Se coloca un protón en un campo eléctrico uniforme y luego s…
Questions
Se cоlоcа un prоtón en un cаmpo eléctrico uniforme y luego se liberа. Después se sitúa un electrón en el mismo punto y también se libera. En esta situación, ¿cuál de las siguientes afirmaciones es correcta?
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SCENARIO: A 24-yeаr-оld аmаteur wrestler repоrts tо you immediately following a match requesting an evaluation of his left wrist and hand. History His main complaint is pain in his left wrist and up in his hand. He tells you that his wrist began to hurt right after a violent takedown where he fell on a hyperextended wrist. Following this, he had trouble actively extending his wrist through the full range because of pain. Nonetheless, he continued to wrestle since he did not want to disqualify himself due to injury. However, he suffered another takedown immediately afterwards but landed on a clenched fist the second time in an effort to protect the injured wrist. He describes it like "punching the mat". He describes his pain in different places within the hand. There is a dull ache that spans the mid-palmar aspect of the wrist and hand (proximal carpal row). At the same time, there is a dull ache that is on the ulnar aspect of the palmar and dorsal sides, mainly near the 5th knuckle. He rates his pain, in both places, as an 8/10 that elevates to a 9/10 when moving his wrist or squeezing his hand. He recalls spraining his wrist periodically throughout his career as a wrestler but cannot recount specific diagnoses. He has also previously dislocated his left middle and ring fingers within the past five years. He denies any pain in his neck, shoulder or elbow and reports no neurological symptoms. However, he does indicate beginning to feel somewhat nauseous as he speaks with you. Observation Upon initial inspection, you note moderate swelling along the palmar aspect of the proximal carpal bone row and radiocarpal joint, especially within the middle third. Swelling is also noticed throughout the hypothenar eminence. When comparing bilaterally, you notice a possible drop off deformity. You do not observe any scars or ecchymosis. Palpation Considerable point tenderness is apparent with palpation of the lunate, triquetrum, and their corresponding intercarpal joint. You also note a hard protrusion within this area that is not perceived through observation. When comparing bilaterally, this protrusion is not on the contralateral hand. Palpation along the fifth metacarpal exacerbates pain and produces crepitus at the metacarpal head and neck. ROM Testing AROM P! with wrist extension that prevents the patient from reaching end range. P! with wrist flexion accompanied with the complaint of feeling something stuck within the joint that prevents the patient from reaching end range. All MCP, PIP, and DIP motions produce too much p! and prevent you from conducting AROM testing PROM P! with wrist extension. You encounter a capsular end-feel and the patient complains of P! before reaching end range. P! with wrist flexion. You encounter a hard-end feel that increases the p! before reaching end range. All MCP, PIP and DIP motions produce too much p! and prevent you from conducting PROM testing RROM P! with wrist extension, rated 3/5. P! with wrist flexion, rated 3/5. All MCP, PIP and DIP motions produce too much p! and prevent you from conducting RROM testing Structural (or Stress) Tests Compression Test applied at the third metacarpophalangeal joint Positive for p! at proximal carpal row No p! is noted in the 3rd metacarpal Lunotriquetral ballottement (or Reagan) Positive for p! and slight laxity Tap (or percussion/vibration) along longitudinal axis of the fifth ray Positive for p! at the 5th MCP Compression applied at the fifth metacarpophalangeal joint Positive for p! down the 5th Metacarpal Neurovascular Tests No significant findings noted. AT RESPONSE: Based on these ensemble findings, what is your diagnosis? DIRECTIONS: Your response must follow best practices for health record documentation (i.e., provide concise, specific, and accurate information that another clinician could easily read and interpret). It is expected that your text entry will include correct spelling. You may (and are encouraged) to use common abbreviations and acronyms linked to anatomical and medical terminology when appropriate.