Podcast
Questions and Answers
Musculoskeletal History & PE ORDER
Musculoskeletal History & PE ORDER
History - MOA, location, duration = First Inspection then palpation = Second ROM/Strength = Third Special Tests = Fourth
If a patient was involved in a motor vehicle accident, you must ask specific details about the crash.
If a patient was involved in a motor vehicle accident, you must ask specific details about the crash.
True
You should always ask about headache when it comes to neck pain
You should always ask about headache when it comes to neck pain
True
What special test is used to help dx cervical disk herniation or spondylosis by rotation or lateral flexion, and compression that causes reproduced pain down arm.
What special test is used to help dx cervical disk herniation or spondylosis by rotation or lateral flexion, and compression that causes reproduced pain down arm.
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What test is conducted by having the patient take a seat, pt’s hand relaxed, cradled in yours, flick long fingernail, look for flexion of index finger/thumb, if present it indicates cervical myelopathy.
What test is conducted by having the patient take a seat, pt’s hand relaxed, cradled in yours, flick long fingernail, look for flexion of index finger/thumb, if present it indicates cervical myelopathy.
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A patient was involved in a head on car accident. The patient reports cervical neck pain a few hours after the accident and headache that is worse with movement. There are no signs of neurological defects. What is likely?
A patient was involved in a head on car accident. The patient reports cervical neck pain a few hours after the accident and headache that is worse with movement. There are no signs of neurological defects. What is likely?
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A patient experiencing localized pain/spasm in trapezius presents with head tilted, what is likely?
A patient experiencing localized pain/spasm in trapezius presents with head tilted, what is likely?
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If a patient does not have neck pain or tenderness, no history of LOC, no mental status changes, no symptoms that refer to the neck, and no distracting injuries, you can clinically rule out cervical fracture.
If a patient does not have neck pain or tenderness, no history of LOC, no mental status changes, no symptoms that refer to the neck, and no distracting injuries, you can clinically rule out cervical fracture.
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A patient presents with limited ROM, neck/shoulder pain worse with upright activity, radiating radicular pain. This condition is caused by Produced by growth of bone spurs, protrusion of ligamentum
flavum, and/or disc herniation. What is this condition?
A patient presents with limited ROM, neck/shoulder pain worse with upright activity, radiating radicular pain. This condition is caused by Produced by growth of bone spurs, protrusion of ligamentum flavum, and/or disc herniation. What is this condition?
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What can be used to localize nerve root involved in Cervical Spondylosis?
What can be used to localize nerve root involved in Cervical Spondylosis?
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Narrowing of sagittal diameter of cervical canal that is often asymptomatic until acute hyper-flexion/extension of c-spine neurologic signs.
Narrowing of sagittal diameter of cervical canal that is often asymptomatic until acute hyper-flexion/extension of c-spine neurologic signs.
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Compression of the spinal cord leading to clumsiness in hands and gait imbalance is called:
Compression of the spinal cord leading to clumsiness in hands and gait imbalance is called:
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A younger patient presents with neck pain and radicular pain with numbness/parathesias in distribution of cervical nerve root that improves with placing hands on top of their head. This is most likely Cervical radiculopathy. What is the common cause for this patient?
A younger patient presents with neck pain and radicular pain with numbness/parathesias in distribution of cervical nerve root that improves with placing hands on top of their head. This is most likely Cervical radiculopathy. What is the common cause for this patient?
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Nucleus pulposis extrudes through annulus fibrosis (the jelly squirts out of the doughnut).
Nucleus pulposis extrudes through annulus fibrosis (the jelly squirts out of the doughnut).
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A patient presents with thoracic back pain that is worse with sitting/bending forward. The patient reports occasionally weakness/ numbness in extremities. What is likely?
A patient presents with thoracic back pain that is worse with sitting/bending forward. The patient reports occasionally weakness/ numbness in extremities. What is likely?
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The lateral curvature of the spine is called
The lateral curvature of the spine is called
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Sagittal imbalance of the spine that results in a "hump back"
Sagittal imbalance of the spine that results in a "hump back"
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If a patient is diagnosed with a spinal deformity such as Scoliosis or Kyphosis as an adolescent, their curve needs to be followed into adulthood!
If a patient is diagnosed with a spinal deformity such as Scoliosis or Kyphosis as an adolescent, their curve needs to be followed into adulthood!
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Conservative spinal deformity management
Conservative spinal deformity management
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What is not a listed common cause of T-spine fractures?
What is not a listed common cause of T-spine fractures?
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What type of T-spine fracture is this???
What type of T-spine fracture is this???
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A patient presents with pain with inspiration and coughing after hard chronic coughing. You diagnosis this as a fib fracture. What is the treatment?
A patient presents with pain with inspiration and coughing after hard chronic coughing. You diagnosis this as a fib fracture. What is the treatment?
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Study Notes
Musculoskeletal History and Physical Examination
- In cases of motor vehicle accidents, it is essential to ask specific details about the crash.
- Neck pain assessments should always include questions about headaches.
Cervical Spine Injuries and Conditions
- The Spurling test is used to help diagnose cervical disk herniation or spondylosis by rotating or laterally flexing the cervical spine, which causes reproduced pain down the arm.
- The inverted supinator reflex test is conducted by having the patient sit, with their hand relaxed and cradled in the examiner's hand; a flick of the long fingernail is performed, and flexion of the index finger or thumb indicates cervical myelopathy.
Whiplash and Neck Pain
- A patient experiencing neck pain and headache after a head-on car accident, with no signs of neurological defects, likely has a whiplash injury.
- A patient presenting with localized pain/spasm in the trapezius, with a tilted head, likely has a strain or spasm of the trapezius muscle.
Cervical Fracture and Spondylosis
- In the absence of neck pain, tenderness, loss of consciousness, mental status changes, or distracting injuries, cervical fracture can be clinically ruled out.
- Cervical Spondylosis is a condition caused by the growth of bone spurs, protrusion of the ligamentum flavum, and/or disk herniation, leading to limited ROM, neck/shoulder pain worsened by upright activity, and radiating radicular pain.
Cervical Radiculopathy and Nerve Root Localization
- The Spurling test can be used to localize the nerve root involved in Cervical Spondylosis.
- Cervical Radiculopathy presents with neck pain and radicular pain with numbness/paresthesias in the distribution of the cervical nerve root, which often improves with placing hands on top of the head.
Thoracic Spine Conditions
- A patient presenting with thoracic back pain worsened by sitting or bending forward, with occasional weakness/numbness in the extremities, likely has a Thoracic Spine condition.
Spinal Deformities
- The lateral curvature of the spine is called Scoliosis.
- Sagittal imbalance of the spine resulting in a "hump back" is known as Kyphosis.
- Patients diagnosed with spinal deformities such as Scoliosis or Kyphosis as adolescents require follow-up into adulthood.
- Conservative management is an option for spinal deformities.
Thoracic Spine Fractures and Fib Fractures
- Not all thoracic spine fractures are caused by motor vehicle accidents.
- A patient presenting with pain on inspiration and coughing after a hard, chronic coughing episode is likely to have a fib fracture, which may be treated with conservative management.
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