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CPD - Musculoskeletal system_T
Terms in this set (60)
31 min. / 32 min. / 26 min. /
Which type of joint is freely movable, such as the knee or shoulder joint? (Both names)
Which type is immovable such as the skull sutures? (Both names)
Which type is slightly movable such as the vertebral bodies of the spine? (Both names)
Synovial joint - diarthrosis
Fibrous joint - synarthrosis
Cartilaginous joint - amphiarthrosis
In which three joints are there fibrocartilagenous disks (menisci) between the articulating bones to distribute and diffuse the forces across the joint more evenly?
The movement at synovial joints can be classified as which three categories of movement?
Uniaxial (one plane, two opposite directions) - ex) knee, elbow
Bilateral (two planes @ right angles)
Multiaxial (multiple directions)
Which type if joint is made of the configuration of two opposing articular surfaces restricting motion, is Uniaxial, like the elbow, knee, & interphalangeal joints of the fingers?
Which type of joint is made of a flat articular surface allowing sliding over eachother, is Uniaxial, like the patello-femoral joint?
Hinge joints (think of a metal door hinge!)
Gliding joint (plane joint)
Which type of joint allows circular rotation, with an osteoligamentous ring, is Uniaxial like the atlas & axis and the proximal radioulnar joint?
In Which type of joint are the surfaces of both bones convex in one direction and concave in the other direction, biaxial, like the carpometacarpal joint("CMJ") of the thumb? *******
In which type of joint is one articulating surface convex on one direction and concave in the other direction, but allows no rotation, is biaxial, like the carpometacarpal joint of the fingers, radio carpal joint (wrist), and the teporomandibular joint?
In which type of joint is one bone a hemispheric head, and the other surface a cup shape, multiaxial, like the hip joint, and shoulder joint?
Ball & socket joint
1)Ball & socket joint?
1) hip & shoulder
2) wrist, TMJ, MCP joints
3) Thumb CMJ
4) elbow, knee
5) proximal radio-ulnar
6) ankle, patella-femoral
What is the main joint that makes up the "shoulder joint"?
However the glenohumoral joint coordinates movements with which two other joints?
What are the three most common causes of shoulder pain?
Rotator cuff tendinitis is caused by injury or gradual wear & tear of which rotator cuff tendon? (And present with pain near the greater tuberosity of the humerus 6-10 hr after acute injury)
Rotator cuff tendinitis (impingement syndrome)
Rotator cuff tears
The elbow joint is made up of which three joints within one joint capsule?
Which joint is the largest synovial joint in the body?
Humeroulnar joint (hinge joint)
Proximal radio-ulnar joint (pivot joint)
The knee joint
The ____ of the knee joint increase the contact surface between the femur & tibia and help to disperse forces associated with movement between the femur & tibia
The stability of a joint depends on I which three factors?
Shape/ depth of the articulating surface
Ligaments (strength & number)
Associated muscles & muscle tone
Which group of muscles act to stabilize the shoulder joint?
Which muscle stabilizes the knee joint?
Rotator cuff (SITS)
Which joint disease is usually poly articular, bilateral, symmetrically affecting small (sometimes large) joints, and affects left and right sides of the body?
Which joint disease tends to involve knees & hips (weight bearing joints) and the cervical & lumbar spine, & gets worse throughout the day?
Osteoarthritis commonly affects which two joints of the hand?
Which joint of the hand is usually spared along with other extremity joints?
Diffuse generalized aching in the periarticular areas accompanied by point tenderness is typical of which which disease?
In what degenerative or inflammatory arthritis does stiffness tend to be localized, of short duration (<30min), and may be worse AFTER resting the joint?
In which type of arthritis does the stiffness tend to be generalized, morning & evening, and last much longer than 30 minutes?
General stiffness and pain in the 20-30 year old age group worse in the morning and better with activity is suggestive of which disease?
Inflammatory arthritis (RA)
___ is an inflammatory disease that causes acute, intermittent disabling pain & swelling, accompanied by redness, warmth, and usually affecting the first tarsometarsal joint
Joint ____ refers to short, low pitch sounds or crackling heard or felt on movement of the joint
There are two significant differences between manifestation of inflammatory vs non-inflammatory arthropathy. In inflammatory arthropathy we see involvement of ____, as well as ____ symptoms like malaise, fever, night sweats, & weight loss
On inspection we need to observe patients for rash. The rash of which disease appears on the scalp, & extensor surface of elbows and/or knees?
Involvement of other systems than musculoskeletal
While inspecting for rash we can also look for a rash in children with juvenile rheumatoid arthritis called ____ disease
We next look for nodules. We see tophi on the helix or anti helix of the ear in ____, and we see see them on the extensor surface of the forearm in ____ ____
Eye inflammation, arthritis of large joints, and urethritis/cervicitis are a triad of symptoms seen in _____ _____
After observing for eye inflammation, we look for mucocutaneous ulcers that can appear in which two diseases?
Reactive arthritis (think king arthur, appears in reaction to something else)
After observing for mucocutaneous ulcers we can look for decreased chest expansion that we can see in which disease?
Which two general observations should be made about the patient before beginning the musculoskeletal examination?
In the musculoskeletal examination, we examine the specific areas using which four skills?
A head tilt abnormality with a twisted neck is called what due to contracted functionally shortened SCM muscle limiting rotation & lateral flexion of the head?
What are the two most common causes of torticolis?
Move (skills of look & feel)
Assessment of function (talk/look/move)
Infections (acute tonsillitis/retro pharyngeal abscess)
If we see head tilt, it might not be due to musculoskeletal impairment. Which ocular problem can lead to head tilt?
A winged scapula is due to weakness/paralysis of the _____ ____ muscle as in lesions to the ____ ____ nerve
Serratus anterior muscle
Long thoracic nerve
Kyphosis normally affects the ___ levels of the spine but it can also affect the cervical spine as well
Kyphosis occurs commonly in older patients, esp women with which two musculoskeletal diseases?
Lateral deviation of the vertebral column is called _____. It is commonly seen in the thoracic vertebrae
An unstable joint often indicates disruption of which part of the joint?
Hypermobility is excessive motion at a joint. It might be normal for a patient, or it could mean what?
Active movement at particular joints of the limb is used to test motor myotomes. In the upper extremities, which level is tested by abduction of the glenohumoral joint?
Flexion of the elbow joint?
Active movement at particular joints of the limb is used to test motor myotomes. In the upper extremities, which level is tested by extension of the elbow?
Flexion at the finger joints?
Abduction & addiction of index, middle & ring fingers?
Active movement at particular joints of the limb is used to test motor myotomes. In the lower extremities, which 2 levels are tested by extension of the knee?
Which 2 by Flexion of the hip?
Which 2 by Plantar flexion of the foot?
L3 & L4
L1 & L2
S1 & S2
Active movement at particular joints of the limb is used to test motor myotomes. In the lower extremities, which 2 levels are tested by flexion of the knee?
Which 2 by plantar flexion of the toes?
L5 & S2
S2 & S3
Spinal puncture should be done at which level to avoid injuring the cord in adults?
In which vertebral injury is a "step off" at the affected spine level felt (e.g. L5/S1) as well as a prominent spinous process at L5 palpable?
Spondylolisthesis (forward deviation of a vertebra)
In the cervical spine, head nodding occurs at the ____ joint, & rotation occurs at the _____ joint
____ joint diseases typically affect the upper cervical spine, while ____ joint diseases affect the lower cervical spine
Atlantooccipital joint (nod "yes")
Atlantoaxial joint (shake "no")
Inflammatory - upper
Degenerative - lower (think degenerative effects more weight bearing)
What are two common injuries that can lead to sciatic nerve root irritation causing sharp pain in the buttocks that radiates down the thigh along L5/S1 dermatome?
Which four muscles make up the rotator cuff?
Prolapsed IV disc
Nerve root entrapment
The rotator cuff keeps the shoulder stable while which two larger muscles exert their force on the shoulder? (These muscles also contribute the rounded appearance of the normal shoulder)
The _____ muscle abducts the shoulder to 15 degrees & the ___ abducts from 15-90 degrees (which nerves innervate these muscles?)
Deltoid & trapezius
Supraspinatus - suprascapular N
Deltoid - Axillary N
In which 2 injuries will a flattened appearance if the shoulder seen?
If which ligament is torn we will also see a mild flattening of the shoulder?
Axillary nerve lesion & deltoid atrophy
Which fracture if the humerus can lead to Axillary nerve injury & deltoid atrophy?
"____ ____" usually denotes severe restriction in all shoulder movements
Surgical neck fracture of the humerus
"___ ___ ___ " a term used to encompass sub acromial bursitis and rotator cuff tenderness
Which shoulder joint clinical condition is due to calcium deposition in the supraspinatus portion of the rotator cuff, felt during 50-130 degrees abduction?
The pain is relieved how?
Shoulder impingement syndrome
Calcific supraspinatus tendinitis
Putting the arm in adduction
Which elbow joint condition is due to inflammation & degeneration of the wrist extensors at their origin?
The pain is aggregated by activities that put the wrist in which position? (Putting strain on the extensor tendons)
Lateral epicondylitis (tennis elbow)
Which elbow joint disease occurs from overuse if the flexor & Pronator muscles of the wrist?
Which nerve of the upper limb sends off a recurrent branch in the hand to innervate the thenar muscles?
Medial epicondylitis (golfer's elbow)
Median nerve (LLOAF)
Which two actions of the hand are defined as movement away and towards the long axis through the middle finger?
When splinting the hand after injury, to prevent permanent deformity the the wrist should be splinted in which position? The MCP joints? The interphalangeal joints?
(Allows the collateral ligaments at their max length & the hand has max strength)
The contents of the carpal tunnel are the four tendons of the ____ ___ ___ muscle, the four tendons of the ____ ____ ____ muscle, the tendon of the ____ ____ ____ & which nerve?
Changes in the muscles of the thenar eminence may mean injury to the ___ nerve, and changes to the hypothenar eminence may mean injury to the ___ nerve
Flexor Digitorum Superficialis
Flexor Digitorum Profundus
Flexor Pollicis Longus
Bony swelling in the DIP and PIP is likely related to degenerative arthritis (osteoarthritis). The swelling in the DIP is called what?
In the PIP?
Bony swelling in the MCP joint is most likely to be caused by which joint disease?
Which finding at the wrist and MCP joints is characteristic of Rheumatoid arthritis?
Ulnar drift (deviation)
Atrophy of the intrinsic muscles in the dorsum of the hand often indicates what?
If we see atrophy in both the thenar & hypothenar eminences, this could be due to an ulnar & median nerve lesion or could be due to what other cause?
Denervation of these muscles (ulnar)
Disuse atrophy as in Rheumatoid arthritis
Which injury of the hand is due to retraction of the digital slips of the palmar aponeurosis and overlying skin of the hand?
This occurs mainly in which two fingers?
Dupuytren's contractures (Also seen in liver Cirrhosis!!)
Which deformity consists of hyper extension of the MP joint and flexion of the interphalangeal joints of the ring and little fingers?
What lesion is this due to?
Ulnar palsy at the wrist
Which nerve provides sensation to the little finger and over the hypothenar eminence?
Which one provides sensation to the pad of the index finger and over the thenar eminence?
A combination of warmth, swelling & tenderness in the hand joints may indicate active _____ occurring
Which nerve provides sensation to the dorsum of the hand in the first web space?
If a patient can do what action, there is a great likelihood that range of motion of the fingers and thumb are full & good?
Which two tests are done if carpal tunnel syndrome is suspected?
Make a tight fist with the fingertips touching the midpalm & the thumb folded over the fingers
Where are the intrinsic muscles of the thumb located?
Which muscle is the sole flexor of the DIP joint?
Which two muscles flex the PIP & MCP joints?
In the thenar eminence
Flexor Digitorum Profundus
Flexor Digitorum Superficialis
Flexor Digitorum Profundus
Which muscles abduct the fingers at the MCP joint?
Which muscles adduct the fingers at the MCP joint?
Dorsal interossei "PADS & DABS"
Muscles of the gluteal region are responsible for which three actions one hip?
Muscles in the anterior compartment of the thigh normally perform which main action?
Extension, rotation, abduction
Extension of the knee joint
Muscles of the posterior thigh compartment usually perform which main action?
Muscles of the medial compartment of the thigh?
Extension of the thigh
Adduct the thigh
Forces applied to the medial and lateral sides of the knee may cause which injury?
Which structures protect the knee from rotational injury?
Collateral ligament injury
Menisci (medial & lateral)
Which compartment of the leg acts to dorsiflex and invert the foot, and invert and extend the toes?
The muscles of the lateral compartment of the leg do which main action?
Evert the foot
Which nerve innervates muscles of the anterior leg compartment?
The lateral compartment?
The posterior compartment?
When inspecting the hip, if the length of the legs is not the same, we need to measure them. We measure from which two specific points?
Which two situations can lead to a discrepancy in limb length, leading the an abducted, externally rotated, & flexed limb?
From the ASIS to the medial malleolus of the same leg
Which leg injury will leave the lower extremity in a position of flexion & external rotation?
Which test do we do to test the strength of the hip and gluteal muscles?
Fracture in the neck of the femur
In a positive Trendelenberg test for gluteal muscles, to which side will the hip "dip" when the patient lifts flexes their leg?
This is due to denervation/weakness In which two muscles?
To the opposite side of the lesion
Gluteus minimus, and medius
What are we testing for when we do the Thomas test?
What is a positive Thomas test result?
Fixed flexion contracture of the hip
The opposite hip will flex and the opposite knee will lift up from the table
Tenderness along the lateral and medial aspects of the knee, with a history of trauma may indicate which 2 injuries?
Generalized swelling and tenderness over the knee joint may indicate what?
Collateral ligament tear
We need to palpate behind the knee for the presence of which three things?
Pulsatile swelling - popliteal aneurysm
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