AHA-EXAM 4 Flashcards
The extension of the patient’s head against the examiner’s hand is a test of?
Sternocleidomastoid muscle strength
Grades of muscle strength? What grade is: Normal muscle strength?
1-5?
5=nl
Sx of bursitis?
inflammation of this structure adjacent to a joint leads to limitation with motion, point tenderness and swelling
Paget disease ?
Excessive bone resorption and bone formation
LEGG-CALVE-PERTHES DISEASE
Avascular necrosis of the femoral head
D/C from nipple- how to determine the # of ducts?
Compress the nipple and examine with a magnifier
Paget dz in breast vs eczema differential?
The response to steroids (eczema)
Mastectomy rand malignancy recurrence?
Recurrence is possible and may be at the scar site. DO BREAST EXAM AND MAMMOGRAM YEARLY STILL & FOCUS ON THE SITE SCAR SITE
Male with enlarged breast tissue (Gynecomastia)
QUESTION USE OF DRUGS (MARIJUANA)
fibrocystic changes in breast sx?
Lumps before menstrual cycles
sentinel nodes location to palpate with a mass finding
supraclavicular fossa
What is the cause of a Peau d’orange appearance to the skin of the breast?
Edema from a blocked lymph drainage
Inverted niplle finding, ask about?
how long they had their nipple inverted
the ant axillary nodes are located at?
along the lower border of the pectoralis major
Retention cyst?
breast mass w/ inflammation of the sebaceous glands in the areola
breast mass that is firm, irregular w/ an area of discoloration
fat necrosis
nonmalignant
expected finding in a 68 yr female at her yearly exam
granular feel to breast tissue
Montgomery tubercles
nontender and nonsuppurative bumps seen on the areola
3 most common breast lumps?
fibroadenoma-benign solid tumors usually in women <30 years of age.
fibrocystic breast changes-heterogenous group of nonproliferative changes of stromal/glandular elements that includes cysts, nodularity, nipple discharge, breast tenderness. usually in women 30-50yrs of age.
breast carcinoma
6 nodes accessible to palpation -breast?
upraclavicular Midaxillary Lateral axillary Anterior axillary Subclavicular nodes
Changes in breast tissue with age?
<25-stromal and lobular tissue. Fibroadenomas common.
25-40-cyclic mastalgia and nodularity.
>40-begin to involute. cysts and duct ectasia common.
>50-increased risk of cancer.
Galactorrhea, meds to ask?
phenothiazines
Mastitis
clogged milk ducts
Fibrocystic dz
enlarged ducts
2-3 cm subareolar duct lesion?
intraductal papillomas
NL finding in a 28 yr old pregnant ?
dilated subcutaneous veins
Radiculitis
a type of dz manifests with burning pain
A type of dz that manifests as a heavy throbbing and aching pain?
Ovarian tumor pressing on the bowel
puberty by race?
Mexicans enter puberty later than blacks and earlier than whites
The appearance of secondary sex charact. in a 8 yr old followed by a sexual maturation can indicate?
tumor
brain tumor or a lesion in the hypothalamus may activate the gonads axis triggering the secretion of growth hormones, sex hormones and leads to early sexual maturation
what inhibits the pituitary from releasing the growth hormone
Somatostatin
inhibits both GHGH and TSH
What age the lymphatic tissue development reach its peak
at 10-12 yrs
used to record deep tendon reflexes?
The incremental grading
pt with hx of depression, experience anger, fear. what regulates anger ?
The lumbic system: mediates the patterns of behavior that determine survival (aggression, affection, fear)
the expression of emotion and behaviors is mediated between the limbic system and the frontal lobe
Delirium vs dementia?
Dementia is the impairment of the cognition that is not reversible and is chronic in progression
delirium is instant and is usually related to a secondary issue that is usually reversible by fixing the causative issue.
Def: Delirium is impaired cognition, consciousness, mood and behavioral dysfunction of acute onset. Disordered perceptions, decreased attention span, suspiciousness and fear with motor and sensory excitement are objective characteristics found in delirium.
what test is used to evaluate the pt’s menta; function with changes in cognition per family complaint?
what score is indicative of dementia?
The Isaac Set Test measures a patient’s mental functioning. Their ability to respond demonstrates executive functioning, alertness, attention span, and recent memory. A score less than 15 is associated with dementia.
Which is a major difference between Alzheimer disease and vascular dementia?
–> Etiology
Dementia is a chronic, slowly progressive disorder of failing memory, cognitive impairment, behavioral abnormalities, and personality changes that often begins after age 60 years and usually related to structural diseases. Vascular dementia is a type of dementia related to acute or embolic strokes or cerebral hemorrhages due to hypertension. Up to 70% of Alzheimer dementia is caused by the presence of senile plaques, and neurofibrillary tangles with abnormal amyloid processing or deposits.
Hormones secretes by ant vs post pituitary ?
ant-FSH
post-LH
Hormones resp. for softening the pelvic cartilage and strengthening the pelvic ligaments in pregnancy?
Relaxin and Progesterone
name of bluish cervix from increase vascularity?
can be a sign of?
Chadwick sign
pregnancy?
Name of soft cervix from inc vascularity?
Goodell sign
Polymenorrhea?
Oligomenorrhea?
1-Short period of period < 19-21
2- longer period> 35
term for cervix pointing ant vs post?
A=Retroverted
P=Anteverted
think opsite!
+ Allis sign?
Infant supine, both knee flexed, feet flat on the exam table and the femur aligned, BUT ONE KNEE IS HIGHER THAN THE OTHER KNEE.
factor to hyperextension to knee?
Weak quadriceps
nl= 130
group successible to subluxation?
Infants/ toddlers
What is tested when head of pt is extended against your hand using pressure?
Sternocleidomastoid muscle stregth
To test for rotator cuff prob?
Neer test
NL plantar flexion?
45 Degree
what is tested w/ straight leg test?
Lumber nerve root irritation assoc w/ herniation at the level L4-L5-S1!!
+ with tenderness or limited ROM
Gower sign?
Generalized weakness when rising from a sitting position by placing her hands on legs and pushing the trunk up
Hawkins test to test for?
Rotator cuff injury
Faber test for?
Hip
test for cerebral function?
Rapid sequence of finger to thumb
Pt c/o feeling as of the whole room is spinning.
You suspect?
Inner ear dysfunction affecting the acoustic nerve
To assess the peripheral nerve sensory function, the NP asks the pt to?
close eyes and place a vibrating tuning fork on the pt’s ankle and ask to indicate what is felt
Acroparesthesia during pregnancy is NL? true or false?
T
Foot drop during pregnancy. why? explain
d/t lumbosacral plexopathy.
Occurs when the lumbosacral trunk, and sometimes the superior gluteal and obturator nerves, is compressed between the maternal pelvic rim and the fetal head (a conduction nerve block), leading to motor deficits in a lower extremity