NR 511 Final Exam Study Guide
(VERSION 3)
1. Signs and symptoms and Signs and symptoms and management of musculoskeletal
management of musculoskeletal sprains/strains/dislocations
sprains/strains/dislocations Kara
Irvin Sprains: stretching or tearing of ligaments that occurs when a joint is forced
beyond its normal anatomical range
First degree- stretching of ligamentous fibers
Second degree- tear of part of the ligament with pain and swelling
Third degree- complete ligamentous separation
Sprain- sudden injury or fall that caused acute pain and swelling that got
worse over a few hours, redness and bruising, active and passive ROM
decreased. Radiography to rule out fx.
Strain: muscle injury caused by excessive tensile stress placed on a muscle
that results in stiffness and decreased function
-effects muscle or tendon that connects a muscle to a bone, complain
of “pulled muscle,” severe cases cause inflammation, swelling, weakness and
loss of function-surgery may be needed
Management: PRICE (protect, rest, ice, compression, elevation), limitation of
activity, physical therapy, NSAIDS, referral to ortho
Dislocation- complete separation of 2 bones that form a joint
Very painful and cause immobility, need immediate medical attention
Referral to orthopedics for possible surgery or reduction with
application of cast or splint.
2. Signs and symptoms and Cervical Spondylosis- neck stiffness, mild aching discomfort with activity. Pain
management of spinal disorders and limited ROM occur with lateral rotation and lateral flexion of the neck
(spondylosis, stenosis, etc.) Sandra toward the affected side. Weakness shoulder abduction- C5. Bicep weakness-
Okonkwo Thank you Ashley L for C6. Tricep weakness-C7.Myelopathy- leg weakness, gait disturbance, balance
completing!!! problems, difficulty performing fine motor tasks, loss of bowel and bladder.
Treatment- cervical traction, PT, pain relievers. Surgery for Myelopathy.
Low back pain-Tenderness and decreased range of motion. Positive straight
leg test. Treatment-NSAIDS, muscle relaxants, opioids, surgical, self-care,
spinal manipulation
Stenosis-pseudoclaudication causing radicular pain in the calves, buttocks,
and upper thighs of one or both legs. Symptoms progress from a proximal to
distal direction. Walking or prolonged standing causes pain and weakness in
buttocks and legs. Stooping over helps relieve pain. Positive Romberg.
, NR 511 Final Exam Study Guide
(VERSION 3)
Reflexes diminished. Management- surgical decompression. NSAIDS, folic
acid, vitamin b12. PT-flexing the spine.Bicycling.
3. Recognition and immediate Immediate management of cauda equina syndrome. (P. 829)
management of cauda equina Cauda equina syndrome is a medical EMERGENCY and requires immediate
syndrome Danie Molly decompression.
If Cauda equina is confirmed, surgical lumbar decompression is necessary to
halt neurological deterioration unless surgery is contraindicated for other
medical reasons.
*Rational on Davis Edge question: Low back pain accompanied by acute onset
of urinary retention or overflow incontinence, loss of anal sphincter tone or
fecal incontinence, loss of sensation in the buttocks and perineum, and motor
weakness in the lower extremities is a red flag for cauda equina syndrome or
severe neurologic compromise
4. Maneuvers and expected findings Neck pain-Spurling’s. Shoulder pain-Apley scratch test(reaching the scapula).
with joint pain (knee, shoulder, wrist, Internal and external flexion. Internal and external abduction. Pain with
etc.) Deanna Morrison Thank you abduction= early supraspinatus tendinitis and subacromial bursitis=early
Ashley L!! rotator cuff injuries. Wrist and hand-allen’s test= radial and ulnar arteries.
Phalens test=median nerve compression. Tinel’s sign assess for compression
neuropathy. Finkelsteins test- de Quervains disease. Knee Pain= Mcmurray,
apprehension sign, bulge sign, inspect/palpate to assess effusion.
5. Initial assessment of FOOSH injury FOOSH: Falling On an Out Stretched Hand. After falling on an outstretched
in correlation to anatomical location hand patients present after trauma with pain and swelling in the distal
of radial head bone Lisa Callahan forearm or wrist. Numbness may be present if the medial nerve is affected.
The mechanism of injury will often provide important clues to the diagnosis.
The examination begins with gentle palpation to locate the area of point
tenderness and includes a thorough neurovascular assessment. A radiograph
of the wrist (including an oblique view) may be necessary to rule out fracture.
Common fractures are the Colles fracture of the distal radius and the
navicular (scaphoid) fracture of the anatomical snuffbox. It is not unusual to
have a navicular fracture missed on radiography, so an orthopedic referral
should be provided when the presenting complaint is pain and trauma to the
soft-tissue area of the anatomical snuffbox.
6. Assessment and management of Trigger points within a muscle. Common cause of nonarticular rheumatic
Myofascial pain Jenna Lara Thank pain. Injections a the trigger point with saline, an anesthetic, or
you Ashley L corticosteroid, dry needling, muscle relaxant tizanidine, NSAIDS, or
cyclooxygenases-2 inhibitors. Tricyclic antidepressants.
7. Health promotion activities to Protection may refer to preventing the injury from occurring or making it less
prevent sport related severe by wearing protective gear, such as helmets, wrist pads, and
musculoskeletal injuries Melissa kneepads. Maintain adequate hydration and proper diet while playing sports.
Schaff Stretch before the activity. Stop when you are injured, do not “tough it out”.
8. Osteopenia Helena Longfellow Osteopenia:
• Is the precursor to osteoporosis. Osteopenia is categorized by the
, NR 511 Final Exam Study Guide
(VERSION 3)
level of T-scores in relation to the results of a dual-energy x-ray
absorptiometry scan or (DXA Scan), which measures the mineral content of
bone. A T-score ranging from -1 to -2.5 would be classified as osteopenia.
Pathophysiology:
• It occurs secondary to uncoupling of osteoclast-osteoblast activity,
resulting in a quantitative decrease in bone mass. Peak bone mass is typically
achieved by males and females just prior to, or early-on in the 3rd decade of
life.
• Beyond age 30, bone resorption gradually becomes favored as
dynamic bone remodeling continues into later decades of life.
• Histologic specimens demonstrate markedly thinned trabeculae,
decreased osteon size, and enlarged haversian and marrow spaces.
Osteopenia Prevention:
• Certain habits can accelerate the process such as:
o Smoking
o Not getting enough calcium and vitamin D
o Drinking too much ETOH
o Use of certain medications (i.e.: corticosteroids and anticonvulsants)
o Not getting enough weight-bearing exercise (at least 30 mins on most
days). If your feet tough the ground during an exercise, it’s probably weight
bearing. Running and walking are weight bearing. Swimming and biking are
not
o Falls
• Women are more likely to have low bone density than men, but it’s no
longer viewed as solely a women’s condition.
• Approx. a third of white and Asian men over age 50 are affected.
• Percentages for Hispanics (23%) and blacks (19%) are lower, but still
sizable.
Current National Osteoporosis Foundation (NOF) recommends testing for:
• Women 65 and older
• Postmenopausal women younger than 65 who have one or more risk
factors, which include being thin
• Postmenopausal women who have had a fracture
• For men: testing is done more on a case-by-case basis.
Osteopenia Treatment:
Can be treated with exercise and nutrition or with medications.
• If T-score is under -2, need to ensure you are doing regular weight-
bearing exercise, and getting enough vitamin D and dietary calcium.
• If T-score is closer to -2.5, a medication may be considered to keep
(VERSION 3)
1. Signs and symptoms and Signs and symptoms and management of musculoskeletal
management of musculoskeletal sprains/strains/dislocations
sprains/strains/dislocations Kara
Irvin Sprains: stretching or tearing of ligaments that occurs when a joint is forced
beyond its normal anatomical range
First degree- stretching of ligamentous fibers
Second degree- tear of part of the ligament with pain and swelling
Third degree- complete ligamentous separation
Sprain- sudden injury or fall that caused acute pain and swelling that got
worse over a few hours, redness and bruising, active and passive ROM
decreased. Radiography to rule out fx.
Strain: muscle injury caused by excessive tensile stress placed on a muscle
that results in stiffness and decreased function
-effects muscle or tendon that connects a muscle to a bone, complain
of “pulled muscle,” severe cases cause inflammation, swelling, weakness and
loss of function-surgery may be needed
Management: PRICE (protect, rest, ice, compression, elevation), limitation of
activity, physical therapy, NSAIDS, referral to ortho
Dislocation- complete separation of 2 bones that form a joint
Very painful and cause immobility, need immediate medical attention
Referral to orthopedics for possible surgery or reduction with
application of cast or splint.
2. Signs and symptoms and Cervical Spondylosis- neck stiffness, mild aching discomfort with activity. Pain
management of spinal disorders and limited ROM occur with lateral rotation and lateral flexion of the neck
(spondylosis, stenosis, etc.) Sandra toward the affected side. Weakness shoulder abduction- C5. Bicep weakness-
Okonkwo Thank you Ashley L for C6. Tricep weakness-C7.Myelopathy- leg weakness, gait disturbance, balance
completing!!! problems, difficulty performing fine motor tasks, loss of bowel and bladder.
Treatment- cervical traction, PT, pain relievers. Surgery for Myelopathy.
Low back pain-Tenderness and decreased range of motion. Positive straight
leg test. Treatment-NSAIDS, muscle relaxants, opioids, surgical, self-care,
spinal manipulation
Stenosis-pseudoclaudication causing radicular pain in the calves, buttocks,
and upper thighs of one or both legs. Symptoms progress from a proximal to
distal direction. Walking or prolonged standing causes pain and weakness in
buttocks and legs. Stooping over helps relieve pain. Positive Romberg.
, NR 511 Final Exam Study Guide
(VERSION 3)
Reflexes diminished. Management- surgical decompression. NSAIDS, folic
acid, vitamin b12. PT-flexing the spine.Bicycling.
3. Recognition and immediate Immediate management of cauda equina syndrome. (P. 829)
management of cauda equina Cauda equina syndrome is a medical EMERGENCY and requires immediate
syndrome Danie Molly decompression.
If Cauda equina is confirmed, surgical lumbar decompression is necessary to
halt neurological deterioration unless surgery is contraindicated for other
medical reasons.
*Rational on Davis Edge question: Low back pain accompanied by acute onset
of urinary retention or overflow incontinence, loss of anal sphincter tone or
fecal incontinence, loss of sensation in the buttocks and perineum, and motor
weakness in the lower extremities is a red flag for cauda equina syndrome or
severe neurologic compromise
4. Maneuvers and expected findings Neck pain-Spurling’s. Shoulder pain-Apley scratch test(reaching the scapula).
with joint pain (knee, shoulder, wrist, Internal and external flexion. Internal and external abduction. Pain with
etc.) Deanna Morrison Thank you abduction= early supraspinatus tendinitis and subacromial bursitis=early
Ashley L!! rotator cuff injuries. Wrist and hand-allen’s test= radial and ulnar arteries.
Phalens test=median nerve compression. Tinel’s sign assess for compression
neuropathy. Finkelsteins test- de Quervains disease. Knee Pain= Mcmurray,
apprehension sign, bulge sign, inspect/palpate to assess effusion.
5. Initial assessment of FOOSH injury FOOSH: Falling On an Out Stretched Hand. After falling on an outstretched
in correlation to anatomical location hand patients present after trauma with pain and swelling in the distal
of radial head bone Lisa Callahan forearm or wrist. Numbness may be present if the medial nerve is affected.
The mechanism of injury will often provide important clues to the diagnosis.
The examination begins with gentle palpation to locate the area of point
tenderness and includes a thorough neurovascular assessment. A radiograph
of the wrist (including an oblique view) may be necessary to rule out fracture.
Common fractures are the Colles fracture of the distal radius and the
navicular (scaphoid) fracture of the anatomical snuffbox. It is not unusual to
have a navicular fracture missed on radiography, so an orthopedic referral
should be provided when the presenting complaint is pain and trauma to the
soft-tissue area of the anatomical snuffbox.
6. Assessment and management of Trigger points within a muscle. Common cause of nonarticular rheumatic
Myofascial pain Jenna Lara Thank pain. Injections a the trigger point with saline, an anesthetic, or
you Ashley L corticosteroid, dry needling, muscle relaxant tizanidine, NSAIDS, or
cyclooxygenases-2 inhibitors. Tricyclic antidepressants.
7. Health promotion activities to Protection may refer to preventing the injury from occurring or making it less
prevent sport related severe by wearing protective gear, such as helmets, wrist pads, and
musculoskeletal injuries Melissa kneepads. Maintain adequate hydration and proper diet while playing sports.
Schaff Stretch before the activity. Stop when you are injured, do not “tough it out”.
8. Osteopenia Helena Longfellow Osteopenia:
• Is the precursor to osteoporosis. Osteopenia is categorized by the
, NR 511 Final Exam Study Guide
(VERSION 3)
level of T-scores in relation to the results of a dual-energy x-ray
absorptiometry scan or (DXA Scan), which measures the mineral content of
bone. A T-score ranging from -1 to -2.5 would be classified as osteopenia.
Pathophysiology:
• It occurs secondary to uncoupling of osteoclast-osteoblast activity,
resulting in a quantitative decrease in bone mass. Peak bone mass is typically
achieved by males and females just prior to, or early-on in the 3rd decade of
life.
• Beyond age 30, bone resorption gradually becomes favored as
dynamic bone remodeling continues into later decades of life.
• Histologic specimens demonstrate markedly thinned trabeculae,
decreased osteon size, and enlarged haversian and marrow spaces.
Osteopenia Prevention:
• Certain habits can accelerate the process such as:
o Smoking
o Not getting enough calcium and vitamin D
o Drinking too much ETOH
o Use of certain medications (i.e.: corticosteroids and anticonvulsants)
o Not getting enough weight-bearing exercise (at least 30 mins on most
days). If your feet tough the ground during an exercise, it’s probably weight
bearing. Running and walking are weight bearing. Swimming and biking are
not
o Falls
• Women are more likely to have low bone density than men, but it’s no
longer viewed as solely a women’s condition.
• Approx. a third of white and Asian men over age 50 are affected.
• Percentages for Hispanics (23%) and blacks (19%) are lower, but still
sizable.
Current National Osteoporosis Foundation (NOF) recommends testing for:
• Women 65 and older
• Postmenopausal women younger than 65 who have one or more risk
factors, which include being thin
• Postmenopausal women who have had a fracture
• For men: testing is done more on a case-by-case basis.
Osteopenia Treatment:
Can be treated with exercise and nutrition or with medications.
• If T-score is under -2, need to ensure you are doing regular weight-
bearing exercise, and getting enough vitamin D and dietary calcium.
• If T-score is closer to -2.5, a medication may be considered to keep
