Final Exam Review: NR509 / NR 509
(Latest ) Advanced
Physical Assessment | 100% Correct
Questions and Answers |
Chamberlain
Question:
Rotator cuff assessment
Answer:
Painful arc test/pain provocation test. Best for ruling out rotator cuff
disorders.
Fully abduct the patients arm from 0 to 180
Shoulder pain from 60 to 120 is positive for subacromial
impingement/rotator cuff tendinitis disorder.
Empty can test: Inability to hold the arm fully abducted in shoulder level or
control lowering the arm is positive for a rotator cuff tear.
,Question:
Anterior Drawer Test
Answer:
With the patient supine, hips flexed, and knees flexed to 90 degrees, feet
flat on the table, cup your hands around the knees with thumbs on the
medial and lateral joint line and fingers on the medial and lateral insertions
of the hamstrings.
Sit on the patient's foot to ensure is does not move during the maneuver.
Draw the tibia forward and observe if it slides forward (like a drawer), from
under the femur.
Knees should have minimal movement.
Movement indicates ACL is not intact and indicates ACL tear.
Question:
Straight Leg Raise
Answer:
Indicates sciatica (radicular low back pain)
Causes pain in affected leg
Negative straight leg raise makes diagnosis unlikely.
,Question:
Romberg test
Answer:
Tests positional sense
Stand with feet together and eyes open for 30 seconds without support,
then close eyes. Swaying should be minimal.
In sensory ataxia, from loss of positional sense, vision compensates for the
sensory loss.
Patient stands well with eyes open, loses balance when eyes are closed.
This is a positive Romberg.
Cerebellar ataxia, patient has difficulty standing with eyes open and closed.
Question:
Tinel's sign
Answer:
Tests for nerve entrapment neuropathy.
From Forceful repetitive handwork with prolonged wrist extension (such as
keyboarding) and mail sorting, vibration, cold exposure, wrist anatomy,
pregnancy, RA, diabetes and hypothyroidism are risk factors for carpal
tunnel.
Repeatedly tap over the course of the median nerve in the carpal tunnel
A shooting pain, aching, or worsening numbness in the median nerve
distribution is a positive test.
, Question:
Phalen's sign
Answer:
Ask the patient to hold the wrists in full flexion and juxtaposing the dorsum
of the hand against each other for 60 seconds with the elbows fully
extended
Numbness and tingling in the median nerve distribution within 60 seconds
is a positive test.
Tinel and phalen signs do not reliably predict positive electrodiagnosis of
carpal tunnel disease.
Question:
Clinical breast examination
Answer:
In woman, assess breast 5-7 days after onset of menstrual cycle.
Look at 4 views: Arms at side Arms overhead: brings out dimpling or
retractions Arms pressed against hips Patient leaning forward
Palpation occurs with patient supine with palpation from clavicle to bra
fold, out to axilla. Palpate 3 minutes each breast with pads of fingers.
Use opposite hand when palpating opposite axilla
Vertical strip technique is best and most validated
Screen breasts every other year at 40 y/o
(Latest ) Advanced
Physical Assessment | 100% Correct
Questions and Answers |
Chamberlain
Question:
Rotator cuff assessment
Answer:
Painful arc test/pain provocation test. Best for ruling out rotator cuff
disorders.
Fully abduct the patients arm from 0 to 180
Shoulder pain from 60 to 120 is positive for subacromial
impingement/rotator cuff tendinitis disorder.
Empty can test: Inability to hold the arm fully abducted in shoulder level or
control lowering the arm is positive for a rotator cuff tear.
,Question:
Anterior Drawer Test
Answer:
With the patient supine, hips flexed, and knees flexed to 90 degrees, feet
flat on the table, cup your hands around the knees with thumbs on the
medial and lateral joint line and fingers on the medial and lateral insertions
of the hamstrings.
Sit on the patient's foot to ensure is does not move during the maneuver.
Draw the tibia forward and observe if it slides forward (like a drawer), from
under the femur.
Knees should have minimal movement.
Movement indicates ACL is not intact and indicates ACL tear.
Question:
Straight Leg Raise
Answer:
Indicates sciatica (radicular low back pain)
Causes pain in affected leg
Negative straight leg raise makes diagnosis unlikely.
,Question:
Romberg test
Answer:
Tests positional sense
Stand with feet together and eyes open for 30 seconds without support,
then close eyes. Swaying should be minimal.
In sensory ataxia, from loss of positional sense, vision compensates for the
sensory loss.
Patient stands well with eyes open, loses balance when eyes are closed.
This is a positive Romberg.
Cerebellar ataxia, patient has difficulty standing with eyes open and closed.
Question:
Tinel's sign
Answer:
Tests for nerve entrapment neuropathy.
From Forceful repetitive handwork with prolonged wrist extension (such as
keyboarding) and mail sorting, vibration, cold exposure, wrist anatomy,
pregnancy, RA, diabetes and hypothyroidism are risk factors for carpal
tunnel.
Repeatedly tap over the course of the median nerve in the carpal tunnel
A shooting pain, aching, or worsening numbness in the median nerve
distribution is a positive test.
, Question:
Phalen's sign
Answer:
Ask the patient to hold the wrists in full flexion and juxtaposing the dorsum
of the hand against each other for 60 seconds with the elbows fully
extended
Numbness and tingling in the median nerve distribution within 60 seconds
is a positive test.
Tinel and phalen signs do not reliably predict positive electrodiagnosis of
carpal tunnel disease.
Question:
Clinical breast examination
Answer:
In woman, assess breast 5-7 days after onset of menstrual cycle.
Look at 4 views: Arms at side Arms overhead: brings out dimpling or
retractions Arms pressed against hips Patient leaning forward
Palpation occurs with patient supine with palpation from clavicle to bra
fold, out to axilla. Palpate 3 minutes each breast with pads of fingers.
Use opposite hand when palpating opposite axilla
Vertical strip technique is best and most validated
Screen breasts every other year at 40 y/o
