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CPA content revision > everything? > Flashcards

everything? Flashcards

1
Q

where is the radial artery palpated

A

between the tendon of flexor carpi radialis and tendon of brachioradialis

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2
Q

where is the ulnar artery

A

lies between the flexor digitorum superficialis and flexor carpi ulnaris

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3
Q

where do you palpate the brachial artery

A

medial to the biceps tendon
middle third of the humerus in the medial bicipital groove

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4
Q

where do you palpate the common carotid artery

A

medial border of sternocleidomastoid muscle
lateral border of thyroid cartilage

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5
Q

where do you palpate for the apex beat

A

5th ICS at mid clavicular line

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6
Q

why can you get a displaced apex beat

A

cardiomegaly

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7
Q

why do people have absent apex beats

A

pericardial effusion
obesity
pleural effusion
emphysema

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8
Q

what are parasternal heaves associated with

A

right ventricular hypertrophy

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9
Q

what causes thrills

A

turbulent blood flow

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10
Q

where is the aortic valve located

A

right sternal border - 2nd ICS

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11
Q

where is the pulmonary valve located

A

left sternal border - 2nd ICS

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12
Q

where is the tricuspid valve located

A

left 5th costosternal border

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13
Q

where is the mitral valve located

A

left 5th ICS at apex beat

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14
Q

what are some causes for ejection systolic murmur

A

aortic stenosis
pulmonary stenosis
aortic sclerosis
hypertrophic obstructive cardiomyopathy
atrial septal defect

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15
Q

what murmur do you hear on auscultation for aortic stenosis

A

ejection systolic murmur

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16
Q

what murmur do you hear on auscultation for aortic regurgitation

A

early diastolic murmur

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17
Q

what murmur do you hear on auscultation for mitral stenosis

A

mid diastolic murmur

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18
Q

what murmur do you hear on auscultation for mitral regurgitation

A

pan systolic murmur

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19
Q

where does the murmur radiate for aortic stenosis and for mitral regurgitation

A

aortic stenosis - radiates to carotid
mitral regurg - radiates to axilla

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20
Q

what are the different arteries you can palpate in the lower limb

A

femoral
popliteal
posterior tibial
dorsalis pedis

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21
Q

what are the borders of the heart

A

right border - 3rd CC to 6th CC - 1cm from the sternal edge
left border - 2nd ICS (2.5cm from eternal edge) to left 5th ICS at MCL
Upper border - 3rd CC (1cm from eternal edge) to 2nd ICS (2.5cm from sternal edge)
Lower border - 6th CC 1cm from sternal edge to 5th ICS at MCL

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22
Q

where do you palpate the carotid artery pulse

A

in the neck
between the lateral side of the thyroid cartilage
and medial border of sternocleidomastoid muscle

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23
Q

where do you palpate the superficial temporal artery

A

front of tragus ear

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24
Q

where do you palpate the subclavian artery

A

palpated in the supraclavicular fossa region
at angle between clavicle and sternocleidomastoid

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25
Q

what are the 2 types of aortic dissection and what do they present with

A

type A = severe chest pain, anterior and posterior (ascending and thoracic aorta)
type B = back pain, chest and abdo pain (descending aorta)

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26
Q

what do you look for on general inspection in a cardio examination

A

pacemaker
bruising
surgical scars
wasting - cachexia

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27
Q

what do you look for on general inspection in abdo examination

A

surgical scars
bruising, asymmetry
distension, masses, hernia

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28
Q

what are the 9 regions of the abdomen

A

right hypochondriac
epigastric
left hypochondriac
left lumbar
umbilical
right lumbar
right iliac fossa/region
hypogastric/suprapubic
left iliac fossa/region

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29
Q

what organ is found in right hypochondriac

A

gallbladder
and liver

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30
Q

what organs are found in epigastric region

A

stomach
duodenum
pancreas

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31
Q

what organ is found in left hypochondriac region

A

pancreas

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32
Q

what organs are found in the umbilical region

A

small bowel
retroperitoneal structures

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33
Q

what organ is found in right lumbar region

A

kidney

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34
Q

what organ is found in the left lumbar region

A

kidney

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35
Q

what organs are found in right iliac fossa

A

appendix and caecum

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36
Q

what organs are found in the hypochondriac/suprapubic region

A

bladder
uterus
adnexa

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37
Q

what organs are found in the left iliac fossa

A

sigmoid colon

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38
Q

is the spleen retro or intraperitoneal

A

intraperitoneal

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39
Q

between which ribs do u find the spleen

A

9-11

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40
Q

what are some causes of splenomegaly

A

portal hypertension secondary to liver cirrhosis
haemolytic anaemia
congestive heart failure
splenic mets
glandular fever

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41
Q

what are the causes for bilaterally enlarged kidneys

A

polycystic kidney disease
amyloidosis

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42
Q

what is a cause for a unilaterally enlarged kidney

A

renal tumours

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43
Q

what is tenderness

A

minimal pressure over a wide area –> peritonitis and sometimes anxiety

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44
Q

what is guarding

A

tends to contract voluntarily when palpation causes pain

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45
Q

what is rigidity

A

inflammation of parietal peritoneum, reflex contraction, involuntary guarding, abdominal wall may not show any movements of inspiration

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46
Q

what is rebound tenderness

A

generalised or localised peritonitis, if the abdominal wall is compressed slowly and then released –> sharp stabbing pain

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47
Q

how would you describe the abdominal aortic pulse in a normal healthy individual

A

Non expansile pulsatile pulse

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48
Q

what could be the cause of an expansile mass

A

abdominal aortic aneurysm

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49
Q

at what level does the aorta bifurcate

A

L4 !!!

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50
Q

what are the names of the horizontal planes (5)

A

transpyloric plane
subcostal plane
supracristal
intertubercular
interspinous

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51
Q

at what vertebral level is the transpyloric plane

A

L1

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52
Q

what organs do you find in the transpyloric plane

A

fundus of the gallbladder
pylorus of the stomach
neck of pancreas
renal hilum
duodenojejunal flexure
end of spinal cord

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53
Q

at what vertebral level is the subcostal plane

A

L3

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54
Q

what organ is found in the subcostal plane (its not acc an organ its like sm else…)

A

origin of the inferior mesenteric artery

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55
Q

at what vertebral level do you find the supracristal plane and what happens here

A

L4
bifurcation of the aorta

56
Q

at what vertebral level is the intertubercular plane

A

L5

57
Q

what do you find in the intertubercular plane

A

tubercle of the crest of ilium

58
Q

at what vertebral level is the interspinous plane found on

A

S2
it is the horizontal plane through the anterior superior iliac spines

59
Q

when you percuss the liver how does the sound change

A

from resonant to dull as you pass the border of the liver

60
Q

what are the surface markings of the liver

A

right 5th rib at mid clavicular line
lower end of sternum
left 5th rib at mid clavicular line
costal margin at right mid axillary line

61
Q

what do you test for in shifting dullness

A

ascites (if area now sounds resonant = ascites)
(due to liver cirrhosis)

62
Q

what could be the cause of absent bowel sounds

A

paralytic ileus or peritonits

63
Q

what are the bowel sounds heard if someone has an intestinal obstruction

A

high pitched and frequent sounds
(tinkling)

64
Q

what are the 3 regions where urinary tract stones reside

A

the pelvic ureteric junction
across the sacroiliac joint
vesicoureteric junction

65
Q

what is the gold standard imaging modality used for the diagnosis of urinary tract stones

A

ultrasound scan

66
Q

what are the surface markings of the spleen

A

from ribs 9-11
between mid axillary line and lateral border of erector spinae muscles

67
Q

where are the ureters

A

5cm lateral to the posterior median line at L1 level
to posterior superior iliac spine

68
Q

what is the position and exposure for the respiratory examination

A

45 degrees
exposed from waist up

69
Q

what can cause tracheal deviation away from the lung lesion

A

TENSION PNEUMOTHORAX
extensive pleural effusion
chest expansion

70
Q

what can cause tracheal deviation towards the lung lesion

A

upper lobe collapse
upper lobe fibrosis
pneumectomy

71
Q

at what level does the trachea bifurcate into the left and right main bronchi

A

at the level of the sternal angle = T4/T5

72
Q

which lobes (upper/middle/lower) does anterior chest wall expansion tell you about

A

upper and middle lobes

73
Q

which lobes (upper/middle/lower) does posterior chest wall expansion tell you about

A

lower lobes

74
Q

what is a cause of unilateral decreased expansion (in the chest wall)

A

pneumothorax
pleural effusion
collapsed lung
consolidation

75
Q

what can cause a bilaterally decreased chest wall expansion

A

asthma or COPD

76
Q

what can cause hyper resonant sounds on percussion of the chest wall

A

pneumothorax
hollow bowels
COPD

77
Q

what can cause hyporesonant sounds on percussion of the chest wall

A

pleural effusion (stoney, dull)
lung tumour (flat, dull)
consolidation (flat, dull)
collapse (flat, dull)

78
Q

where do you auscultate for bronchial sounds and what do they sound like
(idk if u have to know this tbh)

A
  • over trachea
  • over suprasternal notch
  • over manubrium
  • over sternal angle
  • over sternoclavicular joints

high pitch sounds

79
Q

where do you auscultate for vesicular sounds and what do they sound like

A

present over the rest of the chest area where normal lung tissue is present
low pitch sounds

80
Q

what are some causes for reduced intensity of vesicular sounds

A

shallow breathing
airway obstruction
hyperinflation
pneumothorax
pleural effusion
pleural thickening
obesity

81
Q

in obstructive lung disease, what phase becomes prolonged - the inspiratory or expiratory phase

A

expiratory phase

82
Q

what causes a decrease in tactile vocal fremitus

A

caused by a decrease in density :. pneumothorax/COPD
or pleural effusion

83
Q

what causes an increase in tactile vocal fremitus

A

increase in density
consolidation in pneumonia/tumour tissue in cancer

84
Q

what are the cervical lymph nodes you need to palpate

A

submental
submandibular
preauricular
postauricular
occipital
superior deep cervical
inferior deep cervical
supraclavicular

85
Q

what are some causes of cervical lymphadenopathy (enlarged lymph nodes)

A

tuberculosis
lung cancer metastasising to lymph nodes
sarcoidosis
resp tract infection

86
Q

in which condition do you see a meniscus sign on chest x ray

A

pleural effusion

87
Q

what is silhouette sign on a CXR

A

loss of a normal border of a structure on CXR

88
Q

what is the triangle of safety used for

A

chest drains

89
Q

what are the borders for the triangle of safety

A

lateral edge of pectoralis major
base of axilla
Horizontal line at level of 5th ICS
lateral edge of latissimus dorsi

90
Q

what are the surface markings of the lung

A
  • check med ed guide bc its too confusing
91
Q

what are the 2 types of knee deformities

A

valgus - knock kneese
varus - bow legged

92
Q

what condition can cause warmth at the knee joint

A

septic arthritis

93
Q

what is the name given to swelling in the politeal fossa

A

bakers cyst

94
Q

what is an effusion caused by (in the knee)
(an excess of..)

A

synovial fluid

95
Q

in the tap method/sweep test, what is the name of the pouch that needs to be emptied

A

suprapatellar pouch

96
Q

what muscles perform flexion of the knee

A

hamstring muscles
- semitendinosus
- semimembranous
- biceps femoris

97
Q

what muscles perform extension of the knee joint

A

quadriceps muscles
- vastus medialis
- vastus lateralis
- vastus intermedialis
- rectus femoris

98
Q

what are the angles for the range of motion a patient can actively extend/flex their leg/knee

A

0 to 135 degrees

99
Q

what are the angles for the range of motion you can passively flex/extend a patients knee

A

-10 to 145 degrees

100
Q

up to how many degrees is hyperextension normal

A

10 degrees

101
Q

how many cm of movement suggests an ACL pathology

A

> 1.5 cm

102
Q

what motor neuron lesions cause hypertonia/hyper reflexia

A

upper motor neuron lesions

103
Q

what do lower motor lesions cause

A

hypotonia
hyporeflexia

104
Q

what disease could cause rigidity

A

parkisons disease

105
Q

what score do you use to assess power

A

MRC muscle power scale

106
Q

what would be the score on the MRC scale for a patient who can only perform the barest flicker of movement of muscle - but not enough to move the muscle it is attached to

A

1/5

107
Q

what is the MRC muscle power scale out of and what is the highest you can score on it

A

out of 5

5/5

108
Q

describe the muscle power of a patient who scores 0/5 on the MRC power scale

A

no movement

109
Q

what would be the score for a patient on the MRC scale who has normal strength

A

5/5

110
Q

what would be the score for a patient on the MRC scale who can voluntarily move muscle but not enough to overcome gravity

A

2/5

111
Q

describe a patients power with a score of 3/5 on the MRC power scale

A

voluntary movement capable of overcoming gravity but not able to overcome applied resistance

112
Q

describe a patients power with a score of 4/5 on the MRC power scale

A

voluntary movement capable of overcoming resistance

113
Q

what are the nerves (roots) tested in the biceps reflex

A

C5, C6

114
Q

what are the nerves (roots) tested in the triceps reflex

A

C7, C8

115
Q

what are the nerves tested in the supinator (wrist) reflex

A

C6

116
Q

what muscles are involved in flexion of the hip

A

psoas major
iliacus
(sartorius, rectus femoris, pectineus)
- femoral nerve

117
Q

what muscles are involved in extension of the hip joint

A

gluteus maximus (inferior gluteal nerve)

118
Q

what muscles cause abduction of the hip joint

A

gluteus medius and gluteus minimus
(superior gluteal nerve)

119
Q

what muscles cause adduction of the hip joint

A

adductor longus
adductor brevis
adductor magnus
- obturator nerve

120
Q

what muscles are involved in dorsiflexion

A

tibialis anterior
extensor hallucis longus
extensor digitorum longus
- innervated by deep fibular nerve

121
Q

what nerve is involved in plantarflexion

A

tibial nerve
S1-2

122
Q

what are the nerves involved in the knee jerk reflex

A

L2-4 (some people say L3-4 though so double check)

123
Q

what are the nerves involved in the ankle jerk reflex

A

S1-2

124
Q

describe sciatica and what is it caused by

A

pain radiating from the posterior back into the buttock, posterior/lateral thigh and into leg
- caused by herniated lumbar intervebral disc compressing L5-S1 component of sciatic nerve

125
Q

what are the borders of the femoral triangle

A

inguinal ligament
sartorius
adductor longus

126
Q

what is compartment syndrome caused by and presentations

A

pressure in the muscle compartment is so high that venous drainage becomes blocked
ischaemia and death can arise
causes : fractures, burns, infections or prolonged limb compression

presents with 6 Ps
pallor
pulselessness
paralysis
perishingly cold
pain
paraesthesia

127
Q

what is the risk, freq of monitoring and clinical response for a news2 score of 0

A

low risk
minimum 12 hourly monitoring
continue with NEWS2 monitoring

128
Q

what is the risk, freq of monitoring and clinical response for a news2 score of 1-4

A

low risk
minimum 4-6 hourly
inform registered nurse who must assess patient and determine if more freq monitoring or escalation of care

129
Q

what is the risk, freq of monitoring and clinical response for a news2 score of 3 in a single parameter

A

low medium risk
minimum 1 hourly
registered nurse informs medical team who will decide escalation of care

130
Q

what is the risk, freq of monitoring and clinical response for a news2 score of 5-6

A

medium risk
minimum 1 hourly
registered nurse immediately inform medical team looking after patient and request urgent assessment by clinician

131
Q

what is the risk, freq of monitoring and clinical response for a news2 score of 7+

A

high risk
continuous monitoring
registered nurse immediately informs medical team at specialist registrar level
emergency assessment
consider transfer to level 2/3 care or higher dependency unit

132
Q

What are the borders of the liver

A

Right 5th rib in the mid clavicular line to the left 5th ICS in the mid clavicular line
Right 5th rib in mid clavicular line to right costal cartilage at mid axillary line
Left 5th ICS at mid clavicular line to right costal cartilage at mid axillary line (goes through 8/9th costal cartilage)

133
Q

What is the surface marking of the gallbladder

A

At level of right 9th costal cartilage where MCL and transpyloric plane meet

134
Q

What are the borders of the spleen

A

Between ribs 9-11
Posterior abdominal wall
Between left mid axillary line and lateral border of erector spinae muscles

135
Q

What are the surface markings of the kidney

A

Posterior abdominal wall
4-5cm from the posterior median line
3-4cm from the supracristal plane

Right kidney is 2-3cm lower from left

136
Q

What are the surface markings for the abdominal aorta

A

Line from Xiphisternal joint to umbilicus and extends to supracristal plane

CPA content revision (1 decks)

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