PDX 2 Flashcards by Elizabeth Jose

Articular or Extra-articular Structures

Joint Capsule
Articular Cartilage
Synovium and synovial fluid
Intra-articular ligaments
Juxta-articular bone

ARTICULAR

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Articular or Extra-articular Structures

peri-articular ligaments
tendons
bursae
muscle
fascia
bone
nerve
overlying skin

Extra-articular

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Articular or Extra-articular Disease

Swelling
Tenderness
Limit active and passive ROM

Articular

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Articular or Extra-articular Disease

Involve selective portions of joint
Movement dependent

Extra-articular

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What type of synovial joint is found in the shoulder and hip

freely movable

Spheriodal (ball and socket)

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What type of synovial joint is found in the IP joints, hand and foot, elbow

freely movable

Hinge

movement in 1 plane

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What type of synovial joint is found in the knee and TMJ?

freely movable

Condylar (hinges and glides)

2 articulating surfaces

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Fibrous joints are immovable and are found where?

skull sutures

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audible or palpable “crunching” sound
rubbing of ligament/tendon over bone or bone over bone

CREPITUS

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Red Flags of Lower Back Pain

age, weight, time of day, history, present issues

> 50 yrs
History of Cancer
Unexplained weight loss
Pain at Night, worsening with rest, lasting more than one month, un-responsive to treatment
History of IV drug use
Current infection

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motion by the patient vs motion by the examiner?

Active – patient
passive – physician

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signs of inflammation and arthritis

SWTRP

Swelling
Warmth
Tenderness
Redness
Pain

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SITS muscles of the shoulder

Supraspinatus
Infraspinatus
Teres ,inor
Subscapularis

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Predictors of Rotator Cuff Tear

Supraspinatus weakness on abduction
Infraspinatus weakness on external rotation

Positive impingement sing – Neers or Hawkings sign

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What test is this / what does is diagnose?

Adduct arm across chest –> PAIN

Crossover Test – AC Joint Injury
inflammation or arthritis

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What test is this / diagnoses what ?

IR and raise arm while compressing scapula –> PAIN

NEER’s impingement test
= ROTATOR CUFF TEAR

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What test is this / what does is diagnose?

shoulder and elbow flexed to 90 degrees and then IR arm –> PAIN

Hawkin’s Impingement Test
ROTATOR CUFF TEAR

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What test is this / what does is diagnose?

abduct arm with thumb down, ask patient to resist pressure –> weakness to resist

possible rotator cuff tear
EMPTY CAN TEST

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What test is this / what does is diagnose?

Abduct arm to 90 degrees and slowly lowering to side –> inability to slowly lower

DROP ARM TEST
possible rotator cuff tear

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a positive VALGUS stress test indicates

push from lateral to medial –> Pain

MCL Tear

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a postive VARUS stress test indicates

push from medial to lateral –> PAIN

LCL tear

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What test would indicate a potential ACL tear?

Lacmans test – pull anterior with knee 15 degrees

Anterior Drawer Test

pull anterior with knee 90 degrees –> increased excursion

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What test would indicate a possible PCL tear?

Posterior Drawer

push poterior with knee 90 degrees

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What test could check for a meniscal injury?

MCMURRAY Test

rotate and flex/extend – click or tenderness

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What test is this; **weakness on thumb abduction is a positive test** | CARPAL TUNNEL

Finkelstein's Test

you are tapping lightly over the course of the median nerve in the carpal tunnel for **median nerve compression** ... what are you testing for

TINEL SIGN

# WHAT TEST IS THIS hold hands at right angles with wrist flexed and hold for 60 seconds --> reproduces symptoms

Phalens Sign

What are the **nodules on dorsal DIP** called?

HERBEDEN's Nodes

What are the **nodules on dorsal PIP** called?

Bouchard's Nodes

**RA = fusiform/spindle shaped swelling** is most common where?

Acute = PIP Chronic = MCP and PIP | fingers may deviate toward ulnar side

# Name the deformity hyperextended PIP flexed DIP

SWAN NECK

# name the deformity hyperextended DIP Flexed PIP

Boutonniere

**THENAR** atrophy vs **HYPOTHENAR** atrophy

Carpal tunnel syndrome -- THENAR Ulnar nerve compression -- HYPOTHENAR

**tenderness over anatomical snuffbox** **increased risk of avascular necrosis of scaphoid bone** what do you suspect!

Scaphoid Fracture

# What disease! tenderness over the extensor pollicis brevis and abductor pollicis longus tendons | Finkelstein test tuck thumb inside first - ulnar wrist deviation = pain

De Quervian tenosynovitis

primary hip flexor =

iliopsoas

primary extensor of the hop =

gluteus maximus

**Genu Varum vs Genu Valgum**

VARUM = BOWED Legs VALGUM = KNOCK Knees | Genu Recurvatum = Back Knee - extend past normal

How do you **test** **acuity of central vision**?

Snellen Eye chart Rosenbaum -- also tests near vision

# Visual Acuity Recording First number indicates Second Number indicates

First # = distance from eye to chart 2nd # = distance at which normal eye can read letters

**Legally Blind** acuity recording =

20/200

SO4 LR6 Rest are 3

swelling of optic disc due to increased intraocular pressure (glaucoma) =

papilledema

What is the **normal cup:disc ratio**

0.3

When looking at a patient with **hypertension** using a **funduscope**, the arteries appear ...

NARROW Arteriovenous Nicking Copper wiring of arterioles Cotton Wool Spots

When looking at a patient with **diabetes** using a **funduscope**, you notice ...

Neovascularitzation Microaneurysms

Patient presents with **diffusely red eye, painful, decreased vision** **Ciliary injuection** = dilation of deep blood vessels

Uveitis (Iritis)

patient with **narrow angle glaucoma**, has **increased pressure** in their eye due to what?

decreased drainage of aqueous humor

You suspect your patient has **Marcus Gunn Pupil**, you swing your flashlight into the **abnormal** eye and you see what? | afferent pupillary defect

Dilation of both pupils

You are conducting a **flashlight test** on a patient with **syphillis** you observe ...

small irregular pupils that accommodate (constrict) but dont react to light

**misalignment** of the eyes =

hypertropia

unequal pupil size

anisocoria

irregular curvature of cornea/lens blurry vision

Astigmatism

loss of lens elasticity causing decreased ability to foucs on near objects seen with aging

Presbyopia

What clinical **triad** is seen with **Horner's Syndrome**? | damage to reticulospinal fibers

Ptosis Miosis Anhidrosis

sudden onest, "**thunderclap", worst headache of my life** can be indicative of ...

Subarachinoid hemorrhage

lazy eye =

amblyopia

small bump in the eyeleid caused by a blockage of a ting oil gland

Chalazion | styes = hordeolum

**conductive loss** results from problems in what part of the ear?

External/MIddle Ear

**sensorineural loss** arises from problems in what part of the ear?

Innter Ear/Cochlear Nerve

When **bone conduction is longer than** or equal to air conduction it indicates what kind of loss | BC > AC

CONDUCTIVE loss

When **air conduction is longer than bone conduction**, it indicates what kind of loss? | AC > BC

Sensorineural Loss

musical ringing or a rushing or a roaring noise in one or both ears =

Tinnitus

drainage from the nose, often associated with nasal congestion, sense of stuffiness/obstruction

Rhinorrhea

Differences in hair with HYPERthyroidism vs. HYPOthyrodisim

HYPER -- FINE/SILKY Hair HYPO -- coarse/sparse hair

infection of the ear canal = | pain with auricle movement

Otitis externa

infection of middle ear | erythema, distortion/bulging of TM

otitis media

What test checks **conductive** and what checks **localization**?

RINNE Test -- conductive WEBER -- Localization

Where is the **Wharton's** duct located?

base of the tongue, ducts of the submandibular gland

**Proteinuria and Hematuria** are seen in **nephritic syndrome**, but only what is seen in **nephortic syndrome**?

Nephortic = proteinuria

defective articulation = | its a SPEECH disorder

dysarthria

language disorder =

dysphasia

disorder in producing or understanding LANGUAGE

aphasia

inability to perform particular purposive actions

APRAXIA

nonfluent aphasia =

BROCAS Aphasia | Broken Speech

Receptive/Fluent Aphasia =

Wernicke's Aphasia | word salad

Patient has wernickes aphasia, the location of the lesion is ...

Posterior Superior temporal lobe

Your patient has Broca's Aphasia, where is the location of lesion

Posterior Inferior FRONTAL lobe

inability or difficulty ambulating

ATAXIA

**Spasticity** **is increased resistance that worsens at the extremes of range**. This is seen in what type of tract diseases? | rate dependent, increasing with rapid movement

Corticospinal | rigidity is not rate dependent

**Bell's Palsy** is due to a **lesion** in what CN? | motor loss in both upper and lower face

CN VII

Patient is **unable to close eyelids**, has **no facial expression**, **facial droop**, and **cant raise eyelids**. You suspect ...

Bells Palsy

3 **superficial** reflexes

Abdominal, Plantar and Anal

# Test for Meningitis flex hip and knee --> NECK PAIN

Kernig Sign

# Test for meningitis Flex neck --> bending of knee

Brudzinski's Sign

the common causes of **great toe dorsiflexion weakness** are due to what nerve palsy?

Peroneal nerve palsy (failing to actively extend the ankle) or an L5 radiculopathy (isolated toe problem)

abnormality of rapid alternating movements indicates ....

dysdiadochokinesis

When theres an abnormality in point to point movements ...

dysmetria

brief, rapid, jerky, irregular movements | Ex: Sydenham's

CHOREA

twisting, writhing choreiform movements | cerebral palsy

Athetosis

3D's

delirium depression dementia

this system classifies **newborn neurologic recovery from birth and immediate adaptation** to extra uterine life

APGAR score

this scoring system **estimates gestational age to within 2 weeks, even in extremely premature infants**

Ballard Scoring System

ability to selectively and progressively shut out negative stimuli | repetitve sound

HABITUATION

standard to measure developmental milestones throughout infancy and childhood

Denver Developmental Screening Test | personal social, fine motor-adaptive, language, gross motor

blue discoloration of hands and feet in the cold

Acrocyanosis

fine, downy hair growth over body at birth

Languo

smooth, white, raised areas without erythema due to sebum retention in sebaceous gland opening

Milia

dark, bluish pigmentation over buttocks and lumbar region that disappears during childhood

Mongolian Spots

When do anterior and posterior fontanelles close?

Posterior = 2 mo Anterior = 4-26 mo

**Enlarged fontanelle** is seen in what **congenital** problem?

congenital hypothyroidism

**Bulging fontanelle** can be seen with what pressure issue?

INC intracranial pressure

if jaundice happens within the first 24hrs of birth, it may be due to what?

Hemolytic disease | 2-3 weeks after -- biliary osbtruction/liver disease

newborn swelling over **occipito-parietal region** crosses suture lines | resolves in 1-2 days

Caput succedaneum

newborn **sub-periosteal hemorrhage** does NOT cross suture lines | resovles within 3 weeks

Cephalohematoma

pre-mature closure of cranial sutures --> abnormally shaped skull

Craniosynostosis

tiny white or yellow, **rounded muscous retention cysts** are locaated along the **posterio midline of the hard palate**

Epsteins Pearls

# Test for signs of hip dysplasia test for relocating posterior dislocated hip | baby supine -- flex/abduct hip -- movement of fem head back into place

ORTOLANI TEST

# test for signs of hip dysplasia tests for ability to subluxe or dislocate an intact, unstable hip | baby is supine, flex and ADDUCT hip

barlow test

until what age is a positive babinksi response normal

2 yo

decreased arterial perfusion to peripheral tissues is caused by | hair loss over LE, pain w/exertion, muscle atrophy

atherosclerosis

What test can be used in the diagnosis of DVT of the leg

Homan's Sign

What test is used to ensure the patency of the ulnar artery before puncturing the radial artery for blood samples

ALLEN Test

PDX 2 Flashcards

(113 cards)