McMurray sign: injury to the meniscus (knee exam); cause of meniscus injury: suddenly planting leg on ground
and twisting; can cause immediate pain in the planted leg and inability to bear weight. Can lock up when trying
to straighten it.
Phalen’s test: numbness and tingling in the first 3 digits when pressing the dorsal surface of both hands together
in a forced wrist flexion for at least 1 minute (wrist exam)
Radial head fracture: palpate for tenderness, swelling, and crepitus just distal to the lateral epicondyle (wrist
exam)
2
, Articular and non-articular musculoskeletal complaint-differentiation between the two is that non-articular
complaints involves a point or focal tenderness
Bulge test- use to check for knee joint effusion
Carpal Tunnel Syndrome
(Chapter 54 p. 839)
Definition: Inflammation of the median nerve
Initial treatment: wrist splint and NSAID
Herniated Disk
(Chapter 53 p.824)
Most common area: L4-L5 (weakness in the great toe)
Evaluation: straight leg test: patient in supine position and elevate the affected leg, positive if it elicits pain and
sciatic nerve pain
Shoulder Dislocation
(Ch. 52 p.801)
Assessment: shrugging shoulders should elicit pain if positive. Due to excessive pressure put on the shoulders
Muscle Strains
(Ch. 54 p.847)
Degrees of Ankle Sprains:
1st: ligaments are stretched but not torn
2nd: most common; partial tearing of the ligament
3rd: most severe; ligament is torn completely
Risks: Strain can be due to not warming up prior to exercise; Teachable moment when the patient presents with
strain is just to suggest stretching and warm-up exercises prior to the full exercise routine
Assessment: Look for location (e.g. acute low back strain: low back pain not associated with sciatica; is
aggravated by sitting, standing, and certain movements; alleviated with rest; pain locally on palpation and
muscle spasms are felt
Treatment: NSAID and recommend low back strengthening exercises; the type and intensity of the
strengthening exercises depends on the patient’s pain tolerance. Be careful to not add insult to injury.
3
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