Musculoskeletal Flashcards
The musculoskeletal system consists of the body’s bones, joints, and muscles
A)true
B)false
.A
1) for support to stand erect and
(2) for movement. The musculoskeletal system also functions
(3) to encase and pro/ec/thc inner vital organs (e.g., brain, spinal cord, heart), (
4) to prorluce the red blood cells in the bone marrow (hematopoiesis), and
(5) as a reservoir for storage of essential minerals, such as calcium and phosphorus in the bones.
Musculoskeletal system
. It has 206 bones, which support the body like the posts and beams of a building.
A)true
B)false
.A
Bone and cartilage are specialized forms of connective tissue. Bone is hard, rigid, and very dense. Its cells are continually turning over and remodeling.
The joint (or articulation) is the place of union of two or more bones. Joints are the functional units of the musculoskeletal system because they permit the mobility needed for activities of daily living
.
In nonsynovial joints, the bones are united by fibrous tissue or cartilage and are immovable (e.g., the sutures in the skull) or only slightly movable (e.g., the vertebrae).
Synovial joints are freely movable because they have bones that are separated from each other and are enclosed in a joint cavity
.
Just like grease on gears, synovial fluid allows sliding of opposing surfaces, and this sliding permits movement.
.
is avascular; it receives nourishment from synovial fluid that circulates during joint movement. It is a very stable connective tissue with a slow cell turnover. It has a tough, firm consistency, yet is flexible. This cartilage cushions the bones and gives a smooth surface to facilitate movement.
A)cartilage
B)joint
C)muscles
Cartilage
The joint is surrounded by a fibrous capsule and is supported by ligaments.
.
are fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions
A)ligament
B)joint
C)both a and b
Ligament
is an enclosed sac filled with viscous synovial fluid, much like a joint. Are located in areas of potential friction and help muscles and tendons glide smoothly over bone.
A)bursa
B)ligament
C)muscles
Bursa
Muscles account for 40% to 50% of the body’s weight.
A)true
B)false
.true
When they contract, they produce movement
A)muscles
B)joints
C)both a and b
Muscles
Muscles are of three types: skeletal, smooth, and cardiac
A)true
B)false
.true
Each skeletal muscle is composed of bundles of muscle fibers, or fasciculi.
The skeletal muscle is attached to bone by a tendon-a strong fibrous cord.
A)true
B)false
.
The temporomandibular joint (TMJ) is the articulation of the mandible and the temporal bone
A)true
B)false, the joint articulates with the mandible and sphenoid bone
.true
You can feel it in the depression anterior to the tragus of the ear.
A)temporalmandibular joint
B)mandible joint
Temporalmandibular joint
The TMJ permits jaw function for speaking and chewing
A)temporalmandibular joint
B)mandible
Temporalmandibular. Joint
The joint allows three motions: (l) hinge action to open and close the jaws; (2) gliding action for protrusion and retraction; and (3) gliding for side-to-side movement of the lower jaw
A)temporalmandibular joint
B)mandible
Temporalmandibular joint
The vertebrae are 33 connecting bones stacked in a vertical column
A)true
B)false
Ture
Humans have 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 3 or 4 coccygeal vertebrae.
A)true
B)false
True
SPINE
.
The spinous processes of C7 and Tl are prominent at the base of the neck.
A)true
B)false
.true
The inferior angle of the scapula normally is at the level of the interspace between T7 and T8
A)true
B)false
.true
An imaginary line connecting the highest point on each iliac crest crosses L4.
A)true
B)false
.true
An imaginary line joining the two symmetric dimples that overlie the posterior superior iliac spines crosses the sacrum
A)true
B)false
.true
A lateral view shows that the vertebral column has four curves (a double-S-shape)
A)true
B)false
.true
1.cervical and lumbar curves are concave (inward or anterior), and
2.the thoracic and sacrococcygeal curves are convex
A)true
B)true for the first one
C)false
D)true for the second one
.true
The intervertebral disks are elastic fibrocartilaginous plates that constitute one fourth of the length of the column
A)true
B)false
True
Each disk center has a\_\_\_\_\_\_\_\_\_\_\_\_\_ made of soft, semifluid, mucoid material that has the consistency of toothpaste in the young adult. A)nucleus pulposus B)spinal nucleus C)nucleus spine D)all the above
Nucleus pulposus
The disks cushion the spine like a shock absorber and help it move
A)intervertebral disk
B)intercostal disk
C)all the above
Intervertebral disk
The disk then can rupture and the nucleus pulposus can herniate out of the vertebral column, compressing on the spinal nerves and causing pajn
A)true
B)false
True
SHOULDER
.
The glenohumeral joint is the articulation of the humerus with the glenoid fossa of the scapula
A)true
B)false
True
The joint is enclosed by a group of four powerful muscles and tendons that support and stabilize it. Together these are called the rotator cuff of the shoulder.
A)shoulder
B)hip
C)both a and b
Shoulder
The large subacromial bursa helps during abduction of the arm, so that the greater tubercle of the humerus moves easily under the acromion process of the scapula A)shoulder B)subacromial bursa C)both a and b D)clavicle
Subacromial bursa
The scapula and the clavicle connect to form the shoulder girdle.
A)true
B)false
True
You can feel the bump of the scapula’s acromion process at the very top of the shoulder
A)true
B)false
True
The next bump is the greater tubercle of the humerus a few centimeters down and laterally, and from that the coracoid process of the scapula is a few centimeters medially
A)true
B)false
True
ELBOW
.
The elbow joint contains the three bony articulations of the humerus, radius, and ulna of the forearm
A)true
B)false
True
Its hinge action moves the forearm (radius and ulna) on one plane, a!Jowing flexion and extension. The olecranon bursa lies between the olecranon process and the skin A)shoulder B)elbow C)hip D)wrist
Elbow
The sensitive ulnar nerve runs between the olecranon process and the medial epicondyle.
A)true
B)false
True
The radius and ulna articulate with each other at two radioulnar joints, one at the elbow and one at the wrist These move together to permit pronation and supination of the hand and forearm.
A)true
B)false
True
WRIST AND CARPALS
.
Of the body’s 206 bones, over half are in the hands and feet.
A)true
B)false
True
Its condyloid action permits movement in two planes at right angles: flexion and extension, and side-to-side deviation.
A)true
B)false
True
The midcarpal joint is the articulation between the two parallel rows of carpal bones. It allows flexion, extension, and some rotation. The metacarpophalangeal and the interphalangeal joints permit finger flexion and extension. The flexor tendons of the wrist and hand are enclosed in synovial sheaths.
A)true
B)false
True
HIP
.
The hip joint is the articulation between the acetabulum and the head of the femur
A)true
B)false
.
Palpation of these bony landmarks will guide your examination. You can feel the entire iliac crest, from the anterior superior iliac spine to the posterior. The isd1ial tuberosity lies under the gluteus maximus muscle and is palpable when the hip is flexed. The greater trochanter of the femur is normally the width of the person’s palm below the iliac crest and halfway between the anterior superior iliac spine and the ischial tuberosity. Feel it when the person is standing, in a flat depression on the upper lateral side of the thigh.
A)true
B)false
C)ball and socket joint
True
KNEE
.
The knee joint is the articulation of three bones-the femur, the tibia, and the patella (kneecap)-in one common articular cavity
A)true
B)false
True
The knee joint is the articulation of three bones A)the femur, the tibia, and the patella B)knee cap C)femur, tibia and the fibula D)femur, tibia and knee
A fumur tibia and patella
lt is the largest joint in the body and is complex A)shoulder B)knee C)hip D)all the above
Knee
Two wedge-shaped cartilages, called the medial and lateral menisci
A)cushion the tibia and femur.
B)balance the femur
C)both a and b
A
The cruciate ligaments (not shown) crisscross within the knee;
A) they give anterior and posterior stability and help control rotation.
B)aide in the contraction of the knee
C) both a and b
A
prepatellar bursa, lies between the patella and the skin
A)true
B)false
True
Landmarks of the knee joint start with the large quadriceps muscle, which you can feel on your anterior and lateral thigh
A)true
B)false
True
ANKLE AND FOOT
.
The ankle, or tibiotalar joint, is the articulation of the tibia, fibula, and talus
A)true
B)false
True
It is a hinge joint, limited to flexion (dorsiflexion) and extension (plantar flexion) on one plane.
A)true
B)false
TURE
Landmarks are two bony prominences on either sidethe medial malleolus and the lateral malleolus.
A)true
B)false
True
The subtalar joint permits inversion and eversion of the foot
A)true
B)false
True
DEVELOPMENTAL COMPETENCE
.
Infants and Children
.
By 3 months’ gestation, the fetus has formed a “scale model” of the skeleton that is made up of cartilage.
A)true
B)false
True
Bone growth continues after birth-rapidly during infancy and then steadily during childhood-until adolescence, when both boys and girls undergo a rapid growth spurt.
A)true
B)false
True
growth spurt. Long bones grow in two dimensions.
A)false
B)true
True
. Lengthening occurs at the epiphyses, or growth plates. These specialized growth centers are transverse disks located at the ends of long bone. Any trauma or infection at this location puts the growing child at risk for bone deformity. This longitudinal growth continues until closure of the epiphyses; the last closure occurs at about age 20 years.
A)true
B)false
True
At birth, the spine has a single
A)C-shaped curve
B)S-shaped curve
C)both a and b
C shaped curve
At 3 to 4 months, raising the baby’s head from prone position develops the anterior curve in the cervical neck region
A)true
B)false
TURE
From 1 year to 18 months, standing erect develops the anterior curve in the lumbar region.
A)true
B)false
True
growth is marked during the adolescent growth spurt
A)true
B)false
True
muscles respond to increased secretion of growth hormone, to adrenal androgens, and in boys, to further stimulation by testosterone.
A)true
B)false
True
This is due to genetic programming, nutrition, and exercise
A)lifestyles
B)Muscles vary in size and strength in different people
C)African Americans have more muscle
Muscles vary in size and strength in different people.
The Pregnant Woman
.
Increased levels of circulating hormones (estrogen, relaxin from the corpus luteum, and corticosteroids) cause increased mobility in the joints.
A)true
B)false
True
Increased mobility in the sacroiliac, sacrococcygeal, and symphysis pubis joints in the pelvis contributes to the noticeable changes in maternal posture. A)true B)the pregnant women C)both a and b D)flase
Both a and b
The most characteristic change is progressive lordosis, which compensates for the enlarging fetus; otherwise, the center of balance would shift forward.
A)the pregnant women
B)false
C)young adult
The pregnant women
Anterior flexion of the neck and slumping of the shoulder girdle are other postural changes that compensate for the lordosis.
A)the pregnant woman
B)teen mom
C)both a and b
The pregnant women
These upper back changes may put pressure on the ulnar and median nerves during the \_\_\_\_\_\_\_\_\_\_ trimester. Nerve pressure creates aching, numbness, and weakness in the upper extremities in some women A)1 B)3 C)2 D)all the above
3
The Aging Adult
.
Bone remodeling is a cyclic process of bone resorption and deposition. The balance favors deposition until skeletal maturity at 25 to 35 years when bones mass reaches its peak.
A)true
B)false
25-35bone reaches its max
After age 40, loss of bone matrix (resorption) occurs more rapidly than new bone formation. The net effect is a gradual loss of
bone density, or osteoporosis.
A)true
B)flase
Bone starts breaking down at age 40
women have more bone loss than men because for 5 years after menopause, the lack of estrogen leads to accelerated bone loss.
A)true
B)false
True
Postural changes are evident with aging, and decreased height is the most noticeable.
A)true
B)false
True
Long bones do not shorten with age.
A)true
B)flase
True
Decreased height in the aging adult is due to?
A)shortening of the vertebral column. caused by loss of water content and thinning of the intervertebral disks and by a decrease in the height of individual vertebrae from osteoporosis.
B)shortening of long bones
Decreased height is due to shortening of the vertebral column. This is caused by loss of water content and thinning of the intervertebral disks and by a decrease in the height of individual vertebrae from osteoporosis.
A
Both men and women can expect a progressive decrease in height beginning at age 40 years in males and age 43 years in females, although this is not significant until age 60 years
A)true
B)false
True
A greater decrease occurs in the 70s and 80s as a result of osteoporotic collapse of the vertebrae The result is a shortening of the trunk and long extremities. Other postural changes are kyphosis, a backward head tilt to compensate for the kyphosis, and a slight flexion of hips and knees.
A)true
B)false
True
Usually, men and women gain weight in their 40s and 50s.
A)true
B)false
True
They begin to lose fat in the face and deposit it in abdomen and hips. A)the aging adult B)aging women C)aging men D)none
A
In the 80s and 90s, fat further decreases in the periphery, which is especially noticeable in the forearms and apparent over the abdomen and hips.
A)true
B)flase
True
Loss of subcutaneous fat leaves bony prominences more marked (e.g., tips of vertebrae, ribs, iliac crests) and body hollows deeper (e.g., cheeks, axillae).
A)pregnant woman
B)the aging adult
C)both a and b
B the aging adult
; a sedentary lifestyle hastens musculoskeletal changes of aging
A)false
B)true
True
However, physical exercise increases skeletal mass and helps prevent or delay osteoporosis. Physical activity delays or prevents bone loss in postmenopausal women in a dose-dependent manner. Fast walking is the best prevention for osteoporosis; the faster the pace, the higher the preventive effect on the risk for hip fracture.
A)true
B)false
True
The other positive effects of physical activity are improving muscle strength to prevent falls, balance and posture control, decrease in back pain, increase in quality of life, and prevention of cardiovascular disease, cancer, and depression.
A)true
B)false
True.
CULTURE AND GENETICS
.
African-American adults have a decreased risk for fracture when compared with white adults, and Hispanic women have a decreased risk for fractures than white women have.
A)true
B)false
True
African-American and Hispanic children have shown significantly higher bone strength than white children.This is due to structural properties-greater bone density at specific bone sites in African-American and Hispanic children.
A)true
B)false
True
greater bone mass and bone mineral density (BMD) among AfricanAmerican men than among their white counterparts.
A)true
B)false
True
Younger Hispanic men had similar bone strength as African Americans, but older Hispanic men had more rapid loss of BMD and strength. The increased bone strength helps explain fracture risk.
A)false
B)true
True
In the spine, women of all races gained BMD up to 30 to 33 years of age.3 But at the femoral neck in Lhe hip joint, BMD peaked earlier among white women years) than among African Americans (2 l years) and Hispanics (20 years)
A)true
B)flase
True
SUBJECTIVE DATA
.
Joints Pain Stiffness Swelling, heat, redness Limitation of movement, Muscles Pain (cramps) Weakness, Bones Pain Deformity,Trauma (fractures, sprains, dislocations), Functional assessment (activities of daily living [ADLs]),Self-care behaviors Are all.? A)objective data B)subjective data C)both a and b
Subjective data
• Any problems with your joints? Any pain?
A)Joint pain and loss of function are the most common musculoskeletal concerns that prompt a person to seek care.
B)no
A
Location: Which joints? On one side or both sides?
A)tender
B)Rheumatoid arthritis (RA) involves symmetric joints; other musculoskeletal illnesses involve isolated or unilateral joints.
B
Quality: What does the pain feel like: aching, stiff, sharp or dull, shooting? Severity: How strong is the pain?
A)Exquisitely inflammation. tender with acute
B)free of pain
A
Timing: What time of day does the pain occur? How long does it last? How often does it occur?
A)RA pain is worse in morning when arising; osteoarthritis is worse later in the day; tendinitis is worse in morning, improves during the day.
B)arthritis
A
RA pain is worse in morning when arising;
A)true
B)false
True
osteoarthritis is worse later in the day;
A)true
B)false
True
tendinitis is worse in morning, improves during the day.
A)true
B)flase
C)worse at day improves at morning
True
Is the pain aggravated by movement, rest, position, weather? Is the pain relieved by rest, medications, application of heat or ice?
A)Movement increases most joint pain except in RA, in which movement decreases pain.
B)call the doctor
A
Is the pain associated with chills, fever, recent sore throat, trauma, repetitive activity?
A)Joint pain 10 to 14 days after an untreated strep throat suggests rheumatic fever. joint injury occurs from trauma, repetitive motion.
B) flase
A
Joint pain 10 to 14 days after an untreated strep throat suggests rheumatic fever. joint injury occurs from trauma, repetitive motion.
A)true
B)flase
True
Any stiffness in your joints?
A)RA stiffness occurs in morning and after rest periods.
B)false
A
Any swelling, heat, redness in the joints? The nurse would expect
A)pain
B)acute inflammation
C)none
BSuggests acute inflammation
Any limitation of movement in any joint? Which joint? The nurse would suspect?
A)Decreased ROM may be due to joint injury to cartilage or capsule or to muscle contracture
B)Increase in ROM may be due to joint flexibility
A
Any problems in the muscles, such as any pain or cramping? Which muscles? The nurse would suspect which of the following?
A)Myalgia
B)arthalgia
C)both a and b
Myalgia is usually felt as cramping or aching. A
If in calf muscles: Is the pain with walking? Does it go away with rest? The nurse would suspect, which the following?
A)Suggests intermittent claudication
B)Suggests myalgia
A
Are your muscle aches associated with fever, chills, the “flu”? The nurse knows that?
A)Viral illness often includes myalgia
B)Weakness may involve musculoskeletal or neurologic systems
A
Any weakness in muscles? The nurse knows too suspect which abnormal finding, in what two two system?
A)Weakness may involve musculoskeletal or neurologic systems
B)atrophy
A
Do the muscles look smaller there? What term describes this. A)atrophy B)diminishing C)building D)catabolism
A
Any bone pain? Is the pain affected by movement? The knows that which of the following statements might be answered to the question?
A)Fracture causes sharp pain that increases with movement. Other bone pain usually feels “dull” and “deep” and is unrelated to movement.
B)Functional assessment screens the safety of independent living, the need for home health services, and quality of life
A
Functional assessment screens the safety of independent living, the need for home health services, and quality of life?
A)true
B)flase
True
-Bathing-getting in and out of the tub, turning faucets?
-Toileting-urinating, moving bowels, able to get self on/off toilet, wipe self? •
-Dressing-doing buttons, zipper, fasten opening behind neck, pulling dress or sweater over head, pulling up pants, tying shoes, getting shoes that fit?
-Grooming-shaving, brushing teeth, brushing or fixing hair, applying makeup?
-Eating-preparing meals, pouring liquids, cutting up foods, bringing food to mouth, drinking? •
-Mobility-walking, walking up or down stairs, getting in/out of bed, getting out of house?
-Communicating-talking, using phone, writing?
All of the following are relevant to helping the nurse figure out what assessment on the patient?
A)complete assessment
B)functional assessment
C)ADL
B functional assessment
any repetitive motion or chronic stress to joints, the nurse will?
A)Assess risk for back pain or carpal tunnel syndrome.
B)look for books
C)perform hand hygiene
A
If person has chronic disability or crippling illness: the nurse ask, How has your illness affected you, by doing this the nurse will asses for?
A)Self-esteem disturbance, Loss of independence
B) Body image disturbance, Role performance disturbance
C) Social isolation
D)all the above
D
Additional History for Infants and Children
.
Were you told about any trauma to infant during labor and delivery? Did the baby come head first? Was there a need for forceps? The nurse will be asking these questions because?
A)Traumatic delivery increases risk for fractures, (e.g., humerus, clavicle).
B)for the mom to feel safe
A
Did the baby need resuscitation? The nurse ask because?
A)Period of anoxia may result in hypotonia of muscles.
B)hypotension
C)both a and b
A
Additional History for Adolescents
.
Involved in any sports at school or after school? How frequently (times per week)? The nurse ask this question for adolescents group too?
A)Assess safety of sport for child. Note if child’s height and weight are adequate for the particular sport (e.g., football).
B)to assess vitals
A
Use of safety equipment and presence of adult supervision decrease risk for sports injuries?
A)true
B)false
True
Lack of adequate warm-up increases -risk for sports injury.
A)true
B)false
True
Students may not report injury or pain for fear of limiting participation in sport. In which age group? A)adolescents B)preschool C)young adults D)older adults E)infants
A
Additional History for the Aging Adult
.
Use what assessment on the aging adult to elicit any loss of function, self-care deficit, or safety risk that may occur as a process of aging or musculoskeletal illness.
A)complete assessment
B)functional assessment
C)both of none of the above
.
OBJECTIVE DATA
.
A screening musculoskeletal examination suffices for most people? The nurse does which of the following?
A) Inspection and palpation of joints integrated with each body region
B)Observation of ROM as person proceeds through motions described earlier
C) Age-specific screening measures, such as Ortolani sign for infants or scoliosis screening for adolescents
D)all the above
D
During the assessment the nurse should?
A)Support each joint at rest. Muscles must be soft and relaxed to assess the joints under them accurately.
B) Take care when examining any inflamed area where rough manipulation could cause pain and muscle spasm. To avoid this, use firm support, gentle movement, and gentle return to a relaxed state
C)both a and b
D)a and second part of b
C
Presence of swelling is significant and signals joint irritation.
A)true
B)false
True
Swelling may be excess joint fluid (effusion), thickening of the synovial lining, inflammation of surrounding soft tissue (bursae, tendons), or bony enlargement.
A)true
B)flase
True
(complete loss of contact between the two bones in a joint)
A)dislocation
B)subluxation
C)contracture
A
(two bones in a joint stay in contact but their alignment is off);
A)subluxation
B)contracture
C)ankylosis
A
(shortening of a muscle leading to limited ROM of in a joint)
A)contracture
B)ankylosis
C)none
A
or ankylosis (stiffness or fixation of a joint).
A)subluxation
B)contracture
C)ankylosis
C
The nurse Palpates each joint, including its skin for temperature, its muscles, bony articulations, and area of joint capsule, an abnormal finding would be?
A)Warmth and tenderness that signal inflammation.
B) warmth and normal
A
The synovial membrane normally is not palpable. A small amount of fluid is present in the normal joint, but y.it is not palpable.
A)true
B)flase
True
The synovial membrane, When thickened, it feels .
A) “doughy” or “boggy.”
B) “hard” or “painful”
A
Palpable fluid is abnormal. Because fluid is contained in an enclosed sac, if you push on one side of the sac, the fluid will shift and cause a visible bulging on another side.
A)false
B)true
B
What is the most sensitive sign of joint disease.
A)Limitation in ROM
B)Increase in ROM
A
Articular disease (Inside the joint capsule [e.g., arthritis) produces swelling and tenderness around the whole joint, and it limits all planes of ROM in both active and passive motion.
A) articular disease
B)Extra-articular
A
(injury to a specific tendon, ligament, nerve) produces swelling and tenderness to that one spot in the joint and affects only certain planes of ROM, especially during active (voluntary) motion
A)articular disease
B)extra-articular disease
B
Do not confuse crepitation with the normal discrete “crack” heard as a tendon or ligament slips over bone during motion, such as when you do a knee bend.
A)true
B)false
A
is an audible and palpable crunching or grating that accompanies movement. It occurs when the articular surfaces in the joints are roughened, as with rheumatoid arthritis?
A)crepitation
B)dislocation
C)both a and b
A
Test the strength of the prime mover muscle groups for each joint.Muscle strength should be equal bilaterally and should fully resist your opposing force.
A)true
B)false
A
5 Full ROM against gravity, full 100 Normal resistance
4 Full ROM against gravity, some 75 Good resistance
3 Full ROM with gravity 50 Fair
2 Full ROM with gravity eliminated 25 Poor (passive motion
1 Slight contraction 10 Trace 0 No contraction 0 Zero
Muscle testing know it
TEMPOROMANDIBULAR JOINT
.
Swelling looks like a round bulge over the joint, although it must be moderate or marked to be visible.
A)true
B)false
True
Crepitus and pain occur with temporomandibular joint dysfunction
A)true
B)false
True
Instructions to Person and Motion and Expected Range
.
Open mouth maximally.
A)Normal is 3 to 6 cm, or three fingers inserted sideways.
B)Normal is 1 to 9 cm, or three fingers inserted sideways.
C)Normal is 2 to 4 cm, or three fingers inserted sideways.
Normal is 3 to 6 cm, or three fingers inserted sideways. A
Partially open mouth, protrude lower jaw, and move it side to side.
A)Lateral motion. Normal extent is 1 to 2 cm
B)Lateral motion. Normal extent is .5 to 2 m
C)both a and b
ALateral motion. Normal extent is 1 to 2 cm
Lateral motion may be lost earlier and more significantly than vertical.
A)in the TMJ
B) in the mandible
A
Stick out lower jaw.
A)Protrude without deviation.
B)Protrude without rotation.
C)Protrude without both a and b
A
CERVICAL SPINE
.
The spine should be straight and the head erect.
A)false
B)true
True
Palpate the spinous processes and the sternomastoid, trapezius, and paravertebral muscles. They should feel firm, with no muscle spasm or tenderness.
A)true
B)flase
True
Abnormal findings of the cervical spine the nurse would find?(select all that apply)
A) Head tilted to one side.
B)Asymmetry of muscles.
C)Tenderness and hard muscles with muscle spasm.
D)head straight forward
A,B,C
Instructions to Person and Motion and Expected Range of cervical spine
.
Touch chin to chest. Normal finding?
A)Flexion of 45 degrees
B)Flexion of 90 degrees
C)Flexion of 30 degrees
A
Lift the chin toward the ceiling. Normal finding?
A)Hyperextension of 45 degrees.
B)Hyperextension of 90 degrees.
C)Hyperextension of 55 degrees.
C
Touch each ear toward the corresponding shoulder. Do not lift up the shoulder. Normal finding?
A)Lateral bending of 40 degrees
B)Lateral bending of 50 degrees
C)Lateral bending of 70 degrees
A
Turn the chin toward each shoulder. Normal finding?
A)Rotation of 70 degrees
B)Rotation of 90 degrees
C)Rotation of 180 degrees
A
The person normally can maintain flexion against your full resistance. This also tests the integrity of cranial nerve Xl (spinal). Abnormal findings would be?
A)The person cannot hold flexion.
B)The person can hold flexion
A
Shoulder
.
Check the size and contour of the joint, and compare shoulders for equality of bony landmarks. Normally, no redness, muscular atrophy, deformity, or swelling is present.
A)true
B)false
True
Check the anterior aspect of the joint capsule and the subacromial bursa for abnormal swelling.
A)true
B)false
True
Dislocated shoulder
A)loses the normal rounded shape and looks flattened laterally
B)gains the normal rounded shape and looks flattened laterally
True a
Swelling of a shoulder is best seen?
A) anteriorly. Considerable fluid must be present to cause a visible distention because the capsule normally is so loose.
B) posterily. Considerable fluid must be present to cause a visible distention because the capsule normally is so loose
A
Be aware that shoulder pain may be from local causes or it may be referred pain from a hiatal hernia or a cardiac or pleural condition, which could be potentially serious.
A) true
B)false
True
Swelling of subacromial bursa
A)is localized under deltoid muscle and may be accentuated when the person tries to abduct the arm
B)localized under trapezes muscle and may be accentuated when the person tries to abduct the arm
A)
The nurse is aware that, Pain from a local cause is reproducible during the examination by palpation or motion?
A)false
B)true
True B
Start at the clavicle and methodically explore the acromioclavicular joint, scapula, greater tubercle of the humerus, area of the subacromial bursa, the biceps groove, and the anterior aspect of the glenohumeral joint. Palpate the pyramid-shaped axilla; no adenopathy or masses should be present.
A)false
B) true
True b
Abnormal findings of the shoulder would be?
A)Hard muscles with muscle spasm.
B) Tenderness or pain.
C)both a and b
C
Instructions to Person and Motion and Expected Range of the shoulder
.
With arms at sides and elbows extended, move both arms forward and up in wide vertical arcs and then move them back. Normal finding?
A)Forward flexion of 180 degrees. Hyperextension up to 50 degrees
B)Forward flexion of 200 degrees. Hyperextension up to 50 degrees
C)Forward flexion of 90 degrees. Hyperextension up to 50 degrees
D) all the above
AForward flexion of 180 degrees. Hyperextension up to 50 degrees
Rotate arms internally behind back, place back of hands as high as possible toward the scapulae. Normal finding?
A)Rotate arms internally behind back, place back of hands as high as possible toward the scapulae
B)Rotate arms externally behind back, place back of hands as high as possible toward the scapulae
C)both a and b
A
With arms at sides and elbows extended, raise both arms in wide arcs in the corona] plane. Touch palms together above head. Normal finding?
A)Abduction of 180 degrees. Adduction of 30 degrees
B)Abduction of 180 degrees. Adduction of 60 degrees
C)Abduction of 90 degrees. Adduction of 50 degrees
D)Abduction of 180 degrees. Adduction of 50 degrees
Abduction of 180 degrees. Adduction of 50 degrees D
Touch both hands behi.nd the head with elbows flexed and rotated posteriorly. Normal finding?
A)Touch both hands behind the head with elbows flexed and rotated posteriorly.
B)Touch one hand behind the head with elbows flexed and rotated posteriorly.
A
Rotator cuff lesions may cause limited ROM, pain, and muscle spasm during abduction, whereas forward flexion stays fairly normal.
A)true
B)flase
True
The shoulder shrug also tests the integrity of cranial nerve ________ the spinal accessory.
A)11
B)12
C)6
A
. Elbow
.
Check the olecranon bursa and the normally present hollows on either side of the olecranon process for abnormal swelling.
A) true
B) false
True
Subluxation of the elbow shows the forearm dislocated?
A) anteriorly
B) posteriorly.
BSubluxation of the elbow shows the forearm dislocated posteriorly.
Swelling and redness of olecranon bursa are localized and easy to observe because of the close proximity of the bursa to skin
A)true
B)false
True
Effusion or synovial thickening shows first as a bulge or fullness in groove on either side of the olecranon process, and it occurs with
A) gouty arthritis.
B) gout elbowitis
C)both a and b
A
Palpate with the elbow flexed about 70 degrees and as relaxed as possible.Use your left hand to support the person’s left forearm, and palpate the extensor surface of the elbow-the olecranon process and the medial and lateral epicondyles of humerus-with your right thumb and fingers.
A)true
B) flase
True
Epicondyles, head of radius, and tendons are common sites of inflammation and local tenderness, or “tennis elbow.”
A)true
B)false
True
With your thumb in the lateral groove and your index and middle fingers in the mectial groove, palpate either side of the olecranon process using varying pressure. Normally, present tissues and fat pads feel fairly solid. Check for any synovial thickening, swelling, nodules, or tenderness.
A)true
B)flase
True
Abnormal finding in the elbow would be?
A)Soft, boggy, or fluctuant swelling in both grooves occurs with synovial thickening or effusion
B)Hard, swelling, or fluctuant swelling in both grooves occurs with synovial thickening or effusion
ASoft, boggy, or fluctuant swelling in both grooves occurs with synovial thickening or effusion
Subcutaneous nodules are raised, firm, and nontender, and overlying skin moves freely. Common sites are
A)in the olecranon bursa and along extensor surface of the ulna. These nodules occur with RA
B) in the radial bursa and along extensor surface of the ulna.
A
lnstructions to Person and Motion and Expected Range of the elbow
.
Bend and straighten the elbow, normal finding?
A)Flexion of 150 to 160 degrees; extension at 0. Some healthy people lack 5 to l0 degrees of full extension, and others have 5 to 10 degrees of hyperextension.
B)none
A
Movement of 90 degrees in pronation and supination, normal finding?
A)Hold the hand midway; then touch front and back sides of hand to table
B) halfway and touch back to front sides of hand to table
A
Wrist and Hand
.
The normal functional position of the hand shows the wrist in slight extension. This way, the fingers can flex efficiently and the thumb can oppose them for grip and manipulation. The fingers lie straight in the same axis as the forearm. Normally, no swelling or redness, deformity, or nodules are present.
A)true
B)flase
True
Abnormal findings of the wristband hand would be?(select all that apply)
A)Subluxation (partial dislocation) of wrist.
B)Ulnar deviation; fingers list to ulnar side.
C)Dupuytren contracture; flexion contracture of finger(
D)Swan-neck or boutonniere deformity in fingers
E)Atrophy of the thenar eminence
A,b,c,d,e
Use your thumb and index finger in a pinching motion to palpate the sides of the interphalangeal joints (Fig. 22-25). Normally, no synovial thickening, tenderness, warmth, or nodules are present. But in a abnormal finding the nurse would suspect to which finding?
A)Heberden and Bouchard nodules are hard and nontender and occur with osteoarthritis
B)Heberden
C)Bouchard nodules
D)osteoarthritis
A
Instructions to Person and Motion and Expected Range of wrist and hand
.
Bend the hand up at the wrist.normal finding?
A)Hyperextension of 70 degrees (Fig. 22-26, A).
B) Palmar flexion of 90 degrees. Flexion of 90 degrees. Hyperextension of 30 degrees (Fig. 22-26, B).
C) Ulnar deviation of 50 to 60 degrees, and radial deviation of 20 degrees (Fig. 22-26, C).
D)Abduction of 20 degrees; fist tight. The responses should be equal bilaterally (Fig. 22-26, D, E)
A
