NR 511 final
What is a sprain? - (correct Answer) - stretching or tearing of ligaments, occur when joint is forced
beyond its normal limits
What is a first degree sprain? - (correct Answer) - stretching of ligamentous fibers
what is a second degree sprain? - (correct Answer) - partial tear of part of the ligament with pain and
swelling
what is a a third degree sprain? - (correct Answer) - complete tear of ligament
What diagnostic testing should be completed with a sprain? - (correct Answer) - xray to r/o fx
what are s/s of a sprain? - (correct Answer) - acute pain and swelling after a sudden injury. Usually gets
worse over a few hours with redness, swelling and bruising.
what occurs to active and passive ROM with a sprain? - (correct Answer) - it is usually decreased
what is a strain? - (correct Answer) - a muscle injury, caused by excessive tensile stress placed on a
muscle. Results in stiffness and decreased function
what occurs with severe strains? - (correct Answer) - effects muscle or tendon that connects muscle to a
bone. causes inflammation, swelling, weakness and loss of function, may need surgery
How do you manage sprains/strains? - (correct Answer) - PRICE- protect, rest, ice, compression, elevation
limit activity, PT, NSAIDS, referral to ortho
What is a dislocation? - (correct Answer) - complete separation of two bone that form a joint
what are s/s of dislocation? - (correct Answer) - very painful, cause immobility, needs immediate medical
attention
what is the tx for dislocation? - (correct Answer) - referral to ortho for possible surgery or reduction, with
application of cast or splint
what are the cardinal signs of inflammation? - (correct Answer) - swelling, erythema, warmth, pain
what is cervical spondylosis? - (correct Answer) - neck stiffness, mild aching discomfort with activity
what are s/s of cervical spondylosis? - (correct Answer) - Pain and limited ROM occurs with lateral
rotation and lateral flexion of the neck toward the affected side. Weakness shoulder abduction-C5, bicep
weakness-C6, triceps weakness-C7, myelopathy leg weakness
what cervical disc would be associated with weakness on shoulder abduction? - (correct Answer) - C5
what cervical disc would be associated with bicep weakness? - (correct Answer) - C6
,what cervical disc would be associated with tricep weakness? - (correct Answer) - C7
what would leg weakness, gait disturbance, balance problems, difficulty performing motor tasks and loss
of bowel and bladder indicate? - (correct Answer) - myelopathy
What is the treatment for cervical spondylosis? - (correct Answer) - cervical traction, PT, pain relievers,
what is the treatment for myelopathy? - (correct Answer) - surgery
what is a test for low back pain? - (correct Answer) - straight leg test
what is the treatment for low back pain? - (correct Answer) - NSAIDS, muscle relaxants, opioids, surgery,
self-care, spinal manipulation
what is the straight leg test? - (correct Answer) - 1. place pt. in supine position
2. grasp heel of leg being tested and raise leg by flexing hip
3. asses for pain or reproduction of sx before end of normal ROM (70 *)
What is stenosis? - (correct Answer) - -pseudo claudication causing radicular pain in the calves, buttocks,
upper thighs of one or both legs
how do sx progress in stenosis? - (correct Answer) - proximal to distal direction
what aggravates and relieves pain in stenosis? - (correct Answer) - walking or prolonged standing causes
pain and weakness in buttocks and legs
stooping over helps relieve pain
What test can be done to assess for stenosis? - (correct Answer) - -Romberg test-have pt. stand with
arms next to body or crossed in front of body, have pt. close eyes and see if pt. able to maintain his
balance
-reflexes diminished
-with bowel and bladder sx, sphincter tone may be decreased
how do you treat stenosis? - (correct Answer) - surgical decompression, NSAIDS, folic acid, vitamin B12,
PT flexing the spine, bicycling
-weight loss especially intra-abdominal helpful
-exercise on all fours, arching the back, fetal position
what exercises should be avoided with stenosis? - (correct Answer) - ones which extend the spin
(swayback)
How do you treat cauda equina syndrome? - (correct Answer) - medical emergency! Should go to ER,
surgical lumbar decompression is necessary
, What is the sx of cauda equina syndrome? - (correct Answer) - low back pain with acute onset of urinary
incontinence or overflow incontinence, loss of anal sphincter tone or fecal incontinence, loss of
sensation in buttocks or perineum, and motor weakness in lower extremities, perianal numbness
What test can be done to assess neck pain? - (correct Answer) - Spurling
What is the Spurling test? - (correct Answer) - Tests neck compression,
1. have pt.'s neck in extension, rotate neck to affected side, apply downward pressure on the head,
assess pt. for c/o accentuation of limb pain or paresthesia--> positive finding
also observe for atrophy of neck
What test can be done to assess for shoulder pain? - (correct Answer) - apley scratch test
How do you do conduct the apley scratch test? - (correct Answer) - -measures abduction and external
rotation
-have pt. reach behind head and touch superior aspect of opposite scapula
-internal rotation and adduction of shoulder tested by pt. reaching behind back and touch inferior aspect
of opposite scapula
What is pain with shoulder abduction a sign of? - (correct Answer) - early supraspinatus tendinitis, and
sub acromial bursitis= early rotator cuff injuries
What test is done to the wrist and hands? - (correct Answer) - Allen's test
What is the Allen's test? - (correct Answer) - Tests the patency of the radial and ulnar arteries
-compress radial artery at the wrist and have pt. rapidly open and close hand several times. Have pt.
open hand (should be white). Release pressure and hand should flush (patency)
What is the phalens test used for? - (correct Answer) - assesses median nerve compression (carpal
tunnel syndrome)
How do you perform the phalens test? - (correct Answer) - Have pt. maintain forced flexion of wrist for
one minute or more with dorsal surfaces of each hand pressed together. If pt. c/o numbness and
paresthesia in gingers the test is positive
What is the Tinel's sign used for? - (correct Answer) - Compression neuropathy
How do you assess for the Tinel's sign? - (correct Answer) - Percuss the median nerve of the wrist. If the
patient c/o tingling in fingers the test is positive (compression at site of percussion likely--carpal tunnel
syndrome)
What does Finkelstein's test test for? - (correct Answer) - DeQuervain's Tenosynovitis
What is a sprain? - (correct Answer) - stretching or tearing of ligaments, occur when joint is forced
beyond its normal limits
What is a first degree sprain? - (correct Answer) - stretching of ligamentous fibers
what is a second degree sprain? - (correct Answer) - partial tear of part of the ligament with pain and
swelling
what is a a third degree sprain? - (correct Answer) - complete tear of ligament
What diagnostic testing should be completed with a sprain? - (correct Answer) - xray to r/o fx
what are s/s of a sprain? - (correct Answer) - acute pain and swelling after a sudden injury. Usually gets
worse over a few hours with redness, swelling and bruising.
what occurs to active and passive ROM with a sprain? - (correct Answer) - it is usually decreased
what is a strain? - (correct Answer) - a muscle injury, caused by excessive tensile stress placed on a
muscle. Results in stiffness and decreased function
what occurs with severe strains? - (correct Answer) - effects muscle or tendon that connects muscle to a
bone. causes inflammation, swelling, weakness and loss of function, may need surgery
How do you manage sprains/strains? - (correct Answer) - PRICE- protect, rest, ice, compression, elevation
limit activity, PT, NSAIDS, referral to ortho
What is a dislocation? - (correct Answer) - complete separation of two bone that form a joint
what are s/s of dislocation? - (correct Answer) - very painful, cause immobility, needs immediate medical
attention
what is the tx for dislocation? - (correct Answer) - referral to ortho for possible surgery or reduction, with
application of cast or splint
what are the cardinal signs of inflammation? - (correct Answer) - swelling, erythema, warmth, pain
what is cervical spondylosis? - (correct Answer) - neck stiffness, mild aching discomfort with activity
what are s/s of cervical spondylosis? - (correct Answer) - Pain and limited ROM occurs with lateral
rotation and lateral flexion of the neck toward the affected side. Weakness shoulder abduction-C5, bicep
weakness-C6, triceps weakness-C7, myelopathy leg weakness
what cervical disc would be associated with weakness on shoulder abduction? - (correct Answer) - C5
what cervical disc would be associated with bicep weakness? - (correct Answer) - C6
,what cervical disc would be associated with tricep weakness? - (correct Answer) - C7
what would leg weakness, gait disturbance, balance problems, difficulty performing motor tasks and loss
of bowel and bladder indicate? - (correct Answer) - myelopathy
What is the treatment for cervical spondylosis? - (correct Answer) - cervical traction, PT, pain relievers,
what is the treatment for myelopathy? - (correct Answer) - surgery
what is a test for low back pain? - (correct Answer) - straight leg test
what is the treatment for low back pain? - (correct Answer) - NSAIDS, muscle relaxants, opioids, surgery,
self-care, spinal manipulation
what is the straight leg test? - (correct Answer) - 1. place pt. in supine position
2. grasp heel of leg being tested and raise leg by flexing hip
3. asses for pain or reproduction of sx before end of normal ROM (70 *)
What is stenosis? - (correct Answer) - -pseudo claudication causing radicular pain in the calves, buttocks,
upper thighs of one or both legs
how do sx progress in stenosis? - (correct Answer) - proximal to distal direction
what aggravates and relieves pain in stenosis? - (correct Answer) - walking or prolonged standing causes
pain and weakness in buttocks and legs
stooping over helps relieve pain
What test can be done to assess for stenosis? - (correct Answer) - -Romberg test-have pt. stand with
arms next to body or crossed in front of body, have pt. close eyes and see if pt. able to maintain his
balance
-reflexes diminished
-with bowel and bladder sx, sphincter tone may be decreased
how do you treat stenosis? - (correct Answer) - surgical decompression, NSAIDS, folic acid, vitamin B12,
PT flexing the spine, bicycling
-weight loss especially intra-abdominal helpful
-exercise on all fours, arching the back, fetal position
what exercises should be avoided with stenosis? - (correct Answer) - ones which extend the spin
(swayback)
How do you treat cauda equina syndrome? - (correct Answer) - medical emergency! Should go to ER,
surgical lumbar decompression is necessary
, What is the sx of cauda equina syndrome? - (correct Answer) - low back pain with acute onset of urinary
incontinence or overflow incontinence, loss of anal sphincter tone or fecal incontinence, loss of
sensation in buttocks or perineum, and motor weakness in lower extremities, perianal numbness
What test can be done to assess neck pain? - (correct Answer) - Spurling
What is the Spurling test? - (correct Answer) - Tests neck compression,
1. have pt.'s neck in extension, rotate neck to affected side, apply downward pressure on the head,
assess pt. for c/o accentuation of limb pain or paresthesia--> positive finding
also observe for atrophy of neck
What test can be done to assess for shoulder pain? - (correct Answer) - apley scratch test
How do you do conduct the apley scratch test? - (correct Answer) - -measures abduction and external
rotation
-have pt. reach behind head and touch superior aspect of opposite scapula
-internal rotation and adduction of shoulder tested by pt. reaching behind back and touch inferior aspect
of opposite scapula
What is pain with shoulder abduction a sign of? - (correct Answer) - early supraspinatus tendinitis, and
sub acromial bursitis= early rotator cuff injuries
What test is done to the wrist and hands? - (correct Answer) - Allen's test
What is the Allen's test? - (correct Answer) - Tests the patency of the radial and ulnar arteries
-compress radial artery at the wrist and have pt. rapidly open and close hand several times. Have pt.
open hand (should be white). Release pressure and hand should flush (patency)
What is the phalens test used for? - (correct Answer) - assesses median nerve compression (carpal
tunnel syndrome)
How do you perform the phalens test? - (correct Answer) - Have pt. maintain forced flexion of wrist for
one minute or more with dorsal surfaces of each hand pressed together. If pt. c/o numbness and
paresthesia in gingers the test is positive
What is the Tinel's sign used for? - (correct Answer) - Compression neuropathy
How do you assess for the Tinel's sign? - (correct Answer) - Percuss the median nerve of the wrist. If the
patient c/o tingling in fingers the test is positive (compression at site of percussion likely--carpal tunnel
syndrome)
What does Finkelstein's test test for? - (correct Answer) - DeQuervain's Tenosynovitis
