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NRS 410A/B EKGs/Pacemakers > 410C Quiz 2: Neuro Imaging/Hx, MSK Imaging, Rheum, Acid-Base, Simulation > Flashcards

410C Quiz 2: Neuro Imaging/Hx, MSK Imaging, Rheum, Acid-Base, Simulation Flashcards

1
Q

Shoulder Joints

A
  • Contains the scapula, humerus, clavicle, glenohumeral joint, acromioclavicular joint
    • glenohumeral is the actual shoulder joint
    • scapulothoracic joint is in the back → important for impingement injuries
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2
Q

Rotator Cuff General info

A
  • consists of SITS: supra spinatus, infra spinatus, teres minor, sub scapularis
    • impingement syndrome → most important muscle = supra spinatus muscle b/c it passes beneath the acromion
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3
Q

Y view of the shoulder

A
  • aka transcapular view b/c it shoots down the body of the scapula
  • used to look for impingement
  • gets a good look at the acromion
  • used to assess the acromion
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4
Q

What is the grashey view?

A

Shoulder film

no overlap of the humerus and glenoid

  • Used to see the glenohumeral joint
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5
Q

Xray of (lateral & AP) Elbow vs radial-capitellar view

A
  • Xray Elbow:
    • cannot see the radial head that well
  • XR Elbow Radiocapitellar View:
    • if suspect elbow fracture (usually a radial head fracture) → need to order a radiocapitellar view
    • better view of the radial head
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6
Q

Posterior vs Anterior Fat Pads in the Elbow

A
  • Anterior can be normal
  • Posterior is always Pathological
    • indicative of a fracture
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7
Q

Galeazzi Fracture vs Monteggia Fracture

A

“Gruesome Murder”

  • Galeazzi: Radial fracture, ulnar dislocation (distal)
  • Monteggia: Ulnar fracture, radial dislocation (proximal)
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8
Q

Torus/Buckle Fracture

A
  • AP of the wrist
  • kids bones are covered with a very thick, fibrous periosteum
  • torus, buckle, and greenstick are all the same thing
  • **Only found in children → check for open growth plate
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9
Q

Salter Harris Classification

A
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10
Q

Pelvis Fractures

A

Super serious, major trauma!!

look for associated injuries

  • anticipate large blood loss
    • up to 9-15 units of blood in unstable fractures
    • external and internal iliac arteries are present anterior
    • femoral artery, profunda and circumflex artery are present posterior
  • tx:
    • admission
    • look for associated injuries → vessel/bladder/nerve/head trauma/ cervical spine injuries
    • Manage blood loss
    • often surgical
      • **side note: pelvis & ankle are a ring so if there is one fracture it is still stable, but two make it unstable!!!
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11
Q

Garden Classification of Hip Fractures

A
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12
Q

Names of Different Fractures

A
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13
Q

What do you do if you see a tibial plateau fracture?

A

if both side → need CT

could be due to MVA

need neurovascular exam ASAP

check hgb & HCT asap

give blood prn

check for compartment syndrome!

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14
Q

Mortise Joint

A
  • the medial malleolus of the tibia forms the top of the mortise joint
  • can order a mortise view -→ can see both sides
    • spaces in the mortise joint should be equal ~1mm
    • if there is a difference in the spaces = displaced ankle
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15
Q

Lisfranc Injury

A
  • VERY BAD, takes significant trauma
  • Can’t miss
  • usually requires surgery to repair
    • and often has residual issues after surgery
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16
Q

Phalangeal Fractures

A

Most are not problematic except the great toe

  • can often be reduced & taped
  • use postop shoe or split
  • great toe will often require surgery
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17
Q

Jones Fracture

A
  • Proximal 5’th metatarsal diaphysis fracture
  • Pain over the lateral border of the forefoot, especially with weight-bearing
  • The fracture is believed to occur as a result of significant adduction force to the forefoot with the ankle in plantar flexion
  • The area has a poor blood supply
  • Treatment: Walking boot/cast, RICE, surgery for displaced fractures. Requires 6 weeks of non-weight bearing
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18
Q

What should you never do with a fresh fracture?

A

put the pt in the cast → you need to splint then refer

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19
Q

What films do you need to order for a shoulder dislocation?

A

Axillary View and AP view before AND after reduction

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20
Q

If pt fell on their arm in full extension what film do you need to order?

A

Grashey view

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21
Q

What is the most important muscle for impingement?

A

Supraspinatus

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22
Q

If pt has impingement syndrome what film do you always order & why?

A

Y film → b/c if you don’t order Y view you might not know that the acromion is a type III which requires surgery and that is why the injury isn’t resolving → not enough anatomical space for the supraspinatus tendon

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23
Q

If pt comes in for a fall on their hand with positive snuffbox tenderness what film should you order and why?

A

Scaphoid view b/c this is a scaphoid fracture until proven otherwise

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24
Q

Admit Orders Mnemonic

A

ADC Vandalism

  • Admit to
  • Diagnosis
  • Condition
  • Vitals
  • Allergies
  • Nursing Orders
  • Diet
  • Activity
  • Labs
  • IV Fluids
  • Special Studies
  • Medications
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25
Q

Inflammatory Vs Non-Inflammatory Disease

A
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26
Q

Important Hx Elements in Rheumatology

A
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27
Q

Synovial Fluid Analysis

A
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28
Q

Crystals in Gout vs Pseudogout vs Septic Joint

A
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29
Q

ESR vs CRP

A
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30
Q

Normal CRP Levels

A

≤ 0.9 mg/dL = normal to minor elevation (can be elevated due to obesity, pregnancy, DM, common cold, gingivitis, cigarette smoking, sedentary,etc.)

≤ 0.3 = normal healthy adult

31
Q

ANA Testing

32
Q

Rheumatoid Factor

33
Q

Anti-CCP

34
Q

Anemia of Chronic Disease

35
Q

Causes of Anemia in Rheumatoid Arthritis

36
Q

Axial vs Sagittal vs Coronal View of the Brain

37
Q

How and What type of Brain CT do I order for a pt?

38
Q

T or F: MRI is better for nerves & spinal Cord

39
Q

Epidural vs Subdural Hematoma

40
Q

What does this image show?

A

Hydrocephalus

41
Q

What is Bright on a T1 vs T2 MRI

A

T1: blood & fat

T2: water, inflammation, fat

42
Q

T1 vs T2 weighted image anatomy of the spine

43
Q

Clot vs Plasma on a CT vs MRI

44
Q

Images Demonstrating which Vessels Supply Blood to Which Parts of the Brain

45
Q
A

Lewy Body Dementia

46
Q
A

Multiple Sclerosis

47
Q
A

HSV Encephalitis

48
Q

What can PET scans measure & what can they diagnose?

A

blood flow, oxygen use, sugar use

Alzheimer’s Disease, Depression, Epilepsy, Parkinson’s Disease, Cancer

49
Q

Why is EEG used?

A

diagnose and manage epilepsy

investigate encephalitis, dementia, head trauma, brain tumors, hemorrhage

50
Q

What is EMG?

A

Electromyography

tests the muscle and the nerves to that muscle

51
Q

Henderson-Hasselbach Equation

A

pH = pk + [base]/[acid]

52
Q

Henderson-Hasselbach Equation and the bicarbonate buffer system

A

pk = 6.1

have to convert PCO2 into its soluble acid H2CO3 with its solubility coefficient = 0.03

PCO2 *0.03 =H2CO3

53
Q

Bicarbonate Buffer System Equation

A

CO2 +H2O H2CO3 H+ + HCO3-

54
Q

Common causes of respiratory acidosis

A
  1. airway obstruction
  2. disorders of lung tissues
  3. respiratory depression due to oversedation, brain stem trauma
  4. disorder of chest wall
  5. paralysis of respiratory muscles
  6. advanced COPD
  7. asthma
  8. sleep apnea

**pH <7.35 and hypercapnia (high CO2)

55
Q

Respiratory Acidosis

A
  • low pH, high CO2
  • causes potassium shift to the ECF due to the H/K shift; increases the free Ca2+
  • lack of ventilation in relation to metabolic production of carbon dioxide
56
Q

Metabolic Acidosis

A
  • acids in the blood (excluding H2CO3 ) are increased
    • when acid is high in the blood, it soaks up HCO3- due to the buffer role bicarbonate plays and lowers the levels of bicarbonate
  • or bicarbonate is lost
  • pH < 7.35, HCO3- <24
  • **potassium shift to the ECF due to the H/K shift; increases free Ca2+
  • *****ANION GAP**** used to determine cause of metabolic acidosis
57
Q

Causes of Metabolic Acidosis

A
  1. certain types of diarrhea
  2. lactic acidosis due to poor perfusion or hypoxia
  3. Renal failure
  4. diabetic ketoacidosis
  5. ingestion (methanol, ethylene glycol [antifreeze])
58
Q

Anion Gap

A
  • used to determine the cause of Metabolic Acidosis
  • normal range 8-16
  • equation:
    • ANION GAP = ([Na+] + [K+]) - ([HCO3-] + [Cl-])
  • if anion gap is HIGH, suggests that an acid is “soaking” up HCO3-
59
Q

Respiratory Alkalosis

A
  • levels of CO2 in the blood are low due to excess ventialtion relative to carbon dioxide production
  • pH >7.45 abd hypocapnia
  • **potassium shift to the ICF due to H/K shift, hypokalemia, and low serum free Ca2+
60
Q

Common Causes of Respiratory Alkalosis

A
  1. anxiety, panic disorders
  2. excess mechanical ventilation
  3. hypermetabolic states:
    1. fever
    2. anemia
    3. thyrotoxicosis
  4. pregnancy–> increased progesterone increases RR
61
Q

Metabolic Alkalosis

A
  • Retention of HCO3- or excessive loss of metabolic acids
  • pH>7.45, high HCO3-
  • ***potassium shift to the ICF , hypokalemia, less free serum Ca2+***
62
Q

Common Causes of Metabolic Alkalosis

A
  1. vomiting
  2. too much gastric suction
  3. antacids/ excessive bicarbonate intake
  4. hyperaldosteronism with hypokalemia
  5. diuretics
63
Q

Arrow trick for metabolic vs. respiratory alkalosis vs acidosis

64
Q

Calculation Method and Steps for the types of Acid-Base Imbalances

65
Q

Mini Mental Status Exam

A

< 24 is abnormal

66
Q

What Nerve Root does each Reflex test for?

67
Q

What part of the brain does Rapid alternating movements and finger to nose test?

A

Cerebellum

68
Q

What does the Romberg Test Assess

A

Proprioception, healthy dorsal column of the spinal cord

69
Q

What does pronator Drift assess for?

A

upper motor neuron lesion

proprioception

70
Q

Upper Body Dermatomes

71
Q

Sensation Dermatomes

72
Q

Lower Extremity Dermatomes

73
Q

Vibratory Sense Proprioception

74
Q

Dysdiadochokinesia

A

inability to perform rapid-alternating movements

NRS 410A/B EKGs/Pacemakers (7 decks)

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