Clinical Notes Flashcards
How deep does ultrasound penetrate when using a vascular probe?
2-3cm
Where is the thyroid gland?
Thyroid isthmus?
Carotid bulb for carotid massage?
Lies below the thyroid cartilage
Part of the thyroid gland that connects together the lower thirds of the right and left lobes of the thyroid gland
Just inferior to the bifurcation of the common corrotid into internal and external carotid arteries.
What regions of the brain will be affected by interruption of blood flow in the vessels to the circle of Willis?
berry aneurysms can ccurs at the bifurcations in the circle of Willis. Rupture (most common complication) leads to subarachnoid hemorrhage (“worst headache of Iife”) or hemorrhagic stroke. Can also cause bitemporal hemianopia via compression of optic chiasm.
What are two places where a central line can be placed in the neck region?
** subclavian vein**
**internal jugular vein **
Upper Motor Neuron Lesions
- Weakness or paralysis
- Spasticity
- Increased tendon reflexes
- Extensor Babinski response
- Loss of abdominal reflexes
- Little if any muscle atrophy
Lower Motor Neuron Lesions
- Weakness or paralysis
- Wasting and fasciculations of involved muscles
- Hypotonia
- Decreased tendon reflexes
- Normal abdominal and plantar reflexes
Arm flexed, adducted and internally rotated
Leg on same side is in extension with plantar flexion of the foot and toes.
walking, the patient will hold his or her arm to one side and drags his or her affected leg in a semicircle (circumduction) due to weakness of distal muscles (foot drop) and extensor hypertonia in lower limb.
What kind of gait?
**Hemiplegic Gait **
The patient walks with an abnormally narrow base, dragging both legs and scraping the toes. There is also characteristic extreme tightness of hip adductors which can cause legs to cross the midline referred to as a scissors gait.
Diplegic Gait
This gait is seen in bilateral periventricular lesions, such as those seen in cerebral palsy.
The patient has weakness on one side and is leading to a drop in the pelvis on the contralateral side of the pelvis while walking.
Myopathic Gait (Waddling Gait)
(Trendelenburg sign)
This gait is seen in patient with myopathies, such as muscular dystrophy.
In this gait, the patient will have rigidity and bradykinesia. He or she will be stooped with the head and neck forward, with flexion at the knees. The whole upper extremity is also in flexion with the fingers usually extended. The patient walks with slow little steps.
Parkinsonian Gait
Patient displays irregular, jerky, involuntary movements in all extremities. Walking may accentuate their baseline movement disorder.
Choreiform Gait (Hyperkinetic Gait)
This gait is seen with certain basal ganglia disorders including Sydenham’s chorea, Huntington’s Disease and other forms of chorea, athetosis or dystonia
This gait is described as clumsy, staggering movements with a wide-based gait. While standing still, the patient’s body may swagger back and forth and from side to side, known as titubation. Patients will not be able to walk from heel to toe or in a straight line.
Ataxic Gait (Cerebellar)
In an effort to know when the feet land and their location, the patient will slam the foot hard onto the ground in order to sense it. A key to this gait involves its exacerbation when patients cannot see their feet (i.e. in the dark). This gait is also sometimes referred to as a stomping gait since patients may lift their legs very high to hit the ground hard.
Sensory Gait
This gait can be seen in disorders of the dorsal columns (B12 deficiency or tabes dorsalis) or in diseases affecting the peripheral nerves (uncontrolled diabetes).
