56 一位中風患者在復健過程中主訴肩關節疼痛,理學檢查顯示肩關節半脫位(subluxation),下列相關敘述何者最為正確?
使用三角巾將肩關節固定於內轉(internal rotation)角度
常伴隨複雜性區域疼痛症候群第二型(complex regional pain syndrome type 2)的發生
可使用功能性電刺激於三角肌(deltoid)與棘上肌(supraspinatus)
步行訓練時須將手臂置於身體背後
ANS C
BEcause it is only 半脫位, by doing muscle strengthening will do!
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57 下列有關第六頸髓完全損傷患者的敘述,何者錯誤?
需使用口控搖桿滑鼠做電腦輸入 體溫調節不良
突然坐起可能引發低血壓 膀胱過脹可能引起高血壓
ans a
this lesion is too high.
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58 一位69歲的老先生,因地面濕滑不小心拐了一下但並未跌倒,之後出現右側腰臀疼痛,痛會傳導到同側大腿後側,偶爾還會到小腿和腳底,神經學檢查完全正常,但於右臀有一個明顯壓痛點,做髖關節內轉及屈曲(internal rotation & flexion)時會誘發傳導痛到同側後小腿和腳底,則其診斷應為:
右側第一薦椎神經根病變(S1 radiculopathy) 右側梨狀肌症候群(piriformis syndrome)
右小腿動脈栓塞 右側腰方肌(quadratus lumborum)扭傷
piriformis syndrome ans
Piriformis syndrome has been a controversial diagnosis since its initial description in 1928.1 The condition, which can mimic a diskogenic sciatica, usually is caused by a neuritis of the proximal sciatic nerve. The piriformis muscle can either irritate or compress the proximal sciatic nerve due to spasm and/or contracture.Piriformis syndrome is also referred to as pseudosciatica, wallet sciatica, and hip socket neuropathy.
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