2nd semester exam Flashcards
Frontal lobe
voluntary movement, personality, though, insight, judgment; speech
Parietal lobe
primary sensory cortex
Temporal lobe
memory, sensory integration, and hearing
Occipital lobe
primary vision cortex
Cerebellum
coordination of voluntary movements and balance
Brain stem
relay for ascending and descending tracts, cardiorespiratory center
spinal cord
conduit for ascending and descending tracts, reflex activity
Basal ganglia
automated movements
Thalmus
primary sensory relay
hypothalamus
temp, sleep, emotion, pituitary fxn
Corticospinal tract
voluntary muscle movements that originate in motor cortex
Extrapyramidal tract
maintain muscle tone and gross automated movements
cerebellar tract
coordination of movement; maintenance of equilibrium
spinothalamic tract
sensations of pain, temp, light tough
posterior columns
position sense, vibration, and discriminative touch
how many spinal nerves
31: 8- cervical 12- thoracic 5- lumbar 5 - sacral 1 - coccygeal
dysarthria
problem with motor speech
dysphonia
weak breathy voice
expressive aphasia
comprehension intact; can’t speak
Receptive aphasia
comprehension not intact; can speak
global aphasia
combo of receptive and expressive aphasia
apraxia
inability to follow commands
Praxis: ability to follow commands
agnosia
inability to recognize sensory stimuli
Biceps Reflex
C5, C6
Triceps Reflex
C7, C8
Patellar Reflex
L3, L4
Achilles Reflex
S1, S2
dysdiadokinesia
inability to do Rapid alternating movements:
slow & regular = cerebral dysfxn
Fast & irregular = Cerebellar dysfxn
dysmetria
consistent past-pointing, consistent with cerebellar disease
Amelia
Complete absence of a limb
Meromelia
partial absence of a limb
Special Test: Phalens
Hold posterior of hands together (+) if numbness or tingling
Special Test: Tinel
percuss over median nerve at wrist (+) tingling
Special Test: Thomas Test
pt supine, one leg extended and other flexed with knee to chest- assess patient’s ability to keep extended leg flat on table-
detects flexion contractures of the hip
Special Test: Trenelenburg
pt to stand on one leg then the other; note asymmetry in iliac crest; if iliac crest drops on side of lifted leg, hip abductor muscles on the weight-bearing side are weak- detects weak hip abductors
Valgus
Angulation of the distal extremity away from midline = Y legs
Varus
Angulation of distal extremity toward midline = Bow legs
Somatic Pain
Sharp, localized pain on the surface
Visceral Pain
Poorly localized, varies in quality and severity
Parietal Pain
Severe, steady and localized
pain worse with pressure/movement
Referred pain
constant ache
Hamburger sign
Are you hungry? if pt doesnt want to eat favorite foods then consider appendicitis
Tenesmus
Spasm of anal sphincter, feeling of incomplete BM
Jaundice
right upper quadrant pain, confusion or AMS, bleeding gums, back pain, dark urine
Clubbing
crohn’s, celiac disease, malabsorption
Palmar erythema
liver disease
Asterixis
hepatic encephalopathy & kidney disease
hyperextended fingers and release - (+) is slow flap
Xanthelasma
yellow lid plaques
cirrhosis or biliary obstruction
Kayser-Fleischer rings
Brown-yellow corneal rings - wilson’s disease
Panniculus
Fat belly over pubis
Abdominal mass in rectus abdominus
more prominent when muscle contracted
ventral hernias
Purpura - Abdomen
Hypersplenism
impaired clotting
Spider Nevi
Liver disease
looks like a firework
Cullen’s sign
discoloration around umbilicus due to bleeding
Pancreatitis
ectopic pregnancy
Grey-Turner’s sign
Blue discoloration of the flanks - caused by acute, severe pancreatitis
Capust Medusa
engorged veins across abdomen - portal HTN
Borborygmi (sound)
Growling
Markle Sign
Heel Jar test
Murphy Sign
Pt will stop inspiring due to pain when feeling for liver edge
gallbladder or liver inflammation - acute cholecystitis
Castell’s Sign
Spleen palpation
negative if cannot feel spleen
Dyspepsia
heart burn
recurrent discomfort or burning pain centered in upper abdomen
Peritoneal inflammation
Abdominal pain coughing upon light percussion
Phimosis
tight skin that cannot be pulled back from head of penis
Paraphimosis
foreskin cannot be pulled over penis - emergency
Tanner stages
1: childhood size
2: Scrotum enlarges & reddens
3. penis gets longer
4. penis gets thicker
5. adult size
Angiokeratoma of Fordyce
Vessicles have come to the surface - blanchable
normal - may bleed
if unilateral or rapid look for pelvic mass
Balanitis
candida infection on penis
Hypospadias
When urethra is on bottom of penis
Peyronie’s Disease
Fibrosis of Turnica Albuginea with painful penile deviation when erect
Hydrocele
increased fluid in scrotal sac
Breast Arterial Supply
Off internal mammary arteries
lateral thoracic artery
Breast Nerves
Long thoracic - innervates serratus anterior
abducts and laterally rotates scapula
Thoracodorsal nerve: in axilla and innervates latissimus dorsi: adducts, extends, medially rotates arm
Medial Pectoral nerve - innervates pectoralis major and minor
breast exam guidelines
every 3 yrs from 20-39
mammogram guidelines
Every 2 yrs from 50-74
Fibroadenoma
fine, round, mobile, nontender
age 15-25
Cysts
Soft to firm, round, mobile, non tender
age 25-50
Fibrocystic changes
nodular, ropelike
DEXA scan
once at 65 and repeat if necessary
PAP smear
every 3 yrs starting at 21 -29 or 3 yrs after 1st intercourse
PAP w/ HPV every 5 yrs age 30-65
stop PAP but not pelvic exam at 65 if 3 consecutive normal results
identifies cervical cell changes that are present
HPV
identifies virus that may cause changes before changes occur
Menopause
absence of menses for 12 months
age 48-55
Dysmenorrhea
pain with menses
Post - coital
bleeding after intercourse
Amenorrhea
absence of mentrual period
Oligomenorrhea
infrequent menses
>35 day interval
Hypomenorrhea
light, regular bleeding
Polymenorrhea
menses too often
<21 day interval
Menorrhagia
heavy menses
>80ml of blood
Menstrual bleeding
25-80 ml of blood loss
Metorrhagia
Intermenstrual bleeding
Menometrorrhagia
Heavy menses at irregular or more frequent intervals
GP (FPAL)
G = # of pregnancies F= full term (>36wks) P=preterm pregnancies A = abortions or miscarriages L = number of living children
most common hernia in women
Indirect inguinal
Uterine Myomas (Fibroids)
common benign tumors
single or multiple
Prolapsed uterus
weakened pelvic floor muscles
associated with cystocele or rectocele
cystocele
bladder pushes into vaginal wall
cystourethrocele
entire anterior vaginal wall, bladder, and urethra is involved
Rectocele
herniation of rectum into posterior vaginal wall
Bacterial Vaginosis
Clue cells on wet mount
