TEST BANK FOR ADVANCED ASSESSMENT
INTERPRETING FINDINGS AND FORMULATING
DIFFERENTIAL DIAGNOSES, 4TH EDITION,
MARY JO GOOLSBY, LAURIE GRUBBS EXAM
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YOUR EXAMS
Chapter 1: Clinical reasoning, differential diagnosis, evidence-based practice, and symptom ana
Multiple Choice
Identify the choice that best completes the statement or answers the question.
Drop arm test
To test for a tear of the rotator cuff you would perform this test. Which is if the arm is passively abducted at the
shoulder, the person is unable to sustain the position and the arm falls to the side.
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Adhesive capsulitis
This is the name for "Frozen Shoulder"
Adhesive capsulitis
This is when fibrous tissues form in the joint capsule, causing stiffness, progressive limitation of motion and pain. Motion
limited in abduction and external rotation, unable to reach overhead. May lead to atrophy of shoulder girdle muscles.
Gradual onset and unknown cause.
adhesive capsulitis
This is associated with prolonged bed rest or shoulder immobility. May resolve spontaneously and has a gradual onset.
Cause unknown.
subacromial bursitis
This is when inflammation and swelling of subacromial bursa over the shoulder cause limited ROM and pain with motion.
Localized swelling under deltoid muscle may increase by partial passive abduction of the arm.
subacromial bursitis
This is caused by direct trauma, strain during sports, local or systemic inflammatory process, or repetitive motion with
injury.
olecranon bursitis
This is a large, soft known, or "goose egg" and redness from inflammation of olecranon bursa. Localized and easy to see
because bursa lies just under skin.
Gouty arthritis
This is joint effusion or synovial thickening, seen first as bulge or fullness in grooves on either side of olecranon process.
Redness and heat can extend beyond area of synovial membrane. Soft, boggy, or fluctuant fullness to palpation. Limited
extension of elbow
subcutaneous nodules
These are raised, firm, nontender nodules that occur with rheumatoid arthritis. Common sites are in the olecranon bursa
and along extensor surface of arm. The skin slides freely over the nodules.
epicondylitis
This is the name for tennis elbow
epicondylitis
This is chronic disabling pain at lateral epicondlye of humerus, radiates down extensor surface of forearm. Pain can be
located with one finger. Resisting extension of the hand will increase the pain.
epicondylitis
This occurs with activities combining excessive pronation and supination of forearm with an extended wrist. F/E racquet
sports or using a screwdriver.
medial
_____ epicondylitis is rarer and is due to activity of forced palmar flexion of wrist against resistance
ganglion cyst
This is a round, cystic, nontender nodule overlying a tendon sheath or joint capsule, usually on dorsum of wrist. Flexion
makes it more prominent. A common benign tumor, it does not become malignant.
carpal tunnel syndrome
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This is chronic repetitive motion, and occurs between 30 and 60 years of age. It is five times more common in women in
men. Symptoms include pain, burning, and numbness, positiving findings on Phalen test, positive indication of Tinel sign,
and often atrophy of thenar muscles.
carpal tunnel syndrome
Positive Phalen test and indication of Tinel sign indicate what?
ankylosis
This is the wrist in extreme flexion, due to severe rheumatoid arthritis. It is a functionally useless hand because when the
wrist is palmar flexed, a good deal of power is lost from the fingers, and the thumb cannot oppose the fingers.
dupuytren contracture
Chronic hyperplasia of the palmar fascia causes flexion contractures of the digits, first in teh 4th digit, then the 5th digit,
and then the 3rd digit. Note the bands that extend from the midpalm to the digits and the puckering if palmar skin.
dupuytren contracture
This condition occurs commonly in men older than 40 years and is usually bilateral. It occurs with diabetes, epilepsy, and
alcoholic liver disease and as an inherited trait. The contracture is painless but impairs hand function
colles fracture
This is a nonarticular fracture of distal radius, with or without fracture of ulna at styloid process. Usually from a fall on an
outstreched hand, occurs more often in older women. Wrist looks puffy with "silver fork" deformity, a characteristic
hump when viewed from the side.
swan's neck
Flexion contracture resembles curve of a ____ ___. Note flexion contracture of metacarpophalangeal joint, then
hyperextension of the proximal interphalangeal joint, and flexion of the distal interphalangeal joint. It occurs with chronic
rheumatoid arthritis and is often accompanied by ulnar drift of the fingers.
boutonniere deformity
This is when the knuckle looks as if it is being pushed through a button hole. It is a relatively common deformity and
includes flexion of proximal interphalangeal joint with compensatory hyperextension of distal interphalangeal joint.
ulnar deviation or drift
This is when fingers drift to the ulnar side because of stretching of the articular capsule and muscle imbalance. also note
subluxation and swelling in the joints and muscle atrophy on the dorsa of the hands. This is caused by chronic
rheumatoid arthritis.
Rheumatoid Arthritis
This is a chronic systemic inflammatory disease of joints and surrounding connective tissue. Inflammation of synovial
membrane leads to thickening; then fibrosis, which limits motion; and finally bony ankylosis.
Rheumatoid Arthritis
This disorder is symmetric and bilateral and is characterized by heat, redness, swelling, and painful motion of the
affected joints. It is associated with fatigue, weakness, anorexia, weight loss, low grade fever, and lymphadenopathy.
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Ankylosing Spondylitis
This is chronic, progressive inflammation of spine, sacroiliac, and larger joints of the extremities, leading to bony
ankylosis and deformity. This is a form of Rheumatoid Arthritis that affects primarily men by a 1-:1 ratio, in late
adolescence or early adulthood.
Ankylosing Spondylitis
This spasm of paraspinal muscles pulls spine into forward flexion, obliteration cervical and lumbar curves. Thoracic curve
exaggerated into single kyphotic rounding . Also includes flexion deformities of hips and knees.
Osteoarthritis
This is a noninflammatory, localized, progressive disorder involving deterioration of articular cartilages and subchondral
bone and formation of new bone at joint surfaces. Aging increases incidence, nearly all adults older than 60 have some
radiographic signs of this.
Osteoarthritis
In this disorder asymmetric joint involvement commonly affects hands, knees, hips, and lumbar and cervical segments of
the spine. Affected joints hve stifness, swelling, with hard, bony protuberances, pain with motion, and limitation of
motion.
Osteoporosis
This is a decrease in skeletal bone mass occurring when rate of bone resorption is greater than that of bone formation.
Osteoporosis
This is when the weakened bone state increases risk for stress fractures, especially at wrist, hip, and vertebrae. Occurs
primarily in post menopausal white women. Risk for this is also associated with smaller height and weight, younger age at
menopause, lack of physical activity, and lack of estrogen in women.
Atrophy
This is loss of muscle mass and is exhibited as a lack of fullness surrounding the deltoid muscle. It can also occur from
disuse, muscle tissue damage, or motor nerve damage.
Dislocated shoulder
This is exhibited when hunching the shoulder forward and the top of the clavicle dislocates. It occurs with trauma
involving abduction, extension, and rotation.
dislocated shoulder
This could occur when you fall on an outstretched arm or diving into a pool
joint effusion
This is swelling from excess fluid in the joint capsule. Best observed anteriorly. Fluctuant to palpation. Considerable fluid
must be present to cause a visible distention because the capsule normally is so loose.
tear of rotator cuff
Characteristic "hunched" position and limited abduction of arm. Occurs from traumatic adduction while arm is held in
abduction, or from fall on shoulder, throwing , or heavy lifting
osteoarthritis
Name for degenerative joint disease
osteoarthritis
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