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Orthopedics NP

Info & Q: NP EXAM

QuestionAnswer
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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