8.22 Symptom Investigation 4 (Red Flags) Flashcards
What is an objective test that can be used to help dx PVD?
reactive hyperemia test
What is the test procedure for the reactive hyperemia test?
- pt supine, hold leg up in SLR at 45˚
- lower after 1-3 minutes
- looking for how long it takes blood to return to the leg
reactive hyperemia test: normal
3-5 seconds
reactive hyperemia test: PVD
anything over 20 seconds
sensitivity/specificity of Wells criteria for DVT
between 85 and 95%
What are the 5 P’s of compartment syndrome?
- pain
- palpable tenderness
- paresis
- paresthesia
- pulselessness
How does VBI often present?
severe HA ~15 hours prior
In addition to symptoms in the shoulder, where else may s/s of an MI manifest?
arm - typically left, but sometimes right
For pts who have a hx of heart disease or heart attack, what should they always have with them at therapy?
nitroglycerin
Where do Pancoast tumors grow?
apex of the lung (no initial lung symptoms)
Pancoast tumor: after affecting the ulnar distribution, what is affected?
subclavian vein
Pancoast tumors and referral
- refer if they have risk factors and haven’t seen improvement over 2-3 visits
- often misdiagnosed 8 months to 2 years
- makes the difference between metastatis and not
What are the t-spine and rib red flags?
- MI
- stable angina pectoris
- unstable angina pectoris
- pericarditis
- pleurisy
- pulmonary embolus
- pneumonia
- pneumothorax
Stable angina pectoris: what will you see?
- chest pain with predictable level of exertion
- relieved by nitroglycerin
stable angina pectoris: controlling
- not as much damage to the heart
- can be controlled easier than unstable angina
unstable angina pectoris
- chest pain outside of predictable pattern
- not responsive to nitroglycerin
What is the precursor to an MI?
unstable angina pectoris
What should you do if a patient experiences chest pain?
- refer if they aren’t being medically managed
- don’t get them to the level of exertion that induces angina
What is pericarditis?
- inflammation of the pericardium
- sharp, stabbing pain referred to lateral neck or shoulder
What increases pain with pericarditis?
L sidelying (more pressure on the heart)
What relieves pain with pericarditis
forward leaning posture
What is pleurisy?
- inflammation of the lining of the lung
- sharp, stabbing pain with inspiration
- dyspnea
Who gets pleurisy?
hx of a respiratory disorder
Where can pleurisy refer pain to?
shoulder region
What are s/s indicative of a pulmonary embolus?
- chest, shoulder, or upper abdominal pain
- dyspnea
Pts with a hx of ___ are at risk for a PE
DVT
Where is pleuritic pain often referred?
shoulder
What are s/s of pneumonia?
- fever, chills
- HA
- malaise
- nausea
- productive cough
What are some things that would make you think pneumothorax?
- chest pain with inspiration
- difficult to expand rib cage
- recent trauma, coughing, strenuous exercise
What will you hear with a pneumothorax?
- hyperresonance with percussion
- decreased breath sounds
