basic medical examination knowledge Flashcards
an aortic diameter of how many cm is classified as an AAA?
where do you palpate the abdominal aorta?
> 4cm
to the left and just superior to the umbilicus using two index fingers; pulsations should separate fingers
what are the grades for peripheral pulses?
3+ bounding
2+ brisk/normal
1+ weak/diminished
0 absent
what is normal pulse rate?
what is normal BP?
what is normal temperature?
what is normal respiratory rate?
PR=60-80bpm
BP=90/60-140/90; optimal 120/80
temp=36.5-37.2
RR-12-20bpm
what is a deep tendon reflex?
Most objective, simplistic test of sensory and motor system at segmental level of the mm stimulated. It is a single synapse reflex mediated by a monosynaptic arc.
what nerve root levels do the following DTR test: Biceps tendon reflex brachioradialis tendon reflex triceps tendon reflex Patellar tendon reflex achilles tendon reflex
BT C5/6 BRT C5/6 TT C6/7 PT L3/4 AT S1
what can cause hyperreflexia?
what can cause hyporeflexia?
hyper-UMN lesion as inhibitory factors have been removed
hypo-peripheral nerve or nerve root pathology, or LMN lesion
list the myotomes and associated movements to test them in the upper extremity
C4 shoulder shrug C5 abduction C6 elbow flexion/ wrist extension C7 elbow extension C8 finger flexion T1 finger grip *cx radiculopahty, DeQS C8/T1 thumb opposition *CTS
list the myotomes and associated movements to test them in the lower extremity
L1/L2=hip flexion, L3/L4=knee extension, L4/L5=ankle dorsiflexion or knee flexion, L5=big toe extension, S1/S2=ankle plantarflexion
list the location of the synapses and decussation of the STT
First synapse occurs in lamina 2
second synapse in VPL of the thalamus
third in the primary somatosensory cortex of the parietal lobe (post-central gyrus).
decussation within a few levels of entry to enter the contralateral ALS and ascend to the brainstem and diencephalon.
list the synapses and decussation of the DCML system
1st: gracile and cuneate nuclei in caudal medulla
2nd order neuron begins at gracile and cuneate nucleus, decussates, and moves anteriorly to form the medial lemniscus. Ascends and terminates in the thalamus (VPL) nucleus
3rd:primary sensory cortex /post-central gyrus
Decussation occurs in caudal medulla
list some causes of hypertension
medications/illegal drugs, CVD, obstructive sleep apnoea, kidney, adrenal and thyroid dysfunction, congenital defects
Plus all the CVD risk factors
list some causes of hypotension
medications, nutrient deficiencies, allergic reactions, dehydration, loss of blood, septicaemia, pregnancy, CVD, endocrine (thyroid, adrenal) low blood sugar/diabetes
list 2 causes of elevated temperature, and 2 causes of reduced temperature
hyperthermia: infection, trauma, malignancy, blood disorders, drug reactions, immune disorders
hypothermia: exposure to cold, paralysis, interference with vasoconstriction (sepsis, alcohol), starvation, hypothyroidism and hypoglycaemia
list 2 causes of increased tactile femitus, and decreased tactile fremitus
increased: underlying mass e.g. lung tumor, pneumonia
decreased: impeded e.g. obstructed bronchus, pneumothorax, pleural effusion
list 2 causes of increased percussion dullness, and 2 causes of percussion hyper resonance in respiratory examination
dull: pneumonia, consolidation, collapse, stony dullness=pleural effusion
hyper resonance: emphysema or pneumothorax
