Musculoskeletal Assessment, Gait Analysis, Low Back Pain, and Degenerative Joint Disease

Comprehensive practice flashcards covering musculoskeletal injuries, tissue healing, gait analysis, spine anatomy, low back pain evaluation, red/yellow flags, arthritis types, and joint replacement procedures.

Cervical Spine

The uppermost section of the vertebral column consisting of $7$ vertebrae ($C1$ through $C7$) exhibiting a natural lordotic (inward) curvature.

Thoracic Spine

The middle section of the vertebral column composed of $12$ vertebrae ($T1$ through $T12$) characterized by a natural kyphotic (outward) curvature.

Lumbar Spine

The lower back portion of the spine containing $5$ vertebrae ($L1$ through $L5$) with a lordotic curvature that bears substantial body weight and represents the primary location for low back pain.

Cauda Equina

A bundle of individual nerve roots descending from the lower spinal cord within the vertebral canal that resembles a horse's tail.

Lordosis

The normal anterior inward curvature of the vertebral column found in the cervical and lumbar regions.

Kyphosis

The posterior outward curvature naturally found in the thoracic spine.

Scoliosis

An abnormal lateral or sideways curvature and rotational deformity of the spine.

Multifidus

A deep, local spinal stabilizer muscle situated along the vertebral column that spans one or two vertebral levels to maintain segmental spine stability.

Herniated Intervertebral Disc

A condition in which the soft, gelatinous inner nucleus pulposus breaches the torn outer fibrous anulus fibrosus, protruding posteriorly to compress adjacent spinal nerves or the thecal sac.

Sciatica

Leg-dominant radiating nerve pain, numbness, or tingling that travels along the course of the sciatic nerve from the lower back through the buttock down to the lower leg and foot, frequently provoked by lumbar disc herniation.

Piriformis Syndrome

A neuromuscular condition occurring when a tight or spasming piriformis muscle compresses the sciatic nerve passing through or beneath it, producing radiating symptoms down the posterior leg.

Chronic Low Back Pain

Pain and discomfort localized below the costal margin and above the inferior gluteal folds, with or without referred leg pain, persisting for at least $12\,\text{weeks}$ according to European guidelines.

Neurogenic Claudication

A predictable pattern of bilateral or unilateral leg pain, numbness, or heaviness brought on by walking or standing and relieved by sitting or forward flexion, caused by lumbar spinal canal stenosis typically in patients aged $>60$.

Ankylosing Spondylitis

A chronic inflammatory arthritis of the spine and sacroiliac joints presenting with night pain and morning stiffness lasting over $1\,\text{hour}$ that improves with movement, most commonly starting between ages $15$ and $35$.

Red Flags (Spine Assessment)

Clinical warning symptoms indicating serious pathology—such as major trauma, cancer history, unremitting non-mechanical pain, unexplained weight loss, saddle anesthesia, bladder/bowel incontinence, or infection—requiring immediate medical or surgical referral.

Yellow Flags (Spine Assessment)

Psychosocial risk factors—including fear-avoidance beliefs, catastrophizing, belief that movement is harmful, low mood, and an expectation that only passive treatments will help—that increase the likelihood of acute back pain becoming chronic.

Back Dominant Pain

Mechanical back pain localized primarily to the spine, buttocks, or hips without nerve root compromise, which varies in response to postural changes and movements and does not require surgery.

Rubor

A cardinal sign of acute inflammation denoting redness caused by local arteriolar vasodilation and increased blood flow.

Calor

A cardinal sign of acute inflammation denoting localized heat resulting from increased regional blood circulation and metabolic rate.

Dolor

A cardinal sign of acute inflammation denoting pain elicited by mechanical trauma and chemical stimulation of sensory nerve endings by inflammatory mediators.

Tumor (Inflammatory Sign)

A cardinal sign of acute inflammation denoting localized swelling produced by inflammatory exudate, edema, and extravasated blood.

Functio Laesa

A cardinal sign of acute injury denoting loss of function resulting from tissue damage, protective reflex guarding, and the inhibitory effects of pain.

Delayed Onset Muscle Soreness (DOMS)

Muscular pain and stiffness developing $24\text{ to }48\,\text{hours}$ after unaccustomed or eccentric exercise, caused by microscopic disruption of muscle fibers and Z-bands, local edema, and delayed actin-myosin detachment.

Grade I Muscle Strain

A mild muscle injury involving microscopic fiber stretching and small tears with minimal disruption to structural integrity and no noticeable loss of strength.

Grade II Muscle Strain

A moderate muscle injury defined by a larger, incomplete structural tear of muscle fibers with significant pain, swelling, and reduced contractile strength.

Grade III Muscle Strain

A severe muscle injury marked by a complete tear or rupture across the entire muscle belly or musculotendinous junction, causing a complete loss of function.

Comminuted Fracture

A bone fracture pattern in which the bone shatters or breaks into three or more distinct fragments at the site of impact.

Greenstick Fracture

An incomplete pediatric fracture pattern where one side of the flexible bone breaks while the opposing side bends without snapping completely.

Bone Fracture Healing Timeline

The sequential physiological timeline of bone repair comprising hematoma/inflammation ($\text{Week }1$), soft fibrocartilaginous callus formation ($\text{Weeks }2\text{--}3$), hard bony callus formation ($\text{Weeks }4\text{--}16$), and bone remodeling ($\text{Weeks }17\text{ and beyond}$).

Internal Fixation

The stabilization of fractured bone fragments using internally implanted hardware such as metal plates, screws, wires, or intramedullary nails directly on or within the skeleton.

External Fixation

A fracture management system where percutaneous metal pins or wires transfix the bone fragments and attach to an external rigid scaffold frame or ring outside the limb.

Degloving

A severe avulsion injury characterized by extensive peeling away and separation of the skin and subcutaneous tissue from the underlying fascia, muscle, or bone.

Blister

A localized fluid collection within the skin caused by frictional shear forces that induce dermo-epidermal separation.

Stance Phase

The interval of the gait cycle extending from initial contact to toe-off during which the foot remains in contact with the walking surface, comprising approximately $60\%$ of the total cycle.

Swing Phase

The interval of the gait cycle extending from toe-off to initial contact during which the foot is airborne moving forward, comprising approximately $40\%$ of the total cycle.

Step vs. Stride

A step is the linear distance between initial contact of one foot and the subsequent initial contact of the opposite foot, whereas a stride is the distance between consecutive initial contacts of the exact same foot.

Trendelenburg Gait

An abnormal gait deviation marked by excessive downward pelvic tilt on the unsupported swing-leg side, caused by weakness of the hip abductor muscles (chiefly gluteus medius) on the weight-bearing stance leg.

Osteoarthritis

A non-inflammatory, degenerative wear-and-tear joint disorder marked by progressive breakdown of articular hyaline cartilage, subchondral bone sclerosis, subchondral cysts, and osteophyte spur formation.

Osteophytes

Smooth bony outgrowths or spurs that form along articular margins in response to joint degeneration, cartilage thinning, and altered mechanical load distribution.

Rheumatoid Arthritis

A systemic autoimmune inflammatory disorder where the immune system attacks synovial membranes, producing symmetrical joint swelling, cartilage erosion, and late deformities such as ulnar drift.

Total Knee Arthroplasty

Surgical replacement of an arthritic knee joint using three distinct prosthetic elements: a metal femoral component, a metal tibial tray with a high-density plastic bearing surface, and a plastic patellar button.

Acetabular Cup Component

The hemispherical prosthetic cup implanted into the pelvic socket during total hip replacement, often engineered with a roughened pure titanium coating to foster osseointegration and fitted with a smooth plastic liner.

Polymethyl Methacrylate (Bone Cement)

A specialized rapid-curing surgical cement utilized to anchor metallic arthroplasty components to host bone, which hardens fully in under $10\,\text{minutes}$.

Septic Arthritis

Severe acute joint inflammation caused by direct microbial or bacterial invasion of the synovial joint space, frequently secondary to open fractures, wounds, or hematogenous spread.

Juvenile Idiopathic Arthritis

A classification of chronic inflammatory arthritis of unknown etiology with onset in pediatric patients under age $16$.