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OSPE > Systems > Flashcards

Systems Flashcards

1
Q

CNS
CN1
name and tests

A

Olfactory
ask about smell and taste being affected

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2
Q

CNS
CN2
name and tests

A

Optic
visual field test =
nasual: P. covers eye across and follows my finger
Temporal: Hand over same side

peripheral vision decreased can be from glaucoma

Light test:
Both pupils should constrict. if they dont = loss of consensual pupillary light reflex. f only one eye constricts could be Horners syndrome

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3
Q

CNS
CN3
name and tests

A

Oculomotor

H test: follow my pen

looking down tests for the CN4 trochlear
looking up lat tests for CN6 abducens

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4
Q

CNS
CN5
name and test

A

Trigeminal - sensory and motor

Sharp/soft test - sensory

Motor test - V3 mastication test. holding face as P chews

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5
Q

CNS
CN7
name and test

A

Facial - sensory and motor

Facial expressions:
smile
puffed cheeks - i apply pressure
eyes closed - i try open them
surprised face

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6
Q

CNS
CN8
name and test

A

Vestibular - hearing and balance

webers test - tuning fork.
bone conduction on forehead and is sound the same in both ears

Rinnes test - bone conduction on mastoid process. Air conduction - hearing the sound on each ear

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7
Q

CNS
CN9/10
name and test

A

glossopharyngeal and vagus

listen to voice - hoarse/whispered
swallowing test - water
uvala deviation - “awww”
gag reflex - ask

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8
Q

CNS
CN11
name and test

A

Accessory (motor)
restrict scm and trapezius

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9
Q

CNS
CN12
name and test

A

hypoglossal - motor

tongue test:
out
protrusion - tongue to cheek and i push

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10
Q

GIS
Observe

A

Nails: clubbing, can be signs of:
IBS, liver disease
Gastrointestinal tumours
Triple A (AAA)
Cystic and pulmonary fibrosis

Arms: out and hands up. Look for flapping. can be signs of:
liver failure
cardiac/rental failure

Eyes: pull down lids
look for yellowing = pallor and jaudice

Mouth:
Ulcers and pear drop smell = T1/2D
Tongue can show signs for iron, b12 and folate deficiencies if very smooth.

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11
Q

GIS
Considerations for abdominal pain

A

Site
nature of pain
speed of onset
progression
associated features

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12
Q

GIS
Palpation

A

Neck:
stand behind P as they sit and palpate neck for lymph nodes, enlargement can indicate stomach flu

Abdom:
P supine. applying pressure around tummy, asking P for any pain or discomfort. slowing go deeper.

Percussion - liver, spleen (dull), kidney, bladder, aorta

Auscultation - bowel sounds

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13
Q

GIS
conditions

A

Pancreatitis - inflamed pancreas
UTI - infection
Crohn’s disease - inflamed gut
Appendicitis - inflamed appendix
diverticular disease - bulges in intestine = inflamed

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14
Q

GIS
what can i be feeling around stomach

A

guarding - reflex contraction of muscles from pain / inflammation

rebound tenderness - pain caused by sudden withdrawal of pressure. can suggest inflamed visuc. ruptures eg in appendicitis

rigidity - spasm of muscles

sunken abdomen, profound weight loss

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15
Q

GIS
palpation location and possible mass causes

A

top right = liver, gall bladder, kidney

middle top = transverse colon, stomach, pancreas, AAA

top left = spleen, colon, stomach

low left = inflammatory bowel, colon cancer, loaded colon, ovary

middle bottom = bladder, uterus

bottom right = appendix, inflammatory bowel mass, ovary

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16
Q

CVS
observe

A

Breathing: breathlessness, anxiety

Hands: redness, swollen, colour (anaemia), tar stains (smoker)

Eyes: arcus (ring around eye = high cholesterol), anaemia (pale), jaudice (yellow, kidney issues).

Face: mular flash (purple/red rash on cheeks, can be low cardia output)

17
Q

CVS
Pulse

A

Rate - 60/90 per min

Rhythm - regular, irregular

Feeling for collapsing radial pulse:
elevated arm, holding radial pulse and feeling for throbbing

Areas:
radial = wrist
femoral = groin
popliteal = knee
ankle
carotid = neck

18
Q

CVS
BP

A

120/80 healthy
increases with age

put on cuff
hold radial pulse
inflate
slowly let go
note the number when i cant feel pulse
listen on brachial artery
inflate
slowly set go
note when i can hear pulse (SYSTOLIC )
slowly keep getting go
note when i cant hear pulse (DIASTOLIC), will also flicker

Low = dehydration, internal bleeds, medication (antidepressants), diabetes, infections, pregnancy

High = coronary heart disease, diabetes, kidney diseases, hyper/hypothyroidism, stress. medication = the pill, steroids, antidepressants. overweight, high alcohol

19
Q

CVS
BP

A

120/80 healthy
increases with age

put on cuff
hold radial pulse
inflate
slowly let go
note the number when i cant feel pulse
listen on brachial artery
inflate
slowly set go
note when i can hear pulse (SYSTOLIC )
slowly keep getting go
note when i cant hear pulse (DIASTOLIC), will also flicker

Low = dehydration, internal bleeds, medication (antidepressants/betablockers), diabetes, infections, pregnancy

High = diabetes, kidney diseases, hyper/hypothyroidism, stress. medication = the pill, steroids, antidepressants. overweight, high alcohol

20
Q

Auscultation of chest
name valves

A

MY TITS ARE PERFECT

Mitral - Left - mid clavicular line

Tricuspid - left sternum

Aortic - Left below manubrium, 3rn intercostal space

Pulmonary - Right, below manubrium, 3rn intercostal space

Listening for murmurs - change in blood flow. graded 1-6

listen for first pulse - closure of mitral and tricuspid valve

and second pulse should be softer and higher pitched - closure of aortic and pulmonary valve

21
Q

CVS
conditions

A

Dyspnoea - breathlessness
Aneurysm - bulge in artery
Palpitations
Syncope - fainting (vasovagal attacks, blood pooling)
Hypertension
angina - decreased blood to heat muscles

22
Q

PNS
movement and tone

A

ask patient to straight out arms and look for involuntary movement / tremors. caused by lesions of the basal ganglia

tone - flex and extend joints rapidly. assess tone. ankle would be leg rolling = look for spasticity (being from upper motor neurones / rigidity

23
Q

PNS
muscle power

A

i restrict a movement and compare each side

recrease can be from muscle wasting from inactivity

24
Q

PNS
reflexes location

A

tsp where the tendon is

Biceps jerk C5 C6 - lat cubital fossa

Triceps jerk C6 C7 - just above elbow

Supinator jerk C5 C6 - radial puzzle tat

Knee jerk L3 L4 - Just below knee

Ankle jerk L5 S1 - med achilles

25
Q

PNS
what is clonus

A

repetition of involuntary muscular contractions evoked by sudden passive stretch of muscle

can signify hypertonia of upper neurone lesion

26
Q

PNS
How to test clonus

A

sharply push patella towards feet

27
Q

PNS
Hoffmann reflex

A

support hand and flick down middle finger

+ = flexion of index finger and adduction of thumb = dysfunction of cervical segments of spinal cord - eg hyperthyroidism

28
Q

PNS
coordination tests

A

touching nose to my finger = + pass pointing = cerebellar disease

rapid movement, palm to backhand = + inability = cerebellar disease

heel to shin = + wavers away = cerebellar ataxia

29
Q

RSS
Obverse

A

chest: shape, breathing pattern

hands: clubbing of nails, tar strain. flapping tremors = Co2 retention, cardiac failure. Cyanosis (blue fingers) = circulatory failure

30
Q

RSS
Palpation

A

Trachea apex - tenderness
Chest expansion - both hands on a&p chest* - differences = asthma/copd

31
Q

RSS
Percussion

A

Ribs - intercostal space

upper 3/4 ribs

ribs 4-6 side lying

lower ribs on back

should be low pitched and hollow sound

32
Q

RSS
Auscultation (listening)

A

Tactile vocal fremitus =
P sitting saying 99, i feel so sound, comparing sides

Tracheal - very loud, highest pitch

Manubrium - bronchial sound, relatively high pitch

2rd intercostal space, next to sternum =
bronchovesicular = mid loudest, intermediate pitch

mid back P = vesicular sound = soft, low pitch

OSPE (11 decks)

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