Health Assessment NP
Five criteria for diagnosis of RA
1. inflammatory arthritis involving three or more joints
2. postive rhumatoid factor (RF) and/or anti-CCP testing
3. elevated levels of CRP or ESR
4. diseases with similar features have been excluded
5.duration of symptoms >6 weeks
Name of nodules that can form on DIP
Heberden's nodules
name of joints that RA commonly affects first
PIP and MCP
name of nodes that can form on PIP
Bouchard nodes
Grade 1 muscle strength
trace movement
,grade 2 muscle strength
full passive range of motion
grade 3 muscle strength
full range of motion against gravity, no resistance
grade 4 muscle strength
full ROM w resistance, though weak
grade 5 muscle strength
full ROM full strength
C5 dermatome & reflex
lateral upper arm, biceps reflex
C6 dermatome & reflex
radial side of forearm to thumb & index finger, brachioradialis reflex
C7 dermatome & reflex
middle finger, triceps reflex
,AD
C8 dermatome
ulnar forearm to fourth and fifth digits
T1 dermatome
ulnar side of elbow
cervical spine nerve root compression test - passivel extend and rotate pt's
head to affected side and apply axial pressure
Spurling test
cervical spine test - eliminate facet joint etiology, move pt into cervical
extension then laterally flex and rotate to same side
Extension-rotation test
most prominent spinous process
C7
, lumbar spine test - lumbar radiculopathy, while pt is supine lift one leg at a
time to 90 place your other hand on knee to ensure extension. positive if pain
between 30 and 70 degrees of hip flexion that radiates below the knee
Straight leg raise
lumbar spine test for spinal canal involvement in pain, have pt bear down as if
trying to have BM, localized or radicular pain is +
Valsalva maneuver
Spine of the scapula lies on the level of __________ and the entire scapula
typically covers ribs _____ through_____.
T3, 2 through 7
Which parts of the shoulder should be palpated on exam?
scapula - including the coracoid process, acromion process, spine of scapula,
superior and inferior angles of scapula, medial and lateral borders of the
scapula
clavicle - sternal end, acromial end, and entire shaft, and
humerus-deltoid tuberosity, greater tuberosity, bicipital groove, and lesser
tuberosity
Five criteria for diagnosis of RA
1. inflammatory arthritis involving three or more joints
2. postive rhumatoid factor (RF) and/or anti-CCP testing
3. elevated levels of CRP or ESR
4. diseases with similar features have been excluded
5.duration of symptoms >6 weeks
Name of nodules that can form on DIP
Heberden's nodules
name of joints that RA commonly affects first
PIP and MCP
name of nodes that can form on PIP
Bouchard nodes
Grade 1 muscle strength
trace movement
,grade 2 muscle strength
full passive range of motion
grade 3 muscle strength
full range of motion against gravity, no resistance
grade 4 muscle strength
full ROM w resistance, though weak
grade 5 muscle strength
full ROM full strength
C5 dermatome & reflex
lateral upper arm, biceps reflex
C6 dermatome & reflex
radial side of forearm to thumb & index finger, brachioradialis reflex
C7 dermatome & reflex
middle finger, triceps reflex
,AD
C8 dermatome
ulnar forearm to fourth and fifth digits
T1 dermatome
ulnar side of elbow
cervical spine nerve root compression test - passivel extend and rotate pt's
head to affected side and apply axial pressure
Spurling test
cervical spine test - eliminate facet joint etiology, move pt into cervical
extension then laterally flex and rotate to same side
Extension-rotation test
most prominent spinous process
C7
, lumbar spine test - lumbar radiculopathy, while pt is supine lift one leg at a
time to 90 place your other hand on knee to ensure extension. positive if pain
between 30 and 70 degrees of hip flexion that radiates below the knee
Straight leg raise
lumbar spine test for spinal canal involvement in pain, have pt bear down as if
trying to have BM, localized or radicular pain is +
Valsalva maneuver
Spine of the scapula lies on the level of __________ and the entire scapula
typically covers ribs _____ through_____.
T3, 2 through 7
Which parts of the shoulder should be palpated on exam?
scapula - including the coracoid process, acromion process, spine of scapula,
superior and inferior angles of scapula, medial and lateral borders of the
scapula
clavicle - sternal end, acromial end, and entire shaft, and
humerus-deltoid tuberosity, greater tuberosity, bicipital groove, and lesser
tuberosity
