GCU NUR 634 MIDTERM EXAM SCRIPT
COMPLETE QUESTIONS AND ANSWERS
FULL SOLUTION VERIFIED EXPLANATIONS
GRADED A+
⩥ Carpel Tunnel Syndrome.
Answer: a channel beneath the palmar surfaces of the wrist and proximal
hand. The channel contains the sheath and flexor tendons of the forearm
muscles and the median nerve.
⩥ Tinel sign.
Answer: tapping lightly over the course of the median nerve in the
carpel tunnel—aching and numbness in the median nerve distribution is
a positive test
⩥ Phalen sign.
Answer: ask the patient to hold the wrist in flexion for 60 seconds with
the elbows fully extended. Alternatively ask the patient to press the
backs of both hands together to form right angles. These maneuvers
compress the median nerve—numbness and tingling in the median nerve
distribution within 60 seconds is a positive test.
⩥ Scoliosis.
,Answer: lateral and rotatory curvature of the spine brings the head back
to the midline. Often becomes evident during adolescence, before
symptoms appear. Measured leg length is the same in scoliosis.
⩥ McMurray Test.
Answer: (Medial Meniscus and Lateral Meniscus): with the patient
supine, grasp the heel & flex the knee. Cup your other hand over the
knee joint with your fingers along the medial joint line. Externally rotate
the lower leg & push on the lateral side to apply a valgus stress on the
medial side of the joint.
⩥ Abduction Stress Test.
Answer: (MCL): with the patient supine & the knee slightly flexed,
move the thigh about 30 degrees laterally to the side of the table. Push
medially against the knee & pull laterally at the ankle to open the knee
joint on the medial side (valgus stress)
⩥ Adduction Stress Test.
Answer: (LCL): with the thigh & knee in the same position, change your
position so that you can place one hand against the medial surface of the
knee and the other around the lateral ankle. Push laterally against the
knee and pull medially at the ankle to open the knee joint on the lateral
side (varus stress)
⩥ Anterior Draw Sign.
, Answer: (ACL): with the patient supine, hips flexed, & knees flexed to
90 degrees & feet flat on the table, cup your hands around the knee with
the thumbs on the medial & lateral joint line. Draw the tibia forward &
observe if it slides forward from under the femur
⩥ Lachman Test.
Answer: (ACL): place the knee in 15 degree of flexion & external
rotation. Grasp the distal femur on the lateral side with one hand and the
proximal tibia on the medial side with the other. Simultaneously pull the
tibia forward and the femur back. Estimate the degree of excursion
⩥ Posterior Draw Test.
Answer: (PCL): position the patient & place your hands in the positions
described for the anterior drawer test. Push the tibia posteriorly and
observe the degree of backward movement in the femur
⩥ Plantar Fasciitis.
Answer: Focal heel tenderness at the attachment side of the plantar
fascia; risk factors are anatomic (overpronation, flat feet), improper foot
wear, excessive use, & overtraining with prolonged heel strike exercise.
Presence or absence of a heel spur does not change the diagnosis.
⩥ Ankle Sprain.
COMPLETE QUESTIONS AND ANSWERS
FULL SOLUTION VERIFIED EXPLANATIONS
GRADED A+
⩥ Carpel Tunnel Syndrome.
Answer: a channel beneath the palmar surfaces of the wrist and proximal
hand. The channel contains the sheath and flexor tendons of the forearm
muscles and the median nerve.
⩥ Tinel sign.
Answer: tapping lightly over the course of the median nerve in the
carpel tunnel—aching and numbness in the median nerve distribution is
a positive test
⩥ Phalen sign.
Answer: ask the patient to hold the wrist in flexion for 60 seconds with
the elbows fully extended. Alternatively ask the patient to press the
backs of both hands together to form right angles. These maneuvers
compress the median nerve—numbness and tingling in the median nerve
distribution within 60 seconds is a positive test.
⩥ Scoliosis.
,Answer: lateral and rotatory curvature of the spine brings the head back
to the midline. Often becomes evident during adolescence, before
symptoms appear. Measured leg length is the same in scoliosis.
⩥ McMurray Test.
Answer: (Medial Meniscus and Lateral Meniscus): with the patient
supine, grasp the heel & flex the knee. Cup your other hand over the
knee joint with your fingers along the medial joint line. Externally rotate
the lower leg & push on the lateral side to apply a valgus stress on the
medial side of the joint.
⩥ Abduction Stress Test.
Answer: (MCL): with the patient supine & the knee slightly flexed,
move the thigh about 30 degrees laterally to the side of the table. Push
medially against the knee & pull laterally at the ankle to open the knee
joint on the medial side (valgus stress)
⩥ Adduction Stress Test.
Answer: (LCL): with the thigh & knee in the same position, change your
position so that you can place one hand against the medial surface of the
knee and the other around the lateral ankle. Push laterally against the
knee and pull medially at the ankle to open the knee joint on the lateral
side (varus stress)
⩥ Anterior Draw Sign.
, Answer: (ACL): with the patient supine, hips flexed, & knees flexed to
90 degrees & feet flat on the table, cup your hands around the knee with
the thumbs on the medial & lateral joint line. Draw the tibia forward &
observe if it slides forward from under the femur
⩥ Lachman Test.
Answer: (ACL): place the knee in 15 degree of flexion & external
rotation. Grasp the distal femur on the lateral side with one hand and the
proximal tibia on the medial side with the other. Simultaneously pull the
tibia forward and the femur back. Estimate the degree of excursion
⩥ Posterior Draw Test.
Answer: (PCL): position the patient & place your hands in the positions
described for the anterior drawer test. Push the tibia posteriorly and
observe the degree of backward movement in the femur
⩥ Plantar Fasciitis.
Answer: Focal heel tenderness at the attachment side of the plantar
fascia; risk factors are anatomic (overpronation, flat feet), improper foot
wear, excessive use, & overtraining with prolonged heel strike exercise.
Presence or absence of a heel spur does not change the diagnosis.
⩥ Ankle Sprain.
