Advanced health assessment part 3
correct answers
1. What are the symptoms of a torn rotator cuff? - correct-answers-Pain,
limited movement, muscle weakness. Rotator cuff tears are acute
injuries in children and young adults but occur as chronic injuries in older
adults. In acute tears, the shoulder pain is severe, and the patient is
unable to raise the arm sideways because of pain. In a complete tear,
attempts to raise the arm laterally will produce a shoulder shrug. In a
partial tear, the patient can raise the arm but cannot maintain the
position with any resistance. Inflammation secondary to injury can cause
rotator cuff tendinitis that produces shoulder pain, weakness, and a
grating sound with movement.
2. Chronic rotator cuff tears are most common in persons older than 50
years, the result of cumulative and repeated impingement processes.
The onset of pain is insidious and is made worse with the arm in an
overhead position. Patients experience shoulder pain with sleep and
tenderness over the acromioclavicular joint. Examination may reveal
minimal restriction in movement, crepitus, and weakness in external
rotation of the shoulder. Radiographs will show any bony abnormality
such as an acromial spur.
3. What are the symptoms of a torn ACL? - correct-answers-often
associated with an audible pop and a giving-way sensation in the knee,
often with swelling from hemarthrosis. Physical examination reveals a
positive Lachman test. With the patient supine and the knee flexed 20 to
30 degrees, anchor the patient's foot to the table; then pull the tibia
forward. Anterior motion is a sensitive test for ACL laxity.
4. -Lachman test (cruciate ligaments)
5. -With knee flexed 30 degrees, pull tibia forward with one hand while
other hand stabilizes femur.
,6. -Positive test is a mushy or soft end feel when tibia is moved forward,
indicating damage to anterior cruciate ligament.
7. Rotator cuff tendinitis - correct-answers-c/o shoulder pain at the tip of
the shoulder and the upper outer arm. It is made worse by lifting arm
above the shoulder, reaching, pulling and pushing. Ie. Putting on a shirt
or brushing hair. People c/o pain when sleeping on that shoulder.
8. Rotator cuff Tear - correct-answers-pain, weakness of shoulder, most
common in people over age of 40. Loss of motion,pain, loss of strength.
9. Bicipital tendonitis - correct-answers-Is an overuse injury of the biceps
that elicits pain in area highlighted above when patient is asked
10. to supinate arm.
11. Adhesive capsulitis (frozen shoulder) - correct-answers-usually begins
slowly and worsens over time. Over time, any movement of the shoulder
becomes painful and for many people, it worsens at night and disrupts
sleep. Frozen shoulder is caused by a thickening of the capsule around
the shoulder joint which restricts shoulder from moving freely. Exam
reveals severe limitation of movement such as when asked to raise arms
above head like touch down signal or to reach across body and grab the
opposite shoulder.
12. Genu varum presentation? - correct-answers-Genu varum is bowed
legs and genu valgum is knock knees.
13. Bowleg (genu varum) is evaluated with the child standing, facing you,
knees at your eye level. Measure the distance between the knees when
the medial malleoli of the ankles are together. Genu varum is present if a
space of 2.5 cm (1 inch) exists between the knees. The expected 10- to
15-degree angle at the tibiofemoral articulation increases with genu
varum but remains bilaterally symmetric. On future examinations, note
any increase in the angle or increased space between the knees. Genu
varum is a common finding of toddlers until 18 months of age.
Asymmetry of the tibiofemoral articulation angle or space between the
knees should not exceed 4 cm.
, 14. Genu valgum presentation? - correct-answers-Knock-knee (genu
valgum) is also evaluated with the child standing, facing you, knees at
your eye level. With the knees together, measure the distance between
the medial malleoli of the ankles. Genu valgum is present if a space of
2.5 cm (1 inch) exists between the medial malleoli. As with genu varum,
the tibiofemoral articulation angle will increase with genu valgum. On
future examinations, note any increase in the angle or increased space
between the ankles. Genu valgum is a common finding of children
between 2 and 4 years of age (Fig. 21-63). Asymmetry of the
tibiofemoral articulation angle or a space between the medial malleoli
should not exceed 5 cm (2 inches).
15. What are the common laboratory findings associated with gout? -
correct-answers-Laboratory findings during an acute attack show
elevated serum uric acid levels, ESR, and WBC levels. The joint may be
aspirated for fluid to observe uric acid crystals and cultured to exclude
septic arthritis.
16. Legg-Calve-Perthes Disease - correct-answers-Avascular necrosis of
femoral head/ occurs most commonly in boys ages 3-11. Followed by
revascularization and healing. Presents with muscle weakness of upper
thigh, Loss of internal rotation, abduction and decreased ROM or pain in
hip.
17. Osgood-Schlatter - correct-answers-Inflammation of bony outgrowth of
the anterior tibial tubercle/ painful lump below the knee cap. More
common in boys than girls and usually occurs in puberty.
18. What are the presenting symptoms of patellar tendonitis? - correct-
answers-Pain is the first symptom of patellar tendinitis. The pain usually
is located in the section of your patellar tendon between your kneecap
(patella) and the area where the tendon attaches to your shinbone
(tibia).
19. The pain in your knee may:
correct answers
1. What are the symptoms of a torn rotator cuff? - correct-answers-Pain,
limited movement, muscle weakness. Rotator cuff tears are acute
injuries in children and young adults but occur as chronic injuries in older
adults. In acute tears, the shoulder pain is severe, and the patient is
unable to raise the arm sideways because of pain. In a complete tear,
attempts to raise the arm laterally will produce a shoulder shrug. In a
partial tear, the patient can raise the arm but cannot maintain the
position with any resistance. Inflammation secondary to injury can cause
rotator cuff tendinitis that produces shoulder pain, weakness, and a
grating sound with movement.
2. Chronic rotator cuff tears are most common in persons older than 50
years, the result of cumulative and repeated impingement processes.
The onset of pain is insidious and is made worse with the arm in an
overhead position. Patients experience shoulder pain with sleep and
tenderness over the acromioclavicular joint. Examination may reveal
minimal restriction in movement, crepitus, and weakness in external
rotation of the shoulder. Radiographs will show any bony abnormality
such as an acromial spur.
3. What are the symptoms of a torn ACL? - correct-answers-often
associated with an audible pop and a giving-way sensation in the knee,
often with swelling from hemarthrosis. Physical examination reveals a
positive Lachman test. With the patient supine and the knee flexed 20 to
30 degrees, anchor the patient's foot to the table; then pull the tibia
forward. Anterior motion is a sensitive test for ACL laxity.
4. -Lachman test (cruciate ligaments)
5. -With knee flexed 30 degrees, pull tibia forward with one hand while
other hand stabilizes femur.
,6. -Positive test is a mushy or soft end feel when tibia is moved forward,
indicating damage to anterior cruciate ligament.
7. Rotator cuff tendinitis - correct-answers-c/o shoulder pain at the tip of
the shoulder and the upper outer arm. It is made worse by lifting arm
above the shoulder, reaching, pulling and pushing. Ie. Putting on a shirt
or brushing hair. People c/o pain when sleeping on that shoulder.
8. Rotator cuff Tear - correct-answers-pain, weakness of shoulder, most
common in people over age of 40. Loss of motion,pain, loss of strength.
9. Bicipital tendonitis - correct-answers-Is an overuse injury of the biceps
that elicits pain in area highlighted above when patient is asked
10. to supinate arm.
11. Adhesive capsulitis (frozen shoulder) - correct-answers-usually begins
slowly and worsens over time. Over time, any movement of the shoulder
becomes painful and for many people, it worsens at night and disrupts
sleep. Frozen shoulder is caused by a thickening of the capsule around
the shoulder joint which restricts shoulder from moving freely. Exam
reveals severe limitation of movement such as when asked to raise arms
above head like touch down signal or to reach across body and grab the
opposite shoulder.
12. Genu varum presentation? - correct-answers-Genu varum is bowed
legs and genu valgum is knock knees.
13. Bowleg (genu varum) is evaluated with the child standing, facing you,
knees at your eye level. Measure the distance between the knees when
the medial malleoli of the ankles are together. Genu varum is present if a
space of 2.5 cm (1 inch) exists between the knees. The expected 10- to
15-degree angle at the tibiofemoral articulation increases with genu
varum but remains bilaterally symmetric. On future examinations, note
any increase in the angle or increased space between the knees. Genu
varum is a common finding of toddlers until 18 months of age.
Asymmetry of the tibiofemoral articulation angle or space between the
knees should not exceed 4 cm.
, 14. Genu valgum presentation? - correct-answers-Knock-knee (genu
valgum) is also evaluated with the child standing, facing you, knees at
your eye level. With the knees together, measure the distance between
the medial malleoli of the ankles. Genu valgum is present if a space of
2.5 cm (1 inch) exists between the medial malleoli. As with genu varum,
the tibiofemoral articulation angle will increase with genu valgum. On
future examinations, note any increase in the angle or increased space
between the ankles. Genu valgum is a common finding of children
between 2 and 4 years of age (Fig. 21-63). Asymmetry of the
tibiofemoral articulation angle or a space between the medial malleoli
should not exceed 5 cm (2 inches).
15. What are the common laboratory findings associated with gout? -
correct-answers-Laboratory findings during an acute attack show
elevated serum uric acid levels, ESR, and WBC levels. The joint may be
aspirated for fluid to observe uric acid crystals and cultured to exclude
septic arthritis.
16. Legg-Calve-Perthes Disease - correct-answers-Avascular necrosis of
femoral head/ occurs most commonly in boys ages 3-11. Followed by
revascularization and healing. Presents with muscle weakness of upper
thigh, Loss of internal rotation, abduction and decreased ROM or pain in
hip.
17. Osgood-Schlatter - correct-answers-Inflammation of bony outgrowth of
the anterior tibial tubercle/ painful lump below the knee cap. More
common in boys than girls and usually occurs in puberty.
18. What are the presenting symptoms of patellar tendonitis? - correct-
answers-Pain is the first symptom of patellar tendinitis. The pain usually
is located in the section of your patellar tendon between your kneecap
(patella) and the area where the tendon attaches to your shinbone
(tibia).
19. The pain in your knee may:
