HTHRHSC 2500 Med Term Application 5

Roger Bowman, DPT, obtains the history of Carrie Green's current illness and subjective findings. He states that "She has difficulty dressing and with other ADLs requiring use of _____". What does ADL mean?

left arm and shoulder; activities of daily living

Carrie Green "has taken naproxen every 6 hours with temporary relief". Naproxen is a/an __________ (drug category); _________ (action).

NSAID; anti-inflammatory for treatment of mild to moderate pain

The DPT evaluates the DTR of both the left biceps and triceps. What is he testing, what is the reason for the test, and what were the findings? [Select all correct responses.]

-innervation to the triceps and biceps is normal

-used to identify an abnormal response due to disruption of the nerve supply to the muscles (e.g., triceps or biceps in this case study)

-the involuntary response of a muscle tendon to a stimulus

-deep tendon reflexes

Objective findings indicated a dysfunction of the ____ rhythm. The DPT included strength testing of the left shoulder and noted that there was 4-/5 movement against resistance with flexion and abduction due to pain. Abduction of the shoulder is _______.

glenohumeral scapular; movement of the left shoulder away from the midline

Roger Bowman documented that active range of motion of the left shoulder was approximately 80 degree for flexion and abduction; however passive range of motion was within normal limits without significant pain. Range of motion is ______.

a diagnostic procedure to evaluate joint mobility and muscle strength

Roger Bowman noted that internal rotation of the left shoulder was within normal limits; while external rotation was minimally limited. Rotation is _________.

a circular movement around an axis such as the shoulder joint

The DPT also noted that the impingement test was negative and that x-rays were also negative. The impingement test is used to identify _______, which is inflammation of the tendons that get caught in the narrow space between the bones within the shoulder joint.

impingement syndrome

____ is the group of muscles and tendons that hold the head of the humerus securely in place as it moves within the shoulder joint.

Rotator cuff

The DPT treatment plan for Carrie Green recommended passive ROM exercises, isometric exercises, and the RICE protocol. RICE is an acronym for ____.

rest, ice, compression, and elevation

Roger Bowman's assessment was "rotator cuff strain of left shoulder with limitations in ___ range of motion". Strain is an ______.

active; injury (stretching or tearing) to the body of the muscle or to the attachment of a tendon

The anesthesiologist conducts a pre-operative exam of Mary Smith who is scheduled for major abdominal surgery. She tells Dr. Sleip that sh preoperative medication, Mary Smith says, "I know that one of the medications will help me relax, but what is the other one for?" [Explain in layperson's terms.]e is very anxious about the surgery. The anesthesiologist says he will order a sedative to help her relax and an anticholinergic to be given 30 minutes before surgery.

When the nurse prepares to give the preoperative medication, Mary Smith says, "I know that one of the medications will help me relax, but what is the other one for?" [Explain in layperson's terms.]

Mrs. Smith, the anticholinergic drug helps relax the muscles of your stomach, intestines and bladder during surgery."

Office Note: Fred Tunley is a 48 y/o assembly-line worker whose job involves repetitive flexion of his right wrist. He presents with pain, burning and paresthesia in the thumb, index finger, and middle finger. He is unable to lift objects due to pain and weakness in his right hand. Assessment: carpal tunnel syndrome. Plan: carpal tunnel release.

The general surgeon explains this condition to Mr. Tunley in layperson's terms.

"Carpal tunnel syndrome develops when the tendons in your wrist are overused. There is a tunnel in the bones of your wrist that provides a space for the nerve and tendons that bend the fingers to pass through. The constant movement of your right wrist has caused those tendons to become inflamed and swollen. This puts pressure on the nerve which causes the symptoms you are having."

Wendy Tyred is a 27 y/o female with a nine-month history of fatigue unrelieved with rest. She says that she is extremely tired all the time and feels worse at the end of the work day. She stays in bed on the weekends; however, she continues to be fatigued. She complains of muscle and joint pain and periodic sore throats. Wendy explains that she is unable to work or function at the same level that she could just a year ago. Exam shows mild lymphadenopathy of the neck and axilla. After a work-up to rule out other causes, the doctor diagnoses Wendy Tyred with chronic fatigue syndrome.

The office nurse explains the condition to Wendy in layperson's terms.

"While we do not yet know what causes it, chronic fatigue syndrome is a condition that results in extreme tiredness that is not improved by bedrest and is made worse by physical or mental activity."

HPI: Polly Mussal is a 43 y/o African-American female, who reports progressive muscle weakness in upper arms, shoulders, and neck. She cannot pinpoint when she started feeling this weakness; however, she has complained of nonspecific fatigue for several months. She now presents with difficulty swallowing. Plan: MRI, EMG

The neurologist explains the EMG procedure to Polly Mussal in layperson's terms.

"EMG means electromyography. This test will help me identify if muscle disease is causing your weakness and problems swallowing. I will put a thin needle through your skin into the muscles and measure the electrical activity within the muscles when they are stimulated."

Emily Tyrd has just been diagnosed with fibromyalgia. The office nurse helps Emily understand the diagnosis by explaining in layperson's terms.

"Fibromyalgia is a chronic condition that causes extreme tiredness. You can have widespread or specific pain usually in the muscles, but also, joints or bones."

This 78 y/o female developed numbness and tingling on the left side of her body and collapsed. Her daughter was with her and called 911. EMS brought her to the ED. CT scan and MRI confirm CVA with lt side hemiplegia. The consulting neurologist explains hemiplegia to the daughter.

"The stroke occurred on the right side of your mother's brain and damaged her brain's ability to communicate with muscles on the left side of her body. Hemiplegia is a complete loss of muscle function on one side of the body."

Office Notes: John Payne is a 54 y/o male who complains of pain in his leg muscles when he walks, runs or exercises on the elliptical. The pain is relieved at rest. Exam: Pulses in lower extremities diminished; skin discolored. Assessment: Intermittent Claudication; Plan: Evaluate fror peripheral vascular disease; Doppler ultrasound of bilateral lower extremities; CT angiography.

The internist explains intermittent claudication to Mr. Payne in layperson's terms.

"Intermittent claudication is pain that comes and goes because of too little blood flow to your legs, especially when you exercise. It is a symptom of peripheral vascular disease, which can be treated."

Office Note: Peter Graves is a 61 y/o male who presents with drooping of the eyelids, double vision, difficulty chewing and swallowing. The symptoms come and go getting worse as the muscles are used and improving after rest. Assessment: myopathy of head and neck Plan: MRI; electroneuromyography; lab for abnormal antibodies. Findings: Myasthenia Gravis

The neurologist explains myasthenia gravis to Mr. Graves in layperson's terms.

"Myasthenia gravis is a chronic disease that causes serious weakness and rapid tiredness of any of the muscles under your voluntary control. It is an autoimmune condition in which your immune system attacks normal tissue and results in a breakdown in communication between your nerves and muscles".

Polly Mussal EMG Findings: Polymyositis. The neurologist explains this disease in layperson's terms.

"Polymyositis is a disease with muscle inflammation and severe weakness. It affects the muscles you control that are close to the middle of your body or trunk."

The layperson's definition of singultus is _____.

hiccups