Examination of the Upper Extremities

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Where is the ulnar artery located?

At the bend of the elbow

On the medial flexor surface (correct)

Just medial to the biceps tendon

On the lateral flexor surface

Which statement describes range of motion testing for the shoulder?

Standing/sitting position is not important for accurate viewing

Ensure the patient attempts the full range of motion (correct)

Allow the patient to demonstrate without giving clear instructions

Only test passive range of motion

What can cause restricted range of motion in shoulder flexion?

Bursitis (correct)

Adduction tears or sprains

Extension

Internal rotation

During shoulder abduction, how should the arms be raised?

Out to the side and overhead Signup and view all the answers

Which of the following is NOT a motion of the shoulder?

Tendinitis Signup and view all the answers

What should you verbalize when palpating for masses or swelling?

"I don’t feel any masses or swelling" Signup and view all the answers

What are the main components of the upper extremity physical exam?

Inspection, Palpation, Range of Motion, Strength Testing Signup and view all the answers

Which anatomical areas should be inspected during the upper extremity physical exam?

Surface Anatomy, Alignment, Contour, Symmetry Signup and view all the answers

What is the best way to document upper extremity physical exam findings?

Write down all observations without interpretation Signup and view all the answers

What should be done during the palpation of the upper extremities?

Feeling for muscle tone and tenderness Signup and view all the answers

What is the purpose of testing range of motion in the upper extremities?

To evaluate joint flexibility and mobility Signup and view all the answers

What is the clinical significance of normal and abnormal upper extremity physical exam findings?

To identify potential injuries or conditions related to the upper extremities Signup and view all the answers

What is the correct motion for shoulder internal rotation?

Lower your arm and rotate your forearm toward the floor Signup and view all the answers

Which action represents elbow pronation?

Turning the palms down Signup and view all the answers

In elbow supination, what should be done with the palms?

Turn them up Signup and view all the answers

Which joint is affected by osteoarthritis as per the given context?

Proximal interphalangeal joints (PIPs) and distal interphalangeal joints (DIPs) Signup and view all the answers

What is a movement that tests shoulder strength?

Shrug both shoulders upward Signup and view all the answers

Which condition causes ulnar deviation at the metacarpophalangeal joints (MCPs)?

Rheumatoid arthritis Signup and view all the answers

Which of the following is not a recommended observation during the inspection of the elbows?

Crepitus Signup and view all the answers

Which action involves wrist radial and ulnar movement?

Thumb opposition Signup and view all the answers

When testing finger strength, what does 'abduction' refer to?

Spreading fingers apart Signup and view all the answers

Which of the following is a recommended step during the inspection of the hands?

Observing joint swelling Signup and view all the answers

Which of the following is associated with 'Tennis Elbow'?

Lateral epicondylitis Signup and view all the answers

Which of the following is not a recommended observation during the palpation of the hands?

Tone Signup and view all the answers

What should be the direction of force applied during the examination of the upper extremities?

Against the thumb Signup and view all the answers

Which of the following was NOT noted during the upper extremity examination?

Limited range of motion Signup and view all the answers

What strength was observed in the right elbow during the examination?

4/5 Signup and view all the answers

What specific maneuver was the patient unable to perform due to pain in the right elbow?

Full extension Signup and view all the answers

What type of video were students instructed to watch prior to the lab?

Upper Extremity Video Signup and view all the answers

Which reference was NOT mentioned in the text?

Mosby's Medical Dictionary Signup and view all the answers

What is the purpose of asking patients about suicide, as mentioned in the text?

To reduce anxiety and facilitate partnership in suicide prevention Signup and view all the answers

Why is distinguishing between 'active' and 'passive' suicidal ideation important, based on the text?

To identify patients requiring urgent evaluation Signup and view all the answers

What is the significance of Question #9 in the PHQ9, according to the text?

It helps determine if the patient is suicidal Signup and view all the answers

Why do 50% of patients who eventually commit suicide visit a primary care clinician before taking their lives, according to the text?

To present an opportunity for suicide prevention Signup and view all the answers

How do patients usually perceive being asked about suicide, based on the information provided?

As a measure of caring and competence Signup and view all the answers

What is the primary cause for suicide assessment being considered vital, according to the text?

Every patient with Major Depressive Disorder is at risk Signup and view all the answers

What is a recommended step when a patient exhibits nervousness or multiple somatic symptoms?

Ask about past experience with similar symptoms Signup and view all the answers

Which of the following best describes the nature of anxiety disorders compared to episodic anxiety?

Disruptive with irrational fear and dread Signup and view all the answers

Why is it important to explore patients' current worries and concerns?

To establish or reject a diagnosis of an anxiety disorder Signup and view all the answers

What is the relationship between anxiety disorders and depression as mentioned in the text?

Depression often accompanies anxiety disorders Signup and view all the answers

What should healthcare providers do when a patient displays multiple somatic symptoms?

Seek more information to establish or reject an anxiety disorder diagnosis Signup and view all the answers

Why is it essential to consider past symptoms or treatment for anxiety or mood disorders when examining a patient?

To understand the patient's medical history better Signup and view all the answers

What is a common non-verbal cue of possible depression in patients?

Looking down when speaking Signup and view all the answers

What should a clinician do when they notice a patient showing signs of sadness or depression?

Name what they see and note how they feel Signup and view all the answers

Which statement best describes a recommended approach for patients who find it difficult to express feelings about sadness or emotion?

Watch for non-verbal cues of possible depression Signup and view all the answers

What is the purpose of the 2-question screen for depression?

To screen for possible depression Signup and view all the answers

What is a common somatic symptom of depression?

Insomnia Signup and view all the answers

What should a clinician do if they suddenly feel sad about or sorry for a patient?

Note their empathic feeling Signup and view all the answers

What challenge does a healthcare professional face when dealing with an angry patient?

Remaining professional while empathizing with the patient Signup and view all the answers

What is one recommended strategy when a healthcare professional starts feeling angry or defensive?

Stop and reflect upon responses to the patient's emotions Signup and view all the answers

Which of the following is a common misconception when dealing with an angry patient?

The patient's anger is directed at the healthcare professional Signup and view all the answers

What is the time allotted for each interview during the standardized patient activity?

12 minutes Signup and view all the answers

What is the purpose of the 3-minute brief discussion between interviews during the standardized patient activity?

To allow the interviewer to prepare for the next interview Signup and view all the answers

What should be the focus when dealing with a patient who exhibits extreme anger?

Substance abuse Signup and view all the answers

What is a common reason clinicians may be reluctant to explore depression further during a patient visit?

Thinking exploration will take too much time Signup and view all the answers

Why might patients who express sadness be misdiagnosed as grieving rather than suffering from depression?

Patients fail to report their sad feelings Signup and view all the answers

How do tears usually signal an important life issue in medical practice?

They indicate the presence of a depressive illness Signup and view all the answers

What is a key factor that contributes to the difficulty in finding and managing depression according to the text?

Personal beliefs or cultural stigma around depression Signup and view all the answers

Why might some clinicians fail to connect somatic problems with clues to the presence of depression?

Lack good skills in recognizing non-verbal cues Signup and view all the answers

What is a significant barrier to diagnosing and treating depression outlined in the text?

Clinicians' reluctance to discuss emotions Signup and view all the answers

What is a crucial aspect of suicide risk assessment according to the text?

Patients appreciate being asked about suicide as it shows competence and care. Signup and view all the answers

Why is questioning patients about suicide important according to the text?

To distinguish between active and passive suicidal ideation. Signup and view all the answers

Why is it essential to follow up concerning 'active' self-harm thoughts according to the text?

To gauge whether patients require urgent evaluation. Signup and view all the answers

Why does the text highlight the importance of distinguishing between 'active' and 'passive' suicidal ideation?

To determine if immediate psychiatric evaluation is needed. Signup and view all the answers

What does the text suggest is the common outcome when patients are asked about suicide?

Patients appreciate the concern and a chance to discuss openly. Signup and view all the answers

What is the primary purpose for routinely asking depression screening questions according to practice guidelines?

To identify patients suffering from depression Signup and view all the answers

How should caregivers present information about depression to patients for optimal understanding?

By speaking slowly and providing 'small chunk' facts Signup and view all the answers

What distinguishes depression from temporary sadness, according to the text?

Depression results from chemical imbalances in the brain Signup and view all the answers

Why are short pauses recommended after offering information about depression to patients?

To allow patients time for reflection and response Signup and view all the answers

What aspect of depression should healthcare providers actively discuss during interactions with patients?

The treatability and impact on suffering Signup and view all the answers

What role does persistent sadness play in identifying depression, as described in the text?

It reveals hopelessness and loss of enjoyment Signup and view all the answers

What physical problems can be caused by the brain chemistry changes due to depression, as mentioned in the text?

Low energy, change in appetite, pain in the belly or back, or headaches Signup and view all the answers

How do some clinicians compare depression to other chronic illnesses like diabetes, according to the text?

Depression is a deficiency problem like diabetes Signup and view all the answers

What part of the brain is mentioned to have a deficiency in serotonin in individuals experiencing depression?

Prefrontal cortex Signup and view all the answers

What treatment options are usually prescribed for depression, according to the text?

Antidepressants and/or counseling Signup and view all the answers

What skill is suggested in the text to ensure patients understand the information provided about depression and its treatment?

'Teach back' technique Signup and view all the answers

How are outcomes of other illnesses like diabetes and heart trouble affected by treating depression, according to the text?

Outcomes of other illnesses improve with depression treatment Signup and view all the answers

What is a recommended approach to handle a disruptive patient in a healthcare setting?

Leave the room or call Security if the disruption continues. Signup and view all the answers

How does intense anger in some patients relate to other emotions or conditions?

It might be a way to cope with intense fear, such as from a lethal diagnosis. Signup and view all the answers

What is the primary reason for prioritizing personal safety over therapeutic interactions in healthcare settings?

To avoid escalating volatile situations that threaten safety. Signup and view all the answers

How should limits be set when dealing with disruptive patients?

By describing conditions for continued engagement clearly and respectfully. Signup and view all the answers

In what situations should healthcare providers consider leaving or disengaging from a conversation with a patient?

If the patient exhibits disruptive behavior despite warnings. Signup and view all the answers

What is a critical signal that healthcare providers should pay attention to during interactions with angry patients?

The presence of extreme anger that is unusual and may mask other emotions. Signup and view all the answers

What is the recommended approach when a patient is being disruptive?

Disengage from the conversation and ensure your own safety Signup and view all the answers

What is a common underlying cause of extreme anger in patients?

Intense fear Signup and view all the answers

How can alcohol and other drugs impact a patient's anger?

Increase anger and disinhibition Signup and view all the answers

What should be prioritized when dealing with a disruptive patient?

Your own safety Signup and view all the answers

What is the most reliable indicator of personal safety in a situation?

A police report Signup and view all the answers

What is the recommended approach when a patient continues to be disruptive after setting limits?

Call Security Signup and view all the answers