Physical Diagnosis 1 Flashcards
(105 cards)
1
Q
Winged Scapula
A
paralysis of serratus anterior via long thoracic n.
2
Q
ROM Shoulder Testing
A
Active and Passive
- Forward Flexion/Extension
- Abduction/Adduction
- Internal/external rotation
3
Q
rotator cuff function
A
Abduction: supraspinatus
External rotation: 20% teres minor, 80% infraspinatus
Internal rotation: subscapularis
4
Q
Painful Arc Test
A
- Tests for: Shoulder Impingement
- Positive: pain between 60 and 120 degrees
- DDx: subacromial impingement, rotator cuff tendonitis
5
Q
Neer’s
A
- Tests for: Shoulder Impingement
- Positive: pain w/ internal rotation. (90: mild, 60-70: moderate, 45: severe)
- DDx: supraspinatous impingement, rotator cuff tendonitis
6
Q
Hawkins
A
- Tests for: Shoulder impingement
- Positive: pain
- DDx: supraspinatus impingement, rotator cuff tendonitis
7
Q
External lag
A
- Tests for: rotator cuff tear
- Positive: inability to maintain external rotation
- DDx: supraspinatus pathology
8
Q
external rotation resistance
A
- Tests for: rotator cuff tear
- Positive: pain or weakness
- DDx: infraspinatus pathology
9
Q
Gerber Lift Off
A
- Tests for: Subscapularis tear
- Positive: inability to resist
- DDx: subscapularis pathology
10
Q
Empty Can (Jobe’s Test)
A
- Tests for: supraspinatus tear
- Positive: weakness or pain
- DDx: rotator cuff tear, tendinopathy
11
Q
Drop Arm Test
A
- Tests for: rotator cuff tear
- Positive: weakness, difficulty with smooth ROM
- DDx: rotator cuff tear, tendinopathy
12
Q
Apley Scratch Test
A
- Tests for: rotator cuff tear, adhesive capsulitis
- Positive: asymmetry in comparing ROM
- DDx: Rotator cuff pathology, labral pathology, arthritis, adhesive capsulitis
13
Q
Apprehension, relocation and release
A
- Tests for: Shoulder instability
- Positive: pain/apprehension relieved by relocation
- DDx: shoulder laxity, instability
14
Q
Sulcus sign
A
- Tests for: shoulder instability
- Positive: 2cm or more depression of humeral head
- DDx: inferior shoulder instability, subluxation
15
Q
Yergason
A
- Tests for: biceps tendon injury
- Positive: pain, popping, clicking
- DDx: biceps tendonitis, biceps subluxation
16
Q
Speeds
A
- Tests for: biceps tendon injury
- Positive: pain
- DDx: biceps tendonitis
17
Q
Cross-body adduction
A
- Tests for:
- Positive:
- DDx: AC pathology
18
Q
O’Brien’s Test
A
- Tests for: Labral, AC, biceps injury depending on location
- Positive: pain
19
Q
Elbow ROM and Strength testing
A
Passive and active:
- Flexion/Extension
- Supination/pronation
- Radial/Ulnar deviation
20
Q
Epicondylitis
A
- golfer’s elbow: medial epicondyle with flexion
2. tennis elbow: lateral epicondyle with extension
21
Q
Olecranon bursitis
A
- Inflammation of bursa w/ fluid accumulation
2. pain suggests trauma or infection
22
Q
Tinel’s sign at elbow:
A
- Cubital Tunnel Syndrome (percuss ulnar nerve)
2. Positive: shooting electric sensation or paresthesia over ulnar n. distro
23
Q
Subcutaneous Nodules (forearm)
A
- suggests gouty tophi, rheumatoid arthritis
24
Q
Colles’ Fracture
A
- Distal radius fracture
2. Dinner fork deformity
25
Carpal Tunnel Syndrome
1. median n. compression
| 2. results in neuropathy, paresthesias, thenar atrophy
26
Tinel's sign at wrist
1. Tests for carpal tunnel syndrome, palpation of median nerve with extended wrist
2. Positive: shooting electric sensation, paresthesia in median n. distro
27
Phalen's Test
1. Carpal tunnel Syndrome
| 2. Positive: paresthesia in the distro of median n.
28
de Quervain's Tenosynovitis
1. inflammation of 1st dorsal compartment involving abductor pollicis longus and extensor pollicis brevis
2. Caused by overuse, gripping
29
Finkelstein Test
1. test for de Quervain's
| 2. positive: pain along 1st dorsal compartment
30
Ganglion cysts
1. dorsal radial and volar aspects of wrist
2. palpate for soft mobile mass
3. may restrict motion or become painful
31
anatomic snuffbox palpation
1. test for scaphoid fracture
32
Radial deviation of hand
1. test for osteoarthritis
33
ulnar deviation of hand
1. test for rheumatoid arthritis
34
Swan Neck
1. hyperextension of PIP joints with fixed flexion of DIPs
35
Boutonniere
1. Flexion of PIP joint w/ hyperextension of DIP
36
Heberden's nodes
1. Degenerative osteoarthritis
| 2. on DIPs
37
Bouchard's nodes
1. swelling of PIP, RA
38
Neuro check of hands
1. brachial pulse
2. radial pulse
3. sensory over radial n. (over post. thumb)
4. sensory over median n. (distal ant. digit 2)
5. sensory over ulnar n. (distal ant. digit 5)
6. Motor of median: "ok" sign, opposition
7. motor of ulnar: extend digits, cross digit 2 over digit 1
8. motor of radial n.: flex fingers w/ thumb abducted.
39
CN V tests
1. Sensory: light touch over ophthalmic, maxillary, mandibular nn.
2. Motor: palpate masseter
40
CN VII tests
1. facial symmetry w/ eyebrows raised, eyes squeezed shut, puff out cheeks, smile
41
Temporal a. auscultation
1. bruits indicates giant cell (temporal) arteritis
- adults over 50
- jaw claudication
- elevated ESR
- polymyalgia rheumatica
42
Rosenbaum pocket chart
1. screens for presbyopia (impaired near vision)
| 2. bedside screen @ 14 in.
43
EOMs
LR6, SO4, AO3
LR: CN 6
SO: CN 4
All others: CN 3
44
Corneal Light Reflection
tests for conjugate gaze, strabismus
45
Ptosis
1. Eye droop, CN III problem
| 2. Incomplete closure CN VII problem
46
Chalazion
nontender, blockage of meibomian gland, points inside lid
47
Hordeolum
1. tender, margin of eyelid, Staph aureus
2. Inner eyelid = meibomian gland obstruction
3. outer eyelid - obstructed follicle or tear gland
48
Dacrocystitis
1. lacrimal sac inflammation between base of nose and eye
49
Entropion v. Ectropion
Lid eversion
Entro: inward, ectropion, outward
50
Pingueculum vs. Pterygium
Pingueculum: growth of bulbar conjunctiva, harmless
Pterygeum: triangular thickening of bulbar conjunctiva, may impair vision
51
Xanthelasma
raised, yellow cholesterol filled plaques around eyelids
assoc. w/ hyperlipidemia
52
exophthalmos
eyeball protrusion, grave's disease
53
Episcleritis
localized ocular inflamation of episcleral vessels, usuall around central nodule
assoc. w/ autoimmune
54
Subconjungtival hemorrhage
1. Hx of strain, blood thinner use
| 2. harmless bleeding in conjunctiva
55
Hyphema
blood visible in anterior chamber, emergent.
56
Hypertensive vascular changes in eye
1. Copper wire: tortuous vessels w/ increased light reflex
2. Silver wire: vessel wall opaque, stenosis, no blood visible
3. AV nicking: appears as break in vein when artery and vein cross
57
Hypertensive retinopathy
1. Cotton Wool Patches: white lesions w/ irregular borders.
| 2. Hemorrhage: microaneurysm
58
Diabetic retinopathy
1. visible neovascularization
| 2. hard exudates appear creamy/yellow/bright
59
Detached retina
1. curtain like shadow over vision, floaters, flashes
60
Papilledema
sharp borders of disc no longer present
HA, NV may be present
61
Strabismus
1. esotropia: light displaced laterally
| 2. exotropia: light displaced medially
62
Corneal Reflex
CN V sensory and CN VII motor. Tests blink reflex
63
Weber Test
Normal: sound in both ears equally
Abnormal: Lateralization
- conductive loss: lateralization to bad ear
- sensoneural: lateralize to good ear
64
Rinne Test
Compares air and bone conduction
1. normal = AC > BC
2. BC > AC = conductive loss
3. AC > BC = normal or sensorineural loss
65
Ear: Serous effusion w/ air bubbles
indicative of barotrauma or viral URI
66
Common area of epistaxis
Kisselbach's plexus, 90% of epistaxis
67
Septal hematoma
All nasal trauma must rule out septal hematoma
increased nasal obstruction, pain tenderness
common in peds following trauma
68
Rhinitis/sinusitis types and findings
AR: swollen, pale blue, boggy turbinates. Shiners, eye sxs
Sinusitis and URI: erythematous turbinates
Sinusitis: tenderness to palpation
69
torus palantinus
benign midline mass in hard palate
70
Group A Strep
1. ST, fever, known exposure
2. no cough, congestion or fatigue
3. bilateral exudative tonsillitis
71
Epstein Barr
1. ST, fever, fatigue
2. bilateral exudative tonsillitis
3. slight splenomegaly
72
Peritonsilar abscess
1. unilateral peritonsilar swelling and shifted uvula
| 2. hot potato voice, drooling
73
Lymph node examination
small, mobile, nontender nodes are common
74
Goiter
1. enlarged thyroid
2. multiple forms of thyroid dysfunction
3. palpation while pt swallows
75
Cells of epidermis
1. keratinocytes
2. melanocytes
3. merkel cells
4. langerhans cells
76
Terms for distribution of lesions
1. localized: one small area
2. regional: specific region of body
3. disseminated: widely distributed in multiple areas
77
Terms to describe shape or arrangement
1. round/discoid: coin shaped, no central clearing, umbilicated
2. Oval: ovoid, found w/ pityriasis rosea
3. Annular: round, active margins w/ central clearing
4. Dermatomal
5. target
6. linear
7. serpinginous
8. morbilliform: measles like
78
Terms to describe borders
1. distinct: well defined
2. indistinct: border merge w/ normal skin
3. irregular
4. Raised
79
Terms to describe color
1. flesh colored
2. erythematous: red
3. violaceous
4. tan-brown
5. black or blue-black
6. hyper/hypopigmented
80
Macule
flat, non palpable
less than 1cm
81
patch
flat, non palpable
greater than 1 cm
82
papule
elevated, palpable, firm, circumscribed
< 1cm
83
Plaque
elevated, palpable, firm, circumscribed
> 1cm
84
Nodule
elevated, circumscribed, deep, firm
> 1.5 cm
85
tumor
Large nodule deep in dermis
>2 cm
86
Wheal
irregular, transient, superficial edema
87
Vesicle
elevated, well circumscribed, fluid containing
< 1cm
88
Bulla
elevated, well circumscribed, fluid filled
> 1cm
89
Pustule
Elevated, superficial, well circumscribed, pus filled
90
Petechiae
< .5cm, non blanchable, variable distro
91
purpura
> .5 cm, non blanchable, variable distro
92
Ecchymosis
purple lesion, blood outside vessels due to trauma or disorder
93
Spider angioma
blanchable, face, neck, arms, upper trunk
seen w/ liver disease, pregnancy
94
Cherry angioma
bright red papule, 1-6mm in size
non blanchable
95
Hemangioma
benign vascular neoplasm common in infancy
spontaneous involution by age 5-10
96
Papulosquamous lesions
1. papules, plaques, scales
97
Benign nodular lesions
1. nevi, cherry angioma, epidermoid cyst
98
Malignant nodular lesions
1. SCC, BCC
99
Vesiculobollous lesions
1. vesicles and bullae
| 2. impetigo, herpes, pemphigus
100
Maculopapular lesions
1. macules, papules
| 2. viral exanthems, drug eruptions
101
Beau's lines
transverse depressions in nail secondary to trauma or acute illness
102
Onychocryptosis
ingrown nail, nail grows into dermis, can be infected
103
terry's nails
mostly white with a distal band of reddish brown
"ground glass" appearance
104
leukonychia
trauma caused white discoloration
105
koilonychia
spoon nail
