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Musculoskeletal Exam includes

Bone, Joints, Muscles, Tendons, Ligaments

Joint Motions

Flexion, Extension, Abduction, Internal rotation, external rotation, circumduction

Flexion

Bending or Decreasing the angle between bones/limbs

Extension

act of stretching or straightening out a flexed limb

Abduction

Away from the body. (Hitler abducted people)

Internal rotation

rotation of a joint toward the middle of the body

External rotation

turning outward, away from the midline of the body

Circumduction

moving bone or limb in a circle

Examination of Musculoskeletal Exam includes

Inspection, Palpation, ROM evaluation, Muscle strength

Inspection in Musculoskeletal exam

look for swelling, redness, discoloration, anything abnormal,

Palpation in Musculoskeletal exam

tenderness, heat, nodules, effusions (fluid build up)

ROM evaluation

range of motion, see if joints move through normal ROM

Bursitis

Over-use syndrome. bursa are sacks that lie in between muscles and joint spaces provide cushioning. inflammation of the bursa

Subacromial bursa

bursa that cushions the shoulder joint. below the acromion. becomes depressed when the arm is elevated. can't raise their arm to head if they have a bad subasprinatus bursa

Bicep tendonitis

inflammation of the bicep tendon. applying pressure will hurt.

olecranion bursitis

common. doesn't cause much pain but it can become edema. Truck drivers get this in their left arm.

Gout

Inflammation of joints due to the deposit of sodium urate crystals. any flare up causes damage to the joint.

Tophaceous

Nodules caused by accumulation of uric acid and destruction of the joints

Fibromyalgia

Chronic pain syndrome. no blood tests, scans, or anything to diagnosis this.

Scoliosis

Abnormally formed spine that forms with a curvature. common in teenage girls. If occurring in obese or arthritic patients, will be bad/painful.

Dextroscolosis

curving to the right

Levoscolsis

curing to the left.

Rheumatoid Arthritis

Autoimmune conditions. tissues are attacked by antibodies. mostly the synovial membranes. chronic inflammatory arthritis. Over time, fingers will deviate to the ulnar side.

Swan neck deformity

deformed position of the finger, in which the joint closest to the fingertip is permanently bent toward the palm while the nearest joint to the palm is bent away from it (DIP hyperflexion with PIP hyperextension). common in rheumatoid arthritis

Boutonniere deformity

Knuckle looks as if it is being pushed thru a buttonhole. Includes flexion of proximal interphalangeal joint with compensatory hyperextension of distal interphalangeal joint. Common in rheumatoid arthritis.

Osteoarthritis

Slow wear-and-tear on joints. not inflammatory arthritis like gout. have acute flare ups. Use cortisone or NSAIDs. crepitus and heberden's nodes can occur.

crepitus

Cracking of joints. , grating or crackling sensation or sound

heberden's nodes

hard or bony swellings in distal interphalangeal joints. indicate osteoarthritis

Large osteophyte accumulation

in osteoarthritis. excess bone growth around the joints.

Osteoarthritis of the spine

Lipping and spurs. can see on x-rays

lipping

overgrowth of cartilage around edges of joints; looks like candle dripping

spurs

calcified lippings

Dupuytren's contracture

a fixed flexion contracture of the hand where the fingers bend towards the palm and cannot be fully extended (straightened). shortening and thickening of flexible tendon. starts in the digits.

Joint Effusion

f, swelling from excess FLUID in joint capsule. decreases ROM

Arthrocenetsis of knee effusion

bloody. remove the blood by puncturing the skin and pulling the blood out via a syringe. do this when ligament tears and fills the knee immediately with blood. knee swells up within minutes

Ganglion cyst

a harmless fluid-filled swelling that occurs most commonly on the outer surface of the wrist. usually requires no treatment.

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