Vinettes (Irene Gold) Part III

Question 1

A 71 year old patient present to the office with Low Back Pain after gardening, pain has came on 18 hours ago.

What are three possible Diagnosis?
What are three Treatments/Follow ups?
What three things can be a Progression of the complaint?

Answer 1

Diagnosis:
Osteoporotic Fracture
Pathological Fracture
Facet Arthritis

Treatments/Follow ups:
Cryotherapy
Modify Activities of Daily Living (ADL’s)
Refer to an Orthopedist; because of fractures

Progression:
Postural changes
Alter body bio-mechanics
Unrelenting back pain

Question 2

A 41 year old female, pain with abduction, can’t reach over head. Positive findings on Apley’s Scratch and Impingement orthopedic exams.

What are three possible Diagnosis?
What three things are Observed?
What three things can be a Recommended/Rehab?

Answer 2

Diagnosis:
Shoulder Impingement
Supraspinatus Calcification
Hydroxyapatite Deposition Disease (HADD)

Observed:

• Positive Empty Can Test
• Positive Neer’s Test (Patient in a relaxed standing position. The arm to be tested should be moved passively by the examiner. The patients arm of the shoulder to be tested is positioned such that the arm is relaxed at the side of the body and the elbow is fully extended.From the starting position the examiner internally rotates the patients arm and forcefully moves the arm through the full range of forward flexion or until reports of pain.)
• Positive Codman’s Sign

Recommended/Rehab:
Transverse Friction Massage
Codman’s Exercises
Strengthening external should muscles

Question 3

What three conditions can present with an Ivory White Vertebrae (IWV) on x-ray?

Answer 3

Mets (Blastic)
Paget’s
Hodgkin’s

Question 4

Degenerative Spondylitis is seen with what problem?

Answer 4

Facet Arthritis

Question 5

What three bones may be involved in a patient with an Ivory White Vertebrae (IWV)?

Answer 5

Pelvis
Skull
Femur

Question 6

What are three possible sequelae of a patient with an Ivory White Vertebrae (IWV)?

Answer 6

Pathological collapse or a vertebrae
Malignant degeneration
Spinal canal stenosis

Question 7

What are three findings if a patient is deficient in B12?

Answer 7

Stomach issues
Glove and stocking Paresthesia
Normocyctic Normochromic anemia

Question 8

What is the conditions most often seen with facet issue?

Answer 8

Degenerative Joint Disease (DJD) with Canal stenosis

Question 9

68 year old male with low back pain for six months. Pain is a dull ache and is better in the flexed position. There is an increase in pain with extension and rotation. Walking upstairs makes the pain decrease.

What are three possible Diagnosis?
What are three Symptoms?
What three things can be a Treatment?

Answer 9

Diagnosis:
Ligamentum Flava Hypertrophy
Central Disc Protrusion
Canal Stenosis

Symptoms:

• Decrease in the Deep Tendon Reflexes (DTR) or the lower extremity
• Disability
• Muscle weakness

Treatment:
NCV/EMG testing
Centralized Movements
Trial period of adjusting

Question 10

What condition can present similar to DISH?

Answer 10

Diabetes Mellitus

Question 11

What two things will be found in both DISH and Diabetes Mellitus?

Answer 11

Positive HLA B27 test

Ketones in the urine

Question 12

A 19 year old patient present with difficulty walking.

What are three possible Differential Diagnosis?
What three things are Initial Treatment?
What three things can be a Associated Problems?

Answer 12

Differential Diagnosis:
Benign Paroxysmal Positional Vertigo
Vestibular Neuritisis
Free floating otoliths

Initial Treatments:
Epley’s Maneuver
Canalith’s Repositioning
Rule out intercranial pathology

Associated Problems:
Nausea
Loss of balance
Hearing Loss

Patient had Benign Paroxysmal Positional Vertigo

Question 13

A 54 year old with low back pain and pain with extension. Kemp’s test is positive.

What are three possible Differential Diagnosis?
What three things are Positive Findings?
What three things can be a Management?

Answer 13

Differential Diagnosis:
Degenerative Spondylosis (Most commonly at L4)
Facet Syndrome
Lower Cross Syndrome

Positive Findings:
Decrease in disc height
Meniscoid entrapment
Weak core muscles

Management:
William’s Flexion Exercises
Knee to Chest exercises
SPECT test

Question 14

A 24 year old with head/neck pain in the Sub-occipital region.

What are three possible Diagnosis?
What three things are Accompanying Conditions?
What three things can be a Treatment?

Answer 14

Diagnosis:
Agenisis of the Posterior Arch
Congenital anomaly
Hypertrophy of the anterior tubercle

Accompanying Conditions:
Neurological Defects
Atlantoaxial Instability
Anterior Rachischisis ( Rare Spina Bifida with no fusion of the neural arch)

Treatment:
Avoid upper cervical adjustments
Take flexion/extension films
Neurological evaluation

Question 15

A 64 year old with a shuffled gate and no arm movements while walking.

What are three possible Positive Findings?
What three things are Sequelae?
What three things can be a Follow Up?

Answer 15

Positive Findings:
Resting Tremor
Rigidity
Bradykesia (Slow walking)

Sequelae:
Cognitive Impairment
Difficulty Swallowing
Constipation

Follow Up:
Encourage daily activity
Modify home, so falls will happen less often
Refer to a Neurologist

Patient has Parkinson’s

Question 16

What are the treatments and clinical findings of Scheuermann’s Disease?

Answer 16

Treatment:
Stop physical activity
Kinesotaping
Adjust Supine, in an A-P direction

Clinical Findings:
Muscle stiffness/fatigue
Intermittent Pain
Hyperlordosis of the lumbar spine

Question 17

What are three findings with Diabetes Mellitus?

Answer 17

Vessel calcification
Waxy exudates
NVC studies

Question 18

What condition is often seen with exacerbations and remissions, episodic?

Answer 18

Multiple Sclerosis (MS)

Question 19

In the condition of Multiple Sclerosis (MS) what are three:

Follow Up
Associated Signs
Sequelae

Answer 19

Follow Up:
Electrodiagnosis
MRI of the Brain
Protein in the Cerebral-spinal fluid (CSF)

Associated Sign:
Diplopia/Visual Disturbances (Double Vision)
Hyperreflexia
Faculations

Sequelae:
Urinary Incontinence
Optic Atrophy
Vertigo

Question 20

For the condition of Bell’s Palsy what cranial nerve is first effected and what subsequent cranial nerve is effected?

Answer 20

Cranial Nerve VII (7) effects Cranial Nerve VIII (8)

Question 21

What two symptoms may be seen in a patient with Bell’s Palsy?

Answer 21

Hyeracusis- increased sensitivity to sound

Decreased ability to speak

Question 22

In the condition of Rheumatoid Arthritis what are:

X-ray findings (Three)
Lab Test (Two)
Synonyms (Two)

Answer 22

X-ray:
Juxarticular osterosis
Uniform Joint space
Marginal erosion

Labs:
Increase in C Reactive Protein
Increase in Erythrocyte Sedimentation Rate (ESR)

Synonyms:
Sero-positive
Uniform Arthritisis

Question 23

A 56 year old female with neck pain, radiates to the left arm down to the thumb and index finger. Distraction and Compression test are positive.

What are three possible Positive Findings?
What three things are Diagnosis?
What three things can be a Management?

Answer 23

Positive Findings:
Positive Bacody’s
Decrease sensation on lateral arm
Hyporefexia of Brachioradialis

Diagnosis:
C5/C5 IVF encroachment
Peripheral Nerve entrapment
Median nerve entrapment

Management:
NCV study
Adjust
Cervical traction with slight flexion

Question 24

A 82 year old patient with sudden onset of Low Back Pain. States that ice makes it better and rates the pain an 8 out of 10. Pain is described as “Sharp”.

What are three possible Radiographic Findings?
What three things are Initial Diagnosis?
What three things can be a Treatment?

Answer 24

Radiographic Findings:
Osteopenia
Degenerative Disc Disease (DDD)
Arteriosclerosis Plaquing

Initial Diagnosis:
CT
DEXA- Osteopenia
Abdominal Ultrasound

Treatment:
Adjust lumbar spine
Fit for lumbar support
Limit certain physical activities

Question 25

A 21 year old football player presents with shoulder pain. What are three possible Diagnosis? What three things are Initial Treatment? What three things can be a Consequences?

Answer 25

Diagnosis: Acromioclavicular (A-C) Ligament Sprain Acromioclavicular (A-C) Separation Coroclavicular ligament Sprain Initial Treatment: Refer to a surgeon for repair Sling Cryotherapy Consequences: Early onset of Arthritisis Rotor Cuff Tendonopathy Impingement syndrome (Supraspinatus Muscle)

Question 26

A 50 year old male rates pain a 6-7 out of 10. Positive orthopedics are Hibbs and Anvil. What are three possible X-ray Findings? What three things are Sequelae? What three things can be a Diagnosis?

Answer 26

X-ray: Osteolytic Lesion Metaphyseal Lesion Osteopenia Sequelae: Increased infection Unexplained weight loss Aneurism Diagnosis: Multiple Myeloma (MM)******* Primary Neoplasm Hematropic lesion

Question 27

A 17 year old female complains of a dull aching pain rating at a 4-6 out of 10 and had a positive Stork Test. What condition does she have?

Answer 27

Spondylolysis **Stork Test is very indicative of this condition**

Question 28

If a patient has Lower Cross Syndrome what are Three Clinical Findings Three primary Case Management Three muscles to strengthen to prevent injury

Answer 28

Clinical Findings: Increased Lumbar Lordosis Tight/Hypertonic Quadriceps Hypertonic Lumbar erectors Primary Case Management: Take Stress Films Temporary Stop Activities Anti-Lordotic Bracing Muscle to Strengthen: Hamstring Gluteus Maximus Transverse Abdominal

Question 29

A 58 year old with insidious onset of thoracic pain. What are three possible Diagnosis? What three things are Progressions? What three things can be Primary Treatment?

Answer 29

Diagnosis: DISH Anterior Longitudinal Ligament Calcification Ankylosis Progressions: Decrease in breathing (Hoarseness and Dyphagia) Fatigue of postural muscles Develop Hyperinsulinemia (Diabetes Mellitus) Primary Treatment: Monitor Diabetes Positive HLA B27 Thoracic Brace/ Strengthen back muscles

Question 30

In the condition of Bell's Palsy; What are two ways it can be classified? What two symptoms can be see with it? What are three treatments?

Answer 30

Classification: Upper Motor Neuron Lesion (UMNL) Cranial Nerve VII (7) Pathology Symptoms: Decreased taste discrimination Increase tear production while chewing Treatments: Eye Patch Adjust Co-manage

Question 31

What is seen upwards of 90% of the time with Rheumatoid Arthritis?

Answer 31

Baker's Cyst

Question 32

What condition is Ray Sign seen in?

Answer 32

Reactive Arthritis

Question 33

A 10 year old female with right knee pain and swelling. No trauma, overweight, and has asthma, increased temperature and pain is relieved by aspirin. What are three age related conditions? What are three x-ray findings? What are three signs from the history to help determine to diagnosis?

Answer 33

Age related conditions: Chondroblastoma Aneurysmal Bone Cyst (ABC) Simple Bone Cyst (SBC) X-ray findings: Expansive Metaphyseal Fluid Filled Signs: Knee swelling Gender No history of trauma

Question 34

A 25 year old football player has pain brought on by lateral flexion and has week toe off. What are three positive exam findings? What are two sequelae? What are three treatments? What nerve root and disc level are effected?

Answer 34

Positive Exam Findings: Decreased Achilles Reflex Weak Foot Eversion Weak foot plantar flexion Sequelae: Caudia Equina Syndrome Decreased bowel and bladder function Treatments: Flexion Distraction Technique McKenzie Extension Exercises Side Bridge exercises S1 Nerve Root L5 Disc

Question 35

A 50 year old patient with previous skin cancer, hits his head on a shelf. What are three possible Diagnosis? What three things are Signs/Symptoms? What three things can be a Complications?

Answer 35

Diagnosis: Canal Stenosis Upper Motor Neuron Lesion (UMNL) Central Disc Protrusion Sign/Symptoms: Clonus Hyperreflxia of lower extremities Bowel and Bladder disturbances Complications: Weakness of lower extremities Paraplegia Complete loss of Bowel and Bladder

Question 36

A 62 year old male with low back pain. Nothing makes the pain better. Pain gets worse with walking. Pain is rated at a 9 out of 10. What are three possible Positive Findings? What three things are Sequelae? What three things can be seen on X-ray?

Answer 36

Positive Finding: Normocytic Normochromic Anemia Increase in Serum Calcium Increase in Proteins Sequelae: Severe Prolong Back Pain Recurrent Infection Renal Failure X-ray: Vertebral Plana Pathological Fracture Generalized Osteoporosis

Question 37

A 36 year old male with a headache that has gotten worse over the last month. Pain is described as a dull ache and has an anterior head carriage. What are three possible X-ray findings? What three things Exam Findings? What two things can be a Treatment?

Answer 37

X-ray: Occipilization Hypoplastic Disc Congenital Anomaly Exam Findings: Abnormal Flexion/Extension Films Hypertonic Pectoralis Major Hypotonic Serratus Anterior Treatment: Myofacsial Release Technique Ergonomic Retaining

Question 38

A 43 year old male who is obese and diagnosed with Diabetes. Anterior drawer, Lachman's and McMurry's test are Negative. What are three possible Differential Diagnosis? What three things are X-ray findings? What three things can be an Appropriate Diagnostic test?

Answer 38

Differential Diagnosis: Calcium Pyrophosphate Deposition Disease (CPPD) Pseudogout Condrocalcinosis X-Ray: Calcification of the joint Sharp Tibial Plateau Subcondral Cyst Diagnostic Test: Joint Aspiration MRI Biopsy of the Articular Cartilage

Question 39

A 30 year old male presents with left knee pain, was laying carpet two days ago when her heard a "pop". No orthopedic exams were performed due to swelling. What are three possible Positive Findings? What three things are Treatment? What three things can be a Next Step after initial care?

Answer 39

Positive Findings: Bounce Home McMurry's Apley's Compression Treatment: One arm Crutch to reduce the weight Cryotherapy Refer to an Orthopedist Next Step: Knee extension brace Water Resistance exercises Progression back to full weight bearing activities

Question 40

In the condition of Carpal Tunnel what are: Two Differential Diagnosis Three Causes Three Treatments

Answer 40

Differential Diagnosis: Median Nerve Compression Anterior Interosious Nerve Syndrome (Pronator Teres) Causes: Tendinous Nerve Compression Tendinous Sheath Inflammation Tendinous Sheath Scaring Treatment: Fix for Wrist splint Stretch wrist extensors Adjust lunate A-P

Question 41

A 26 year old football player was hit from behind and complains of neck pain. What are three possible Common Findings on X-ray? What three things are Differential Diagnosis? What three other test can be ordered?

Answer 41

Common Findings on X-ray: Congenital Block Occiipalization Atlas Hypertrophy Differential Diagnosis: Whiplash Odontoid Fracture Os Odentodium Other test: Flexion/Extension Films MRI Neurological Evaluation

Question 42

A 19 year old female has low back pain and stiffness in the morning. What are three Lab test? What three things are Additional Findings? What three things can be a done for Case Management?

Answer 42

Labs: ANA Serum Glucose Anti-DNA Additional Findings: Malar Rash Oral Ulcers Discoid Lesion Management: Chiropractic Care Avoid the Sun Activities to Tolerance

Question 43

A male patient was playing basketball two weeks ago and has eccemosis, pain and swelling in his ankle from an inversion sprain. What are three Initial Treatments? What three things are Long Term Treatments? What three things can be a Complication?

Answer 43

Initial Treatment: Refer to an Orthopedist Ice Place on Crutches Long Term Treatment: Wobble Board Eversion Exercises Orthopedics Complications: Non Union Fracture Peronus Brevis Weakness Excessive Bone Deformity

Question 44

A 24 year old female with extreme neck pain. Right head tilt, looking over the left shoulder produces headache and SCM tightness. What are three possible Diagnosis? What three things are Causes? What three things can be a Treatment?

Answer 44

Diagnosis: Spastic Torticolis Wry Neck Myofascial Pain Syndrome Causes: Cold Environment Biochemical Focal Muscle Dystonia Treatment: Trigger Point Therapy Vasocoolent Spray and Stretch Myofascial Release Technique

Question 45

A 12 year old male presents with neck pain and has decrease neck extension. What are three possible Diagnosis? What three things are Treatment? What three things can be a Finding if not resolved?

Answer 45

Diagnosis: Benin Bone Tumor Expansial Bone Lesion Enlargement Treatment: Surgical Curettage Surgical Excision Surgical Stabilization If not Resolved: Spinal Cord Compression Painful Scoliosis Gait Disturbances

Question 46

A 50 year old female chronic shoulder pain, pain overhead, decrease ROM. No trauma, pain is relieved by aspirin. Gradual onset over the last four months and the pain is getting worse. What are three possible Diagnosis? What three things are Treatment? What three things can be a Follow Up?

Answer 46

Diagnosis: Adhesive Capsulitis (Frozen Shoulder) Impingement Syndrome (Supraspinatus Muscle) Bursitis Treatment: Finger Tip Wall Walk Codman's Pendulum Exercises Ultrasound Follow Up: Strengthen Shoulder Stabilizers Active ROM exercises **All finding were= NORMAL**

Question 47

In the condition of Scheuermann's Disease: What are: Two x-ray findings? Two other names? Three signs/symptoms?

Answer 47

X-ray Findings: End plate Irregularity Decreased Anterior Body height Other Names: Juvenile Hyperkyposis Vertebral Epiphestisis Sign/Symptoms: Early Degenerative Joint Disease (DJD) Postural Fatigue Worsening Anemia

Question 48

In the condition of Scleroderma what are: Three X-ray findings? Three associated findings? Three complications?

Answer 48

X-ray findings: Acro-Osteolytsis Systemic Sclerosis Calcium Cutis Associated Findings: Raynaud's Phenomenon Skin Hardening Positive ANA test Complications: Dysphgia Gastroesophageal problems Pulmonary Fibrosis

Question 49

If a Patient has a Prostate issue: What three Labs will be positive? What other three conditions may they possible have? What are three follow ups?

Answer 49

Labs: Prostate Specific Antigen (PSA) Alkaline Phosphate Acid Phosphate ``` Conditions: Mets (Blastic) Paget's Hodgkin's *All have Ivory White Vertebrae on X-Ray* ``` Follow Up: Refer to an Oncologist MRI of the Prostate Radio-nucleotide Bone Scan

Question 50

In the condition of Regional Complex Pain Syndrome: What are two other names? What three ways can it be treated? What are three additional findings?

Answer 50

Other Names: Reflex Sympathetic Dystrophy Syndrome Sudeck's Atrophy Treatment: Triple Radio-nucleotide Themography Doppler Ultrasound Additional Findings: Atropic Skin Changes Thenar Hypertrophy Hyperhydrosis (Excessive Sweating)

Question 51

What is two other names for the most common benign bone tumor or the hand? What three findings will be present on the X-ray? What is one differential diagnosis?

Answer 51

Other names: Ollier's Disease Multiple Enchondromas X-ray findings: Geographical Expansile Cortical thinning Differential Diagnosis: Pathological Fracture

Question 52

A 27 year old male with asthma, with cortical steroid injections, has limited right lateral flexion. What are three possible X-ray Findings? What three things are Progressions? What three things can be a Next Step?

Answer 52

X-Ray Findings: Hemivertebrae Structural Scoliosis Primary defect of growth center ``` Progressions: Neurological Defects Progressive Scoliosis Cardiac Involvement Degenerative Joint Disease (DJD) ``` Next Step: Adjust Spinal Stretching Exercises Extension Muscle Rehab

Question 53

A 30 year old male pain for a week. Supraspinatus tendon two years ago. Shoulder abduction, greater than 90 degrees creates pain. Flexion is limited. Muscle test is a 4 out of 5. Speed's test is positive. Negative Orthopedic exams include: Empty can, Yeargason's and Wright's. What are three possible Differential Diagnosis? What three things are Prevention? What three things can be a Follow Up?

Answer 53

Differential Diagnosis: Bicipital Tendonitis SLAP Lesion Subdeltoid Bursitis Prevention: Strengthen Rotor Cuff muscles Isometric curls Ergonomic re-education Follow Up: Limit overhead movements Passive ROM MRI

Question 54

The disc above affect which nerve?

Answer 54

The one below

Question 55

If there is pain on the Lateral Aspect of the Medical Femoral condyle what condition is present?

Answer 55

Osteochondritis Dessecans (OCD)

Question 56

What is the name of the positive Orthopedic exam for Osteochondritis Dessecans?

Answer 56

Wilson's Test; pain with internally rotating the tibia during extension of the knee between 90° and 30°, then relieving the pain with tibial external rotation

Question 57

What condition has the following characteristics: Painless 20 year old female Expansile Eccentric Location Blood Filled Found in the Metaphyseal and Diaphyseal areas of the bone

Answer 57

Aneurysmal Bone Cyst (ABC)

Question 58

What is the most common benign bone tumor of the spine?

Answer 58

Hemagioma (Vascular Neogenisis)

Question 59

What is the appearance of a Hemagioma on X-Ray?

Answer 59

Corduroy Cloth

Question 60

What two additional findings are often seen in a patient with a Hemagioma?

Answer 60

Vertebral body expands into the cord | Calvirum (Skull) Involvement

Question 61

What condition is found most in males, peaking at the age of 20. Found in the spine and in long bones and considered a very large Osteoid Osteoma?

Answer 61

Osteoblastoma

Question 62

What three symptoms will a Osteoblastoma produce?

Answer 62

Decrease ROM Muscle splinting Scoliosis

Question 63

What are three treatments for Osteoblastoma?

Answer 63

Surgical Curettage Surgical Excision Surgical Reconstruction

Question 64

What two things will happen to the patient if nothing is done to an Osteoblastoma?

Answer 64

Painful scoliosis | Spinal canal stenosis with neurological effects

Question 65

If there is pinpoint/one finger pain in the abdominal region what does the patient have?

Answer 65

Peptic Ulcer

Question 66

If the patient is able to pinpoint the pain in the shoulder what condition do they have?

Answer 66

Bursitis

Question 67

Urinary Bladder has referred pain where?

Answer 67

Supra pubic region

Question 68

Where is the referral for small intestine issues?

Answer 68

Peri-umbilical region

Question 69

If a patient has dermatomal pain where does it originate?

Answer 69

Nerve Root

Question 70

What type of pain comes from a facet? | What is the lowest area facet pain will travel to?

Answer 70

Type: Scleratogonous Travel: Never below the knee

Question 71

Where is kidney pain felt?

Answer 71

In the flank region on the posterior aspect of the patient

Question 72

Where is pain from a pancreatic issue located and what makes it better?

Answer 72

Located: T10-T12 Better: Leaning forward

Question 73

What is the pain referral patten for the Gallbladder?

Answer 73

Inferior angle of the right scapula

Question 74

In what population do you often see Gallbladder issues?

Answer 74

Females, over 40, with flatulence, multiple kids, that eat fast food fatty meals

Question 75

What is the pain referral pattern for a patient with a heart problem?

Answer 75

Left shoulder, down the medial arm and forearm to the hand

Question 76

If a patient has blurred vision and a throbbing migraine. Two clinical findings? Three treatments? Two Aggravating factors?

Answer 76

Clinical Findings: Photophobia Nausea Treatments: Adjust Dietary Log Massage Therapist Aggravating Factors: Red wine Hormonal Imbalance

Question 77

A 50 year old smoker that has pain with walking. Three Differential Diagnosis Three Labs to be ordered Three Treatments

Answer 77

Differential Diagnosis: Deep Vein Thrombosis (DVT) Vascular Claudication Phlebitis Labs: D-Dimer Complete Blood Count (CBC) Doppler Ultrasound Treatments: Compressive Socks Elevate Legs Anticoagulant Therapy

Question 78

What are four radiographic findings for Paget's Disease?

Answer 78

Saber Sign Shepard's Crook Cotton Wool Skull Brim Sign

Question 79

What condition is the most primary malignancy of bone and does not destroy the pedicle?

Answer 79

Multiple Myeloma

Question 80

What is the radiographic finding on the skull for Multiple Myeloma? What does it do to the color of the x-ray?

Answer 80

Skull will have multiple holes similar in size X-ray will be darker

Question 81

What are four Lab findings to confirm Multiple Myeloma?

Answer 81

M spike on Immnoelectrophorisis Reverse in the A/G ratio Bence Jones Proteinuria Elevated ESR

Question 82

What is the rule when there are two cranial nerves that have a reflex?

Answer 82

Lower numbered Cranial nerve= Sensory | Higher numbered cranial nerve= Motor

Question 83

What type of Lesions are all Cranial Nerve Lesions?

Answer 83

Lower Motor Neuron Lesions (LMNL)

Question 84

What is the treatment for all muscle spasms? (Four Things)

Answer 84

Trigger Point Therapy Spray and Stretch Cryotherapy TENS unit

Question 85

When performing Romberg's Test: Where is the problem? Patient struggles with eyes open:___________ Patient struggles with eyes closed:__________ Patient has not problem with this test:________

Answer 85

Open: Cerebellum Closed: Posterior Columns No problem: Vestibular (C.N VIII (8))

Question 86

A 35 year old female has bilateral head and neck pain. She is a bank teller. What is three Etiology? What are three Managements? Three things to Adviser her to do?

Answer 86

Etiology: Cervical Rib Hypertonic Scalene Medicus Neurological Compromise Management: Stretch Pectoralis Muscles Neck retraction Stretch Scalene muscles Advice: Refer for Neurological Consult Order Nero-diagnostic studies NCV studies