116 Questions
What is the term for the injury that occurs when the ends of the joints of two bones are forcibly separated?
Dislocation
What is the purpose of bursae in the musculoskeletal system?
To reduce friction between moving parts
What is the term for the inflammation of a tendon?
Tendinitis
What is the term for a break in the continuity of a bone?
Fracture
What is the term for the connective tissue that connects bone to bone?
Ligament
What is the term for a partial dislocation of a joint?
Subluxation
What is the term for the inflammation of a joint?
Arthritis
What is the term for an injury to a muscle or tendon?
Strain
What does a bulge along the inguinal ligament suggest?
An inguinal hernia or aneurysm
What is the possible cause of focal tenderness over the trochanter?
Tendinopathy of the gluteus medius
Which of the following is NOT a cause of groin tenderness?
Fracture of the femur
Palpation of the psoas bursa is done with the patient in which position?
Supine, with the hip flexed and internally rotated
What is the purpose of flexing the knee during the flexion test?
To relax the hamstrings
What is the location of the trochanteric bursa?
Over the greater trochanter
Which of the following is a possible cause of tenderness over the posterolateral surface of the greater trochanter?
Localized tendinitis
What is the purpose of placing the hand under the patient's lumbar spine during the flexion test?
To support the patient's back
What is the purpose of grading the severity of pain on a scale of 1-10?
To evaluate the response to treatment
What is the benefit of asking the patient to 'point to the pain' during the assessment?
To localize the area of pain
What is the purpose of determining whether the pain is localized or diffuse?
To identify the underlying cause of pain
What is the significance of assessing the patient's posture and habitus during the examination?
To understand the patient's overall physical condition
What is the purpose of performing special tests during the examination?
To rule out other potential causes of pain
What is the significance of assessing the patient's gait and movement patterns during the examination?
To determine if the patient is antalgic or guarding
What is the purpose of considering age-related changes during the examination?
To rule out other potential causes of pain that may be related to age
What is the significance of determining whether the pain is inflammatory or non-inflammatory?
To develop an effective treatment plan
What is the position of the hip joint in relation to the inguinal ligament?
Below the middle third of the inguinal ligament
What is the characteristic of the acetabulum?
A confluence of all three bones of the pelvis
During which phase of the gait cycle do most hip problems appear?
During the stance phase
What is the percentage of the normal gait cycle when the foot is on the ground and bears weight?
60%
Which muscle group lies anteriorly and flexes the hip?
Flexor group
At which level is the iliac crest located?
Level L4
What is the percentage of the normal gait cycle when the foot moves forward and does not bear weight?
40%
Which bony structure is located at the level of S2 on the posterior surface of the hip?
Posterior superior iliac spine
What is the primary function of the concave and convex curves of the spine?
To distribute upper body weight to the pelvis and lower extremities
Which of the following muscles is NOT involved in the movement of flexion of the spine?
Erector spinae
What is the purpose of the Spurling's test in the examination of the spine?
To identify cervical nerve root involvement
Which of the following is NOT a component of the complex mechanics of the back?
Tendons of the shoulder joint
What is the primary muscle involved in the movement of extension of the spine?
Erector spinae
What is the normal range of motion of the cervical spine during flexion?
The question does not provide enough information to determine the answer
Which of the following is a sign of cervical radiculopathy?
Reproduced pain in the arm on the same side as the head is turned
During the inspection of the spine, what is the examiner looking for?
Alignment in the sagittal and coronal plane
What is the primary function of the anterior cruciate ligament in the knee joint?
To prevent the tibia from sliding forwards on the femur
During the McMurray Test, what is the purpose of applying a valgus stress on the medial side of the joint?
To assess the integrity of the medial meniscus
What is the normal range of motion of the knee joint during flexion?
125-135 degrees
What is the primary function of the posterior cruciate ligament in the knee joint?
To prevent the tibia from sliding backwards on the femur
During the assessment of the meniscus, what is indicated if a click is felt or heard at the joint line during flexion and extension of the knee?
A potential meniscus tear
What is the purpose of assessing the internal and external tibial rotation of the knee joint?
To assess the range of motion of the knee joint
What is the purpose of Lachman's test in the examination of the knee?
To assess the ACL
During Lachman's test, what is the degree of flexion of the knee?
15° of flexion
What is the normal range of motion of the knee joint during extension?
0-10 degrees hyperextension
What is the primary function of the MCL and LCL in the knee joint?
To provide medial and lateral stability to the knee joint
What is the action of the thumb of the tibial hand during Lachman's test?
Applying pressure on the joint line
What is the expected finding in a normal knee during Lachman's test?
A firm endpoint to forward movement
What is the significance of internal rotation of the foot during the assessment of the meniscus?
It stresses the lateral meniscus
What is the purpose of milk external rotation during Lachman's test?
To tense the ACL
What is the primary purpose of the anterior drawer test?
To assess the integrity of the ACL
What is the characteristic of the posterior drawer test?
Minimal posterior movement and excursion of the tibia relative to the femur
What is the correct position of the patient during the abduction stress test?
Supine with the knee slightly flexed
What is the purpose of stabilizing the femur during the abduction stress test?
To prevent excessive movement of the femur
What is the correct hand placement during the anterior drawer test?
Fingers in the popliteal fossa and thumbs on the lateral and medial joint line
What is the significance of the degree of backward movement during the posterior drawer test?
It indicates the integrity of the PCL
What is the purpose of the examiner sitting on the patient's foot during the posterior drawer test?
To minimize foot movement
What is the purpose of performing the adduction stress test on the LCL?
To evaluate the stability of the lateral knee joint
What is the mechanism of the bulge sign in detecting knee joint effusions?
Displacing fluid downward from the suprapatellar recess to the lateral aspect of the knee
What is the primary aspect of the joint being assessed during the adduction stress test?
Ligamentous integrity
What is the purpose of feeling for excessive widening of the joint during the adduction stress test?
To determine the severity of the ligamentous injury
What is the direction of the force applied to the knee joint during the adduction stress test?
Lateral to medial
What is the significance of the endpoint during the adduction stress test?
It signals the ligament is no longer intact
What is the primary purpose of the special techniques used in the examination of the knee joint?
To identify the presence of a knee joint effusion
What is the purpose of the balloon test during the examination of the knee?
To detect the presence of fluid in the suprapatellar recess
Which nerve is responsible for knee extension?
Femoral nerve
What is the significance of a hypoactive or absent patellar reflex?
It suggests a L4 radiculopathy
Which of the following nerves is responsible for foot dorsiflexion?
Deep peroneal nerve
What is the location of the popliteal pulse?
Behind the knee
Which nerve is responsible for sensation on the medial thigh?
Obturator nerve
What is the purpose of palpating for fluid ejected or 'ballooning' into the spaces next to the patella?
To detect the presence of fluid in the suprapatellar recess
Which of the following pulses is NOT typically assessed during the examination of the knee?
Radial pulse
Which muscle is responsible for moving the foot outward?
Fibularis brevis
Which ligament fans out from the inferior surface of the medial malleolus to the talus and proximal tarsal bones?
Deltoid ligament
What is the purpose of the muscles in the medial compartment of the foot?
Inversion of the foot
Which malleolus is the fibularis longus and fibularis brevis muscle located beneath?
Lateral malleolus
What is the direction of the heel when the muscles in the medial compartment of the foot contract?
Inward
Which ligament is less substantial and has a higher risk for injury from inversion injuries?
Three ligaments laterally
What is the location of the muscles in the lateral compartment of the foot?
Anterior surface of the ankle
What is the function of the ligaments that extend from each malleolus onto the foot?
To stabilize the ankle joint
Which muscle is responsible for external rotation of the shoulder joint and is also difficult to palpate?
Teres minor
What is the purpose of the Neer impingement sign in the examination of the shoulder joint?
To assess the impingement of the rotator cuff tendons
Which of the following muscles is responsible for internal rotation of the shoulder joint?
Subscapularis
What is the purpose of the Apley scratch test in the examination of the shoulder joint?
To assess the overall shoulder rotation
Which of the following muscles is responsible for abduction of the shoulder joint?
Supraspinatus
What is the purpose of palpating the subacromial and subdeltoid bursae during the examination of the shoulder joint?
To assess the underlying palpable SITS muscles
Which of the following muscles is responsible for flexion of the shoulder joint?
Anterior deltoid
What is the purpose of the painful arc test in the examination of the shoulder joint?
To assess the rotator cuff tendons
Which bony prominence should you move your thumb medially and down a short step to reach?
Coracoid process of the scapula
What is the correct location of the SITS muscles' insertion?
Greater tubercle of the humerus
Where should you place your index finger to palpate the biceps tendon?
On the anterior surface of the arm, halfway between the coracoid process and the greater tubercle
What is the purpose of rotating the glenohumeral joint externally during the examination of the biceps tendon?
To track the muscle and its tendon proximally into the intertubercular groove
What is the correct position of the humerus during the examination of the subacromial subdeltoid bursa and the SITS muscles?
Passively extended by lifting the elbow posteriorly
What is the purpose of palpating the lateral aspect of the humerus during the examination of the biceps tendon?
To grasp the humerus and palpate the greater tubercle
What is the result of rolling the tendon under the fingertips during the examination of the biceps tendon?
Increased tenderness of the biceps tendon
What is the correct sequence of palpation during the examination of the biceps tendon?
Coracoid process, greater tubercle, lateral aspect of the humerus, and then the biceps tendon
What is the primary function of the radiocarpal joint at the wrist?
To provide most of the flexion and extension at the wrist
What is the characteristic of the 'cascade sign' during wrist inspection?
Fingers converge toward the scaphoid tubercle when flexed at the MCPJ and PIPJ
What is the significance of trophic changes during wrist inspection?
They indicate sympathetic nervous system derangement
What is the purpose of palpating the anatomic snuffbox during wrist examination?
To assess the abductor and extensor muscles of the thumb
What is the term for the inflammation of a tendon?
Tendinitis
What is the significance of discoloration during wrist inspection?
It indicates a vascular disorder
What is the purpose of inspecting the wrist for swelling?
To assess for joint effusion or inflammation
What is the significance of thenar atrophy during wrist inspection?
It indicates median nerve involvement
What is the purpose of the Finkelstein test?
To test for tenosynovitis
Which maneuver is used to test the Tinel sign?
Tapping over the course of the medial nerve
What is the purpose of the Phalen maneuver?
To test for carpal tunnel syndrome
What is the correct position of the patient's elbows during the Phalen maneuver?
Fully extended
Which of the following is a common finding in patients with carpal tunnel syndrome?
All of the above
What is the purpose of the Finkelstein test and the Phalen maneuver?
To diagnose carpal tunnel syndrome and tenosynovitis
What is the correct technique for performing the Finkelstein test?
Grasping the thumb against the palm and moving the wrist towards the ulnar deviation
What is the primary purpose of the Tinel sign and the Phalen maneuver?
To diagnose wrist and hand disorders
Study Notes
Here are the study notes based on the provided text:
Knee Joint Examination
- Knee flexion: 125-135 degrees
- Knee extension: 0-10 degrees hyperextension
- Rotation: 10-15 degrees internal and external tibial rotation
- Reflexes: Patellar (L4) - hypoactive/absent indicates L4 radiculopathy; hyperactive indicates UMN injury
Knee Joint Provocative Tests
- Bulge sign (for minor effusions): apply pressure on the suprapatellar recess to displace fluid downward
- Anterior drawer test: pull the tibia forward; positive test if tibia displaces forward
- Posterior drawer sign: push the tibia posteriorly; excessive movement suggests an insufficient or torn PCL
- Lachman's test: most sensitive exam test for ACL tears
- Abduction (or Valgus) stress test: apply a valgus stress to the medial side of the knee; excessive widening indicates a torn MCL
Special Techniques
- McMurray Test: for meniscal injury; palpate for clicks or tenderness along the joint line during flexion and extension
- Balloon test: for major effusions; palpate for fluid ejected or "ballooning" into the spaces next to the patella
Neurovascular Examination
- Motor: knee flexion (sciatic nerve), knee extension (femoral nerve), foot plantarflexion (tibial nerve), foot dorsiflexion (deep peroneal nerve)
- Sensory: medial thigh (obturator nerve), anterior thigh (femoral nerve), posterolateral leg (sciatic nerve), dorsal foot (peroneal nerve), plantar foot (tibial nerve)
- Pulses: popliteal, dorsalis pedis, posterior tibial
Shoulder Joint Examination
- Range of motion: flexion (anterior deltoid, pec major, coracobrachialis, bicep brachii), extension (lat dorsi, teres major, posterior deltoid, tricep brachii), abduction (supraspinatus, middle deltoid, serratus anterior), adduction (pec major, coracobrachialis, lat dorsi, teres major, subscapularis), internal rotation (subscapularis, anterior deltoid, pec major, teres major, latissimus dorsi), external rotation (infraspinatus, teres minor, posterior deltoid, supraspinatus)
-
Special maneuvers:
- Acromioclavicular joint: Apley scratch test
- Rotator cuff (pain provocation tests): painful arc test, Neer impingement sign
Wrist Joint Examination
- Bones: distal radius and ulna, 8 carpal bones
- Joint capsule: radiocarpal (wrist) joint, distal radioulnar joint, intercarpal joints
- Ligaments: radiocarpal ligament, intercarpal ligaments
Musculoskeletal System
-
Basic terminology:
- Joint: articulation of bones
- Ligament: connects bone to bone
- Tendon: connects muscle to bone
- Bursae: fluid-filled sacs to reduce friction
- Cartilage: connective tissue (articular vs fibrous)
- History: onset, palliative, provocative, quality, radiation, severity, timing
- Inspection: posture, habitus, guarding, movement, muscle atrophy
- Palpation: temperature, tenderness, crepitus, joint effusion
Test your knowledge of the musculoskeletal system, including basic terminology, types of joints, and common injuries such as strains, sprains, and fractures. Learn about the different connective tissues and their functions in the body.
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