Term
| synarthroidal/fibrous joint |
|
Definition
immovable
ex: tibia/fibula, radius/ulna, sutures of skull |
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Term
| amphiarthroidal/cartilaginous joint |
|
Definition
slightly movable
ex: pubic symphysis, IV discs, facets |
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Term
| diarthroidal/synovial joint |
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Definition
freely movable
all other joints; lined by and surrounded by synovium |
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Term
| functional joint classifications |
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Definition
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|
Term
| structural joint classifications |
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Definition
| fibrous, cartilaginous, synovial |
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Term
|
Definition
ball and socket
hinge
condyloid (ellipsoidal)
saddle
gliding
pivot |
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Term
|
Definition
bone can move along indefinite number of axes
ex: hip, glenohumeral joint |
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|
Term
|
Definition
motion in only one plane
ex: elbow, knee |
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Term
|
Definition
| ex: thumb at carpometacarpal joint |
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|
Term
|
Definition
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|
Term
|
Definition
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|
Term
| condyloid (ellipsoidal) joint |
|
Definition
rounded end of bone inserts into shallow cavity of another bone; does flexion, extension, ADD, ABD, and circumduction
ex: carpals to radius and ulna, MCP joints) |
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|
Term
| What are you checking for when you inspect and palpate in a musculoskeletal exam? |
|
Definition
alignment
symmetry
size of joint and surrounding structures
deformity |
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|
Term
| When assessing an injury, always include the joint _______ and _______, as well as compare ______ to _______. |
|
Definition
above and below
left to right |
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|
Term
|
Definition
temperature
tenderness
swelling
effusion (fluid under the joint)
crepitus |
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Term
|
Definition
| clinician driven (part moved by clinician) |
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|
Term
|
Definition
| patient driven (demonstrated by patient) |
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|
Term
| What do you use measure angles? |
|
Definition
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Term
|
Definition
0=no contractility
1=slight contractility,no movement by pt.
2=fullROM, gravity eliminated (passive)
3=full ROM vs gravity
4=full ROM vs gravity, some resistance
5=full ROM vs gravity, full resistance |
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|
Term
| What signifies true TMJ dysfunction? |
|
Definition
| pain, crepitus, locking, or popping |
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|
Term
|
Definition
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|
Term
|
Definition
| inferior angles of the scapulae |
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Term
|
Definition
| umbilicus (dermatome is of T10) |
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|
Term
|
Definition
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|
Term
|
Definition
convex
normal to a degree in the thoracic and sacral vertebrae |
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|
Term
|
Definition
concave
normal to a degree in cervical and lumbar vertebrae |
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|
Term
|
Definition
"hunchback"
occurs with osteoporosis, rheumatoid arthritis, and sometimes pregnancy |
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Term
| What can be used to diagnose a compression fracture of the spine? |
|
Definition
| percussion with a vibratory hammer; pt will have severe pain at segment with compression fracture when base of vibratory hammer is placed on it |
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Term
| HNP (Supine) Straight Leg Raise Test |
|
Definition
-tests L4, L5, S1
-examiner flexes hip (knee extended)
-positive test if pain below the knee area when lower extremity extended > 30 degrees
-flexion of the knee eliminates the pain |
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|
Term
| HNP (Sitting) Straight Leg Raise Test |
|
Definition
-"flip sign"
-seated position (slight lean forward)
-extend leg at knee against resistance
-positive test if pt leans backward ("flip sign"); has (radicular) pain with extension or resistance |
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|
Term
| HNP Bragard Stretch Test for L4, L5, S1 |
|
Definition
-patient supine with neck slightly flexed
-examiner holds lower leg/ankle
-lower extremity raised slowly until pain felt
-lower slightly
-briskly dorsiflex foot and internall rotate lower extremity simultaneously
-pain in leg indicates herniated lumbar disc |
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|
Term
| HNP Femoral Stretch Test (Hip Extension Test) |
|
Definition
-tests L1, L2, L3, and sometimes L4 levels
-extend hip and flex knee
-positive if pian in dermatome distribution (anterior thight) with lower extremity extension |
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|
Term
| What bony landmarks of the shoulders should be palpated? |
|
Definition
sternoclavicular joint
clavicle
acromioclavicular joint
spine of the scapula
coracoid process
greater tubercle of humerus
biceps groove |
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|
Term
| What muscles of the shoulders should be palpated? |
|
Definition
supraspinatus
infraspinatus
teres minor
subscapularis
deltoid |
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Term
| What muscles are responsible for external rotation of the shoulder? |
|
Definition
supraspinatus
infraspinatus
teres minor |
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|
Term
| What muscle is responsible for internal rotation of the shoulder? |
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Definition
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|
Term
| What signifies a rotator cuff tear or inflammation? |
|
Definition
| pain and/or disability between 60 and 120 degrees of ABD |
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|
Term
|
Definition
-tests rotator cuff integrity and strength
-flex shoulder to 90 degrees
-flex elbow to 90 degrees
-internally rotate shoulder
-positive test if pain in rotator cuff region |
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|
Term
|
Definition
labrum vs AC joint pathology
*watch video* |
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|
Term
|
Definition
biceps tendinitis vs labral pathology
*watch video* |
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|
Term
|
Definition
-tests rotator cuff integrity and strength
-internally rotate shoulder as examiner flexes shoulder up to 150 degrees
-presses supraspinatus into antero-inferior subacromial area
-positive test is pain
-maneuver also checks serratus anterior integrity and rules out winged scapula
*watch video* |
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|
Term
|
Definition
-serratus anterior muscle
-injury to long thoracic n. causes paralysis to this muscle
-scapula lifts away (wings) from the posterior chest wall
-deformity accentuated by extending the arm or pushing against a wall
-common in women who have had a mastectomy |
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|
Term
| Supraspinatus Stress Test |
|
Definition
-ABD arm to 90 degrees, then flex anteriorly 30 degrees
-pronate forearm
-apply mold resistance downward on the forearm
-positive test if pain or weakness elicited
-"empty can test" |
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|
Term
|
Definition
-passively ABD shoulder to 90 degrees
-pt relaxes arm fully
-advise you are going to let go of arm, then let go and ask patient to lower arm slowly
-positive test if patient unable to lower slowly in a fluid manner
-sign of supraspinatus injury |
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|
Term
| How do you test the subscapularis? |
|
Definition
-arm at side, elbow flexed to 90 degrees
-move forearm medially against resistance |
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|
Term
| How do you test the infraspinatus and teres minor? |
|
Definition
-have arm at side, elbow flexed to 90 degrees
-move forearm laterally against resistance |
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|
Term
| complete rupture of supraspinatus |
|
Definition
-most common between ages 55 and 65
-active ABD very limited
-further ABD accomplished with elevation of the scapula and shoulder shrugging or assistance from the opposite hand |
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Term
| impingement syndrome and subacromial bursitis |
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Definition
| repetitive activity with the arm above horizontal compresses the rotator cuff and related structures between the humeral head and the coracoacromial arch (space varies between individuals--some predisposed) |
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Term
| Cross Chest ("Crossover") Test |
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Definition
-evaluates the AC joint
-arm horizontally across chest
-examiner presses against arm to stress the joint |
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Term
| swan neck finger deformity |
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Definition
| hyperextended PIP joint, flexed DIP joint |
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Term
| boutonniere finger deformity |
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Definition
| flexed PIP, hyperextended DIP |
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Term
|
Definition
| hard or bony swellings that develop in DIP joints |
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Term
|
Definition
| hard or bony swellings that develop in PIP joints |
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Term
|
Definition
| forms on top of a joint, usually in wrist or foot |
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Term
|
Definition
-tests for carpal tunnel syndrome
-light percussion over nerve (median at wrist, ulnar at cubital tunnel of elbow)
-tingling and/or reproduction of symptoms is positive test |
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|
Term
|
Definition
-tests for carpal tunnel syndrom
-hold wrist in acute flexion for 60 seconds
-numbness or tingling is positive sign |
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|
Term
|
Definition
-tests for De Quervain's tenosynovitis
-tuck thumb in hand and deviate wrist to ulnar side
-pain is a positive test |
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|
Term
|
Definition
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|
Term
|
Definition
-rules out hip flexion contracture
-pt supine, one leg extended, flex other hip and knee |
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|
Term
| Patrick's test (AKA FABER test) |
|
Definition
-stresses the hip and SI joint
-flexion, ABD, external rotation of the hip
-positive test reproduces back or buttock pain
-groin pain is more indicative of hip joint pathology
*watch video* |
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|
Term
| Barlow and Ortolani manuevers |
|
Definition
-performed at each pedi visit until age 1
-detects hip dislocation/subluxation
-preferably one hip tested at a time |
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|
Term
|
Definition
-examiner's thumb on inside of thigh
-base of examiner's thumb on knee
-examiner's fingers gripping outer thigh with fingertips over trochanter
-ADD thigh and apply downward pressure
-attempt to dislocate hip |
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|
Term
|
Definition
-slowly ABD thigh with axial pressure
-exert pressure in reverse order (presses head of femur back into position)
-attempt to relocate hip |
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|
Term
|
Definition
-tests for hip dislocation or foreshortened femur
-both knees flexed with feet flat on table
-examiner at infant's feet
-observe height of knees |
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|
Term
|
Definition
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|
Term
|
Definition
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|
Term
| femur-tibia angle should be... |
|
Definition
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|
Term
|
Definition
| rebound sensation as structure floating within a fluid is moved and returns to its original position |
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|
Term
| How do you check for ballottement in the knee? |
|
Definition
-knee extended
-downward pressure with one hand on suprapatellar pouch
-push patella downward against femur with finger of other hand
-tapping or clicking means + for effusion
-release deep pressure against patella but keep light pressure
-patella "floats" if + for effusion |
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|
Term
| How do you check for the bulge sign in the knee? |
|
Definition
-knee extended
-milk medial aspect upward 2-3 times
-tap lateral side of patella
- + for effusion if "returning" fluid creates bulge in hollow area medial to patella |
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|
Term
|
Definition
-tests LCL
-test in extension and 30 degree flexion
-stabilize femur with one hand, hold ankle in other hand
-force ankle toward midline and apply internal rotational force |
|
|
Term
|
Definition
-tests MCL
-test in extension and 30 degree flexion
-stabilize femur with one hand, hold ankle with other hand
-force ankle away from midline and apply external rotational force |
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|
Term
| anterior and posterior drawer test |
|
Definition
-assesses ACL and PCL
-pt supine, knee flexed 45-90 degrees, foot flat on table
-examiner's hands circle upper tibia with thumbs apart and just proximal to tibial tuberosity and just distal to joint line
-anterior drawer: draw tibia forward
-posterior drawer: push tibia backward
-positive test: movement > 5mm in either direction |
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|
Term
|
Definition
-determines integrity of the ACL
-PCL must be intact
-most sensitive test for ACL
-pt supine, knee flexed 10-15 degrees
-one hand grasps and stabilies the thigh while pulling the tibia anteriorly
-forward translation of the tibial plateau > 5mm = tear in ACL |
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|
Term
|
Definition
-detects meniscal tears
-pt supine with knee flexed
-one hand circles distal femur, other holds ankle or heel
-fully flex knee, then externally rotate foot with extending knee (tests medial meniscus)
-fully flex knee, then internally rotate foot while extending knee (tests lateral meniscus) |
|
|
Term
|
Definition
-detects meniscal tears
-pt c/o "locking" or "buckling" of the knee
-pt prone with knee flexed to 90 degrees
-examiner's hand presses downward on heel, then heel rotated |
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Term
|
Definition
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|
Term
|
Definition
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Term
|
Definition
| club foot (walking on lateral side) |
|
|
Term
|
Definition
-outward turning of foot (walking on medial side)
-will see calus on medial plantar surface of big toe
-causes knee, ankle, hip, and back pain |
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|
Term
|
Definition
| Achilles tendon deviates laterally |
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|
Term
| anterior drawer test for the ankle |
|
Definition
| checks integrity of the 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 |
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|
Term
|
Definition
| hyperextended MTP with flexed proximal joint |
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|
Term
|
Definition
|
|
Term
|
Definition
| hyperextended MTP with flexed proximal and distal joints |
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|
Term
| You ________ a muscle or tendon, but you _________ a ligament. |
|
Definition
|
|
Term
|
Definition
-stretching or partial tear of a muscle or tendon
-if complete rupture, have inability to move joint and requires surgical repair
-more common in middle-aged and older
-sudden stretch while muscle in contraction |
|
|
Term
|
Definition
-stretching or partial tear of supporting structures of a joint
-occur in all ages
-sudden trauma
-graded based on degree of injury and stability of the joing |
|
|
Term
| grade I (first degree) sprain |
|
Definition
-partial tear
-no instability of joint with stress
-treat based on symptoms |
|
|
Term
| grade II (second degree) sprain |
|
Definition
-partial tear
-instability noted on stress
-treatment: immobilize and protect |
|
|
Term
| grade III (third degree) sprain |
|
Definition
-complete tear
-complete opening of joint on stress
-treatment: immobilize, possible surgical repair |
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|
Term
|
Definition
|
|
Term
| What is the most common sprain? |
|
Definition
| ankle (mainly inversion injuries) |
|
|
Term
| What is the most commonly injured ligament in the ankle? |
|
Definition
| anterior talofibular ligament (extends anteriorly from distal fibula to neck of talus) |
|
|
Term
| What is the 2nd most commonly injured ligament in the ankle? |
|
Definition
| calcaneofibular ligament (extends from tip of lateral malleolus inferiorly and posteriorly to calcaneus) |
|
|
Term
| What is the minor ligament at the posterior aspect of the ankle? |
|
Definition
|
|
Term
| How is the deltoid ligament of the ankle tested? |
|
Definition
|
|
Term
|
Definition
-more common after age 40
-pt's often describe an audible "pop"
-inablility to plantar flex
-treatment: casting in plantar flexion or may need surgical repair with casting; very long recovery |
|
|
Term
|
Definition
-tests Achilles tendon
-pt prone, knee extended
-squeezing calf muscle should produce involuntary plantar flexion
-absence of plantar flexion is positive test |
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|
Term
| Calcaneal fractures have a strong associates with __________ _______ fractures. |
|
Definition
| lumbar spine (compression or burst fractures) |
|
|
Term
| Leg length is measured from ________ to the ________ _________, crossing the knee on the _________ side. |
|
Definition
| ASIS; medial malleolus; medial |
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|
Term
| Arm length is measured from the ________ ________ to the _______ _________ _____________. |
|
Definition
| acromion process; distal ulnar prominence |
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|
Term
| Always get comparison films if.... |
|
Definition
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