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Advanced Health Assessment > Quiz 3 > Flashcards

Quiz 3 Flashcards

(56 cards)

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1
Q

correct position for prostate exam

A

Sims (side lying) position

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2
Q

digital rectal/prostate exam, what area of prostate palpating?

A

posterior aspect

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3
Q

what should normal prostate feel like

A

rubbery and smooth

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4
Q

how do you know rectal prolapse

A

see sliding of rectum, especially when straining during BM or bearing down

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5
Q

external hemorrhoid appearance

A

external= small mass, PINK or red/beefy normal. Purple/dark is concerning (thrombos hemorrhoid) and is more urgent, need hemorrhoidectomy

pts will feel like they’re sitting on something

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6
Q

internal hemorrhoid feeling/sx

A

blood in stool
rectum= soft mass inside/protrusion. Patient may feel like “grapes” are inside

HARD= concern

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7
Q

causes of rectal bleeding

A
  • hemorrhoid
  • cancer (change in bowel habits, pain, blood) need f/u
  • fissures (from constipation, etc)
  • colitis/inflammation/infection of bowel (Crohn’s, c-diff, etc. bleeding to be expected)
  • GI bleed (lower= bright red, upper= black/tarry)
  • medications (NSAIDs, ASA)

Tylenol, iron, thyroid supp. DO NOT cause bleeding

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8
Q

sequence of MSK exam

A

inspect, palpate, passive then active ROM, stability tests, specialized tests

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9
Q

normal changes with aging in MSK

A

-joint stiffness pain
-osteoarthritis risk
-increased bone resorption so not as much surface area= instability
decreased ROM

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10
Q

joint symmetry technique

A

INSPECT and compare both sides

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11
Q

assess for joint effusion

A

palpate
soft, spongy feeling

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12
Q

Tinel test

A

It is performed by lightly tapping (percussing) over the nerve on ulnar side to elicit a sensation of tingling or “pins and needles” in the distribution of the nerve.

Tells you if medial nerve is involved in carpal tunnel

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13
Q

Phalen test

A

inverse praying hands, if pt gets tingling then= compression of carpal tunnel nerve

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14
Q

Lachman test

A

stability testing that looked for ACL tear

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15
Q

characteristics of osteoarthritis

A

heberden nodes
distal joints
enlarged joints

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16
Q

characteristics of rheumatoid arthritis

A

buchards nodes
proximal joints

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17
Q

risk factors for OA

A

old age
family hx
vitamin D deficiency
smoking
obesity
previous joint injury (runners, overuse)

DECREASED risk w/ more active lifestyle (nonimpact,
not overuse bc overuse=risk)

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18
Q

tests that will look at meniscus

A

MRI
McMurrays

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19
Q

McMurray

A

internal & external rotation of knee to see if any laxity to test for meniscus tear

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20
Q

infant test for hip displasia

A

ortolani and barlow tests

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21
Q

dx plantar faciitis

A

pain to base of heel, bottom of arch
pain worse in MORNING before stretch ligament then worse right at night before bed

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22
Q

tests for rotator cuff tear

A
  1. Neers test (raise arm=tingling/pain)
  2. drop arm test (no strength to hold arm up against gravity)
  3. Hawkin’s test (can barely push against resistance when abduct shoulder)

decreased ROM
traumatic or atraumatic
reduced strength

tx= sling, rest, ROM/PT, maybe surgery

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23
Q

sx spinal stenosis

Study These Flashcards
A

*pain w/ walking and standing upright

24
Q

OA vs RA

Study These Flashcards
A

OA= joint enlargement, localized weakness

RA= not overuse injury so doesn’t improve if rest joint, atrophy of muscles

25
scolioisis dx
bend over and look for lateral curvature of spine when standing upright, shoulders will be uneven
26
red, swollen joint dx
infection (septic arthritis) vs gout mobility is biggest difference. infection will COMPLETELY inhibit ROM, gout will be painful but will still move SV fluid tap is most definitive to dx infection
27
gout
distal, small joints uric acid
28
shoulder injury tests
empty can test (adduct test, thumbs down, reduced strength) drop arm test hawkins (abduct)
29
strength grading
0-5 * 0= no movement (paralysis) 1= movement but just flicker of muscle 2= movement not against gravity 3= movement against gravity 4= weakness against resistance *5= full strength against resistance
30
ROM positions
flexion= towards body extension= out from body abduction= away from body adduction= toward body supination= upward (palms up) pronation= downward
31
goals sports physical
risk of injury CV (*murmur), MSK (bones/joints), *sensory (vision, hearing etc), congenital anomalies NOT looking for= Nose, throat, focussed. (PND etc)
32
functional assessment older adult
ADLs (can they perform?) make sure living conditions compatible with physical ability GROSS motor movement not strength DONT care about- able to move heavy boxes, etc. only basic ADLs
33
normal gait for older adult
slower, balance, field shoulder width apart, regular arm swing, even step NOT shuffling
34
neuro sequence
NO auscultation, palpation, percussion *inspect & special tests #1 mental status, CN (2-12), sensation (upper/lower), strength (upper/lower), coordination (rapid alt. movements), reflexes, gait, skull & spine general inspection
35
CN
1= sensory (olfactory- smell something) 2= sensory (optic nerve- visual acuity/confrontation) **3= motor (medial up/lateral down EOM) **4= motor (trochlear (down/medial) EOM) 5= both motor/sensory (trigeminal- face sensation and chewing) **6= motor (abducens, LATERAL*, EOM) *7= both (facial nerve taste, motor *smile, raise eyebrows) 8= sensory (auditory) 9/10= both (gag reflex (not in awake adult), glossopharyngeal, vagus, uvula rises, swallowing, taste) **11= motor (shoulder shrug, accessory) 12= motor (turn head against resist, hypoglossal move tongue side to side)
36
normal/abnormal neuro in aging
normal= sensory deficits (touch, taste, hearing, eyesight) abnormal= motor and cognition deficits
37
testing equilibrium
*Romberg= stand w/ eyes closed, feet together, arms by side should be able to keep balance without swaying
38
DTRs
upper= bicep, brachioradialus, tricep lower= patellar, ankle
39
deficit in lumbar spine, where decreased DTR?
patellar
40
deficit in cervical spine where decreased DTR?
higher cervical= tricep/bicep lower= brachioradialus
41
dermatome levels
sensory test & if concerned about CNS; most often unilateral thumb= C6 radial aspect 2nd/3rd (middle) fingers= C7 ring finger/pinky= C8
42
proprioception-what is it and how to test
awareness of body position in space have person close eyes, you move their toe up/down and see if they know position
43
graphesthesia
type of proprioception test draw in palm and pt tells you what you drew
44
stereognosis
type of proprioception test ID object in hand
45
2 point discrimination
how long it takes to feel two different points
46
concerning findings meningitis
neck pain unable to touch chin to chest (*nuccal rigidity) fever n/v HAs altered mental status kernig sign= lay flat, lift leg causes pain in neck brudzinski sign= can't flex knees and neck at same time, wont be able to, so lay flat lift head up and they will try to bend knees
47
straight leg test
spinal stenosis with radiculopathy (irritation of nerve root) lumbar root irritation lay flat, lift leg up, shooting pain down other side
48
tension HA
band like, tight, across head, squeezing
49
migraine
unilateral, n/v, photophobia, stabbing, throbbing, pulsing
50
cluster HA
behind one eye, severe pain, lacrimation
51
parkison's s/s
shuffling gait pill rolling finger movements tremors
52
altered MS change older adult
*** have to r/o organic causes of altered mental status changes older adult (metabolic etc) dementia r/o comes after
53
reflexes in pediatrics
normal= babinski (toes flare/opposite for adult), rooting reflex (stop 4 months), startle reflex
54
sequence of physical exam
head to toe document by system
55
best way to get dx ddx
subjective & objective data, come up with dx and ddx, THEN order tests that confirm/refute, use test results to make ultimate dx
56

Advanced Health Assessment (3 decks)

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