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Physical exam > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

hyperopia

A
  • farsightedness
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2
Q

presbyopia

A
  • aging vision
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3
Q

myopia

A
  • near sightedness
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4
Q

scotomoas

A
  • blind spots
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5
Q

diplopia

A
  • double vision

- occurs with lesion in brainstem, cerebellum, or CN palsy

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6
Q

anisocoria

A
  • pupil size difference > 0.4 mm
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7
Q

conductive hearing loss

A
  • problems with external/ middle ear

- noisy environment may help

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8
Q

sensorineural loss

A
  • problems in inner ear, cochlear n, central brain connections
  • trouble understanding speech
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9
Q

tinnitus

A
  • perceived sound with no external stimulus
  • ringing, rushing, roaring
  • occurs with hearing loss and vertigo
  • meniere’s disease
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10
Q

vertigo

A
  • perception that the room is spinning
  • either central or peripheral
  • usually from lesion on CN VIII or central pathway of brain
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11
Q

presyncope

A
  • feeling of falling or passing out
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12
Q

lightheadedness

A
  • dizziness upon standing or sitting up
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13
Q

disequilibrium

A
  • feeling unsteady or losing balance
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14
Q

rhinorrhea

A
  • drainage from nose
  • often assoc with nasal congestion, sneezing, watery eyes, throat discomfort, itchy eyes
  • itchy eyes -> allergic cause
  • seasonal onset -> allergic rhinitis
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15
Q

drug induced rhinitis

A
  • excessive use of decongestants or cocaine

- aka rhinitis medicamentosa

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16
Q

nasal congestion

A
  • sense of stuffiness or obstruction
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17
Q

epistaxis

A
  • bloody nose
  • can originate in sinuses or nasopharynx
  • posterior nosebleed can leak into throat not nose
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18
Q

hoarseness

A
  • change in voice quality
  • husky, rough, lower pitched
  • causes are overuse and acute viral laryngitis
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19
Q

goiter

A
  • enlarged thyroid gland
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20
Q

hirsutism

A
  • excessive facial hair
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21
Q

auscultatory gap

A
  • silent interval that may be present between systolic and diastolic pressures
  • prevents over inflation and ensures you dont miss BP readings
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22
Q

what is a normal pressure difference between arms

A
  • 5-10 mmHg
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23
Q

what does BP difference in each arm of 10-15 mmHg suggest?

A
  • subclavian steal syndrome

- aortic dissection

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24
Q

what does HTN in upper extremities and low BP in lower extremities suggest

A
  • coarctation of aorta

- occlusive aortic disease

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25
Q

ptosis

A
  • drooping of upper eyelid

- associated with homer’s syndrome, weak muscles, or congenital abnormalities

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26
Q

entropion

A
  • inward turn of lower lid

- common in elderly

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27
Q

ectropion

A
  • outward turn of lower lid

- common in elderly

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28
Q

lid retraction and exopthalmos

A
  • wide stare with protrusion of eyeball

- associated with hyperthyroidism, graves disease, tumor

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29
Q

pinguecula

A
  • harmless yellowish triangular nodule in conjunctiva next to iris
  • associated with aging
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30
Q

hordeolum

A
  • aka stye

- painful tender infection of gland at lid margin

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31
Q

xanthelesam

A
  • slightly raised, yellow, well demarcated plaque on nasal portion of eyelid
  • common with lipid disorders
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32
Q

chalazion

A
  • blocked meibomian gland

- points inside the lid

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33
Q

episcleritis

A
  • localized inflammation of episcleral vessels

- associated with RA, sjorgen’s, and herpes zoster

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34
Q

darcyocystitis

A
  • inflammation of lacrimal sac
  • swelling between lower eyelid and nose
  • tearing is prominent
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35
Q

acrus senilus

A
  • corneal acrus
  • thin grey circle close to edge of cornea
  • normal aging
  • associated with hyperlipoproteinemia
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36
Q

kayser fleicher ring

A
  • copper deposition -> golden/brown ring in periphery of cornea
  • d/t mutation in chromosome 13 (wilson’s disease)
37
Q

corneal scar

A
  • greyish white opacity in cornea

- secondary to injury or inflammation

38
Q

cataracts

A
  • opacity of lens through pupil

- old age, smoking, DM, steroid use

39
Q

pterygium

A
  • triangular thickening of bulbar conjunctiva growing toward cornea
40
Q

peripheral cataract

A
  • spoke like shadows
41
Q

tonic (adie’s) pupil

A
  • pupil is large, regular, and unilateral

- reaction to light is reduced and/or slowed or absent

42
Q

CN III paralysis

A
  • dilated pupil is fixed
  • ptosis of eyelid
  • lateral deviation of eye
43
Q

horner’s syndrome

A
  • affected pupil is small but reactive to light
  • usually with ptosis of eyelid
  • involved iris may be lighter
44
Q

argyll robertson’s pupils

A
  • small irregular pupils
  • accommodate but does not react to light
  • CNS syphilis
45
Q

one blind eye

A
  • shining light in normal eye -> consensual constriction, light in blind eye -> no response in either eye
46
Q

weber test

A
  • test for lateralization if pt reports ringing or hearing loss
  • place vibrating tuning form on vertex of skull or mid forehead
  • ask if hear the sound equally or more so in one ear
47
Q

weber results suggesting conductive hearing loss

A
  • lateralizes to impaired ear

- occurs in otitis media, TM perf, obstruction of ear canal, disruption of ossicles

48
Q

weber results suggesting sensorineural hearing loss

A
  • lateralizes to good ear
49
Q

rinne test

A
  • compares air vs. bone conduction
  • place lightly vibrating fork on mastoid bone
  • when pt can no longer hear sound place fork next to ear canal and check if can hear the sound again
  • normally AC> BC
50
Q

rinne results suggesting conductive hearing loss

A
  • sound is heard through bone as long or longer than air
51
Q

rinne results suggesting sensorineural hearing loss

A
  • sound is heard longer through air
52
Q

arteries of the eye

A
  • light red
  • small
  • bright light reflex
53
Q

veins of the eye

A
  • dark red
  • large
  • absent light reflex
54
Q

CN VI

A
  • lateral rectus innervation

- abducens

55
Q

CN IV

A
  • superior oblique innervation

- trochlear

56
Q

CN III

A
  • superior rectus
  • inferior rectus
  • medial rectus
  • inferior oblique
  • occulomotor
57
Q

near test

A
  • pupillary constriction with gaze shifted to a near object

- can assess for convergence at the same time

58
Q

end organs impacted by HTN

A
  • eyes- hypertensive retinopathy
  • heart- LV hypertrophy
  • brain- neurologic deficits suggesting stroke
  • kidneys- urinalysis and blood tests for renal function
59
Q

hyphema

A
  • blood in anterior chamber
60
Q

hypopyon

A
  • pus in anterior chamber
61
Q

lagopthalmos

A
  • inability to fully close eyelids

- CN VII

62
Q

coloboma

A
  • cat eye
63
Q

keratoconus

A
  • thinning disorders of cornea
64
Q

iritis

A
  • inflammation around iris

- marked photosensitivity

65
Q

mydriasis

A
  • dilation of pupil
66
Q

normal IOP

A
  • 10-22 mmHg
67
Q

swinging flashlight test

A
  • test for functional impairment of optic nerve

- look for direct and consensual constriction

68
Q

marcus gunn pupil

A
  • swinging light in abnormal pupil causes partial dilation of both pupils
  • swinging light in normal eye causes consensual constriction
  • d/t afferent and efferent stimuli reduction -> net dilation
  • aka afferent pupillary defect
69
Q

normal BP

A
  • systolic < 120

- diastolic <80

70
Q

preHTN

A
  • systolic 120-139

- diastolic 80-89

71
Q

stage I HTN

A
  • systolic 140-159

- diastolic 90-99

72
Q

stage II HTN

A
  • systolic > or equal to 160

- diastolic > or equal to 100

73
Q

normal BP if pt has diabetes or renal disease

A
  • systolic < 130

- diastolic < 80

74
Q

nociceptive pain

A
  • pain linked to tissue damage
75
Q

neuropathic pain

A
  • lesions or disease affecting somatosensory system

- burning or shock like

76
Q

central sensitization

A
  • alteration of CNS processing sensation -> increased pain signaling
  • pain more severe than expected
77
Q

psychogenic pain

A
  • many factors influence pain

- pscyh, personality, culture, coping

78
Q

idiopathic pain

A
  • without identifiable etiology
79
Q

what percent of adults are overweight or obese in the US

A
  • 69%
80
Q

wong baker faces pain rating scale

A
  • can be used in children and those with language barrier
81
Q

CN I

A
  • olfactory n
  • sense of smell
  • make sure both nostrils are patent
  • block one nostril, close eyes and have pt smell and ID familiar substance
82
Q

CN II

A
  • optic n
  • test visual acuity
  • check pupil size
83
Q

CN III, IV, VI

A
  • extraocular movements
  • check six cardinal directions of gaze
  • check convergence
  • look for nystagmus
84
Q

CN V

A
  • trigeminal n
  • motor function- have pt clench jaw, palpate temporal and masseter m
  • use sharp and dull object to test for sensation on face
85
Q

CN VII

A
  • facial N

- ask pt to raise eyebrows, frown, close both eyes tightly, show upper and lower teeth, smile, puff cheeks

86
Q

CN VIII

A
  • vestibulocochlear N
  • asses hearing with whispered voice test
  • if hearing loss detected use weber and rinne
87
Q

CN IX and X

A
  • glossopharyngeal and vagus nn
  • control swallowing, raised palate, gag reflex
  • listen to pts voice
  • as pt to say “ah”
  • gag reflex
88
Q

CN XI

A
  • spinal accessory n
  • pt turn head both ways against your hand
  • pt shrug both shoulders upwards against your hands
89
Q

CN XII

A
  • hypoglossal n
  • important for tongue symmetry, position, and movement
  • listen to articulation
  • assess movement of tongue
  • look for atrophy or fascinations

Physical exam (3 decks)

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