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boards review > Clinical Science 4 > Flashcards

Clinical Science 4 Flashcards

1
Q

What is the Feiss Line

A
  • Line running from Tip of the Medial Malleolus, Navicular, to Base of 1st MT
  • Foot is flat when Navicular lies below the Feiss line
  • reduced longitudinal arch
  • Calcaneus Valgus
  • Increase weight bearing to Med aspect of foot
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2
Q

The 3 Dynamic Ligaments of the Foot and Ankle:

A

Tib Ant
Tib Post
Fib Longus

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3
Q

Plantar Fasciitis

A

Over use injury
Pain going up/down stairs
Morning Pain
Tender on palpation of Calcaneus

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4
Q

Mms involved with Foot Drop

A

Tib Ant
Ext Hallucis Longus
Ext digitorum Longus
(L4 + L5)

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5
Q

Test for Morton’s Neuroma

A

Squeeze Test

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6
Q

The Inguinal Triangle is made up of:

A

Add Longus
Sartorius
Inguinal Lig

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7
Q

Hip Anteversion=

A

Toe in stance

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8
Q

Which Bursa is related directly to the hip?

A

Iliopectineal (iliopsoas) Bursa

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9
Q

Traction of the hip affects which Bursas?

A

Iliopectineal
Ishiogluteal
Trocanteric
Ischiopubic

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10
Q

Leg Length Discrepancy has an effect on:

A

Posture + bio mechanics

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11
Q

Supine to Sit Test results=

A

Post Pelvic Tilt = Short to Long

Ant Pelvic Tilt = Long to Short

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12
Q

Case Study: Hip + Ant Groin Pain. Worse in the morning and better after walking =

A

Osteoarthritis

Spcl Test = Scouring test (only if unDx’d)

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13
Q

Peripheral Vascular Disease PVD/PAD

A
  • Slow progressive circulatory disorder in any BV outside the heart (Aa, Vv, Lymph)
  • Brain, Heart, Legs don’t receive adequate blood flow
  • legs + feet MC affected
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14
Q

Conditions Assoc with PVD/PAD

A

DVT
Varicose Veins
Chronic Venous Insuff.
Lymphedema

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15
Q

S/Sx of PVD

A

50% of peole Dx’d are symptom free

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16
Q

Claudication:

A

MC symptom of PV is Intermittant claudication

= limping b/c of pain in thigh, calf and/or buttocks when walking

“Angina of the legs”
Demand for O2 increases with mvmt = Pain
More severe than this is Critical Limb Ischemia

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17
Q

Atherosclerosis

A

PVD/PAD

S/Sx depend on degree blood flow blocked to legs

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18
Q

Critical Limb Ischemia CLI

A

-MOST SEVERE Sx of PVD Via atherosclerosis
- lack of O2 to limb at rest
“Pain at Rest”
Can result in tissue breakdown, ulcers, gangrene
- may include all other types of PVD Sx also

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19
Q

Direction for constipation massage =

A

Clockwise

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20
Q

Vat Test:

A

Tests vert Aa blood flow
Put supine, Passive EXT + ROT of neck (performed in both directions)

+ dizziness, dysphagia, hearing/vision disturbance, syncope, nausea

21
Q

Lower Motor Neuron Signs=

A
  • Indicates that lesion is ABOVE the Ant. Horn Cell (spinal cord, brain stem, motor cortex)
  • increased mm tone (spasticity)
  • Weakness (flexors weaker than extensors in legs / opposite in arms)
  • increased reflexes, up going plantar response, sustained clonus
22
Q

Lower Motor Neuron Signs:

A

Lesion of either in Anterior Horn Cell
Or
Distal to Ant. Horn Cell (Ant horn cell, root, plexus, peripheral nerve)

DECREASED mm Tone
Passive Rot of neck in both directions = dizzy, nausea, syncope, dysarthria, dysphagia, hearing/vision disturbances

23
Q

Klumpke’s Paralysis

A

“Claw Hand”
C8/T1
- Forearm is Supinated, wrist + finger are Flexed
- affects hands + intrinsic mm + flexors of wrists/fingers

*If Horner’s Syndrome is present = Miosis (constrict pupils)

24
Q

Polio/Post Polio

A

Most people don’t have S/sx
If yo do = fever, fatigue, flu-like, stiff neck/back, P in limbs

  • spreads via contact with stool/ droplets of infected person, lives in throat & intestines
  • Attacks Motor Nerves = Paralysis, mm wasting/atrophy, areflexia, mm fasciculations
25
Q

Post Polio

A

People who had polio develop Post Polio Syndrom years later :(

S/Sx = tiredness, new mm weakness, mm + jt Pain

No prevention or Cure

26
Q

Sinusitis

A
  • Inflam of mucus lining in nasal passages/ sinus cavities

Frontal (behind forehead)
Maxillary (behind cheekbones) - largest
Ethmoid (behind nose)
Sphenoid (behind eyes)

Tx = diaphrag breathing, pre facial steam (5mins), prone my press on sinuses

27
Q

Mvmt of Ribs with breath (inspiration vs expiration):

A

Insp: Ribs 1-6 = “Pump Handle” pull ribs Up + Forwards= increases Anteroposterior diameter (stenum moves with these ribs)
Ribs 7-10 = “Bucket Handle” ribs move Up + BACKWARDS

Ribs 11-12= “Caliper Action” increases Lat diameter

28
Q

Red Flags for Headaches:

A
  • Neuro Sx/S (altered mental sate, weakness, Diplopia, papilledema, focal Neuro deficits)
  • Immunosuppression / Cancer
  • Meningitis
  • Sudden HA onset after 50 yrs (brain tumor)
  • Thunderclap HA (severe sudden)
  • Sx of Giant Cell Arteritis
  • Systemic Sx (fever, weight loss0
  • progressively worsening HA
  • Red eye / halos around lights
29
Q

For every inch of head forward posture:

A

It increases the weight of the head on the spine by 10lbs

2x weight/pressure

30
Q

What is Rebound Tenderness:

A
  • Physical sign that may be found when examining the abdomin.
  • Refers Pain upon REMOVAL of pressure
  • Indicates possible Appendicitis
31
Q

Define Hemophilia:

A

Bleeding disorder where normal clotting factors are weak/absent

ABSOLUTE CI for Massage

32
Q

Why does Edema occur on Pt’s with Chronic Kidney Disease?

A
  1. Heavy loss of protein in urine

2. Impaired kidney function

33
Q

Define Chronic Kidney Disease

A

Gradual loss of kidney function

Dangerous levels of fluid, electrolytes + wastes build in body

34
Q

CI’s for Hypertension, why do we have to be careful?

A

because we increase blood circulation which can increase Intravascular Pressure.

Someone with HT already has excess pressure against BV walls

35
Q

Asthma

A
  • Airways narrow, swell, produce excess mucus
    = Difficulty breathing, coughing, Wheezing, shortness of breath

CI’s = acute attack, respitory tract infection

Allergy induced
Occupational Astra
Exersize-induced

36
Q

Extrinsic vs Intrinsic Asthma

A

Extrinsic: Attack are related to irritants + most childhood asthma

Intrinsic: No known cause + adult onset

37
Q

Degrees of severity of Asthma: (3)

A

Mild - occasional wheezing/coughing

Moderate - Daily symptoms

Severe - daily, nocturnal, absence from work/school, hospital admittance

38
Q

Thrombophlebitis:

A

Inflam of the wall of a vein with assoc thrombosis, often occurs in legs during preganancy

39
Q

What’s the difference btw Emphysema & Chronic Bronchitis

A

Both are types of COPD that often coexist

Emphysema: “Pink Puffer”

Bronchitis: “Blue Bloater”

40
Q

Emphysema:

A

Form of COPD = permanent enlargement of airways / destruction of ALVEOLI - enlarged air spaces called “Bulae”

Proteolytic enzymes destroys lung tissue -Mainly caused by smoking, irreversible.

“Pink Puffer”

41
Q

Chronic Bronchitis;

A

Form of COPD, long term cough that lasts for at least 3 months for 2 consecutive years
- Inflam/irritation to bhronchioles = mucus that inter fears with breathing
Difficult to expel with coughing + perf habitat for bacteria/infection
Caused by smoking

42
Q

Postural drainage positions for upper, mid (right), lower lobes:

A

Upper lobes: seated

Right Middle: laying supine with pillow under R thorax + knees

Lower: Pt prone, triangle of pillows under hips

*diaphrag + segmental & pursed lip breathing + cough coaching

43
Q

Buerger’s Disease:

A

Thromboangiitis Obliterans (aka Buerger’s Disease)

Recurring progressive Inflam + clotting of sm & med arteries/veins of hand and feet

44
Q

Cor Pulmonale:

A
  • Right Heart failure b/c of long term high BP on Aa and Right Lung Ventricle
  • Can also be caused by Chronic Long conditions that lower blood O2 levels for long periods (COPD, Cystic Fibrosis, Kyphosis/Scoliosis, Interstial lung disease, sleep Apnea)
45
Q

Critical Limb Ischemia (CLI)

A

Most severe PVD caused by Atherosclerosis

“Pain at rest”
Tissue necrosis b/c of lack of O2 = gangrene / ulcers :(

46
Q

S/Sx of PVD:

A 
Cold feet
Burning aching Pain while lying down, relieved by sitting
Pallor when legs are raised
Brittle, thin, shiny skin
Non healing wounds/ulcers
Red/blue extremities
Fungal infections
47
Q

Upper body Dermatomes:

A 
C1 top of head
C2 temporal/occipital region
C3 neck adn post cheek
C4 Sup shoulder & clavical
C5 Deltoid + Lat Arm
C6 Lat Forearm, thumb, index finger
C7 Post Lat Forearm & middle finger
C8 Medial forearm, ulna border & ring/little finger
T1 Med side of forearm & upper arm
48
Q

Lower body Dermatomes:

A

L1 Back, hip, groin
L2 Ant sup thigh, med thigh, above knee
L3 Back, Ant thigh + Med knee
L4 Lat thigh/knee, ant med lower leg to med big toe
L5 Lat knee & Lat lower leg & top of foot

49
Q

Functional Organization of the cerebral cortex (sensory areas)

A

Primary somatosensory area
Primary visual area
Primary gustatory
Primary olfactory

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