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Case history, etc. Flashcards

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1
Q

list the components for a case history

A

details of chief complaint
comprehensive health history
review of systems

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2
Q

components of examination process

A 
general inspection
vitals
CN exam
visceral exam
cerebellar and proprioception exam
multimodal exam
sensory exam
muscle strength exam
DTR exam
superficial, pathological, visceral reflexes
ROM
orthopedic test (standardized)
orthopedic test (specific)
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3
Q

chiropractic examination

A 
instrumentation
static palpation
motion palpation
leg lengths
x rays
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4
Q

synthesis/assessment

A

group together clues from history, exam, special studies and procedures performed
create a problem list in order of priority

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5
Q

therapeutic program

A 
chiropractic management plan
adjustments
support procedure
physical therapy
work instruments
sleep and activity instructions
exercise instructions
diet instructions
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6
Q

concurrent care

A

recommending consulting with another healthcare provider while under care

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7
Q

referral

A

referring patient to another healthcare provider before any other chiropractic care

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8
Q

recommendations

A

review findings with patient and explain your findings

recommend therapeutic program

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9
Q

when are re-evaluations done?

A

at predetermined intervals or as the case demands

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10
Q

patient status/current plan

A

continue with therapeutic program
modify therapeutic program
recommend consultation or referral OR
dismiss patient if they have reached maximum medical improvement

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11
Q

as a chiropractic physician one of our duties to the patient is to…

A

formulate a diagnosis

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12
Q

history process and gathering of information by the interview process, what types of questions are preferred? what are the other types of questions you could ask?

A

open ended questions
direct questions
leading question

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13
Q

Questions to ask about the onset.

A

can you point to where it is?
when did you first notice it? Gradual or sudden?
what was the exact day you noticed it?
do you know what caused your symptoms?
have the symptoms changed over time?
are there any new symptoms associated with it?
has it gotten worse or better?
how long has it been since you have felt well?

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14
Q

provoke examples

A

lifting, bending, reaching, sitting

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15
Q

palliative examples

A

anti-inflammatory drugs, ice, rest, adjustments

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16
Q

joint quality of pain

A

sharp pain on motion, constant pain

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17
Q

nerve quality of pain

A

constant pain, burning, hot, tingle

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18
Q

peripheral nerve quality of pain

A

numbness, tingling, burning (multidermatomal)

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19
Q

muscle quality of pain

A

dull ache, cramping, knot, spasm

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20
Q

sceratogenous quality of pain

A

radiating dull or deep ache

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21
Q

ligament quality of pain

A

deep burning or dull pain

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22
Q

vascular quality of pain

A

throbbing

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23
Q

unilateral radiating pain that follows a dermatome indicates?

A

NR irritation/compression

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24
Q

unilateral radiating pain that follows a multi-dermatomal pattern indicates?

A

peripheral N irritation/compression, vascular, brachial plexus injury

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25
bilateral radiating pain that involves the upper extremities only indicates?
cervical myelopathy C6-T2
26
bilateral radiating pain that involves the upper and lower extremities indicates?
spinal cord lesion C5 and above
27
bilateral radiating pain that involves the lower extremities indicates?
lumbar spinal cord lesion, spinal cord stenosis
28
visual analog scale
patient marks on a 10 cm line how much pain they are in
29
borg scale
ask patient on a scale of 1-10 how bad their pain is
30
minimal pain
pain is annoying, no impairment with activity
31
slight pain
pain is tolerable, impairment with activity
32
moderate pain
pain causes marked impairment with activity
33
marked pain
pain keeps patient from doing any acitivities
34
increased pain that occurs at night and the patient reports having unexplained weight loss suggests?
cancer
35
intermittent pain
less than 25% of the time
36
occasional pain
25-50% of the time
37
frequent pain
50-75% of the time
38
constant pain
75-100% of the time
39
benefits of a good examination
determine that a musculoskeletal lesion is present location of the problem pathological conditions that could cause these problems analyze the history, examination and testing
40
dermatome pain pattern
radiating, sharp, stabbing, well demarcated
41
myotogenous pain pattern
pain referral within muscular or fascial tissue
42
scerotogenous pain pattern
dull, achy, diffuse, difficult to pinpoint
43
vascular pain pattern
throbbing
44
visceral pain pattern
referred pain, deep
45
components of vital signs
``` respiration blood pressure temperature height and weight mental status ```
46
active ROM importance
helps determine if there is subluxation, muscle spasm, muscle strain, ligament sprain, general arthritic condition, post surgical condition, obesity
47
passive ROM importance
tests end of ROM for any pathologies or subluxationsf
48
bone to bone passive ROM
abrupt stop when two hard surfaces meet
49
capsular end feel
"leathery" slight give at end of ROM
50
springy block
usually pathological, generally represents interarticular displacement
51
empty feel
usually pathological
52
your static and motion palpation examination findings reveal that the patient experiences pain before end range can be reached you with your passive ROM. what does this suggest?
acute condition
53
your static and motion palpation exam findings reveal that the patient experiences pain as the end range can be reached you with your passive ROM. what does this suggest?
subacute condition
54
your static and motion palpation exam findings reveal that the patient experiences pain after the end ROM reached you with your passive ROM. what does this suggest?
chronic condition
55
resisted muscle testing that is painless and strong
normal
56
resisted muscle testing that is painful and strong
grade I strain
57
resisted muscle testing that is painful and weak
grade II strain
58
resisted muscle testing that is painless and weak
grade III strain
59
decreased RBCs mean..?
anemia, neoplasm of bone, lupus
60
increased RBCs mean..?
polycythemia, severe diarrhea, dehydration, poisoning
61
total WBC count
shifts in differential may be present in infections
62
increased ESR
infection, neoplasm and other necrotic processes
63
alkaline phosphatase
increase in primary and secondary osseous neoplams
64
acid phosphatase
increased in prostatic tumors
65
decreased serum proteins
edema, liver disease, malabsorption, diarrhea, starvation
66
increased serum proteins
lupus, RA, chronic infection, multiple myeloma
67
what are the indications for Xray?
``` soft tissue injury bony misalignment loss of integrity/osseous structures and joint space dislocation fracture certain tyes pf stress injuries metastatic disease degenerative disease abnormalities in growth plate some primary tuors metabolic disease ```
68
red flags for xray and other lab studies
prior cancer or recent infection, fever over 100, IV drug abusee, prolonged steroid use, low back pain worse with rest, unexpected weight loss
69
indications for CT
fracture, IVD protrusions or herniations facet disease central canal and lateral recess stenosis metabolic bone disease
70
indications for MRI
``` IVD protrusion, herniation early stages of DDD spinal cord tumors intracranial disease CNS disease metastatic bone disease spinal stenosis cerebral edema meniscal tear soft tissue tumor ```
71
when do you order MRI with contrast?
patietn with acutre low back apin and have had recent surgery
72
indications for bone scan
spinal tumor infection occult fracture
73
indications for electromyography
muscle issues
74
indications for nerve conduction velocity exam
sciatica
75
indications for angiography
intercranial aneurysms, vascular disorders, hematomas, tumors
76
indications for thermography
NR compression
77
instrumentation beak to the right along with radiating pain to the right suggests?
nerve compression
78
instrumentation break to the left along with radiating pain to the right suggests
nerve irritation
79
what patient would benefit from a cranial nerve exam?
trauma, stroke, etc
80
control all motor and sensory functions of the head, face and neck as well as..?
special senses
81
___pain may be the greatest cause of headaches
cervicogenic
82
___vertigo may be the greatest cause of dizziness
cervicogenic
83
CN abnormalities may arise from...
specific lesions to the nerve lesion in nucleus communicating pathways to and from cortex, diencephalon, cerebellar or other parts of brainstem generalized problems with nerves or muscles
84
more than one CN may be affected by a generalized disorder like...?
myasthenia gravis
85
multiple lesions may be noted with...?
MS, cerebral vascular disease
86
unilateral cranial nerve syndrome affection V, VII, VIII...
cerebellopontine angle lesion
87
unilateral cranial nerve syndrome affecting III, IV, V and VI...
cavernous sinus lesion
88
combined unilateral cranial nerve syndrome affection IX, X and XI...
jugular foramen lesion
89
the most common cause of instrinsic brainstem lesion in younger patient is..? older patient?
young: MS old: vascular disease
90
hypoalgesia
area of greatest sensory loss
91
hyperalgesia
area where sensory increases
92
alganesthesia/analgesia
insensitive to pain
93
hypalgesia
decreased sensitivity
94
hyperalgesia
increased sensitivity

NMS (16 decks)

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