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</p> Signup and view all the answers

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

    <p>Tendinitis</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;</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</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</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</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</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</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</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</p> Signup and view all the answers

    Which action represents elbow pronation?

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

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

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

    What is a movement that tests shoulder strength?

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

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

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

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

    <p>Crepitus</p> Signup and view all the answers

    Which action involves wrist radial and ulnar movement?

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

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

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

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

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

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

    <p>Tone</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</p> Signup and view all the answers

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

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

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

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

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

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

    Which reference was NOT mentioned in the text?

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

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

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

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

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

    What is a common somatic symptom of depression?

    <p>Insomnia</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</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</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</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</p> Signup and view all the answers

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

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

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

    <p>Substance abuse</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</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</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</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</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</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</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.</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.</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.</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.</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.</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</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</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</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</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</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</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</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</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</p> Signup and view all the answers

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

    <p>Antidepressants and/or counseling</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</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</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.</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.</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.</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.</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.</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.</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</p> Signup and view all the answers

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

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

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

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

    What should be prioritized when dealing with a disruptive patient?

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

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

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

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