IM - Evals 7 Flashcards
(119 cards)
1
Q
Cause of sciatica
A
Impingement of the L4, L5, or S1 nerve secondary to a herniated disk
2
Q
Presentation of sciatica
A
Unilateral neuropathic pain extending from the gluteal region down the posterolateral leg of the foot
3
Q
Most common cause of shoulder pain
A
Rotator cuff tendinitis
4
Q
Presentation of rotator cuff tendinitis
A
Pain upon active abduction but not passive abduction and evidence of impingement signs such as pain with overhead activities as stated in the case of pain after lifting heavy weigh
5
Q
Structures involved in articular conditions
A
Synovium, synovial fluid, articular cartilage, intraarticular ligaments, joint capsule, juxtaarticular bone
6
Q
Presentation of articular inflammation
A
Deep or diffuse pain Pain or limited range of motion on active and passive movement Swelling, crepitation, instability, locking, deformity
7
Q
Structures involved in NON-articular conditions
A
Extraarticular ligaments, tendons, bursae, muscle, fascia, bone, nerve, and overlying skin
8
Q
Presentation of NON-articular inflammation
A
Painful on active but not passive range of motion
9
Q
TRUE leg length is measured from
A
Anterior superior iliac spine and medial malleolus
10
Q
APPARENT leg length is measured from
A
Umbilicus up to the medial malleolus
11
Q
Arthritis conditions more common among MEN
A
Gout, spondyloarthritis, and ankylosing spondylitis
12
Q
Arthritis conditions more common among WOMEN
A
RA (rheumatoidarthritis) fibromyalgia and lupus (systemic lupus erythematosous/SLE)
13
Q
Common locations affected by Osteoarthritis
A
DIP, MCP, and 1st CMC
14
Q
Test for Cruciate ligament tear
A
Drawer sign
15
Q
Test for Carpal Tunnel Syndrome
A
Tinel’s sign or Phalen’s sign
16
Q
Test for Rotator cuff tendinitis
A
Drop arm test
17
Q
Test for De Quervain’s tenosynovitis
A
Finkelstein’s test
18
Q
Test for Meniscal tear
A
McMurray test
19
Q
Hard, bony outgrowths or gelatinous cysts on the proximal interphalangeal joints.
A
Bouchard’s nodes
20
Q
Hard or bony swellings that can develop in the distal interphalangeal joints (DIP)
A
Heberden’s nodes
21
Q
Associated symptoms of inflammation with morning stiffness of inflammatory arthritis
A
> 1 hour
Precipitated after a long period of rest
Improves with intake of anti inflammatory medications and movement/activity
22
Q
Associated symptoms of inflammation with morning stiffness of NON-inflammatory arthritis
A
<1 hour
Precipitated by a short brief period of rest
The pain is more lightly aggravated when the patient starts moving after
23
Q
A condition that causes pain, stiffness, and a sensation of locking or catching when you bend and straighten your finger
A
Trigger finger
24
Q
Another name for trigger finger
A
Stenosing tenosynovitis
25
Involves disruption of normal flexor tendon function in the had as a result from infection
Acute flexor tenosynovitis
26
A deformity of the finger caused when the tendon that straightens your finger (the extensor tendon) is damaged
Mallet finger
27
Specific rash of rheumatic fever
Erythema marginatum
28
Area of the brain responsible for coma
Cerebral hemisphere
29
A supratentorial mass lesion affecting the diencephalon/brainstem would have the following characteristics
Initial focal cerebral dysfunction
Dysfunction progressing rostral to caudal
Signs reflecting dysfunction at one level
Signs often asymmetrical
30
Pupils in cases of metabolic encephalopathy and bithalamic lesions
Small but reactive
31
Pupils when there are lesions compressing CN III
Large or fixed unreactive pupil and some degree of ptosis (neurologic emergency = uncal herniation)
32
Pupils in cases of midbrain lesions
Fixed in midposition
33
Pupils in cases of pons lesions
Pinpoint but reactive
34
Rhythmic waxing and waning of respiratory amplitude
Cheyne-Stokes respiration
35
Localization of Cheyne-Stokes respiration
Bilateral hemispheric dysfunction
36
Apnea for >10 seconds after 5 deep breaths
Posthyperventilation apnea
37
Localization of Posthyperventilation apnea
Bilateral hemispheric dysfunction
38
Continuous deep breathing
Central reflex hyperpnea
39
Localization of Central reflex hyperpnea
Bilateral hemispheric (e.g. trauma), lower midbrain, upper pons
40
Prolonged aspiratory time (“inspiratory cramp”)
Apneustic respiration
41
Localization of Apneustic respiration
Pons
42
Infrequent irregular breaths
Ataxic respiration
43
Localization of Ataxic respiration
Lower pons or upper medulla
44
Failure of involuntary respiration with retained voluntary respiration
Ondine’s curse
45
Localization of Ondine’s curse
Medulla
46
No respiration
Apnea
47
Localization of Apnea
Medulla down to C4: peripheral nerves, neuromuscular junction
48
Cold water injection
Mimics a head turn to the contralateral side; both eyes will turn toward the ipsilateral ear, with horizontal nystagmus to contralateral ear
49
Hot water injection
Mimics a head turn to the ipsilateral side; both eyes will turn toward the contralateral ear, with horizontal nystagmus to the ipsilateral ear
50
Difference in pupil size
Anisocoria
51
Cause of Anisocoria
Caused by Horner syndrome or CN III palsy
52
eyes drift upward, and “beat” or jump downward
Down-beating nystagmus
53
Cause of Down-beating nystagmus
Cerebellar degeneration syndromes, or lesions affecting the pons and cerebellum
54
Characteristics of Supratentorial mass lesion affecting diencephalon/brainstem
Initial focal cerebral dysfunction
Dysfunction progresses rostral to caudal
Signs reflect dysfunction at one level
Signs often asymmetrical
55
Characteristics of Subtentorial structural lesion
Symptoms of brainstem dysfunction or sudden-onset coma
Brainstem signs precede/accompany coma
Cranial nerve and oculovestibular dysfunction
Early onset of abnormal respiratory patterns c
56
Characteristics of Metabolic-toxic coma
Motor signs usually symmetrical
Pupil responses generally preserved
Myoclonus, asterixis, tremulousness, and generalized seizures common
Acid-base imbalance common, with compensatory ventilator changes
57
Characteristics of Psychogenic coma
Eyelids squeezed shut
Pupils reactive or dilated, unreactive (cycloplegics)
Oculocephalic reflex unpredictable, nystagmus on caloric tests
Motor tone normal or inconsistent
No pathologic reflexes
(Awake-pattern EEG)
58
Absent response to Doll's eye maneuver
Damage in the brainstem region
59
Presentation of decorticate posturing
Stiff with bent arms, clenched fists, and legs held out straight. The arms are bent in toward the body and the wrists and fingers are bent and held on the chest.
60
Presentation of decerebrate posturing
The arms and legs being held straight out, the toes being pointed downward, and the head and neck being arched backward
61
Cause of cluster breathing
Damage to the pons of medulla
62
Causes of comatose
Lesions in the dorsolateral pons and periaqueductal gray area that surrounds third ventricle causes comatose state.
Lesions involving both cerebral hemispheres.
Lesions affecting thalamus (destructive or compressive) such as thrombosis of deep internal veins can cause coma.
63
Two cholinergic nuclei responsible for initial arousing or alerting input
Laterodorsal tegmentum and pedunculopontine tracts
64
A condition in which a patient is aware but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except for vertical eye movements and blinking
Locked-in syndrome
65
Kernig's sign refers to
Resistance to passive leg flexion associated with pain
66
Complete sensory loss of all sensory modalities below the level of the lesion, complete paralysis below the level of the lesion, and bowel/bladder incontinence
Spinal cord
67
Ipsilateral sensory loss in face, contralateral sensory loss of arm and leg, cranial neuropathies and ataxia.
Brainstem
68
Glove and stocking pattern type of sensory loss
Peripheral nerve
69
Complete loss of all sensory modalities in the affected dermatome
Dorsal root ganglia
70
Contralateral sensory loss affecting the face, arm and leg; with hemineglect, astereognosis and visuospatial deficits
Cerebral cortex
71
A bundle of nerve fibers which cross the midline of the spinal cord just anterior (in front of) to the gray commissure
Anterior white commissure
72
aka Posterolateral tract contains centrally projecting axons from dorsal root ganglion cells carrying crude touch and pressure information (location, intensity and quality)
Lissauer’s tract
73
Spinal cord syndrome with ipsilateral loss of proprioception/vibration sense and motor, and contralateral loss of pain and temperature sense is called
Brown Sequard syndrome
74
Infarcts affecting this arterial territory will cause a characteristic pattern of weakness-preferentially affecting the leg more than the face and the arms
Anterior cerebral artery
75
A kind of visuospatial dysfunction wherein the patient fails to register a tactile stimulus (light touch) on one side of their body when both sides are stimulated simultaneously (i.e. double simultaneous stimulation) is called
Sensory extinction
76
Patient is unable to recognize objects placed in the affected hand yet had preserved cutaneous sensation
Astereognosia
77
Patient denies the presence of a neurological impairment on one side, most often weakness is the patient aware and reacting appropriately to the deficit
Anosognosia
78
Patient denies ownership of the limbs on one side of their body, or even attributes the limb to another person
Non-belonging
79
Inability to discriminate right and left, seen in Gerstmann Syndrome
Right-left disorientation
80
A neuropsychiatric disorder that is characterized by a constellation of symptoms that suggests the presence of a lesion in the dominant hemisphere (usually left) including angular and supramarginal gyri (Brodmann area 39,40) near the temporal and parietal lobe junction
Gerstmann syndrome
81
Symptoms included in Gerstmann syndrome
1. Dysgraphia/agraphia-deficiency in the ability to write
2. Dyscalculia/acalculia-difficulty in learning or comprehending mathematics
3. Finger agnosia-inability to distinguish the fingers on the hand
4. Left-right disorientation-deficiency to identify which is right or left
82
Contralateral hemiparesis with ipsilateral peripheral facial palsy
Subcortical area, brainstem
83
Contralateral hemiparesis with aphasia
Cerebral cortex
84
Contralateral hemiparesis with homonymous hemianopia
Subcortical area, internal capsule
85
Proximal and bulbar weakness, which fluctuates with activity and time of day
Neuromuscular junction
86
Sensory and automatic deficits with weakness involving muscle corresponding to a specific nerve
Peripheral nerves
87
Upper extremity involvement
RA and OA
88
Lower extremity involvement
RA and Gout
89
Axial skeleton involvement
OA, Ankylosing spondylitis, infrequent in RA except cervical spine
90
Incomplete or partial dislocation of a joint or organ
Subluxation
91
Permanent shortening of a muscle or joint usually in response to prolonged hypertonic spasticity in a concentrated muscle area
Contracture
92
Also called luxation, occurs when there is an abnormal separation in the joint, where two or more bones meet
Dislocation
93
Abnormal popping or crackling sound in either a joint or the lungs, which may be faint or loud enough for people to hear. It is often accompanied by a popping or crunching sensation that may sometimes be uncomfortable or painful
Crepitus
94
PIP, MCP, intercarpal, and wrist joints involvement
Rheumatoid arthritis
95
May mimic pattern of joint involvement seen
| in OA, but can be distinguished by the presence of inflammatory signs
Psoariatic arthritis
96
Test designed to reproduce symptoms of rotator cuff impingement through flexing the shoulder and pressure application
Impingement test
97
Used to test for biceps tendon pathology
Yegarson's test
98
Determine a patient's ability to sustain humeral joint motion through eccentric contraction as the arm is taken through the full motion of abduction to adduction
Drop arm test
99
Way to detect irritated nerves performed by lightly tapping (percussing) over the nerve to elicit a sensation of tingling
Tinel's test
100
Bow-legged; "sakang"
Genu varum
101
Knock-knee; "piki"
Genu valgum
102
Hyperextended knees
Genu recurvatum
103
A non-specific
| diagnosis referring to anterior knee pain
Patellofemoral syndrome
104
Indications of ultrasound
Synovial cysts
Rotator cuff tendinitis
Tendon injury
105
Indications of Radionuclide scintigraphy, Technetium-99m
Metastatic bone survey
Evaluation of Paget's disease
Acute and chronic osteomyelitis
106
Indications of Radionuclide scintigraphy, 111 In-WBC
Acute infection
Prosthetic infection
Acute osteomyelitis
107
Indications of Radionuclide scintigraphy, 67 Ga
Acute and chronic infection
| Acute osteomyelitis
108
Indications of CT scan
```
Herniated IV disk
Sacroilitis
Spinal stenosis
Spinal trauma
Osteoid osteoma
Stress fracture
```
109
Indication of MRI
Avascular necrosis
Osteomyelitis
Intraarticular derangement of soft-tissue injury
Derangemnts of axial skeleton and spinal cord
Herniated IV disk
Pigmented villonodular synovitis
Inflammatory and metabolic muscle pathology
110
True hip joint pain is described as
Located anteriorly over the inguinal ligament and may radiate medially to the groin
111
Lesion at the posterior area of the inferior frontal gyrus (Area 44)
Broca’s aphasia
112
Lesion at the posterior area of the superior temporal gyrus (Area 22)
Wernicke’s aphasia
113
Lesion at the lateral hemisphere (supplied by middle cerebral artery)
Global aphasia
114
Triad of hydrocephalus
1. Behavioral changes
2. Bowel or bladder incontinence
3. Weakness of both lower extremities with signs of hyperreflexia and clonus
115
Presentation of Erb Duchenne palsy
Pronation of the forearm
Extension of the elbow
Shoulder is adducted and internally rotated
116
Parietal lobe lesions can manifest as
Hemineglect
Right-left disorientation
Asterereognosis
117
A defect in the actual handling of common objects or a loss of conceptual knowledge relating to the use of the tools; ask what hammer is for; dominant temporo-parietal area
Ideational apraxia
118
Inability to perform motor act on command that can be performed spontaneously; stick out tongue, walk, salute; left parietal area
Ideomotor apraxia
119
Inability to put together component parts to form a single shape or figure; ask to copy geometric pattern; right parietal hemisphere
Visuoconstructive/Constructional apraxia
