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FNP: Systems Review > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q
  • Wrist pain on palpation on anatomic snuffbox.
  • Pain on axial loading of the thumb/Pain when making a fist or gripping something
  • History of falling forward with outstretched hands
A
  • Navicular Fracture
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2
Q

What will the Xray show in Navicular Fractures

A
  • Initial Xray may NOT show fracture, but 2 weeks later will show the scaphoid fracture
  • High risk of avascular necrosis and non-union
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3
Q
  • Fracture of the distal radium of the forearm, along with displacement of wrist
  • History of falling forward with outstretched hands
  • Also known as the “dinner fork” fracture
A
  • Colles Fracture
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4
Q

The most common type of Colles’ fractures are:

A
  • Wrist
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5
Q
  • Acute onset of saddle anesthesia, bladder or bowel incontinence (retention of bladder)
  • Bilateral numbness and weakness of legs
  • Pressure on a sacral nerve results in inflammatory and ischemic changes in the nerves.
A
  • Cauda Equina Syndrome (Send to ER immediately)
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6
Q
  • This type of radiograph shows bone fractures, damaged bone (osteomyelitis and metastases), metal, and other dense objects.
A
  • Xrays
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7
Q
  • It is the GOLD STANDARD for injuries of the cartilage, menisci, tendons, ligaments, or any joint of the body.
  • Does not use radiation
A
  • MRI (Magnetic Reasonance Imaging)
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8
Q
  • Uses Xray images to form 3D pictures

* Detects bleeding, aneurysms, masses, pelvic and bone trauma, fractures

A
  • CT (Computed Tomography)
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9
Q

Hyperextension or backward curvatures of the knees

A
  • Genu recurvatum
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10
Q

Genu Varum

A
  • Bowlegs
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11
Q

Genu Valgum

A
  • Knock Knees
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12
Q

After an injury to a joint, within the 1st 48 hours, what should NOT take place

A
  • NO EXERCISE OF ANY FORM (not even isometric)
  • NO HEAT OF ANY FORM
  • NO ACTIVE RANGE OF MOTION
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13
Q
  • It tests for Anterior Cruciate Ligaments (ACL) tears
  • Shows laxity in Knee Joint (Knee Instability)
  • Produces a “click” when if positive
A
  • McMurray Test
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14
Q
  • Tests for Ankle instability or Joint laxity in Ankle

* Brace heel and invert foot

A
  • Talar Tilt Test
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15
Q
  • A positive Talar Tilt test is suggestive of:
A
  • A grade III ankle sprain
  • Calcaneofibular Ligament Rupture
  • Anterior Talofibular Ligament Rupture
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16
Q
  • The “Tinel” or “Phalen” test is done to evaluate:
A
  • Carpel Tunnel
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17
Q
  • The “Lachman’s” test screens for _______
A
  • Knee instability (more sensitive than Drawer test) suggests ACL damage.
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18
Q

Inflammation of the digital nerve of the foot, between the 3rd and 4th metatarsal (toe) is known as?

A
  • Morton Neuroma
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19
Q

This test is done by grasping the 1st and 5th toe, then squeezing the forefoot. It screens for Morton’s Neuroma

A
  • Mulders Test
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20
Q

Morton’s neuroma risk is increased by what?

A
  • Wearing high-heeled shoes
  • Wearing tight shoes
  • Being Obese
  • Being a Runner or Dancer
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21
Q
  • Caused by “Overuse Syndrome” of the hand and the wrist.
  • An inflammation of the tendon and sheath, in the 1st dorsal compartment of the wrist/located at the base of the thumb.
  • Dorsal thumb pain is a cardinal sign/symptom
  • The orthopedic maneuver to test for this is the “Finklestein’s Test”
A
  • De’Quervain’s Tenosynovitis
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22
Q

De’Quervain’s screen is considered “positive” when what happens?

A
  • Their is pain and tenderness at the wrist (on the thumb side)
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23
Q

A type of bursitis located behind the knee is called

A
  • Baker’s Cyst
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24
Q
  • It test for “Lumbar Nerve Root” compression

* Can be done sitting or lying down

A
  • Straight Leg Raise
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25
Q

The Spurling Test assesses:

A
  • Cervical Root Compression

* Cervical Radiculopathy

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26
Q
  • Thick “sterile” serous fluid that provides lubrication for the joint.
  • If it is cloudy, it can be indicative of infection.
A
  • Synovial Fluid
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27
Q
  • Cresent-shaped cartilage located in each knee.
  • They located Anteriorly and Posteriorly
  • Damage to them may cause a “LOCKING” of the knee
A
  • Meniscus
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28
Q
  • What is a complication of joint injections
A
  • Tendon Rupture
  • Nerve Damage
  • Infection
  • Bleeding
  • Hypothalmic-pituitary-adrenal suppression
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29
Q
  • Phalanges refer to the
A
  • Fingers and Toes

* Singular form is “Phalanx”

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30
Q
  • Acute or Recurrent Pain on the bottom of the feet.
  • Aggravated by walking.
  • Caused by MicroTears in the plantar fascia, due to tightness of the Achilles Tendon
A
  • Plantar Fasciitis
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31
Q
  • Which groups have a higher risk of “Plantar Fasciitis”
A
  • Obese
  • Diabetics
  • Aerobic Exercisers
  • Flat feet,
  • Prolong standers/walkers
32
Q
  • Treatment for Plantar Fasciitis includes:
A
  • NSAIDs (oral or topical)
33
Q
  • Uric acid crystals inside joints and tendons due to excess production or decrease excretion of purine crystals.
  • Predisposition for 1st joint of the large toe.
A
  • Gout
34
Q
  • 1st goal in an “Acute” gout attack is to:
A
  • Provide pain relief = N.S.A.I.Ds are the mainstay and 1st line.
35
Q
  • 1st line therapy for treating patients with acute gout is:
A
  • N.S.A.I.Ds (Naproxen/Anaprox, Indomethacin/Indocin)

* Steroids (Prednisone or corticosteroid injections)

36
Q
  • Which maintenance gout medications are not to be used during a gout attack?
A
  • Allopurinol (cause gout to move to big joints)

* Probenicid (increase uric acid in the big joints)

37
Q
  • The dose of colchicine during a gout attack should be:
A
  • 0.6mg every hour (until relief or G.I symptoms) up to 2.4mg
38
Q
  • The most common joint disease in America
  • Pain in joints exacerbated by activity and relieved by rest.
  • Morning stiffness usually is less than an hour (
A
  • Osteoarthritis/Degenerative Joint Disease
39
Q
  • The Xray in an osteoarthritic patient will show:
A
  • Joint Space Narrowing
40
Q
  • The most common joints affected by osteoarthritis include:
A
  • Hips
  • Knees
  • Interphalangeal (Fingers)
41
Q
  • Heberden’s nodes are found where:

* Bouchard’s nodes are found where:

A
  • Heberden’s nodes = Distal Interphalangeal joints

* Bouchard’s nodes = Proximal interphalangeal joints

42
Q
  • 1st line therapy for Osteoarthritis is:
A
  • Exercise and Weight Loss
43
Q
  • 1st line pharmacological therapy for OA includes:
A
  • Acetaminophen
44
Q
  • Over the counter nutritional supplements to help manage osteoarthritis include:
A
  • Glucosamine
  • Chondroitin
  • ** Use both in conjunction, they provide a synergistic effect**
45
Q
  • A multisystem autoimmune disease that is more common in African American and Hispanic women.
  • Classical sign is a maculopapular “butterfly” shaped rash on the middle of the face (malar rash).
A
  • Systemic Lupus Erythematous
46
Q
  • Systemic autoimmune disease
  • Symmetrical, polyarticular joint destruction
  • More common in women than men
  • Morning stiffness last longer than an hour (> 60 minutes).
A
  • Rheumatoid Arthritis
47
Q
  • Classic sign of Rheumatoid Arthritis is
A
  • Swan Neck Deformities (flexion of the DIP and hyperextension of the PIP)
  • Boutonnere Deformities (Hyperextension of the DIP and flexion of the PIP)
48
Q
  • Pharmacological therapy for Rheumatoid Arthritis includes:
A
  • Disease Modifying Agents for Rheumatoid Disease (DMARDs)
  • NSAIDs (for inflammation and pain)
  • Systemic oral steroids
49
Q
  • Complications of Rheumatoid Arthritis, as well as Ankylosing Spondylitis includes:
A
  • Uveitis = swelling of the uvea (middle layer of the eye that supplies blood to the retina)
50
Q
  • Gradual onset of pain on the outside of the elbow that sometimes radiates to the forearm.
  • Pain worsening with grasping and twisting movements (opening jars, shaking hands).
  • Hand grip is often WEAK on the affected side
A
  • Lateral Epicondylitis (Tennis Elbow)
51
Q
  • Gradual onset of pain on the inside of the elbow.

* Forearm weakness, pain is aggravated by wrist flexion.

A
  • Medial Epicondylitis (Golfer’s Elbow)
52
Q
  • People with gout should avoid foods high in:
A
  • Purine (Sardines, Organ meats, Shellfish)
53
Q
  • Mild stretching and damage to the “ligament fibers”.
  • Mild to moderate pain, but able to bear weight and ambulate.
  • The above mentioned is what grade of sprain*
A
  • Grade I Sprain
54
Q
  • What are the risk associated with high dose N.S.A.I.Ds
A
  • G.I Bleeds, and…
  • Cardiovascular risk
  • Renal damage
55
Q
  • The most common reason for acute low back pain is:
A
  • Lumbosacral strain
56
Q
  • If radiculopathy is suspected with low back pain, or low back pain last longer than a month (4 weeks), which diagnostic test should be done
A
  • MRI

* CT Scan

57
Q
  • Complete “Ligament” tear
  • Ankle instability
  • Severe Pain, with moderate to severe ecchymosis.
  • Unable to bear weight on affect limb
  • The above mentioned is what grade of sprain*
A
  • Grade III Sprain
58
Q
  • Pain and stiffness in a particular shoulder, with…

* Decrease range of motion, or loss of movement

A
  • Adhesive Capsulitis (FROZEN SHOULDER)
59
Q
  • What disease is frequently associated with Adhesive Capsulitis/Frozen Shoulder?
A
  • Diabetes
60
Q
  • Chronic inflammatory disorder that affects mainly the sacroiliac joints and spine (axial skeleton).
  • Other joints that can be affected are the shoulders and hips.
  • Pain is usually in upper back/Thoracic area
  • Associated with low-grade fever and fatigue
  • May have chest pain with respiration (costochondritis)
A
  • Ankylosing Spondylitis
61
Q
  • 1st line treatment for Ankylosing Spondylitis
A
  • NSAIDs
62
Q
  • What Impact does “HYPERTENSION” have when determining a patients risk for sports
A
  • No risk (Exercise is encouraged)

* As long as their is no target organ damage, or extreme elevated BP

63
Q
  • Shoulder pain when patients use overhead activity or motions are considered as:
A
  • Impingement Syndrome, or

* Rotator cuff tendinopathy

64
Q
  • Risk factors for Bursitis include:
A
  • Joint Overusage
  • Trauma
  • Infection
  • Arthritis
65
Q
  • This murmur increases in sound when standing, squatting, or Valsalva maneuver.
  • Dypsnea, chest pain, and post-exertional syncope often reported.
  • In the above mentioned, what decisions can be made on sports/exercising*
A
  • Sports participation should be determined on an individual basis
  • Indicative of Hypertrophic Cardiomyopathy
66
Q
  • On a sports physical, if a murmur with a buzzing quality is found, and it softens or disappears when the patient sits or stands, what should be done next?
A
  • Nothing, it is a benign finding

* No limitations on sports activity

67
Q
  • In patients with Mitral Valve Prolapse, how should a exercise regimen be determined?
A
  • Based on ventricular size and function
  • Normal ventricular function = full participation.
  • Patients may proceed with activity in the ABSENCE of symptoms.
68
Q
  • Hypovolemic shock would most likely occur with fractures of the
A
  • Pelvis
69
Q
  • Risk factors associated with osteopenia and osteoporosis
A
  • Excessive alcohol intake
  • Cigarette smoking
  • Asian and Caucasian Ancestry
  • Old Age
  • Anorexia Nervosa
  • Small Bone Frame
70
Q
  • Gout of the big toe is also known as:
A
  • Podagra
71
Q
  • Untreated gout can lead to
A
  • Joint immobility and renal failure
72
Q
  • Kyphosis is a late sign of
A
  • Osteoporosis
73
Q
  • When do the posterior fontanels close in an infant
A
  • At 3 months of age
74
Q
  • How does aspirin usage affect GOUT?
A
  • Inhibits the ability to excrete uric acid.
75
Q
  • 1st line therapy for “Prepatellar Bursitis”
A
  • Bursal Aspiration (it affords significant pain relief)

FNP: Systems Review (10 decks)

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