Musculoskeletal System Exam

Front 1

signs of jt inflammation

Back 1

reddness, heat, swelling, tender to palpation

Front 2

fx of tendons

Back 2

attach mm to bone, transmit mm force across jt

Front 3

what is tendinitis

Back 3

inflammation or microtear of tendon the tenosynovium surrounding tendon

Front 4

difference b/n tendon pain & jt pain

Back 4

jt pain -pain w/ any mvmt of jt
tendonitis-pain w/ PROM at extremes or AROM only

Front 5

what are ligaments

Back 5

attach bone to bone

Front 6

signs of mild ligamentous injury (2)

Back 6

TTP at area of ligament
P w/ lig stretching

Front 7

signs of severe ligamentous injury (2)

Back 7

gapping
ecchymoses

Front 8

what are bursae

Back 8

(def) fluid filled synovial sacs
(fx) facilitate mvmt over articulating sxs
-over bony prominences
-bn adjoining mm w/ different directions of contraction

Front 9

signs of bursitis

Back 9

ttp around the bursa (occ swelling)

Front 10

3 types of jt swelling

Back 10

1) bony enlargement often due to osteophytes [hard] -OA
2)synovial proliferation (synovitis) [spongy]- RA
3)intra-articular fluid -[fluctuant]- septic arthritis

Front 11

should jts be warmer or cooler than surrounding tissues

Back 11

cooler

Front 12

what is crepitus
3 things it can be due to?

Back 12

crunching
1) cartilage irregularities
2) bone on bone
3)tendon

Front 13

significance of jt cracking or popping

Back 13

none unless accompanied by pain

Front 14

pattern of jt involvemnt (3)
with what modifier

Back 14

monoarticular (1jt)
pauciarticular (2-4 jts)
polyarticular (>4jts)
symmetric v. asymmetric

Front 15

how do you measure range of motion

Back 15

comparing one side to the other

Front 16

findings of jt hypermovility (3)

Back 16

1)oppose thumb passively to forearm
2)hyperextension of fingers >10
3)hyperextension of elbows & knees >10
4)ability to touch palms to floor w/ flexion at the waist

Front 17

what dz assoc w/ jt hypermobility

Back 17

ehlers danlos (in most cases benign)

Front 18

what 3 bones make up the shoulder

Back 18

humerus clavical scapula

Front 19

what 4 jts make up the scapula

Back 19

glenohumeral
acromioclavicular
sternoclavicular
scapulothoracic

Front 20

"static" stabilizers of shoulder (4)

Back 20

capsul (labrum
3 ligaments
-acromioclavicular
-coracoclavicular,
-coracoacromial

Front 21

"dynamic" shoulder stabilizers
(2 categories, 3 mm)

Back 21

1) scapular stabulizers
-trapezius
-rhomboid
-teres major
2) rotator cuff
-supraspinatus
-infraspinatus
-teres minor
-subscapularis
3) Deltoid

Front 22

rotator cuff mm

Back 22

SITS
supraspinatus
infraspinatus
teres minor
subscapularis

Front 23

fx of RCM

Back 23

stabilize shoulder
and abduction & IR & ER

Front 24

general insertion of RCM

Back 24

humerus

Front 25

deltoid fx
injured often

Back 25

abduction after 90*
NO

Front 26

biceps fx

Back 26

powerful flexor supinator

Front 27

most common site of biceps tendonitis

Back 27

long head tendon
bicipital groove of humerus
b/n greater & lesser tuberosities & under the transverse humoral ligament

Front 28

origin & insertion of bicepts
LH
SH

Back 28

LH-upper edge of glenoid labrum & supraglenoid tubercle
SH-coracoid process

merge to insert radius

Front 29

ROM of shoulder

Back 29

F
E
AB
AD
IR
ER

Front 30

How do you test ROM of shoulder -AB

what is normal? average

Back 30

AB
raise arms away from body to level of shoulder with palm facing down [90* glenohumeral]
then aboce head w/ palms facing each other-90*-60*scapulothoracic/30*combined GH/ST]

nml 180, av 150

Front 31

How do you test ROM of shoulder -AB/ER
nml ER

Back 31

place hand behind head trying to reach down spine as far as possible.

nml C7/90*

Front 32

How do you test ROM of shoulder -AD/IR

Back 32

ask pts to place hand behind back, trying to reach w/ thumb as far up to scapula and spne as possible
nml -T7/lower border of scapula
AD-45*/IR-90*

Front 33

How do you test ROM of shoulder -F

Back 33

trace an arc forward w/ elbow straight "Heil Hitler"
nml 180*

Front 34

How do you test ROM of shoulder -E

Back 34

trace an arc backwards
nml 45*

Front 35

if AROM of shoulder elicits pain what should you do

Back 35

PROM-no p w PROM=tendonitis
crepitus=DJD

Front 36

what area of shoulder girdle should be palpated (5)

Back 36

AC jt
LH of biceps tendon
coracoid process
rotator cuff
GH jt

mneu: Really Great & Beatiful ACtresses

Front 37

where do you palpate the AC jt

Back 37

top of shoulder radiating torward the neck

Front 38

where do you palpate the LH of biceps tendon

Back 38

ant shoulder, in bicipital groove

Front 39

where do you palpate the coracoid process

Back 39

ant shoulder

Front 40

where do you palpate the rotator cuff

Back 40

lat aspect of shoulder

Front 41

recurrent shoulder sublux in young people indicates_____

Back 41

multidirectional instability

Front 42

constant shoulder pain & decreased ROM in diabetics indicates_____

Back 42

adhesive capsulitis

Front 43

pain & weakness in workers whose jobs requie recurrent overhead action suggests _____

Back 43

rotator cuff pathology

Front 44

shoulder pain after FOOSH

Back 44

AC pathology

Front 45

general approach to shoulder exam

Back 45

inspect
palpate
AROM, PROM
strength

Front 46

In testing strenght how to you asses the supraspinatus
what is the name of this test
what is +ECM indicate

Back 46

arm flexed 90 in scapular plane & forearm pronated (thumbs down )
empty can manuver
Supraspin tendinitis or tear

Front 47

In testing strenght how to you asses the subscapulateres minor and infraspinatisris

Back 47

test internal rotation. arm rotated internally w/ dorsum agaist buttock. have pt lift hand against resistance

Front 48

what mm are you testing when you test ER strenth (2)

Back 48

teres minor
infrispinatis

Front 49

how do you isolate biceps

Back 49

flexion supination

Front 50

what is shoulder pad sign?
what is it typical of

Back 50

bilateral shoulder effusion
amyloidosis

Front 51

what are the most common msk causes of shoulder pain

Back 51

Bursitis
Impingment (complication of tendinitis & rotator cuff tears)
Frozen shoulder & Fracture
Dislocated or unstable shoulder
Osteoarthritis
(Basically I Test Religiously For Damaged Objects)

Front 52

origins of REFERRED shoulder pain

Back 52

myocardium
hepatobiliary
diaphram
c-spine

Front 53

how does referred shoulder pain present

Back 53

nondescript, poorly localized, not reproducable on exam

Front 54

how do you dx shoulder synovitis

Back 54

fullness/bogginess just below clavicle, medial to the deltoid

Front 55

how do you dx AC arthritis

Back 55

TTP at jt
CROSS BODY TEST-P at jt w/ cross-body adduction across chest so hand touches opposite shoulder

Front 56

how do you dx AC seperation

Back 56

hx of FOOSH
deformity
TTP & P at jt w/ cross body test

Front 57

who gets bicipital tendinitis

Back 57

1)shoulder overuse in overhead athletes
-baseball pitchers, raquet players, swimmers, rowers/kayacers
or 2) people who have other shoulder problems as well

Front 58

how do you dx bicipital tendinitis

Back 58

achy ant shoulder pain, worsened by overhead activity, lifting heavy objects, elevated pushing/pulling
EXAM-pt tenderness over bicipital groove. Pain w/ elbow flexion. May have a painful arc manuver. + Speeds test & Yergison's test

Front 59

what is yergisons test

Back 59

resist hand supination while putting pressure on biceps tendon

Front 60

what is speed's test

Back 60

resist elbow flexion while putting pressure on the biceps tendon

Front 61

pt reports a long h/o shoulder pain. on lifting heavy biceps pt rports a sudden, painful and audable snap. He has a bulge over the anterior upper arm. What is the dx?

Back 61

rupture of the LH of biceps tendon

Front 62

what is shoulder impingement

Back 62

mechanical impingement of the rotator cuff tendon

Front 63

where can the RCT get impinged

Back 63

below coracoacromial jt, acromial process
subacromial bursa

Front 64

what is the most commonly injured RC mm

Back 64

supraspinatus