final Flashcards

1
Q

Hyperhidrosis

A

increased moisture of skin , typically affects the soles of the feet, usually idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Bromohidrosis

A

FOOT odor causes include poor hygiene, talc powder or topical erythromycin (topical antibiotic) can be used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Tinea pedis

A

Athlete’s foot, 3 types: interdigital infections, moccasin distribution, vesiculobullos (arch) infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Interdigital tinea pedis: presentation and tx

A

present in the web spaces, maceration, scaling, erythema. Tx: betadine, powders, antifungal gel, anti septic castallini’s PAINT***

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Mocassin tinea pedis: presentation and tx

A

scaling of the plantar surface, hyperkeratosis, topical or oral antifungal for tx.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Vesicular tinea pedis

A

marked by vesicles in the arch of the foot, crusting tx: topical antifungal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are hyperkeratotic lesions?

A

corns , calluses, hammertoes. Develops in response to friction or pressure, usually over bony prominent areas.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are hyperkeratotic lesions?

A

corns , calluses, hammertoes. Develops in response to friction or pressure, usually over bony prominent areas.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are two types of corns/ hyperkeratotic lesions?

A

heloma dura- dorsal hard corns, usually over the PIPJ and heloma molle- soft corns, usually interdigitial corn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are three types of ulcers?

A

neuropathic, vascular, and pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are underlying conditions that cause chronic wounds?

A

diabetes, poor circulation, poor nutritional status, pressure, immunodeficiencies, infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are arterial ulcers?

A

caused by ischemia, presence of PVD, VERY PAINFUL, no debridement used, send to vascular.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are diabetic ulcers?

A

trauma, pressure is SECONDARY to NEUROPATHIC disease or vascular disease related to DM.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are pressure ulcers?

A

Localized, tissue damage due to pressure ( bed ulcers) decubitus ulcer (aka)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are venous ulcers?

A

Caused by impaired venous return, excessive EDEMA, treated with compression. Dont use compression on sickle cell patients, most sickle cell patients develop salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is gangreene?

A

occurs when tissue dies (necrosis) because its blood supply is interrupted. Can be caused by infection, injury, or a complication of a long term condition.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the five types of gangreene?

A
  1. dry gangreene- least severe, 2. wet gangrene 3. gas gangrene- caused by bacteria, medical emergency, can have crackling sound 4. internal gangrene- intestines. 5. fournier’s gangrene- of genitals, causes death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Subungual hematoma-

A

blood under the nail, usually painful, caused by trauma. Tx: drill hole with a 18 gauge needle w/ cold water soak, total nail avulsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is onychocryptosis?

A

ingrown toenail. caused by chronic pressure of the nail fold by the nail plate. Leading edge of the toenail acts like a foreign body and can cause inflammation and infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is hallux abducto valgus?

A

bunion deformity, lateral deviation of hallux with or without medial and or dorsal prominence of the 1st MT head. BOTH FEET USUALLY AFFECTED** causes: biomechanics, trauma, shoe gear- MOST COMMON CAUSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are tx for bunions?

A

NSAIDS- motrin, otc pads, wider shoe gear, night splints, custom orthotics, surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is hallux rigidus / limitus?

A

Hallux limitus- limited range of motion of the first MTPJ seen at toe off, Hallux rigidus- loss of motion MTPJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are common causes of hallux rigidus/limitus?

A

dorsiflexed 1st ray, 1st ray hypermobility, long 1st ray , prolonged 1st MTPJ immobilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are tailors bunions?

A

abduction of the 5th metatarsal , lateral bowing of the 5th metatarsal, enlargement of the 5th MT head, biomechanical, arthritic changes of the 5th MT head.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are hammertoes?

A

They are contracted at the plantarflexed PIP**, DIP- neutral or hyperextended, MTP- dorsiflexed. Can be flexible, semi rigid or rigid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is plantar fascitis associated with?

A

cavus and planus feet. Hallmark symptom: first step in the morning is extremely painful- POST STATIC DYSKINESIA. Plantar pain due to repeated microtrauma. Straining of the posterior attachment to the medial tubercle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are treatments for plantar fasciitis?

A

NSAIDS, local steroid injection, strappings, orthotics, stretching, PT, SX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is Gout?

A

joints are red, swollen, and extremely tender. Tophi can be at base of toe. Patients usually complain of the bed sheets touching the toe causes pain. It is a metabolic disorder with depositions of monosodium urate crystals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Why does gout occur, what body parts are involved?

A

Metabolic disorder, deposition of urate crystals form at coldest locations. Pred. dx in adult men. Acute gouty arthritis is the most clinical manifestation. 75% 1st MTPJ involved.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What sign helps dx Gout?

A

Martel’s sign xray, serum uric acid levels increased, TX- NSAIDS, colcrys, injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are DVT’s?

A

blood clots which usually form in the deep venous system of the LE. Can lead to Pulm Emb. Pain, heat, SWELLING in the affected limb, compression of calf causes pain ***

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What causes DVT’s?

A

trauma, prolonged bed rest, chronic deep venous insufficiency, estrogen/oral contraceptive use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are treatments for DVT?

A

anticoagulents, blood thinners (heparin, warfarin, coumadin, eliquis, rivaroxaban( Xarelto)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is diabetic neuropathy?

A

Related to serum glucose, encompasses sensory, motor, and autonomic, loss of sensation, atrophy of interosseous, tingling/shooting pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are tx for diabetic neuropathy?

A

creams- Arnica, pills- GABA, injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is objective medical documentation?

A

**written documentation of observable, measurable and reproducible findings from examination and supporting lab or tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Why is documentation important?

A

patient care, communication, written records, legal records

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the elements of good documentation?

A

accuracy, legibility, timeliness, unaltered, professionalism, completeness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

BUN

A

blood urea nitrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

COPD

A

chronic obstructive pulm disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

ECG/ EKG

A

electrocardiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

GI

A

gastrointestinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

RBC

A

Red blood cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

ROM

A

range of motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the chief complaint?

A

In patient’s words, brief statement of the reason the patient is seeking care.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the history of present illness?

A

HPI includes facts that explore in detail the CC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

NLDOCAT used for HPI

A

nature( pain) , location, duration, onset, cause, aggravating/alleviating, treatments attempted*****

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Past medical history includes:

A

childhood illness, major adult illnesses , accidents, immunizations, dev’t history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Past surgical history

A

Operations include: indication, date, outcome complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Social history includes: travel,smoking/alcohol. What are pack years?

A

number of cigarettes/ packs per day and duration of time. If patient has smoked 2 packs per day for 20 years: 2x 20= 40 pack years*****

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Medications asked can include:

A

name, dose, freq., duration, alt/compli medical practices, herbal therapies, vitamins, supplements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Allergies can include:

A

drug causing reactions, PCN , Sulfa drugs, codeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Review of systems:

A

typically 3 questions for each system- general: fatigue, fever, sweating. Start from head , work way down. Excessive thirst, hunger- DIABETES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

healthy pulse and resp rate should be:

A

60-100, and 15-20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

For the physical exam, General includes:

A

Awake, alert, oriented (AAOx3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Objective physical exam includes:

A

vascular, neurologic, orthopedic, dermatologic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Assessment-

A

your opinion, evaluation, diagnosis, diff. diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Subjective vs objective data:

A

subj- what the patient relates, what others relate to you about the patient obj- what YOU observe, direct measurements( bp, temp) labs, xrays, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Symptoms vs signs

A

symptoms are SUBJECTIVE , and a response to what the patient feels , described by the patient to clarify the illness, symptoms are not absolute. Signs are OBJECTIVE finding upon physical examination of the patient. signs can be observed and quantified.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Proper way to correct a written note:

A

initial and date, cross out with black ink, one line cross out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

osteoblasts

A

bone formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

osteoclasts

A

bone resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What are ligaments

A

specialized connective tissue that connects bones, joint stability, barrier protection . Composed of COLLAGEN type I 90%, similar to tendons however, more elastin, uniform microvascularity, not under muscle tension. Exercise increases strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is articular cartilage?

A

covers articulating surfaces, decreases friction, distributes loads, avascular, aneural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is articular cartilage composed of?

A

water 65-80% , 90% in osteo arthritis , increase water, decrease strength. Collagen type II - 95%, proteoglycan 10-15% provides compressive strength. Chondrocytes: 5 % collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is a capsule?

A

connective fibers, attaches around articular ends of bones, richly vascularized, reinforced by collateral ligaments * heals similar to tendons, however, more vascular- faster healing w/less complication**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are the three types of muscle and their differences?

A

SKELETAL- attached to bones with single long multinucleated cells with striations, CARDIAC- walls of the heart, uninucleate cells striations with intercalated disks, SMOOTH-walls of hollow visceral organs, single fusiform cells, uninucleate, NO striations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Basic unit of contration

A

myofibril that consists of sarcomere with H band(thick) and I (thin) band endoym-perimy-epimysium bind fasicles to form muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What are differences between the types of muscle fiber?

A

type 1 : slow twitch, red fiber, aerobic oxidation, endurance actibity. type 2- fast twitch, white fiber, anarobic , strength activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What are the different types of muscle contraction?

A

isotonic- contraction in which the muscle length will shorten and movt of a limb takes place. isometric- muscles shortens, but no movement in limb takes place. Isokinetic- muscle shortens and movt takes place, speed of contraction remains the same through entire motion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What are tendons?

A

collagen structures that transmit muscle motion to produce joint motion. Composed of fibroblasts 85% type 1 collagen, 5% type 2 collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is the sagittal plane

A

a vertical plane dividing the body into right and left parts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Coronal /frontal plane

A

a vertical plane dividing body into anterior and posterior parts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

transverse/horizontal plane

A

A plane parallel to the floor or supporting surface, dividing body into superior and inferior parts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

what are the cardinal planes of the foot

A

sagittal- dividing foot into med and lat, frontal- distal(ant) and prox (post) parts, transverse- dorsal (sup) and plantar (inf) parts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

inversion

A

movement in which the plantar surface of the foot moves toward the midline. medial border is elevated. vara/ varus /varum- sole/calcaneus moves medially

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

genu varum-

A

bow legged (knees out)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

genu valgus

A

knock kneed (knees close together)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

active vs passive ROM

A

active- movement by the PATIENT. Joint range of motion available. Passive- movement by the examiner, joint range of motion available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

1st MPJ- dorsiflexion is what degree

A

greater than 65 degrees dorsiflexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Subtalar joint ROM

A

prone position,20 degrees inversion 10 degrees eversion 30 degrees total

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Pes cavus

A

high arch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

pes planus

A

flat foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Ankle equinus

A

a limitation of normal range of dorsiflexion motion of the ankle less than 10 degrees dorsiflexion

85
Q

pseudo ankle equinus

A

cavus foot,not true equinus

86
Q

What occurs during the swing phase

A

foot is not in contact with the ground

87
Q

General survey of patient includes:

A

signs of distress, gait/motor activity, weight, height, inspection of patient

88
Q

What is auscultation and how are sounds heard?

A

listening to sounds produced by the body . Indirect- uses stethescope. FLAT diaphragm picks up HIGH - pitched respiratory sounds best. BELL picks up LOW pitched sounds such as heart murmurs. *****

89
Q

What is the order of techniques for assessment?

A

Inspect, palpation, percussion, auscultation* except for the abdomen which is Inspect, auscultation, percuss , palpate*

90
Q

Where is the apex of the heart located? point of impulse sound?

A

point of max impulse where the apex of the heart is resting against the anterior chest wall. This is the best place to listen to the heart. Between the 5th and 6th rib.

91
Q

Where are heart sounds heard?

A

PATM pulmonic- 2nd and 3rd left interspace, aortic- 2-3 right interspace, tricuspid- left sternal border, mitral- apex of heart

92
Q

What is the 5th vital sign?

A

pulse rate, blood press sys/dias, respiration rate, temperature, PAIN -5th

93
Q

What is a pulse rate?

A

The rhythmic dilation of an artery that results from beating of the heart

94
Q

What is the most common cause of an abnormal pulse?

A

Atrial Fibrilation

95
Q

What can a fast pulse indicate?

A

infection, dehydration, stress, anxiety, thyroid disorder, shock, anemia, heart conditions. LOW heart rate for those who are athletic.

96
Q

Where should pulses be checked?

A

DP, PT, bilaterally on both sides. If these pulses are absent, check the popliteal or femoral pulses

97
Q

Where is the dorsalis pedis pulse?

A

between the 1st and 2nd MT

98
Q

Where is the posterior tib pulse?

A

posterior to medial malleolus

99
Q

What does capillary refill show?

A

Cap refill times greater than 2 to 3 seconds suggests peripheral vascular disease , arterial blockage, dehydration, or heart failure.

100
Q

What is an avg respiration rate?

A

12-20 breaths per minute, for infants- 30-60 bpm

101
Q

What is tachypnea?

A

shallow, rapid breathing

102
Q

Bradypnea

A

abnormally slow breathing rate

103
Q

What is a desired BP?

A

90-119 systolic measures the pressure in the arteries when the heart beats. Diastolic- measures the pressure in the arteries between heartbeats when the heart muscle is resting between beats and refilling with blood. 60-79 diastolic ** MORE concerned about lower #

104
Q

hypertension

A

blood pressure reading of 180/110 or greater

105
Q

Pectus excavatum

A

depression pushes heart to the side , depression in sternum

106
Q

What peripheral clues may suggest pulmonary or cardiac difficulties?

A

clubbing of fingers, odor of breath, cyanosis or pallor of skin, nails and lips, lips pursing, nostrils flaring. i.e Pink puffer- pink cheeks, thin, leaning forward EMPHYSEMA decrease in CO. or blue bloater- airway obstructed, chronic bronchitis, decrease ventilation, hypoxemia, increase CO bluish appearance ( common sympt)

107
Q

what three lines divide the chest?

A

mid sternal, mid clavical ,right ant axillary line

108
Q

what three lines are on the side of the chest?

A

posterior axillary line, midaxillary line, ant axillary line

109
Q

lines on back?

A

vertebral and scapular line

110
Q

The interior of the chest is divided into what three spaces?

A

mediastinum, right and left pleural cavities

111
Q

characteristics of the lungs

A

highly elastic, lungs paired but not symetric right lung: 3 lobes, left lung: 2 lobes and a lingula lobes contain bv’s, lymph, nerves, alveoli

112
Q

what are the parts of the tracheobronchial tree

A

trachea divides into right and left main bronchi. R bronchus divides into 3 branches, Left bronchus divides into two branches each branch divides into bronchioles Acini are the terminal resp units

113
Q

for infants and children the circumfrence of the chest is _____ as head circumference until 2 yrs

A

the same

114
Q

what mechanical changes occur to pregnant women?

A

lower ribs flare, diaphragm rises above usual position , diaphragm movement increases so that major work of breathing is done by the diaphragm, tidal volume increases

115
Q

what changes can be viewed in older adults?

A

barrel chest from loss of muscle strength in thorax and loss of lung resiliency, decrease in vital capacity , fatigue cannot keep up with demand, increase in residual volume.

116
Q

hemoptysis

A

blood in cough

117
Q

pectus carinatum

A

sternum protruding

118
Q

kyphoscoliosis

A

very curved vertebrae

119
Q

tet spell

A

children with teratology of fallot exhibit bluish skin during episodes of crying or feeding, decrease in O2

120
Q

splinter hemorrhages

A

bacterial endocarditis

121
Q

inspection for airway obstruction includes:

A

stridor- high pitched noise, nostril flaring, cough, chest retraction

122
Q

what is a normal respiratory rate

A

12 -20 breaths per min

123
Q

bradypnea

A

less than 12/min

124
Q

tachypnea

A

more than 20 breaths/min

125
Q

hyperventilation

A

deeper, quick breaths

126
Q

sighing

A

freq interspersed deep breathing

127
Q

cheyne stokes

A

varying periods of increased depth interspersed with apnea

128
Q

kussmaul

A

rapid, deep, labored

129
Q

ataxic

A

disorganization with irregular and varying depths of respir

130
Q

biot

A

irregularly interspersed periods of apnea in a disorganized seq of breaths

131
Q

tactile fremitus

A

vibrations felt with the hands during vocal fremitus

132
Q

least reliable test

A

percussion - compares tones bilaterally, direct and indirect

133
Q

hyper resonance indicates what condition

A

emphysema or pneumothorax

134
Q

dullness indicates what

A

diminished air exchange, pleural effusion or lobar pneumonia

135
Q

vocal resonance

A

increased resonance of voice sounds heard during ausculation of the lungs. Fluid causes sound of voice to be transmitted loudly

136
Q

bronchophony

A

abnormal transmission of sounds from the lung or bronchi

137
Q

pectoriloquy

A

when ausculating lungs, the resonance increases

138
Q

egophony

A

increase resonance of voice sounds heard, caused by fibrosis or lung consolidation

139
Q

PMI location

A

5th and mid clav.

140
Q

heart sounds- which are most distinct

A

S1 or S2

141
Q

which heart sounds are most difficult

A

S3 and S4

142
Q

S1 heart sound

A

beginning of systole, coincides with upswing of carotid pulse

143
Q

S2

A

beginning of diastole , splits during inspiration

144
Q

S3

A

occurs in diastole, difficult to hear louder with increased venous pressure

145
Q

S4

A

heard in older patients, before S1 gallop pushes blood into LV

146
Q

direct vs indirect observations

A

direct- emg/ncv, lab studies, indirect- examination, inference to known pathologies

147
Q

upper motor neurons

A

always and everywhere in the CNS pathology

148
Q

lower motor neurons

A

central or peripheral pathology

149
Q

basal ganglia(CNS)

A

abnormal movements , disorders of tone, NOT TO BE CONFUSED WITH MYOTONIA

150
Q

schwan cells

A

myelin in the peripheral system

151
Q

oligodendrites

A

myelin in the central ns.

152
Q

cerebellar

A

coordination of smooth mov’ts , decomposition of movt , dysdiadochokinesia- inability to do rapid alt movts, dysmetria, tremors

153
Q

extrapyramidal CNS

A

akinesia/bradykinesia, failure of gait initiation, postural changes, rigidity, tremors , PARKINSONISM IS CLASSIC EXAMPLE cog wheel rigidity

154
Q

Pyramidal

A

corticospinal, CNS, upper motor syndrome, extraspinal- descending signs and symptoms, intraspinal- ascending signs and symptoms, lower motor syndrome

155
Q

upper motor manifestations

A

diffuse weakness, fatigue, hyperreflexia, incoordination, clonus, ipsi/contralateral to lesion, increased tone, rigidity/spasticity, decreased superficial reflexes EXCEPT BABINSKI REFLEX, upgoing extensor-plantar reflex

156
Q

Lower motor manifestations

A

decreased reflexes, diffuse or local weakness, fasciculations, hypotonia, muscle atrophy, ipsilateral to lesion, sup reflexes decreased or absent, downgoing or mute extensor -plantar reflex

157
Q

cortex

A

unimodal, contralateral to lesions

158
Q

posterior column/medial leminiscus

A

conscious proprioception, light touch, vibratory sensation, epicritic sensations

159
Q

spinocerebellar

A

unconscious proprioception,ipsilateral to lesions

160
Q

spinothalalamic

A

ligh touch, pain/tickle, and temp (lateral) often characterized by dissociated sensory loss

161
Q

PNS sensory classifications

A

nerve root (post) dorsal root ganglion, plexes, peripheral nerves ALWAYS pan sensory and ipsilateral to LESIONS

162
Q

spacial classifications: proximal and distal

A

proximal is further from end organ and has a worse prognosis. Distal (nearer to end organ) has a better prognosis.

163
Q

What are three functional classifications?

A

diffuse- diabetes, alcohol, HIV , focal- vascular , multifocal- mult sclerosis

164
Q

axonopathy

A

at axon, neuropraxia

165
Q

myelinopathy

A

ms in periphery, compression

166
Q

neuronopathy

A

affect cell body, polio, breast cancer

167
Q

plexopathy

A

plexes/nerve crossing

168
Q

radiculopathy

A

spinal nerve involvement/spinal roots

169
Q

etiology: cryptogenic disease

A

do not know cause

170
Q

What is the difference between signs and symptoms

A

signs are NOTED BY PHYSICIAN on examination, symptoms are what the patient is aware of.

171
Q

Common motor symptoms:

A

fatigue, incoordination, invol movement.

172
Q

If you can swallow liquids and not solids, what does that mean?

A

if you cannot swallow liquids, there is nerve damage. If you cannot swallow solids, there is musculature damage.

173
Q

Without a thorough history, everything else is without context. More info per second can be obtained by doing what?

A

watching the patient stand and walk

174
Q

A structured examination has a far higher info yield than what

A

labratory studies

175
Q

Taking a good history makes or breaks a physician’s ability to do what ?

A

To take an assessment properly a good history will make or break you

176
Q

What is the grading scale for reflexes?

A

0= no visible rxn, 1- hyporeflexia, 2= normal, 3= brisk, 4- hyperactive common modifiers: clonus, hung, pendular

177
Q

what is the extensor plantar reflex?

A

Babinski sign, graded upgoing - upper motor lesion, downgoing = normal, mute- nothing happens

178
Q

inversion synonyms

A

vara, varus, varum

179
Q

eversion synonyms

A

valga, valgus, vagum

180
Q

subjective

A

what the patient relates, what others relate to you about the patient, CC, HPI

181
Q

objective

A

what YOU observe, direct measurements (bp, temp) Labs, xray, physical findings

182
Q

symptoms are ____________

A

subjective , from the patient

183
Q

signs are ____________

A

objective , can be observed and quantified

184
Q

assesment

A

evaluation, diagnosis, differential diagnosis

185
Q

plan

A

orderly progression of steps, diagnostic tests, therapeutic plans

186
Q

professionalism in charting

A

include only objective info, no slang , always write clearly

187
Q

addendum

A

as soon as the need for revision is identified. date and time must be documented, always made by the original author

188
Q

parkinson’s disease

A

extrapyramidal CNS basal ganglia Failure of gait initiation, resting tremor, cog wheel rigidity, flexion

189
Q

upper motor neuron lesions include:

A

diffuse weakness, fatigue, incoordination, ipsilat or contral to region, preserved muscle mass, increased tone, rigidity, decreased babinski reflex sign, upgoing extensor-plantar reflex**

190
Q

lower motor neuron lesions include:

A

central or peripheral, decreased reflexes, hypotonia, muscle atrophy, ipsilateral to lesion, fasciculations

191
Q

allodynia

A

experience of pain from a non painful stimulus . Pain response from stimuli that normally does not cause pain

192
Q

Romburg sign

A

arms forward , eyes closed. testing to see if patient can close eyes and extend arms without losing balance. tests the loss of motor coordination (ataxia)

193
Q

ptosis

A

drooping of eyelid CN 3 occulomotor

194
Q

hordeolum

A

infection acute with discharge int or ext stye

195
Q

chalazion

A

inflam of tear gland

196
Q

zanthoma

A

yellow on skin , high chl athersclerosis

197
Q

aniscoria

A

unequal pupil above 1mm *problem

198
Q

horner’s syndrome

A

sympathetic disease

199
Q

hearing tests

A

whisper, tuning fork, rinne’s test, weber’s test lateralize to good ear- neurosensory loss, lateralizing to bad ear- conductive hearing loss

200
Q

deontology / non consequentialism

A

Deon- duty. Some acts are right or wrong indep. of their consequences. Look to one’s obligation to determine what to do.

201
Q

consequentialism

A

actions determined by consequence of the act. Consider ALL consequences prior to action

202
Q

utilitarian ethics

A

greatest good for the largest number of people

203
Q

intuitionism

A

resolves dilemmas by appealing to one’s intuition

204
Q

rights theory

A

resolves ethical dilemmas by first determining what rights or moral claims are involved and take precedence. personal/societal

205
Q

virtue ethics

A

tells us what kind of person one ought to be, rather than what they do. Focus is one the character of the person.

206
Q

veracity

A

the duty to tell the truth

207
Q

non comparative justice

A

method of distributing needed kidneys using a lottery system

208
Q

comparative justice

A

making decision based on criteria and outcomes