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116 notecards = 29 pages (4 cards per page)

Viewing:

Musculoskeletal Assessment

front 1

support, movement, protection, production, and storage

back 1

5 functions of the bones joints and muscles

front 2

cortical bone

back 2

dense bone that forms the outer shell

front 3

trabecular bone

back 3

sponge bone found at the ends of long bones and in vertebrae

front 4

ostepblasts

back 4

build new bone

front 5

osteoclasts

back 5

break down bone tissue

front 6

osteocytes

back 6

mature bone cells that maintain the bone matrix

front 7

bone remodeling

back 7

helps repair micro-damage and adapt to new loads in response to stress and hormonal signals bone reforms

front 8

PTH calcitonin and vitamin D

back 8

hormones that play key roles in regulating calcium levels and bone turnover

front 9

osteoporosis

back 9

balance between bone resorption and formation is disrupted leading to fragile bones

front 10

synarthrosis

back 10

non-synovial immovable joint (growth plate, between distal ends of radius and ulna, root to tooth to mandible)

front 11

amphiarthrosis

back 11

non-synovial slightly movable joint (vertebrae, symphysis pubis)

front 12

diarthrosis

back 12

freely movable joint (shoulder, elbow)

front 13

synovial

back 13

cavity filled with lubricant freely movable

front 14

uniaxial joints

back 14

includes hinge and pivot joints

front 15

hinge

back 15

joint- angular movement in 1 axis and 1 plane (elbow finger knee)

front 16

pivot

back 16

joint- rotary movement, a ring rotates around (radioulnar, 1st and 2nd cervical vertebrae)

front 17

biaxial joints

back 17

includes saddle and condyloid joints

front 18

saddle

back 18

articulating surface of 1 bone is convex and surface of 2nd bone is concave (thumb)

front 19

condyloid

back 19

angular motion on 2 planes without axial rotation (wrist between distal radius and carpels)

front 20

multiaxial joints

back 20

includes ball and socket and gliding joints

front 21

ball and socket joint

back 21

joint- round end of bone into cuplike cavity (shoulder hip)

front 22

gliding joint

back 22

joint- sliding motion (vertebrae, tarsal bones of ankle)

front 23

tendons

back 23

strong connective tissue, outer cover of muscle belly, attaches muscle to bone

front 24

cartilage

back 24

avascular, dense, connective tissue covers end of opposing bones withstands increased pressure and tension

front 25

ligaments

back 25

strong fibrous connective tissue, connect bones to each other at joint level and encase capsule, support purposeful joint movement and prevent wrong movement

front 26

bursa

back 26

enclosed sac filled with viscous fluid located in areas of potential friction act as cushion between surfaces

front 27

myofibrils

back 27

make up the skeletal muscle fibers

front 28

sarcomeres

back 28

repeating units of myofibrils that are the functional units of contraction

front 29

sliding filament theory

back 29

explains how muscles contract

front 30

myosin heads bind to actin filaments and pull them inward shortening the sarcomere

back 30

muscle contraction

front 31

ATP

back 31

required for muscle contraction; triggered by calcium ion release

front 32

calcium ions

back 32

released from the sarcoplasmic reticulum

front 33

excitation contraction coupling

back 33

begins with a nerve impulse travels down the motor neuron and results in muscle contraction

front 34

Type I Slow Twitch

back 34

fatigue-resistant, used for endurance

front 35

Type II Fast Twitch

back 35

generate more force, used for short bursts of power

front 36

sarcopenia

back 36

muscle mass and strength decline with age

front 37

strength testing, reflexes, and electromyography

back 37

three things used to evaluate muscle function

front 38

joints

back 38

health history stiffness redness swelling pain with motion complaints of pain that coincide with climate change

front 39

muscles

back 39

health history weakness fatigue aching wasting associated factors related to exercise or sudden movement

front 40

skeletal

back 40

health history gait change limping numbness tingling crepitus recent fractures

front 41

how the injury occurred and how the patient self treated

back 41

two important factors during MS health assessment

front 42

Onset, Location, Duration, Characteristics, Alleviating/Aggravating Factors, Radiation, Timing, Severity

back 42

history of present illness factors

front 43

illness, trauma, deformity, immunosuppression, DM, PVD, med use (NSAIDS)

back 43

past medical history factors important during MS assessment

front 44

RA, osteoporosis, Gout, Paget's, Dupuytren's contracture, SLE, Marfan's syndrome, scoliosis

back 44

relevant family medical history for MS assessment

front 45

ETOH and tobacco use (risk of osteoporosis), work environment, home environment, hobbies/activities

back 45

relevant social history for MS assessment

front 46

obesity, poor nutrition, low calcium intake, medication history, chronic illness, age, and gender

back 46

7 risk factors for musculoskeletal problems

front 47

compare side to side, size, contour, swelling, redness, deformities

back 47

MS inspection includes:

front 48

dislocation subluxation contracture and ankylosis

back 48

four deformities of MS system

front 49

subluxation

back 49

partial dislocation

front 50

ankylosis

back 50

fusion of bones across a joint

front 51

ROM

back 51

palpation part of MS assessment

front 52

active ROM

back 52

done by patient refusal or inability suggesting significant injury

front 53

passive ROM

back 53

done by examiner with patient relaxed and supporting injured area

front 54

isometric

back 54

contracts muscles at injured area without moving bones, noting any visible defects

front 55

heat, tenderness, swelling, masses

back 55

four signs to look for during palpation of MS system

front 56

crepitus

back 56

grating seen with arthritis

front 57

palpable fluid, visible bulging, doughy/boggy, and crepitus

back 57

four abnormalities to observe in MS assessment

front 58

muscle testing grading

back 58

done with patient flexing and holding against resistance

front 59

5 full range of motion/full resistance

back 59

patient has full ability to demonstrate full range of motion of the joint with the examiner applying full pull or force in the opposite direciton

front 60

4 full ROM/ some resistance

back 60

patient has full ability to demonstrate full range of motion of the joint with the examiner applying less opposite pull or force in the opposite direction

front 61

3 full ROM with gravity

back 61

there is no resistance applied by the examiner but the patient is able to have full ROM against normal gravity

front 62

2

back 62

full range of motion gravity removed

front 63

1

back 63

slight contraction 10%

front 64

0

back 64

no contraction 0%

front 65

3 or less

back 65

muscle strength grade that indicates disability

front 66

strain

back 66

injury in the muscle tears or pulls that heals faster

front 67

sprain

back 67

injury of the ligament that heals slowest

front 68

joint, ligament bursa

back 68

pain with passive ROM

front 69

muscle and tendon

back 69

pain with active ROM

front 70

detection of congenital deformities and enormous changes during infancy

back 70

focus of infant MS assessment

front 71

upper extremity abnormalities

back 71

abnormalities in older children rare outside of injury

front 72

lower extremity and spinal

back 72

issues to look for in older child MS assessment

front 73

grade 1

back 73

strain with no specific event; pain and stiffness after activity; pain is vague not one specific spot, no pain with rest; nearly full strength

front 74

grade 2

back 74

strain pain with several steps, muscle spasm; relatively small area of pain; strength significantly decreased to resisted contraction with pain; definite limp

front 75

antalgic gait

back 75

gait with definite limp

front 76

grade 3

back 76

strain with sudden intense pain (like someone hit me with a rock); point of pain in area of tear in tendon or muscle belly; strength- can't develop tension in muscle unit; gait- can't use muscle to ambulate

front 77

osteoarthritis, rheumatoid arthritis, osteoporosis and fibromyalgia

back 77

four common MS issues

front 78

osteoporosis

back 78

risk factors include being a caucasian or asian woman, small thin frame, positive family history close relatives, early or surgically induced menopause, chronic illnesses, amenorrhea, low life-time calcium intake, anorexia, impaired GI absorption, immobilization or sedentary lifestyle, smoking and alcohol use, low testosterone in men, use of certain medications

front 79

44 million Americans

back 79

osteoporosis prevalence

front 80

55% of people 50+

back 80

percentage and age of osteoporosis prevalence

front 81

10 million, 8 million, 2 million

back 81

amount of individuals, women, and men estimated to already have osteoporosis

front 82

44 million

back 82

amount of people estimated to have low bone mass putting them at risk for osteoporosis

front 83

$19 billion

back 83

estimated national direct care expenditures for osteoporotic fractures

front 84

fibromyalgia

back 84

chronic pain disorder with debilitating symptoms such as muscle tendon and joint pain as well as fatigue; symptoms overlap with other disease; unknown etiology but linked to anxiety depression stress conditions infections and viruses

front 85

shoulder

back 85

includes glenohumeral joint, acromion process, clavicle, acromioclavicular joint, greater tubercle, coracoid process; muscles are deltoid, trapezius, biceps, rotator cuff, supraspinatus, infraspinatus, trees minor, subscapularis

front 86

Hawkins

back 86

subacromial impingement; forward abduct sagittal plane patient's arm at 90 degrees with elbow bent internally; rotate arm internally; pain with internal rotation is positive test

front 87

Neer test

back 87

impingement bursitis; stabilize the scapula and internally rotate patient's arm and raise straight rotated arm; pain anywhere along upward trajectory is positive test

front 88

Gerbers liftoff test

back 88

supscapularis muscle/tendon, bursitis; patient standing and clinician behind, external rotate arm placing dorsal of hand to small of back instructing patient to lift the hand off the back while applying resistance against the patient; if patient cannot resist, lift hand, or compensate with elbow or shoulder extension is positive test

front 89

empty can test

back 89

supraspinatus muscle/tendon assessment; help rule out likelihood of bursitis; patient straight arm elevated 90 degrees in sagittal plane and rotate fully internally pronation of forearm with thumb down as if pouring liquid from a can with clinician applying resistance; pain or weakness with resistance is a positive test

front 90

painful arc

back 90

subacromial impingement syndrome, bursitis; with straight arm patient abducts arm along coronal plane then adduct back; pain between 60-120 degrees in either direction that remits after 120 degrees or below 60 is positive

front 91

drop arm test

back 91

full thickness of rotator cuff tear of supraspinatus/infraspinatus; clinician passively abducts patient's straight arm to 90 degrees in coronal plane with full external rotation then releases arm, instructing patient to hold then slowly lower the arm; if patient suddenly drops arm or there is weakness or pain is a positive test

front 92

Hawkins, Neer, Gerbers liftoff, empty can, painful arc, and drop arm

back 92

six shoulder special tests

front 93

clavicle

back 93

at risk for fracture in infants; found in 2.9% of term infants often on the right side; often silent and noticed after a few weeks by palpable callous

front 94

elbow

back 94

includes medial epicondyle, lateral epicondyle, flexors, and extensors

front 95

valgus and varus stress test and book test

back 95

two special tests for elbow

front 96

bursitis

back 96

known as big red elbow

front 97

epicondylitis

back 97

muscle mass inflamed as it attaches to the bone

front 98

golfer's elbow

back 98

epicondylitis on medial elbow

front 99

tennis elbow

back 99

epicondylitis on lateral elbow

front 100

book/polk test lateral

back 100

patient grasps item with palm facing floor with arm pronated and attempt to lift; pain is positive test

front 101

book/polk test medial

back 101

patient grasps item with palm facing up with arm supinated and attempts to lift (bicep curl); pain is a positive test

front 102

nursemaids elbow

back 102

found in toddlers; subluxation of radial head d/t tugging injury

front 103

hand

back 103

includes radiocarpel joint, carpals, metacarpophalangeal joint, phalanges, interphalanges (proximal and distal)

front 104

neuromuscular assessment of hand

back 104

Sensation intact to light touch and two-point discrimination in median, ulnar, and radial nerve distributions. Capillary refill <2 seconds; radial and ulnar pulses palpable.

front 105

Phalens and tinels tests

back 105

special tests of hand

front 106

ulnar deviation

back 106

fingers outward

front 107

ankylosis

back 107

wrist extreme flexion

front 108

dupuytrens contracture

back 108

contractures of fingers contracting inward towards the thumbs; usually appears at 40-60 years; occurs more often and more severe in males or Northern European origin; associated with alcohol and epilepsy medications, diabetes; autosomal dominant in some cases; most often in ring and little fingers; bilateral 45%

front 109

swan neck and Boutonnière

back 109

deformities seen with RA

front 110

ganglion of wrist

back 110

no data

front 111

Heberden's and Bouchard's

back 111

DIP and PIP seen with OA

front 112

carpal tunnel syndrome

back 112

presents with numbness tingling weakness sleepless nights and pain up and down arm; caused by repetitive use, endocrine (DM), pregnancy, thyroid, anoxia; diagnosed with tingles and phalanx positive tests

front 113

phalens

back 113

test most specific for carpal tunnel syndrome

front 114

polydactyly

back 114

extra fingers

front 115

syndactyly

back 115

webbed fingers

front 116

hip/spine

back 116

includes paraspinals, quadrates lumborum, psoas, gluteals, piriformis, hamstrings