Deck 13: Neurovascular Healing and Thromboembolic Disease

Question 1

Which is the best definition of the term neurotmesis?

A) Reduction in nerve conduction at the site of injury,usually due to compression
B) The nerve epineurium remains intact while the perineurium and endoneurium incur damage in varying degrees
C) The entire nerve trunk is transected or ruptured
D) The peripheral nerve is compressed,causing ischemia

Answer 1

The entire nerve trunk is transected or ruptured

Question 2

Which noninvasive test is used to diagnosis DVT?

A) Homans test
B) Peripheral pulse assessment test
C) Duplex ultrasonography
D) Chest X-ray

Answer 2

Duplex ultrasonography

Question 3

Which of the following is the outermost layer of a blood vessel?

A) Tunica adventitia
B) Tunica media
C) Tunica intima
D) Tunica inner

Answer 3

Tunica adventitia

Question 4

What is the postoperative treatment of total joint arthroscopy patients to prevent DVT?

A) Low-molecular-weight heparin
B) Heparin
C) Coumadin
D) All of the above

Question 5

Which is the best definition of the term axonotmesis?

A) Nerve conduction at the site of injury is reduced,usually due to compression
B) The nerve epineurium remains intact while the perineurium and endoneurium incur damage in varying degrees
C) The entire nerve trunk is transected or ruptured
D) The peripheral nerve is compressed,causing ischemia

Question 6

What factors are included in Virchow's triad?

A) Hypercoagulability,venous stasis,venous injury
B) DVT,PE,postoperative status
C) Total knee or hip replacement and venous stasis
D) None of the above

Question 7

Which of the following is the most common cause of mortality and morbidity in hospitalized patients-particularly in hip and knee arthroplasties?

A) Deep vein thrombosis (DVT)
B) Pulmonary embolism (PE)
C) Hematoma
D) B and C
E) A and B

Question 8

When assessing the motor and sensory nerve recovery of your physical therapy patient,you note that the patient has good motor (M)and fair sensory (S)recovery.How would you chart this finding?

A) M5,S5
B) M5,S4
C) M4,S3
D) M4,S4

Question 9

Which of the following is true about the vascular supply to nerves?

A) The peripheral nerves do not have an extensive blood supply
B) Nerves require an ongoing nutritive energy supply for nerve conduction
C) Peripheral nerves do not require much vascularization
D) All of the above

Question 10

Which of the following is critical for the physical therapist assistant to avoid in the immediate postoperative period after nerve coaptation or autograft?

A) Overzealous range of motion (ROM)exercise
B) Superficial heat application
C) Sensory reeducation exercise
D) Stimulation of distal target sites

Question 11

What is the name of the surgical procedure that reconnects nerve stumps or fascicles?

A) Neuropathy
B) Neurorrhaphy
C) Zenografting
D) Direct coaptation
E) B and D

Question 12

What is the innermost lining of a blood vessel called?

A) Tunica adventitia
B) Tunica media
C) Tunica intima
D) Tunica inner

Question 13

What are the common complications of a dislocated deep vein thrombus?

A) Loss of pulses in the distal extremity
B) Pulmonary infarction,shock,death
C) Hard signs of arterial hemorrhage
D) Difficulty walking long distances

Question 14

How far can you stretch (elongate)a peripheral nerve before you tear it?

A) 1%
B) 5%
C) 20%
D) 70%

Question 15

Which nonpharmacologic actions are taken to prevent DVT?

A) Antiembolism stockings
B) Intermittent pneumatic compression
C) Ambulation as soon as possible postoperatively
D) All of the above

Question 16

Which of the following is a "hard" sign of peripheral artery injury?

A) Hematoma over a peripheral artery
B) Neurologic deficit originating in a nerve adjacent to the injured artery
C) Absent or diminished peripheral pulse distal to the injury
D) Pulselessness,pallor,and paralysis

Question 17

What test is considered the gold standard for diagnosis of a suspected arterial injury?

A) Physical assessment of the hard signs
B) Physical assessment of the soft signs
C) Doppler or duplex ultrasonography
D) Percutaneous arteriography

Question 18

Select the best rationale for the double crush syndrome

A) The syndrome occurs in major motor vehicle accidents with multiple injuries
B) The syndrome is not frequently seen but involves compression on two different nerves
C) The compression on one area of a nerve reduces conduction and blood supply,which puts the rest of the nerve at risk for injury
D) None of the above

Question 19

Which of the following is the correct order for the organized and predictable inflammatory response in blood vessels?

A) Remodeling and maturation,coagulation,fibroplasia,inflammation
B) Coagulation,fibroplasia,inflammation,remodeling,and maturation
C) Fibroplasia,coagulation,inflammation,remodeling,and maturation
D) Coagulation,inflammation,fibroplasia,remodeling,and maturation

Question 20

When assessing the motor and sensory nerve recovery of your outpatient therapy patient,you chart M5,S4.What does this mean?

A) The patient has no motor or sensory recovery
B) The patient has fair motor and fair sensory recovery
C) The patient has normal motor and normal sensory recovery
D) The patient has poor motor and poor sensory recovery