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Physical Assessment > Chapter 23, Module 6; UE Limb Pain > Flashcards

Chapter 23, Module 6; UE Limb Pain Flashcards

1
Q

DESCRIPTION: Have patient supinate forearm against resistance.

A

Yergason test

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2
Q

FINDINGS: A positive test produces pain in bicipital groove and is suggestive of bicipital tendinitis.

A

Yergason test

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3
Q

DESCRIPTION: Ask patient to externally rotate and abduct shoulder.

A

Rotator cuff tear

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4
Q

FINDINGS: In a partial tear, patient can raise arm but cannot maintain position against resistance; in a complete tear, attempts to abduct arm will produce a shoulder shrug.

A

Rotator cuff tear

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5
Q

DESCRIPTION: Have patient resist forearm supination with elbow flexed 90 degrees.

A

Tennis elbow

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6
Q

FINDINGS: Pain with this movement indicates lateral humeral epicondylitis.

A

Tennis elbow

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7
Q

DESCRIPTION: Have patient flex fingers over a clenched thumb; then passively deviate wrist ulnarly.

A

Finkelstein test

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8
Q

FINDINGS: Movement produces pain in de Quervain disease (first dorsal compartment tenosynovitis).

A

Finkelstein test

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9
Q

DESCRIPTION: Tap over median nerve (palmar surface of wrist) to assess for compression neuropathy.

A

Tinel sign

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10
Q

FINDINGS: In a positive test, patient reports a tingling or prickling sensation distal to site tapped along first three digits, wrist pain, and weak grip.

A

Tinel sign

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11
Q

DESCRIPTION: Ask patient to maintain palmar flex¬ ion for 1 min with dorsal surfaces of each hand pressed together.

A

Phalen test

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12
Q

FINDINGS: Test is positive if maneuver produces numbness and paresthesia in fingers innervated by median nerve.

A

Phalen test

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13
Q

Repetitive trauma activities; pain with movement

A

Tenosynovitis (tendinitis)

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14
Q

Swelling over tendon, crepitus

A

Tenosynovitis (tendinitis)

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15
Q

DIAGNOSTIC STUDIES OF Tenosynovitis (tendinitis)?

A

None

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16
Q

History of overuse; aching pain over affected bursae that radiates along limb

A

Bursitis

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17
Q

Local tenderness, swelling; limited joint motion; muscle weakness

A

Bursitis

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18
Q

DIAGNOSTIC STUDIES OF Bursitis?

A

None

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19
Q

Pain in trigger sites throughout body, joint stiffness, disturbed sleep

A

Fibrositis

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20
Q

Fatty, fibrous nodules in muscles; palpation of trigger points elicits pain

A

Fibrositis

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21
Q

DIAGNOSTIC STUDIES OF Fibrositis?

A

None

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22
Q

Presentation depends on age, location of infection; history of infection, trauma, penetration, invasive procedure; refusal to bear weight (hip); constant pain

A

Osteomyelitis

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23
Q

Fever, chills, vomiting; pain localized over affected area but progressively worsens; soft tissue injury or abscess

A

Osteomyelitis

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24
Q

DIAGNOSTIC STUDIES OF Osteomyelitis?

A

Increased WBCs, ESR, CRP; radiographs

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25
Older  adults;  asymmetrical  joint pain  and  stiffness  that  improves throughout  day;  history  of repetitive  joint  trauma;  obesity
Osteoarthritis
26
DIP,  PIP  joints  enlarged; Heberden  nodes;  limited cervical  spine  ROM
Osteoarthritis
27
DIAGNOSTIC  STUDIES OF Osteoarthritis?
ESR;  radiograph  may reveal  osteophytes, loss  of  joint  space
28
Morning  stiffness  of  small  joints; symmetrical  involvement; anorexia,  weight  loss
Rheumatoid  arthritis
29
Fever,  rheumatoid  nodules, ulnar  deviation  of  wrists
Rheumatoid  arthritis
30
DIAGNOSTIC  STUDIES OF Rheumatoid  arthritis?
Increased  ESR, positive  rheumatoid factor,  anemia  on CBC  count;  radio¬ graph  shows  bony erosion
31
History  of  systemic  infection,  malaise,  diaphoresis,  refusal  to  bear weight  (hip),  acute  joint  pain
Septic  arthritis
32
Fever;  red,  swollen  joint; limited  range  of  motion
Septic  arthritis
33
DIAGNOSTIC  STUDIES OF Septic  arthritis?
WBCs, culture  of  joint aspirate,  ESR,  CRP, ultrasound  of  joint
34
History  of  trauma,  pain
Shoulder  dislocation
35
Limited  rotation,  arm abduction,  and  hand supination
Shoulder  dislocation
36
DIAGNOSTIC  STUDIES OF Shoulder  dislocation?
Radiograph  of  shoulder with  AP  view  and internal/external rotation
37
History  of  trauma,  pain
Acromioclavicular joint  injury
38
Limited  shoulder  movement;  obvious  deformity
Acromioclavicular joint  injury
39
DIAGNOSTIC  STUDIES OF Acromioclavicular joint  injury
Radiograph  of  shoulder with  AP  view  and internal/external rotation
40
History  of  overuse  of  biceps;  pain worse  with  movement
Bicipital  tendinitis
41
Positive  Yergason  test;  pain localized  over  intertubercular  groove
Bicipital  tendinitis
42
DIAGNOSTIC  STUDIES OF Bicipital  tendinitis?
Radiograph  (Fisk view)
43
Acute:  younger  people,  history  of trauma,  severe  pain;  chronic: older,  pain  worse  with  overhead movement,  sleep  disturbance
Rotator  cuff  tear
44
Acute:  inability  to  raise  arm laterally,  shrug  shoulders; chronic:  tenderness  over AC  joint,  crepitus,  weakness  in  external  shoulder rotation
Rotator  cuff  tear
45
DIAGNOSTIC  STUDIES OF Rotator  cuff  tear?
Radiograph  may reveal  humeral displacement or  spurs;  MRI
46
Repetitive  motion  of  or  pressure  to elbow;  localized  pain
Olecranon  bursitis
47
Warmth,  redness,  and  swelling  over  joint;  full  ROM
Olecranon  bursitis
48
DIAGNOSTIC  STUDIES OF Olecranon  bursitis?
Radiograph  to  rule out  fracture  of olecranon  process
49
History  of  repetitive  contraction  of extensor  and  supinator  muscles; pain  over  lateral  epicondyle  that progresses
Lateral  humeral epicondylitis
50
Tenderness  over  lateral  epicondyle;  palpation  produces  pain,  motion  does not;  supination  against resistance  worsens  pain
Lateral  humeral epicondylitis
51
DIAGNOSTIC  STUDIES OF Lateral  humeral epicondylitis?
NONE
52
Occurs  in  children;  pain  in  elbow or  arm
Subluxation  of  radial head
53
Affected  arm  is  flexed;  child cries  when  attempts  are made  to  move  joint
Subluxation  of  radial head
54
DIAGNOSTIC  STUDIES OF Subluxation  of  radial head?
Radiograph  of  elbow
55
History  of  fall  on  an  outstretched hand;  pain  and  swelling  of forearm  and  wrist
Wrist  fracture
56
Palpation  of  snuffbox  increases  pain;  observe  for joint  deformity
Wrist  fracture
57
DIAGNOSTIC  STUDIES OF Wrist  fracture?
Three-view  radiographs  to  determine scaphoid  or  Collies fracture
58
History  of  trauma  or  fall,  joint tenderness
Finger  fracture
59
Joint  swelling,  instability
Finger  fracture
60
DIAGNOSTIC  STUDIES OF Finger  fracture?
 Three-view  radiographs  (PA,  lateral, and  oblique)
61
Noticeable  lump  on  dorsal  surface of  wrist
Ganglion
62
Gelatinous  filled  nodule, soft,  transilluminates
Ganglion
63
DIAGNOSTIC  STUDIES OF Ganglion?
None
64
History  of  upper  respiratory  tract infection;  malaise,  chills,  cold symptoms,  general  muscle  aches
Viral  infections
65
Fever,  ill-appearing  adult  or child
Viral  infections
66
DIAGNOSTIC  STUDIES OF Viral  infections?
Viral  serum  titer
67
Diffuse  pain;  varies  in  pattern of  activity,  setting;  history of  depression  or  anxiety
Psychogenic
68
Normal  examination  or  patient  response  to  examination  maneuvers  disproportionate  to  physical findings  or  subjective complaints
Psychogenic
69
DIAGNOSTIC  STUDIES OF Psychogenic?
None
70
Female  20-50  yr  old;  history  of depression,  sleep  disturbance, chronic  fatigue,  general  muscle and  joint  aches
Fibromyalgia
71
Palpation  of  trigger  points will  produce  pain;  normal physical  examination
Fibromyalgia
72
DIAGNOSTIC  STUDIES OF Fibromyalgia?
none
73
African  American,  family  history; appears  after  age  6  mo;  acute pain  with  swelling  of  hands  and feet,  abdominal  pain,  decreased appetite,  malaise
Sickle  cell  disease
74
Normal  examination
Sickle  cell  disease
75
DIAGNOSTIC  STUDIES OF Sickle  cell  disease?
Hemoglobin  S genotype
76
Female;  transient  arthritis  of  small joints,  malar  rash
Systemic  lupus erythematosus
77
Normal  examination  may have  joint  tenderness  on palpation
Systemic  lupus erythematosus
78
DIAGNOSTIC  STUDIES OF Systemic  lupus erythematosus?
Kidney  function  tests, antinuclear  anti¬ body,  CBC
79
History  of  sleeping  with  arm against  head;  morning  shoulder pain;  pain  worse  with  lifting; paresthesia,  weakness,  or clumsiness  of  hand;  symptoms worse  at  night
Thoracic  outlet syndrome
80
Bruit  over  supraclavicular fossa;  pallor,  decreased pulses  of  upper  extremity,  weakness,  skin  and nail  atrophy
Thoracic  outlet syndrome
81
DIAGNOSTIC  STUDIES OF Thoracic  outlet syndrome?
None
82
History  of  repetitive  upper  extremity motion;  paresthesia,  weakness, or  clumsiness  of  hand;  symptoms  worse  at  night
Carpal  tunnel syndrome
83
Positive  Phalen  test  and Tinel  sign;  weakness  of hand;  dry  skin  over  distribution  of  median  nerve
Carpal  tunnel syndrome
84
DIAGNOSTIC  STUDIES OF Carpal  tunnel syndrome?
none

Physical Assessment (27 decks)

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