Comprehensive

Question 1

Aortic valve

Answer 1

2nd IC space R sternal border

Question 2

Pulmonic valve

Answer 2

2nd IC space left sternal border

Question 3

Where is Erb’s point and what is its significance?

Answer 3

3rd IC space left sternal border…..pulmonic murmurs best heard here

Question 4

Tricuspid valve

Answer 4

4th/5th IC space left sternal border

Question 5

Mitral valve

Answer 5

5th IC space, left midclavicular

Question 6

Describe chest lead placements

Answer 6

V1 = 4th IC space R sternal border
V2 = 4th IC space L sternal border
V3 = diagonal between V2 and V4 (find V4 first)
V4 = 5th IC space, midclavicular line
V5 = level with V4, anterior axillary line
V6 = level with V4 and V5, midaxillary line

Question 7

Lateral leads

Answer 7

1 and AVL

Question 8

Inferior leads

Answer 8

2, 3, and AVF

Question 9

Numbers to know for EKG rhythm

Answer 9

300, 150, 100, 75, 60, 50

Question 10

Ischemia =

Answer 10

ST Segment Depression OR inverted T wave

Question 11

Acute MI =

Answer 11

ST Segment elevation

Question 12

Locations to auscultate on anterior chest wall

Answer 12

1st IC space, medial 1/3 of clavicle
5th IC space, mid-clavicular
6th IC space, anterior axillary

Question 13

Locations to auscultate on posterior chest wall

Answer 13

Just above spine of scapula (T3)
Mid scapula (T6)
Tip of scapula-medially (T9)
Tip of scapula-laterally (T9)

Question 14

Upper lobes apical segments

Answer 14

Slump against pillow

Clap between clavicle and scapula

Question 15

Upper lobes posterior segments

Answer 15

Lean over pillow

Clap over upper back

Question 16

Upper lobes anterior segments

Answer 16

Supine table flat. Pillows under knees, knees flexed

Clap between clavicle and nipple

Question 17

Right middle lobe

Answer 17

Bed elevated 16 inches
Turn rotated 1/4 backwards and knees flexed. Pillow behind patient to help with this
Clap over right nipple area

Question 18

Left upper lobe lingular segments

Answer 18

Bed elevated 16 inches
Turn 1/4 backwards and knees flexed. Pillow behind patient.
Clap over left nipple area

Question 19

Lower lobes lateral basal segments

Answer 19

Bed elevated 20 inches
Turn 1/4 upwards with upper knee flexed and pillow between knees. Top arm flexed overhead
Clap over lower ribs

Question 20

Lower lobes posterior basal segments

Answer 20

Bed elevated 20 inches
Lie on stomach with pillow under hip
Clap over lower ribs close to spine on each side

Question 21

Lower lobes anterior basal segments

Answer 21

Bed elevated 20 inches
Lying on side with top knee flexed and pillow between the knees
Clap over lower ribs

Question 22

Lower lobes superior segments

Answer 22

Bed flat and 2 pillows under hips

Clap over middle of back at tip of scapula

Question 23

Where should limb leads be placed

Answer 23

Right arm
Left leg
Left arm

Question 24

Breath sound commonly heard in COPD

Answer 24

wheezes

Question 25

Modalities to use for Pain

Answer 25

TENS (sensory and motor)

Question 26

Modalities to use for swelling

Answer 26

Nonthermal US or ice

Question 27

Modalities to use for muscle weakness

Answer 27

E-stime

Question 28

Modalities to use for muscle tightness

Answer 28

Thermal US or heat

Question 29

Settings for sensory TENS - frequency - duration - tx time

Answer 29

Freq = 100Hz Duration = 100 microsec Tx time = as needed

Question 30

Settings for motor TENS - frequency - duration - tx time

Answer 30

Freq = 5Hz Duration = 400 microsec Tx time = 30 min

Question 31

Tx time for ice

Answer 31

20 min

Question 32

Tx time for heat

Answer 32

30 min

Question 33

Settings for thermal US - freq - duty cycle - intensity - tx time

Answer 33

- Freq = 1 MHz (deep) or 3 MHz (superficial) - duty cycle = 100% - intensity = 1.5 W/cm2 - tx time = 8 min

Question 34

When to use thermal vs. non thermal US

Answer 34

``` Thermal = chronic Nonthermal/pulsed = acute ```

Question 35

Setting for nonthermal US

Answer 35

- Freq = 1 MHz (deep) or 3 MHz (superficial) - Duty cycle = 50% - Intensity = 1.5 w/cm2 - tx time = 8 min

Question 36

Settings for Estim - Freq - amplitude - pulse duration - on/off ratio - ramp rise/decay time

Answer 36

-freq = 30pps -intensity = max tolerance - pulse duration = 350 microsec - on/off = 1:5 ratio ramp rise/decay time= 4 sec

Question 37

General contraindiations for modlities

Answer 37

1. ) Pacemaker 2. ) Arrhythmia 3. ) Pregnancy 4. ) Thromboplebitis 5. ) Joint replacement

Question 38

Tests for impingement

Answer 38

1. ) Hawkins Kennedy 2. ) Infrapsintus 3. ) Painful arc

Question 39

Test for RTC tear

Answer 39

1. ) Drop arm 2. ) Infraspinatus 3. ) Painful arc

Question 40

Tests for Shoulder Labral tear

Answer 40

1. ) O'brien | 2. ) Crank

Question 41

Tests for shoulder stability

Answer 41

1. ) Load and shift | 2. ) Sulcus

Question 42

Tests for frozen shoulder

Answer 42

1.) Lift off test

Question 43

Test for hip labral tear

Answer 43

scour

Question 44

Tests for trochanteric bursitis

Answer 44

1. ) Ober | 2. ) MMT of Abd

Question 45

Test for Meniscus

Answer 45

Apley's (with compression)

Question 46

Test for PFPS

Answer 46

McConnell's

Question 47

What should you follow a manip up with

Answer 47

hand heel rocking

Question 48

Side effects of nitrates

Answer 48

1. ) Headache 2. ) Lightheadedness 3. ) Low BP

Question 49

Side effects of beta blockers

Answer 49

1. Fatigue/weakness | 2. ) SOB

Question 50

Big side effect of Calcium channel blockers

Answer 50

Edema in legs/feet

Question 51

What should you avoid in someone who had a medial meniscus injury

Answer 51

avoid excessive hamstring exercise because of potential involvement of medial hamstring

Question 52

Contraindications for manip

Answer 52

1. ) Pregnancy 2. ) Instability 3. ) Surgical hx 4. ) Steroid use 5. ) Osteoporosis 6. ) Pt says NO 7. ) Fx 8. ) Too acute to assess 9. ) Blood thinner 10. Involved medical hx

Question 53

Patellar Ottawa Ankle Rules

Answer 53

1. ) Age over 55 2. ) Isolated tenderness over patella 3. ) Tenderness of fibular head 4. ) Inability to flex to 90 degrees 5. ) Inability to weight bear immediately after injury

Question 54

Anterior lateral hip precautions

Answer 54

Avoid ext, ER, abd

Question 55

Posterior lateral and minimally invasive

Answer 55

avoid flex, IR, ADD