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Chapter 14 Practice Questions

Terms in this set (13)

1. The most common sites of referred pain from systemic diseases
are:
a. Neck and back
b. Shoulder and back
c. Chest and back
d. None of the above
b. Shoulder and back
2. To screen for back pain caused by systemic disease:
a. Perform special tests (e.g., Murphy's percussion, Bicycle
test)
b. Correlate client history with clinical presentation and ask
about associated signs and symptoms
c. Perform a Review of Systems
d. All of the above
d. All of the above
3. What are two ways of classifying back pain (as presented in the
text)?
Back pain can be examined and classified in many ways. We have presented Sources of Back Pain (e.g., visceral, neurogenic, vasculogenic, spondylogenic, psychogenic, neoplasm; see Table 3-3) and Location of Back Pain (e.g., cervical spine, scapula, thoracic spine, lumbar spine, sacrum, sacroiliac; see Table 14-1).
4. Which statement is the most accurate?
a. Arterial disease is characterized by intermittent claudication,
pain relieved by elevating the extremity, and history of
smoking.
b. Arterial disease is characterized by loss of hair on the lower
extremities, throbbing pain in the calf muscles that goes away
by using heat and elevation.
c. Arterial disease is characterized by painful throbbing of the
feet at night that goes away by dangling the feet over the bed.
d. Arterial disease is characterized by loss of hair on the toes,
intermittent claudication, and redness or warmth of the legs
that is accompanied by a burning sensation.
c. Arterial disease is characterized by painful throbbing of the
feet at night that goes away by dangling the feet over the bed.
5. Pain associated with pleuropulmonary disorders can radiate to:
a. Anterior neck
b. Upper trapezius muscle
c. Ipsilateral shoulder
d. Thoracic spine
e. All of the above
e. All of the above
6. Which of the following are clues to the possible involvement of
the GI system?
a. Abdominal pain alternating with TMJ pain within a 2-week
period of time
b. Abdominal pain at the same level as back pain occurring
either simultaneously or alternately
c. Shoulder pain alleviated by a bowel movement
d. All of the above
b. Abdominal pain at the same level as back pain occurring
either simultaneously or alternately
7. Percussion of the costovertebral angle resulting in the reproduction
of symptoms signifies:
a. Radiculitis
b. Pseudorenal pain
c. Has no significance
d. Medical referral is advised
d. Medical referral is advised
8. A 53-year-old woman comes to physical therapy with a report
of leg pain that begins in her buttocks and goes all the way down
to her toes. If this pain is of a vascular origin she will most likely
describe it as:
a. Sore, hurting
b. Hot or burning
c. Shooting or stabbing
d. Throbbing, "tired"
d. Throbbing, "tired"
9. Twenty-five percent of the people with GI disease, such as
Crohn's disease (regional enteritis), irritable bowel syndrome,
or bowel obstruction, have concomitant back or joint pain.
a. True
b. False
a. True
10. Skin pain over T9 to T12 can occur with kidney disease as a
result of multisegmental innervation. Visceral and cutaneous
sensory fibers enter the spinal cord close to each other and converge
on the same neurons. When visceral pain fibers are stimulated,
cutaneous fibers are stimulated, too. Thus visceral pain
can be perceived as skin pain.
a. True
b. False
a. True
11. Autosplinting is the preferred mechanism of pain relief for back
pain caused by kidney stones.
a. True
b. False
b. False
12. Back pain from pancreatic disease occurs when the body of
the pancreas is enlarged, inflamed, obstructed, or otherwise
impinging on the diaphragm.
a. True
b. False
a. True
13. A 53-year-old postmenopausal woman with a history of breast
cancer and mastectomy 5 years ago presents with a report of
sharp pain in her midback. The pain started after she lifted her
2-year-old granddaughter 3 days ago. Tylenol seems to help, but
the pain is keeping her awake at night. Once she wakes up, she
cannot find a comfortable position to go back to sleep. What are
the red flags?
Red flags include age (over 50), previous history of cancer, and lack of pain relief with recumbency. Screening should follow the decision-making model presented in Chapter 1.
Conduct a careful history of symptoms, and ask about symptoms anywhere else in the body.
Find out when the last medical follow-up was done by the oncologist and when the patient had her last clinical breast examination and mammogram. Clinical assessment should include vital signs, lymph node palpation, skin inspection that includes the mastectomy site, and a neurologic screening examination. Palpate the painful area and perform a percussive Tap test.
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