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H & P 2 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

CN I

A

Olfactory, sensory

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2
Q

CN II

A

Optic, sensory

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3
Q

CN III

A

Oculomotor, motor

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4
Q

CN IV

A

Trochlear, motor

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5
Q

CN V

A

Trigeminal

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6
Q

CN VI

A

Abducens, motor

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7
Q

CN VII

A

Facial, sensory and motor

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8
Q

CN VII

A

Acoustic, sensory

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9
Q

CN IX

A

Glossopharyngeal, motor and sensory

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10
Q

CN X

A

Vagus, motor and sensory

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11
Q

CN XI

A

Spinal accessory, motor

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12
Q

CN XII

A

Hypoglossal, motor

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13
Q

Pupil response to direct and concentric light and accommodation tests…

A

CN II (and CN III)

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14
Q

Six extraocular muscles tests…

A

CN III, CN IV, CN VI

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15
Q

Assessing facial VII

A 
Raise both eyebrows
Frown
Close eyes tightly and don't allow you to open them
Smile
Show teeth
Puff checks
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16
Q

Peripheral injury

A

Affects upper and lower face, Bell’s palsy

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17
Q

Central injury

A

Affects the lower face (the most)

UMN’s opposite side

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18
Q

Anterior 2/3 of the tongue

A

Sweet and salty, facial sensory

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19
Q

CN IX glossopharyngeal sensory

A

Posterior 1/3 of tongue

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20
Q

Whisper test

A

If they pass this, you don’t do anything else

If they don’t pass, you have to do Weber and Rhinne

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21
Q

Vestibular proprioception function assessed with …

A

Romberg

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22
Q

Motor testing of glossopharyngeal

A

Difficulty swallowing

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23
Q

Sensory testing of glossopharyngeal

A

Gag reflex present or absent

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24
Q

Vagus nerve motor testing

A

Swallowing, rising soft palate

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25
Q

Vagus nerve sensory testing

A

Hoarseness

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26
Q

Spinal accessory testing

A

Shoulder shrug, head turned to side against resistance

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27
Q

Hypoglossal testing

A

Move tongue In and out of mouth

L T D N sounds

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28
Q

Posterior horn

A

Sensory

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29
Q

Upper motor neurons

A

Cellular bodies in cerebral cortex/brain stem

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30
Q

Lower motor neurons

A

Cell bodies in spinal cord

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31
Q

3 pathways from anterior horn

A

Corticospinal tract

Basal ganglia

Cerebellar system

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32
Q

Corticospinal tract

A

Voluntary movement

Cross contralateral side of medulla

Forms pyramid structure

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33
Q

Basal ganglia system

A

Complex, maintains muscle tone and control body movements

Posture, gate

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34
Q

Cerebellar system

A

Sensory and motor

Coordinates motor activity

Equilibrium for posture, gait

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35
Q

If defect is above the medulla then…

A

Contralateral side because of the crossover

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36
Q

If the defect is below the medulla, then…

A

Ipsilateral side

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37
Q

Muscle strength grading

A 
1- trace contraction
2- passive movement
3- active movement against gravity
4- active movement with some resistance 
5- active movement with full resistance
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38
Q

Biceps testing…

A

C5 and C6

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39
Q

Triceps testing…

A

C6, C7, C8

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40
Q

Extension at wrist testing…

A

C6, C7, C8, radial

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41
Q

Grip, testing…

A

C7, C8, T1

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42
Q

Finger abduction testing…

A

C8, T1, ulnar nerve

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43
Q

Thumb opposition testing…

A

C8, T1, median nerve

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44
Q

Flexion of hip in leg extension tests…

A

L2, L3, L4, iliopsoas

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45
Q

Adduction at the hips is testing…

A

L2, L3, L4

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46
Q

Abduction at the hips testing…

A

L4, L5, S1

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47
Q

Extension at the hips testing…

A

S1, gluteus Maximus

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48
Q

Extension at the knee testing…

A

L2 L3 L4

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49
Q

Flexion at the knee testing…

A

L4 L5 s1, s2

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50
Q

Dorsiflexion testing

A

L4 L5

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51
Q

Plantar flexion testing

A

S1

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52
Q

Dysdiadochokinesia

A

Inability to perform quick movements

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53
Q

Dysmetria

A

Overshooting or undershooting intended movement of arm/leg

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54
Q

Pronator drift

A

Arms straight ahead, supination arms up eyes closed

Watch for drift and slight pronation of one arm 30 seconds then tap down briskly and watch for imbalance

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55
Q

DTR scale

A 
0- no response
1- sluggish
2- normal
3- slightly hyperactive
4- brisk, hyperactive
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56
Q

Biceps DTR testing…

A

C 5, c6

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57
Q

Brachoradialis DTR testing…

A

C5, C6

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58
Q

Triceps DTR testing…

59
Q

Patellar DTR testing…

60
Q

Achilles DTR testing

61
Q

Clonus

A

Do if hyperactive/hyperreflexive

Flexed knee and briskly dorsiflex ankle, UMN disease

62
Q

Cremasteric reflex testing…

A

Lumbar 1, 2

63
Q

Plantar reflex testing…

A

Lumbar 5

Sacral 1

64
Q

Babinski

A

Toes fan out and dorsiflexion of big toe
Abnormal

<2 years old or UMN lesion in the corticospinal tract

65
Q

Nipple dermatome

66
Q

Umbilicus dermatome

67
Q

Thumb dermatome

68
Q

Middle finger dermatome

69
Q

Ring and little finger dermatome

70
Q

Inguinal dermatome

71
Q

Knee dermatome

72
Q

Anterior ankle, medial foot/toes dermatome

73
Q

Heel, posterior foot, lateral toes dermatome

74
Q

Perianal dermatome

75
Q

Big toe test

A

Tests position, lift up or down and have them tell you which way you are lifting it

76
Q

Sterognosis

A

Identify objects in hands

77
Q

Graphesthesia

A

Write on hand with a blunt edge

78
Q

Extinction

A

Touching two places simultaneously and ask where you are touching the patient

79
Q

Ataxia

A

Positive Romberg

Staggering, wide stance

80
Q

Chorea

A

Involuntary movements of the face, neck and may involve body

Brief, rapid, jerky, rhythmic

Basal ganglia over activity, huntington’s, etc

81
Q

Parkinson’s

A

Resting, pilll rolling tremor

Muscular rigidity

Instable balance

Shuffling gate

Soft voice, drooling

82
Q

Intention tremor

A

Tremor worsens near target

Cerebellar disorders, like MS or alcohol abuse

83
Q

Essential postural tremor

A

Bilateral/symmetric
Hands with outstretched arms
Progressive
Autosomal dominant

84
Q

Postural physiologic tremor

A

Arms extended
Disappears at rest

Hyperthyroid, hypoglycemia

85
Q

Asterixis

A

Outstretched hand with fingers separated and dorsiflexed wrists

Jerky movement of flexion/extension at wrist (hepatic encephalopathy)

86
Q

Athetosis

A

Involuntary, writhing, convoluted movement

Associated with chorea

Cerebral palsy

Huntington’s

87
Q

Dystopia

A

Involuntary sustained contractions

Focal- single body part, females in 30-40s

Could be idiopathic, CNS disorders

88
Q

Tardive dyskinesia

A

Involuntary movements of tongue, lips, face, mouth, jaw

89
Q

Aphasia

A

Inability to comprehend or formulate language

90
Q

Global aphasia

A

Damage to both language centers

91
Q

Broca’s aphasia

A

Understand speech of others, but can’t communicate

Frontal lobe

92
Q

Wernicke’s aphasia

A

Temporal lobe

Difficulty understanding speech

Long nonsense phrases

93
Q

Bell’s palsy

A

Rapid onset, spontaneous resolution up to a week

94
Q

Meningitis signs/symptoms

A

Flue, headache, stiff neck, 3-7 days onset from exposure

AMS, fever, nuchal rigidity

Petechiae and purpura

95
Q

Brudzinski

A

Supine patient, involuntary flexing of hip and knees with neck flexion

96
Q

Kernig

A

Supine patient with flexion hip and knees

Positive test when resistance or lower back pain with straightening

97
Q

Myasthenia gravis hx

A

Double vision, droopy eyelids, difficulty walking, fatigue and weakness

98
Q

Myasthenia gravis exam

A

Ptosis
Facial weakness with puffing out cheeks
Hypophonia

99
Q

MS hx

A

Fatigue, urinary, blurred or double vision, weakness, tingling, sexual dysfunction

100
Q

MS exam

A

Muscle weakness, hyperactive DTS, paresthesias, sensory loss, intention tremor, optic neuritis

101
Q

Peripheral neuropathy hx

A

Gradual onset

Numbness, tingling, burning

Night pains, walking on cotton

102
Q

Peripheral neuropathy exam

A

Reduced sensation of foot with monofilament

Diminished ankle/knee reflexes

Decreased vibratory sensation below knees

103
Q

Trigeminal neuralgia hx

A

Sharp, severe sudden onset of pain, usually unilateral and chronic

Intermitten a few times a day

Chewing, swallowing and cold

104
Q

Trigeminal neuralgia exam

A

Normal to slight diminished sensations

Pain in nerve distribution

105
Q

Decorticate rigidity

A

Hands flexed and up by chest

106
Q

Decerebrate rigidity

A

Hands moved to side, flexed

Significant disease, people are dying, severe brain injury

107
Q

Mild GCS

108
Q

Moderate GCS

109
Q

Severe GCS

110
Q

Oculocephalic reflex

A

Doll’s eyes, brainstem is in tact if the eyes move opposite to the way you turn them

111
Q

Lethargy

A

Aware of a loud voice, brief response

112
Q

Obtunded

A

Shake patient gently, look at you and may respond with confusion

113
Q

Stupor

A

Sternal rub, verbal responses absent but have some sort of facial reaction

114
Q

Coma

A

Repeated stimuli with no response

115
Q

HEEADSSS

A 
Home
Education/employment
Eating
Activity
Drugs/alcohol
Sexuality
Suicidal/depression
Safety
116
Q

CRAFFT

A 
Car
Relax
Alone
Forget
Family/friends
Trouble

About substance abuse

117
Q

Healthy weight

A

5th percentile, no less than 85h percentile

118
Q

Palpate suture lines until…

A

Child is 2-3

119
Q

Anterior fontanelle closes …

A

8 months-2 years

120
Q

Poster fontanelle closes…

A

1-2 months

121
Q

2 line difference between the eyes…

A

Referral even though they are normal range

122
Q

3-5 years visual acuity

123
Q

6 years visual acuity

124
Q

Using intercostal for breathing at…

125
Q

Umbilical hernias often resolve on their own by…

A

Age 2, if not consider a referral

126
Q

Genu varum

A

1-2 yeras old, knees out

127
Q

Genu valgum

A

2-4 years, leg bowing

128
Q

Leg calve perthes

A

3-11 year olds

Knee, thigh or groin pain

Loss of internal rotation and abduction

Aseptic necrosis of femoral head

129
Q

Osgood schlater

A

9-16, male athletes

Inflammation of tibia tuberosity

130
Q

SCFE

A

10-16, males more commonly

20-40% biltaerla

Commonly obese, hypothyroid, low growth hormone

Knee pain referred from hip, limp, out toeing and short stance on affected side

131
Q

Detect scoliosis ages

132
Q

Percentage of curve that needs to intervene with scoliosis

133
Q

Don’t assses DTR in children…

A

Less than 6 unless concerne about insult to CNS or developmental abnormality

134
Q

Denver II assesses

A

Gross motor
Fine motor
Verbal
Personal/social

135
Q

Connor scale

A

ADHD screening

136
Q

Back or zung

A

Depression scales

137
Q

Visit dentist at…

A

Age 1 or 6 months after 1st tooth

138
Q

Molars erupt at…

A

12 month of age, additional sets developing at 2

139
Q

Most have all 20 teeth at…

140
Q

Permanent teeth replace baby teeth at…

141
Q

Only proven benefit of PEP

A

Recognize at risk athletes of orthopedic injury

142
Q

Perform PPE…

A

Within 6 weeks of participation

143
Q

Concussion signs/symptoms

A 
Headache, LOC
N/V
Balance problems, dizziness
Double vision
Sensitivity to light/noise
Foggy, difficulty concentrating
Confusion
144
Q

Concussion wok up

A

Rule out skull fracture

Symptom based diagnosis

ACE from

H & P 2 (3 decks)

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