Nurs 623-624 Exam 4 Questions and Answers 100% Pass

Nurs 623-624 Exam 4 Questions and Answers 100% Pass •Anterior drawer test has a low sensitivity and high specificity for confirming ACL pathology, so a positive test strongly suggests a problem but a negative test does not rule out an ACL tear. A positive test strongly suggests a problem but a negative test does not rule out an ACL tear. When assessing the patient with musculoskeletal problems, it is important to determine if the problem is: acute or chronic, articular or nonarticular, inflammatory or noninflammatory, and localized or systemic in distribution. Acute (less than 6 weeks duration) or chronic (more than 6 weeks duration), Flammatory or inflammatory Articular structures • synovium, • synovial fluid, • articular cartilage, • intra-articular ligaments, • joint capsule, • juxta-articular bone Articular problems are characterized by deep or diffuse pain, • deep or diffuse pain, • limited ROM (passive & active), • swelling, • crepitation, • instability, • 'locking', • Deformity Nonarticular (or periarticular) structures • identified as supportive extra-articular ligaments, • tendons, • bursae, • muscle, • fascia, • bone, • nerve, • overlying skin • Nonarticular disorders are characterized by painful active, but not passive ROM, • demonstrated point or focal ternderness in regions distinct from articular structures, • physical findings far from the joint capsule. • Usually do not find crepitus, instability or deformity History · Chronology of complaint gives important diagnostic clues · onset, or did it develop over some time · evolution of the problem, such as chronic, intermittent, · migratory and duration of the problem. Physical Examination · Distinguish between mechanical problems, soft tissue disease, and noninflammatory and inflammatory joint disease. · Inspecting the involved site and observe for side to side symmetry · The uninvolved side should be examined first and compared with the involved side (this will mean the painful portion of the exam will be last) · evaluate for warmth over the joint, joint effusion, and pain on joint motion. You should have the patient perform as much active ROM as possible during the exam, Low Back Pain · Also called low back strain or lumbar strain · Injury to paravertebral spinal muscles, ligamentous injuries, disc herniation or leaking of substances from nucleus pulposus · Back pain associated with neurological deficit, decreased or absent pulses, or bowel or bladder dysfunction is potentially life threatening & warrants immediate referral. · Low back pain is a common complaint seen in primary care. · Pain may be caused by a herniated disc or from leaking of substances from the nucleus pulposus that can induce inflammation and cause irritation. · often difficult to localize an injury to a specific structure. Chronic low back pain is pain that lasts longer than 3 months. Symptoms associated with chronic low back pain are typically recurrent and episodic, but may be unremitting. Treatment for injury to muscle and ligamentous structures is similar. Acute vs. chronic Acute LBP will often spontaneously resolve and the patient may be back to functioning normally within a month Factors to consider in diagnosing cause of pain: • Age, pain onset (acute or insidious), • Pain location as unilateral or bilateral can help differentiate among these differentials. • Pain increases. Pain decreases, Straight-leg raising Younger patients, under 50 years of age, are more likely to have spondylolisthesis, • muscle strain, • scoliosis, • herniated disc. Older