Jarvis Ch. 22

Describe the Ortolani maneuver for checking an infant's hips.

Supine, flex knees holding thumbs on inner mid-thighs and fingers outside on hips. Adduct legs until thumbs touch, then life and abduct, moving knees apart and down.

Differentiate synovial from non-synovial joints.

Synovial - freely moveable Non-synovial - immovable, united by fibrous tissue

Explain the method for measuring leg length.

True leg length - measure between fixed points, from anterior iliac spine to medial malleolus, crossing medial side of knee

Contrast Bouchard's nodes with Heberden's nodes in osteoarthritis.

Bouchard - proximal interphalangeal joints, less common Herberden - distal interphalangeal joints, more common

Differentiate the following: Dislocation Subluxation Contracture Ankylosis

Dislocation - complete loss of contact between two bones in a joint Subluxation - two bones in joint stay in contact, but alignment is off Contracture - shortening of muscle leading to limited ROM of joint Ankylosis - stiffness or fixation of a joint

Draw and describe swan neck deformity and boutonniére deformity in rheumatoid arthritis

Swan neck - flexion contracture resembles curve of swan in metacarpopharangeal joint (hyperextension) Boutonniére - knuckle looks like it's being pushed through a buttonhole

lowering a body part

depression

moving a body part backward and parallel to the ground

retraction

chronic systemic inflammatory disease of joints and surrounding connective tissue

rheumatoid arthritis

moving the head around a central axis

rotation

turning the forearm so that the palm is up

supination

(clubfoot) congenital deformity of the food in which it is plantar flexed and inverted

talipes equinovarus

Differentiate testing of active ROM versus passive ROM.

Active ROM - patient is doing movements themselves Passive ROM - patient is relaxed ad nurse moves limbs

When performing a functional assessment for an older adult, state the common adaptations that the aging person makes when attempting these maneuvers: Walking Climbing up stairs Walking down stairs Picking up object from floor Rising up from sitting in chair Rising up from lying in bed

Walking - shuffling pattern; swaying; arms out to help balance; broader base of support; person may watch feet Climbing up stairs - person holds handrail; may haul body up with it; may lead with favored (stronger) leg Walking down stairs - holds handrail, sometimes with both hands. If person is weak, he or she may descend sideways, lowering weaker leg first. If person is unsteady, he or she may watch feet Picking up object from floor - person often bends at waist instead of bending knees; holds furniture to support while bending and straightening Rising up from sitting in chair - person uses arms to push off chair arms, upper trunk leans forward before body straightens, feet planted wide in broad base of support Rising up from lying in bed - may roll to one side, push with arms to lift up torso, grab bedside table to increase leverage

List 4 signs that suggest inflammation in a joint.

Warmth Tenderness Swelling Masses

Examination of the shoulder includes 4 motions. These are: a. forward flexion, internal rotation, abduction, and external rotation b. abduction, adduction, pronation, and supination c. circumduction, inversion, eversion, and rotation d. elevation, retraction, protraction, and circumduction

a. forward flexion, internal rotation, abduction, and external rotation

The bulge sign is a test for: a. swelling in the suprapatellar pouch b. carpal tunnel syndrome c. Heberden's nodes d. Olecranon bursa inflammation

a. swelling in the suprapatellar pouch

moving a limb away from the midline of the body

abduction

moving a limb toward the midline of the body

adduction

immobility, consolidation, and fixation of a joint because of disease, injury, or surgery; most often due to chronic rheumatoid arthritis

ankylosis

inability to perform coordinated movements

ataxia

When assessing an infant, the examiner completes the Ortolani maneuver by: a. lifting the newborn and noting a C-shaped curvature of the spine b. gently lifting and abducting the infant's flexed knees while palpating the greater trochanter with the fingers c. comparing the height of the tops of the knees when the knees are flexed up d. palpating the length of the clavicles

b. gently lifting and abducting the infant's flexed knees while palpating the greater trochanter with the fingers

A 2-year-old child comes to the clinic for a health examination. A common finding for this age group is: a. kyphosis b. lordosis c. scoliosis d. no deviation is normal

b. lordosis

Pronation and supination of the hand and forearm are the result of the articulation of the: a. scapula and clavicle b. radius and ulna c. patella and condyle of fibula d. femur and acetabulum

b. radius and ulna

enclosed sac filled with viscous fluid located in joint areas of potential friction

bursa

A positive Phalen test and Tinel sign are found in a patient with: a. a torn meniscus b. Hallux vulgus c. carpal tunnel syndrome d. tennis elbow

c. carpal tunnel syndrome

A 70-year-old woman has come for a health examination. Which of the following is a common age-related change in the curvature of the spinal column? a. lordosis b. scoliosis c. kyphosis d. lateral scoliosis

c. kyphosis

The examiner measures a patient's legs for length discrepancy. Which is a normal finding? a. no difference in measurements b. 0.5 cm difference c. within 1 cm of each other d. 2 cm difference

c. within 1 cm of each other

moving the arm in a circle around the shoulder

circumduction

dry crackling sound or sensation due to grating of the ends of damaged bone

crepitation

Anterior and posterior stability are provided to the knee joint by the: a. medial and lateral menisci b. patellar tendon and ligament c. medial collateral ligament and quadriceps muscle d. anterior and posterior cruciate ligaments

d. anterior and posterior cruciate ligaments

Hematopoiesis takes place in which of the following? a. liver b. spleen c. kidneys d. bone marrow

d. bone marrow

During the assessment of the spine, the patient would be asked to: a. adduct and extend b. supinate, evert, and retract c. extend, adduct, invert, and rotate d. flex, extend, abduct, and rotate

d. flex, extend, abduct, and rotate

Fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions are known as: a. bursa b. tendons c. cartilage d. ligaments

d. ligaments

directed toward or located on the surface

dorsal

flexion contracture of the fingers due to chronic hyperplasia of the palmar fascia

dupuytren contracture

raising a body part

elevation

moving the sole of the foot outward at the ankle

eversion

straightening a limb at a joint

extension

bending a limb at a joint

flexion

round, cystic, nontender nodule overlying a tendon sheath or joint capsule, usually on dorsum of wrist

ganglion

lateral or outward deviation of the great toe

hallux valgus

moving the sole of the foot inward at the ankle

inversion

outward or convex curvature of the thoracic spine; hunchback

kyphosis

fibrous band running directly from one bone to another bone that strengthens the joint

ligament

inward or concave curvature of the lumbar spine

lordosis

center of the intervertebral disc

nucleus puplosus

bony projection of the ulna at the elbow

olecranon process

kneecap

patella

refers to the surface of the sole of the foot

plantar

turning the forearm so that the palm is down

pronation

moving a body part forward and parallel to the ground

protraction

extent of movement of a joint

range of motion (ROM)

nerve pain along the course of the sciatic nerve that travels down from the back or thigh through the leg and into the foot

sciatica

S-shaped curvature of the thoracic spine

scoliosis

strong fibrous cord that attaches a skeletal muscle to a bono

tendon

wryneck; contraction of the cervical neck muscles, producing torsion of the neck

torticollis