Exam 3 Flashcards by Trinity Smith

this type of peripheral disease is atherosclerotic

PAD

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this type of peripheral disease is thromboembolic

PVD

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pulse grading scale

0- absent
1- weak
2- normal
3- bounding

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sharply demarcated pallor due to spasms of distal arteries in the fingers
(normal radial and ulnar pulses)

Raynaud’s disease

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what are 5 things to palpate for the arm peripheral vascular exam?

capillary refill
radial pulse
brachial pulse
epitrochlear nodes
axillary nodes

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normal capillary refill time

3 sec

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upon inspection of the abdomen, aortic pulsations in the typical adult suggest what?

AAA

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normal width of the aorta

1.4-3 cm

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normal width of inguinal nodes

1-2 cm

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if there’s unilateral edema, measure ____ cm below the tibial tuberosity on each leg and compare. If difference greater than _____ cm, then ______ may be indicated

10 cm
>3cm
DVT

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this type of ulcer is due to ischemia and has well demarcated borders

arterial

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this type of ulcer is due to increased venous pressure and is shallow with irregular borders

venous

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what are 6 things to palpate on the peripheral vascular leg exam?

femoral pulse
popliteal pulse
posterior tibial pulse
dorsalis pedis pulse
pitting edema
cords/ tenderness

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where should you check for pitting edema?

dorsum of foot
medial malleolus
over the shins

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DVT in a proximal vein (femoral or iliac) increases PE risk by ___%

50%

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this special test tests for calf pain on dorsiflexion

Homan’s sign

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this special tests evaluates the patency of the ulnar and radial arteries

Allen test

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explain the steps of the Allen test

1- pt clenches fist
2- occlude radial and ulnar arteries
3- unclench fist
4- let go of ulnar artery
5- watch for reperfusion

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what is a normal result of the Allen test?

color returns in 3-5 sec

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this special tests evaluates the blood flow to the legs

Buerger’s test

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explain the steps of the Buerger’s test

1- raise leg to 60 degrees for 1 min
2- sit up and dangle feet
3- evaluate for reperfusion/ return of color

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list the normal timing for the Buerger’s test

color returns in <10 sec

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abnormal findings of Buerger’s test

> 30 sec for return of normal color and arterial ischemia–> rubor/ reactive hyperemia

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this special test evaluates the ratio of BP of the foot and the arm

Ankle Brachial Index (ABI)

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calculation of the ABI

highest pressure of the 2 arteries of the foot divided by the highest average systolic pressure of either arm (*round 2 decimal places)

is the ABI calculated for both legs?

yes

what is normal ABI?

0.90-1.40

list abnormal values of ABI

<0.50- severe PAD <0.90- PAD >1.40- calcified vessel

is the ankle or the brachial BP typically higher?

ankle

what is valgus?

legs turned inward (knock knees)

what is varus?

legs turned outward (bowleg)

what are the shoulder rotator cuff muscles?

supraspinatus infraspinatus teres minor subscapularis

normal flexion of shoulder

180 degrees

normal extension of shoulder

60 degrees

normal external rotation of the shoulder

100 degrees

normal internal rotation of the shoulder

70 degrees

normal abduction of the shoulder

180 degrees

normal adduction of the shoulder

75 degrees

in this shoulder special test, there may be pain with forward flexion

Neer's impingement

in this special shoulder test, the shoulder and the elbow are flexed to 90 degrees and then internally rotated

Hawkin's impingement

in this shoulder special test, the pt internally rotates the arms with the thumbs down and the clinical pushes down

empty can test

in this shoulder special test, the pt abducts the arm to 90 degrees and holds

drop arm test

in this shoulder special test, the pt's arm is adducted across their chest

crossover test *AC joint separation

what extra factor does the crossover test and the apley scratch test test for?

adhesive capsulitis

normal flexion range of elbow

140 degrees

what are 4 ROM for the elbow

flexion extension supination pronation

snuff box tenderness suggests a.....

scaphoid fx

MCP pain/ bogginess suggests what?

PIP and DIP pain/ bogginess suggests what?

Bouchard's nodes

PIP

Herberden's nodes

DIP

hand and wrist ROM

flexion and extension ulnar (adduction) and radial deviation (abduction)

this is thumb movement pain

DeQuervain's tenosynovitis

describe the finkelstein test

pt grasps their thumb and performs ulnar deviation (+= pain--> tenosynovitis)

list 3 carpal tunnel tests

Tinel's sign Phalen's sign thumb adduction (with resistance)

describe tinel's sign

tap over medial nerve at the wrist--> aching in 2-4th fingers

describe phalen's sign

pt flexes wrist for 60 sec--> aching in 2-4th fingers

what does thumb adduction against resistance specifically test?

weakness to median nerve

step offs on palpation of the spine indicates what?

spondyloithesis

pain upon palpation of the sacroiliac joints indicates what?

sacroilitis or ankylosing spondylitis

where is the sciatic nerve located?

between greater trochanter and ischial tuberosity

ROM of the spine includes....

flexion and extension lateral flexion rotation

this type of scoliosis disappears with forward flexion of the spine

postural

this type of scoliosis persists with forward flexion and presents with a rib hump

structural

this special test tests for pyelonephritis

CVAT

this is referred to as "saddle anesthesia" and involves numbness from S2-S4 and requires an emergent MRI

cauda equina syndrome

this spine special tests tests for lumbar herniated discs

straight leg raise

this spine special test tests for cervical radiculopathy

spurling's test

explain how to perform spurling's test

pt turns head to affected side clinician applies downward pressure

this gait has foot dragging and is stiff

spastic

this gait has a stooped head with the neck forward and is commonly seen in parkinsons

propulsive

in this gait, the toes hit the ground and it indicates tibial muscle weakness

steppage

in this gait, the knees and the thighs hit and it is commonly seen in those with CP

scissor

this gait is common in childhood and dislocation

waddling

on palpation of the hip, this type of pain is often referred to as low back pain but is actually due to...

trochanteric bursitis

this is "weaver's bottom" due to prolonged sitting

ischiogluteal bursitis

ROM of the hip

flexion and extension abduction and adduction internal and external rotation

in this knee special test, the knee is flexed 90 degrees and the tibia is pulled forward

anterior drawer

what part of the knee does the anterior drawer test analyze?

ACL

in this knee special test, the knee is flexed 15 degrees and the tibia is pulled forward while the femur is pushed back

Lachman's test

what part of the knee does Lachman's test analyze?

ACL

in this knee special test, the knee is pushed medially while the ankle is pulled laterally

valgus

what part of the knee does the valgus test analyze?

MCL

in this knee special test, the knee is pulled laterally while the ankle is pushed medially

varus

what part of the knee does the varus test analyze?

LCL

in this knee special test, the knee is flexed 90 degrees and the tibia is pushed back

posterior drawer

what part of the knee does the posterior drawer test analyze?

PCL

in this knee special test, grasp the heel and flex the knee with internal and external roation

McMurray test

what does the McMurray test analyze?

meniscus

in this knee special test, the pt is prone with the knee flexed and pressure is applied

apley grind test

what part of the knee does the apley grind test analyze?

meniscus

foot and ankle ROM

plantarflexion and dorsiflexion inversion- bottom of foot IN eversion- bottom of foot OUT

what part of the foot does the anterior drawer test analyze?

ATFL

what part of the food does the talar tilt analyze?

CFL

what part of the foot/ ankle does the thompson test analyze?

achilles (no movement= rupture)

pronator drift checks for corticospinal lesion in the ______ hemisphere

contralateral

muscle strength scale

5- normal 4- active movement against gravity and some resistance 3- active movement against gravity 2- active movement w/o gravity 1- barely detectable 0- none

shoulder abduction

C5 and C6

elbow flexion

C5 and C6

elbow extension

C6, 7 and 8

wrist extension

C6 and C7 radial nerve

finger extension

C7 and C8 radial nerve

finger abduction

C8 and T1 ulnar

thumb abduction

C8 and T1 median

hip flexion

L2-4

hip adduction

L2-4

hip abduction

L4, L5 and S1

hip extension

knee extension

L2-L4

knee flexion

L4-S2

dorsiflexion

L4 and L5

plantarflexion

sterognosis

identify object

graphesthesia

identify number drawn on hand

2 point discrimmination should be less than _____mm

3 mm

muscle reflex grading

4- brisk with clonus 3- brisker than average 2- average 1- diminished 0- absent

tricep spinal reflex

C6 and C7

brachioradialis reflex

C5 and C6

biceps spinal reflex

C5 and C6

knee spinal reflex

L1-L3

ankle spinal reflex

abdominal reflex above umbilicus

T8-T10

abdominal reflex below umbilicus

T10-T12

normal response to plantar reflex

plantarflexion

anal reflex

S2-S4

3 meningeal sign special tests

nuchal Brudinski Kernig

lumbosacral radiculopathy test

straight leg raise

asterixis tests for what?

metabolic encephalopathy

obtundation

shake pts as they're sleeping

eyes opening on glasgow coma scale

4- spontaneous 3- to command 2- to pain 1- none

best motor on glasgow coma scale

6- obeys verbal orders 5- localizes pain 4- withdrawls 3- flexion 2- extension 1- none

best verbal on glasgow coma scale

5- oriented 4- disoriented 3- inappropriate words 2- inappropriate sounds 1- none

what CN is pupillary light reflex?

CN2 and CN3

in what kind of coma do you have a light rxn when testing the pupillary light reflex?

metabolic coma

ocular position and ocular movement is which CNs?

CN3, 4 and 6

oculocephalic reflex tests which CNs?

CN3, 4, 6 and 8

intact oculocephalic reflex results in what?

doll's eyes

when do you perform oculovestibular reflex?

if absent oculocephalic

what CNs does oculovestibular test?

CN3, 4, 6, and 8

what CNs does corneal reflex test?

CN5 and 7

gag reflex is which CNs?

9 and 10

Exam 3 Flashcards

(141 cards)