Exam 1 Flashcards
VINDICATE
Vascular
Inflammatory
Neoplastic
Drugs
Infectious
Congenital
Autoimmune
Traumatic
Endocrine/metabolic
Pedal plantarflexion test
For vascular/intermittent claudication
Calf raise 50x - comparable to treadmill walking
Positive test = recreation of vascular pain and > 8/10 pain
Blood pressure ranges: Optimal, pre-hypertension, hypertension
Optimal: <120/<80
Pre-hypertension: 120-139/80-89
Hypertension: >140/>90
HR range
60-100 bpm, may be slightly lower in well-conditioned athletes
RR range: normal and abnormal
Normal: 15-20 bpm
Abnormal: <12 OR >25
Locations of atypical signs/symptoms for cardiopulmonary systems: Heart, Lungs & Bronchi, Diaphragm
Heart: T1-T5, cervical anterior, jaw, teeth, epigastric, left UE, right shoulder and UE
Lungs and Bronchi: T5-T6, ipsilateral thoracic spine, chest wall, cervical (diaphragm involved)
Diaphragm: C3-C5, cervical spine
Inflammatory: sig difference in measurement between joint circumference, terms
1.5cm = significant difference
Rubor - redness due to increased blood flow
Calor - heat due to increased blood flow
Dolor - pain due to pressure of interstitial fluid
Edema - swelling due to proteins and fluid moving into interstitial space
Functio Laeso - swelling to limit joint motion
Neoplastic: CAUTION & things to consider
Changes in B&B habits
A sore that does not heal in 6 weeks
Unusual bleeding or discharge (continues)
Thickening or lump (breast or elsewhere)
Indigestion or difficulty in swallowing
Obvious change in wart or mole
Nagging cough or hoarseness
History, clinical presentation, signs and symptoms
VINDICATE: Drugs - what to consider
Dosage (especially in home health)
Side effects
VINDICATE: Autoimmune - what to look for
Typically appear as exacerbations and remissions
Be aware of polyarthritis and polymyalgia
Subcutaneous nodules over extensor area of forearm
Unusual joint swelling not linked to trauma
Skin lesions, rash, etc.
MADGE: IgM, IgA, IgD, IgG, IgE
VINDICATE: Trauma - signs
Gray-turner’s Sign: uncommon subcutaneous sign of intra-abdominal pathology, manifests as ecchymosis and/or discoloration of the flanks - related to necrotising pancreatitis
Cullin’s Sign: bruising around umbilical region indicative of hemorrhagic pancreatitis
Upper right quadrant
Liver
Galllbladder
Lower lung
Diaphragm
Upper left quadrant
Stomach
Spleen
Lower intestine
Lung/diaphragm
Lower right quadrant
Lower intestine
Appendix
Lower left quadrant
Lower bowels
Descending colon
Abdominal aorta
Addison’s v Cushing’s
Addisons - need to “add” cortisol
Cushing’s - need to “cushion” effect of increased cortisol
Cervical myelopathy: general effects/overview, 5 diagnostic tests
Severe degenerative changes in the c-spine, loss of balance/clumsiness, unsteady gait, difficulty with fine motor tasks
Tests: gait deviation, Hoffman’s, Babinski, inverted supinator sign (indicative of C5-C6 lesion), >45 y/o (3+/5 positive signs)
Babinski - what sort of lesion if + bilaterally vs unilaterally?
Bilateral = UMN lesion
Unilateral = LMN lesion
Out of visual, vestibular, and somatosensory systems, which is quickest and most sensitive to balance disturbance?
Somatosensory
Motor output of vestibular system
Oculomotor: gaze stabilization
Vestibulospinal: postural control/reflexes
3 functions of peripheral vestibular system
- Helps maintain posture and balance under static and dynamic conditions, esp. with head motion
- Helps maintain a stable visual image for clear vision
- Provides info for spatial orientation
3 functions of vestibular system
- Head position and movement
- Postural stability/balance
- Compensatory eye movement during head movement
CN 3 Palsy
Lateral deviation
Downward deviation
Ptosis
CN 4 Palsy
Upward deviation
CN 6 Palsy
Medial deviation
Central eye movements
Smooth pursuit - tracking moving object
Vergence system - tracking object changing in depth
Saccades - switching from one target to another
Always do a general health screen, screen specific systems when…
Several red flags are revealed in general screen
Unable to determine the source of symptoms is mechanical
Pt not responding as predicted to POC
Any other changes in status indicating a need
BP response to exercise
Medical consult encouraged if >140/90
Urgent referral if >200/110 or systolic pressure <80 or diastolic pressure >100
