Examination of the Upper Extremities
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Questions and Answers

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?

<p>Out to the side and overhead (C)</p> Signup and view all the answers

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

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

What should you verbalize when palpating for masses or swelling?

<p>&quot;I don’t feel any masses or swelling&quot; (D)</p> Signup and view all the answers

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

<p>Inspection, Palpation, Range of Motion, Strength Testing (B)</p> Signup and view all the answers

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

<p>Surface Anatomy, Alignment, Contour, Symmetry (D)</p> Signup and view all the answers

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

<p>Write down all observations without interpretation (C)</p> Signup and view all the answers

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

<p>Feeling for muscle tone and tenderness (D)</p> Signup and view all the answers

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

<p>To evaluate joint flexibility and mobility (C)</p> Signup and view all the answers

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

<p>To identify potential injuries or conditions related to the upper extremities (A)</p> Signup and view all the answers

What is the correct motion for shoulder internal rotation?

<p>Lower your arm and rotate your forearm toward the floor (D)</p> Signup and view all the answers

Which action represents elbow pronation?

<p>Turning the palms down (B)</p> Signup and view all the answers

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

<p>Turn them up (D)</p> Signup and view all the answers

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

<p>Proximal interphalangeal joints (PIPs) and distal interphalangeal joints (DIPs) (D)</p> Signup and view all the answers

What is a movement that tests shoulder strength?

<p>Shrug both shoulders upward (C)</p> Signup and view all the answers

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

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

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

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

Which action involves wrist radial and ulnar movement?

<p>Thumb opposition (D)</p> Signup and view all the answers

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

<p>Spreading fingers apart (C)</p> Signup and view all the answers

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

<p>Observing joint swelling (B)</p> Signup and view all the answers

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

<p>Lateral epicondylitis (D)</p> Signup and view all the answers

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

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

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

<p>Against the thumb (B)</p> Signup and view all the answers

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

<p>Limited range of motion (C)</p> Signup and view all the answers

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

<p>4/5 (C)</p> Signup and view all the answers

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

<p>Full extension (C)</p> Signup and view all the answers

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

<p>Upper Extremity Video (A)</p> Signup and view all the answers

Which reference was NOT mentioned in the text?

<p>Mosby's Medical Dictionary (C)</p> Signup and view all the answers

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

<p>To reduce anxiety and facilitate partnership in suicide prevention (C)</p> Signup and view all the answers

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

<p>To identify patients requiring urgent evaluation (B)</p> Signup and view all the answers

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

<p>It helps determine if the patient is suicidal (D)</p> 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?

<p>To present an opportunity for suicide prevention (B)</p> Signup and view all the answers

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

<p>As a measure of caring and competence (A)</p> Signup and view all the answers

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

<p>Every patient with Major Depressive Disorder is at risk (D)</p> Signup and view all the answers

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

<p>Ask about past experience with similar symptoms (D)</p> Signup and view all the answers

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

<p>Disruptive with irrational fear and dread (A)</p> Signup and view all the answers

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

<p>To establish or reject a diagnosis of an anxiety disorder (C)</p> Signup and view all the answers

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

<p>Depression often accompanies anxiety disorders (B)</p> Signup and view all the answers

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

<p>Seek more information to establish or reject an anxiety disorder diagnosis (B)</p> 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?

<p>To understand the patient's medical history better (B)</p> Signup and view all the answers

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

<p>Looking down when speaking (B)</p> Signup and view all the answers

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

<p>Name what they see and note how they feel (C)</p> 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?

<p>Watch for non-verbal cues of possible depression (C)</p> Signup and view all the answers

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

<p>To screen for possible depression (A)</p> Signup and view all the answers

What is a common somatic symptom of depression?

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

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

<p>Note their empathic feeling (B)</p> Signup and view all the answers

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

<p>Remaining professional while empathizing with the patient (D)</p> Signup and view all the answers

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

<p>Stop and reflect upon responses to the patient's emotions (A)</p> Signup and view all the answers

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

<p>The patient's anger is directed at the healthcare professional (D)</p> Signup and view all the answers

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

<p>12 minutes (C)</p> Signup and view all the answers

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

<p>To allow the interviewer to prepare for the next interview (D)</p> Signup and view all the answers

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

<p>Substance abuse (B)</p> Signup and view all the answers

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

<p>Thinking exploration will take too much time (C)</p> Signup and view all the answers

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

<p>Patients fail to report their sad feelings (C)</p> Signup and view all the answers

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

<p>They indicate the presence of a depressive illness (B)</p> 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?

<p>Personal beliefs or cultural stigma around depression (D)</p> Signup and view all the answers

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

<p>Lack good skills in recognizing non-verbal cues (B)</p> Signup and view all the answers

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

<p>Clinicians' reluctance to discuss emotions (B)</p> Signup and view all the answers

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

<p>Patients appreciate being asked about suicide as it shows competence and care. (C)</p> Signup and view all the answers

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

<p>To distinguish between active and passive suicidal ideation. (B)</p> Signup and view all the answers

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

<p>To gauge whether patients require urgent evaluation. (B)</p> Signup and view all the answers

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

<p>To determine if immediate psychiatric evaluation is needed. (B)</p> Signup and view all the answers

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

<p>Patients appreciate the concern and a chance to discuss openly. (C)</p> Signup and view all the answers

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

<p>To identify patients suffering from depression (C)</p> Signup and view all the answers

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

<p>By speaking slowly and providing 'small chunk' facts (C)</p> Signup and view all the answers

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

<p>Depression results from chemical imbalances in the brain (C)</p> Signup and view all the answers

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

<p>To allow patients time for reflection and response (A)</p> Signup and view all the answers

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

<p>The treatability and impact on suffering (D)</p> Signup and view all the answers

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

<p>It reveals hopelessness and loss of enjoyment (A)</p> 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?

<p>Low energy, change in appetite, pain in the belly or back, or headaches (A)</p> Signup and view all the answers

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

<p>Depression is a deficiency problem like diabetes (A)</p> Signup and view all the answers

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

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

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

<p>Antidepressants and/or counseling (C)</p> 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?

<p>'Teach back' technique (D)</p> 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?

<p>Outcomes of other illnesses improve with depression treatment (C)</p> Signup and view all the answers

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

<p>Leave the room or call Security if the disruption continues. (A)</p> Signup and view all the answers

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

<p>It might be a way to cope with intense fear, such as from a lethal diagnosis. (B)</p> Signup and view all the answers

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

<p>To avoid escalating volatile situations that threaten safety. (B)</p> Signup and view all the answers

How should limits be set when dealing with disruptive patients?

<p>By describing conditions for continued engagement clearly and respectfully. (A)</p> Signup and view all the answers

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

<p>If the patient exhibits disruptive behavior despite warnings. (C)</p> Signup and view all the answers

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

<p>The presence of extreme anger that is unusual and may mask other emotions. (D)</p> Signup and view all the answers

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

<p>Disengage from the conversation and ensure your own safety (D)</p> Signup and view all the answers

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

<p>Intense fear (D)</p> Signup and view all the answers

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

<p>Increase anger and disinhibition (D)</p> Signup and view all the answers

What should be prioritized when dealing with a disruptive patient?

<p>Your own safety (B)</p> Signup and view all the answers

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

<p>A police report (C)</p> Signup and view all the answers

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

<p>Call Security (B)</p> Signup and view all the answers

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