NR511 Final Exam Study Guide
Topics:
o Common M/S disorders
o Common spine disorders
o Metabolic disorders
o Endocrine disorders
o Wounds, lacerations & bites
o Common hematological disorders
o Common male GU dis
...
NR511 Final Exam Study Guide
Topics:
o Common M/S disorders
o Common spine disorders
o Metabolic disorders
o Endocrine disorders
o Wounds, lacerations & bites
o Common hematological disorders
o Common male GU disorders
o Testicular disorders
Chapters + lectures:
Wk 5:
o Chapter 52: Common Musculoskeletal Complaints
o Chapter 53: Spinal Disorders
o Chapter 54: Soft-Tissue Disorders
o Lectures
o Hollier
o DE
Wk6:
o Chapter 57: Glandular Disorders (p. 880-897 only)
o Chapter 59: Metabolic Disorders
o Chapter 73: Common Injuries (p.1210-1223 only) 1212-1213 table 73.1
o Review thyroid lecture again
o Lectures
o Hollier
o DE
Wk7:
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NR511 Final Exam Study Guide
o Chapter 46: Nocturia in Men (p. 682) & Testicular Pain (p. 685)
o Chapter 49: Prostate Disorders
o Chapter 50: Penile & Testicular Disorders
o Chapter 61: Hematological Disorders
o Lectures
o Hollier
o DE
Completion of study guide: IIII
1. Signs and
symptoms and
management of
musculoskeletal
sprains/strains/dislocations
Signs and symptoms and management of musculoskeletal sprains/strains/dislocations
Sprains: stretching or tearing of ligaments that occurs when a joint is forced beyond its normal
anatomical range
First degree- stretching of ligamentous fibers
Second degree- partial tear of part of the ligament with pain and swelling
Third degree- complete ligamentous separation
Sprain- sudden injury or fall that caused acute pain and swelling that got worse over a few
hours, redness and bruising, active and passive ROM decreased. Radiography to rule out fx.
Strain: muscle injury caused by excessive tensile stress placed on a muscle that results in
stiffness and decreased function
-effects muscle or tendon that connects a muscle to a bone, complain of “pulled
muscle,” severe cases cause inflammation, swelling, weakness and loss of function-surgery may
be needed
Management: PRICE (protect, rest, ice, compression, elevation), limitation of activity, physical
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NR511 Final Exam Study Guide
therapy, NSAIDS, referral to ortho
Dislocation- complete separation of 2 bones that form a joint
Very painful and cause immobility, need immediate medical attention
Referral to orthopedics for possible surgery or reduction with application of cast or splint.
four cardinal signs of inflammation (erythema, warmth, pain, or swelling) -SPEW
2. Signs and symptoms and
management of spinal
disorders (spondylosis,
stenosis, etc.)
Cervical Spondylosis- neck stiffness, mild aching discomfort with activity. Pain and limited ROM
occur with lateral rotation and lateral flexion of the neck toward the affected side. Weakness
shoulder abduction- C5. Bicep weakness- C6. Tricep weakness-C7.Myelopathy- leg weakness,
gait disturbance, balance problems, difficulty performing fine motor tasks, loss of bowel and
bladder. Treatment- cervical traction, PT, pain relievers. Surgery for Myelopathy.
Low back pain-Tenderness and decreased range of motion. Positive straight leg test. TreatmentNSAIDS, muscle relaxants, opioids, surgical, self-care, spinal manipulation
Stenosis-pseudoclaudication causing radicular pain in the calves, buttocks, and upper thighs of
one or both legs. Symptoms progress from a proximal to distal direction. Walking or prolonged
standing causes pain and weakness in buttocks and legs. Stooping over helps relieve pain.
Positive Romberg. Reflexes diminished. With bowel or bladder symptoms, sphincter tone may
be decreased
Management- surgical decompression. NSAIDS, folic acid, vitamin b12. PT-flexing the
spine.Bicycling.
Intermittent use of NSAIDs may be helpful, as well as folic acid or vitamin B12 supplementation
in some cases depending on results of laboratory tests.
Management revolves around physical therapy or an exercise program that focuses on flexing
the spine. Flexion of the spine increases intraspinal volume. Bicycling is one exercise that is
done with the spine in flexion. Improving abdominal muscle tone lifts the pelvis anteriorly and
flexes the lumbar spine. Reduction of intra-abdominal fat is critical to achieving the objective.
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NR511 Final Exam Study Guide
Thus, weight loss may be pivotal. Lumbar flexion exercises increase spinal canal volume.
Examples include exercise on all fours, arching the back, or in the fetal position. Exercises that
extend the spine should be avoided (swayback).
3. Recognition and
immediate management of
cauda equina syndrome
Immediate management of cauda equina syndrome. (P. 829)
Cauda equina syndrome is a medical EMERGENCY and requires immediate decompression.
If Cauda equina is confirmed, surgical lumbar decompression is necessary to halt neurological
deterioration unless surgery is contraindicated for other medical reasons.
*Rational on Davis Edge question: Low back pain accompanied by acute onset of urinary
retention or overflow incontinence, loss of anal sphincter tone or fecal incontinence, loss of
sensation in the buttocks and perineum, and motor weakness in the lower extremities is a red
flag for cauda equina syndrome or severe neurologic compromise. Perianal numbness.
Cauda equina compression is characterized by bilateral lower extremity weakness, anesthesia,
or paresthesia of the perineum and buttocks (saddle anesthesia). There may or may not be
bowel or bladder incontinence or bladder retention. When there is neurologic deficit affecting
the bowel or bladder, these changes may not be reversed with surgical decompression,
4. Maneuvers and
expected findings with
joint pain (knee, shoulder,
wrist, etc.)
Neck pain-Spurling’s.
Shoulder pain-Apley scratch test(reaching the scapula). Internal and external flexion. Internal
and external abduction. Pain with abduction= early supraspinatus tendinitis and subacromial
bursitis=early rotator cuff injuries. Wrist and hand-allen’s test= radial and ulnar arteries.
Phalens test=median nerve compression.
Tinel’s sign assess for compression neuropathy – tapping over nerve.
Finkelsteins test- de Quervains disease. Thumb between finger and point.
Knee Pain= Mcmurray, apprehension sign, bulge sign, inspect/palpate to assess effusion.
Lachman, drawer sign – ACL,
Thumb test - PCL
MCL, LCL test are valgus and varus
Tennis elbow cup coffee cup sign
CTS-NSAIDs not effective
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NR511 Final Exam Study Guide
Achillies rupture – Thompson test
5. Initial assessment of
FOOSH injury in correlation
to anatomical location of
radial head bone Lisa
Callahan
FOOSH - Falling On an Out Stretched Hand. After falling on an outstretched hand patients
present after trauma with pain and swelling in the distal forearm or wrist. Numbness may be
present if the medial nerve is affected. The mechanism of injury will often provide important
clues to the diagnosis. The examination begins with gentle palpation to locate the area of point
tenderness and includes a thorough neurovascular assessment. A radiograph of the wrist
(including an oblique view) may be necessary to rule out fracture. Common fractures are the
Colles fracture of the distal radius and the navicular (scaphoid) fracture of the anatomical
snuffbox. It is not unusual to have a navicular fracture missed on radiography, so an orthopedic
referral should be provided when the presenting complaint is pain and trauma to the soft-tissue
area of the anatomical snuffbox. Scaphoid injury
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