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74 Cards in this Set

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Moving a body part downward
Moving thumb to touch little finger
Bending the limb at the joint, decrease angle between bones, bring bones together
Increases angle to straight line. Zero degrees
Turning forearm so palm is face up
Moving sole of foot inward
Eversion -moving sole of foot outward
Turning forearm so palm is facedown
Moving a body part upward ie. shrugging shoulders. You get Bonus points if you name cranial nerve.
Spinal accessory XI 😉
Circular motion that combines flexion, extension, abduction, and adduction. ie. moving arm in a circle around shoulder
Moving body part forward and parallel to the ground
Moving body part backward and parallel to the ground
Turning of the joint around axis
Strength testing of joints
No muscle contraction when resistance applied
Strength testing of joints "1"
A slight muscle contraction but insufficient for joint movement
Strength testing of joints "2"
Weak contraction -full passive range of motion.
Strength testing of joints "3"
Contraction weak but full active movement against resistance
Strength testing of joints "4"
Some muscle strength against resistance
Strength testing of joints. "5"
Normal strength with resistance
Pregnant women
Increased joint mobility d/t hormones, increased mobility of pelvic joints = changes in posture. Lordosis compensates for enlarging uterus
Infants and children
Fetus forms cartilaginous skeleton by 3 months. All muscle fibers present at birth but lengthen with growth. Growth hormone, adrenal androgens, and testosterone contribute to growth spurts in boys
Rapid growth, complete approx. age 20, closure of epiphysis of long bones
Older adults
Decreased bone density, increased bony prominence, cartilage degeneration, joint stiffness, muscle atrophy, kyphosis, PTH levels increase=bone re absorption reduces bone density
Flaccidity, decreased muscle tone
Increased muscle tone, often noted with extreme flexion or extension
Simian crease
Single crease across entire palm. Associated with Down's syndrome
Webbed digits
Genu varum
Bow leg. Measure distance between knees when ankles together 2.5 cm =genu varum
Genu valgum
Knock knee. Measure distance between ankles when knees together. 2.5 cm = genu valgum
Articular disease
Typically involves swelling and tenderness of the entire joint and limits both active and passive ROM due to either stiffness or pain.
Extra-articular disease
Typically involves selected regions of the joint and types of movement
Collagen fibers connect muscle to bone
Collagen fibers connect muscle to bone
Rope like bundles of collagen fibrils that connect bone to bone
Collagen fibers connect muscle to bone
Rope like bundles of collagen fibrils that connect bone to bone
Pouches of synovial fluid that cushion the movement of tendons and muscles over bone or other joint structures c
Condylar joints
ie. knee the articulating surfaces are convex or concave. Allow for flexion, extension , rotation and motion in a coronal plane
Low back pain
85% idiopathic usually from musculoligamentous injuries and age related degenerative processes of the intervertebral discs and facet joints
Common or concerning symptoms
Low back pain, neck pain, monoarticular or polyarticular joint pain, inflammatory or infectious joint pain, joint pain with systemic features-fever, chills, rash, anorexia. Joint pain with symptoms from other organ systems.
Assessment tips for assessing joint pain
Ask pt to point to pain. When and mechanism of injury esp. If hx of trauma. ? If pain is localized or diffuse, acute or chronic, inflammatory or non-inflammatory.
Midline back pain
Assess for musculoligamentous injury, disc herniation, vertebral collapse, spinal cord metastases, and rarely epidural abscess.
Midline back pain
Assess for musculoligamentous injury, disc herniation, vertebral collapse, spinal cord metastases, and rarely epidural abscess.
Pain off midline
Assess for muscle strain, sacroiliitis, trochanteric bursitis, sciatica, and hip arthritis . Also pyelonephritis or stones.
Radicular gluteal and posterior leg pain in the S1 distribution that increases w/ cough or valsalva

Spinal stenos
Leg pain resolves w/ rest and/or forward flexion
Cauda equina syndrome
S2-4 midline disc or tumor if there is bowel or bladder dysfunction esp. With saddle anesthesia or perineal numbness.
Cauda equina syndrome
S2-4 midline disc or tumor if there is bowel or bladder dysfunction esp. With saddle anesthesia or perineal numbness.
In cases of low back pain plus another indicator
10% probability of serious systemic disease
Radicular pain
Arises from spinal nerve compression most commonly C7 followed by C6. Usually caused by foraminal impingement from degenerative joint changes (70-75%) rather than disc herniation (20-25%).
Pain in one joint
Injury, monoarticular arthritis, possible tendinitis or bursitis. Lateral hip pain near the greater trochanter suggests trochanteric bursitis.
Acute septic arthritis or gout
Severe pain of rapid onset in a red swollen joint.
Fever, chills, warmth, redness seen in...
Septic arthritis also consider gout or possible rheumatic fever
Stiffness and limited motion after inactivity occurs I'm degenerative joint disease but only lasts a few minutes .
Stiffness and limited motion after inactivity occurs I'm degenerative joint disease but only lasts a few minutes .
TMJ syndrome
Unilateral chronic pain w/ chewing, jaw clenching, or teeth grinding. Associated w/ stress; may also present w/ headache. Pain and tenderness on palpating.
Pain with chewing
Trigonal neuralgia or temporal arteritis
Rheumatoid arthritis
Chronic inflammation of synovial membranes. Hands-MIP & PIP, feet metatarsphalangeal joints, wrists, knees, ankles. Onset 20-40 years of age. Systemic autoimmune disorder. Bilateral and symmetrical. Subcutaneous nodules, morning stiffness x 1 hr. onset insidious w/ exacerbation and remission. Joint Tenderness often warm but seldom red. Weakness, fatigue, wt. loss, and low fever are common. In chronic disease, swelling and thickening of metacarpophalangeal and proxim interphalangeal joints. Rom limited. Ulnar deviation. Fingers may show swan neck deformities. Less common boutonnière deformity. Rheumatoid nodules in acute or chronic stage. Interosseous muscles atrophy.
Deterioration of joint cartilage and new bone. Onset older than 50 in women, 40-50 in men. Localized, progressive, non-inflammatory. Stiffness later in the day. Rest relieves pain. Heberden's nodes on the dorsolateral aspects of distal interphalangeal joints, hard and painless. Flexion and deviation deformities at develop. Bouchard's nodes on proximal interphalangeal joints less common. Metacarpophalangeal joints are spared.
Empty can test
Superspinatus/rotator cuff
Arms extended and elevated to 90 degrees. Rotate arm to have thumbs pointing down. Examiner places downward pressure on arm while pt resists. Pain=positive test.
Full can test- thumbs point up for infraspinatus strength.
Joint dislocation
Ends of bones slip out of joint. Usually sports related. Severe dislocation can cause tearing of muscles, ligaments, and tendons. Pain, swelling, and immobility of affected joint. Requires medical attention.
Inflammation of bursa. Swelling, tenderness and increased pain w/ movement. Can follow injury, infection, or rheumatic condition. More common in shoulders, elbows, and hips
Red flags
Pain with neurologic deficits, pain in a child, pain w/ fever and/or stiff neck, pain worse at night, urinary incontinence or loss of bowel function.
Carpal tunnel syndrome
Compression of medial or ulnar nerve. Subjective: numbness and tingling in the hands worse at night, pain may radiate to arms. Objective: weakness of the hand. + Tinel sign. Phalens sign.
Tinel's sign
Strike the median nerve-tingling or pricking sensation radiating from wrist to. The hand especially the thumb, index and middle fingers. Positive sign associated w/carpal tunnel syndrome
Phelan's sign
Wrists in flexion x 1 minute. Positive tingling in thumb, index finger, and middle/lateral half of ring finger
Spurling's Test
Evaluates for cervical root impingement. With head extended and rotated toward the painful shoulder, apply an axial load to the cervical spine. Place hand on top of head apply pressure. Pain with this maneuver is a positive test.
Apprehension test
Patient holds arm in neutral position elevated 90 degrees. Examiner places mild pressure on anterior aspect of arm while rotating externally. Positive=pain. Suggests glenohumeral joint instability, found in young, active, healthy.
Sulcus test
Shoulder instability. Pt. arm relaxed at their side. Examiner grasps pts elbow and pulls down on it. Positive test=sulcus appears in subacromial area. Measured in centimeters.
Neer's impingement
Press on scapula to prevent scapula motion with one hand and raise the patients arm with other. This compresses the tuberosity of the humerus against the acromion. Pain=+ test. Inflammation or rotator cuff tear.
Hawkins impingement sign
Flex pts shoulder and elbow to 90 degrees with palm facing down. With one hand on forearm and one on the arm, rotate the arm internally. This compresses the greater tuberosity against the acromial ligament. Pain is positive test indicating possible inflammation or rotator cuff tear.
Test for medial epicondylitis
Pt arm flexed 90 at elbow with palm supination. Examiner holds elbow and palm. Pt to flex wrist and forearm pronation while resisting the motion. Pain may be indicative of medial epicondylitis.
Gouty arthritis
Inflammatory reaction to micro crystals of urate. Base of big toe, instep or dorsa of feet, ankles, knees, and elbows. Early attacks to one joint. Sudden onset , often at night, after injury, surgery, fasting, or excessive food or etoh. Occ. isolated attacks lasting days - wks. Swelling within and around joint. Very tender, hot, and red. Motion limited by pain. Poss. Fever. Consider also septic arthritis.
Chronic tophaceous gout
Mult. Local accumulations of urate in joints and other tissues (tophi) w/ or w/o inflammation. Feet, ankles, wrists, fingers, and elbows. Spread not symmetrical. Gradual onset of chronicity w/ repeated attacks. Present as tophi in joints, Bursae, and subcutaneous tissue. Check ears and extensor surfaces for trophi. Stiffness and decreased rom.
Hallux valgus
Lateral deviation of great toe and enlargement of the head of the first metatarsal on its medial side forming a bunion or bursa. The bursa may become inflamed. Women 10x more likely than men to be affected .