NSG 464 Final Exam Review – Nursing Study Guide with Verified Content
Osteoarthritis (OA)
Heberden Nodes (DIP joints) and Bouchard Nodes (PIP joints)
- hard and painless
- flexion and deviation deformities
- MCP rarely involved
- Radial deviation
Rheumatoid Arthritis (RA)
Symmetric deformity in PIP, MCP, wrist joints
- Tender, painful, stiff
- DIP, MCP, wrist
- Fusiform or spindle-shaped swelling of PIP joints
- Ulnar deviation
,Pain Provocation Test
Positive: shoulder pain from 60-120 degrees
Nerve Impingement Sign
Press on scapula, raise patient's arm
Hawkins Impingement Sign
flex arm and shoulder 90• w/ palm down and rotate arm internally
-will compress greater tuberosity against coracoacromial ligament
External Rotation Lag Test
Flex arm 90 degrees with palm up, rotate into full external rotation
- Positive: unable to maintain external rotation; supraspinatus and infraspinatus disorder
Internal Rotation Lag Test
Ask pt to place dorsum of hand on low back, elbow flexed 90 degrees
- Lift hand off back, further internally rotating shoulder
- Positive: unable to hold this position; subscapularis disorder
Drop Arm Test
Fully abduct arm to shoulder level and lower slowly
,- Positive: weakness, supraspinatus rotator cuff tear or bicipital tendinitis
External Rotation Resistance Test
Adduct and flex arm 90 degrees with thumb turned up
- apply pressure to wristpositive: infraspinatus disorder
Empty Can Test
Elevate arms to 90° in front of pt and internally rotate arms with thumbs pointing down; ask pt to
resist as you place downward pressure on arms
Positive for Rotator cuff tear if weakness present
Lateral Epicondylitis tennis elbow, characterized by pain on the
outer side of the forearm
Medial Epicondylitis golfer's elbow, characterized by pain on the
palm-side of the forearm
Colles fracture fracture of the distal
radius at the wrist
, Anatomical Snuffbox > Radial artery here
Avascular necrosis, most commonly injured wrist bone
Thumb Abduction Test
Ask patient to raise the thumb straight up as you apply downward resistance
Positive test - weakness on thumb abduction
- Most sensitive carpal tunnel test
Tinel Test
Percussion on medial nerve
- Positive: aching and numbing, tingling
Phalen's Sign
Hold backs of hands together with wrists in flexion for 60 seconds
- Positive: numbness/tingling
Sensation Test: median nerve
pulp of index finger
Sensation Test: ulnar nerve
pulp of 5th finger
Osteoarthritis (OA)
Heberden Nodes (DIP joints) and Bouchard Nodes (PIP joints)
- hard and painless
- flexion and deviation deformities
- MCP rarely involved
- Radial deviation
Rheumatoid Arthritis (RA)
Symmetric deformity in PIP, MCP, wrist joints
- Tender, painful, stiff
- DIP, MCP, wrist
- Fusiform or spindle-shaped swelling of PIP joints
- Ulnar deviation
,Pain Provocation Test
Positive: shoulder pain from 60-120 degrees
Nerve Impingement Sign
Press on scapula, raise patient's arm
Hawkins Impingement Sign
flex arm and shoulder 90• w/ palm down and rotate arm internally
-will compress greater tuberosity against coracoacromial ligament
External Rotation Lag Test
Flex arm 90 degrees with palm up, rotate into full external rotation
- Positive: unable to maintain external rotation; supraspinatus and infraspinatus disorder
Internal Rotation Lag Test
Ask pt to place dorsum of hand on low back, elbow flexed 90 degrees
- Lift hand off back, further internally rotating shoulder
- Positive: unable to hold this position; subscapularis disorder
Drop Arm Test
Fully abduct arm to shoulder level and lower slowly
,- Positive: weakness, supraspinatus rotator cuff tear or bicipital tendinitis
External Rotation Resistance Test
Adduct and flex arm 90 degrees with thumb turned up
- apply pressure to wristpositive: infraspinatus disorder
Empty Can Test
Elevate arms to 90° in front of pt and internally rotate arms with thumbs pointing down; ask pt to
resist as you place downward pressure on arms
Positive for Rotator cuff tear if weakness present
Lateral Epicondylitis tennis elbow, characterized by pain on the
outer side of the forearm
Medial Epicondylitis golfer's elbow, characterized by pain on the
palm-side of the forearm
Colles fracture fracture of the distal
radius at the wrist
, Anatomical Snuffbox > Radial artery here
Avascular necrosis, most commonly injured wrist bone
Thumb Abduction Test
Ask patient to raise the thumb straight up as you apply downward resistance
Positive test - weakness on thumb abduction
- Most sensitive carpal tunnel test
Tinel Test
Percussion on medial nerve
- Positive: aching and numbing, tingling
Phalen's Sign
Hold backs of hands together with wrists in flexion for 60 seconds
- Positive: numbness/tingling
Sensation Test: median nerve
pulp of index finger
Sensation Test: ulnar nerve
pulp of 5th finger
