OSCES Flashcards
(232 cards)
1
Q
Blood flows through the heart in what system?
A
Right Atrium > Tricuspid Valve > Right Ventricle > Pulmonary Valve > Pulmonary Artery > Pulmonary Vein > Left Atrium > Mitral Valve > Left Ventricle > Aortic Valve > Aorta
2
Q
Veins do what?
A
Return blood to heart
3
Q
What is systole?
A
Mitral and Tricuspid Closure
4
Q
What is diastole?
A
Aortic and Pulmonary closure
5
Q
Where to listen to aortic valve?
A
upper right sternal border at the level of the 2nd right intercostal space
6
Q
where to listen to pulmonary valve?
A
upper left sternal border at the level of the 2nd left intercostal space
7
Q
where to listen to tricuspid valve?
A
lower left sternal border at the level of the 4th left intercostal space
8
Q
where to listen to mitral valve?
A
over the apex beat point (which is normally (if palpable) felt just within the mid-clavicular line at the level of the 5th intercostal space)
9
Q
Features of JVP? (5)
A
Non Palpable
Multiphasic
Occludable
Varies with Head Tilt
Varies with Respiration
10
Q
What does JVP reflect?
A
Atrial Pressure
11
Q
When could S3 be heard?
A
Diastole
12
Q
S4 is usually associated with?
A
Left Ventricular Hypertrophy
13
Q
When looking at hands in cvs examination what to look for? (7)
A
Tar Stain
Warmth
Peripheral Cyanosis
Clubbing
Splinter Haemorrhages
Cap Refill
Fine Tremor
14
Q
What to look for when assessing radial pulse? (4)
A
Rate
Rhythm
Volume
Character
15
Q
What to look for when assessing face in cardiovascular examination? (7)
A
Malar Flush
Xanathelasmata
Corneal Arcus
Anaemia
Central Cyanosis
Angular Stomatitis
Sore Red Tongue
16
Q
What does Malar Flush indicate?
A
Mitral Stenosis
17
Q
What to look for when assessing back of chest for cvs exam?
A
Sacral Oedema
Crackles (Left Sided Heart Failure)
18
Q
What to look for when assessing abdomen in cvs exam? (2)
A
Tender Liver
Ascites
19
Q
What to look for when assessing legs in cvs exam?
A
Pitting oedema
Arterial Disease: Cold, Smooth, Hairless, Increased Cap Refill, Arterial Leg Ulcers, Gangrene
Varicose Veins
Venous Insufficiency eg Lipodermatosclerosis, Ulceration
20
Q
What to look for when looking for arterial disease in cvs exam? (6)
A
Cold
Smooth
Hairless
Increased Cap Refill
Arterial Leg Ulcers
Gangrene
21
Q
Where can JVP be found in cvs exam?
A
Internal Jugular Vein in Supraclavicular Area
22
Q
What to assess in inspection of chest in cvs exam? (4)
A
Chest deformities
Scars
Cardiac Pacemaker
Visible pulsation
23
Q
What to assess in palpation of cvs exam? (5)
A
Tracheal Position
Cardiac Pacemaker
Apex Beat
Heaves
Thrills
24
Q
Where can apex beat be found?
A
5th Intercostal Space
25
What are heaves?
Right Ventricular Hypertrophy
26
What are thrills?
Palpable murmurs usually systolic
27
Where to palpate for thrills?
Both sides of sternum and apex
28
Where to assess for aortic stenosis?
Listen over aortic valve area again and then over both the carotid arteries with the stethoscope diaphragm for the murmur and the radiation of this high-pitched ejection systolic murmur.
29
What type of murmur is aortic stenosis?
high pitched ejection systolic
30
Where to listen for mitral regurgitation?
Listen again over the apex and then in L axilla with the stethoscope diaphragm for radiation of this high-pitched pansystolic murmur.
31
What type of murmur is mitral regurgitation?
Pansystolic Murmur
32
Where to listen for mitral stenosis?
Ask the patient to roll onto their left side and at listen at the apex with the stethoscope bell with the breath held in expiration, for this low-pitched ‘rumbling‘ mid-diastolic murmur.
33
What type of murmur is mitral stenosis?
low pitched rumbling mid diastolic
34
Where to listen for aortic regurgitation?
Ask the patient to sit up, leaning forwards, and ask them to hold their breath in expiration (“please take a deep breath in, breathe out, now hold your breath”). Listen at the lower left sternal edge with the diaphragm of the stethoscope for the high-pitched early diastolic murmur.
35
What type of murmur is aortic regurgitation?
High pitched early diastolic murmur
36
What peripheral pulses to palpate in cvs exam? (8)
Radial
Brachial
Carotid
Femoral
Radio Femoral Delay
Popliteal
Posterior Tibial
Dorsalis Pedis
37
Where to palpate for brachial pulse?
In the antecubital fossa, medial to biceps tendon
38
Where to palpate for carotid pulse?
Neck medial to Sternocleidomastoid muscle
39
Where to palpate femoral pulse?
Just inferior to inguinal ligament half way between ant sup iliac spine and symphysis pubis.
40
Where to palpate popliteal pulse?
Behind knee joint, deep in popliteal fossa. With knee flexed to 30 ensure patient relaxed and hold knee with both hands with thumbs in front
41
Where to palpate posterior tibial pulse?
Behind and 2cm below medial malleolus
42
Where to palpate dorsalis pedis pulse?
On dorsum of foot, lateral to tendon of extensor hallucis longus
43
How to estimate systolic blood pressure?
Palpate Brachial Pulse
Inflate until pulse not palpable and note pressure on dial = estimated systolic pressure
Deflate cuff rapidly to zero
44
How to ausculate systolic blood pressure and diastolic blood pressure accurately?
Stethescope to brachial artery
Refinlate up to 30mmHg more than estimated systolic pressure
Slowly open valve and release pressure from cuff
Note onset of repeated beats/tapping = systolic pressure
Continue to let air slowly out of cuff, once beats disappear = diastolic pressure
45
ECG - Where to Put V1
4th intercostal space to the right of the sternum
46
ECG where to put V2
4th intercostal space to the left of the sternum
47
ECG where to put V3
midway between Leads 2 and 4
48
ECG where to put V4
5th left intercostal space midclavicular line
49
ECG where to put V5
same horizontal level as Lead 4 anterior axillary line
50
ECG where to put V6
same horizontal level as Lead 4 mid axillary line
51
What is PR Interval on EVG
the time taken from atrial depolarisation to ventricular depolarisation and should be between 0.12 - 0.2 secs.
52
What is QRS complex on ECG
represents ventricular depolarization and should be < 0.12 secs
53
What is QT Interval on ECG
time spent in ventricular depolarization and repolarization – beginning of Q to end of T – max 0.42 secs*
54
How to interpret ecg?
Is there any electrical activity?
What is the QRS rate?
Is the QRS rhythm regular or irregular?
Are the QRS complexes broad or narrow?
Is atrial activity present?
Is there a relationship between atrial activity and ventricular activity?
55
How to calculate qrs rate on ecg
If the QRS complexes are at regular intervals, the rate can be calculated by counting the number of large squares between the peaks of the QRS complexes and dividing that number into 300.
If the QRS complexes are not at regular intervals, the method above cannot be used. In this case, you need to count the number of QRS complexes that occur over a fixed time (usually 6 secs) and multiply (by 10) to get a rate/minute, in the same way as you would count a pulse over 15 secs and multiply by 4.
56
How to calculate rhythm on ecg
Sometimes it is very obvious that an ECG shows an irregular rhythm, but to be sure, line up a strip of paper along the rhythm strip and mark 3-4 complexes. Now move the paper strip along the rhythm strip by 1 or 2 complexes and see if the following QRS complexes line up with your marks.
57
How to calculate broad or narrow qrs on ecg
Normally the QRS complex should be <0.12 secs (less than3 small squares). Count from the start of the Q wave to the end of the S wave.
Widened QRS complexes usually indicate that the depolarisation has begun in the ventricle itself rather that the SA node
58
How to calculate relationship between atria and ventricles on ecg
Look for P waves. If they are present, ask – is every P wave followed by a QRS and does every QRS have a P wave before it. What is the PR interval? (Normal = 0.12 - 0.2 seconds, 3-5 small squares). This will enable you to diagnose heart block
59
What is odynophagia?
painful swallow
60
what is haematochezia?
passage of fresh blood from anus
61
What is foetor hepaticus?
breath smells musky - liver problems
62
Name the nine regions of the abdomen?
Right Hypochondrium
Epigastrium
Left Hypochondrium
Right Flank
Umbilical Region
Left Flank
Right Iliac Fossa
Hypogastrium/Suprapubic
Left Iliac Fossa
63
Examining an abdominal mass - what do you need to describe? (10)
Site
Size
Shape
Surface
Edge/Outline
Tender to Palpation
Consistency
Mobility
Pulsatile
Fluctuant
64
In GI Exam, what to look at on hands? (9)
Tar Stain
Nail Colour: Anaemia and Leukonychia
Clubbing
Koilonychia
Palmar Erythaema
Pale Palmar Creases
Dupuytrens Contracture
Flap Tremor
Fine Tremor
65
What does Leukonychia indicate?
Hypoalbumininema
66
What does Koilonychia indicate?
Iron deficiency anaemia
67
What does flapping tremor indicate?
Liver Failure
68
What does fine tremor indicate?
Alcohol/Alcohol Withdrawal
69
What to look for in arms on GI exam? (5)
Bruising
Scratch Marks/Pruritus
Muscle Wasting
Track Marks
Skin Turgor
70
What can scratch marks/pruritus indicate?
Chronic Cholestasis
71
What to look for in face on GI exam? (5)
Parotid Swelling
Jaundice
Anaemia
Angular Stomatitis and Sore Red Tongue
Foetor Hepaticus
72
What does Angular stomatitis and sore red tongue indicate?
Fe Deficiency Anaemia
73
What would Foetor Hepaticus represent?
Liver Failure
74
What to look for in mouth in GI exam? (4)
Gum Swelling/Bleed
Dentition
Salivary Glands
Apthous Ulcers
75
Tonsilar lymph node drains where?
Oropharynx
76
Submandibular lymph node drains where?
2/3 of tongue and floor of mouth
77
Submental lymph node drains where?
Tip of tongue and anterior floor of mouth
78
Preauricular lymph node drains where?
Face including parotid
79
What to look for on chest in GI exam? (3)
Spider Naevi
Gynaecomastia
Loss of Body hair in Males
80
What to look for in Legs on GI Exam? (3)
Peripheral Oedema
Loss of Body Hair
Erythema Nodosum
81
What does Peripheral oedema in legs indicate on GI exam?
Hypoalbuminaemia/Liver failure
82
What to look for on inspection in GI exam? (9)
Scars
Visible Pulsation
Skin Lesions
Scratch Marks
Abdo Shape
Stoma
Caput Medusae
Petechiae
Striae
Distention
83
What does distended veins/caput medusae mean?
Portal Hypertension
84
What to feel for on palpation of abdomen in GI exam? (5)
Tenderness
Guarding
Rebound Tenderness
Rigidity
Masses
85
Where can the liver be palpated? upper and lower border
Upper: 5th Right Intercostal Space on Full Expiration
Lower: Costal Margin on Full Inspiration
86
Where can spleen be palpated?
9th-11th Ribs on Left Side
87
Where can kidneys be palpated?
Renal Angle formed by 12th rib and vertebral column from T12-L3
88
What does shifting dullness mean?
Ascitic Fluid >1.5 Litres
89
What to ausculate for in GI exam? (6)
Bowel Sounds
Abdominal Aorta
Renal Arteries
Liver
Spleen
Rubs
90
Who is screened in Bowel Cancer Screening?
Men and Women Age 50-74 every 2 years
91
Head and Neck Examination
- What to look for on inspection of face? (8)
Expression
Symmetry
Features of Cushings eg Acromegaly, Bony Changes
Swellings
Hair
Shape of Face
Scars
Skin
92
Head and Neck Examination
- What to look for on inspection of Eyes? (6)
Lid Lag
Proptosis
Eye Movements
Jaundice
Anaemia
Thyroid Eye Disease
93
Head and Neck Examination
- What to look for on inspection of nose? (4)
Front,Side and Above Nose
Discharge
Block Nostrils
Nasal Vestibule
94
Head and Neck Examination
- What to look for on inspection of mouth? (6)
Lips
Open Mouth
Oropharynx/uvula/tonsils
Tongue
Underside of Tongue
Dentition
95
Head and Neck Examination
- Where to palpate for skull and face? (6)
Mastoid Processes
Orbital Margins
Temporal Arteries
Maxilla
mandible
TM Joint
96
Head and Neck Examination
- where to palpate nose? (2)
Nasal Cartilage and Bones
Paranasal Sinuses (Maxillary, Ethmoidal, Frontal)
97
Upper Limb Neuro Examination
- Observation? (6)
Muscle Atrophy
Fasiculations
Skeletal Deformity
Scars
Tremor
Involuntary Movements
98
Upper Limb Neuro Examination
- What involuntary movements to look for on observation? (4)
Dystonia
Chorea and Athetosis
Ballismus
Ticks
99
What is Dystonia?
Sustained muscle contractions which are twisting and repetitive
100
What is Chorea and Athetosis?
Writhing movements
101
What is ballismus?
Violent Flinging movements
102
Upper Limb Neuro Examination
What is spascitiy in tone? (2)
Hypertonia
Feature of UMNL
103
Upper Limb Neuro Examination
- What to test in power (7)
Shoulder Abduction
Elbow Flex and Extend
Wrist Flex and Extend
Finger Flex and Extend
Intrinsic Muscles of Hand
Grip
Pronator Drift
104
What does MRC Scale 5 mean?
Full Power
105
How to assess Upper Limb Neuro Shoulder Abduction Power?
For the shoulders: put elbows up in the air (i.e. abduct to 90°) and “do not let me push them down” as you oppose them pushing down at the elbow.
106
How to assess Upper Limb Neuro Elbow Flex and Extend?
For the elbows: flex elbows in front of chest “pull me towards you” as you resist (elbow flexion) and then “push me away,”(elbow extension) Be careful if they are stronger than you then it may be better to ask them to keep their arm still and not let you straighten or bend it.
107
How to assess upper limb neuro wrist flexion/extension power?
* For the wrists: make a fist and cock it back (extend) - while you resist this. Then ask the patient to bend the fist down against your resistance (flex).
108
How to assess upper limb neuro intrinsic muscles of hand power?
For the hands:hold fingers out straight “keep them there” as you try to flex them at the metacarpophalangeal joint (i.e. test finger extensor muscles - radialnerve).Then as they try to flex them at MCP joint against resistance (i.e. finger flexion C8)
109
How to assess upper limb neuro intrinsic finger muscles power?
Intrinsic hand muscles: spread fingers wide apart “don’t let me close them” as you try to push the fingers together (i.e. test finger abductor muscles, innervated by ulnar nerve), then to turn hand over (supinated) and push thumb up in the air against your finger (i.e. test thumb abduction - abductor pollicis brevis. Median nerve)
110
How to assess upper limb neuro grip power?
Grip – “Squeeze my fingers” (Median & ulnar nerves)
111
How to assess upper limb neuro pronator drift?
ask patient to hold arms out straight in front of them, palms up to the ceiling, and close their eyes. Watch for any drifting of the arms downwards or into pronation. This is a sign of weakness. NB This is a sign of a cerebral hemisphere problem, rather than a limb problem.
112
What does finger flexion power assess eg what dermatome?
C8
113
Finger abductor muscles are innervated by?
Ulnarn erve
114
Finger abduction muscles are innervated by?
Median Nerve
115
Testing hand power grip in neuro upper limb examination tests what nerves?
Median and Ulnar Nerves
116
Pronator Drift being positive is a sign of what?
Cerebral Hemisphere issue
117
What to test in upper limb neuro coordination? (2)
Finger-Nose
Dysdiachokinesis
118
What reflexes to test in upper limb neuro examination? (3)
Biceps
Supinator
Triceps
119
What dermatomes are being tested in biceps reflex?
C5/6
120
What dermatomes are being tested in supinator reflex?
C6
121
What dermatomes are being tested in Triceps reflex?
C7
122
Where to hit for Triceps reflex?
Tendon directly about 2cm above olecranon
123
What dermatomes are being tested in upper limb neuro light touch? (5)
C5,C6,C7,C8 and T1
124
What to test in upper limb neuro sensation? (4)
Light Touch
Pinprick
Vibration
Joint Position (Proprioception)
125
Fibres for fine touch, proprioception and vibration are carried in what column/tract?
Dorsal Column
126
Fibres for pain and temperature are carried in what column/tract?
Spinothalamic Tract
127
Dorsal column carries what fibres?
Fine touch, proprioception and vibration
128
Spinothalamic Tract carries what fibres?
Pain and Temperature
129
What to assess in Neuro Lower Limb Examination observation? (5)
Muscle Atrophy
Fasiculations
Skeletal Deformity
Scars
Tremor
Involuntary Movement
130
What to assess in Neuro Lower Limb Examination tone? (4)
Hip Rotation
Hip Flexion
Knee Flexion
Ankle Colnus
131
What to assess in Neuro Lower Limb Examination Power? (7)
Hip Flexion
Hip Extension
Knee Flexion
Knee Extension
Ankle Dorsiflexion
Ankle Plantarflexion
Big Toe Extension
132
Big toe extension in neuro lower limb examination looks at what muscle?
Extensor Hallucis LOngus
133
Neuro Lower Limb Examination
How to test Hip Flexion and Extension?
Hip: straight leg raise pushing thigh up against your hand “keep it there do not let me push it down”(flexion) and then pushing down against your hand(extension)
134
Neuro Lower Limb Examination
How to test knee flexion and extension?
Knee: bend one knee “pull heel towards your bottom” (flexion) and then to straighten the knee (extension) “push me away”.
135
Neuro Lower Limb Examination
How to test ankle dorsiflexion and plantarflexion?
Ankle: pull foot back towards them keeping their knee straight (dorsiflexion) against your hand and then push their foot down against your hand (plantarflexion
136
Neuro Lower Limb Examination
How to test extensor hallux longus?
pull big toe towards them (keeping leg straight)
137
Neuro Lower Limb Examination
How to test coordination? (2)
Heel-Shin Test
Gait
138
Neuro Lower Limb Examination which reflexes to check? (3)
Knee
Ankle
Plantar Response
139
How to test knee reflex?
Knee reflex: place your left forearm under one knee and gently lift the leg off the bed - you should do the lifting and the patient’s heel should stay resting on the bed. Strike the patellar tendon, just below the lowest point of the patella.
140
How to test ankle reflex?
1. For the right ankle reflex, ask the patient to flex their right knee and externally rotate the right hip, they can cross their ankles if this helps. Hold the right foot with your left hand in such a way that you stretch the Achilles tendon and you have a clear view of the calf muscles. Strike the Achilles tendon and look for calf muscle contraction. Then perform the same manoeuvre on the left. You may need to put your left arm in a slightly awkward position in order to hold the foot while not obstructing your view of the left calf.
141
What does knee reflex test?
L3-4
142
What does ankle reflex test?
S1
143
What dermatomes does Lower Limb Neuro sensation test? (5)
L2,L3,L4,L5,S1
144
What to to test in Lower Limb Neuro Sensation? (5)
Light Touch
Pinprick
Vibration
Joint Position
Romberg Test
145
What is Romberg Test
Stand with feet close together
Close eyes
146
Positive Romberg Test indicates what?
Proprioception issues
147
How to assess gait in lower limb neuro examination? (4)
Walk and Turn
Heel to toe
Rise from Sit
Walk on Tiptoes and on heels
148
How to test proximal lower limb power in lower limb neuro examination?
Rise from chair without using arms
149
How to test distal lower limb power in lower limb neuro examination?
Walk on heels and stand on tip toes
150
For neuro examination reflexes what does +++ mean?
Increased/Exaggerated/Brisk
151
For neuro examination reflexes what does ++ mean?
Normal
152
For neuro examination reflexes what does + mean?
reduced
153
For neuro examination reflexes what does + with a _ underneath mean?
Only present with reinforcement
154
for neuro examination reflexes what does
- mean
absent
155
If large toe extends in plantar response what does that mean?
Abnormal Plantar Response
156
If large toe extends and other toes abduct in plantar response what does that mean?
Positive babinski sign
157
A positive babinski sign is a sign of what?
Likely UMNL
158
What does MRC 0 mean
No muscle contraction visible
159
What does MRC 1 mean
Flicker of contraction with no movement
160
What does MRC 2 mean?
Joint movement when effect of gravity eliminated
161
What does MRC 3 mean?
Movement against gravity but not against examiner resistance
162
What does MRC 4 mean?
Movement against resistance but weaker than normal
163
What does MRC 5 mean?
Normal Power
164
How to test olfactory nerve (I)
Change in smell
165
How to test optic nerve II? (6)
Visual Acuity with Snellen Chart
Pupil response to light
Visual fields
Visual inattention
Accomodation
Fundoscopy
166
If a pupil response to light is afferent which nerve is affected?
CN II Optic
167
If a pupil response to light is efferent which nerve is affected?
CN III Occulomotor
168
How to test pupil responses in optic nerve
First in side the light is shining (Ipsilateral) - direct response constriction
Second in opposite side from where light is shining (contralateral) indirect response constriction
169
Bitemporal Hemianopia is a sign of
Cranial nerve problem
170
Homonymous Hemianopia is a sign of
Hemisphere problem
171
Right sided inattention in visual inattention would only notice what side movement?
Left Sided
172
Visual inattention is a sign of
Hemisphere problem
173
What should happen to pupils in accomodation when testing Optic Nerve
Constrict as eyes converge
174
What does Oculomotor Nerve (III) innervate (7)
Superior, Medial and Inferior Rectus Muscles
Inferior Oblique
Levator Palpaebrae Superioris
Parasympathetic innervation of constrictor pupillae and ciliary muscle (accomodation)
175
How to test occulomotor nerve (III) (3)
Pupil Abnormality
Ptosis
H- Nystagmus
176
What does the Trochlear Nerve (IV) innervate?
Superior Oblique muscle of eye
177
What does Trigeminal Nerve (V) innervate
Sensation to face and motor function to muscles of mastification
178
How to test trigeminal nerve (v) (4)
Sensation
Palpate Massester Muscle and Clench Teeth
Open Jaw against Resistance for Pterygoid Muscles
Corneal Reflex
179
How to test for Trigeminal V1?
Touch opthalamic (forehead) area for sensation
180
How to test for Trigeminal V2?
Touch maxillary area
181
How to test for Trigeminal V3
Touch Mandibular (lower jaw area)
182
The abducens nerve (VI) innervates what muscle
Lateral rectus
183
The facial nerve (VII) innervates what muscle? (3)
Muscles of facial expression
Taste to Anterior 2/3 of Tongue
Secretormotor to submandibular and sublingual glands
184
Facial nerve (VII) how to test? (3)
Inspection
Facial Movement: Wrinkle Forehead, Screw eyes, smile, puff out cheeks
Taste Sensation
185
How to test vestibulochlear nerve (VIII) (3)
Check for Nystagmus
Check for Balance
Hearing tests
186
Glossopharyngeal Nerve (IX) does what (3)
carries sensation from pharynx and tonsils and sensation and taste from posterior 1/3 of tongue and innervates stylopharyngeus
187
Vagus nerve (X) does what? (2)
Carries sensation and innervates paletine pharyngeal and laryngeal muscles
188
How to test Glossopharyngeal and Vagus Nerves? (3)
Open mouth say ahh
Cough
Gag reflex
189
Accessory Muscle innervates (2)
Upper trapezius and sternocleidomastoid
190
Hypoglossal Nerve (XII) innervates
Muscles of tongue
191
How to test Hypoglossal nerve? (3)
Inspect mouth
Check tongue
speech
192
How to do whispered voice test?
Stand 60cm from ear and rub tragus of opposite ear
193
Rinne's Test does what?
Compares air conduction to bone conduction
194
Rinnes test is positive if?
Air Conduction > Bone Conduction
195
What does Bone Conduction > Air Conduction mean in Rinne's?
Conductive Deafness
196
In Weber's Test if there is a conductive deafness what will happen?
Sound will be heard loudest in that ear
197
In Weber's test if there is a sensorineural deafness what will happen?
Sound will be referred to good (unaffected) ear
198
Absence of red reflex on fundoscopy indicates?
Cataract
199
Fundoscopy: what to look for on fundus (4)
Optic Disc: shape, colour, definition, vessels
Vessels: arteries, veins
Retina: colour, haemorrhages, exudates, detachment, tears
Macula
200
GCS - Eye Opening? (4)
Spontaneous 4
Speech 3
Pain 2
No response 1
201
GCS Verbal Response? (5)
Orientated 5
Confused talks in sentences but disorientated 4
Verbalises words 3
Vocalises sounds not words 2
No vocalisation 1
202
GCS Motor Response (6)
Obeys Commands 6
Localises to Pain 5
Normal Flexion to Pain 4
Abnormal Flex to Pain 3
Extension to Pain 2
No Response 1
203
What are the 10 parts of Abbreviated Mental Test?
1. Age
2. Time
3. Address
4. Year
5 Name of this place
6. Identity two people
7. DOB
8. Date of first world war
9. Name of present monarch
10 Count backwards 20-1
204
What is a myotome?
Group of muscles that single spinal nerve root innervates
205
What is dermatome?
Area of skin supplied by single spinal nerve
206
Clinical features of UMN lesion (4)
Increased Tone
Hypereflexia
Upgoing Plantars
Weakness
207
Clinical features of LMN lesions (4)
Muscle Fasiculation
Reduced Tone
Hyporeflexia
Weakness/Muscle Atrophy
208
What is polyuria?
Frequency of urine
209
What is oliguria?
Reduced urine output
210
what is anuria?
no urine output
211
Urinary Examination
- What to look for on hands and nails? (4)
Nail Pigmentation
Beau Lines
Splinter Haemorrhages
Flap Tremor
212
Causes of Haematuria? (7)
Glomeruelonephritis
UTI
Renal Stones
Tumour of Kidney, Ureter, Bladder, Prostate
Acute Tubular Necoris
Severe Exercise
213
Prostate Examination
- Inspection (6)
Pubic Hair
Scrotal Skin
Scrotal Contours for Swelling/Scars/Veins
Urethral Meatus and Foreskin
Glans Penis
214
How does prostate gland feel in BPH Prostate exam?
Enlarged, Smooth and Soft
215
Right Lung has how many lobes?
3
216
Normal respiratory rate
12-15
217
Stony Dullness on respiratory examination means what?
Fluid present
218
Respiratory examination
Increased vocal resonance means what
Consolidation or cavity formation
219
Respiratory Examination
What to look for on hands and nails (7)
Tar Staining
Warmth
Peripheral Cyanosis
Clubbing
Cap Refill
Fine Tremor
Flap Tremor
220
How to assess for clubbing? (4)
Loss of Nail Angle
Increased Nailbed Fluctuation
Increase in Longitudinal nail curvature
Increase bulk of soft tissues over terminal phalnges
221
FIne tremor may indicate?
Overuse of Beta Agonists
222
Name all the lymph nodes? (8)
Supraclavicular
Anterior Cervical
Tonsilar
Submanidbular
Submental
Pre and Post Auricular
Posterior Cervical
223
Name the 5 areas that need to be percussed in respiratory exam?
Apices
Upper
Middle
Lower
Axilla
224
Signs expect to see on examination in COPD?(5)
Wheeze
Raised JVP
Pursed Lip Breathing
Hyperinflated Chest
Use of Accessory Muscles
225
Signs expect to see on examination in Acute Lobar Pneumonia? (5)
Tachypnoea
Tachycardia
Reduced Expansion
Dull Percussion
Bronchial Breathing
226
Signs expect to see on examination in Pneumothorax (4)
Reduced Expansion
Hyper Resonance
Raised Resp Rate
Tachycardia
227
Signs expect to see on examination in collapse of lung?
228
Signs expect to see on examination in pleural effusion? (3)
Decreased Expansion
Stony Dull Percussion
Diminished Vocal Resonance
229
Signs expect to see on examination in acute severe asthma (3)
Tachycardia
Tachypnoea
Inability to complete sentences in one b
230
How many pairs of spinal nerves
31
231
What does the Superior oblique muscle do? (innervated by trochlear nerve)
moves eye down and out
232
What does the lateral rectus muscle do (innervated by abducens nerve)
Abducts eye
