N202 Musculoskeletal

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N202 Musculoskeletal
2010-11-30 13:14:22
N202 Musculoskeletal

N202 Musculoskeletal, for final exam
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  1. In adults, what type of bone produces RBCs?
    flat bones
  2. What are 2 examples of minerals taht can be stored in bones and joints?
    calcium and iron
  3. What are nonmobile joints called?
  4. What are moveable joints called?
  5. What do synovial joints have in them?
    Cartilage, Ligaments, bursa, muscles attached, tendons and fasiculi
  6. What does cartilage do?
    covers the surface of bone
  7. What do ligaments do?
    • Connects bone to bone
    • provides joint stability
  8. What is bursa?
    sac of viscous synovial fluid for friction free movement of joint
  9. What is bursitis?
    • inflammation of bursa
    • may be caused by overuse or infection
  10. What are fasculi?
    bundles of muscle fibers
  11. what are tendons?
    attach muscle to bone
  12. what is tendonitis?
    inflammation of tendon
  13. What is flexion?
    forward or lateral bending
  14. What is abduction?
    away from midline
  15. what is pronation?
    palm down
  16. what is inversion?
    sole in
  17. what is protraction?
    body part forward
  18. where can you internally rotate?
    shoulder and hip
  19. what is radial deviation?
    move hand inward
  20. what is rotation?
    moving head around central point
  21. what is extension?
  22. what is adduction?
    towards midline
  23. what is supination?
    palm up
  24. what is eversion?
    sole out
  25. what is retraction?
    body part backward
  26. what part of the body can you externally rotate?
  27. what is ulnar deviation?
    move hand outward
  28. What is RA? What are the symptoms?
    Rheumatoid arthritis. It is inflammation of synovium (lining of the joint)

    • symmetric joint involvement
    • worse in the am
    • movement decreases pain
  29. What is DJD? What are th charicteristics of it?
    Osteoarthritis, Degenerative Joint Disease. The cartilage wears away.

    • may affect unilateral joint
    • worse in pm (wear and tear disease)
  30. What is MOI?
    Method of Injury
  31. What is HNP? What are the sensory and motor changes that come with it?
    Herniated Nucleus Pulposus ("herniated intervetebral disc")

    • Sensory changes: numbness of LE (lower extremities), tingling
    • motor changes: weakness
  32. what may preclude independent living?
    decreased functional ability
  33. What are the 4 things you will do to examine each joint?
    • inspect
    • palpate
    • test ROM
    • test muscle strength
  34. What techniques will you use while examining?
    • cephlocaudal (head to toe)
    • proximal to distal
    • support each joint
    • compare corresponding joint (examine unaffected joint first)
  35. What are the signs of inflammation or infection of a joint?
    redness, heat, swelling, pain
  36. What are the 2 causes of joint swelling?
    • effusion (excess joint fluid)
    • inflammation of surrounding soft tissue (bursa tendon)
  37. What is a dislocation?
    bone out of joint position
  38. what is a subluxation
    parital dislocation, bone moves in and out of position
  39. what is a contracture?
    shortening of muscle leading to limited ROM

    associated with BR and immobility
  40. What is crepitation? (in conjunction with ROM?)
    noise adn palpable crunching with motion
  41. What are the 5 grades on the ROM scale?
    • 5- FROM against full resistance- normal
    • 4- FROM against some resistance- slight weakness
    • 3- FROM without resistance- moderate weakness (can move against gravity- over head, but not resistance)
    • 2- Full passive ROM- severe weakness, can only roll extremity- cant raise arms over head
    • 1- slight muscle contraction- can not move extremity
    • 0- no muscle contraction
  42. How wide should one be able to open their TMJ?
    3-6 cm
  43. How far should one be able to move their TMJ side to side?
    1-2 cm
  44. What nerve are you assessing when palpating the masseter muscle?
  45. What bones are considered art of the shoulder?
    scapula, humerus and clavicle
  46. What is the subacromial bursa?
    • cushioning pad
    • allows humerus to move under the acromion process of the scapula during abduction of the arm.
  47. What four muscles are part of the rotator cuff?
    • supraspinatus
    • infraspinatus
    • teres minor
    • subscapularis

    (and tendons that stabilize the joint)
  48. What are the palpable landmarks of the shoulder?
    • acromian process of the scapula
    • greater tublercle of the humerus
    • coracoid process of the scapula
  49. What is the arm drop test for? What are the components of the test?
    tests for rotator cuff tears

    • abduct arms past 90 degrees adn ask to lower slowly
    • at about 90 degrees, if the arm suddenly drops, there is a supraspinatus muscle weakness, may see the deltoid attempting to compensate
  50. What are the bone of the elbow?
    articulation of teh humerus, radius and ulna
  51. Where is the olecranon bursa?
    between olecranon process and skin
  52. What is the "funny bone" nerve?
    • ulnar nerve, olecranon nerve
    • between medial epicondyle and olecranon process.
  53. What is epicondylitis

    • occurs with repetitive movement
    • assess for pain with flexion and extension
  54. What would pain over the medial epicondyle suggest?
    medial epicondylitis or golfer's elbow
  55. What would pain over the lateral epicondyle suggest?
    lateral epicondylitis or tennis elbow (from backhand swing movement)
  56. Whar are characteristics of Osteoarthritis or DJD?
    hard tender nodules on fingers:

    • Heberden's nodes: DIP joint
    • Bouchards nodes: PIP joint
  57. What is common with RA?
    • Flexion contracture of MCP
    • called Swan's neck or boutonniere deformity
  58. When do we commonly see carpel tunnel syndrome?
    during pregnancy
  59. What are the median nerve distribution tests for Carpel tunnel syndrome? and the results?
    • Phalen's- positive (paresthesia of fingers with median nerve distribution
    • Tinel's sign- positive (numbness and tingling over median nerve distribution)
    • Thenar eminence atrophy
  60. What are the Ulnar nerve distribution tests for carpel tunnel syndrome?
    • Phalen's- positive (paraesthesia of fingers with ulnar nerve distribution)
    • Hypothenar atrophy
  61. What is Phalen's?
    (a test for CTS)
    90 degree flexion of wrist x 60 sec

    will cause paraesthesia of fingers if t has CTS
  62. What is tinel's sign?
    (a test for CTS)
    percuss median nerve

    will cause numbness and tingling if pt has CTS

    seen in median nerve distribution
  63. What is Hypothenar atrophy?
    (a test for CTS)
    palmar area distal to wrist on ulnar side

    seen in ulnar nerve distribution
  64. What is thenar emience atrophy?
    (a test for CTS)
    • round mound proximal to thumb
    • seen in median nerve distribution
  65. What comprises the hip?
    acetabulum and head of femur.
  66. Do you inspect the hip while standing or sitting?s
  67. What are palpable landmarks of the hip?
    • anterior superior ilian crests
    • ischial tuberosity (what you sit on)
    • greater trochanter
  68. What are the 3 bones that comprise teh knee?
    femur, tibia and patella
  69. What is the largest joint in the body?
  70. What does the medial and lateral menisci do?
    cushions tibia and femur (it is cartilage)
  71. What are the ligaments of the knee?
    medial and lateral collateral (med and lat stability)

    anterior adn posterior cruciate (post and ant cushions)
  72. Palpate the knee while the pt is.........
  73. What are things that we will inspect for in the knee?
    • shape and contour (note hollows on either side of patella)
    • note inflammation and deformities
    • assess quads for atrophy
  74. What comprises the tibiotalor joint?
    articulation of tibia, fibula nad talus
  75. What are the landmarks of the ankle?
    • medial malleolus
    • lateral malleolus
    • most feet have a longitudinal arch
  76. What should you have the pt do while you are inspecting the ankle- sit, stand, or walk?
    all three
  77. Findings with the toes:
    • Toes should lie flat
    • hammer toes are more common with a high arch (hyerextension od MTP and flexion of PIP)
    • claw toes
    • hallux valgus (bunion)- lateral deviation of toes
  78. Where should weight bear on the foot?
    Weight should fall in the middle of the foot
  79. What are the characteristics of a supinated foot?
    strike of heel on ground is concentrated on outsid eof foot; ankles appear to turn outward
  80. What are the characteristics of a pronated foot?
    strike of heel on ground is concentrated on inside of foot; ankles appear to turn inward
  81. What is the technical name for a foot drop?
    plantar flexion
  82. Wherer are the 4 major landmarks of the spine?
    • C7- at vetebral prominens
    • T7- inferior angle of scapula
    • L4- crosses the highest point on each iliac crest
    • S2- crosses two symmetric dimples over posterior superior iliac spines
  83. What are the 4 curves of the spine?
    • cervical
    • thoracic
    • lumbar
    • sacral
  84. What is scoliosis?
    lateral curvature of thoracic adn lumbar spine- note asymmetry of shoulders, scapular, and iliac crests when bending forward.
  85. What is kyphosis?
    enhanced thoracic curve
  86. what is lordosis?
    enhanced lumbar curve
  87. How do we measure leg length?
    anterior iliac spine to medial malleolus
  88. What are the 4 landmarks that we inspect for the back?
    symmetry of shoulders, scapulae, iliac crests, and gluteal folds with knees and feet together.
  89. What indicates a herniated nucleus pulposus?
    pain shoots down buttocks and leg past knee
  90. When does long bone growth end?
    until about age 20
  91. Where do children grow? (place on bone, name for growth plate)
  92. What are common sightings in preschool aged children?
    • lordosis is common
    • normally may apear flat footed (fat pad along arch until age 3)
    • walks with broad stance until age 3
    • toeing in common until age 3

    • Not so normal things::
    • oberve for bow legs or knock knees
    • check for trendelenburg sign
  93. What is genu varum?
    bow legs
  94. what is genu valgum?
    knock knees
  95. What age should you start scoliosis screening?
    age 12
  96. What does pregnancy do to the spine?
    • progressive lordosis
    • anterior cervical flexion, kyphosis, adn slumping of the shoulder girdle by 3rd trimester (may cause median and ulnar nerve impingement in upper extremities)
  97. What are common findings in older adults?
    • osteoporosis
    • height decreses (up to 2 inches)
    • loss of sq fat from bony prominences
    • loss of muscle mass
  98. What are the characteristics of the height decreses in older adults?
    • discs thing and collapse (6th adn 7th decade)
    • kyphosis of spine occurs with backward head tilt
    • hips and knees flex
    • up to 2 in of loss
  99. What is osteoporosis?
    • loss of bone matrix
    • more in females than males
    • more in whites than blacks
  100. What are the advantages of blacks in consideration of their bones?
    longer and denser long bones (less osteoporosis)
  101. Asians and Eskimos have a lower _______ thank whites and blacks
    bone density