Lecutre 2 Reverse Flashcards
(89 cards)
1
Q
- Attention2. Memory3. Orientation4. Perceptions5. Thought process/content6. Insight7. Judgement8. Affect9. Mood10. Language11. Higher cognitive functions
A
Components of mental status
2
Q
- Medically unexplained physical Sx2. High Sx count3. High severity of the complaint when organic causes are ruled out4. Chronic pain5. Recent stressor6. Difficult encounters7. Low self rating of health8. Frequent use of healthcare servicces9. Substance abuse10. Cognitive complaints of any sort
A
What triggers a MSE?
3
Q
Mis-interpretation of real stimuli1. Grief2. PTSD3. Schizophrenia
A
Illusions & when are they seen?
4
Q
- Date orientation - 5 pts2. Place orientation - 53. Register - 3 (Name objects & repeat)4. Serial 7’s - 5 (Count back from 7, WORLD)5. Recall - 3 (3 objects from register)6. Naming - 2 7. Repeating phrase - 18. Verbal commands - 3 9. Written commands - 1 10. Writing - 111. Drawing - 1
A
MMSE components
5
Q
24 or higherDepends on age & education
A
What is a normal MMSE score?
6
Q
- MSE2. CN3. Sensory4. DTR/Plantar response5. Cerebellar function6. Muscle strength7. Motor screening
A
What does a neuro exam test?
7
Q
OlfactorySensory
A
CN I
8
Q
OpticSensory - visual acuity & visual fields
A
CN II
9
Q
OculomotorMotor - raise eyelids, most EOMParasympathetic - pupil constriction, lens shape
A
CN III
10
Q
TrochlearMotor - downward, inward eye mvmt (SO)
A
CN IV
11
Q
TrigeminalMotor - jaw opening & clenching, masticationSensory - 3 branches
A
CN V
12
Q
AbducensMotor - lateral eye mvmt (LR)
A
CN VI
13
Q
FacialMotor - facial expression muscles (except jaw), eye closure, mouth closureSensory - taste (ant. 2/3 tongue)Parasympathetic - Secretion of saliva & tears
A
CN VII
14
Q
AcousticSensory - hearing & equilibrium
A
CN VIII
15
Q
GlossopharyngealMotor - voluntary muscles for swallowing & pronationSensory - nasopharynx, gag reflex, taste (post. 2/3 tongue)Parasympathetic - secretion of saliva, carotid reflex
A
CN IX
16
Q
VagusMotor - Voluntary muscles of phonation & swallowSensory - behind ear, part of external canalParasympathetic - secretion of digestive enzymes, peristalsis, carotid reflex, heart, lungs, digestive tract
A
CN X
17
Q
Spinal AccessoryMotor - turn head, shoulder shrug, some phonation
A
CN XI
18
Q
HypoglossalMotor - tongue mvmt for speech, sound articulation, swallowing
A
CN XII
19
Q
Front & back of neck
A
Spinal nerve C3
20
Q
thumb/C85th finger
A
Spinal nerve C6
21
Q
nipple line
A
Spinal nerve T4
22
Q
umbilicus
A
Spinal nerve T10
23
Q
inguinal
A
Spinal nerve L1
24
Q
Anogenital
A
Spinal nerve S2/3
25
Knee
Spinal nerve L4
26
Motor TractA - contralateral SxB - ipsilateral Sx
Lesions above & below corticospinal tract
27
1. + babinski2. Inc. DTRs3. Muscular spasticity1. MS2. ALS
UMN lesions Sx & when are they seen
28
1. Dec. DTRs2. Ipsilateral weakness3. Dec. or absent muscle tone1. Nerve transection2. Guillan-Barre3. Polio
LMN lesions Sx & when are they seen
29
Participate in reflex activity, regulation of position & autonomic function1. Spinothalamic2. Posterior Column
What are the sensory pathways?
30
Sensory pathwayCrosses in cord1. Pain2. Temp3. Crude touch
Spinothalamic tract
31
Sensory pathwayCrosses in the medulla1. Position2. Vibration3. Fine touchAll affected by diabetic neuropathy
Posterior Column tract
32
1. Level of spinal lesion2. Electrolyte disturbances3. Endocrine disturbances4. UMN vs LMN disease
What do differences in reflexes indicate?
33
Delayed DTR
What kind of reflex does hypermagnesemia cause?
34
Biceps & Brachioradialis - C5&6Triceps - C6&7Patellar - L2,3&4Achilles - S1
DTR & Spinal nerves
35
0 - absent1+ - Hypoactive2+ - Normal3+ - Hyperactive4+ - Hyperactive w/ clonus
Grading DTRs
36
1. Dysmetria2. Nystagmus3. Intention tremor4. Ataxia
What are cerebellar disease signs?
37
0/5 - No muscle mvmt1/5 - Visible contraction but no joint mvmt2/5 - Mvmt at joint, but not against gravity3/5 - Mvmt against gravity, but not against resistance4/5 - Mvmt against resistance but less than normal5/5 - Normal strength
Grading Muscle Strength
38
Rooting - 4 moPalmar grasp - 6 moMoro - 2 moPlantar - 1 yr Frontal Release signs
Primitive reflexes
39
Tap on Parkinson's Pts head & they don't stop blinking
What is the Glabellar reflex?
40
Pain when extending knee w/ leg in air Sign of meningeal irritation
What is Kernig's sign?
41
Move hips when flex head while laying downSign of meningeal irritation
What is Brudzinski's sign?
42
1. Rigidity2. Bradykinesia3. Resting tremor4. Slow, shuffling gait w/ loss of arm swing5. Flexed body posture6. Excessive salvation7. Masked facies
Signs of Parkinson's
43
1. Spastic weakness2. Hyperactive reflexes3. + Babinski4. Pronator drift
UMN signs
44
1. Flaccid weakness2. Hypoactive reflexes3. Muscle atrophy4. Fasciculations
LMN signs
45
1. Resting tremor, rigidity2. Postural deformity & instability3. Slow RAM
Extrapyrimidal signs
46
1. Intention tremor2. Ataxia3. Impaired RAM
Cerebellar signs (B1 deficiency)
47
Serratus anteriorFrom long thoracic nerve May be caused by C7 entrapment from mastectomy Pts
What muscle is paralyzed with a winged scapula?
48
SCM contraction1. Hematoma2. Tear3. Phenothiazines
Causes of torticollis
49
T10-T12
Which vertebrae are most susceptible to compression Fx?
50
Supraspinatous
Which rotator cuff muscle is most likely to be injured?
51
Cross over test
How do you test for AC separation?
52
Yergason test
How do you test for biceps tendonitis?
53
Biceps & supinator
What muscles are involved in supination of forearm?
54
Pronator teres
What muscles are involved in pronation of forearm?
55
Pt stands on one leg & opposite hip should point down
What is the Trendelenburg test?
56
0-3 Genu varum3-8 Genu valgus
Normal knee deviation ages
57
Lachman test Flex knee 20-30 degresesDIsplace tibia anteriorly
How do you test for ACL tear
58
ACL injury
#NAME?
59
PCL injury
#NAME?
60
Meniscal injury
#NAME?
61
Valgus - MCL Varus - LCL
Valgus vs. varus stress tests
62
Pain w/ patellar grind test
Test for patellofemoral syndrome?
63
Anterior tibiofibular ligament
Inversion of ankle causes which sprain?
64
Ottawa Ankle rules1. Malleoli point tenderness2. Unable to WB
When do you get an ankle Xray?
65
Grab gastrocnemius & soleus Foot should plantar flex if achilles intact
What is the Thompson test?
66
Kids - autoimmune & hereditaryPatchy hair loss w/o scarring
Who gets alopecia areata?
67
Telogen effluvium
What is the MCC of hair loss in women?
68
iron deficiency anemia? Spoon shaped nails
What causes koilonychia?
69
White lines on nailsAfter serious systemic illness
What causes leukonychia?
70
Psoriasis & atopic dermatitis
What causes pitted nails?
71
Separation of nail plate from nail bed
What is onycholysis?
72
Fungal infection of nailTineal ungium
What is onychomycosis?
73
Infection of nailStaph most common
What is paronychia?
74
Single band along fingernail = cancer
What is melanonychia?
75
40
When should you start doing routine digital rectal exams?
76
ProstateStaged via Gleeson score Prevalence assoc. w/ ageassoc. w/ BRCA2 gene Biopsy cut point >4 Start at age 50
What is the most common male cancer?
77
< 35 GC/chlymidia >40 GRE - enterobacteraciae Dysuria, pelvic & rectal pain, fever
Acute prostatitis
78
40 & yearly
When do you do mammograms?
79
20 then q3y40 every year
When do you do clinical breast exams?
80
Ulnar
Which nerve does finger spread test?
81
CN V
Which nerve does the corneal reflex test?
82
CN IX & X
Which nerves does the gag reflex test?
83
I
II
VIII
(1,2,8)
Sensory ONLY Cranial nerves?
84
VII
IX
X
(7,9,10)
Motor, Sensory & Parasympathetic Cranial nerves?
85
IV
VI
XI
XII
(4,6,11,12)
Motor ONLY Cranial nerves?
86
IX
X
XII
(9,10,12)
Cranial nerves involved in swallowing?
87
T8-12
Nerves involved in abdominal reflex?
88
Extensor
Which surfaces does psoriasis usually appear on?
89
Flexor
Which surfaces does atopic dermatitis usually appear on?
