Term
| the musculoskeletal system provides... |
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Definition
| the stability and mobility for physical activity |
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Term
| you should always test the _______________ side first |
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Definition
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Term
| Schema of the musculoskeletal exam |
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Definition
observation function palpation neurological tests special tests |
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Term
| what are you observing during the musculoskeletal exam? |
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Definition
functional movements (ADLs) posture shape/deformity/swelling/atropy skin-color/scar-circulation assistive devices |
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Term
| how do you test musculoskeletal function? |
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Definition
active motions passive motions resisted movements traction/compression gliding |
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Term
| what do you palpate in the musculoskeletal system? |
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Definition
skin/subcutaneous tissue muscles/tendons (and their insertions) tendons/sheaths/bursae joints (bone/capsule/ligaments) nerves/blood vessels (intacts and circulation) |
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Term
| sports injury risk factors |
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Definition
poor physical conditioning failure to warm up mm adequately intensity of competition collision and contact sports participation rapid growth overuse of joints |
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Term
| which muscles and their tendons compromise the rotator cuff? |
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Definition
supraspinatus infraspinatus teres minor subscapularis |
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Term
| which 2 joints comprise the shoulder girdle? |
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Definition
glenohumeral acromioclavicular sternoclavicular |
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Term
| which joints allow for forearm pronation and supination? |
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Definition
| the articulation of the radius and ulna at the proximal and distal locations |
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Term
what kind of joint is the wrist? what kind of movement does is permit? |
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Definition
a condyloid joint permits flexion and extension |
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Term
| what helps stabilize and protect the head of the femur? |
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Definition
| the depth of the acetabulum as well as the joint, which is supported by 3 strong ligaments |
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Term
| what reduces friction in the hip and knee? |
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Definition
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Term
| how do the collateral ligaments help the knee? |
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Definition
| they give medial and lateral stability to the knee; protecting the knee from valgus and varus stress |
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Term
| what do the 2 cruciate ligaments add to the knee? |
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Definition
| anterior and posterior stability |
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Term
| what ligament protects the knee from hyperextension? |
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Definition
| the anterior cruciate ligament |
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Term
| what 3 bones articulate to form the tibiotalar joint (ankle joint)? |
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Definition
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Term
| where are the ligaments that protect the ankle located? |
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Definition
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Term
| the tibiotalar joint permits what kind of movement? |
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Definition
| dorsiflexion and plantar flexion |
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Term
| why can the ankle pivot and rotate if the tibiotalar joint only permits flexion and extension? |
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Definition
bc it also has a talocalcaneal and transverse tarsal joint |
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Term
| what are some complaints patients have about their joints? |
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Definition
stiffness or limitation of mvt change in size or contour swelling or redness constant pain or pain with particular mvts unilateral or bilateral involvement interference with daily activities joint locking or giving way
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Term
| what are some muscular complaints patients will come in with? |
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Definition
limitation of mvt weakness or fatigue paralysis tremor or tic spasms clumsiness wasting aching pain |
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Term
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Definition
difficulty with gait or limping numbness tingling pressure sensation pain with mvt crepitus deformity or change in skeletal contour |
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Term
| what equipment would you need to do a musculoskeletal exam? |
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Definition
skin-marking pencil goniometer tape measure reflex hammer |
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Term
| how do you begin your examination of the musculoskeletal system? |
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Definition
by observing the patient's gait and posture when they enter the room note how the pt walks, sits, rises from sitting position, takes off a coat, and responds to directions given during the examination |
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Term
| musculoskeletal exam: examine each region of the body for... |
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Definition
limb and trunk stability muscular strength and function joint function position the extremities uniformly so you can check for asymmetry |
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Term
| you should inspect a patient from what views |
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Definition
anterior posterior and lateral |
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Term
| observe the extremities for... |
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Definition
| overall size, gross deformity, bony enlargement, alignment, contour, and symmetry of length and position |
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Term
| what should you note during palpation of the bones, joints and surrounding mms? |
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Definition
heat tenderness swelling fluctuation of a joint crepitus pain resistance to pressure |
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Term
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Definition
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Term
| when can crepitus be felt? |
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Definition
when 2 bony surfaces rub together as the joint moves when 2 rough edges of a broken bone rub together or w/ the mvt of a tendon inside the tendon sheath when tenosynovitis is present |
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Term
| mm tone is often evaluated ______________ |
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Definition
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Term
| pain, limitation of mvt, spastic mvt, joint instability, deformity and contracture suggest a problem with... |
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Definition
| the joint, related mm group or nn supply |
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Term
| which should come first: passive mvt testing or active mvt testing? |
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Definition
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Term
| Is ROM of motion is often greater during passive or active movements? |
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Definition
| passive, by about 5 degrees |
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Term
| what are the mm function level grades |
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Definition
0 = no evidence of mvt 1 = trace of mvt 2 = full ROM, but no against gravity 3= full ROM against gravity but not against resistance 4= full ROM against gravity & some resist., but weak 5 = full ROM against gravity, full resistance gravity = passive mvt |
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Term
| to assess muscle strength have the patient: |
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Definition
1. contract the mm 2. to resist as you apply forace against the mm contraction 3. tell the pt to push against your hand to feel resistance |
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Term
| normal ROM of the cervical spine |
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Definition
45 degrees of flexion and extension 40 degrees to the right and left (ear to shoulder) 70 degrees of left rotation and right rotation |
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Term
| what are the major landmarks of the back? |
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Definition
spinal process of C7 and T1 the scapulae iliac crests paravertebral mm |
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Term
| in what patients is lordosis common? |
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Definition
those who are markedly obese or pregnant |
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Term
| a gibbus (sharp angular back deformity) is assc with what? |
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Definition
| a collapsed vertebra from osteoporosis |
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Term
| why should you percuss the spinal processes? |
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Definition
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Term
| what is a good position for the pt to be in so you can check for an unexpected curvature of the spine? |
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Definition
| they should bend forward slowly and try to touch their toes |
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Term
| a lateral curvature or rib hump of the back should make you suspect... |
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Definition
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Term
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Definition
bend forward and try to touch toes -- 75-90 degs bend back at waist as far as possible -- 30 deg bend to each side as far as possible -- 35 degs bilaterally swing the upper trunk from the waist in a circular motion front to side to back to side while you stabilize the pelvis -- 30 degs forward and backward |
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Term
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Definition
raise arms forward and straight up over head, expect forward flexion of 180 degrees extend and stretch arms behind the back, expect hyperextension of 50 degrees lift arms laterally and straight up over head, expect should abduction of 180 degrees swing each arm across the front of the body, expect internal rotation of 90 degrees place arms behind the hips, elbows out, expect external rotation of 90 degrees place both arms behind the head, elbows out, expect external rotation of 90 degrees |
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Term
| subcutaneous nodules along pressure points of the ulnar surface of the elbow may indicate: |
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Definition
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Term
| the expected carrying angle of the arm is: |
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Definition
| approximately 0-15 degrees laterally |
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Term
| a lateral carrying angle > 15 is: |
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Definition
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Term
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Definition
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Term
| at what angle should the arm be flexed to palpate the extensor surface of the ulna? |
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Definition
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Term
| how do you test an elbow's ROM? |
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Definition
with the elbow fully extended at 0 degrees, bend and straigthen the elbow. Expect flexion of 160 degrees and extension returning to 0 or 180 degrees of full extension with the elbow flexed at a right angle, rotate the hand from palm side down to palm side up. expect pronation and supination of 90 degrees |
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Term
| deviation of fingers to the ulnar side, and swan neck or boutonniere deformities of the fingers usually indicates... |
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Definition
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Term
| what do you differently when you palpate the IP joints vs the MCP joints? |
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Definition
IP use thumb and index finger MCP use both thumbs |
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Term
| examination of ROM of the hands and wrists |
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Definition
bend the fingers forward at the CMP jt; stretch the fingers up and back at the knuckle, expect MCP flexion = 90 deg, hyperextension up to 90 deg touch the thumb to each fingertip and to the base of the little finger; make a fist. all mvts should be possible spread the fingers apart then touch them together; both mvts should be possible bend the hand at the wrist up & down. expect flexion of 90 degs and hyperext of 70 degs with the palm side down, turn each hand to the right and left. expect radial motion of 20 degs and ulnar motion of 55 degs |
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Term
| what is the expected ROM when you, while supine, raise the leg with the knee extended above the body? |
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Definition
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Term
| when you swing your leg behind the body without arching the back you should expect an ROM of... |
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Definition
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Term
| what ROM should you see when you ask the pt to, while supine, raise one knee to the hecst while keeping the other leg straight |
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Definition
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