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Flashcards in High yield Deck (123):
1

what are the borders of the anterior triangle of the neck?

superior mandable lateral by the medial border of the sternocleidomastoid m, medially by the midline

2

border of posterior triangle

medial border is sternocliedomastoid m, clavicle is inferior border and trap is lateral border/ the spinal accesory nereve runs through the posterior triangle

3

what is a virchows node and what does it suggest

left sided enlarged supraclavicular lymph node that suggest malignancy of thorax or abdoman

4

what does a right sided englarged supraclacicular lymph node suggest

malignancy of lungs, mediasteinum, esophogus

5

what muscle attaches to the labrum of the shoulder

biceps

6

what does O'Brians test test for?

O’Brien’s test: positions the arm for resistance testing in a way that specifically targets a SLAP (superior labrum anterior to posterior) labral tear.
Flex arm to 90°and adduct across the chest
Internally rotate with the thumb pointing down and push down on the arm

7

what does the apprehesnsion test test for?

Apprehension test: positions the shoulder in abduction and external rotation that reduces stability of the joint and can promote anterior dislocation. Patient may become apprehensive in this position.

8

Drop arm test

Drop arm: used to assess a severe tear or full rupture of the supraspinatus tendon. ROM 0-90° = supraspinatus, 90-120° (or so) = deltoid. When a full supraspinatus tear exists, the patient cannot hold the arm in a position between 0-90° .

9

speeds test

Speed’s test: resisted bicep flexion reproduces pain localized to the tendon suggesting tendonitis.

10

cervical compression test

aka Axial/Vertical Compression Test
Apply direct vertical compression without sidebending or rotation to provoke symptoms of a pinched nerve.

11

spurlings maneuver

**Sidebending to the affected side with compression down along the spinal axis. Reproduces radicular symptoms

12

distraction test

Alleviates radicular symptoms and supports a diagnosis of radiculopathy pull up on head

13

Roo's test

Arms abducted to 90°, externally rotated
Elbows flexed at 90°
Patient slowly opens and closes his hands for 3 minutes.
tests for thoracic outlet syndrome

14

Adson's test

The arm of the standing (or seated) patient is abducted 30 degrees at the shoulder and maximally extended.
• The radial pulse is palpated and the examiner grasps the patient's wrist.
• The patient then extends neck and turns the head toward the symptomatic shoulder and is asked to take a deep breath and hold it.
• The quality of the radial pulse is evaluated in comparison to the pulse taken while the arm is resting at the patient's side.
• Some clinicians have patients turn their heads away from the side tested in a modified test.

15

lift off test

: With arm internally rotated so dorsum of hand rests on low back, have patient lift the hand off their low back posteriorly against your resistance.

tests for subscap injury

16

crossover test

Adduct the arm across the chest which compresses the acromioclavicular joint and causes pain if there has been disruption of the AC joint or arthritis.

17

neers impingement sign

Stabilize scapula
Internally rotate and flex arm
Subacromial impingement
Supraspinatus pathology
hail hitler one

18

Hawkins impingment sign

The patient is examined while sitting with their shoulder flexed to 90° and their elbow flexed to 90°. The examiner grasps and supports proximal to the wrist and elbow to ensure maximal relaxation, the examiner and the patient then quickly rotate the arm internally. Pain located below the acromioclavicular joint with internal rotation is considered a positive test result for subacromial impingement or rotator cuff tendinitis

19

medial epicondylititis test what

flex wrist

20

lateral epicondylitits test what

extend wrist

21

finkelsteins test

Patient grips thumb inside fist. Examiner gently ulnar-deviates the wrist. If pain occurs along the thumb or wrist, the test is positive for tenosynovitis of the extensor pollicis brevis and abductor pollicis longus (De Quervain’s Disease).

22

tinels test or sign

tap over median nerve

23

phalens sign

median nerve impingment

24

reverse phalens sign

median nerve impingemnt

25

Describe visceral pain

source is usually hollow organ caused by distension or stretching. Comes and goes, crescendo/decrescendo pattern. Not well localized

26

describe parietal pain

Caused by inflammation of the peritoneum. Steady aching pain that is usually well localized.

27

what refers pain to the right shoulder?

glabladder/liver

28

what refers pain to the back?

aorta/pancreas

29

What refers pain to the left shoulder?

spleen

30

What refers pain to the flank and groin?

kidney

31

what is adequate exposure of the abdomen

xiphoid to the pubis

32

what is rovsings sign?

deep palpation of llq cause pain in rlq

33

What is lloyds sign?

tenderness as CVA striking of back

34

Condyloma acuminata caused by ?

HPV

35

Condylomata lata caused by?

syphilis

36

five f's of acute cholyctstitis

The 5 “f’s” – female, fat, fertile, fair, flatulent.

37

what is murpheys sign?

RUQ pain and sudden arrest of inspiration during palpation of the liver and gallbladder.

38

what is the diagnostic triad for acute cholectystits?

RUQ pain, fever and leukocytosis.

39

presentation of chlaymdyia?

elevated WBC non gonococcal urethritis

40

presentation of Gonhearra

WBC with Gm(-) intracellular diplococci

41

hypospadias def

congenital displacement of the urethral meatus on the inferior surface of the penis along the urethral groove.
Important in a new born exam. Maybe associated with congenital renal abnormalities.

42

epispadias def

congenital displacement of the urethral meatus on the superior surface of the penis

43

causative organism and path of primary syphilis

Treponema pallidum – causative organism
Syphilitic Chancre – painless round or oval erosion or ulcer. Non-tender enlarged inguinal lymph nodes are common.
RPR and VDRL are positive, screening test, many false positives.
FTA- ABS is positive or Dark Field Microscopy, confirmatory test.

44

gentital herpes pathology?

cluster of small vesicles. Burning and painful. Progress to ulcers on a erthymic base. Dx – viral culture of the fluid in the vesicle.
Herpes simplex virus 1 and 2 – causative organism

45

what causes venereal warts?

HPV

46

gonococcal urethritis gram stain

Gram-negative intracellular diplococci of GC
WBC = neutrophils
abrupt incubation period

47

non-gonococcal urethritis gram stain

polymorphonuclear leukocytes NGU=chlamydia

48

define menorrhagia

excessive bleeding

49

define Metrorrhagia –

Metrorrhagia – bleeding between periods

50

where does LNMP info go?

very fist sentence of HPI

51

how should you insert a speculum?

horizontally and inferiorly gently downward posterior force

52

what is the purpose of a pap smere?

To find “pre-cancerous” (i.e., DYSPLASIA) lesions of the cervix

53

what is version?

Version is the relationship between the fundus of the uterus and the vagina

54

what is flexion for cervix?

Flexion is the relationship between the fundus of the uterus and the cervix – think of uterus as having a HINGE at internal os of cervix

55

what supplies the breast with blood

(1) perforating branches of the internal mammary artery
(2) lateral branches of the posterior intercostal arteries
(3) branches from the axillary artery, including the highest thoracic, lateral thoracic, and pectoral branches of the thoracoacromial artery.

56

where does the axilary tail of the breast drain lymph?

subscapular group of axillary nodes.

57

where does the upper portion of the breast drain lymph?

into infra clavicular group.

58

Most of the lymph from subareolar and submammary plexus is drained to the?


anterior or pectoral group of axillary nodes

59

Medial part of the breast is drained by

sub mammary plexus of the opposite
breast and also to the lymph glands along the internal thoracic artery and then to the mediastinal nodes

60

The inferior part of the breast is drained by?

lymphatics of abdominal wall and to the extra peritoneal lymphatic plexus.

61

when is the optimal time to examine the breast?

5-7 days from “day 1” of the LNMP (estrogen is lower, thus less swelling/tenderness w/exam)

62

stages of change for motivational interviewing?

Precontemplation
Contemplation
Preparation
Action
Maintenance
Relapse

63

torticollis pathology

spasm of sternocleidomastoid causing ipsilateral sidebending and contralateral roatation

64

in thoracic outlet syndrome adsons tests what?

tests the radial pulse for compression of the subclaciamn artery betweeen the MIDDLE AND ANTERIOR SCALENE and 1st rib...extension with abduction test for pec minor impingment

65

trap primary action

Superior portion- elevates scapula
Middle portion- retracts scapula
Lower portion- depresses scapula


66

Pectoralis major action

Depresses, adducts, internally rotates humerus

67

Coracobrachialis action

Flexes and adducts humerus

68

Deltoid action

Anterior portion- flexes humerus
Middle portion- abducts humerus after 90°
Posterior portion- extends humerus

69

Teres Major action

Internally rotates humerus

70

Rhomboids action

Retracts scapula

71

Latissimus Dorsi action

Internally rotates and extends humerus

72

Serratus Anterior action

Protracts and stabilizes scapula/ assocaited with winged scapula due to damage of long thoracic nerve

73

Supraspinatus action


Abducts up to 90°

74

Infraspinatus action


Externally rotates humerus

75

Teres Minor action


Externally rotates humerus

76

Subscapularis action


Internally rotates humerus

77

the crossover test checks?

AC joint pathology or arthritis of AC joint

78

what ligament holds the radial head in place?

annular ligament

79

what fracture is associated with snuffbox tenderness?

scaphoid bone... problematic because of limited blood supply

80

pathology of mallet finger?

Mallet finger reflects an avulsion of the extensor tendon at the DIP joint.

81

Boutonniére Deformity pathology

Boutonniére Deformity reflects an avulsion of the extensor tendon at the PIP joint.

82

what does homans sign test for?

Evaluates for DVT (deep venous thrombosis)
Dorsiflex patient’s ankle with leg extended at knee. Pain in calf is a positive sign.

83

FABER testing?

Patrick's test or FABER test (for Flexion, ABduction, and External Rotation) is performed to evaluate pathology of the hip joint or the sacroiliac joint. The test is performed by having the tested leg flexed and the thigh abducted and externally rotated.

84

what is the thessely test for?

standing and twisting tests for meniscal tears more specific than mcmurry test

85

what does mcmurrays test for?

meniscal tear the knee is held by one hand, which is placed along the joint line, and flexed to complete flexion while the foot is held by the sole of the foot with the other hand. The examiner then places one hand on the medial side of the knee to pull the knee towards varus position,pulling the knee laterally (bow legged). The other hand rotates the leg internally while extending the knee.

86

thompson test?

test for the rupture of the Achilles tendon. The patient lies face down with feet hanging off the edge of the bed squeeze calf.

87

Kleiger test

Maneuver used to determine stability of the deltoid ligament. The examiner stabilizes the leg just above the ankle with one hand and everts the foot with the other. Pain or instability suggests injury to the deltoid ligament.

88

motor, reflex and sensation for L4

motor: anterior tibialis
reflex:patellar tendon
sensation:medial aspect of foot

89

motor, reflex and sensation for L5

motor: extensor hallucis longus
reflex: none
sensation: medial aspect of dorsal and plantar foot surfaces not including heel

90

motor, reflex and sensation S1

motor: gastroc/soleus (repetitive toe raises)
reflex: achiles tendon
sensation: lateral aspect of foot

91

straight leg raises tests for?

sciatica

92

what describes true hip pain?

pain in groin

93

what is the thomas test?

patien supine grab knee and bring it to chest
If the iliopsoas muscle is shortened, or a contracture is present, the lower extremity on the involved side will be unable to fully extend at the hip.

94

what is ballottment test?

indicates increased fluid in the suprapatellar pouch over the patella at the knee joint. To test ballottement the examiner would apply downward pressure towards the foot with one hand, while pushing the patella backwards against the femur with one finger of the opposite hand. A "milking" motion is used with the downward pressure. If a bogginess around the joint occurs, then the test is positive for ballottement.

95

where is the pes anserine bursa located?

medial and just below the tibial plateau

96

what does lachmans test for?

ACL injury pull anterior and externally rotate

97

What are the most common ligaments injured in an ankle sprain?

Anterior talofibular and calcaneofibular

98

components of a plumb line

ear shoulder greater trochanter, fibular head, lateral malleolus

99

stance phase and swing phase percent of gait cycle

60 stance 40 swing

100

T3 spinous process is at what level?

spine of scapula

101

t7 spinous process is at what level?

inferior angle of the scapula

102

L4 spinous process at what level?

level of iliac crest

103

Small intestine vicerosomatic reflex?

T10-T11

104

colon and rectum vicerosomatic reflex?

T12-L2

105

Bladder vicerosomatic reflex?

T12-L2

106

Ovaries/testes viscerosomatic reflex?

T10-T11

107

Uterus/prostate vicerosomatic reflex

T12-L2

108

what is the most common site of injury to the lumbar spine

L5/S1

109

what is reiter syndrome?

triad of arthritis, conjunctivitis, and urethritis

110

osteoarthritis pathology

degenerative disc disease common in L5-S1
Deterioration and loss of cartilage and normal bone
Low grade inflammatory issue

111

osteoporosis pathology

thinning of bones

112

sciatic nerve cord levels

l4-s3

113

what type of joint is the hip?

Hip is Spheroidal
Synovial
Joint

114

what test is most specific to the hip joint?

FABER test figure four may elicit SI tenderness

115

the pes anserinas is the attachment point for what muscles?

sartorius, gracilis, semitendinosus

116

what is a bakers cist

Cyst in the popliteal fossa, most often medial
Leg extended check posterior/medial aspect of knee for swelling or fullness, sometimes tenderness as well

117

Prepatellar Bursitis: Anterior pathology

associated with excessive kneeling pain is equal active and passive ROM for bursitis

118

what does apelys compression test check for?

Patient prone with knee flexed to 90˚
Stabilize thigh with one hand while leaning onto heel compressing medial and lateral menisci. Rotate heel during compression noting any pain

119

what does a valgus stress on the knee check for?

medial meniscus tear Push medially against knee while laterally against ankle

120

what does a varus stress in the knee check for?

lateral meniscus tear Push laterally against knee while medially against ankle

121

what does the talar tilt test for?

Pt is sitting with legs dangling off table
Doc inverts the calcaneus
If the talus gaps or rocks in the ankle mortise, the ATF & calcaneofibular ligs are torn and the test is positive

122

what is a high ankle sprain?

Syndesmosis between Fibula and Tibia

123

when should you perform a foot x-ray

Pain around the malleolus and tenderness in posterior malleolar area or tip of fibula
OR
Pain around the malleolus and unable to weight bear immediately and more than 4 steps in ED
OR
Pain in mid-foot and either
1. Tenderness at base of 5th metatarsal or navicular, OR
2. Inability to weight bear immediately OR more than 4 steps in ED