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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
Q

Older adults; asymmetrical joint pain and stiffness that improves throughout day; history of repetitive joint trauma; obesity

A

Osteoarthritis

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26
Q

DIP, PIP joints enlarged; Heberden nodes; limited cervical spine ROM

A

Osteoarthritis

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27
Q

DIAGNOSTIC STUDIES OF Osteoarthritis?

A

ESR; radiograph may reveal osteophytes, loss of joint space

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28
Q

Morning stiffness of small joints; symmetrical involvement; anorexia, weight loss

A

Rheumatoid arthritis

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29
Q

Fever, rheumatoid nodules, ulnar deviation of wrists

A

Rheumatoid arthritis

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30
Q

DIAGNOSTIC STUDIES OF Rheumatoid arthritis?

A

Increased ESR, positive rheumatoid factor, anemia on CBC count; radio¬ graph shows bony erosion

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31
Q

History of systemic infection, malaise, diaphoresis, refusal to bear weight (hip), acute joint pain

A

Septic arthritis

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32
Q

Fever; red, swollen joint; limited range of motion

A

Septic arthritis

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33
Q

DIAGNOSTIC STUDIES OF Septic arthritis?

A

WBCs,culture of joint aspirate, ESR, CRP, ultrasound of joint

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34
Q

History of trauma, pain

A

Shoulder dislocation

35
Q

Limited rotation, arm abduction, and hand supination

A

Shoulder dislocation

36
Q

DIAGNOSTIC STUDIES OF Shoulder dislocation?

A

Radiograph of shoulder with AP view and internal/external rotation

37
Q

History of trauma, pain

A

Acromioclavicular joint injury

38
Q

Limited shoulder movement; obvious deformity

A

Acromioclavicular joint injury

39
Q

DIAGNOSTIC STUDIES OF Acromioclavicular joint injury

A

Radiograph of shoulder with AP view and internal/external rotation

40
Q

History of overuse of biceps; pain worse with movement

A

Bicipital tendinitis

41
Q

Positive Yergason test; pain localized over intertubercular groove

A

Bicipital tendinitis

42
Q

DIAGNOSTIC STUDIES OF Bicipital tendinitis?

A

Radiograph (Fisk view)

43
Q

Acute: younger people, history of trauma, severe pain; chronic: older, pain worse with overhead movement, sleep disturbance

A

Rotator cuff tear

44
Q

Acute: inability to raise arm laterally, shrug shoulders; chronic: tenderness over AC joint, crepitus, weakness in external shoulder rotation

A

Rotator cuff tear

45
Q

DIAGNOSTIC STUDIES OF Rotator cuff tear?

A

Radiograph may reveal humeral displacement or spurs; MRI

46
Q

Repetitive motion of or pressure to elbow; localized pain

A

Olecranon bursitis

47
Q

Warmth, redness, and swelling over joint; full ROM

A

Olecranon bursitis

48
Q

DIAGNOSTIC STUDIES OF Olecranon bursitis?

A

Radiograph to rule out fracture of olecranon process

49
Q

History of repetitive contraction of extensor and supinator muscles; pain over lateral epicondyle that progresses

A

Lateral humeral epicondylitis

50
Q

Tenderness over lateral epicondyle; palpation produces pain, motion does not; supination against resistance worsens pain

A

Lateral humeral epicondylitis

51
Q

DIAGNOSTIC STUDIES OF Lateral humeral epicondylitis?

A

NONE

52
Q

Occurs in children; pain in elbow or arm

A

Subluxation of radial head

53
Q

Affected arm is flexed; child cries when attempts are made to move joint

A

Subluxation of radial head

54
Q

DIAGNOSTIC STUDIES OF Subluxation of radial head?

A

Radiograph of elbow

55
Q

History of fall on an outstretched hand; pain and swelling of forearm and wrist

A

Wrist fracture

56
Q

Palpation of snuffbox increases pain; observe for joint deformity

A

Wrist fracture

57
Q

DIAGNOSTIC STUDIES OF Wrist fracture?

A

Three-view radiographs to determine scaphoid or Collies fracture

58
Q

History of trauma or fall, joint tenderness

A

Finger fracture

59
Q

Joint swelling, instability

A

Finger fracture

60
Q

DIAGNOSTIC STUDIES OF Finger fracture?

A

Three-view radiographs (PA, lateral, and oblique)

61
Q

Noticeable lump on dorsal surface of wrist

A

Ganglion

62
Q

Gelatinous filled nodule, soft, transilluminates

A

Ganglion

63
Q

DIAGNOSTIC STUDIES OF Ganglion?

A

None

64
Q

History of upper respiratory tract infection; malaise, chills, cold symptoms, general muscle aches

A

Viral infections

65
Q

Fever, ill-appearing adult or child

A

Viral infections

66
Q

DIAGNOSTIC STUDIES OF Viral infections?

A

Viral serum titer

67
Q

Diffuse pain; varies in pattern of activity, setting; history of depression or anxiety

A

Psychogenic

68
Q

Normal examination or patient response to examination maneuvers disproportionate to physical findings or subjective complaints

A

Psychogenic

69
Q

DIAGNOSTIC STUDIES OF Psychogenic?

A

None

70
Q

Female 20-50 yr old; history of depression, sleep disturbance, chronic fatigue, general muscle and joint aches

A

Fibromyalgia

71
Q

Palpation of trigger pointswill produce pain; normal physical examination

A

Fibromyalgia

72
Q

DIAGNOSTIC STUDIES OF Fibromyalgia?

A

none

73
Q

African American, family history; appears after age 6 mo; acute pain with swelling of hands and feet, abdominal pain, decreased appetite, malaise

A

Sickle cell disease

74
Q

Normal examination

A

Sickle cell disease

75
Q

DIAGNOSTIC STUDIES OF Sickle cell disease?

A

Hemoglobin S genotype

76
Q

Female; transient arthritis of small joints, malar rash

A

Systemic lupus erythematosus

77
Q

Normal examination may have joint tenderness on palpation

A

Systemic lupus erythematosus

78
Q

DIAGNOSTIC STUDIES OF Systemic lupus erythematosus?

A

Kidney function tests, antinuclear anti¬ body, CBC

79
Q

History of sleeping with arm against head; morning shoulder pain; pain worse with lifting; paresthesia, weakness, or clumsiness of hand; symptoms worse at night

A

Thoracic outlet syndrome

80
Q

Bruit over supraclavicular fossa; pallor, decreased pulses of upper extremity, weakness, skin and nail atrophy

A

Thoracic outlet syndrome

81
Q

DIAGNOSTIC STUDIES OF Thoracic outlet syndrome?

A

None

82
Q

History of repetitive upper extremity motion; paresthesia, weakness, or clumsiness of hand; symptoms worse at night

A

Carpal tunnel syndrome

83
Q

Positive Phalen test andTinel sign; weakness of hand; dry skin over distribution of median nerve

A

Carpal tunnel syndrome

84
Q

DIAGNOSTIC STUDIES OF Carpal tunnel syndrome?

A

none

Physical Assessment (27 decks)

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