Musculoskeletal - Dr. Alasky

Front 1

Tests for Rotator Cuff Tear?

Back 1

Neer (arm help straight up over head. Forward flexion of internally rotated arm)
Hawkins (Passive internal rotation of humerus flexed 90 deg.)

Empty can
External Rotation
Internal Rotation

Drop-Arm Rotator cuff test (Arm passively raised to 160 deg. then pt. asked to slowly lower arm. Pos. sign = inability to control the lowering of the arm)

Front 2

Ant. Glenohumeral Instability

Back 2

Aprehension test (pt. holds arm flexed to 90 and elbow flexed to 90 while Dr. holds their wrist. Dr. Applies external rotation force. pos. sign = pt. apprehension)

Front 3

Posterior Shoulder Instability

Back 3

Jerk Test (pts. arm is abducted 90 and internally rotated. adduct humerus across body. pos. sign = if pt. jerks)

Front 4

Multidirectional Instability

Back 4

Sulcus Sign (push down on top of pts. shoulder - pso sign is if there is widening between humerus and acromion)

Front 5

Biceps Tendonitis

Back 5

Speeds (arm held straight down with palm forward. flex wrist against resistance)

Yergasons (pt. attempts to flex elbow and supinate wrist against resistance while arm is at side flexed 90 deg.)

Front 6

Biceps Rupture

Back 6

Popeye sign

Front 7

Superior Labrum Anterior to Posterior (SLAP Lesion)

Back 7

O'Briens (=pt puts arm in "nazi sign" position of about 60 deg. Pt. tries to adduct arm while Dr. resists)

Types I->IV
I = Frayed
II = Detached Sup. Labrum from sup. glenoid
III = Bucket Tear
IV = Tear into sup. Labrum

Front 8

AC = Acromioclavicular injuries

Back 8

+ Cross-Arm Abduction test

Types I--> VI
I = Downward force = AC stress
II = Downward force = AC broken
III = Downward force = AC AND Coracoclavicular ligs torn
IV = FORWARD force = CC ligs torn. Clavicle PIERCES AC lig
V = Downward force = AC AND CC ligs break , but more than type III
VI = CC lig breaks

Front 9

Scaphoid Fracture

Back 9

Scaphoid Compression Test (=hold thumb and apply pressure through 1st metacarparl onto scaphoid bone)

FOOSH = Fall On Outstretched Hand

TX = ACUTE = short-arm thumb-spica SPLINT

THEN

Short-arm thumb spica CAST 6-12 weeks

Front 10

DeQuervain's Tenosynovitis

Back 10

Finkelstiens (pt makes fist with thumb inside, Dr. pushes wrist towards ulna)

Front 11

Triangular Fibrocartilage Complex Injuries

Back 11

Triangular Fibrocartilage Complex Injuries Test (=Pronate wrist deviated to ulnar side)

Front 12

Medial Epicondylitis (golfer's elbow)

Back 12

Medial Epicondyle Test (Dr. thumb on medial epicondyle - passively supinate forearm while extending wrist and elbow)

Front 13

Lateral Epicondylitis (Tennis Elbow)

Back 13

Tenderness distal to lateral epicondyle

Also: pain with resisted wrist and long finger extension

Front 14

Ulnar Collateral Lig. Injuries

Back 14

Valgus stress test (=outward/external)

Front 15

Hip Flexors?

Back 15

Iliposoas

Sartorius

Innervated by Femoral n.

Front 16

Hip Extensors?

Back 16

Gluteus maximus (=inferior gluteal n.)

Semitendinosus
Semimembranosus
Biceps Femoris
(=Tibial n. or Sciatic n.)
(Short head = Peroneal br.)

Front 17

Acute Muscle strain of the hip

Back 17

Most common hip injury

Front 18

Avulsion Fracture of Hip

Back 18

=bc of sudden muscle contraction

Front 19

Femoral Stress Fracture

Back 19

Tension or Compression-sided

Tension = higher of neck of femur
Compression = inf. femur neck

Front 20

Slipped Capital Femoral Epiphysis

Back 20

Femur head ONTO neck

Front 21

Trochanteric Bursitis?

Back 21

Ober's Test (Checks for IT band tightness - pt on side, knee flexed, his aBducted then released. Leg should aDDUct freely, if it doesn't then that's a positive test)

IT Band Syndrome

Inflammation of Trochanteric bursa

Front 22

Extensor Hood Rupture

Back 22

Elson test (=finger over edge of table, PIP joint flexed 90, have pt. extend against resistance)

DIP Hyperextension
PIP Flexion

Treatment = PIP joint full extension with DIP joint allowed to flex for 6 weeks

Front 23

Mallet Finger

Back 23

Pt. can't extend DIP joint

Forced Flexion of DIP joint

TX: BONY = DIP in Extension 4 weeks

TENDON = DIP Extension 6-8 weeks

THEN protect with splint during sports

Front 24

Jersey Finger

Back 24

Forced Extension (football/rugby players)

Pt. can't FLEX DIP joint

TX = SURGERY REFERRAL ASAP

Front 25

Spondylolysis Vs. Spndylolithsthesis?

Back 25

Spondylolysis = Fracture in pars interarticularis
Test = stork test = pt. stands on one leg

Spondylolisthesis = Slippage

Front 26

SIGNS of Sponsylolysis?

Back 26

Pain/tenderness of paraspinals

One leg-raising test

Stork Test (see how long they can stand there while holding one leg up)

Tight Hamstrings

X-Ray = Scottie Dog
SPECT SCAN (=pars defect)

Front 27

ACL

Back 27

Ant. Drawer

Lachman (Knee flexed 20-30, Dr. holds above patella and at bottom of tibia. Dr. pulls forward on tibia to see if the tibia displaces the femur. Feel for the end point of the ACL as it tight - the end point should be sharply defined)

Front 28

PCL

Back 28

Post. Drawer
Post Sag test (Lebolt's material)

Front 29

Menisci (medial and lateral)

Back 29

McMurray
Apley (="Apley Grind Test = grind knee into table)

Duck walk (=squat?)

Front 30

Collateral Ligaments (medial and lateral collateral ligaments)

Back 30

Valgus and Varus Stress

Front 31

Triad of persistent swelling, joint line pain, duck walk sign

Back 31

Meniscal injury

Front 32

Osgood-Schlatter's disease?

Back 32

Tibial tubercle

X-ray = tissue Pulling away (Montgomery's lecture)

Front 33

Patellofemoral pain syndrome?

Back 33

Pysical or Biochemical CHANGE in patellofemoral joint

Tests:
Patella-femoral test THEN do the patella grind or compression test

Front 34

Syndesmosis

Back 34

Syndesmosis test = pull foot from side to side

X-ray = clear space widening

Front 35

Most common ankle sprain?

Back 35

Ant. Talodibular

BUT
most common TORN = Lateral Ankle Sprain

Front 36

Most common TORN ligament in ankle?

Back 36

Lateral ankle sprain

Front 37

Tx for Lateral Ankle Sprain?

Back 37

RICE
ROM Exercises (=alphabet exercises)
Strengthening (when swelling subsides)
One-foot balancing
Air-Cast
(casts NOT encouraged)
Functional Treatment preferred

Front 38

Which part of the pre-participation physical exam provides the Best change of detecting Hypertrophic Cardiac Myopathy

Back 38

History

Front 39

Whats the number one cause of morbidity and mortality in adolescents?

Back 39

High-risk behaviors

Front 40

Innervation of Iliopsoas?

Back 40

Femoral n.

Front 41

Innervation of Sartorius?

Back 41

Femoral n.

Front 42

Innervation of gluteus maximus?

Back 42

Inferior gluteal n.

Front 43

Innervation of Semitendinosus?

Back 43

Tibial branch of sciatic

Front 44

Innervation of Biceps Femoris?

Back 44

Tibial branch of sciatic, but the short head is innervated by the peroneal branch

Front 45

To look at for knee?

Back 45

Observation
effusion = something wrong, pt. walking

ROM - active and passive

Palpation - do in sitting position, pay attention to joint line tenderness

TESTS:
McMurray (put thumb and fingers on joint line, then internally and externally rotate of foot to see if theres a click or pt feels pain along joint line)

Ant. Drawer
Post. Drawer
Duck Walk

Front 46

Meniscal Injury Clues

Back 46

Twist on planted foot with a POP or CLICK (often associated with recurrent swelling, locking, or giving way)

EXAM:
Joint line tenderness
Pain with Hyperflexion (passive)
Positive McMurray's
Hurts to Duck Walk

Front 47

Most commonly sprained ankle ligament?

Most commonly TORN ankle Injury?

Back 47

Anterior Talofibular = most commonly sprained

Lateral Ankle Sprain

Front 48

How do you treat a Lateral Ankle Sprain?

Back 48

RICE
ROM
-Alphabet
-Strengthening with swelling/pain improves
One-foot balancing
-Air Cast
-Early Immobilization
(NOTE- casts discouraged)
Functional treatment preferred

Front 49

Over what bone do a lot of vessels in the ankle run over?

Back 49

Navicular

So DON'T MISS fracture of navicular bone=tissue can necrose

Front 50

Positive calcaneal compression test = what?

Back 50

Sever's Disease