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Clinical Skills > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

this type of peripheral disease is atherosclerotic

A

PAD

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2
Q

this type of peripheral disease is thromboembolic

A

PVD

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3
Q

pulse grading scale

A

0- absent
1- weak
2- normal
3- bounding

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4
Q

sharply demarcated pallor due to spasms of distal arteries in the fingers
(normal radial and ulnar pulses)

A

Raynaud’s disease

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5
Q

what are 5 things to palpate for the arm peripheral vascular exam?

A

capillary refill
radial pulse
brachial pulse
epitrochlear nodes
axillary nodes

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6
Q

normal capillary refill time

A

3 sec

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7
Q

upon inspection of the abdomen, aortic pulsations in the typical adult suggest what?

A

AAA

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8
Q

normal width of the aorta

A

1.4-3 cm

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9
Q

normal width of inguinal nodes

A

1-2 cm

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10
Q

if there’s unilateral edema, measure ____ cm below the tibial tuberosity on each leg and compare. If difference greater than _____ cm, then ______ may be indicated

A

10 cm
>3cm
DVT

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11
Q

this type of ulcer is due to ischemia and has well demarcated borders

A

arterial

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12
Q

this type of ulcer is due to increased venous pressure and is shallow with irregular borders

A

venous

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13
Q

what are 6 things to palpate on the peripheral vascular leg exam?

A

femoral pulse
popliteal pulse
posterior tibial pulse
dorsalis pedis pulse
pitting edema
cords/ tenderness

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14
Q

where should you check for pitting edema?

A

dorsum of foot
medial malleolus
over the shins

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15
Q

DVT in a proximal vein (femoral or iliac) increases PE risk by ___%

A

50%

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16
Q

this special test tests for calf pain on dorsiflexion

A

Homan’s sign

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17
Q

this special tests evaluates the patency of the ulnar and radial arteries

A

Allen test

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18
Q

explain the steps of the Allen test

A

1- pt clenches fist
2- occlude radial and ulnar arteries
3- unclench fist
4- let go of ulnar artery
5- watch for reperfusion

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19
Q

what is a normal result of the Allen test?

A

color returns in 3-5 sec

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20
Q

this special tests evaluates the blood flow to the legs

A

Buerger’s test

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21
Q

explain the steps of the Buerger’s test

A

1- raise leg to 60 degrees for 1 min
2- sit up and dangle feet
3- evaluate for reperfusion/ return of color

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22
Q

list the normal timing for the Buerger’s test

A

color returns in <10 sec

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23
Q

abnormal findings of Buerger’s test

A

> 30 sec for return of normal color and arterial ischemia–> rubor/ reactive hyperemia

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24
Q

this special test evaluates the ratio of BP of the foot and the arm

A

Ankle Brachial Index (ABI)

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25
Q

calculation of the ABI

A

highest pressure of the 2 arteries of the foot divided by the highest average systolic pressure of either arm (*round 2 decimal places)

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26
Q

is the ABI calculated for both legs?

A

yes

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27
Q

what is normal ABI?

A

0.90-1.40

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28
Q

list abnormal values of ABI

A

<0.50- severe PAD
<0.90- PAD
>1.40- calcified vessel

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29
Q

is the ankle or the brachial BP typically higher?

A

ankle

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30
Q

what is valgus?

A

legs turned inward (knock knees)

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31
Q

what is varus?

A

legs turned outward (bowleg)

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32
Q

what are the shoulder rotator cuff muscles?

A

supraspinatus
infraspinatus
teres minor
subscapularis

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33
Q

normal flexion of shoulder

A

180 degrees

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34
Q

normal extension of shoulder

A

60 degrees

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35
Q

normal external rotation of the shoulder

A

100 degrees

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36
Q

normal internal rotation of the shoulder

A

70 degrees

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37
Q

normal abduction of the shoulder

A

180 degrees

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38
Q

normal adduction of the shoulder

A

75 degrees

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39
Q

in this shoulder special test, there may be pain with forward flexion

A

Neer’s impingement

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40
Q

in this special shoulder test, the shoulder and the elbow are flexed to 90 degrees and then internally rotated

A

Hawkin’s impingement

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41
Q

in this shoulder special test, the pt internally rotates the arms with the thumbs down and the clinical pushes down

A

empty can test

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42
Q

in this shoulder special test, the pt abducts the arm to 90 degrees and holds

A

drop arm test

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43
Q

in this shoulder special test, the pt’s arm is adducted across their chest

A

crossover test
*AC joint separation

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44
Q

what extra factor does the crossover test and the apley scratch test test for?

A

adhesive capsulitis

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45
Q

normal flexion range of elbow

A

140 degrees

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46
Q

what are 4 ROM for the elbow

A

flexion
extension
supination
pronation

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47
Q

snuff box tenderness suggests a…..

A

scaphoid fx

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48
Q

MCP pain/ bogginess suggests what?

A

RA

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49
Q

PIP and DIP pain/ bogginess suggests what?

A

OA

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50
Q

Bouchard’s nodes

A

PIP

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51
Q

Herberden’s nodes

A

DIP

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52
Q

hand and wrist ROM

A

flexion and extension
ulnar (adduction) and radial deviation (abduction)

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53
Q

this is thumb movement pain

A

DeQuervain’s tenosynovitis

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54
Q

describe the finkelstein test

A

pt grasps their thumb and performs ulnar deviation
(+= pain–> tenosynovitis)

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55
Q

list 3 carpal tunnel tests

A

Tinel’s sign
Phalen’s sign
thumb adduction (with resistance)

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56
Q

describe tinel’s sign

A

tap over medial nerve at the wrist–> aching in 2-4th fingers

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57
Q

describe phalen’s sign

A

pt flexes wrist for 60 sec–> aching in 2-4th fingers

58
Q

what does thumb adduction against resistance specifically test?

A

weakness to median nerve

59
Q

step offs on palpation of the spine indicates what?

A

spondyloithesis

60
Q

pain upon palpation of the sacroiliac joints indicates what?

A

sacroilitis or ankylosing spondylitis

61
Q

where is the sciatic nerve located?

A

between greater trochanter and ischial tuberosity

62
Q

ROM of the spine includes….

A

flexion and extension
lateral flexion
rotation

63
Q

this type of scoliosis disappears with forward flexion of the spine

A

postural

64
Q

this type of scoliosis persists with forward flexion and presents with a rib hump

A

structural

65
Q

this special test tests for pyelonephritis

A

CVAT

66
Q

this is referred to as “saddle anesthesia” and involves numbness from S2-S4 and requires an emergent MRI

A

cauda equina syndrome

67
Q

this spine special tests tests for lumbar herniated discs

A

straight leg raise

68
Q

this spine special test tests for cervical radiculopathy

A

spurling’s test

69
Q

explain how to perform spurling’s test

A

pt turns head to affected side
clinician applies downward pressure

70
Q

this gait has foot dragging and is stiff

A

spastic

71
Q

this gait has a stooped head with the neck forward and is commonly seen in parkinsons

A

propulsive

72
Q

in this gait, the toes hit the ground and it indicates tibial muscle weakness

A

steppage

73
Q

in this gait, the knees and the thighs hit and it is commonly seen in those with CP

A

scissor

74
Q

this gait is common in childhood and dislocation

A

waddling

75
Q

on palpation of the hip, this type of pain is often referred to as low back pain but is actually due to…

A

trochanteric bursitis

76
Q

this is “weaver’s bottom” due to prolonged sitting

A

ischiogluteal bursitis

77
Q

ROM of the hip

A

flexion and extension
abduction and adduction
internal and external rotation

78
Q

in this knee special test, the knee is flexed 90 degrees and the tibia is pulled forward

A

anterior drawer

79
Q

what part of the knee does the anterior drawer test analyze?

A

ACL

80
Q

in this knee special test, the knee is flexed 15 degrees and the tibia is pulled forward while the femur is pushed back

A

Lachman’s test

81
Q

what part of the knee does Lachman’s test analyze?

A

ACL

82
Q

in this knee special test, the knee is pushed medially while the ankle is pulled laterally

A

valgus

83
Q

what part of the knee does the valgus test analyze?

A

MCL

84
Q

in this knee special test, the knee is pulled laterally while the ankle is pushed medially

A

varus

85
Q

what part of the knee does the varus test analyze?

A

LCL

86
Q

in this knee special test, the knee is flexed 90 degrees and the tibia is pushed back

A

posterior drawer

87
Q

what part of the knee does the posterior drawer test analyze?

A

PCL

88
Q

in this knee special test, grasp the heel and flex the knee with internal and external roation

A

McMurray test

89
Q

what does the McMurray test analyze?

A

meniscus

90
Q

in this knee special test, the pt is prone with the knee flexed and pressure is applied

A

apley grind test

91
Q

what part of the knee does the apley grind test analyze?

A

meniscus

92
Q

foot and ankle ROM

A

plantarflexion and dorsiflexion
inversion- bottom of foot IN
eversion- bottom of foot OUT

93
Q

what part of the foot does the anterior drawer test analyze?

A

ATFL

94
Q

what part of the food does the talar tilt analyze?

A

CFL

95
Q

what part of the foot/ ankle does the thompson test analyze?

A

achilles
(no movement= rupture)

96
Q

pronator drift checks for corticospinal lesion in the ______ hemisphere

A

contralateral

97
Q

muscle strength scale

A

5- normal
4- active movement against gravity and some resistance
3- active movement against gravity
2- active movement w/o gravity
1- barely detectable
0- none

98
Q

shoulder abduction

A

C5 and C6

99
Q

elbow flexion

A

C5 and C6

100
Q

elbow extension

A

C6, 7 and 8

101
Q

wrist extension

A

C6 and C7
radial nerve

102
Q

finger extension

A

C7 and C8
radial nerve

103
Q

finger abduction

A

C8 and T1
ulnar

104
Q

thumb abduction

A

C8 and T1
median

105
Q

hip flexion

A

L2-4

106
Q

hip adduction

A

L2-4

107
Q

hip abduction

A

L4, L5 and S1

108
Q

hip extension

A

S1

109
Q

knee extension

A

L2-L4

110
Q

knee flexion

A

L4-S2

111
Q

dorsiflexion

A

L4 and L5

112
Q

plantarflexion

A

S1

113
Q

sterognosis

A

identify object

114
Q

graphesthesia

A

identify number drawn on hand

115
Q

2 point discrimmination should be less than _____mm

A

3 mm

116
Q

muscle reflex grading

A

4- brisk with clonus
3- brisker than average
2- average
1- diminished
0- absent

117
Q

tricep spinal reflex

A

C6 and C7

118
Q

brachioradialis reflex

A

C5 and C6

119
Q

biceps spinal reflex

A

C5 and C6

120
Q

knee spinal reflex

A

L1-L3

121
Q

ankle spinal reflex

A

S1

122
Q

abdominal reflex above umbilicus

A

T8-T10

123
Q

abdominal reflex below umbilicus

A

T10-T12

124
Q

normal response to plantar reflex

A

plantarflexion

125
Q

anal reflex

A

S2-S4

126
Q

3 meningeal sign special tests

A

nuchal
Brudinski
Kernig

127
Q

lumbosacral radiculopathy test

A

straight leg raise

128
Q

asterixis tests for what?

A

metabolic encephalopathy

129
Q

obtundation

A

shake pts as they’re sleeping

130
Q

eyes opening on glasgow coma scale

A

4- spontaneous
3- to command
2- to pain
1- none

131
Q

best motor on glasgow coma scale

A

6- obeys verbal orders
5- localizes pain
4- withdrawls
3- flexion
2- extension
1- none

132
Q

best verbal on glasgow coma scale

A

5- oriented
4- disoriented
3- inappropriate words
2- inappropriate sounds
1- none

133
Q

what CN is pupillary light reflex?

A

CN2 and CN3

134
Q

in what kind of coma do you have a light rxn when testing the pupillary light reflex?

A

metabolic coma

135
Q

ocular position and ocular movement is which CNs?

A

CN3, 4 and 6

136
Q

oculocephalic reflex tests which CNs?

A

CN3, 4, 6 and 8

137
Q

intact oculocephalic reflex results in what?

A

doll’s eyes

138
Q

when do you perform oculovestibular reflex?

A

if absent oculocephalic

139
Q

what CNs does oculovestibular test?

A

CN3, 4, 6, and 8

140
Q

what CNs does corneal reflex test?

A

CN5 and 7

141
Q

gag reflex is which CNs?

A

9 and 10

Clinical Skills (6 decks)

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