NUR 604 EXAM 2- DIAGNOSTIC
QUESTIONS AND ANSWERS
Thompson test purpose - ANSWER-Achilles tendon rupture Thompson test implement - ANSWER-Have patient kneel in the chair facing away from you so their legs stick out backward and their foot is hanging down over the end of the chair (or laying prone with feet hanging over table) → you squeeze the gastrocnemius (calf muscle) and you'll see the foot move with the flexion and extension as you are squeezing.*If the Achilles tendon is ruptured → it will not move.*If there's no movement or a decrease in movement → usually a rupture or tear Drop arm test (Codman's test) purpose - ANSWER-Rotator cuff *Helps diagnose a rotator cuff tear, shoulder impingement (painful condition caused by rubbing or pressure on a tendon, nerve, etc., by adjacent structures), and differentiate between shoulder and rotator cuff issues Drop arm test (Conman's test) implement - ANSWER-Slowly have the patient drop their arm from an abduction position *Discomfort or hard to do → look for a rotator cuff tear or shoulder impairment.Assess the other side Ask the patient to fully abduct the arm to shoulder level, up to 90°, and lower it slowly. Note that abduction above shoulder level, from 90° to 120°, reflects action of the deltoid muscle *The patient sits or stands while the examiner passively raises their arm to 90 degrees and then asks them to slowly lower it back to their side *Indication: If the patient is unable to lower their arm or drops it suddenly, it could indicate a rotator cuff tear, especially of the supraspinatus tendon Apley scratch test (Dawbarns test) purpose - ANSWER-Overall shoulder rotation *Measures the range of motion in the shoulders and thoracic spine. It's used to help identify limitations in flexibility and potential issues with the shoulder, such as instability, pain, or a rotator cuff tear.Apley scratch test (Dawbarns test) implement - ANSWER-Ask the patient to touch the opposite scapula using the two motions shown below.*Abduction and external rotation *Adduction and internal rotation Tinel's test - ANSWER-method that involves tapping on the median nerve to check for tingling or pain, indicating nerve damage Lachman's test - ANSWER-assess the integrity of the anterior cruciate ligament (ACL). Performed with patient lying supine, involves pulling the tibia forward while stabilizing the femur. Positive results indicate ACL injury of laxity. 1 / 2
Anterior Drawer test - ANSWER-evaluates the anterior stability of the knee, specifically ACL. Patient positioned supine with knees flexed and the examiner pulls the tibia anteriorly. Increased movement compared to the unaffected knee indicates potential ACL damage.Pivot shift test - ANSWER-assess anterolateral instability associated with ACL tear.Flexing the knee while applying valgus force, the examiner observes tibial translation that may reveal laxity in the ACL McMurray test - ANSWER-used to detect meniscus tear. Involves flexing and extending the knee while applying rotational force to elicit a clicking sound or pain, indicating potential meniscus damage Valgus and Varus stress test on the knee - ANSWER-assess the integrity of the medial and collateral ligaments. With the knee flexed, lateral or medial forces are applied to gauge stability, excessive movement indicates ligamentous injury Anterior Drawer test for ankle - ANSWER-done to estimate stability of ATFL. Patient is seated at the edge of the bed or lying supine with their knee flexed.Posterior Drawer test for ankle - ANSWER-...Hawkins-Kennedy purpose - ANSWER-Subacromial impingement syndrome *A condition that occurs when the rotator cuff tendons and subacromial bursa are compressed Hawkins-Kennedy implement - ANSWER-The patient's arm is positioned at 90° of shoulder flexion and 90° of elbow flexion, then the examiner internally rotates the patient's arm while stabilizing the shoulder *Positive test: patient experiences pain between 70- 120 degrees of internal rotation Hawkins impingement sign. Flex the patient's shoulder and elbow to 90° with the palm facing down. Then, with one hand on the forearm and one on the arm, rotate the arm internally. This compresses the greater tuberosity against the supraspinatus tendon and coracoacromial ligament.Straight leg test - ANSWER-To assess low back pain Raise the patient's relaxed and straightened leg, flexing the thigh at the hip Lachman test purpose - ANSWER-ACL Lachmans test implement - ANSWER-Place the knee in 15° of flexion and mild external rotation. Grasp the distal femur on the lateral side with one hand and the proximal tibia on the medial side with the other. With the thumb of the tibial hand on the joint line, forcefully and simultaneously pull the tibia forward and the femur back.Estimate the degree of forward excursion. There should be a firm endpoint to any forward movement. Lack of a firm endpoint with excessive movement may indicate the ACL is no longer intact.*Pull the tibia forward while the knee is flexed (can do with patient lying or sitting up).Brace the lower part of their extremity between your legs
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