2
MUSCULOSKELETAL PAIN - DR. MURPHY Exam || || || || || ||
4 Ch 14-18 questions with accurate detailed
|| || || || || || ||
answers
1. The most common sites of referred pain from systemic diseases are
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a. neck and back.
|| || ||
b. shoulder and back.
|| || ||
c. chest and back.
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d. None of the above. - ✔✔B
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2. To screen for back pain caused by systemic disease
|| || || || || || || || ||
a. perform special tests (e.g., Murphy's percussion, Bicycle test).
|| || || || || || || ||
b. correlate client history with clinical presentation and ask about associated signs and symptoms.
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c. perform a review of systems.
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d. All of the above. - ✔✔D
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3. What are the two ways of classifying back pain (as presented in the text)? - ✔✔Back pain can
|| || || || || || || || || || || || || || || || || || ||
be examined and classified in many ways. We have presented Sources of Back Pain (e.g., visceral,
|| || || || || || || || || || || || || || ||
neurogenic, vasculogenic, spondylogenic, psychogenic, neoplasm; see Table 3-3) and Location of
|| || || || || || || || || || ||
Back Pain (e.g., cervical spine, scapula, thoracic spine, lumbar spine, sacrum, sacroiliac; see
|| || || || || || || || || || || || || ||
Table 14-1). ||
4. Which statement is the most accurate?
|| || || || || ||
a. Arterial disease is characterized by intermittent claudication, pain relieved by elevating the
|| || || || || || || || || || || || ||
extremity, and history of smoking. || || || ||
,2
b. Arterial disease is characterized by loss of hair on the lower extremities, throbbing pain in the
|| || || || || || || || || || || || || || || || ||
calf muscles that goes away by using heat and elevation.
|| || || || || || || || ||
c. Arterial disease is characterized by painful throbbing of the feet at night that goes away by
|| || || || || || || || || || || || || || || || ||
dangling the feet over the bed. || || || || ||
d. Arterial disease is characterized by loss of hair on the toes, intermittent claudication, and
|| || || || || || || || || || || || || || ||
redness or warmth of the legs that is accompanied by a burning sensation. - ✔✔(C) Answer (A) is
|| || || || || || || || || || || || || || || || ||
not correct because pain from arterial disease is not relieved by elevating the extremity; (B) is not
|| || || || || || || || || || || || || || || || || ||
correct for the same reason; (D) is not correct because arterial disease is characterized by cold
|| || || || || || || || || || || || || || || ||
skin temperature and pallor caused by the lack of oxygen and blood flow to the lower extremities;
|| || || || || || || || || || || || || || || || ||
venous disease is characterized by redness or warmth caused by blood that gets pooled in the
|| || || || || || || || || || || || || || || ||
lower extremities and cannot return centrally because of valve insufficiency.
|| || || || || || || || ||
5. Pain associated with pleuropulmonary disorders can radiate to
|| || || || || || || ||
a. anterior neck.
|| ||
b. upper trapezius muscle.
|| || ||
c. ipsilateral shoulder.
|| ||
d. thoracic spine.
|| ||
e. All of the above. - ✔✔. (E) Pain associated with pulmonary disorders can occur anywhere over
|| || || || || || || || || || || || || || || || ||
the lung fields (see Fig. 7-1), with the possibility of additional referral to the neck and shoulder on
|| || || || || || || || || || || || || || || || ||
the involved side(s).
|| || ||
6. Which of the following are clues to the possible involvement of the GI system?
|| || || || || || || || || || || || || ||
a. Abdominal pain alternating with TMJ pain within a 2-week period of time.
|| || || || || || || || || || || ||
b. Abdominal pain at the same level as back pain occurring either simultaneously or alternately.
|| || || || || || || || || || || || || ||
c. Shoulder pain alleviated by a bowel movement.
|| || || || || || ||
d. All of the above. - ✔✔(B) Temporomandibular joint (TMJ) pain is possible with cardiac
|| || || || || || || || || || || || || || ||
involvement but not likely with gastrointestinal disease; pain alleviated by a bowel movement || || || || || || || || || || || || ||
usually occurs with disease of the colon, which does not refer pain to the shoulder unless massive
|| || || || || || || || || || || || || || || || ||
retroperitoneal bleeding occurs, in which case, earlier symptoms of pain, bowel distention, and || || || || || || || || || || || || ||
blood in the stools would prevail.
|| || || || ||
, 2
7. Percussion of the costovertebral angle resulting in the reproduction of symptoms signifies
|| || || || || || || || || || || ||
a. radiculitis.
||
b. pseudorenal pain.
|| ||
c. has no significance.
|| || ||
d. medical referral is advised. - ✔✔(D) A positive Murphy's percussion test for renal disease is
|| || || || || || || || || || || || || || || ||
suspected; Murphy's percussion should be negative in the presence of pain and symptoms caused
|| || || || || || || || || || || || || ||
by radiculitis or pseudorenal pain from any cause.
|| || || || || || ||
8. A 53-year-old female comes to physical therapy with a report of leg pain that begins in her
|| || || || || || || || || || || || || || || || || ||
buttocks and goes all the way down to her toes. If this pain is of a vascular origin, she will most
|| || || || || || || || || || || || || || || || || || || || ||
likely describe it as || || ||
a. sore, hurting.
|| ||
b. hot or burning.
|| || ||
c. shooting or stabbing.
|| || ||
d. throbbing, "tired". - ✔✔(D) Vascular pain is often described as "throbbing"; vascular
|| || || || || || || || || || || || ||
claudication may be described as "aching" or "cramping" or "tired," but this could be caused by
|| || || || || || || || || || || || || || || ||
the aggravating factors (increases with physical exertion, promptly relieved by resting); remains
|| || || || || || || || || || || ||
unchanged regardless of the position of the spine. || || || || || || ||
Neurogenic pain may be described as hot or burning, stabbing, shooting, or tingling. Look for
|| || || || || || || || || || || || || || ||
other neurologic changes; perform the bicycle test. Pain increased by spinal extension and
|| || || || || || || || || || || || ||
relieved by spinal flexion is a positive sign of neurologic involvement.
|| || || || || || || || || ||
Muscular pain is often described as dull, sore, aching, and hurting; palpate for myalgia and trigger
|| || || || || || || || || || || || || || ||
points, and perform resistive muscle testing.
|| || || || || ||
9. Twenty-five percent of the people with GI disease, such as Crohn's disease (regional enteritis),
|| || || || || || || || || || || || || || ||
irritable bowel syndrome, or bowel obstruction, have concomitant back or joint pain.
|| || || || || || || || || || ||
a. True
||
MUSCULOSKELETAL PAIN - DR. MURPHY Exam || || || || || ||
4 Ch 14-18 questions with accurate detailed
|| || || || || || ||
answers
1. The most common sites of referred pain from systemic diseases are
|| || || || || || || || || || ||
a. neck and back.
|| || ||
b. shoulder and back.
|| || ||
c. chest and back.
|| || ||
d. None of the above. - ✔✔B
|| || || || || ||
2. To screen for back pain caused by systemic disease
|| || || || || || || || ||
a. perform special tests (e.g., Murphy's percussion, Bicycle test).
|| || || || || || || ||
b. correlate client history with clinical presentation and ask about associated signs and symptoms.
|| || || || || || || || || || || || ||
c. perform a review of systems.
|| || || || ||
d. All of the above. - ✔✔D
|| || || || || ||
3. What are the two ways of classifying back pain (as presented in the text)? - ✔✔Back pain can
|| || || || || || || || || || || || || || || || || || ||
be examined and classified in many ways. We have presented Sources of Back Pain (e.g., visceral,
|| || || || || || || || || || || || || || ||
neurogenic, vasculogenic, spondylogenic, psychogenic, neoplasm; see Table 3-3) and Location of
|| || || || || || || || || || ||
Back Pain (e.g., cervical spine, scapula, thoracic spine, lumbar spine, sacrum, sacroiliac; see
|| || || || || || || || || || || || || ||
Table 14-1). ||
4. Which statement is the most accurate?
|| || || || || ||
a. Arterial disease is characterized by intermittent claudication, pain relieved by elevating the
|| || || || || || || || || || || || ||
extremity, and history of smoking. || || || ||
,2
b. Arterial disease is characterized by loss of hair on the lower extremities, throbbing pain in the
|| || || || || || || || || || || || || || || || ||
calf muscles that goes away by using heat and elevation.
|| || || || || || || || ||
c. Arterial disease is characterized by painful throbbing of the feet at night that goes away by
|| || || || || || || || || || || || || || || || ||
dangling the feet over the bed. || || || || ||
d. Arterial disease is characterized by loss of hair on the toes, intermittent claudication, and
|| || || || || || || || || || || || || || ||
redness or warmth of the legs that is accompanied by a burning sensation. - ✔✔(C) Answer (A) is
|| || || || || || || || || || || || || || || || ||
not correct because pain from arterial disease is not relieved by elevating the extremity; (B) is not
|| || || || || || || || || || || || || || || || || ||
correct for the same reason; (D) is not correct because arterial disease is characterized by cold
|| || || || || || || || || || || || || || || ||
skin temperature and pallor caused by the lack of oxygen and blood flow to the lower extremities;
|| || || || || || || || || || || || || || || || ||
venous disease is characterized by redness or warmth caused by blood that gets pooled in the
|| || || || || || || || || || || || || || || ||
lower extremities and cannot return centrally because of valve insufficiency.
|| || || || || || || || ||
5. Pain associated with pleuropulmonary disorders can radiate to
|| || || || || || || ||
a. anterior neck.
|| ||
b. upper trapezius muscle.
|| || ||
c. ipsilateral shoulder.
|| ||
d. thoracic spine.
|| ||
e. All of the above. - ✔✔. (E) Pain associated with pulmonary disorders can occur anywhere over
|| || || || || || || || || || || || || || || || ||
the lung fields (see Fig. 7-1), with the possibility of additional referral to the neck and shoulder on
|| || || || || || || || || || || || || || || || ||
the involved side(s).
|| || ||
6. Which of the following are clues to the possible involvement of the GI system?
|| || || || || || || || || || || || || ||
a. Abdominal pain alternating with TMJ pain within a 2-week period of time.
|| || || || || || || || || || || ||
b. Abdominal pain at the same level as back pain occurring either simultaneously or alternately.
|| || || || || || || || || || || || || ||
c. Shoulder pain alleviated by a bowel movement.
|| || || || || || ||
d. All of the above. - ✔✔(B) Temporomandibular joint (TMJ) pain is possible with cardiac
|| || || || || || || || || || || || || || ||
involvement but not likely with gastrointestinal disease; pain alleviated by a bowel movement || || || || || || || || || || || || ||
usually occurs with disease of the colon, which does not refer pain to the shoulder unless massive
|| || || || || || || || || || || || || || || || ||
retroperitoneal bleeding occurs, in which case, earlier symptoms of pain, bowel distention, and || || || || || || || || || || || || ||
blood in the stools would prevail.
|| || || || ||
, 2
7. Percussion of the costovertebral angle resulting in the reproduction of symptoms signifies
|| || || || || || || || || || || ||
a. radiculitis.
||
b. pseudorenal pain.
|| ||
c. has no significance.
|| || ||
d. medical referral is advised. - ✔✔(D) A positive Murphy's percussion test for renal disease is
|| || || || || || || || || || || || || || || ||
suspected; Murphy's percussion should be negative in the presence of pain and symptoms caused
|| || || || || || || || || || || || || ||
by radiculitis or pseudorenal pain from any cause.
|| || || || || || ||
8. A 53-year-old female comes to physical therapy with a report of leg pain that begins in her
|| || || || || || || || || || || || || || || || || ||
buttocks and goes all the way down to her toes. If this pain is of a vascular origin, she will most
|| || || || || || || || || || || || || || || || || || || || ||
likely describe it as || || ||
a. sore, hurting.
|| ||
b. hot or burning.
|| || ||
c. shooting or stabbing.
|| || ||
d. throbbing, "tired". - ✔✔(D) Vascular pain is often described as "throbbing"; vascular
|| || || || || || || || || || || || ||
claudication may be described as "aching" or "cramping" or "tired," but this could be caused by
|| || || || || || || || || || || || || || || ||
the aggravating factors (increases with physical exertion, promptly relieved by resting); remains
|| || || || || || || || || || || ||
unchanged regardless of the position of the spine. || || || || || || ||
Neurogenic pain may be described as hot or burning, stabbing, shooting, or tingling. Look for
|| || || || || || || || || || || || || || ||
other neurologic changes; perform the bicycle test. Pain increased by spinal extension and
|| || || || || || || || || || || || ||
relieved by spinal flexion is a positive sign of neurologic involvement.
|| || || || || || || || || ||
Muscular pain is often described as dull, sore, aching, and hurting; palpate for myalgia and trigger
|| || || || || || || || || || || || || || ||
points, and perform resistive muscle testing.
|| || || || || ||
9. Twenty-five percent of the people with GI disease, such as Crohn's disease (regional enteritis),
|| || || || || || || || || || || || || || ||
irritable bowel syndrome, or bowel obstruction, have concomitant back or joint pain.
|| || || || || || || || || || ||
a. True
||
