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H & P 2 > Exam 2 > Flashcards

Exam 2 Flashcards

(144 cards)

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1
Q

CN I

A

Olfactory, sensory

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2
Q

CN II

A

Optic, sensory

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3
Q

CN III

A

Oculomotor, motor

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4
Q

CN IV

A

Trochlear, motor

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5
Q

CN V

A

Trigeminal

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6
Q

CN VI

A

Abducens, motor

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7
Q

CN VII

A

Facial, sensory and motor

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8
Q

CN VII

A

Acoustic, sensory

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9
Q

CN IX

A

Glossopharyngeal, motor and sensory

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10
Q

CN X

A

Vagus, motor and sensory

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11
Q

CN XI

A

Spinal accessory, motor

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12
Q

CN XII

A

Hypoglossal, motor

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13
Q

Pupil response to direct and concentric light and accommodation tests…

A

CN II (and CN III)

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14
Q

Six extraocular muscles tests…

A

CN III, CN IV, CN VI

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15
Q

Assessing facial VII

A 
Raise both eyebrows
Frown
Close eyes tightly and don't allow you to open them
Smile
Show teeth
Puff checks
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16
Q

Peripheral injury

A

Affects upper and lower face, Bell’s palsy

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17
Q

Central injury

A

Affects the lower face (the most)

UMN’s opposite side

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18
Q

Anterior 2/3 of the tongue

A

Sweet and salty, facial sensory

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19
Q

CN IX glossopharyngeal sensory

A

Posterior 1/3 of tongue

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20
Q

Whisper test

A

If they pass this, you don’t do anything else

If they don’t pass, you have to do Weber and Rhinne

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21
Q

Vestibular proprioception function assessed with …

A

Romberg

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22
Q

Motor testing of glossopharyngeal

A

Difficulty swallowing

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23
Q

Sensory testing of glossopharyngeal

A

Gag reflex present or absent

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24
Q

Vagus nerve motor testing

A

Swallowing, rising soft palate

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25
Vagus nerve sensory testing
Hoarseness
26
Spinal accessory testing
Shoulder shrug, head turned to side against resistance
27
Hypoglossal testing
Move tongue In and out of mouth L T D N sounds
28
Posterior horn
Sensory
29
Upper motor neurons
Cellular bodies in cerebral cortex/brain stem
30
Lower motor neurons
Cell bodies in spinal cord
31
3 pathways from anterior horn
Corticospinal tract Basal ganglia Cerebellar system
32
Corticospinal tract
Voluntary movement Cross contralateral side of medulla Forms pyramid structure
33
Basal ganglia system
Complex, maintains muscle tone and control body movements Posture, gate
34
Cerebellar system
Sensory and motor Coordinates motor activity Equilibrium for posture, gait
35
If defect is above the medulla then...
Contralateral side because of the crossover
36
If the defect is below the medulla, then...
Ipsilateral side
37
Muscle strength grading
``` 1- trace contraction 2- passive movement 3- active movement against gravity 4- active movement with some resistance 5- active movement with full resistance ```
38
Biceps testing...
C5 and C6
39
Triceps testing...
C6, C7, C8
40
Extension at wrist testing...
C6, C7, C8, radial
41
Grip, testing...
C7, C8, T1
42
Finger abduction testing...
C8, T1, ulnar nerve
43
Thumb opposition testing...
C8, T1, median nerve
44
Flexion of hip in leg extension tests...
L2, L3, L4, iliopsoas
45
Adduction at the hips is testing...
L2, L3, L4
46
Abduction at the hips testing...
L4, L5, S1
47
Extension at the hips testing...
S1, gluteus Maximus
48
Extension at the knee testing...
L2 L3 L4
49
Flexion at the knee testing...
L4 L5 s1, s2
50
Dorsiflexion testing
L4 L5
51
Plantar flexion testing
S1
52
Dysdiadochokinesia
Inability to perform quick movements
53
Dysmetria
Overshooting or undershooting intended movement of arm/leg
54
Pronator drift
Arms straight ahead, supination arms up eyes closed Watch for drift and slight pronation of one arm 30 seconds then tap down briskly and watch for imbalance
55
DTR scale
``` 0- no response 1- sluggish 2- normal 3- slightly hyperactive 4- brisk, hyperactive ```
56
Biceps DTR testing...
C 5, c6
57
Brachoradialis DTR testing...
C5, C6
58
Triceps DTR testing...
C6 C7
59
Patellar DTR testing...
L2, 3, 4
60
Achilles DTR testing
S1
61
Clonus
Do if hyperactive/hyperreflexive Flexed knee and briskly dorsiflex ankle, UMN disease
62
Cremasteric reflex testing...
Lumbar 1, 2
63
Plantar reflex testing...
Lumbar 5 | Sacral 1
64
Babinski
Toes fan out and dorsiflexion of big toe Abnormal <2 years old or UMN lesion in the corticospinal tract
65
Nipple dermatome
T4
66
Umbilicus dermatome
T10
67
Thumb dermatome
C6
68
Middle finger dermatome
C7
69
Ring and little finger dermatome
C8
70
Inguinal dermatome
L1
71
Knee dermatome
L3
72
Anterior ankle, medial foot/toes dermatome
L5
73
Heel, posterior foot, lateral toes dermatome
S1
74
Perianal dermatome
S5
75
Big toe test
Tests position, lift up or down and have them tell you which way you are lifting it
76
Sterognosis
Identify objects in hands
77
Graphesthesia
Write on hand with a blunt edge
78
Extinction
Touching two places simultaneously and ask where you are touching the patient
79
Ataxia
Positive Romberg Staggering, wide stance
80
Chorea
Involuntary movements of the face, neck and may involve body Brief, rapid, jerky, rhythmic Basal ganglia over activity, huntington's, etc
81
Parkinson's
Resting, pilll rolling tremor Muscular rigidity Instable balance Shuffling gate Soft voice, drooling
82
Intention tremor
Tremor worsens near target Cerebellar disorders, like MS or alcohol abuse
83
Essential postural tremor
Bilateral/symmetric Hands with outstretched arms Progressive Autosomal dominant
84
Postural physiologic tremor
Arms extended Disappears at rest Hyperthyroid, hypoglycemia
85
Asterixis
Outstretched hand with fingers separated and dorsiflexed wrists Jerky movement of flexion/extension at wrist (hepatic encephalopathy)
86
Athetosis
Involuntary, writhing, convoluted movement Associated with chorea Cerebral palsy Huntington's
87
Dystopia
Involuntary sustained contractions Focal- single body part, females in 30-40s Could be idiopathic, CNS disorders
88
Tardive dyskinesia
Involuntary movements of tongue, lips, face, mouth, jaw
89
Aphasia
Inability to comprehend or formulate language
90
Global aphasia
Damage to both language centers
91
Broca's aphasia
Understand speech of others, but can't communicate Frontal lobe
92
Wernicke's aphasia
Temporal lobe Difficulty understanding speech Long nonsense phrases
93
Bell's palsy
Rapid onset, spontaneous resolution up to a week
94
Meningitis signs/symptoms
Flue, headache, stiff neck, 3-7 days onset from exposure AMS, fever, nuchal rigidity Petechiae and purpura
95
Brudzinski
Supine patient, involuntary flexing of hip and knees with neck flexion
96
Kernig
Supine patient with flexion hip and knees Positive test when resistance or lower back pain with straightening
97
Myasthenia gravis hx
Double vision, droopy eyelids, difficulty walking, fatigue and weakness
98
Myasthenia gravis exam
Ptosis Facial weakness with puffing out cheeks Hypophonia
99
MS hx
Fatigue, urinary, blurred or double vision, weakness, tingling, sexual dysfunction
100
MS exam
Muscle weakness, hyperactive DTS, paresthesias, sensory loss, intention tremor, optic neuritis
101
Peripheral neuropathy hx
Gradual onset Numbness, tingling, burning Night pains, walking on cotton
102
Peripheral neuropathy exam
Reduced sensation of foot with monofilament Diminished ankle/knee reflexes Decreased vibratory sensation below knees
103
Trigeminal neuralgia hx
Sharp, severe sudden onset of pain, usually unilateral and chronic Intermitten a few times a day Chewing, swallowing and cold
104
Trigeminal neuralgia exam
Normal to slight diminished sensations Pain in nerve distribution
105
Decorticate rigidity
Hands flexed and up by chest
106
Decerebrate rigidity
Hands moved to side, flexed Significant disease, people are dying, severe brain injury
107
Mild GCS
13-15
108
Moderate GCS
9-12
109
Severe GCS
3-8
110
Oculocephalic reflex
Doll's eyes, brainstem is in tact if the eyes move opposite to the way you turn them
111
Lethargy
Aware of a loud voice, brief response
112
Obtunded
Shake patient gently, look at you and may respond with confusion
113
Stupor
Sternal rub, verbal responses absent but have some sort of facial reaction
114
Coma
Repeated stimuli with no response
115
HEEADSSS
``` Home Education/employment Eating Activity Drugs/alcohol Sexuality Suicidal/depression Safety ```
116
CRAFFT
``` Car Relax Alone Forget Family/friends Trouble ``` About substance abuse
117
Healthy weight
5th percentile, no less than 85h percentile
118
Palpate suture lines until...
Child is 2-3
119
Anterior fontanelle closes ...
8 months-2 years
120
Poster fontanelle closes...
1-2 months
121
2 line difference between the eyes...
Referral even though they are normal range
122
3-5 years visual acuity
20/40
123
6 years visual acuity
20/30
124
Using intercostal for breathing at...
Age 6-7
125
Umbilical hernias often resolve on their own by...
Age 2, if not consider a referral
126
Genu varum
1-2 yeras old, knees out
127
Genu valgum
2-4 years, leg bowing
128
Leg calve perthes
3-11 year olds Knee, thigh or groin pain Loss of internal rotation and abduction Aseptic necrosis of femoral head
129
Osgood schlater
9-16, male athletes Inflammation of tibia tuberosity
130
SCFE
10-16, males more commonly 20-40% biltaerla Commonly obese, hypothyroid, low growth hormone Knee pain referred from hip, limp, out toeing and short stance on affected side
131
Detect scoliosis ages
6-12
132
Percentage of curve that needs to intervene with scoliosis
25-40%
133
Don't assses DTR in children...
Less than 6 unless concerne about insult to CNS or developmental abnormality
134
Denver II assesses
Gross motor Fine motor Verbal Personal/social
135
Connor scale
ADHD screening
136
Back or zung
Depression scales
137
Visit dentist at...
Age 1 or 6 months after 1st tooth
138
Molars erupt at...
12 month of age, additional sets developing at 2
139
Most have all 20 teeth at...
30 months
140
Permanent teeth replace baby teeth at...
6 or 7
141
Only proven benefit of PEP
Recognize at risk athletes of orthopedic injury
142
Perform PPE...
Within 6 weeks of participation
143
Concussion signs/symptoms
``` Headache, LOC N/V Balance problems, dizziness Double vision Sensitivity to light/noise Foggy, difficulty concentrating Confusion ```
144
Concussion wok up
Rule out skull fracture Symptom based diagnosis ACE from

H & P 2 (3 decks)

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