H&P PE Flashcards
(105 cards)
1
Q
POS Rhinne AC > BC
A
normal or sensorineural hearing loss with impaired air and bone conduction
2
Q
NEG Rhnne BC > AC
A
conductive hearing loss
3
Q
Weber heard to one side
A
lateralization
4
Q
Weber heard to affect side
A
conductive hearing loss
5
Q
Weber heard to unaffected side
A
sensorineural loss
6
Q
Inspection of Neck
A
- symmetry 2. lesions 3. masses 4. tracheal position 5. JVD
7
Q
What do you do first in neck exam
A
auscultation prior to palpation of carotids and thyroid for bruits
8
Q
Palpation of cervical lymph nodes
A
- anterior auricular 2. posterior auricular 3. submental 4. submandibular 5. posterior cervical chain 6. anterior cervical chain 7. supraclavicular 8. infraclavicular
9
Q
Pt. supine, flex neck fwd - + = hips flex
A
brudzinski
10
Q
Flex at hip and knee extend knee - pain
A
kernig
11
Q
Order of Respiratory Exam
A
- inspection 2. palpation 3. percussion 4. auscultation
12
Q
Sound transmitted louder at area of consolidation
A
bronchophony
13
Q
e –> a at area of consolidation
A
egophony
14
Q
whispered words louder at area of consolidation
A
whispered pectoriloquy
15
Q
Pneumonia finding
A
inc. tactile fremitus; dec. resonance on percussion
16
Q
Pneumothorax finding
A
dec. tactile remitus; inc. resonace on percussion
17
Q
Pleural effusion finding
A
dec. tactile remitus & resonace on percussion
18
Q
S1
A
closure of AV valves, marks onset of systole
19
Q
S2
A
closure of semilunar valves (aortic, pulmonic)
20
Q
Ejection click–early systole
A
diseased aortic valve (right after S1)
21
Q
Opening snap–early diastole
A
mitral disease (mitral valve opening)
22
Q
S3
A
rapid deceleration of blood; decreased compliance in adults (immediately after S2)
23
Q
S4
A
atrial kick against decreased compliance (immediately befor S1)
24
Q
crescendo/decresendo murmur
A
aortic stenosis
25
plateau murmur
mitral regurg, tricuspid regurg, VSD
26
decrescendo murmur
aortic regurg
27
radiation of murmur to neck (carotids)
aortic stenosis
28
radiation of murmur to axilla
mitral regurg
29
Grade 1 murmur
very faint, possibly not heard in all positions
30
Grade 2 murmur
quiet, but heard immediately after placing the stethoscope on the chest
31
Grade 3 murmur
moderately loud
32
Grade 4 murmur
loud, with palpable thrill
33
Grade 5 murmur
very loud, with thrill may be heard when stethoscope is partly off chest
34
Grade 6 murmur
very loud, with thrill; may be heard with stethoscope entirely off chest
35
Lateral decubitus increases ability to hear
mitral stenosis, S3, S4
36
Sitting, leaning fwd, breathe out and hold exaggerates
Aortic murmur
37
Standing, squatting, valsalva exaggerates
mitral valve prolapse, aortic stenosis
38
Aortic heard
2nd R ICS along sternal border
39
Pulmonic heard
2nd L ICS along sternal border
40
Tricuspid heard
4th/5th ICS along sternal border
41
Mitral heard
4th/5th ICS MCL
42
Allen Test
tests compentency of radial and ulnar arteries - done prior to ABG; ulnar first
43
Allen Test normal
pinks in 3 - 5 seconds
44
Order of Abdominal Exam
inspection, AUSCULTATION, palpation (light to deep), percussion
45
Rovsing sign
pain in RLQ with LLQ pressure = appendicitis
46
Psoas sign
E hip making psoas muscle contract = appendicitis
47
Obturator sign
F hip/knee, IR = appendicitis
48
Murphy's sign
push up under RCM, have patient take deep breath in, + = suddently halting breath
49
Lloyds punch
CVA tenderness - nephrolithiasis, hydrophrosis, pyelonephritis
50
CN II - Optic Testing
Visual acuity (chart), Peripheral fields, Sensory portion of direct/consensual pupillary reflex
51
CN III - Occulomotr Testing
Motor portion of direct/consenual pupillary reflex; EOM for MR, IO, SR, IR; Ptosis
52
CN IV - Trochlear Testing
EOM - SO ( eyes down and inward)
53
CN V MOTOR- Testing
Clench teeth, palpating muscles of mastication
54
CN V SENSORY - Testing
Test sensation in each branch with eyes closed
55
CN VI - Abducens Testing
EOM LR (moves eyes lateral)
56
CN VII MOTOR - Facial Testing
facial symmetry: raise eyebrows, smile, frown, puff cheecks, show teeth, close eyes against resistance
57
CN VIII - Vestibulocochlear Testing
Whispered word/finger rub; Nystagmus (vestibular function)
58
CN IX - Glossopharyngeal Testing
say 'AH' - symmetrical rise of uvula (deviate away from lesion); sensory of gag reflex
59
CN X - Vagus Testing
Assess for dysphonia; (GAG - MOTOR)
60
CN XI - Spinal Accessory Testing
Head turn against resistance (SCM); shrug shoulders (trapezius)
61
CN XII - Hypoglossal Testing
Observe tongue for fasciculations; stick tongue out (deviates TOWARD lesion)
62
Strength scale
0 - 5
63
5/5 strength
Complete ROM against gravity with full resistance
64
4/5 strength
Complete ROM against gravity with some resistance
65
3/5 strength
Complete ROM against gravity
66
2/5 stength
Complete ROM with gravity eliminated (rare)
67
1/5 strength
Evidence of slight contractility with no joint movement
68
0/5 strength
No evidence of contractility (visual or tactile)
69
Shoulder abduction innervation
Axillary (C5-6)
70
Elbow flexion innervation
Musculocutaneous (C5-6)
71
Elbow extension innervation
Radial (C6-8)
72
Wrist flexion innervation
Median (C6-7)
73
Wrist extension innervation
Radial (C6-8)
74
Grip (finger adduction) innervation
Median (C6-8)
75
Finger abduction innervation
Ulnar (C8-T1)
76
Thumb abduction innervation
Median (C8-T1)
77
Hip adduction innervation
Obturator (L2-4)
78
Hip abduction innervation
Superior gluteal (L4-S1)
79
Knee extension innervation
Femoral (L2-4)
80
Knee flexion innervation
Sciatic (L4-S1)
81
Dorsiflexion innervation
Deep peroneal (L4-5)
82
Plantarflexion innervation
Tibial (L5-S2)
83
Proprioception
toe up or down
84
Patient points to area touched
Point localization
85
Asking patient if being touched on R/L/both sides
Extinction
86
Use paper clip
2 point distinction
87
Recognition of familiar object in palm with eyes closed
Stereognosis
88
Recognition of # drawn on palm with eyes closed
Graphesthesia
89
Scale of reflexes
0 - 4
90
0 reflex
Absent (even with reinforcement)
91
1+ reflex
Hypoactive
92
2+ reflex
Normal
93
3+ reflex
Hyperactive without clonus
94
4+ reflex
Hyperactive with clonus
95
Clonus
rapid alternating contractions and relaxations of muscle after forced stretch
96
Biceps tendon reflex
C5
97
Brachioradialis tendon reflex
C6
98
Triceps tendon reflex
C7
99
Patellar tendon reflex
L4
100
Achilles tendon reflex
S1
101
Tests for cerebellar function
RAM, F-N, pronator drift, heel-shin, gait, tandem walk (heel-toe), romberg
102
Romberg
test of position sense. Stand with feet together, eyes closed for 30 - 60 sec without support
103
Positive Romberg
Cerebellar ataxia - patient has difficulty standing with feet together whether eyes are open or closed
104
Pronator Drift
Stand 20 - 30 sec with both arms straight forward, palms up, eyes closed. Tap arms briskly downward (return to normal) - response requries muscular strength, coordination, good sense of position
105
Positive pronator drift
pronation of one forearm - corticospinal tract lesion in C/L hemisphere
