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Orthopedics NP
Info & Q: NP EXAM
| Question | Answer |
|---|---|
| Injuries to muscles are called? | Strains |
| Injuries to ligaments are called? | Sprains |
| Bursitis is inflammation of the? | Bursa sac |
| Bursa are made of what? | Fluid that may provide good source of nutrition for bugs therefore look for infection |
| Tendonitis is inflammation of? (Tindinitits) | Tendons |
| Tendonitis and bursitis are dx how? | clinical exam |
| Bursitis is usually characterized by pain when doing what? | pain at rest and pain with motion |
| A pt. with tendonitis usually has a history of? | repetitive motion |
| What 3 pt should we avoid using NSAIDS with? | 1. CAD 2. renal disease 3. heart failure |
| Golfers elbow is located where? | medial epicondyle |
| Tennis elbow is located where? | lateral epicondyle |
| Tennis elbow hurts when the pt does this? | a backhand shot |
| A common way to break this bone is to fall on an outstretched hand. | scaphoid bone |
| Another name for the scaphoid bone is? | navicular |
| The most common complaint when a pt has a fx scaphoid is? | dull wrist pain when squeezing |
| This assessment technique is suspicious of a scaphoid fx? | snuffbox tenderness |
| How do you identify the "anatomic snuffbox"? | have pt open 5 finger and take your thumb and put in the "snuffbox" to apply pressure. Tenderness is suggestive of fx of scaphoid fx. |
| Why is scaphoid fx so important to ID and refer for tx? | Because scaphoid gets "indirect" blood supply therefore less chance to heal |
| With a positive Finklestein Test consider? | DeQuervain's tenosynovitis |
| How to you do the Finklestein test? | Have pt place thumb in the palm of hand then wrap fingers around thumb. Then have them deviate their wrist. Tenderness will be consistent with DeQuervain's tenosynovitis. |
| Do Phanlen's test to assess for? | Carpal tunnel syndrome (Median nerve) |
| Describe Phanlen's test? | Reverse praying; Have pt the back of his two hands together and then start talking to him. This will narrow the canal that the nerve passess thru thus increasing the symptoms in the thumb, index or middle finger |
| Describe Tinel's test? | Tap the median nerve thus causing symtoms in the thumb, index or middle finger (median nerve) |
| What is the most common cause for adult shoulder pain? | shoulder impingment |
| What is a positive impingement sign? | have pt put arm a 90 then lift slowly; if pain in shoulder when lifting then consider impingement |
| What type of people get impingement injury? | people that do things over their head; baseball pitchers, tennis, wall painters |
| What muscle is the most commonly torn with rotator cuff injury? | Supraspinatus |
| How do you assess for torn rotator cuff? | Positive Drop arm test - pt inability to smoothly control shoulder adduction |
| what type of people get torn rotator cuff? | baseball players, swimmers, older pt b/c as age the fluid dries up |
| An ankle sprain is like a torn piece of paper: there are 3 grades I, II, III (describe each) | I. min torn lig; stable joint II. sev torn lig; stable joint III. complete torn lig; unstable joint |
| X-ray the ankle if (3) | 1. point of exquisite tenderness 2. pain near ankle or mid foot (jones fx) 3. inability to bear wt immed after injury (4 steps) |
| Always protect a joint until proven there is no fx? T or F | True |
| Always refer an ankle injury when: (3 rules) | 1. Grade III 2. Eversion sprain 3. not better in 3 weeks |
| When testing the meniscus in the knee use this test? | McMurray's |
| What is the most frequently injured knee ligament? | medial collateral |
| What is the most frequently torn meniscus? | medial meniscus |
| The second most common type of knee pain is the tibial tuberosity or the prominent tibial tubercle: | Osgood-schlatter |
| Morning stiffness lasting less than one hour is characteristic of: | osteoarthritis |
| First line tx for osteoarthritis is? | exercise |
| These nodes affect distal joints? | Heberden's Nodes |
| Describe an osteo-arthritic joint on x-ray: | 1. there is good bone dense 2. decrease in joint space 3. no cartilage |
| Describe a rheumatoid arthritic joint on x-ray: | 1. decrease bone dense and mass 2. joint space is gone 3. much edema |
| Joint inflammation is characteristic with what type of arthritis? | Rheumatoid Arthritis (RA) |
| A pt presents with joint pain and swelling in wrists, fingers, and shoulders. She has RA and thereby also c/o? | malaise and constitutional symptoms |
| Which arthritis is it if morning stiffnes is less than one hour? | Osteoarthritis (OA)_ |
| Which arthritis is systemic? | Rheumatoid Arthritis (RA) |
| Which arthritis is associated with multiple joints symetrically? | Rheumatoid Arthritis (RA) |
| These nodes affect proximal joints? | Buchard's nodes |
| Heberden's nodes and Buchard's nodes are asso with which arthritis? | Osteoarthritis (OA) |
| What does an NSAID do to ASA? | makes it less effective |
| Why is Gout called Monday Morning Arthrtis? | Because of the drinking done over the weekend |
| Gout is a high concentration of what? | uric acid that forms stones |
| Why do Gout or uric acid stones precipitate out to the Great Toe? | 1. Gravity 2. The toes are cooler than other body temp |
| Do not use this medicine in an acute attack of gout? | Allopurinol; because might make more stones |
| What vitamin do we want our osteoporitic pts to take? | Vit D3 |
| How do we get bone to grow? | pound it (stand on your nose for 30 minutes everyday) |
| A pt with low back pain had an episode of bladder incontinence. What should the NP assess for and why? | Assess for cauda equina and send to ER |
| Carpal Tunnel Syndrome is irritation of this? | Median nerve |
| Do Tinel's Test to assess what? | for carpal tunnel syndrome (median nerve) |
Created by:
dprest
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