Labs Flashcards
1
Q
What is the order of examination for the abdomen?
A
- inspection
- Ascultation
- Percussion
- Palpation
2
Q
White or silvery lines on the abdomen are what? Are they concerning?
A
Rapid growth, not concerning
3
Q
True or false: bulging at the umbilicus in an infant is a sign of umbilical hernia due to abdominal muscles failing to close, and is always concerning
A
False-usually will resolve on its own. otherwise true
4
Q
What is borborygmi?
A
growling stomach sounds
5
Q
What is a normal liver size?
A
6-12 cm
6
Q
Guarding and rigidity. Which is voluntary and which is not?
A
Guarding = voluntary
Rigidity is not
7
Q
Which side do you have to stand on when assessing the abdomen?
A
Right side for some reason
8
Q
True or false: a normal sized spleen is not palpable
A
True
9
Q
What is the obturator test?
A
Flex at the hip. Rotate pt. If there is pain, may be appendicitis
10
Q
What is the Iliopsoais test?
A
Pt flexes hip against resistance. If there is pain, may be appendicitis
11
Q
What is the heel jar test?
A
Having the pt stand on their heels, then dropping to floor. If there is pain, may be appendicitis
12
Q
What is Rovsing’s sign?
A
RLQ pain is increased when palpating the LLQ. May be appendicitis
13
Q
What is Kehr’s sign?
A
Abdominal pain radiation to the left shoulder. May be sleen issue
14
Q
What is shifting dullness?
A
Assessing tympany and dullness supine, then again on a side. If areas of sounds change, could be ascites
15
Q
What is Aaron’s sign?
A
Pain or distress in the area of the pts heart or stomach on palpation of Mcburney’s point. May be appendicitis
16
Q
What is Ballance?
A
Fixed dullness to percussion in the left flank and dullness in the right flank that disappears on change of position
Indicates peritoneal irritation
17
Q
What is Blumberg’s sign?
A
Rebound TTP. May be Peritoneal irritation or appy
18
Q
What is the dance sign?
A
Absence of bowel sounds in the RLQ
May be Intussusception
19
Q
What is Romberg-Howship’s sign?
A
Pain down the medial aspect of the thigh to the knees
May be strangulated obturator hernia
20
Q
What is the Vaginal Introitus?
A
the vaginal opening
21
Q
What are the Skene glands?
A
(paraurethral/lesser vestibular) glands - Situated just below the inferior opening of the
urethral meatus.
22
Q
What is the ectocervix?
A
the vaginal surface of the cervix that is visible when using a
speculum
23
Q
Lymph from the vulva and lower vagina drains where?
A
Into the inguinal nodes
24
Q
Lymph from the internal genitalia and upper vagina drain where?
A
The pelvic and abdominal nodes
25
True or false: Asymmetric labia majora are normal
True
26
How do you differentiate between a caruncle (benign) and a carcinoma (malignant) of the urethra?
palpate the urethra through the
vagina feeling for thickening, nodularity, or tenderness. The inguinal
nodes should be palpated for masses as well.
27
What are the two ways of assessing muscle control of the perineum in women? What is an abnormal result?
a. Have the patient squeeze the vaginal opening around your finger.
b. Kegel contraction, or
contract her pelvic floor muscles as if she were trying to stop the flow of urine
during micturition.
Abnormal if she cannot contract for longer than 3 seconds
28
If the muscles of the perineum of a women are weak, what can this lead to? (2)
Pelvic/LBP
| Urinary incontinence
29
How do you inspect the Skene gland?
Insert your index finger into the vagina up to the second joint
Exert an upward pressure and move the finger forward
30
How do you inspect the Bartholin gland?
Insert your index finger into the vagina near the posterior end of the introitus
Palpate the tissue between your finger and thumb
31
How do you ascess for a Cystolcele or a rectocele? (2)
Ask pt to bear down
Cystocele- a bulge is appreciated in the upper, anterior vaginal wall
Rectocele- a bulge is appreciated in the lower, posterior vaginal wall
32
What are the steps of a pelvic exam? (5)
1. Lube
2. Apply downward pressure with hand
3. Insert speculum above finger
4. Remove finger
5. Do pelvic stuffs, then remove
33
What should be done with the speculum to keep the introitus relaxed?
assert a gentle downward pressure with the speculum
34
Along which wall should the speculum be inserted? Why?
Posterior to avoid pressure on the urethra
35
What is the size of a normal cervical os?
1-3 cm
36
White and curdy discharge = ?
Candidal vaginitis
37
Yellowish green or gray discharge = ?
Trichomonas
38
Gray or white thin discharge that is smell = ?
BV
39
When in the menstrual cycle should a women have a pap smear performed?
Anytime when she is not actually menstruating
40
What is a pap smear?
Using a brush during a pelvic exam to gather endothelial cells to diagnose cervical CA
41
What is the purpose of a bimanual exam? (2)
To check the position of the uterus and ovaries and for masses
42
What are the steps to performing a bimanual exam?
1. Lube
2. Insert 2nd and 3rd fingers using downforce
3. Allow for relaxation
4. Palpate
43
Cervical motion tenderness = ?
PID
44
How do you palpate a uterus? What five things should you assess for?
bimanual exam, use pressure on abdomen onto hand
1. Position
2. Size
3. Mobility
4. Tenderness
5. Contour
45
What percent of patients can ovaries be felt in?
~50%
46
What is the term for a uterus that is tipped forward toward the front of the abdomen?
Anteverted
47
What is the term for a uterus tin which the body and fundus of the uterus flex forward at the cervix
Anteflexed
48
What is the term for a uterus that is tilted posteriorly?
Retroverted
49
What is the term used to describe when the body of the uterus is angled backward in relation to the cervix?
Retroverted
50
Thickening of the skin, particularly on the palms and soles may be a sign of what?
A systemic disorder, including exposure to arsenic or other
| toxins.
51
How do you ascess for skin turgor?
Pinching skin and seeing how long it takes to retract back
52
True or false: normally, moles on a person have one color (per mole) and tend to look alike to other moles
True
53
When are moles concerning, relative to their shape?
Irregular borders or fading into surrounding skin
54
When are moles concerning, relative to their surface?
scaly, rough, irregular, or “pebbly” appearance
55
When are moles concerning, relative to their size?
If larger than 6mm
56
True or false: Typical adult has 10-40 moles scattered over the
body
True
57
Nail darkening can result from what? (4)
1. Antimalarial drug therapy
2. candida infection
3. hyperbilirubinemia
4. chronic trauma.
58
Green to black discoloration can indicate what?
Pseudomonas infection
59
A single blue or black nail can suggest what?
melanoma or trauma
60
Longitudinal red or brown streak in the nail beds can indicate what?
endocarditis or vasculitis
61
Rippling of a nail is from what?
Chronic paronychia or eczema
62
A “boggy” nail base is associated with what?
Clubbing
63
What is Onycholysis?
separation of the nail plate from the nail
| bed
64
How do you assess for the nail bed angle?
Schamroth's sign
65
Clubbing is present if nail base angle is what greater than or equal to what?
≥ 180˚
66
What is the serous membrane surrounding the testes?
Tunica vaginalis
67
Lymphatic drainage of the penile and scrotal surfaces goes where?
to the inguinal nodes
68
Lymph from the testes drains where?
into the abdomen
69
What is phimosis?
When the foreskin cannot be retracted
70
What is Balanitis?
inflammation of the glans in an uncircumcised patient
71
What is Hypospadia?
a congenital condition in which the meatus is located
| more ventrally
72
What is Epispadias?
a congenital condition in which the meatus is located on
| the dorsal surface of the penis
73
Asymmetry of the scrotum is a normal finding. Why?
Due to the left spermatic cord being longer than the right
74
When can the testes be considered completely descended? (hint, not a time, but the result of a test)
If testicle can be pushed into the scrotum
75
What does a thickened vas deferens indicate?
Chronic infection
76
A hydrocele results
| from what?
the tunica vaginalis (an embryonic structure) not completely
| closing during development
77
Feeling a presence on the side of the finger indicates what type of hernia?
Direct
78
Feeling a presence on tip of the finger indicates what type of hernia?
Indirect
79
When documenting rectal lesions, what is the 12 o'clock position?
Ventral midline
80
What are the initial steps of performing a rectal exam? (4)
1. Lube
2. have pt bear down
3. When relaxation felt, slip in more
4. Tighten sphincter
81
What are the steps of assessing the rectal walls?
Reach as far into the resctum as possible, and palpate walls
82
What are the four things that should be assessed when performing a rectal exam?
1. Sphincter tone
2. Palpate muscular ring
3. Palpate anal walls
4. Palpate prostate
83
What is the consistency of a prostates?
Like a pencil eraser
84
What are the symptoms of prostatic enlargement?
Nocturia
Urine dribble
Tries to void, but can't
Small urine stream
(NUTS)
85
What is the order of assessment for the lower limb?
```
Inspection
Palpation
ROM
Strength
Special testing
```
86
Which comes first in the assessment, AROM or PROM?
AROM
87
How is muscle tone assessed?
By feeling resistance to stretch
88
What does a 0 mean on strength testing?
No movement
89
What does a 1 mean on strength testing?
Trace movement
90
What does a 2 mean on strength testing?
full motion, but not against gravity
91
What does a 3 mean on strength testing?
Full motion against gravity, but not against resistance
92
What does a 4 mean on strength testing?
Full motion against gravity and some resistance, but weak
93
What does a 5 mean on strength testing?
Full motion against gravity and resistance (normal)
94
Weakness with pain indicates that the weakness is (BLANK) in origin, whereas painless
weakness is suggestive of a (BLANK) problem.
Weakness with pain indicates that the weakness is MUSCULAR in origin, whereas painless weakness is suggestive of a NEUROLOGICAL problem.
95
genu valgum = ?
Knock knees
96
genu varum = ?
Bowlegs
97
What are the four motions of the leg assessed?
Flexion/extension
| Internal/external rotation
98
What is the ballottement test? What is it used for?
Pushing down on the patella of an extended leg, looking for movement of fluid
tests for patellar effusion
99
What is the bulge sign? What is it used for?
Moving fluid in an extended leg down from the patella, then tapping on the medial side, looking for fluid movement
assesses for minor effusions of the knee
100
What is the McMurrary test? What is it used for?
Rotating the tibia of a flexed knee, applying valgus stress, then extend the knee maintaining force
evaluates for a torn meniscus in the knee on the
posterior side
101
What is Lachman's test? What is it used for?
Same and posterior drawer, but with knee flexed 20 degrees.
Evaluates the PCL w/o compensation by hamstrings
102
What is Pivot shift test? What is it used for?
Applying valgus stress to a slightly flexed knee, then extending
Evaluates the ACL
103
The varus stress test evaluates instability of the (BLANK) collateral ligament, and the valgus stress test evaluates for (BLANK) collateral ligament
instability.
The varus stress test evaluates instability of the lateral collateral
ligament, and the valgus stress test evaluates for medial collateral ligament
instability.
104
What are the steps of the varus/valgus stress test?
For the varus test, apply a varus force against ankle and internal rotation, while pulling laterally at the ankle.
For the valgus test, apply a valgus force against ankle
and external rotation, while pulling laterally at the ankle.
105
What are the steps of the Apley compression test? What does it test for?
Moving ankle of a 90 degrees flexed knee
Tests for torn medial/lateral meniscus
106
What are the steps of the Apley distraction test? What does it test for?
Moving ankle of a 90 degrees flexed knee, with compression on the posterior thigh
This evaluates ligament injury
107
Nodules along the Achilles =?
RA
