signs, tests and classifications Flashcards
(39 cards)
rovsing’s sign
indicative of acute appendicitis
positive: palpation of the left lower quadrant of a person’s abdomen increases the pain felt in the right lower quadrant
homan’s sign
test for deep vein thrombosis (DVT)
the patient will actively extend their knee which will then be raised to 10 degrees, then passively and abruptly dorsiflexes the foot and squeezes the calf with the other hand
positive: deep calf pain and tenderness
chvostek sign
tests for hypocalcemia
positive: twitch of the facial muscles that occurs when gently tapping an individual’s cheek, in front of the ear (stimulating the facial nerve)
could also indicate kidney failure, acute pancreatitis, certain medications (e.g., bisphosphonates, proton pump inhibitors) or electrolyte imbalances, such as low levels of vitamin D and magnesium
trousseau’s sign
indicator of low calcium levels in the blood
put a BP cuff on the patient for 2-3 minutes to block the brachial artery
positive: flexion of the wrist, the thumb, and the joints located between the palm of the hand and the fingers (i.e., metacarpophalangeal joints), along with the extension of the fingers
mulder’s sign
test for Morton’s neuroma
positive: painful, palpable click when squeezing together metatarsal together (typically occurs between 3rd and 4th toes)
grey-turner’s sign
a sign of retroperitoneal hemorrhage or pancreatitis
positive: blue discolouration/bruising of the flanks
cullen’s sign
sign of acute pancreatitis
blue discolouration/bruising of the skin around the umbilicus
(caused by pancreatic enzymes that have tracked along the falciform ligament and digested subcutaneous tissues around the umbilicus)
murphy’s sign
tests for gallbladder inflammation (cholecystitis)
positive: pain on inspiration whilst palpating the right upper quadrant
prehn’s sign
used to determine whether testicular pain is caused by epididymitis or testicular torsion
performed by lifting one half of the scrotum
positive (epidiymitis): pain relieved
negative (testicular torsion): pain made worse
simmon’s test
test for achilles tendon rupture
positive: no plantarflexion on squeezing rested calf
coomb’s test
test for autoimmune haemolytic anemia
- direct Coombs’ test involves looking directly at red blood cells found in a sample of blood (aka direct antiglobulin test or DAT) and checks whether there are antibodies that have already attached themselves to RBC surface
- indirect Coombs’ test looks at the plasma (aka indirect antiglobulin test or IAT) and looks for antibodies in the bloodstream that aren’t attached to RBC’S but could
schober’s test
used to determine if there is a decrease in lumbar spine range of motion (commonly due to ankylosing spondylitis)
- mark the skin in the midline of the spine 5cm below and 10cm above the posterior superior iliac spine (or PSIS, this is approx L2)
- ask the patient to touch their toes to assess lumbar flexion
- measure the distance between the two lines
positive: < 20cm distance between 2 marks on flexion (less than 5cm increase)
schirmer’s test
test to diagnose dry eye syndrome
done by placing a strip of filter paper in the patient’s lower lid with their eyes closed for 5 minutes, before removing it and measuring the moisture on each side
positive: <10mm of moisture
FIT test
test to find early bowel cancer (faecal immunochemical test)
positive: faecal occult blood (FIT) >10 mcg Hb/g (doesn’t immediately confirm cancer as there are other causes of GI bleeding)
lachman’s test
test for laxity or rupture of the anterior cruciate ligament (ACL)
with the knee flexed 30 degrees, use your dominant hand to pull the tibia forwards on the femur while the other hand stabilises the femur
positive: significant anterior movementof the tibia on the femur
ipswich touch test
assess the extent of peripheral neuropathy
it consists of touching six toes and recording how many of the touches felt by the patient
buerger’s test
used to assess the adequacy of the arterial supply to the leg
with the patient positioned supine, stand at the bottom of the bed and raise both of the patient’s feet to 45º for 1-2 minutes, then swing legs over the bed
positive: goes pale when raised and very red after swinging over the bed
cough impulse test
test for varicose veins
place your hand over the saphenofemoral junction (2-3cm below and lateral to the pubic tubercle) and ask the patient to cough
positive: if you feel an impulse over the SFJ (indicates dilatation of the saphenous vein at the SFJ, suggesting varicose veins)
perthe’s test
used to distinguish between venous valvular insufficiency in the deep, perforator and superficial venous systems
apply a tourniquet at the proximal mid-thigh level whilst the patient is standing and ask them to walk around the room (or continually alternate between standing on tip-toes and flat feet) for 5 minutes
positive: varicose veins remain distended ore become more distended (suggests a problem with the deep venous system)
tap test
special test for varicose veins, assesses the lower limb venous valve competency
apply pressure to the saphenofemoral junction (SFJ) and tap the distal varicose vein
positive: thrill (suggests incompetent valve between VV and SFJ)
brodie-trendelenburg test
used to determine the competency of the valves in the superficial and deep veins of the legs in patients with varicose veins
finkelstein test
a test used in the diagnosis De Quervain’s Tendonitis
barlow’s test
test to identify congenital posterior sublimation or dislocation in infants
ortolani’s test
used to detect the presence of a dislocated hip in CDH (congenital diaphragmatic hernia)
