Advanced PE Flashcards
McBurney’s Point
1/3 of the way from the ASIS to the umbilicus
McBurney’s sign
deep tenderness suggests appendicitis
Rebound tenderness
push in slowly and rapidly release. pain on rebound indicates an inflamed peritoneum
Rovsing’s sign
palpate LLQ. Pain in the RLQ suggests appendicitis
Obturator sign
hold R hip and knee at 90 degrees. internally and externally rotate hip. Pain indicates peritoneal infection, inflammation, or appendicitis
Psoas Sign
- RLQ pain when patient flexes hip
2. RLQ pain when patient extends hip (when laying on side)
Markle’s sign
the heel jar test. Jump off the table or hit heels to move the peritoneal cavity. RUQ pain is a positive sign
Murphy’s Sign
palpate the gallbladder/liver. Sudden pause during deep inspiration indicates gallbladder disease
Bronchophony
increased loudness or clarity in an area (while patient speaks) indicates consolidation
Whispered Pectoriloquy
increased loudness or clarity in an area (while patient whispers) indicates consolidation
Egophony
when patients say “eeeeee” if it is heard as “aaaaaa” suggests consolidation
Straight Leg Raise test
raise a straight leg to 30 degrees. pain in the leg suggests nerve root irritation or L4/L5 herniation
Tinel’s sign
tap median nerve - tingling indicates Carpal tunnel syndrome
Phalen’s Sign
hold flexed wrists together for 1 min - tingling indicates Carpal tunnel syndrome
Snuff Box tenderness
scaphoid fracture id tenderness
McMurray test
Flex knee and hip to 90 degrees, apply lateral forces and straighten feeling for clicks or pain to evaluate menisci
Foot rotates externally + valgus(medial) force - Medial M
Foot rotates internally + varis(lateral) force - Lateral M
Drawer test
Anterior mvmt of the tibia - ACL damage
Posterior mvmt of the tibia- PCL damage
Lachman Test
push thigh, pull tibia and feel for laxity for ACL damage
Varus and valgus stress tests
to evaluate the collateral ligaments
Varus(Lateral force) laxity - Medial Collateral
Varis(Medial force) laxity - Lateral Collateral
Floppy muscles
hypotonic/Flacid
Variable increased resistance
spacticity
High resistance then sudden relaxation of muscle
clasped knife spactisity
Persistent resistance
lead pipe spasticity
Racket-like jerkiness
cogwheel rigidity
front of the neck dermatome
C3
Nipple dermatome
T4
Umbilicus dermatome
T10
Thumb dermatome
C6
Inguinal dermatome
L1
Knee dermatome
L4
Anterior ankle and foot dermatome
L5
Shoulder dermatome
C4
Inner and outer forearm dermatome
C6 - T1
thumbs and little fingers dermatome
C6 and C8
Front of thighs dermatome
L2 - L3
Calves dermatome
L4 - L5
Little Toes dermatome
S1
Stereognosis
being able to identify an object by touch
Graphesthesia
identify a number or letter drawn on the patients hand
2 poing discrimination
the smallest distance a patient can differentiate should be less that 5mm
Point Localization
touch a point with eyes close ad then have patient relocate the spot
Pronator drift
hold arms out, palms up with eyes closed for 20-30 seconds. drifting suggests UMN damage
Asterixis
dorsiflex outstretched arms. Shaking motion indicates metabolic and toxic encephalopaties
Burdinski’s Sign
Pain when flexing the neck. A meningeal sign
Kernig’s Sign
Patient cannot fully extend knee. A meningeal sign
Corneal Reflex
to test CN V - a cotton wisp touches to the eye
Gag Reflex
test CN IX and X
Mental Status Exam
- Appearance and Behavior
- Cognitive Function
- Emotional Stability
- Speech and Language
Glascow Scale
coma scale to assess altered consciousness
