Quiz 2

Question 1

This article deals specifically with pathologies related to the _ and accompanying _ _ system and the _.

Answer 1

Pathologies related to HEART and accompanying PERIPHERAL VASCULAR system and the LUNGS

Question 2

Due to the serious nature of many of these illness it is _ _ _ that the physical therapist would be _ by trunk or neck pain. However it _ the importance of _ _ so that appropriate _ _ can be initiated.

Answer 2

Due to serious nature of many of these illness it is NOT AS LIKELY that the PT would be FOOLED by trunk and neck pain.

However it MAGNIFIES the importance of EARLY DETECTION so that appropriate MEDICAL TREATMENT can be initiated.

Question 3

The heart is a common cause of _, _ and _ pain, but can also refer pain to the _, _ _ and _. In the Upper extremity the pain may be _ or _, but is classically found in the _ _ and is most commonly _ _.

Answer 3

The heart is a common cause of CHEST, NECK AND ARM pain, but can also refer pain to the JAW, POSTERIOR THORAX AND EPIGASTRIUM.

In the upper extremity the pain may be UNILATERAL or BILATERAL, but is classically found in the C8 DISTRIBUTION and is most commonly LEFT SIDED.

Question 4

Pain is usually described as a _ or _ _ but can manifest itself as a more common complaint of _ _ or _ _ dysfunction of the _ _ including the _ and _ regions.

Answer 4

Usually described as TIGHTNESS OR PRESSURE but can manifest itself as a more common complaint of GASTROINTESTINAL ILLNESS or MUSCULOSKELETAL SYSTEM dysfunction of the UPPER QUARTER including the FACIAL and CRANIAL regions

Question 5

With angina: onset of pain is usually associated with _, typically lasts _ _ _ _ and is relieved by _. However it may occur at _ or when _ and can last - minutes.

Answer 5

Onset of pain is usually associated with ACTIVITY, typically lasts LESS THAN 5 MINUTES and is relieved by REST.

However it may occur at REST or when SLEEPING and can last 20-30 minutes.

Question 6

Other symptoms of cardiovascular disease include _ of _ including both _ on exertion and _ _ _ (which can be relieved by _ _ in bed, and sleeping _ _ or with the _ _ by _).

Answer 6

Other symptoms include SHORTNESS OF BREATH, including both DYSPNEA on exertion and PAROXYSMAL NOCTURNAL DYSPNEA ( which may be relieved by SITTING UP in bed, and sleeping SITTING UP or with the HEAD ELEVATED by PILLOWS).

Question 7

With cardiovascular disease patient may also present with _ _, easy _, _, and _ of _.

Answer 7

May also present with ANKLE EDEMA, easy FATIGUABILITY, PALPATIONS and LOSS OF CONSCIOUSNESS

Question 8

During a physical exam, a resting pulse of greater than _ or lower than _ beats per minute is considered abnormal. Also a BP of greater than / that is consistent on _ _ _, is also a reason for further medical evaluation.

Answer 8

A resting pulse of greater than 100 or lower than 50 beats per minute is considered abnormal.

Also a BP of greater than 160/90 that is consistent on SEVERAL CONSECUTIVE READINGS is also a reason for further medical evaluation

Question 9

Coronary artery disease occurs more commonly in _ over _ years old, and in individuals who _, are _, or are _. What other condition is often present in these patients?

Answer 9

Occurs more commonly in MEN over 40 years old, and in individuals who SMOKE, are OBESE, or are HYPERRLIPIDEMIC.

Peripheral vascular disease is often present

Question 10

Coronary artery disease manifests as _, _ _, heart _ and sudden _. Because _ often precedes an _, _ _ is critical.

Answer 10

Manifests as ANGINA, MYOCARDIAL INFARCTION, heart FAILURE, and sudden DEATH.

Because ANGINA often precedes an MI, EARLY DIAGNOSIS is critical.

Question 11

Any neck, chest or arm pain associated with _ or _ is potentially critical and should _ the _ of the presence of _ _.

Answer 11

Associated with DYSPNEA OR SWEATING is potentially critical and should RAISE THE SUSPICION of the presence of SERIOUS DISEASE.

Question 12

_ _ _ may also manifest as angina, especially _ _ and _ _ _ _ which is a common cause of sudden death in young athletes. It occurs in all _ _ without _ _.

Answer 12

VALVULAR HEART DISEASE may also manifest as angina especially AORTIC STENOSIS and IDIOPATHIC HYPERTROPHIC SUB-AORTIC STENOSIS which is a common cause of sudden death in young athletes.

It occurs in all AGE RANGES without SEXUAL PREDILECTION.

Question 13

With valvular heart disease there may be a history of _ _ or _ _.

Answer 13

There may be a history of RHEUMATIC FEVER or HEART MURMUR.

Question 14

_ _ _ is common disease in young women. Symptoms include prolonged _ _ pain, _ and _.

Answer 14

MITRAL VALVE PROLAPSE is common is disease in young women.

Symptoms include prolonged NONSPECIFIC CHEST pain, PALAPITATIONS, and LIGHTHEADEDNESS

Question 15

_ is inflammation of the sac surrounding the heart, and usually causes a _ _ pain in the chest or left shoulder pain. Pain may be aggravated by _ or _ in _ _ and may be relieved by _ _.

Answer 15

PERICARDITIS is inflammation of the sac surrounding the heart, and usually causes a SHARP BURNING pain in the chest or left shoulder pain.

Pain may be aggravated by COUGHING OR CHANGE IN BODY POSITION and may be relieved by LEANING FORWARD

Question 16

_ has many causes including infection, trauma, cancer, collagen vascular disease, irriadiation, and infarction. _ _ often occurs in apparently healthy people after a _ _.

Answer 16

PERICARDITIS has many causes . . .

POST-INFECTIOUS PERICARDITIS often occurs in apparently healthy people after a PRECEDING INFECTION.

Question 17

_ are potentially dangerous arterial conditions, especially when the _ _ is involved.

Answer 17

ANEURYSMS are potentially dangerous arterial conditions, especially when the AORTIC ARTERY is involved.

Question 18

Aortic aneurysms may be caused by _ of the _ _ of the middle layer of the aortic wall, or a tear in the _ _ of the aorta, thus widening it.

Answer 18

May be caused by DESTRUCTION of the ELASTIC FIBERS of the middle layer of the aortic wall, or a tear in the INNER LINING of the aorta, thus widening it.

Question 19

Most aortic aneurysms occur just _ to the _ _ and are _, but are found with palpation to the _ _ region. Produces a _ that is more prominent, broader and distinct.

Answer 19

Most aortic aneurysms occur just CAUDAL to the RENAL ARTERIES and are ASYMPTOMATIC, but are found with palpation to the MID ABDOMINAL region.

Produces a PULSATION that is more prominent, broader and distinct.

Question 20

The palpable pulse is approximately _ _ _ or _ and should raise suspicion in the therapist’s mind of the presence of an aneurysm. Overly aggressive _ or _ _ _ in abdominal region could potentially worsen the aneurysm.

Answer 20

Palpable pulse is approximately TWO INCHES WIDE OR GREATER and should raise suspicion. . . .

Overly aggressive PALPATION OR SOFT TISSUE MOBILIZATION in the abdominal region could potentially worsen the aneurysm

Question 21

Symptomatic aortic aneurysm may be manifested solely by a _, _, _ or _ mid back, chest, left shoulder or abdominal pain.

Answer 21

Manifested by a DEEP, DIFFUSE, THROBBING OR ACHING mid back, chest, left shoulder or abdominal pain.

Question 22

Symptoms of abdominal aneurysm may be associated with _ _ and relieved by _. Because of the anatomical location of aorta, it may result in a multitude of other _ _ _ including the _ nerves, the _ and the _.

Answer 22

May be associated with INCREASED ACTIVITY and relieved by REST.

Because of the anatomical location of aorta, it may result in the multitude of other SEEMINGLY UNRELATED SYMPTOMS including the SPINAL nerves, the ESOPHAGUS, and the BRONCHI.

Question 23

Complaints associated with abdominal aneurysm include difficulty with _ or _. Generally occur in the _ and _ _ over a period of many years, but once ruptured are _ _.

Answer 23

Include difficulty with SWALLOWING OR BREATHING

Generally occur in the ELDERLY and SLOWLY ENLARGE over a period of many years, but once ruptured are RAPIDLY FATAL.

Question 24

_ _ of the _ is a common problem in the elderly and in smokers. The classic symptom is _ or _ most often felt in the _, _ or _ associated with physical activity and relieved by rest.

Answer 24

OCCLUSIVE DISEASE of the ARTERIES is a common problem in the elderly and in smokers.

Classic symptom is CLAUDICATION OR PAIN is most often felt in the BUTTOCKS, THIGHS, OR CALVES associated with physical activity and relieved by rest.

Question 25

With occlusive disease there is often a consistent relationship between the _ or _ of _ activity and the onset of pain.

Answer 25

Consistent relationship between the DURATION OR INTENSITY OF MUSCLE activity and the onset of pain.

Question 26

_ lower extremity symptoms may occur with involvement of the _. Where as _ lower extremity symptoms can be related to _ of _ _ such as the _ or _ arteries.

Answer 26

BILATERAL LE symptoms may occur with involvement of the AORTA. Whereas UNILATERAL LE symptoms can be related to OCCULUSION of PERIPHERAL VESSELS such as the ILIAC or FEMORAL arteries.

Question 27

Bilateral and unilateral LE symptoms can easily be confused with those of _ _, _ _ disease, or _ _ disease.

Answer 27

Can easily be confused with those of SPINAL STENOSIS, HERNIATED DISC disease or DEGENERATIVE JOINT disease.

Question 28

Besides the symptom of intermittent claudication, diminished or absent _, _ over the _, _ nails, skin _, and _ loss of the distal extremity all suggest involvement of the _ _ system.

Answer 28

Diminished or absent PULSES, BRUITS over the PULSES, DYSTROPHIC nails, skin ULCERS, and HAIR LOSS of the distal extremity all suggest involvement of the PERIPHERAL VASCULAR system.

Question 29

Areritis, or inflammation of the arteries, occurs in many diseases including _ _ no _ _ _. Usually accompanied by obvious systemic disorders such as _ and _ diseases.

Answer 29

Occurs in many diseases including RHEUMATOID ARTHRITIS AND SYSTEMIC LUPUS ERYTHMATOSUS.

Usually accompanied by obvious systemic disorders such as RENAL AND SKIN diseases.

Question 30

_ _ is a vasculitic condition that primarily causes aching and stiffness in numerous regions including the neck, shoulders, trunk and hips.

Answer 30

Polymyalgia rheumatica is a vasculitic condition . . . .

Question 31

Polymyalgia rheumatica is a disease of the _ and is also associated with _, _ , _ loss, _ and extremity _.

Answer 31

Is a disease of the ELDERLY and is also associated with MALAISE, FATIGUE, WEIGHT loss, FEVER and extremity CLAUDICATION .

Question 32

_ _ is manifested only be headaches which may precede sudden blindness as the _ _ and then the optic _ become progressively involved.

Answer 32

TEMPORAL ARTERITIS is manifested only be headaches which may precede sudden blindness as the TEMPORAL ARTERY and then the optic ARTERY become progressively involved.

Question 33

What should alert the therapist to possible presence of temporal arteritis?

Answer 33

Tenderness with palpation along the course of the temporal artery (just anterior to the ear and running, vertically)

Question 34

Temporal arteritis may occur with _ _ or without any other obvious systematic vasculitic conditions.

Answer 34

May occur with POLYMYALGIA RHEUMATICA or without . . . .

Question 35

The lungs and associated structures have the potential to cause _ _ or _ pain, and can also result in referral of pain to the _ or _ regions.

Answer 35

Have the potential to cause LOCAL THORACIC OR CHEST pain, and can also result in referral of pain to the CERVICAL OR SHOULDER regions.

Question 36

_ _ is rarely manifested as a pain syndrome without associated symptoms of disease being present.

Answer 36

PULMONARY DISEASE is rarely manifested as a pain syndrome . . . .

Question 37

Symptoms of pulmonary disease other than pain include sore _, _, _, _, _ and _. _ increases the risk for the most common conditions of the respiratory system including _ and _.

Answer 37

Symptoms include sore THROAT, FEVER, HOARSENESS, COUGH, DYSPNEA, STRIDOR, AND WHEEZING.

SMOKING increases the risk for the most common conditions of the respiratory system including CANCER AND INFECTION.

Question 38

When the pleura or outer lining of the lung is inflamed _ pain occurs, and the intensity will usually vary with _ or during the _ _. Pain will overly the _ of _ and in the absence of a thorough exam can be confused with chest wall pain of _ origin.

Answer 38

. . . Is inflamed PLEURITIC pain occurs, and the intensity will usually vary with COUGHING or during the RESPIRATORY CYCLE.

Pain will overly the AREA OF INFLAMMATION and in the absence of a thorough exam can be confused with chest wall pain of MUSCULOSKELETAL origin.

Question 39

When the diaphragm is involved pain may be referred to the _ and _ regions.

Answer 39

May be referred to the SHOULDER AND NECK regions.

Question 40

_ is the most common problem involving the pulmonary system. Most are _ and obviously _. However they may be _ and _, especially _ and _ infections.

Answer 40

INFECTION is the most common problem involving the pulmonary system.

Most are ACUTE and obviously SYMPTOMATIC. However they may be SUBTLE AND CHRONIC, especially TUBERCULOSIS and FUNGAL infections.

Question 41

Common symptoms (of pulmonary infection) are more likely to be _ in the _ than in the _ patient.

Answer 41

Are more likely to be ABSENT in the ELDERLY than in the YOUNGER patient.

Question 42

_ _ of the larynx and lung are common, with the lungs being the most frequent site of _ _.

Answer 42

PULMONARY CANCERS of the larynx and lung are common, with the lungs being the most frequent site of METASTATIC CANCER.

Question 43

Cancer is most prevalent in _ around the _ of _.

Answer 43

Most prevalent in SMOKERS around the AGE OF 60.

Question 44

If the tumor occurs in the _ of the lung the pain syndrome may precede _ or any noticeable change in a _ _.

Answer 44

If the tumor occurs in the PERIPHERY of the lung the pain syndrome may precede COUGHING or any noticeable change in CHRONIC COUGH.

Question 45

When the _ of the lung is involved (_ syndrome) pain the _, _ and _ _ may occur. Also due to it’s close proximity to the _ _ it may cause impingement that results in _ _ _ or _ _ type symptoms.

Answer 45

When the APEX of the lung is involved (PANCOAST’S syndrome) pain in the NECK, SHOULDER AND UPPER EXTREMITY may occur.

Also due to its close proximity to the BRACHIAL PLEXUS it may cause impingement that results in THORACIC OUTLET SYNDROME or CERVICAL NEUROPATHY type symptoms.

Question 46

Other than past medical history and family history, testing should include checking a patients _ _, _, observation of _ and _ including checking for _ _ of the distal extremity parts.

Answer 46

Testing should include check a patient’s BLOOD PRESSURE, PULSES, observation of NAILS AND SKIN including checking for HAIR LOSS of the distal extremity parts.