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diagnostics Exam 3 > Muscular > Flashcards

Muscular Flashcards

1
Q

Ottawa rules for knee injuries

A
  1. Age 55 or older
    OR
  2. Isolated tenderness of patella no bone tenderness of the knee other than patella
    OR
  3. Tenderness of the head of fibula
    OR
  4. Inability to flex to 90 degrees
    OR
  5. inability to bear weight immediately and in the emergency department for 4 steps
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2
Q

Ottawa rules for ankle injuries

A

inability to bear weight or take 4 step
pain/bone tenderness
– at distal fibula and lateral malleolus
– distal fibular and medial malleolus
–at base of the fifth metatarsal
–at the navicular

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3
Q

types of joints

A

hinge, synovial and fibrous

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4
Q

Synovial joint

A

hip and kneemove a lot
Most common, are oily to allow the bones to move freely
* Ball-and-socket joints of hip

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5
Q

Hinge joint

A

knee

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6
Q

Cartilaginous joints

A

the back, they; move a little
located Between the vertebrae having no gap but held together by cartilage; move only a little

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7
Q

Fibrous joints
are

A

fixed, don’t move
The flat cranial bones, which have no gap between the bones and hardly move
Flat cranial bone

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8
Q

Ligaments

A

connect bone to bone

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9
Q

Tendons

A

Tendons connects muscle to bone

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10
Q

Identify the mechanism of injury: How did the injury happened?

A

The patient fell with their left arm outstretched, landing on the tips of his fingers, and now has pain in his left wrist.

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11
Q

ACL tears anterior cruciate ligament tear

A

History: cutting or pivoting activity with leg planted; sudden pop or snap, feeling like knee is coming apart
Exam: large effusion; quick onset; tiptoes gait; positive, Lachman’s or drawer test
Diagnostic: Xray to rule out fracture; MRI

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12
Q

Myofascial pain

A

History: Stress, previous neck injuries
Exam: asymmetric trigger points medial to scapula and over the trapezius
Diagnostic: None

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13
Q

Frozen shoulder (adhesive capsulitis)

A

History: insidious onset, women above 50; diabetics, prolonged immobilization, or held in bed in dependent position
Exam: total restriction of normal range of motion Diagnostic None

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14
Q

Ganglion cyst:

A

History: painless to dull ache nodule
Exam: gelatinous filled nodule on the dorsum of the wrist
Diagnostic: None

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15
Q

CTS carpal tunnel syndrome

A

History: increased pain at night; numbness at median nerve distribution; repetitive movement; pregnancy, arthritis, hypothyroidism, ETOH
Exam: wasting of the thenar eminence; positive Tinel’s sign, and positive Phalen’s sign
Diagnostic: Carpal view x-ray, EMG –-electromyography study, and nerve conduction studies help diagnose nerve damage or disease

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16
Q

Shin splints

A

History: dull intermittent pain over distal third of the tibia; develops slowly and aggravated over time; history of running or impact sport or activity
Exam: tenderness over medial tibial
Diagnostic: AP lateral X-ray may show fracture; bone scan will be positive with uptake along the medial tibial

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17
Q

Bakers Cyst

A

History: Swelling behind the knee; pain or pressure with extension; aggravated with walking
Exam: firm palpable mass behind the knee on the medial side; seen best with patient standing; edema with large cysts
Diagnostic: None

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18
Q

Septic arthritis

A

History: Fever, chills, malaise; intense pain in the joint; most common in the knee; history of rheumatoid arthritis; immunocompromised and systemic infection
Exam: area around joint is shot and red, and erythematous
Diagnostic: CBC, culture of joint aspirate, ESR and CRP, ultrasound of the joint

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19
Q

Sprains

A

Sprains injury to ligaments

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20
Q

Strains

A

injury to tendons

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21
Q

Moderate or grade 2:

A

partial tear, mild swelling or tenderness; loss of mobility

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22
Q

Sprains grades
Minor or Grade 1:

A

Sprains grades
no tear; little swelling or tenderness; no loss of stability

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23
Q

Plantar fasciitis

A

History: flat footed or very high arch; heel pain with weight bearing; maximum after long periods of non-weight or first thing in the morning; obesity
Exam: palpable pain in the tension area of fascia; increased pain with dorsiflexion of toes
Diagnostic: None

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24
Q

Osgood-Schlatter:

A

History: mild ache that is worse over time, two weeks period; exacerbated by repeated extension and flexion or direct impact on-site
Affects girls above 11 years old and boys above 13
Exam: tenderness, swelling, pain over tibial tubercle
Diagnostic: X-ray of knee rotated inward may show soft tissue swelling

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25
Q

Sprain Severe or grade 3:

A

complete rupture of ligaments; severe swelling, hemorrhage, and tenderness; loss of foot stability

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26
Q

Tanner Scoring:

A

Stages of development used to assess pubertal development. For males score is 3
so that they can play varsity sports against older kids

27
Q

According to the Ottawa Rules, which of the following criteria indicates the need for an X-ray in knee injuries?
A. Age 45 or older
B. Isolated tenderness of the patella
C. Ability to bear weight immediately.
D. Ability to flex beyond 90 degrees

A

B. Isolated tenderness of the patella

28
Q

For ankle injuries, an X-ray is indicated if there is bone tenderness at the:
A. Anterior edge of the tibia
B. Posterior edge of the lateral malleolus
C. Medial malleolus only
D. Heel

A

B. Posterior edge of the lateral malleolus

29
Q

For ankle injuries, an X-ray is indicated if there is bone tenderness at the:
A. Anterior edge of the tibia
B. Posterior edge of the lateral malleolus
C. Medial malleolus only
D. Heel

A

B. Posterior edge of the lateral malleolus

30
Q

A fibrous joint is characterized by:
A. Free movement
B. Movement in one direction
C. Slight movement
D. No movement

A

D. No movement

31
Q

Ligaments connect:
A. Muscle to muscle
B. Bone to bone
C. Muscle to bone
D. Bone to cartilage

A

B. Bone to bone

32
Q

positive Lachman’s test suggests injury to the:
A. ACL
B. PCL
C. LCL
D. MCL

A

A. ACL

33
Q

The primary symptom of myofascial pain is:
A. Large effusion
B. Asymmetric trigger points
C. Wasting of the thenar eminence
D. Gelatinous filled nodule

A

B. Asymmetric trigger points

34
Q

Which diagnostic test is essential for confirming carpal tunnel syndrome?
A. MRI
B. X-ray
C. EMG
D. CBC

A

C. EMG

35
Q

Shin splints typically cause pain in the:
A. Anterior third of the tibia
B. Distal third of the tibia
C. Medial malleolus
D. Lateral side of the foot

A

B. Distal third of the tibia

36
Q

A Grade 2 sprain is characterized by:
A. No tear
B. Partial tear
C. Complete rupture
D. Bone fracture

A

B. Partial tear

37
Q

Inability to bear weight both immediately and in the emergency department is an Ottawa criterion for radiography for injuries to the:
A. Hip
B. Knee
C. Ankle
D. Foot

A

C. Ankle

38
Q

Cartilaginous joints are typically found in:
A. The knee
B. The hip
C. The back
D. The elbow

A

C. The back

39
Q

The initial diagnostic step for a suspected ACL tear is:
A. MRI
B. X-ray
C. Ultrasound
D. Physical examination

A

B. X-ray

40
Q

Plantar fasciitis diagnostic typically requires:
A. X-ray
B. MRI
C. Physical examination
D. Blood tests

A

C. Physical examination

41
Q

The hallmark sign of a ganglion cyst is:
A. A hard, immovable lump
B. A soft, gelatinous filled nodule
C. A warm, red, and painful area
D. A bruise-like discoloration

A

B. A soft, gelatinous filled nodule

42
Q

What is the primary management strategy for frozen shoulder (adhesive capsulitis)?
A. Immediate surgery
B. High-intensity weight lifting
C. Physical therapy and gradual mobilization
D. Steroid injections only

A

C. Physical therapy and gradual mobilization

43
Q

A hallmark symptom of plantar fasciitis is:
A. Numbness in the toes
B. Heel pain, especially in the morning
C. Swelling of the entire foot
D. Continuous cramping

A

B. Heel pain, especially in the morning

44
Q

Osgood-Schlatter disease primarily affects:
A. Adult women
B. Elderly men
C. Adolescent athletes
D. Infants

A

C. Adolescent athletes

45
Q

The Ottawa Rules for foot injuries recommend an X-ray if there is:
A. Pain in the heel only
B. Inability to bear weight both immediately and in the emergency department
C. Swelling in the toes
D. Pain in the anterior part of the foot

A

B. Inability to bear weight both immediately and in the emergency department

46
Q

A synovial joint is characterized by:
A. No movement
B. Limited movement
C. Free movement
D. Movement in one plane only

A

C. Free movement

47
Q

. The mechanism of injury described as falling with an outstretched arm likely affects the:
A. Hip
B. Wrist
C. Ankle
D. Shoulder

A

B. Wrist

48
Q

Carpal Tunnel Syndrome (CTS) is often associated with:
A. Increased pain in the morning
B. Increased pain at night
C. Decreased pain with use
D. Pain only in the little finger

A

B. Increased pain at night

49
Q

A Grade 3 sprain is characterized by:
A. No tear
B. Partial tear
C. Complete rupture
D. Bone bruising

A

C. Complete rupture

50
Q

Septic arthritis is most commonly diagnosed with:
A. MRI
B. Physical examination alone
C. Culture of joint aspirate
D. X-ray

A

C. Culture of joint aspirate

51
Q

The main difference between a sprain and a strain is:
A. A sprain affects muscles, whereas a strain affects ligaments
B. A sprain affects ligaments, whereas a strain affects muscles
C. There is no difference; both terms can be used interchangeably
D. A sprain is more severe than a strain

A

A sprain affects ligaments, whereas a strain affects muscles

52
Q

Baker’s Cyst is characterized by:
A. Swelling behind the knee
B. Hard lump in front of the knee
C. Sharp pain on the inside of the knee
D. A clicking sound when bending the knee

A

A. Swelling behind the knee

53
Q

The diagnostic workup for ACL tears often includes:
A. Ultrasound as the first-line imaging test
B. MRI to assess soft tissue damage
C. CT scan for detailed bone analysis
D. X-ray to rule out other injuries

A

B. MRI to assess soft tissue damage

54
Q

Shin splints are primarily managed through:
A. Surgical intervention
B. Rest and physical therapy
C. Immediate return to high-impact activities
D. Steroid injections

A

B. Rest and physical therapy

55
Q

A hinge joint, like the knee, allows for:
A. Rotation only
B. Movement in multiple directions
C. Movement in one plane only
D. No movement

A

C. Movement in one plane only

56
Q

According to the Ottawa Ankle Rules, an X-ray is not required if the patient:
A. Can bear weight immediately after the injury.
B. Has tenderness at the base of the fifth metatarsal.
C. Shows swelling in the malleolar zone.
D. Reports pain in the lateral ankle.

A

A. Can bear weight immediately after the injury.

57
Q

For an adult patient with knee pain, the Ottawa Rules suggest an X-ray if they:
A. Are younger than 55 years.
B. Can flex the knee to 90 degrees.
C. Cannot bear weight immediately and in the emergency department.
D. Have isolated tenderness of the kneecap.

A

C. Cannot bear weight immediately and in the emergency department.

58
Q

Ottawa Rules:

A

Criteria for the use of radiography X-ray in acute ankle and knee injuries

59
Q

. An Ottawa Knee Rule that prompts radiography is:
A. Age under 55 without a significant injury history
B. Isolated thigh pain with no knee involvement
C. Inability to bear weight both immediately after injury and in the emergency department.
D. Full knee flexion without pain

A

C. Inability to bear weight both immediately after injury and in the emergency department

59
Q

The Ottawa Foot Rules recommend an X-ray if there is:
A. Swelling of the entire foot.
B. Pain in the lateral side of the fifth metatarsal.
C. An abrasion on the heel.
D. Tenderness in the anterior tibial region.

A

B. Pain in the lateral side of the fifth metatarsal.

60
Q

A patient unable to flex the knee to 90 degrees after an injury should:
A. Be given NSAIDs and sent home.
B. Undergo an immediate knee replacement.
C. Receive an X-ray according to the Ottawa Knee Rules.
D. Perform physical therapy for three weeks before reassessment.

A

C. Receive an X-ray according to the Ottawa Knee Rules.

61
Q

For patients presenting with foot pain, the inability to bear weight is an indication for X-ray according to:
A. The Berlin Rules
B. The Ottawa Foot Rules
C. The New York Standards
D. The Paris Criteria

A

B. The Ottawa Foot Rules

62
Q

. According to the Ottawa Rules, radiography for ankle injuries is not needed if:
A. There is isolated tenderness of the patella
B. The patient is under 55 years of age
C. The patient can bear weight immediately and in the ED
D. Pain is only present in the malleolar zone without bone tenderness

A

C. The patient can bear weight immediately and in the ED

63
Q

A patient complains of pain in his joints that is worse in the morning, better after he
moves around for a while, and then worsens again if he sits for long periods. What other signs of the problem should the nurse assess?
a. Tendinitis
b. Osteoarthritis
c. Rheumatoid arthritis
d. Intermittent claudication ANS: C

A

c. Rheumatoid arthritis

diagnostics Exam 3 (4 decks)

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