Clinical Assessment Quiz
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Questions and Answers

What is the recommended adult dose of Indomethacin?

  • 4-15mg every 3-4 hours
  • 25mg x4/day
  • 50-200mg per day (correct)
  • 25mg every morning
  • Which of the following is NOT a key principle to follow when interpreting a plain film (radiograph)?

  • Cartilage
  • Adequacy
  • Muscles (correct)
  • Bones
  • Which of the following is considered a yellow flag?

  • Pain on the affected side
  • Psychosocial indicators suggesting increased risk of progression to long-term distress (correct)
  • Firm end feel
  • Possible serious underlying pathology
  • What is the purpose of measuring axillary crutches below the axilla?

    <p>To avoid pressure on the axillary nerves and blood vessels. (A)</p> Signup and view all the answers

    What is a red flag in a musculoskeletal assessment?

    <p>Possible serious underlying pathology (D)</p> Signup and view all the answers

    Which of these descriptions is most likely to refer to a deep, constant pain?

    <p>A dull ache that is always present (C)</p> Signup and view all the answers

    What sign of a musculoskeletal injury involves a change in skin color that indicates impaired blood flow?

    <p>Rubor (A)</p> Signup and view all the answers

    Which of the following radiological imaging techniques is most commonly used to visualize bone structures?

    <p>X-ray (A)</p> Signup and view all the answers

    A patient with a lesion to the median nerve at the wrist may experience difficulty with which movement?

    <p>Opposing the thumb (C)</p> Signup and view all the answers

    Which of the following is a feature commonly observed during a general assessment of a patient with a musculoskeletal injury?

    <p>Compensatory mechanisms (D)</p> Signup and view all the answers

    What is NOT a factor determining irritability?

    <p>Patient's age (D)</p> Signup and view all the answers

    When measuring hip adduction AROM, which landmark is used as the distal/moving arm?

    <p>Greater trochanter (B)</p> Signup and view all the answers

    What is the expected end feel of hip internal rotation in an unaffected joint?

    <p>Springy to firm (B)</p> Signup and view all the answers

    Which of the following are potential consequences of prolonged bed rest?

    <p>Increased risk of respiratory infections (A), Decreased muscle strength and range of motion (B), Increased risk of deep vein thrombosis (DVT) and pulmonary embolism (C)</p> Signup and view all the answers

    Which of these is NOT a reason for having greater PROM than AROM in ankle dorsiflexion?

    <p>Ligamentous restriction (A)</p> Signup and view all the answers

    During shoulder abduction, what type of movement does the humerus undergo relative to the glenoid cavity?

    <p>Rolls cephalad and slides caudad (C)</p> Signup and view all the answers

    Which outcome measure is MOST appropriate for assessing lower limb function?

    <p>Lower Extremity Functional Scale (A)</p> Signup and view all the answers

    Which muscle group is primarily responsible for controlling ankle motion during the terminal stance phase of gait?

    <p>Plantarflexor muscle group (C)</p> Signup and view all the answers

    What questions might you ask a patient about the mechanism of injury to gain a better understanding of their condition?

    <p>All of the above (D)</p> Signup and view all the answers

    Which of the following are potential symptoms that a patient may report after a musculoskeletal injury?

    <p>All of the above (D)</p> Signup and view all the answers

    Flashcards

    Passive Joint ROM Test Findings

    Clinically significant findings for hip extension include pain on the affected side and firm vs springy end feel.

    Axillary Crutches Measurement

    The axillary support of axillary crutches must be measured below the axilla to avoid neurovascular bundle compression.

    Muscle Strength Test Validity Factors

    Factors ensuring validity of ankle plantarflexors muscle strength test include proper position, consistent effort, and appropriate resistance.

    ABCs of Radiograph Interpretation

    Key principles in interpreting a radiograph are Adequacy & Alignment, Bones, Cartilage, and Soft tissues.

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    Red Flag vs Yellow Flag

    A red flag indicates possible serious underlying pathology, while a yellow flag suggests psychosocial risks for long-term distress.

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    Factors Determining Irritability

    Severity of pain, amount of activity, time to reduce pain.

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    Anatomical Landmarks for AROM

    Proximal/stable arm, axis of rotation, distal/moving arm ensure reliable measurements.

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    End Feel: Hip Extension

    Springy end feel indicates elasticity in hip extension range.

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    PROM vs. AROM in Ankle Dorsiflexion

    Greater PROM may occur due to muscle weakness or pain inhibiting active movement.

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    Effects of Bed Rest

    Includes muscle atrophy, joint stiffness, and reduction in cardiovascular fitness.

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    Postural Hypotension

    A drop in blood pressure due to changes in posture, causing dizziness.

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    Glenohumeral Joint Movement

    The humerus rolls upward and glides downward in shoulder abduction.

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    Gait Cycle - Loading Response

    The phase when the foot makes contact with the ground and weight is accepted.

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    Lowest Center of Mass

    Occurs during double limb support when both feet are on the ground in gait.

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    Symptoms of Musculoskeletal Issues

    Common patient reports include pain, stiffness, weakness, and sensory changes.

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    Nature of Pain

    Describes types of pain sensations like sharp, dull, and burning.

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    Palpation Examination Findings

    Clinical signs revealed through palpation, including warmth and deformity.

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    Radiological Imaging Types

    Various imaging techniques for diagnosis: X-ray, ultrasound, MRI, etc.

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    Ulnar Nerve Lesion Findings

    Sensory loss in medial fingers, weakness in hand muscles, ulnar claw hand.

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    Median Nerve Lesion at Wrist

    Results in sensory loss and potential weakness in thumb and thumb opposition.

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    Study Notes

    Pre-tutorial Activity (Quiz)

    • Quiz Content: Covers subjective assessment, objective assessment, gait aids, functional anatomy, biomechanics, pathology, and pharmacology.
    • Resource Use: Use recommended references, online databases, and textbooks.
    • Correct Answers: Posted on vUWS for students who complete and submit the activity in the Independent Learning Folder Week 1.

    Special Examination Questions

    • Two Key Questions:
      • Pain that wakes you up at night.
      • Recent and sudden weight loss.
    • Reasoning: These questions are clinically significant, as they can highlight underlying or serious conditions.

    Body Chart Completion

    • Patient Complaint: Constant (5/10) diffuse pain on the posterior aspect of the left forearm with no associated sensory changes, neck pain or shoulder pain.
    • Additional Pain: Intermittent pain (2/10) at the site of a left tibia & fibula fracture with a dry dressing. Aggravated by walking, with tingling on the left foot dorsum after 10 minutes of walking.
    • Recent Onset: Right knee pain (around the patella) when walking, not related to previous injury to the legs. LBP 5yrs prior.

    Passive Joint ROM Test

    • Significant Findings: Pain on the affected side, firm or springy end feel.

    Axillary Crutches Support

    • Measurement Level: Ensure the axillary support of axillary crutches is measured below the axilla to avoid compression on the neurovascular bundle.

    Ankle Plantarflexor Muscle Strength Test

    • Key Factors:
      • Validity of the test: Factors influencing the reliability of muscle strength test result are important .

    Social History Questions

    • Example Questions
      • 3 key questions to elicit social history

    Plain Film Interpretation Principles

    • Key Principles: Adequacy & Alignment, Bones, Cartilage, and Soft Tissues.

    Analgesics

    • Oral: Paracetamol (X2 500mg tablets every 4hrs), Tramadol (25mg every morning, up to 25mg x4/day), Indomethacin (50-200mg per day).
    • IV (PCA): Morphine (4-15mg every 3-4hrs, IM or subcutaneous 2.5-20mg every 3-4hrs, oral/sublingual 5-30mg every 3-4hrs, rectal 10-30mg every 4hrs)

    Red and Yellow Flags

    • Red Flag: Possible serious underlying pathology.
    • Yellow Flag: Psychosocial indicators suggesting increased risk of progression to long-term distress.

    Pain Irritability Factors

    • Factors: Severity of pain, amount of activity to aggravate pain, amount of time to allow pain to reduce.

    Hip Adduction AROM Measurement

    • Anatomical Landmarks: Proximal (stable) arm, axis of rotation, distal (moving) arm - These are used for reliable measurement.

    Unaffected Joint End Feels

    • Movements and their respective unaffected end feels.

    Ankle Dorsiflexion PROM vs AROM

    • Reason: Muscle weakness, active insufficiency, pain due to contractile component, or inhibition of muscle (weakness).

    Outcome Measures

    • Example: 6MWT, 10MWT, Berg Balance Scale, DASH, Tampa Scale, Functional Status Questionnaire, AAOS Lower Limb Questionnaire.

    Bed Rest Effects

    • Effects: Postural hypotension, increased risk of respiratory infection, decreased lung volumes & MCC (muscle, connective, and cartilage effects), impaired immune response, increased risk of DVT & emboli, impaired venous stasis, etc.

    Humerus and Glenoid

    • Movement: Humerus rolls cephalad and slides caudad on the glenoid cavity during shoulder abduction.

    Gait Cycle Muscle Function

    • Muscle: Quadriceps femoris at knee for the loading response.

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    Description

    This quiz focuses on various aspects of clinical assessment, including subjective and objective assessment techniques, gait aids, and the functional anatomy related to patient complaints. You will also explore clinical significance through examination questions related to pain and weight loss. Use recommended resources to enhance your understanding.

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