Assessment 1 Flashcards
1
Q
1
A
Olfactory
2
Q
2
A
Optic
3
Q
3
A
Oculomotor
4
Q
4
A
Trochlear
5
Q
5
A
Trigeminal
6
Q
6
A
Abducens
7
Q
7
A
Facial
8
Q
8
A
Acoustic
9
Q
9
A
Glossopharyngeal
10
Q
10
A
Vagus
11
Q
11
A
Spinal accessory/ shoulders
12
Q
12
A
Hypoglossal
13
Q
Sense of smell
A
1
14
Q
Vision
A
2
15
Q
Pupillary construction, lid elevation (opening eyes), extraoccular movements
A
3
16
Q
Downward internal rotation of eye
A
4
17
Q
Temporal & masseter muscles (jaw clenching) and lateral jaw movement
A
5
18
Q
Facial sensory
Ophthalmic
Maxillary
Mandibular
A
5
19
Q
Lateral deviation of eyes
A
6
20
Q
Facial movements closing eyes and mouth
Facial expressions
A
7
21
Q
Taste and sensation of the ear
A
7
22
Q
Hearing and balance
A
8
23
Q
Pharynx
A
9
24
Q
Sensory of pharynx posterior tongue and taste
A
9
25
Motor of pharynx palate larynx
10
26
Sensory if pharynx and larynx
10
27
Sternocleidomastoid and trapezius movement
11
28
Tounge movement
12
29
only sinuses you can palpate
Frontal and maxiallary are the only ones you can palpate and percuss
30
what are the four pairs of sinuses
Maxillary sinuses. (largest of the paranasal sinuses, located in the maxillary bone and shaped like pyramid)
Frontal sinus. (situated above the eyebrow.)
Ethmoid sinus. ( drain directly beneath the nasal conchae.)
Sphenoid sinus.
31
Entropion
inverted eyelashes
lower lid turns inward
feels like something in eye all the time
32
Ectropion
everted eyelashes
low lid loose
common in stroke - worry about dryness
33
health disparity
health difference between more or less privileged social groups. adversely affect disadvantaged groups.
higher burden of illness, injury, disability, or mortality experienced by one group relative to another.1
systemic and persistent. not random
wealth, racial ethnic, gender, age, disability, sexual orientation or characteristics reflecting social privilege/
34
health care disparity
differences between groups in health insurance coverage, access to and use of care, and quality of care.
35
visual acuity assesses which cranial nerves
2
3
4
6
36
exophthalmos
bugged out eyes - forward protrusion
| visible rim of sclera
normal lid covers top of iris so no white sclera is seen on top
37
proptosis
protrusion and downward look of the eyeball
both - likely hyperthyroid
unilateral - tumor, hemorrhage, or trauma
38
cone of light on Right ear drum
5 o'clock
39
Ptosis
drooping upper lid
Parlysis of
Nerve 3 – ocular motor
40
cotton wool patches in eye exam =
diabetic and hypertensive retinopathy
41
layer of skin with no blood vessels
Epidermis
42
lichenification
thick, leathery patches of skin.
d/t excessive itching or rubbing of the skin because the outer layer of skin naturally thickens with the extra irritation, and it often happens in tandem with eczema
43
eccrine sweat glands are found _____
widely distributed
| E for everywhere
44
apocrine sweat glands are found _____
axillary and genital/groin
often open to hair follicles
- these guys are the reason for BO
45
Morphology of a Lesion
TSAD
Type
Shape
Arrangement
Distribution
46
Primary lesions include
```
macule
patch
papule
plaque
nodule
cyst
vesicle
pustule
bulla
abcess
wheal
scaling
hyperkeratosis
```
47
nevus
birthmark or mole
48
secondary lesions
```
lichenification
crusting
dystrophy
excoriation (can occur without a primary)
erosion
fissure
ulcer
```
49
Adenopathy:
large swollen lymph nodes
50
Olfactory
1
51
Optic
2
52
Occulomotor
3
53
Trochlear
4
54
Trigeminal
5
55
Abducens
6
56
Facial
7
57
Acoustic
8
58
Glossophyrngeal
9
59
Vagus
10
60
Accessory
11
61
Hypoglossal
12
62
Rinne test
evaluating unilateral hearing loss. sounds transmitted by air conduction to those transmitted by bone conduction through the mastoid. place on bone then in air and compare
In an ear with normal hearing and an ear with sensorineural hearing loss, air conduction (AC) is more than bone conduction (BC) AC > BC Positive
In an ear with conductive hearing loss, bone conduction (BC) is better than air conduction (AC)
63
Weber test
strikes a tuning fork and places it on the middle of your head.
ask pt to note where the sound is best heard: the left ear, the right ear, or both equally
64
Bronchophony
pt says 99 or 66 while you auscultate
Normally muffled
sound of the patient's voice becomes less distinct as the auscultation moves peripherally; bronchophony is the phenomenon of the patient's voice remaining loud at the periphery of the lungs or sounding louder than usual over a distinct area of consolidation, such as in pneumonia.
65
egophany
while auscultating have patient say E
E to A transition indicates pneumonia
66
whispered pectoriloquy
Whispered pectoriloquy
Ask pt. to say “ninety – nine” or “one, two, three”.
Normally whispered voice heard faintly or indistinctly
67
Tactile fremitus
Palpable vibrations transmitted through the bronchopulmonary tree to chest wall when speaking
Use ball of hand
Repeat “ninety – nine
Increased over consolidation – PNA
Decreased in copd and pleural effusion
68
Diaphragmatic Excursion
Percuss - Note distance between the levels of dullness on full expiration and full inspiration
Normal is about 3-5.5 cm
Comparing side to side is the full test – someone with scoliosis may have different measurements
69
Assessment of Jugular Venous Distention (JVD)
Position with HOB at 30 degrees.
Identify the external jugular vein and find the pulsation of the internal jugular vein.
Identify the highest point of pulsation. Measure the distance between the sternal angle and this point.
70
Allen's test
– occluding radial and ulner arteries– release one and assess perfusion of arterial blood flow to the hands.
71
Buerger's test
adequacy of the arterial supply to the leg. It is performed in two stages.
With the patient supine, elevate both legs to an angle of 45 degrees and hold for one to two minutes. Then sit the patient up and ask them to hang their legs down over the side of the bed at an angle of 90 degrees.
Observe the color of the feet. Pallor indicates ischaemia. It occurs when the peripheral arterial pressure is inadequate to overcome the effects of gravity. The poorer the arterial supply, the less the angle to which the legs have to be raised for them to become pale.
Gravity aids blood flow and colour returns in the ischaemic leg. The skin at first becomes blue, as blood is deoxygenated in its passage through the ischaemic tissue, and then red, due to reactive hyperaemia from post-hypoxic vasodilatation. leg will revert to its original colour more slowly than normal.
72
Psoas Test
```
Supine
legs straight
hand above pt’s right knee
ask pt to raise right leg against resistance (flex hip)
+ pain in abdomen =+psoas
appendicitis
```
73
Obturator sign
pt supine
flex knee and hip and internally rotate
pain may be elicited in RLQ
appendicitis
74
Murphy’s sign
Inspiratory arrest/pain with deep palpation of right subcostal area
Have patient Take large long deep breath as you palpate may stop or gasp because of pain
Acute Cholecystitis
75
Rosving’s sign
Referred Pain LLQ (press) feels it on the R
appendicitis
76
Aaron’s sign
(referred pain felt in epigastric area upon firm pressure over McBurney’s point. (1/3rd the distance from the superior iliac spine to umbilicus)
77
Phalen's
ask the patient to hold
the wrists in flexion for 60 seconds with the
elbows fully extended
( \/ - hands)
78
Tinel sign
by tapping lightly over the
course of the median nerve in the carpal
tunnel
Aching and numbness in the median
nerve distribution is a positive test
79
SITS
Supraspinatus—directly under the acromion (tip of shoulder blade laterally)
■ Infraspinatus—posterior to supraspinatus
■ Teres minor—posterior and inferior to the supraspinatus
■ Subscapularis—inserts anteriorly and is not palpable
80
empty can test
The patient then elevates the arms to 90 degrees and horizontally adducts 30 degrees to the scapular plane with thumbs down to the empty can position. The examiner provides downward pressure to test the patient’s strength in this position. A positive test for rotator cuff tear is more weakness in the empty can, patient complaint of pain, or both.
81
Winging
dysfunction involving the stabilizing muscles of the scapula resulting in imbalance and abnormal motion of the scapula or protrusion
82
Cozen's test
- evaluate for lateral epicondylitis or, tennis elbow.
pt flexes wrist and examiner tries to extend
The test is said to be positive if a resisted wrist extension triggers pain to the lateral aspect of the elbow owing to stress placed upon the tendon of the extensor carpi radialis brevis muscle
83
Finkelstein's Test
To test thumb function, ask the patient to grasp the
thumb against the palm and then move
the wrist toward the midline in ulnar deviation
– pain + de Quervain's tenosynoviti
84
FABER Test
– hip Patrick's test or FABER test (for Flexion, ABduction, and External Rotation) is performed to evaluate pathology of the hip joint or the sacroiliac joint. The test is performed by having the tested leg flexed and the thigh abducted and externally rotated. hip, lumbar spine, or sacroiliac joint dysfunction, or an iliopsoas spasm
85
SLR
| straight leg raise
Place the patient in the supine position. Raise the patient’s relaxed and straightened
leg, flexing the thigh at the hip . Some examiners first raise the
patient’s leg with the knee flexed, then extend the leg
Assess the degree of elevation at which pain occurs, the quality and distribution
of the pain, and the effects of foot dorsiflexion.
Foot dorsiflexion
can further increase leg pain
If the patient
has low back pain that radiates down the thigh and leg, commonly called sciatica if in the sciatic nerve distribution, test straight-leg raising on each side in turn. Tightness or discomfort in the
buttocks or hamstrings is common during these maneuvers and should not be
interpreted as “radiating pain” or a positive test.
86
Brudzinski Sign.
As you flex the neck, watch the hips and knees in reaction
to your maneuver. Normally they should remain relaxed and motionless. Flexion of both the hips and knees is a
positive
meningitis
87
Kernig Sign
Flex the patient’s leg at both the hip (at 90 degrees) and the knee, and then slowly extend the leg and straighten the knee
subsequent extension in the knee is painful (leading to resistance
Discomfort behind the knee during full extension is normal but should not produce pain.
88
Two-point discrimination
Using the two ends of an opened paper clips or ends of q-tips , touch a finger pad in two places simultaneously
Alternate the double stimulus irregularly
with a one-point touch.
Find the minimal distance at which the patient can discriminate one from
two points (normally <5 mm on the finger pads). This test may be used on
other parts of the body, but normal distances vary widely from one body
region to another.
Lesions of the sensory cortex increase
the distance between two recognizable
points.
89
Stereognosis
the ability to identify an object by
| feeling it.
90
graphesthesia
```
With the blunt end of a pen or pencil,
draw a large number in the patient’s
palm
(If arthritis or other conditions prevent
the patient from manipulating
an object well enough to identify it)
```
91
Proprioception
(Joint Position
Sense). Grasp the patient’s big toe,
holding it by its sides between your thumb
and index finger, with the
patient’s eyes closed, ask the patient to
say “up” or “down” when moving the
large toe in a small arc.
```
Loss of position sense, like loss of
vibration sense, is seen in tabes dorsalis (demylenation - loss of coordination)
multiple sclerosis, or B12 deficiency
from posterior column disease, and in
diabetic neuropathy.
```
92
Simmonds' test aka Thompson test
movement of the foot on squeezing the corresponding calf
test for the rupture of the Achilles tendon
no foot movement = +
