OSCE for Abd, C spine, L spine Flashcards Preview

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Flashcards in OSCE for Abd, C spine, L spine Deck (68):
1

what is the joint between vertebral articular processes?

zygapophyseal joint "facet"

2

what does an increased jugular venous pressure indicate?

right sided heart failure

3

what does a non midline trachea indicate?

tension pneumothorax

4

what can be observed doing thyroid palpation?

goiter, tenderness

5

what does a positive c spine compression/spurlings maneuver test indicate?

central neuropathy

6

what does a neck distraction test indicated?

central neuropathy

7

what does a positive valsalva test indicate?

+ is when sx are reproduced with valsalva
indicates space occypying lesion in cervical canal

8

what is a positive Roos/east test and what does it indicate?

+ reproduction of sx
thoracic outlet due to subclavian compresion

9

what does a positive adson test indicate?

+ loss or change in pulse
when looking away=thoracic outlet due to scalenes
when looking towards=thoracic outlet due to 1st rib

10

what does wrights hyperabduction test indicate?

+ loss or change in pulse
indicates thoracic outlet syndrome via pec minor

11

what does a costoclavicular/halstead test indicate?

+ loss or change in pulse
thoracic outlet due to 1st rib

12

what does a kerning sign (nuchal rigidity) indicate?

+neck stiffness
indicates meningitis

13

what does a brudzinski sign indicate?

+flexion in both hips and knees
indicates meningitis

14

what does a kernig sign indicate?

+ increased resistance to hip flexion and pain behind knee
indicates dural irritation

15

what is a jefferson fracture? cuase?

C1 compression fracture
head on hit like football

16

what is a wedge fracture?

flexion and compression injury of c spine

17

what is a dens fracture?

C2 odontoid process fracture needs surgury

18

what is a hangmans fracture?

hyperextension C2 bilateral arch fracture

19

spinous process fracture?

hyperextension or avulsion force from muscle contraction

20

what is clay shovelers fracture?

C6 or C7 fracture

21

whaat is a teardrop fracture?

flexion/compression injury --> anterior/inferior teardrop fragment

22

what is a burst fracture?

idk

23

what causes anterior subluxation?

facet dislocation without fracture

24

what is the order of an abdominal exam?

inspect, auscultate, percuss, palpate

25

what is cullens sign?

eccymosis around the umbilicus indicating hemmorhage

26

what is grey turners sign?

flank ecchymosis secondary to hemmorhage

27

what are normal bowel sounds? abnormal?

5-34 clicks,

high pitched, decreased, absent

28

what sound do you want to hear upon percussion of the abdomen? when will you hear dullness?

tympani

over the liver and spleen

29

where do you percuss the liver?

6-12 cm down at the mid clavicular line on the right

30

where do you percuss the spleen?

ribs 6-10, mid axillary line on left

31

how do you want to palpate the abdomen?

light 1cm then moderate 2-3cm then deep 3 cm. all in all 4 quadrants

32

what is rebound tenderness? what does it indicate?

pain upon removal of pressure rather than the application of pressure

peritonitis

33

where is mcburneys point and what does tenderness here indicate?

1/3 distance between ASIS and umbilicis
+pain indicates appendicitis

34

what does rosvigs sign indicate?

appendicitis

35

what does a positive iliopsoas test indicate?

indicates irritation of the psoas muscle from the appendix

36

what does a positive obturator test indicate?

irritation of the obturator muscle from the appendix

37

what does a positive heel strike indicate?

appendicitis or peritonitis

38

how do you palpate the liver?

palpate liver edge during patient inhalation

39

what does a positive murpheys sign indicate?

cholecystitis or cholelithiasis

40

what is courvoisiers sign and what does it indicate?

enlarged non tender gallbladder, indicates pancreatic disease/cancer

41

what does a positive lloyds punch indicate?

infection around kidney, pyelonephritis, kidney stone

42

how do you palpate the aorta?

just above umbilicus, slightly left of midline, should be less than 3cm

43

where do lumbar roots exit the vertebra?

below whatever one theyre named for

44

where does the spinal cord end?

L1-L3ish

45

where does the cauda equina begin?

L2-L3

46

what do you want to look for when observing a low back pain complaint?

slumped over, erect, assymetry, lordosis, gait changes

47

what could a slumped over stance indicate?

depression, muscle spasm, reactive effort to relieve impinging lumbar nerves in intervertebral foramen

48

what could an erect stance indicate?

protecting herniated discs or effects of spinal stenosis

49

what could asymmetry indicate?

short leg, sacral base problem, scoliosis

50

what could gait changes indicate?

listing-disc herniation, muscle weakness
foot drop-fibular nerve injury
shuffling-parkinsons

51

what do you want to palpate when examining the low back? and what are you looking for at each landmark

spinous processes (step offs, fracture, dislocation, arthritis)

SI joint- sacroiliitis, ankylosing spondylitis

paravertebral muscles-MSK a normalities, strain, overuse, SD

palpate area over symptoms-herniated disc may produce tenderness pretty much anywhere near it

palpate for sciatic nerve tenderness-could indicate herniated disc or mass lesion

palpate the skin

52

what does the straight leg test tell you? (lasegue test)

+ test is worsening radicular pain at 30-60 degrees
indicates lumbosacral radiculopathy (usually from herniated disc)

+ at >70 is more likely mechanical issue
>15 could be IT band

53

what are other signs or symptoms of radiculopathy?

muscle weakness and dermatomal sensory loss

54

where do most disc herniations occur?

L5-S1

55

what does the cross straight leg test tell you?

+ pain in the contralateral leg
indicates lumbosacral radiculopathy

56

what does a positive hoovers sign indicate?

+ no downward force of unaffected leg when they "attempt" to life the affected leg

indicates malingering

57

what does a postive thomas test indicate?

iliopsoas contracture, causes a lot of LBP

58

what does the gaenlen test indicate?

+ pelvic pain
SI joint dysfunction

59

what can a valsalva test indicate?

+ reproduction of sciatic symptoms
indicates sciatica

60

what can a stork test indicate?

+ low back pain
indicates pars defect/stress fracture

61

what are symptoms of cauda equina syndrome? is this emergent?

yes its emergent

low back pain, bowel/bladder dysfunction, sensory loss of perineum, bilateral sciatica

62

what is spina bifida?

split in vertebrae with no spinal protrusion

63

what is a meningocele?

meninges forced out between vertebrae

64

what is a myelomeningocele?

spinal cord protrudes through opening

65

what is fergusons angle? what is normal?

the angle between the planes of the most fucked up vertebrae in scoliosis i guess
30-40 degrees

66

what is spondylosis?

degenerative change in vertebrae, osteoarthritis pretty much

67

what is spondylolysis?

scotty dog pars interarticularis fracture of vertebrae

68

what is spondylolisthesis?

anterior displacement of vertebrae