|
|
Term
|
Definition
- wrist in acute flexion for 60 seconds, like a reverse prayer position
- also tests for carpel tunnel
- numbness or tingling is positive sign of carpel tunnel |
|
|
Term
|
Definition
- tuck thumb in hand and deviate wrist to ulnar side
- pain means positive sign for De Quervain's tenosynovitis |
|
|
Term
| symptoms and causes of De Quervian's Tenosynovitis and what test used to detect this? |
|
Definition
- inflammation of abbductor pollicis longus (drummers, carpenters)
- Finklestein's test, tuck thumb in hand and deviate to ulnar side, pain is positive sign of this conditoin |
|
|
Term
|
Definition
| pt stands on one foot, weak hip abductors if pelvis tilts |
|
|
Term
| with knee extended, hip should be able to flex and extend how many degree? |
|
Definition
- flexion 90 degrees
- extension 30 degrees |
|
|
Term
| with knee flexed, hip should be able to flex how many degrees? |
|
Definition
|
|
Term
|
Definition
| flex hip when knee if flexed, hip should flex to 120 degrees, can be used to test for flexion contractures |
|
|
Term
| external rotation of hip should be ___. internal rotation of hip should be ___. |
|
Definition
external rotation 45 degrees
internal rotation 40 degrees |
|
|
Term
| Abduction of hip should be __. Adduction of hip should be __. |
|
Definition
- abduction: up to 45 degrees
- adduction: up to 30 degrees |
|
|
Term
| Patrick's test of the ___ is also called ___ test, and it stresses the __ and __ joint. |
|
Definition
- hip
- FABER
- hip
- SI joint |
|
|
Term
| explain Patrick's/FABER test: |
|
Definition
- flexes, abducts, and externally rotate hip to put pressure on hip and SI joint
- positive test= back or butt pain indicative of pelvis problems
- groin pain is more associated with hip joint problems |
|
|
Term
| what maneuvers do you use to evaluate the hips of infants? |
|
Definition
| - Barlow and Ortolani maneuvers |
|
|
Term
| how often are the Barlow and Ortolani maneuvers performed? |
|
Definition
- at each pedi visit until age 1
- detects hip dislocation/subluxation
- test one hip at a time
- gentle pressing force |
|
|
Term
| describe the Barlow technique: |
|
Definition
- examiner's thumb on inside of thigh, base of the thumb on the infant's knee
- rest of fingers grip outer thigh with fingertips over trochanter
- ADDUCT THIGH AND APPLY DOWNWARD PRESSURE |
|
|
Term
| describe the Ortolani technique: |
|
Definition
| - slowly abduct thigh as axial pressure is maintained, exert pressure in reverse order |
|
|
Term
| so basically Barlow dislocates hip,and Ortolani relocates hip. |
|
Definition
|
|
Term
| Barlow pushes in and down. Ortolani pushes out and up. |
|
Definition
|
|
Term
|
Definition
- in infants
- sign of hip dislocation or foreshortened femur
- both knees flexed with feet flat on table
- examiner at infant's feet, assess height of knees |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Knee normal range of motion: |
|
Definition
- knee flexion up to 130 degrees
- knee extension up to 15 degrees |
|
|
Term
| Knee effusions: Ballottement |
|
Definition
- rebound sensation as structure floating within a fluid is moved and returns to its original position
- technique: knee extended, downward pressure with one hand on suprapatellar pouch > push patella downward to femur with finger of other hand>if there is tapping or clicking> + effusion
- if positive release deep pressure, but keep light pressure, if patella floats also (+) effusion |
|
|
Term
|
Definition
|
|
Term
| Knee normal range of motion: |
|
Definition
- knee flexion up to 130 degrees
- knee extension up to 15 degrees |
|
|
Term
|
Definition
| - knee extended> milk medial knee upward three times > tap lateral side of patella> + if returning fluid creates bulge in hollow area of medial patella where you just milked |
|
|
Term
| to identify knee stability the patient must ___ for all the tests. |
|
Definition
|
|
Term
| Varus and Valgus stress tests: |
|
Definition
- test in extension and 30 degree flexion
- femur stabilized with one hand, ankle with other |
|
|
Term
|
Definition
- force ankle towards midline + internal rotational force
- tests LCL (lateral collateral ligament) |
|
|
Term
|
Definition
- force ankle away from midline plus external rotational force
- tests MCL (medial collateral ligament) |
|
|
Term
| anterior and posterior drawer test to identify knee instability : |
|
Definition
- assesses ACL and PCL (anterior and posterior cruciate ligaments)
- patient supine, knee flexed 45 to 90 degrees, foot placed flat on table
- examiner's hand circled around upper tibia with thumbs apart and just proximal to tibial tuberosities, and just distal to joint
- anterior drawer if can pull tibia foward
- posterior drawer is positive and can push tibia back
- positive if movement is greater than 5 cm in either dircetion |
|
|
Term
| Lachman's test determines integrity of the ___. |
|
Definition
|
|
Term
| most sensitive test for the ACL that requires the PCL to be intact? |
|
Definition
|
|
Term
| Lachman's test technique: |
|
Definition
patient supine, knee flexed 10to 15 degrees
- one hand grasps and stabilizes the thigh, while pulling the tibia anteriorly
- foward translation of the tibial plateau greater than 5 cm= tear in ACL |
|
|
Term
| McMurray test is used to check for what, and describe the technique? |
|
Definition
- meniscal tears
- patient is supine with knees flexed
- examiner encircles femur with one hand and holds the ankle with the other
- fully flex the knee, then externally rotate foot as you extend knee- tests medial meniscus
- fully flex knee, then internally rotate foot while extending the knee, this tests the lateral meniscus |
|
|
Term
|
Definition
- patient complains of locking or buckling knee, then perform this test
- patient prone with knee flexed at 90 degrees
- examiners hand presses downward on heel, the rotate the heel |
|
|
Term
| examine ankles with sitting, walking, and standing. check medial and lateral malleoli, Achilles tendon, foot and ankle contour, position, size and number of toes. |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| club foot- only lateral side of foot touches ground |
|
|
Term
|
Definition
| outward turning of foot with patient walking on medial side of foot |
|
|
Term
|
Definition
| - achilles does not run straight down ankle to foot, it deviates laterally |
|
|
Term
|
Definition
| forefoot is deviated medially |
|
|
Term
|
Definition
| forefoot is deviated medially |
|
|
Term
| normal range of motion of ankle movements: |
|
Definition
Dorsiflexion to 20°
Plantar flexion to 45°
Ankle inversion to 30°
Ankle eversion to 20°
Ankle adduction to 20°
Ankle abduction to 10°
Flex, extend, fan toes |
|
|
Term
| anterior drawer test for the ankle tests the integrity of ____ ___ ___. |
|
Definition
| - anterior talofibular ligament |
|
|
Term
|
Definition
- lateral deviation of great toe
- bunion forms due to inflamed bursa formation at pressure point over 1st metatarsal head, medial aspect |
|
|
Term
|
Definition
| - hyperextended MTP with flexed proximal joint |
|
|
Term
|
Definition
|
|
Term
|
Definition
| hyperextended MTP with flexed proximal and distal joints |
|
|
Term
| you strain a __ or ___. you ___ a ligament. |
|
Definition
strain a muscle or tendon
sprain a ligament |
|
|
Term
| strain is stretching or partial tear of muscle or tendon. If there is a complete strain then what happens? |
|
Definition
- rupture
- inability to move joint
- surgical repair required
- usually caused by a sudden stretch when the muscle is in contraction
- more common in older population |
|
|
Term
| Sprain is stretching or partial tear of supporting structures of a joint. these occur in all age groups, caused by sudden trama, graded based on degree of injury and stability of joint. a high ankle sprain may require surgery. |
|
Definition
|
|
Term
|
Definition
Grade I or First Degree
- partial tear
- no instability of joint with stress
- TX: symptomatic
Grade II or Second Degree
- partial tear
- instability noted on stress
- TX: immobilize to protect
Grade III or Third Degree
- complete tear
- complete opening of joint on stress
- TX: immobilize, possibly repair |
|
|
Term
| ankle sprains are mainly ___ injuries. |
|
Definition
|
|
Term
| 2 major ligaments over lateral aspect of ankle joint: |
|
Definition
- anterior talofibular ligament
- calcaneofibular ligament |
|
|
Term
| anterior talofibular ligament extends anteriorly from the __ __ to the neck of the ___. |
|
Definition
|
|
Term
| calcaneofibular ligament goes from the tip of the __ ___ inferiorly and posteriorly to the ___. |
|
Definition
- lateral malleolus
- calcaneous |
|
|
Term
| most commonly injured ankle ligament: |
|
Definition
| anterior talofibular ligament |
|
|
Term
| second most commonly injured ankle ligament: |
|
Definition
| - calcaneofibular ligament |
|
|
Term
| what is the minor ligament on the back of the ankle: |
|
Definition
| posterior talofibular ligament |
|
|
Term
| what ligament is over the medial portion of the ankle joint? |
|
Definition
| deltoid ligament, so you test its integrity by eversion |
|
|
Term
|
Definition
More common after age 40
Patients often describe an audible “pop”
Inability to plantar flex |
|
|
Term
|
Definition
patient prone, knee extended, squeeze calf and foot should plantarflex
- absense of plantar flexion is positive test for ruptured achilles tendon |
|
|
Term
| treatment of achilles tendon rupture: |
|
Definition
| cast in plantar flexion, or may need surgical repair with casting, long recovery |
|
|
Term
|
Definition
Calcaneus very dense and extremely strong
Most breaks occur 2nd to fall from significant height
Strong association ( 25%) with lumbar spine fracture
compression or burst fracture |
|
|
Term
| leg length is measured from the __ __ __ __ to the __ __ crossing the knee on the __ side. |
|
Definition
- anterior superior iliac spine (ASIS)
- medial malleolus
- medial |
|
|
Term
| arm length is measured from ___ __ to the distal __ ___. |
|
Definition
- acromion process
- ulnar prominence
- circumference is measured at same land mark ilaterally |
|
|
Term
| comparison are necessary to check if epiphysisis is open. |
|
Definition
|
|
