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Physical Assessment > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

musculoskeletal system functions

A

support body, movement, encase and protect vital organs, produce RBC in bone marrow, storage of certain minerals

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2
Q

most active joint in the body?

A

temporomandibular joint

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3
Q

bony landmarks of shoulder

A

acromion, coracoid process, acromioclavicular joint

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4
Q

temporomandibular joint motion and expected range

A

open mouth maximally, protrude lower jaw and move side to side, stick out lower jaw

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5
Q

shoulder motion and expected range

A

arms forward and up, arms behind back and hands up, arms to sides and up over head, touch hands behind head

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6
Q

elbow joint bones

A

ulnar, radius and humerus

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7
Q

palpable landmarks of elbow joints

A

olecranon process, later and medial epicondyles

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8
Q

“funny bone”

A

ulnar nerve

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9
Q

elbow motion and expected range

A

bend and straighten elbow, pronation and supination

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10
Q

wrist/hand motion and expected range

A

bend hand up, bend hand down, bend fingers up and down, turn hands out and in, spread fingers, make fist, touch thumb to each finger

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11
Q

ulnar nerve controls sensation where?

A

pinky and half of ring finger

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12
Q

median nerve controls sensation where?

A

part of thumb, index, middle and part of ring finger

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13
Q

radial nerve controls sensation where?

A

part of thumb

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14
Q

tests for checking for carpal tunnel

A

phalen’s test (press backs of hand together for 30 sec) and tinel’s test (tap median nerve)

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15
Q

osteoarthritis

A

degenerative joint disease, hard, nontender nodules 2-3mm in size, heberden’s nodes (bony overgrowth at DIP), bouchard’s nodes (PIP), metacarpophalangeal joints are sparred

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16
Q

rheumatoid arthritis

A

autoimmune, tender, painful, stiff joints, symmetric, PIP and MCP involvement (warm and tender), ulnar deviation, swan neck deformity, boutonniere deformity

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17
Q

ulnar deviation

A

middle, ring and pinky fingers deviated to the side

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18
Q

swan neck deformity

A

DIP flexion, PIP hyperextension

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19
Q

boutonniere deformity

A

PIP flexion, DIP hyperextension

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20
Q

hip expected range and motion

A

raise leg, knee to chest, flex knee and hip, swing foot in and out, swing leg laterally and medially, stand and swing leg back

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21
Q

knee joint ligaments

A

anterior and posterior cruciate, medial and lateral collateral

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22
Q

collateral ligaments provide support for what kind of motion

A

stability for side to side movement

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23
Q

ankle/foot expected range and motion

A

point toes up and down, turn soles in and out, flex and straighten toes

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24
Q

cervical spine motion and expected range

A

chin to chest, lift chin, each ear to shoulder, turn chin to shoulder

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25
Q

area of language comprehension

A

wernicke’s area

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26
Q

area for motor function for lanuage

A

broca’s area

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27
Q

corticospinal tract controls

A

skilled voluntary movement like writing

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28
Q

extrapyramidal tract controls

A

gross motor movements like arm swinging when walking

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29
Q

posterior column functions

A

proprioception, vibration, localized touch

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30
Q

peripheral nervous system is made of

A

cranial nerves, spinal nerves, reflex arc

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31
Q

what are the 5 components of reflexes

A

functional synapse, intact sensory nerve, intact motor nerve, neuromuscular junction is intact, muscle is competent

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32
Q

light headedness is usually a sign of a problem with

A

heart

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33
Q

vertigo is a sign of a problem with

A

neuro

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34
Q

3 important things to remember for neuro exam

A

mental status intact?, are right and left sided findings the same/symmetric, if findings are asymmetric does the lesion lie in the CNS or PNS

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35
Q

7 components of neuro exam

A

mental status, cranial nerves, motor system, sensory system, coordination, romberg/gait, reflexes

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36
Q

p wave of ekg is

A

atria depolarizing and contracting

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37
Q

QRS wave is

A

beginning of ventricles contracting

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38
Q

ST segment represents

A

plateau phase of repolarization

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39
Q

T wave represents

A

final rapid phase of ventricular repolarization/ventricle contracting

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40
Q

long QT interval warms that a patient is

A

vulnerable to irregular rhythms

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41
Q

hesitancies in speech could be a sign of

A

aphasia in a patient with a stroke

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42
Q

monotone inflection could be a sign of

A

schizophrenia or severe depression

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43
Q

circumlocutions

A

words or phrases are substituted for things pt cant remember

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44
Q

paraphasias

A

words are malformed or wrong

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45
Q

Bell’s palsy signs

A

peripheral lesion in CN 7, paralysis in upper and lower part of the face, eye would not close on that side, flat nasal labial fold

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46
Q

central lesion/stroke signs

A

lesion in CNS, little bit of innervation in upper face so eyes would close, flat nasal labial fold

47
Q

spastic muscle tone

A

upper motor neuron of corticospinal tract at any point from the cortex to the spinal cord, causes clasp knife rigidity

48
Q

rigid muscle tone

A

basal ganglia system is effected, constant state of resistance in any direction, lead pipe and cogwheel rigidity

49
Q

flaccid muscle tone

A

effects the lower motor neuron at any point from the anterior horn cell to the peripheral nerves

50
Q

fasciculation

A

rapid continuous twitching of a resting muscle

51
Q

tetany

A

involuntary muscle spasm

52
Q

myoclonus

A

rapid sudden jerk

53
Q

spinothalamic tract senses

A

pain, temperature, light or crude touch

54
Q

posterior column senses

A

vibration, proprioception, fine discrimination

55
Q

clonus test

A

rapidly flex foot, if foot oscillates after that is positive, test of upper motor lesion

56
Q

cremasteric reflex

A

stroke inner thigh causes cremator muscle to pull up testes

57
Q

upper motor neuron problems

A

CVA, stroke, MS, cerebral palsy, spastic/increased tone, positive babinksi

58
Q

lower motor neuron problems

A

polio, spinal cord lesion, loss of tone

59
Q

growth and development pattern

A

cephalocaudal, proximal to distal, gross to fine

60
Q

hypertonic muscle

A

heightened muscle tone

61
Q

hypotonic muscle

A

floppy and lose muscles

62
Q

scoliosis

A

screen with scholiometer (if angle is greater than 7 it is bad)

63
Q

hip dysplasia

A

hip dislocation

64
Q

barlow maneuver

A

adduct hip, push thigh posteriorly and hip goes out of socket

65
Q

ortolani maneuver

A

abduct thigh, apply downward pressure, clunk means unstable hip has been reduced

66
Q

trendelenburg gait

A

colateral side drops, causes uneven gait

67
Q

genu varum “bow legged”

A

normal until 3, refer if angle is acute

68
Q

genu valgum “knock kneed”

A

normal until age 7, correctable until age 9

69
Q

3 causes of intoeing

A

from hip (femoral anteversion, caution on child’s seating), from tibia (tibial tortion, knees still face forward), from the foot (metatarsal adductus, distal half of the foot points in)

70
Q

disappearing baby reflexes

A

palmar grasp, placing/stepping, rooting/sucking, moro, tonic neck, plantar reflex, babinski

71
Q

abnormal childhood reflexes

A

oppenheimer, chaddock, snouting

72
Q

oppenheimer

A

run reflex hammer down interior calf, abnormal if big toe fans out

73
Q

chaddock

A

reflex hammer down outer foot, abnormal if big toe fans out

74
Q

snouting

A

reflex hammer on philtrum, abnormal if lips scrunch up

75
Q

normal PR interval

A

less than .2sec

76
Q

Normal QRS interval

A

less than .08 sec

77
Q

QT interval

A

less than .4sec

78
Q

where do limb leads record activity

A

frontal plane of the body

79
Q

chest leads record activity

A

in the horizontal plane of the body

80
Q

lichen sclerosis

A

labia/clitoris is reabsorbed

81
Q

cystocele

A

bladder prolapses out bc anterior wall of vagina is too weak

82
Q

rectocele

A

rectum protrudes out, posterior wall of vagina is too weak

83
Q

reducable hernia

A

can be moved out of the way

84
Q

irreducable hernia

A

can’t be moved, can become gangrenous

85
Q

indirect hernia

A

internal ring, canal, external ring, scrotum, bulge over midpoint of ligament, pain with baring down, most common type of hernia, auscultate for bowel sound, more common in young men

86
Q

direct hernia

A

painless, herniates directly behind and through external ring, rarely goes into scrotum, usually in older men from weight lifiting or obesity

87
Q

femoral cana hernia

A

can become strangulated, extremely painful, least common in men and most common in women

88
Q

how to calculate HR from EKG

A

300-150-100-75-60-50

89
Q

regular heart rhythm

A

all RR intervals are equal in length

90
Q

regularly irregular heart rhythm

A

RR intervals are different lengths but overall pattern is similar

91
Q

irregularly irregular heart rhythm

A

no overall pattern

92
Q

sinus tach rate

A

greater than 100

93
Q

saw tooth ekg

A

atrial flutter, 240-360bpm, single ectopic foci

94
Q

afib ekg

A

multiple weak ectopic foci resulting in weak tiny p wave, irregularly irregular rate, don’t know when ventricles will contract

95
Q

pts with afib need to be on

A

coumadin bc blood pools in atria

96
Q

what can irritate a ventricular foci

A

low O2 and hypokalemia

97
Q

what does a PVC look like

A

giant ventricular complex and a compensatory pause

98
Q

how many PVCs in a minute is considered pathological

A

6 or more

99
Q

PVCs can lead to

A

vtach or vfib

100
Q

vtach is the result of

A

one strong ventricular focus that hijacks the conduction system of the heart, can’t sustain life for long, usually leads to vfib

101
Q

what does vtach look like

A

very rapid, enormous PVC like waves

102
Q

vfib looks like

A

beating of many weak ectopic foci, uncoordinated contractions

103
Q

how to treat vfib

A

CPR and defibrilation

104
Q

what is first degree AV heart block

A

PR interval >.2, consistent

105
Q

second degree AV heart block types

A

wenckebach and mobitz type 1

106
Q

wenckeback second degree AV block

A

progressively longer PR duration until a nonconducted PR, regularly irregular

107
Q

mobitz type 2

A

normal p waves and interval until no QRS, can have different degrees (2:1 is 2 p waves per QRS)

108
Q

3rd degree or complete heart block

A

AV node is totally blocked so there is no relationship between P wave and QRS complex, treat with a pacemaker

109
Q

tendons

A

hook muscle to bone

110
Q

ligaments

A

hook bone to bone

111
Q

what bone is not involved in the knee

A

fibula

112
Q

broca’s aphasia

A

expressive

113
Q

wernickes aphasia

A

receptive

114
Q

positive babinski could indicate

A

stroke, MS, meningitis, etc.

Physical Assessment (3 decks)

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