BASICS FOR ALL Flashcards
Cardiovascular
clubbing cap refill blood pressure JVP with liver apex placement, heaves and thrills APTM mitral regurgitate aortic regurgitate lung bases oedemas
urinalysis, fundoscopy
angina, MSK, MI, pericarditis
Respiratory
Inspect x2 CO2 flap Clubbing cap refill RR JVP with liver tracheal position apex beat percuss above clavicles Percuss and auscultate UNDER ARMPITS oedemas lymph nodes Chest expansion POSTERIOR (back)
sputum analysis
PE, MSK, cancer, infections, pneumothorax
GI
hepatic flap clubbing shifting dullness eyes, mouth, toungue auscultate renal bruits and aorta (2 marks) lymph nodes and Virchov's node (2 marks)
PR, groin, hernia, external genitalia, DRE, Temperature, urinalysis (5 marks)
colon/large bowel cancer, gastritis, ulcers, gallstones, appendicitis, cholecystitis, biliary colic, ascending cholangitis
ABCDE
A- chest movements, breath on cheek
put on 15l non-rebreather mask
B- chest expansion tracheal deviation RR pulse oximeter listen percuss ABG
C- JVP central cap refill heart sounds HR BP Temp Urine output Bloods- FBC, U&E, glucose (3 Marks) ECG request IV lines- 2 wide bore cannulas
D- Blood glucose
AVPU
E- exposure
pupil response
haemorrhage protocol if needed (2 marks)
IV BOLUS (2 marks) if needed
Upper Limb Neuro
SWIFT on inspection pronator drift Tone Power Coordination Reflexes Sensation Pinprick Temperature Vibration Propriception
diabetic neuropathy, sensory neuropathy, hypothyroidism (3 marks)
Lower limb neuropathy
SWIFT on inspection Tone Power Coordination Reflexes Sensation Pinprick Temperature Vibration Propriception GAIT- 3 different ROMBERG'S TEST
diabetic neuropathy, sensory neuropathy, hypothyroidism (3 marks)
Cranial Nerve MS
Clearly inspect face (1)
Ask about change in smell (1)/ taste (1)
Visual acuity (3), snellen chart
Visual fields each eye - X
mention fundoscopy (1)
Direct and consensual pupil responses & accommodation (2)
Eye movements (2) stop at H points and I
facial sensation (light touch) (2)
Hearing tests- whisper, Rhine’s, webber’s (3)
palpate masseters on clenching/opening jaw (1)
Raise brows, scrunch eyes, blow out cheeks, purse lips (3)
Shrug shoulders and turn head both sides (2)
Palatal movements and symmetry (say ah) (1)
inspect tongue for wasting (1)
Tongue power and movement (out, move & against cheek) (2)
Mention jaw jerk, corneal and gag reflexes (3)
Conductive deafness, obstruction to ear canal - (if hearing)
Ophthalmology
Inspect from front, side and back- face and eyes Snellen H, double vision Visual fields- X blind spot focus pupil reactions swinging light test correct holding of ophthalmoscope red reflexes examine anterior segment of eye on PATIENT examine posterior segment and fundus - 2 words
HBA1C (1), BP (1), Cranial nerve exam RETINOPATHY SCREENING (1)
diabetes, glaucoma
Neck & Thyroid
GAIT Hands : Tremor, sweaty, Temperature Tinnel's and Phanels Radial Pulse Arms reflexes Face and eyes from front, side and back lower lid retraction loss of eyebrows H lid lag pupils
Toungue protrusion,
neck -swallow
palpate thyroid, with swallowing palpate lymph glands carotid arteries Auscultate thyroid for bruits, carotid artries Percuss for goitre- chest Pretibial oedema proximal myopathy - arms folded, stand Pemberton's sign- arms above head
T4, TSH, USS, ECG
Wrist and Hand
SWIFT Temperature FEEL (bony landmarks, metac squeeze, snuffbox, ulnar and radius) MOVE (wrist thumb fingers) POWER (pinch grip) Function ( opposition, power grip, paper grip) TESTS De Quervan's (fist and down) Tinel's (tap) Phanels (reverse prayer)
VASCULAR cap refil radial pulse Allen's test SENSATION
Osteoarthritis, gout, carpal tunnel, dupytren’s, de quervains tenosynovitis
Elbow exam
Inspect
TEMPERATURE
feel
move- flex, extend, pronate
TESTS:tennis elbow (pronate push) golfers elbow (supinate push)
Shoulder exam
Inspect
TEMPERATURE
feel
MOVE- 8 moves (shoulder dance)
TESTS: Arc test - Impingement Full can/ empty can test scarf test - ac joint drop arm test (rotator cuff injury)
Neuro exam, vascular exam, radiograph of shoulders, spine and elbow exam (3 marks)
frozen shoulder, nerve impingement, rotator cuff tear, calcified tendonitis, nerve impingement
Ankle and Foot exam
Inspect, ask about pain, shoulder, hip, knee, ankle alignment, from all 4 directions
GAIT
TEMPERATURE of ANKLE AND FOOT ALL SIDES
feel
MOVE- dorsal and plantar flexion, inversion and eversion, TOES
Simmond’s test (calf squeeze)
x ray, knee, back exam
Knee exam
Inspect, ask about pain, shoulder, hip, knee, ankle alignment, from all 4 directions
GAIT
TEMPERATURE
feel with knee straight, for joint effusion (patellar tap), knee bent, quadriceps circumference
MOVE- flex, extend,
patella apprehension test (push patella laterally)
anterior/ posterior drawer test (knee bent push and pull)
lateral collateral ligament
medial collateral ligament
(for both put stress on knee in rotation)
X-ray, neurovascular, ankle, hip
Hip exam
Inspect - shoulder, hip, knee, ankle alignment, from all 4 directions, ask about pain
GAIT
TEMPERATURE
feel
Trendelenburg’s test
MEASURE aparent length and true length
MOVE- 6
Thomas’ test
Back exam, knee exam, neuromuscular exam, x rays, MRI
Osteoarhtritis, trochanteric bursitis.
