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Musculoskeletal Exams

Terms in this set (7)

-Inspects (contours, shape, alignment, resting position). Symmetry of quads, effusion, popliteal swlling (baker's cyst)
-Identifies structure of the knee: femur, tibia, fibula, patella, quadriceps, hamstring, calf muscles, ACL (crosses obliquely from anterior medial tibia to lateral femoral condyle), PCL, MCL, LCL (lateral femoral epicondyle and head of fibula), and patellar ligament, lateral and medial meniscus.
-Palpates: quad insertion above patella, patella and patellar tendon (inserts distally in tibial tuberosity), tibiofemoral joint (thumbs in soft tissue of depression on either side of patellar tendon), medial/lateral meniscus, assess medial and lateral joint compartments, MCL/LCL origin insertion, assess patellofemoral compartment (trace patellar tendon distally ntil palpate tibial tuberosity- ask pt to extend knee to ensure intact, could be torn if tender), suprapatellar pouch (above patella- 10cm)
-ROM passive then active: knee flexion (hambstring, bring heel to butt), extension (quad, straighten leg out), internal rotation (while sitting, swing lower leg toward midline, external rotation (while sitting swing lower leg away from midline)
-Strength: resisted knee flexion (testing hamstring), resisted knee extension testing quads)
-Demonstrates Effusion tests: Bulge sign (milk downward apply medial pressure, tap knee behind lateral margin), Balloon sign (place thumb and index finger of R hand on each side of patella from below, w/ L hand compress suprapatellar pouch and feel for fluid entering spaces), Ballotting the patella (milk quad down, hold above patella, and tap
-Demontrates McMurry test for meniscal injury (pendulum, feel click/pop/pain = +)
-Demonstrates varus (LCL) and valgus (MCL) stress testing
-Demonstrates Anterior Drawer (ACL) and Posterior Drawer (PCL) tests
-Inspects contours, bony anatomy, muscle contour, atrophy, scapular winging)
-Identifies structures: scapula, humerus, clavicle, deltoid, SITS muscles insert at greater tubercle (supraspinatus directly under the acromion, infraspinatus posterior to and above teres minor, teres minor posterior and inferior to the supraspinatus, subscapularis inserts anteriorly and is NOT palpable)
-Palpates: acromion, sternoclavicular and acromioclavicular joints, bicipital groove and tendon, anterior and posterior glenohumeral joint line
-Assess ROM: flexion (raise arms in front of you and overhead --> anterior deltoid and pec), extension (raise arms behind you --> posterior deltoid, lats, teres minor), abduction (raise arms out to side and up to ears --> supraspinatus), adduction (cross arm in front of body --> subscapularis, teres minor, pecs), internal rotation (hand cuffed, thumb touch scapula --> subscapularis, anterior deltoid), external rotation (rubber band --> infraspinatus, teres minor)
-Strength: resisted forward elevation, resisted external and internal rotation
-Crossover Test: AC joint, adduct arm across chest, touch my hand and resist (+pain in the AC joint = OA of AC joint)
-Apley Stratch Test: touch opposite scapula from above and below (difficult = RC d/o or adhesive capsulitis)
-Neers Test: tests RC to r/o tendintis, bursistis, impingement: Press on scapula with one hand interally rotate with thumb down and raise pt's arm with other (pain+=inflammation or RC tear)
-Hawkin's Impingement Sign: Forward flex arm to 90 degrees, then interanally rotate (pain = impingement)
-Empty Can Test (supraspinatus strength) against resistance
-Infraspinatus Strength: rubber band ext rot
-Forearm Supination: elbow side/grab had to shake. Have pt supinate and flex while you resist (+test is pain over bicep tendon -->inflammation of biceps tendon and possible RC tear)
-Drop arm test: have pt hold arm out to ade at shoulder level and lower slowly (+ test is not able to hold arm or cannot control lowering --> RC tear)