Nurs 623-624 Exam 4 with || || || || ||
precise solutions ||
•Anterior drawer test has a low sensitivity and high specificity for confirming
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ACL pathology, so a positive test strongly suggests a problem but a negative test
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does not rule out an ACL tear. - Correct answer ✔A positive test strongly
|| || || || || || || || || || || || || ||
suggests a problem but a negative test does not rule out an ACL tear.
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When assessing the patient with musculoskeletal problems, it is important to
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determine if the problem is: - Correct answer ✔acute or chronic, articular or
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nonarticular, inflammatory or noninflammatory, and localized or systemic in
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distribution. Acute (less than 6 weeks duration) or chronic (more than 6 weeks
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duration), Flammatory or inflammatory || || ||
Articular structures - Correct answer ✔• synovium, • synovial fluid, • articular
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cartilage, • intra-articular ligaments, • joint capsule, • juxta-articular bone
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Articular problems are characterized by - Correct answer ✔deep or diffuse pain,
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• deep or diffuse pain, • limited ROM (passive & active), • swelling, •
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crepitation,
• instability, • 'locking', • Deformity
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Nonarticular (or periarticular) structures - Correct answer ✔• identified as
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supportive extra-articular ligaments, || ||
,• tendons, • bursae, • muscle, • fascia, • bone, • nerve,
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• overlying skin •
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Nonarticular disorders are characterized by - Correct answer ✔painful active, || || || || || || || || || ||
but not passive ROM,
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• demonstrated point or focal ternderness in regions distinct from articular
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structures,
• physical findings far from the joint capsule.
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• Usually do not find crepitus, instability or deformity
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History - Correct answer ✔· 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 - Correct answer ✔· 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 - Correct answer ✔· Also called low back strain or lumbar strain
|| || || || || || || || || || || || || ||
· Injury to paravertebral spinal muscles, ligamentous injuries, disc herniation or
|| || || || || || || || || ||
leaking of substances from nucleus pulposus
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· 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.
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· often difficult to localize an injury to a specific structure.
|| || || || || || || || || ||
Chronic low back pain is - Correct answer ✔pain that lasts longer than 3
|| || || || || || || || || || || || || ||
months.
Symptoms associated with chronic low back pain are - Correct answer
|| || || || || || || || || || ||
✔typically recurrent and episodic, but may be unremitting. || || || || || || ||
Treatment for injury to muscle and ligamentous structures is similar. - Correct
|| || || || || || || || || || || ||
answer ✔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: - Correct answer ✔• Age, pain
|| || || || || || || || || || || || || ||
onset (acute or insidious),
|| || || ||
precise solutions ||
•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. - Correct answer ✔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: - Correct answer ✔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 - Correct answer ✔• synovium, • synovial fluid, • articular
|| || || || || || || || || || || ||
cartilage, • intra-articular ligaments, • joint capsule, • juxta-articular bone
|| || || || || || || || ||
Articular problems are characterized by - Correct answer ✔deep or diffuse pain,
|| || || || || || || || || || ||
• deep or diffuse pain, • limited ROM (passive & active), • swelling, •
|| || || || || || || || || || || || || || ||
crepitation,
• instability, • 'locking', • Deformity
|| || || || ||
Nonarticular (or periarticular) structures - Correct answer ✔• identified as
|| || || || || || || || || ||
supportive extra-articular ligaments, || ||
,• tendons, • bursae, • muscle, • fascia, • bone, • nerve,
|| || || || || || || || || || ||
• overlying skin •
|| || ||
Nonarticular disorders are characterized by - Correct answer ✔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 - Correct answer ✔· 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 - Correct answer ✔· 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 - Correct answer ✔· 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 - Correct answer ✔pain that lasts longer than 3
|| || || || || || || || || || || || || ||
months.
Symptoms associated with chronic low back pain are - Correct answer
|| || || || || || || || || || ||
✔typically recurrent and episodic, but may be unremitting. || || || || || || ||
Treatment for injury to muscle and ligamentous structures is similar. - Correct
|| || || || || || || || || || || ||
answer ✔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: - Correct answer ✔• Age, pain
|| || || || || || || || || || || || || ||
onset (acute or insidious),
|| || || ||
