SC 1/21/15

Question 1

When is the BATHE technique useful and what does BATHE stand for?

Answer 1

B – Background “Tell me what’s going on?”

A – Affect “What feelings does it stir up inside you?”

T – Troubling “What is it about the situation that troubles you the most?”

H – Handling “How would you say you have handled this situation so far?”

E – Empathy “This sounds like a truly difficult situation. My heart goes out to you.”

Question 2

What are the 3 main types of joints? Give one example of each in your answer

Answer 2

Synovial – knee
Cartilaginous – vertebrae
Fibrous - skull

Question 3

What is the difference between a synovial joint and a fibrous joint?

Answer 3

Synovial joint has capsule and synovial fluid

-synovial joints move more freely than fibrous joints

Question 4

List the 3 types of synovial joints and give an example of each.

Answer 4

spheroidal (shoulder)

Hinge (fingers)

Condylar (Knee)

Question 5

Mr. Backe is here to see you today for low back pain.

What are the “red flags” for serious underlying systemic disease to ask him about? Please list at least 4.

Answer 5

• Hx of cancer
• Unexplained weight loss
• Hx of IV drug use
• Pain at night/rest

Question 6

What social history information would be important to ask him about to help you more fully rule out trauma as a cause of or contributor to his back pain?

Answer 6

Ask Mr. Backe what he does for work or if he has had a change in activity like a new exercise regiment.

Question 7

Please name at least 3 systemic symptoms that could be associated with joint pain.

Answer 7

• Fever
• Rash
• Weight loss

Question 8

What are the primary components of any joint exam?

Answer 8

• Inspection
• Palpation
• Range of Motion (both active and passive)
• Neuromuscular
• Joint Specific Testing

Question 9

Pain or weakness on the supraspinatus, infraspinatus AND impingement tests (Neer’s or Hawkins) indicate a high likelihood (LR 48) of what injury?

Answer 9

Torn rotator cuff

Question 10

On your exam of a shoulder, what three signs are you looking for to help distinguish inflammatory from noninflammatory joint pain?

Answer 10

Tenderness
warmth
redness

Question 11

What is the single best maneuver for detecting a rotator cuff tear in this patient (LR 5.0 if positive)?

Answer 11

Drop arm test

Question 12

Ms. Rodilla is a 24 year old graduate student who is complaining of knee pain after an injury playing soccer in a competitive league over the weekend. She is having trouble verbally describing exactly where her right knee pain is located.

What could you ask her to do to help her show you exactly where her pain is located and what one of two maneuvers might you do to detect if she has an ACL tear?

Answer 12

• Ask her to point to pain

- Lachman Test

Question 13

What structural deficits of the knee does the McMurray test help identify and how is the medial structural deficit differentiated from the lateral?

Answer 13

• Used to evaluate medial and lateral meniscal tears
• If you do the maneuvar with external rotation of the lower leg/foot-medial meniscus
• Internal rotation of the lower leg/foot- lateral meniscus