NR 511 Final exam A+ Verified Solutions
2024
cervical Spondylosis - ANS-- Chronic, degenerative, causes stiffness and pain, very
common >50yo
- S: neck stiffness, mild aching esp with activity, trouble turning neck from side to side,
limited ROM, Paresthesias follow dermatomes
O:weak shoulder abduction, bicep weakness (c6 involvement), tricep weakness (C7
involvement), myelopathy s/s: leg weakness, gait disturbances, balance problems,
impaired fine motor loss of bowel and bladder control
dx: MRI
tx: if radiculopathy: cervical traction. physical therapy, NSAIDs, oral steroid, steroid
epidural injections, surgery (last)
edu: 75-90% of pts improve with conservative tx
Lumbar spinal stenosis - ANS-Narrowing of one or more levels of the L spinal canal and
compression of nerve roots. L1-2 most common
- S: symptoms may follow lifting accident or minor trauma or gradually occur.
pseudoclaudication causing radicular complaints in calves, butt, upp thighs, weakness
in legs and butt. may improve by leaning forward. leg/back pain after sleeping on back
O: + romberg test, impaired proprioception, sensory changes, decr anal sphincter tone
dx: x-ray, MRi
tx: b/b incontinence, neuro changes or gait disturbances may need surgery. NSAIDs,
Folic acid, B12, PT/OT, decr belly fat, bicycling, lumbar epidural corticosteroid injection
Cauda Equina Syndrome - ANS-*medical emergency*
S: BLE weakness, anesthesia, or paresthesia of the perineum and buttocks (saddle
anesthesia). may or may not be B/B incontinence or bladder retention (may not be
reversed). S/S may be acute or insidious. stumbling, weak quads or hip extensors,
unable to walk on heels and toes, foot drop.
dx:MRI
management: surgical lumbar decompression
s/s and management of sprains - ANS-- usually have swelling, pain and disability (or
deformity)
-1st: stretching of ligamentous fibers- symptom Tx
-2nd: tear of part of the ligament, with pain and swelling- Immobilization to protect
, injured part, but full healing expected
-3rd: complete ligamentous separation- immobilization; possible surgery
- Hx of sudden injury or fall
-redness/bruising over the joint, decr A&P ROM,pain with movement of joint
s/s and management of strains - ANS-- affect the muscles or tendons that connect to a
muscle to a bone.
-don't usually cause swelling or redness
-ROM may be limited, but can still use limb
- if severe, the entire muscle or tendon may be torn, causing inflammation and swelling,
weakness, and loss of function
- surgery may be needed
Spurling's maneuver- neck pain - ANS-1. With the patient's neck in extension, rotate
neck to the affected side.
2. Apply downward pressure on the head.
3. Assess for patient complaint of or accentuation of limb pain or paresthesia (a positive
finding). Also observe for obvious atrophy in the neck.
-assess nerve root compression
Radiculopathy - ANS--caused by spinal root compression, injury, or inflammation-
most commonly d/t disc herniation or spinal stenosis from degenerative disease.
straight leg test - ANS-1. The patient is placed in a supine position. 2. Grasp the heel
of the leg to be tested and raise the leg by flexing the hip. 3. Assess for pain or
reproduction of symptoms before the end of the normal range of motion (70
degrees).
- nerve root compression test. used to evaluate lumbar nerve root impingement
-positive if pain
Diagnostic MS tests - ANS-- X- bony structures. ( if fracture or misalignment is
suspected)
- CT scan:disc rupture, spinal stenosis, tumors.
-Ultrasound: ligament, tendon and muscle tears. or can find intra-abdominal etiology
- Bone scan: measure abnormal metabolic activity seen with tumors, infection and
fractures
-MRI: soft-tissue injury nerve impingement, tumor, infection, disc herniation, disc
rupture, trauma to ligaments, tendons, muscles or blood vessels. ** also if pt is surgical
candidate or have evidence of systemic disease
2024
cervical Spondylosis - ANS-- Chronic, degenerative, causes stiffness and pain, very
common >50yo
- S: neck stiffness, mild aching esp with activity, trouble turning neck from side to side,
limited ROM, Paresthesias follow dermatomes
O:weak shoulder abduction, bicep weakness (c6 involvement), tricep weakness (C7
involvement), myelopathy s/s: leg weakness, gait disturbances, balance problems,
impaired fine motor loss of bowel and bladder control
dx: MRI
tx: if radiculopathy: cervical traction. physical therapy, NSAIDs, oral steroid, steroid
epidural injections, surgery (last)
edu: 75-90% of pts improve with conservative tx
Lumbar spinal stenosis - ANS-Narrowing of one or more levels of the L spinal canal and
compression of nerve roots. L1-2 most common
- S: symptoms may follow lifting accident or minor trauma or gradually occur.
pseudoclaudication causing radicular complaints in calves, butt, upp thighs, weakness
in legs and butt. may improve by leaning forward. leg/back pain after sleeping on back
O: + romberg test, impaired proprioception, sensory changes, decr anal sphincter tone
dx: x-ray, MRi
tx: b/b incontinence, neuro changes or gait disturbances may need surgery. NSAIDs,
Folic acid, B12, PT/OT, decr belly fat, bicycling, lumbar epidural corticosteroid injection
Cauda Equina Syndrome - ANS-*medical emergency*
S: BLE weakness, anesthesia, or paresthesia of the perineum and buttocks (saddle
anesthesia). may or may not be B/B incontinence or bladder retention (may not be
reversed). S/S may be acute or insidious. stumbling, weak quads or hip extensors,
unable to walk on heels and toes, foot drop.
dx:MRI
management: surgical lumbar decompression
s/s and management of sprains - ANS-- usually have swelling, pain and disability (or
deformity)
-1st: stretching of ligamentous fibers- symptom Tx
-2nd: tear of part of the ligament, with pain and swelling- Immobilization to protect
, injured part, but full healing expected
-3rd: complete ligamentous separation- immobilization; possible surgery
- Hx of sudden injury or fall
-redness/bruising over the joint, decr A&P ROM,pain with movement of joint
s/s and management of strains - ANS-- affect the muscles or tendons that connect to a
muscle to a bone.
-don't usually cause swelling or redness
-ROM may be limited, but can still use limb
- if severe, the entire muscle or tendon may be torn, causing inflammation and swelling,
weakness, and loss of function
- surgery may be needed
Spurling's maneuver- neck pain - ANS-1. With the patient's neck in extension, rotate
neck to the affected side.
2. Apply downward pressure on the head.
3. Assess for patient complaint of or accentuation of limb pain or paresthesia (a positive
finding). Also observe for obvious atrophy in the neck.
-assess nerve root compression
Radiculopathy - ANS--caused by spinal root compression, injury, or inflammation-
most commonly d/t disc herniation or spinal stenosis from degenerative disease.
straight leg test - ANS-1. The patient is placed in a supine position. 2. Grasp the heel
of the leg to be tested and raise the leg by flexing the hip. 3. Assess for pain or
reproduction of symptoms before the end of the normal range of motion (70
degrees).
- nerve root compression test. used to evaluate lumbar nerve root impingement
-positive if pain
Diagnostic MS tests - ANS-- X- bony structures. ( if fracture or misalignment is
suspected)
- CT scan:disc rupture, spinal stenosis, tumors.
-Ultrasound: ligament, tendon and muscle tears. or can find intra-abdominal etiology
- Bone scan: measure abnormal metabolic activity seen with tumors, infection and
fractures
-MRI: soft-tissue injury nerve impingement, tumor, infection, disc herniation, disc
rupture, trauma to ligaments, tendons, muscles or blood vessels. ** also if pt is surgical
candidate or have evidence of systemic disease
