Patho MSK questions and answers, rated A+. 2022

Patho MSK questions and answers, rated A+. 2022 Document Content and Description Below Patho MSK questions and answers, rated A+. 2022 what cord does the axillary nerve branch from? - posterior cord A 30-year-old right-handed woman presents complaining of pain in the rig ht side of her neck, shoulder, arm, hand, chest, and somewhat down her back. She describes her pain as dull and aching. She works as a computer operator and first noticed symptoms about 2 years ago. Along with the pain, she has developed severe numbness in her right arm and hand, which frequently wakes her at night. She notices she drops things and has marked difficulty working over her head. Common household tasks have become very difficult for her (e.g., vacuuming, sweeping, mopping). Cold exacerbates her symptoms. She has previously had 2 courses of physical therapy without improvement of her symptoms. Physical exam reveals 3+ supraclavicular tenderness on the right. She has a positive Adson sign on the right and a positive Roos test on the right in 5 seconds. Atrophy of the thenar eminence is noted in her right hand. Her grip is 2 out of 5 on the right, with a 1 out of 5 interossi on the right. Her ulnar conduction velocity on the right side is 40 m/second and on the left side is 55 m/second. Her median conduction velocity on the right side is 43 m/second and 58 m/second on the left side. - thoracic outlet syndrome A 23-year-old man presents with swelling and pain in his left arm after strenuous exercising with upper extremity lever weights. Symptoms started 75 minutes after the exercises. The arm turned reddish, and he described it as "feeling different than it ever had before". He has Raynaud phenomenon with marked cold sensitivity and writing increases his symptoms. No supraclavicular tenderness is present. He has a venous collateral over his left shoulder. He has a 4+ bilateral Adson sign and a 4+ Roos test on the left with mild anterior deltoid pain in 5 seconds. His grip is 4 out of 5 bilaterally and his interossi are 4 out of 5 bilaterally. Doppler ultrasonography of the left upper extremity demonstrated a clot in his left subclavian vein. The diagnosis of venous TOS (Paget-Schroetter syndrome) was confirmed. - thoracic outlet syndrome A 24-year-old man presents to the emergency room after a fall onto his shoulder while playing football. He is an otherwise healthy man who has had no prior shoulder problems. The patient is unable to actively abduct or flex his arm secondary to pain. He is maintaining his arm in a position of slight external rotation and abduction. There is a palpable prominence inferior to his coracoid process. Sensation in his axillary nerve distribution is intact with a normal neurovascular exam. - shoulder (GH) dislocation posterolateral humeral head fx? - hill Sachs lesion which shoulder injury is consistent w/ a MVA? - SC joint A right-handed 65-year-old man presents after painting a room in his house. He complains of pain in his right shoulder, which worsens with overhead lifting, and some night pain since the onset of symptoms. He has no past history of shoulder problems and no other medical conditions. He has no neurologic symptoms and does not complain of weakness. - Rotator Cuff tear A 57-year-old woman who is typically sedentary presents complaining of shoulder pain after a trip and fall onto her outstretched hand. She has no prior history of shoulder injuries. She has pain on the lateral aspect of her shoulder and weakness with external rotation and forward elevation. - Rotator Cuff tear what stage of impingement syndrome do you see tendon degeneration? - 3rd A 50-year-old woman with diabetes presents with a 2-month history of insidious onset right shoulder pain. She denies a history of shoulder trauma. She has no history of neck pain, arm/hand weakness, or numbness or paresthesias of the arms/hands. She complains of shoulder pain at extremes of range of motion and has difficulty sleeping on the affected side. She has noticed increasing difficulty with activities of daily living, including brushing her hair, as well as putting on or taking off her blouse and brassiere. Her exam shows a marked decrease in both active and passive range of motion of the right shoulder; with forward flexion (FF) to 75°, abduction (ABD) to 75°, external rotation (ER) to 15°, and internal rotation (IR) to the iliac crest with pain at extremes of motion. Rotator cuff strength is normal. - frozen shoulder A 65-year-old man presents for follow-up 6 months after a mild acromioclavicular sprain that occurred after falling directly onto the left shoulder. He was treated with sling immobilization for 2 weeks. His acromioclavicular joint pain has completely resolved, but he now complains of shoulder stiffness. He is a construction worker and has noticed difficulty reaching overhead to perform his job over the past several months. Exam shows that he has no tenderness to palpation of the acromioclavicular joint, and has a negative cross arm adduction test. He is severely limited in his range of motion, with FF to 100°, ABD to 80°, ER to 10°, and IR to the iliac crest. - frozen shoulder which injury often occurs with RCT? - bicep tendonitis name an AI and a ricket Bourne dz associated w/ GH arthritis? - RA Lyme Neal is a 31 yo female weight lifter w/ initial pain upon starting the workout. Dx? - osteolysis holstein lewis Fx. nerve? - radial thenar wasting, + tinnel, + phalen? - carpal tunnel syndrome carpal bones on the radial aspect of the wrist? - Scaphoid and trapezium carpal bones on the ulnar aspect of the wrist? - pisiform and hamate hook A 50-year-old woman presents with numbness and tingling in her hands. The symptoms are worse in her right (dominant) hand and with activities such as holding a book or a steering wheel, or brushing her hair. The discomfort in her hands frequently wakes her at night and she has to shake or hang her hand out of her bed for relief. - carpal tunnel syndrome A 20-year-old man presents to his primary care physician with low back pain and stiffness that has persisted for more than 3 months. There is no history of obvious injury but he is a very avid sportsman. His back symptoms are worse when he awakes in the morning, and the stiffness lasts more than 1 hour. His back symptoms improve with exercise. He has a desk job and finds that sitting for long periods of time exacerbates his symptoms. He has to get up regularly and move around. His back symptoms also wake him in the second half of the night, after which he can find it difficult to get comfortable. He normally takes an anti-inflammatory drug during the day, and finds his stiffness is worse when he misses a dose. He has had 2 bouts of iritis in the past. - Ankylosing spondylitis A 17-year-old boy presents with an 18-month history of pain in his right ankle and both heels, with early morning stiffness and fatigue. He was forced to give up sports, and walking short distances is proving difficult due to heel pain. Examination reveals marked tenderness and swelling over bilateral Achilles tendons. - Ankylosing spondylitis herniated disc, what happens with... extension: flexion: - extension: ease flexion: pain absent patellar reflex? - L4 absent achilles reflex? - S1 spondilo..... break in vertebrae? - spondilolysis A 65-year-old retired construction worker has had lower back pain for 3 years. For the past 12 months he has been experiencing bilateral leg pain and a sense of heaviness in the legs when he is walking. The pain is relieved by bending over or sitting down. Over the past few months the distance he is able to walk has become progressively shorter and he has assumed a stooped posture. Physical exam is essentially unremarkable. Distal pulses are palpable and there is no appreciable weakness or muscle atrophy in the legs, or findings of hip or knee pathology. - spinal stenosis A 25-year-old man presents to the emergency room after an automobile accident. He was ejected from the vehicle. He complains of numbness in both lower extremities and cannot move his legs. There is no pinprick sensation below the umbilicus except for an anal wink, and there is no rectal tone. The bulbocavernosus reflex is weakly present. - cauda equina syndrome A 40-year-old woman presents with back pain and difficulty with her gait. She has a long history of smoking and has had some hemoptysis recently. Her exam reveals diminished pinprick sensation from the nipple line caudally, power in the lower extremities of 4/5, absent joint position sense in the lower extremities, and diminished vibratory sense. Anal sphincter tone is intact. - cauda equina syndrome pt has leg weakness, bladder distension and saddle numbness? - cauda equina syndrome Pain in groin Weight bearing pain SLR painful Dx? - Avascular necrosis of the femoral head 2 common causes of Avascular necrosis of the femoral head? - alcohol High dose steroids A 13-year-old African-American boy presents with hip, groin, thigh, and medial knee pain. He is overweight and recently experienced an adolescent growth spurt. On physical exam, the affected leg is externally rotated and there is limited range of motion in the hip joint. He is unable to bear weight on the affected leg. - Slipped capital femoral epiphysis Osgood-Schlatter lesion more common in? - teenage boy A 13-year-old male basketball player presents with several months of insidious onset of unilateral anterior knee pain, worse during practice and games, and alleviated by rest, ice, and anti-inflammatory medications. Physical examination demonstrates prominence of the tibial tubercle, with mild swelling and tenderness to palpation over the tubercle. image Resisted knee extension also causes pain. - Osgood-Schlatter lesion A 20-year-old female basketball player lands awkwardly from a rebound, feels a sudden painful pop in her right knee, and falls to the ground. She is unable to return to play and feels that her knee keeps giving out when she tries to bear weight. She reports that her knee became very swollen within 1 or 2 hours after the injury. - ACL A 30-year-old football player was injured when his left knee was rolled into accidentally by a teammate. The patient felt the knee hyperextend, bend inward, and pop. He was unable to keep playing and complained that his knee felt like it kept twisting. The knee swelled moderately over the next few hours. - ACL A 21-year-old rugby player was tackled on the lateral side of his left lower thigh. During the course of the tackle, the player felt a tearing sensation on the medial part of his knee that was associated with excruciating pain. Immediately after the play, he was unable to get up or walk. On physical exam, there is significant tenderness of the adductor tubercle and joint line. Valgus stress testing (abduction stress test) image demonstrates some medial instability at 30° of knee flexion, but with a firm endpoint (i.e., resistance is felt). Anterior drawer test image and Lachman test image are negative. - MCL varus stress, ligament injury? - LCL A 20-year-old soccer player twists his right knee while playing the game. He immediately feels the knee swell. He continues to play the soccer game that day despite experiencing intermittent pain. He reports that the knee catches and locks intermittently. On examination the right knee joint is swollen with tenderness along the affected joint line. - meniscal tear A 60-year-old woman recently felt a catch in her left knee when getting out of the car. She reports that, since then, her left knee has been aching when she walks several blocks or is sitting in a movie theater. She says that the knee catches, and she has intermittent swelling behind the knee. On inspection of the knee, a popliteal (Baker) cyst is noted at the posterior aspect of the knee joint. Further examination reveals positive McMurray and Apley tests. - meniscal tear A 65-year-old man presents with acute pain and swelling in the left leg for the past 3 days. The pain is localized in the posteromedial calf and worsens during standing and walking. There are no known risk factors for DVT, a history of previous DVT, or trauma. Past medical history is significant for hypertension and osteoarthritis of both knees. Medications include metoprolol and NSAIDs. Physical exam reveals a normal vascular exam, absent leg edema, calf tenderness, and a prominent nonpulsatile mass behind the knee. Duplex ultrasound identifies a cyst in the popliteal crease measuring 4 cm x 5 cm. - popliteal cyst A 60-year-old woman presents complaining of bilateral knee pain on most days of the past few months. The pain was gradual in onset. The pain is over the anterior aspect of the knee and gets worse with walking and going up and down stairs. She complains of stiffness in the morning that lasts for a few minutes and a buckling sensation at times in the right knee. On exam, there is a small effusion, diffuse crepitus, and limited flexion of both knees. Joint tenderness is more prominent over the medial joint line bilaterally. She has a steady but slow gait, slightly favoring the right side. - Osteoarthritis A 55-year-old woman has been complaining of pain and swelling in several fingers of both hands for the past 2 months. She describes morning stiffness lasting 30 minutes. Her mother tells her that she had a similar condition at the same age. She denies any other joint pain or swelling. On exam, she has tenderness, slight erythema, and swelling in one PIP joint and two DIP joints in each hand. She has squaring at the base of her right thumb (the first carpometacarpal joint). There is no swelling or tenderness in her MCP joints. - Osteoarthritis Osteoarthritis: PIP nodule? DIP nodule? - PIP = bouchard DIP = heberden A 70-year-old woma