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Physical Assessment > Exam 3 > Flashcards

Exam 3 Flashcards

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1
Q

musculoskeletal system functions

A

support body, movement, encase and protect vital organs, produce RBC in bone marrow, storage of certain minerals

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2
Q

most active joint in the body?

A

temporomandibular joint

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3
Q

bony landmarks of shoulder

A

acromion, coracoid process, acromioclavicular joint

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4
Q

temporomandibular joint motion and expected range

A

open mouth maximally, protrude lower jaw and move side to side, stick out lower jaw

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5
Q

shoulder motion and expected range

A

arms forward and up, arms behind back and hands up, arms to sides and up over head, touch hands behind head

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6
Q

elbow joint bones

A

ulnar, radius and humerus

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7
Q

palpable landmarks of elbow joints

A

olecranon process, later and medial epicondyles

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8
Q

“funny bone”

A

ulnar nerve

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9
Q

elbow motion and expected range

A

bend and straighten elbow, pronation and supination

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10
Q

wrist/hand motion and expected range

A

bend hand up, bend hand down, bend fingers up and down, turn hands out and in, spread fingers, make fist, touch thumb to each finger

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11
Q

ulnar nerve controls sensation where?

A

pinky and half of ring finger

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12
Q

median nerve controls sensation where?

A

part of thumb, index, middle and part of ring finger

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13
Q

radial nerve controls sensation where?

A

part of thumb

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14
Q

tests for checking for carpal tunnel

A

phalen’s test (press backs of hand together for 30 sec) and tinel’s test (tap median nerve)

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15
Q

osteoarthritis

A

degenerative joint disease, hard, nontender nodules 2-3mm in size, heberden’s nodes (bony overgrowth at DIP), bouchard’s nodes (PIP), metacarpophalangeal joints are sparred

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16
Q

rheumatoid arthritis

A

autoimmune, tender, painful, stiff joints, symmetric, PIP and MCP involvement (warm and tender), ulnar deviation, swan neck deformity, boutonniere deformity

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17
Q

ulnar deviation

A

middle, ring and pinky fingers deviated to the side

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18
Q

swan neck deformity

A

DIP flexion, PIP hyperextension

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19
Q

boutonniere deformity

A

PIP flexion, DIP hyperextension

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20
Q

hip expected range and motion

A

raise leg, knee to chest, flex knee and hip, swing foot in and out, swing leg laterally and medially, stand and swing leg back

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21
Q

knee joint ligaments

A

anterior and posterior cruciate, medial and lateral collateral

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22
Q

collateral ligaments provide support for what kind of motion

A

stability for side to side movement

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23
Q

ankle/foot expected range and motion

A

point toes up and down, turn soles in and out, flex and straighten toes

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24
Q

cervical spine motion and expected range

A

chin to chest, lift chin, each ear to shoulder, turn chin to shoulder

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25
area of language comprehension
wernicke's area
26
area for motor function for lanuage
broca's area
27
corticospinal tract controls
skilled voluntary movement like writing
28
extrapyramidal tract controls
gross motor movements like arm swinging when walking
29
posterior column functions
proprioception, vibration, localized touch
30
peripheral nervous system is made of
cranial nerves, spinal nerves, reflex arc
31
what are the 5 components of reflexes
functional synapse, intact sensory nerve, intact motor nerve, neuromuscular junction is intact, muscle is competent
32
light headedness is usually a sign of a problem with
heart
33
vertigo is a sign of a problem with
neuro
34
3 important things to remember for neuro exam
mental status intact?, are right and left sided findings the same/symmetric, if findings are asymmetric does the lesion lie in the CNS or PNS
35
7 components of neuro exam
mental status, cranial nerves, motor system, sensory system, coordination, romberg/gait, reflexes
36
p wave of ekg is
atria depolarizing and contracting
37
QRS wave is
beginning of ventricles contracting
38
ST segment represents
plateau phase of repolarization
39
T wave represents
final rapid phase of ventricular repolarization/ventricle contracting
40
long QT interval warms that a patient is
vulnerable to irregular rhythms
41
hesitancies in speech could be a sign of
aphasia in a patient with a stroke
42
monotone inflection could be a sign of
schizophrenia or severe depression
43
circumlocutions
words or phrases are substituted for things pt cant remember
44
paraphasias
words are malformed or wrong
45
Bell's palsy signs
peripheral lesion in CN 7, paralysis in upper and lower part of the face, eye would not close on that side, flat nasal labial fold
46
central lesion/stroke signs
lesion in CNS, little bit of innervation in upper face so eyes would close, flat nasal labial fold
47
spastic muscle tone
upper motor neuron of corticospinal tract at any point from the cortex to the spinal cord, causes clasp knife rigidity
48
rigid muscle tone
basal ganglia system is effected, constant state of resistance in any direction, lead pipe and cogwheel rigidity
49
flaccid muscle tone
effects the lower motor neuron at any point from the anterior horn cell to the peripheral nerves
50
fasciculation
rapid continuous twitching of a resting muscle
51
tetany
involuntary muscle spasm
52
myoclonus
rapid sudden jerk
53
spinothalamic tract senses
pain, temperature, light or crude touch
54
posterior column senses
vibration, proprioception, fine discrimination
55
clonus test
rapidly flex foot, if foot oscillates after that is positive, test of upper motor lesion
56
cremasteric reflex
stroke inner thigh causes cremator muscle to pull up testes
57
upper motor neuron problems
CVA, stroke, MS, cerebral palsy, spastic/increased tone, positive babinksi
58
lower motor neuron problems
polio, spinal cord lesion, loss of tone
59
growth and development pattern
cephalocaudal, proximal to distal, gross to fine
60
hypertonic muscle
heightened muscle tone
61
hypotonic muscle
floppy and lose muscles
62
scoliosis
screen with scholiometer (if angle is greater than 7 it is bad)
63
hip dysplasia
hip dislocation
64
barlow maneuver
adduct hip, push thigh posteriorly and hip goes out of socket
65
ortolani maneuver
abduct thigh, apply downward pressure, clunk means unstable hip has been reduced
66
trendelenburg gait
colateral side drops, causes uneven gait
67
genu varum "bow legged"
normal until 3, refer if angle is acute
68
genu valgum "knock kneed"
normal until age 7, correctable until age 9
69
3 causes of intoeing
from hip (femoral anteversion, caution on child's seating), from tibia (tibial tortion, knees still face forward), from the foot (metatarsal adductus, distal half of the foot points in)
70
disappearing baby reflexes
palmar grasp, placing/stepping, rooting/sucking, moro, tonic neck, plantar reflex, babinski
71
abnormal childhood reflexes
oppenheimer, chaddock, snouting
72
oppenheimer
run reflex hammer down interior calf, abnormal if big toe fans out
73
chaddock
reflex hammer down outer foot, abnormal if big toe fans out
74
snouting
reflex hammer on philtrum, abnormal if lips scrunch up
75
normal PR interval
less than .2sec
76
Normal QRS interval
less than .08 sec
77
QT interval
less than .4sec
78
where do limb leads record activity
frontal plane of the body
79
chest leads record activity
in the horizontal plane of the body
80
lichen sclerosis
labia/clitoris is reabsorbed
81
cystocele
bladder prolapses out bc anterior wall of vagina is too weak
82
rectocele
rectum protrudes out, posterior wall of vagina is too weak
83
reducable hernia
can be moved out of the way
84
irreducable hernia
can't be moved, can become gangrenous
85
indirect hernia
internal ring, canal, external ring, scrotum, bulge over midpoint of ligament, pain with baring down, most common type of hernia, auscultate for bowel sound, more common in young men
86
direct hernia
painless, herniates directly behind and through external ring, rarely goes into scrotum, usually in older men from weight lifiting or obesity
87
femoral cana hernia
can become strangulated, extremely painful, least common in men and most common in women
88
how to calculate HR from EKG
300-150-100-75-60-50
89
regular heart rhythm
all RR intervals are equal in length
90
regularly irregular heart rhythm
RR intervals are different lengths but overall pattern is similar
91
irregularly irregular heart rhythm
no overall pattern
92
sinus tach rate
greater than 100
93
saw tooth ekg
atrial flutter, 240-360bpm, single ectopic foci
94
afib ekg
multiple weak ectopic foci resulting in weak tiny p wave, irregularly irregular rate, don't know when ventricles will contract
95
pts with afib need to be on
coumadin bc blood pools in atria
96
what can irritate a ventricular foci
low O2 and hypokalemia
97
what does a PVC look like
giant ventricular complex and a compensatory pause
98
how many PVCs in a minute is considered pathological
6 or more
99
PVCs can lead to
vtach or vfib
100
vtach is the result of
one strong ventricular focus that hijacks the conduction system of the heart, can't sustain life for long, usually leads to vfib
101
what does vtach look like
very rapid, enormous PVC like waves
102
vfib looks like
beating of many weak ectopic foci, uncoordinated contractions
103
how to treat vfib
CPR and defibrilation
104
what is first degree AV heart block
PR interval >.2, consistent
105
second degree AV heart block types
wenckebach and mobitz type 1
106
wenckeback second degree AV block
progressively longer PR duration until a nonconducted PR, regularly irregular
107
mobitz type 2
normal p waves and interval until no QRS, can have different degrees (2:1 is 2 p waves per QRS)
108
3rd degree or complete heart block
AV node is totally blocked so there is no relationship between P wave and QRS complex, treat with a pacemaker
109
tendons
hook muscle to bone
110
ligaments
hook bone to bone
111
what bone is not involved in the knee
fibula
112
broca's aphasia
expressive
113
wernickes aphasia
receptive
114
positive babinski could indicate
stroke, MS, meningitis, etc.

Physical Assessment (3 decks)

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