NR 511 Final exam Questions with Verified Answers (Correct
Update)
Question 1: cervical Spondylosis
Answer: - 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
Question 2: Lumbar spinal stenosis
Answer: 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
Question 3: Cauda Equina Syndrome
Answer: 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
Question 4: s/s and management of sprains
Answer: - 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 separationimmobilization; possible surgery
- Hx of sudden injury or fall
-redness/bruising over the joint, decr A&P ROM,pain with movement of joint
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, Question 5: s/s and management of strains
Answer: - 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
Question 6: Spurling's maneuver- neck pain
Answer: 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
Question 7: Radiculopathy
Answer: -caused by spinal root compression, injury, or inflammation- most commonly d/t disc
herniation or spinal stenosis from degenerative disease.
Question 8: straight leg test
Answer: 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
Question 9: Diagnostic MS tests
Answer: - 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
- EMG: conduction studies to diagnose radiculopathy
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Update)
Question 1: cervical Spondylosis
Answer: - 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
Question 2: Lumbar spinal stenosis
Answer: 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
Question 3: Cauda Equina Syndrome
Answer: 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
Question 4: s/s and management of sprains
Answer: - 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 separationimmobilization; possible surgery
- Hx of sudden injury or fall
-redness/bruising over the joint, decr A&P ROM,pain with movement of joint
Page 1
, Question 5: s/s and management of strains
Answer: - 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
Question 6: Spurling's maneuver- neck pain
Answer: 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
Question 7: Radiculopathy
Answer: -caused by spinal root compression, injury, or inflammation- most commonly d/t disc
herniation or spinal stenosis from degenerative disease.
Question 8: straight leg test
Answer: 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
Question 9: Diagnostic MS tests
Answer: - 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
- EMG: conduction studies to diagnose radiculopathy
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