NR511pFinalpExampStudypGuide 1
NR 511Full updated NR511 Final Exam Study Guide June 2020 UPDATED 2022
p p p p p p p p p p p
Topics:
o CommonpM/Spdisorders
o Commonpspinepdisorders
o Metabolicpdisorders
o Endocrinepdisorders
o Wounds,placerationsp&pbites
o Commonphematologicalpdisorders
o CommonpmalepGUpdisorders
o Testicularpdisorders
Chaptersp+plectures:
Wkp5:
o p p Chapterp52:pCommonpMusculoskeletalpComplaints
o p p Chapterp53:pSpinalpDisorders
o Chapterp54:pSoft-TissuepDisorders
o p p Lectures
o Hollier
o p p DE
Wk6:
o Chapterp57:pGlandularpDisordersp(p.p880-897ponly)
o Chapterp59:pMetabolicpDisorders
o Chapterp73:pCommonpInjuriesp(p.1210-1223ponly)p1212-1213ptablep73.1
o Reviewpthyroidplecturepagain
o p p Lectures
o Hollier
o DE
Wk7:
, NR511pFinalpExampStudypGuide 2
o Chapterp46:pNocturiapinpMenp(p.p682)p&pTesticularpPainp(p.p685)
o Chapterp49:pProstatepDisorders
o Chapterp50:pPenilep&pTesticularpDisorders
o Chapterp61:pHematologicalpDisorders
o p p Lectures
o Hollier
o DE
Completionpofpstudypguide:pIIII
1. Signspandpsymptomspandpmanagementpofpmusculoskeletalpsprains/strains/dislocations
Signspandpsymptom
spandpmanagementpofpmus Sprains:pstretchingporptearingpofpligamentspthatpoccurspwhenpapjointpispforcedpbeyondpitspnormalpan
culoskeletalpsprains/strains atomicalprange
/dislocations Firstpdegree-pstretchingpofpligamentouspfibers
Secondpdegree-
ppartialptearpofppartpofpthepligamentpwithppainpandpswellingpThirdpdegree-
pcompletepligamentouspseparation
Sprain-
psuddenpinjuryporpfallpthatpcausedpacuteppainpandpswellingpthatpgotpworsepoverpapfewphours,predn
esspandpbruising,pactivepandppassivepROMpdecreased.pRadiographyptoprulepoutpfx.
Strain:pmusclepinjurypcausedpbypexcessiveptensilepstresspplacedponpapmusclepthatpresultspinpstiffn
esspandpdecreasedpfunction
-effectspmuscleporptendonpthatpconnectspapmuscleptopapbone,pcomplainpofp“pulled
muscle,”pseverepcasespcausepinflammation,pswelling,pweaknesspandplosspofpfunction-
surgerypmaypbepneeded
Management:pPRICEp(protect,prest,pice,pcompression,pelevation),plimitationpofpactivity,pphysicalp
, NR511pFinalpExampStudypGuide 3
therapy,pNSAIDS,preferralptoportho
Dislocation-pcompletepseparationpofp2pbonespthatpformpapjoint
Veryppainfulpandpcausepimmobility,pneedpimmediatepmedicalpattention
Referralptoporthopedicspforppossiblepsurgeryporpreductionpwithpapplicationpofpcastporpsplint.
fourpcardinalpsignspofpinflammationp(erythema,pwarmth,ppain,porpswelling)p-SPEW
2.pSignspandpsymptomspandp CervicalpSpondylosis-
managementpofpspinalpdiso pneckpstiffness,pmildpachingpdiscomfortpwithpactivity.pPainpandplimitedpROMpoccurpwithplateralprot
rdersp(spondylosis,pstenosi ationpandplateralpflexionpofpthepneckptowardpthepaffectedpside.pWeaknesspshoulderpabduction-
s,petc.) pC5.pBiceppweakness-pC6.pTriceppweakness-C7.Myelopathy-
plegpweakness,pgaitpdisturbance,pbalancepproblems,pdifficultypperformingpfinepmotorptasks,plossp
ofpbowelpandpbladder.pTreatment-pcervicalptraction,pPT,ppainprelievers.pSurgerypforpMyelopathy.
Lowpbackppain-Tendernesspandpdecreasedprangepofpmotion.pPositivepstraightplegptest.pTreatment-
pNSAIDS,pmuscleprelaxants,popioids,psurgical,pself-care,pspinalpmanipulation
Stenosis-
pseudoclaudicationpcausingpradicularppainpinpthepcalves,pbuttocks,pandpupperpthighspofponeporpbot
hplegs.pSymptomspprogresspfrompapproximalptopdistalpdirection.pWalkingporpprolongedpstandingpca
usesppainpandpweaknesspinpbuttockspandplegs.pStoopingpoverphelpsprelieveppain.
PositivepRomberg.pReflexespdiminished.pWithpbowelporpbladderpsymptoms,psphincterptonepmayp
bepdecreased
Management-psurgicalpdecompression.pNSAIDS,pfolicpacid,pvitaminpb12.pPT-
flexingpthepspine.Bicycling.
IntermittentpusepofpNSAIDspmaypbephelpful,paspwellpaspfolicpacidporpvitaminpB12psupplementationpi
npsomepcasespdependingponpresultspofplaboratoryptests.
Managementprevolvesparoundpphysicalptherapyporpanpexercisepprogrampthatpfocusesponpflexingpt
hepspine.pFlexionpofpthepspinepincreasespintraspinalpvolume.pBicyclingpisponepexercisepthatpis
donepwithpthepspinepinpflexion.pImprovingpabdominalpmuscleptonepliftsptheppelvispanteriorlypandpflex
esptheplumbarpspine.pReductionpofpintra-abdominalpfatpispcriticalptopachievingpthepobjective.
, NR511pFinalpExampStudypGuide 4
Thus,pweightplosspmaypbeppivotal.pLumbarpflexionpexercisespincreasepspinalpcanalpvolume.pExample
spincludepexerciseponpallpfours,parchingpthepback,porpinpthepfetalpposition.pExercisespthatpextendptheps
pinepshouldpbepavoidedp(swayback).
3.pRecognitionpandpimmedi Immediatepmanagementpofpcaudapequinapsyndrome.p(P.p829)
atepmanagementpofpcaudap CaudapequinapsyndromepispapmedicalpEMERGENCYpandprequirespimmediatepdecompression.
equinapsyndrome IfpCaudapequinapispconfirmed,psurgicalplumbarpdecompressionpispnecessaryptophaltpneurologicalpdet
eriorationpunlesspsurgerypispcontraindicatedpforpotherpmedicalpreasons.
*RationalponpDavispEdgepquestion:pLowpbackppainpaccompaniedpbypacuteponsetpofpurinarypreten
tionporpoverflowpincontinence,plosspofpanalpsphincterptoneporpfecalpincontinence,plosspofpsensati
onpinpthepbuttockspandpperineum,pandpmotorpweaknesspinptheplowerpextremitiespispapredpflagpforp
caudapequinapsyndromeporpseverepneurologicpcompromise.pPerianalpnumbness.
Caudapequinapcompressionpispcharacterizedpbypbilateralplowerpextremitypweakness,panesthesia,po
rpparesthesiapofpthepperineumpandpbuttocksp(saddlepanesthesia).pTherepmayporpmaypnotpbepbow
elporpbladderpincontinenceporpbladderpretention.pWhenptherepispneurologicpdeficitpaffectingpthepb
owelporpbladder,pthesepchangespmaypnotpbepreversedpwithpsurgicalpdecompression,
4.pManeuverspandpexpecte Neckppain-Spurling’s.
dpfindingspwithpjointppainp(k Shoulderppain-
nee,pshoulder,pwrist,petc.) Apleypscratchptest(reachingpthepscapula).pInternalpandpexternalpflexion.pInternalpandpexternalpa
bduction.pPainpwithpabduction=pearlypsupraspinatusptendinitispandpsubacromialpbursitis=earlyp
rotatorpcuffpinjuries.pWristpandphand-allen’sptest=pradialpandpulnarparteries.
Phalensptest=medianpnervepcompression.
Tinel’spsignpassesspforpcompressionpneuropathyp–ptappingpoverpnerve.
Finkelsteinsptest-pdepQuervainspdisease.pThumbpbetweenpfingerpandppoint.
KneepPain=pMcmurray,papprehensionpsign,pbulgepsign,pinspect/palpateptopassesspeffusion.p
Lachman,pdrawerpsignp–pACL,
Thumbptestp-pPCL
MCL,pLCLptestparepvalguspandpvarus
Tennispelbowpcuppcoffeepcuppsign
pCTS-NSAIDspnotpeffective
NR 511Full updated NR511 Final Exam Study Guide June 2020 UPDATED 2022
p p p p p p p p p p p
Topics:
o CommonpM/Spdisorders
o Commonpspinepdisorders
o Metabolicpdisorders
o Endocrinepdisorders
o Wounds,placerationsp&pbites
o Commonphematologicalpdisorders
o CommonpmalepGUpdisorders
o Testicularpdisorders
Chaptersp+plectures:
Wkp5:
o p p Chapterp52:pCommonpMusculoskeletalpComplaints
o p p Chapterp53:pSpinalpDisorders
o Chapterp54:pSoft-TissuepDisorders
o p p Lectures
o Hollier
o p p DE
Wk6:
o Chapterp57:pGlandularpDisordersp(p.p880-897ponly)
o Chapterp59:pMetabolicpDisorders
o Chapterp73:pCommonpInjuriesp(p.1210-1223ponly)p1212-1213ptablep73.1
o Reviewpthyroidplecturepagain
o p p Lectures
o Hollier
o DE
Wk7:
, NR511pFinalpExampStudypGuide 2
o Chapterp46:pNocturiapinpMenp(p.p682)p&pTesticularpPainp(p.p685)
o Chapterp49:pProstatepDisorders
o Chapterp50:pPenilep&pTesticularpDisorders
o Chapterp61:pHematologicalpDisorders
o p p Lectures
o Hollier
o DE
Completionpofpstudypguide:pIIII
1. Signspandpsymptomspandpmanagementpofpmusculoskeletalpsprains/strains/dislocations
Signspandpsymptom
spandpmanagementpofpmus Sprains:pstretchingporptearingpofpligamentspthatpoccurspwhenpapjointpispforcedpbeyondpitspnormalpan
culoskeletalpsprains/strains atomicalprange
/dislocations Firstpdegree-pstretchingpofpligamentouspfibers
Secondpdegree-
ppartialptearpofppartpofpthepligamentpwithppainpandpswellingpThirdpdegree-
pcompletepligamentouspseparation
Sprain-
psuddenpinjuryporpfallpthatpcausedpacuteppainpandpswellingpthatpgotpworsepoverpapfewphours,predn
esspandpbruising,pactivepandppassivepROMpdecreased.pRadiographyptoprulepoutpfx.
Strain:pmusclepinjurypcausedpbypexcessiveptensilepstresspplacedponpapmusclepthatpresultspinpstiffn
esspandpdecreasedpfunction
-effectspmuscleporptendonpthatpconnectspapmuscleptopapbone,pcomplainpofp“pulled
muscle,”pseverepcasespcausepinflammation,pswelling,pweaknesspandplosspofpfunction-
surgerypmaypbepneeded
Management:pPRICEp(protect,prest,pice,pcompression,pelevation),plimitationpofpactivity,pphysicalp
, NR511pFinalpExampStudypGuide 3
therapy,pNSAIDS,preferralptoportho
Dislocation-pcompletepseparationpofp2pbonespthatpformpapjoint
Veryppainfulpandpcausepimmobility,pneedpimmediatepmedicalpattention
Referralptoporthopedicspforppossiblepsurgeryporpreductionpwithpapplicationpofpcastporpsplint.
fourpcardinalpsignspofpinflammationp(erythema,pwarmth,ppain,porpswelling)p-SPEW
2.pSignspandpsymptomspandp CervicalpSpondylosis-
managementpofpspinalpdiso pneckpstiffness,pmildpachingpdiscomfortpwithpactivity.pPainpandplimitedpROMpoccurpwithplateralprot
rdersp(spondylosis,pstenosi ationpandplateralpflexionpofpthepneckptowardpthepaffectedpside.pWeaknesspshoulderpabduction-
s,petc.) pC5.pBiceppweakness-pC6.pTriceppweakness-C7.Myelopathy-
plegpweakness,pgaitpdisturbance,pbalancepproblems,pdifficultypperformingpfinepmotorptasks,plossp
ofpbowelpandpbladder.pTreatment-pcervicalptraction,pPT,ppainprelievers.pSurgerypforpMyelopathy.
Lowpbackppain-Tendernesspandpdecreasedprangepofpmotion.pPositivepstraightplegptest.pTreatment-
pNSAIDS,pmuscleprelaxants,popioids,psurgical,pself-care,pspinalpmanipulation
Stenosis-
pseudoclaudicationpcausingpradicularppainpinpthepcalves,pbuttocks,pandpupperpthighspofponeporpbot
hplegs.pSymptomspprogresspfrompapproximalptopdistalpdirection.pWalkingporpprolongedpstandingpca
usesppainpandpweaknesspinpbuttockspandplegs.pStoopingpoverphelpsprelieveppain.
PositivepRomberg.pReflexespdiminished.pWithpbowelporpbladderpsymptoms,psphincterptonepmayp
bepdecreased
Management-psurgicalpdecompression.pNSAIDS,pfolicpacid,pvitaminpb12.pPT-
flexingpthepspine.Bicycling.
IntermittentpusepofpNSAIDspmaypbephelpful,paspwellpaspfolicpacidporpvitaminpB12psupplementationpi
npsomepcasespdependingponpresultspofplaboratoryptests.
Managementprevolvesparoundpphysicalptherapyporpanpexercisepprogrampthatpfocusesponpflexingpt
hepspine.pFlexionpofpthepspinepincreasespintraspinalpvolume.pBicyclingpisponepexercisepthatpis
donepwithpthepspinepinpflexion.pImprovingpabdominalpmuscleptonepliftsptheppelvispanteriorlypandpflex
esptheplumbarpspine.pReductionpofpintra-abdominalpfatpispcriticalptopachievingpthepobjective.
, NR511pFinalpExampStudypGuide 4
Thus,pweightplosspmaypbeppivotal.pLumbarpflexionpexercisespincreasepspinalpcanalpvolume.pExample
spincludepexerciseponpallpfours,parchingpthepback,porpinpthepfetalpposition.pExercisespthatpextendptheps
pinepshouldpbepavoidedp(swayback).
3.pRecognitionpandpimmedi Immediatepmanagementpofpcaudapequinapsyndrome.p(P.p829)
atepmanagementpofpcaudap CaudapequinapsyndromepispapmedicalpEMERGENCYpandprequirespimmediatepdecompression.
equinapsyndrome IfpCaudapequinapispconfirmed,psurgicalplumbarpdecompressionpispnecessaryptophaltpneurologicalpdet
eriorationpunlesspsurgerypispcontraindicatedpforpotherpmedicalpreasons.
*RationalponpDavispEdgepquestion:pLowpbackppainpaccompaniedpbypacuteponsetpofpurinarypreten
tionporpoverflowpincontinence,plosspofpanalpsphincterptoneporpfecalpincontinence,plosspofpsensati
onpinpthepbuttockspandpperineum,pandpmotorpweaknesspinptheplowerpextremitiespispapredpflagpforp
caudapequinapsyndromeporpseverepneurologicpcompromise.pPerianalpnumbness.
Caudapequinapcompressionpispcharacterizedpbypbilateralplowerpextremitypweakness,panesthesia,po
rpparesthesiapofpthepperineumpandpbuttocksp(saddlepanesthesia).pTherepmayporpmaypnotpbepbow
elporpbladderpincontinenceporpbladderpretention.pWhenptherepispneurologicpdeficitpaffectingpthepb
owelporpbladder,pthesepchangespmaypnotpbepreversedpwithpsurgicalpdecompression,
4.pManeuverspandpexpecte Neckppain-Spurling’s.
dpfindingspwithpjointppainp(k Shoulderppain-
nee,pshoulder,pwrist,petc.) Apleypscratchptest(reachingpthepscapula).pInternalpandpexternalpflexion.pInternalpandpexternalpa
bduction.pPainpwithpabduction=pearlypsupraspinatusptendinitispandpsubacromialpbursitis=earlyp
rotatorpcuffpinjuries.pWristpandphand-allen’sptest=pradialpandpulnarparteries.
Phalensptest=medianpnervepcompression.
Tinel’spsignpassesspforpcompressionpneuropathyp–ptappingpoverpnerve.
Finkelsteinsptest-pdepQuervainspdisease.pThumbpbetweenpfingerpandppoint.
KneepPain=pMcmurray,papprehensionpsign,pbulgepsign,pinspect/palpateptopassesspeffusion.p
Lachman,pdrawerpsignp–pACL,
Thumbptestp-pPCL
MCL,pLCLptestparepvalguspandpvarus
Tennispelbowpcuppcoffeepcuppsign
pCTS-NSAIDspnotpeffective
