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Physical exam > Exam 1 > Flashcards

Exam 1 Flashcards

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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
ptosis
- drooping of upper eyelid | - associated with homer's syndrome, weak muscles, or congenital abnormalities
26
entropion
- inward turn of lower lid | - common in elderly
27
ectropion
- outward turn of lower lid | - common in elderly
28
lid retraction and exopthalmos
- wide stare with protrusion of eyeball | - associated with hyperthyroidism, graves disease, tumor
29
pinguecula
- harmless yellowish triangular nodule in conjunctiva next to iris - associated with aging
30
hordeolum
- aka stye | - painful tender infection of gland at lid margin
31
xanthelesam
- slightly raised, yellow, well demarcated plaque on nasal portion of eyelid - common with lipid disorders
32
chalazion
- blocked meibomian gland | - points inside the lid
33
episcleritis
- localized inflammation of episcleral vessels | - associated with RA, sjorgen's, and herpes zoster
34
darcyocystitis
- inflammation of lacrimal sac - swelling between lower eyelid and nose - tearing is prominent
35
acrus senilus
- corneal acrus - thin grey circle close to edge of cornea - normal aging - associated with hyperlipoproteinemia
36
kayser fleicher ring
- copper deposition -> golden/brown ring in periphery of cornea - d/t mutation in chromosome 13 (wilson's disease)
37
corneal scar
- greyish white opacity in cornea | - secondary to injury or inflammation
38
cataracts
- opacity of lens through pupil | - old age, smoking, DM, steroid use
39
pterygium
- triangular thickening of bulbar conjunctiva growing toward cornea
40
peripheral cataract
- spoke like shadows
41
tonic (adie's) pupil
- pupil is large, regular, and unilateral | - reaction to light is reduced and/or slowed or absent
42
CN III paralysis
- dilated pupil is fixed - ptosis of eyelid - lateral deviation of eye
43
horner's syndrome
- affected pupil is small but reactive to light - usually with ptosis of eyelid - involved iris may be lighter
44
argyll robertson's pupils
- small irregular pupils - accommodate but does not react to light - CNS syphilis
45
one blind eye
- shining light in normal eye -> consensual constriction, light in blind eye -> no response in either eye
46
weber test
- 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
weber results suggesting conductive hearing loss
- lateralizes to impaired ear | - occurs in otitis media, TM perf, obstruction of ear canal, disruption of ossicles
48
weber results suggesting sensorineural hearing loss
- lateralizes to good ear
49
rinne test
- 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
rinne results suggesting conductive hearing loss
- sound is heard through bone as long or longer than air
51
rinne results suggesting sensorineural hearing loss
- sound is heard longer through air
52
arteries of the eye
- light red - small - bright light reflex
53
veins of the eye
- dark red - large - absent light reflex
54
CN VI
- lateral rectus innervation | - abducens
55
CN IV
- superior oblique innervation | - trochlear
56
CN III
- superior rectus - inferior rectus - medial rectus - inferior oblique - occulomotor
57
near test
- pupillary constriction with gaze shifted to a near object | - can assess for convergence at the same time
58
end organs impacted by HTN
- eyes- hypertensive retinopathy - heart- LV hypertrophy - brain- neurologic deficits suggesting stroke - kidneys- urinalysis and blood tests for renal function
59
hyphema
- blood in anterior chamber
60
hypopyon
- pus in anterior chamber
61
lagopthalmos
- inability to fully close eyelids | - CN VII
62
coloboma
- cat eye
63
keratoconus
- thinning disorders of cornea
64
iritis
- inflammation around iris | - marked photosensitivity
65
mydriasis
- dilation of pupil
66
normal IOP
- 10-22 mmHg
67
swinging flashlight test
- test for functional impairment of optic nerve | - look for direct and consensual constriction
68
marcus gunn pupil
- 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
normal BP
- systolic < 120 | - diastolic <80
70
preHTN
- systolic 120-139 | - diastolic 80-89
71
stage I HTN
- systolic 140-159 | - diastolic 90-99
72
stage II HTN
- systolic > or equal to 160 | - diastolic > or equal to 100
73
normal BP if pt has diabetes or renal disease
- systolic < 130 | - diastolic < 80
74
nociceptive pain
- pain linked to tissue damage
75
neuropathic pain
- lesions or disease affecting somatosensory system | - burning or shock like
76
central sensitization
- alteration of CNS processing sensation -> increased pain signaling - pain more severe than expected
77
psychogenic pain
- many factors influence pain | - pscyh, personality, culture, coping
78
idiopathic pain
- without identifiable etiology
79
what percent of adults are overweight or obese in the US
- 69%
80
wong baker faces pain rating scale
- can be used in children and those with language barrier
81
CN I
- 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
CN II
- optic n - test visual acuity - check pupil size
83
CN III, IV, VI
- extraocular movements - check six cardinal directions of gaze - check convergence - look for nystagmus
84
CN V
- 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
CN VII
- facial N | - ask pt to raise eyebrows, frown, close both eyes tightly, show upper and lower teeth, smile, puff cheeks
86
CN VIII
- vestibulocochlear N - asses hearing with whispered voice test - if hearing loss detected use weber and rinne
87
CN IX and X
- glossopharyngeal and vagus nn - control swallowing, raised palate, gag reflex - listen to pts voice - as pt to say "ah" - gag reflex
88
CN XI
- spinal accessory n - pt turn head both ways against your hand - pt shrug both shoulders upwards against your hands
89
CN XII
- 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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