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Advanced Health Assessment > Exam 5 > Flashcards

Exam 5 Flashcards

1
Q

Brudzinski’s Sign

A
  • test for MENINGEAL IRRITATION
  • passively bending/flexing the head towards the chest.
  • Positive: HIP AND KNEES REFLEX UP TO RELIEVE PAIN IN LOWER BACK D/T INFLAMMAITION OF LUMBAR NERVE ROOT
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2
Q

Kernig’s sign

A
  • test for meningeal irritation
  • flex patients hip into 90 degree one at a time while the opposite leg is flat on table then attempt to straighten leg up.
  • Positive: resistance to leg straightening d/t pain in hamstring or back d/t inflammation at lumbar nerve root.
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3
Q

Romberg Test

A
  • BALANCE TEST for CEREBELLAR DYSFUNCTION
  • have patient stand with feet together, arms straight down, and eyes closed
  • Positive: UNABLE TO BALANCE, excessive swaying, opens eyes, takes step forward or out
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4
Q

Babinski’s Sign

A
  • stroke plantar surface of foot on lateral border from heel to toe
  • Positive: toes fan out in the presence of CVA, head injury, infarct, and dementia
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5
Q

S/S of upper motor neuron diseas

A
  • SLOWNESS OF MOVEMENT (BRADYKANESIA)
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6
Q

Straight leg (Lesegue’s test)

A
  • TEST FOR NERVE ROOT COMPRESSION AT S1 AND L5

- Positive: leg/glute pain with passive leg raising

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7
Q

S/S of S1 root compression

A

FOOT NUMBNESS AND PLANTAR FLEXION FOOT WEAKNESS

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8
Q

Herniated disk / Sciatica

A
  • ELECTRIC LOWER BACK PAIN THAT RADIATES INTO BUTTOX AND LOWER LEGS
  • Positive SLR test
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9
Q

Tinel’s sign

A
  • test for carpel tunnel
  • tap anterior wrist
  • Positive: PINS & NEEDLES SENSATION IN THE MEDIAL NERVE
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10
Q

Phalens

A
  • test for carpel tunnel
  • engage in full flexion of wrist for 60 sec.
  • Positive: tingling sensation of medial nerve after 1 min of flexion
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11
Q

Lachman’s test

A
  • test for torn ACL
  • knee flexed 20-30 degrees with foot planted on table while supine. Pull tibia forward
  • Positive: ANTERIOR MOTION INDICATES ACL LAXITY/TEAR
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12
Q

Drawer’s sign

A
  • test for ligament instability
  • supine, flex knee 45 degrees with foot on table. apply slow, steady, anterior pull while also pushing the tibia back
  • Positive: anterior movement
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13
Q

McMurry Maneuver

A
  • test for Meniscus injury
  • supine, place hand under the heel, flex knee 90 degrees, apply lateral/medial force to the knee while extending and abducting it.
  • Positive: PALPABLE & AUDIBLE CLICK INDICATED MENISCUS INJURY
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14
Q

Fencing Position

A
  • TONIC NECK REFLEX IN INFANTS THAT DISSAPPEARS AT 4-6 MONTHS
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15
Q

Acoustic blink reflex

A
  • seen in infants

- BILATERAL BLINK REFLEX IN RESPONSE TO LOUD NOISE

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16
Q

Febrile seizure

A
  • occurs in INFANTS> 6 MONTHS W/FEVER OF 101
  • seizure in infants <6 mo suggest meningitis
  • benign febrile seizure in small infants is uncommon
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17
Q

Ortolani Maneuver

A
  • test for hip dislocation
  • rotate hips in frog leg position. click/clunk or palpated dislocation
  • INDICATES REDUCIPLE HIP DYSPLASIA
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18
Q

Barlow Maneuver

A
  • test for hip dislocation
  • push both knees together up and down
  • “clunk” sound while trochanter slips back into acetabulum indicated reducible hip”
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19
Q

Primary headache

A

ABSENCE OF STRUCTURAL PATHOLOGY/SYSTEMIC DISEASE.

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20
Q

Secondary Headache

A

ATTRIBUTED TO UNDERLYING DISEASE (sinusitis).

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21
Q

Tension-type headache

A
  • most common type in adults

- bandlike tightness/pressure

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22
Q

Cluster headache

A
  • Pain is UNILATERAL, OCULAR, PERIOCULAR, and described as BURNING, PIERCING, or NEURALGIC.
  • associated with IPSILATERAL LACRIMATION, RHINORRHEA, CONJUNCTIVAL INJECTIONS, PTOSIS, and EYELID EDEMA.
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23
Q

Migraine without aura

A
  • headache is UNILATERAL and THROBBING

- most often accompanied by NAUSEA, PHOTOPHOBIA, and EXACERBATED by PHYSICAL ACTIVITY

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24
Q

CN: II

A

optic

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25
Q

CN: III

A

oculomotor

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26
Q

CN: IV

A

trochlear

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27
Q

CN: V

A

Trigeminal

28
Q

CN: VI:

A

abducens

29
Q

CN: VII

A

FACIAL PARALYSIS

30
Q

Trigeminal Neuralgia

A
  • pain associated with CN V

- characterized by bursts or jabs of sharp or electrical pain.

31
Q

Diagnostic criteria of Trigeminal Neuralgia

A
  • NO DIAGNOSTIC STUDIES

- normal physical exam: stimulation of sensory triggers provoke pain by rubbing or touching the face and swallowing

32
Q

Bell’s Palsy

A
  • abrupt onset of unilateral facial paralysis d/t CN VII dysfunction
  • most cases resolve spontaneously
  • etiology: viral, autoimmune, tumor or vessel compress nerve
33
Q

Benign Paroxysmal Positional Vertigo

A
  • acute onset of vertigo w/rapid head movement or positional change
  • caused by tiny calcium crystals in the inner ear that dislodge and migrate into semicircular canals.
34
Q

Meniere’s Disease

A

characterized by classic triad if s/s: VERTIGO, HEARING LOSS, and TINNITIS.
- NOT CURABLE

35
Q

Labyrinthitis

A
  • severe vertigo that lasts several days d/t viral or bacterial illness or complication of otitis media or meningitis.
  • distinguished from vestibular neuritis by the accompanying hearing loss d/t destruction of the inner ear.
  • visual ocular reflex lateralize to the affected side.
36
Q

Syncopal episode

A
  • FIRST LINE EVALUATION: EKG
37
Q

Multiple Sclerosis

A
  • GRADUAL PROGRESSION OF FATIGUE, GENERALIZED MUSCLE WEAKNESS, HYPERATIVE DTRs, ATAXIA, and BLURRED VISION.
  • Cause: DESTRUCTIVE PROCESS OF MYELIN SHEATH
38
Q

Parkinson’s Disease

A

Classic 3 symptoms: TREMORS, MUSCLE RIGIDITY, AND BRADYKINESIA

39
Q

Sinusitis

A
  • associated with sore throat, headache worsened w/coughing or bending, cough worsened while supine, morning periorbital edema, fever, malaise, and recent URI
40
Q

Temporal Arteritis

A
  • TENDER, NODULAR TEMPORAL ARTERY d/t vasculitis of internal carotid artery
  • ELEVATED ESR is almost always present
41
Q

TIA

A

transient episode of TEMPORAY neurological deficit.

42
Q

TIA/CVA non-modifiable risk

A
  • AGE, AA/RACE/ETHNICITY, FAMILY HX,
43
Q

TIA/CVA secondary risk reduction

A
  • DIET, EXERCISE, TOBACCO & ALCOHOL CESSATION, DM/HTN/HLD MANAGEMANT
44
Q

Bursitis

A
  • extra-articular pain caused by inflammation of bursae
  • common in shoulder, elbows, and hips
  • most common cause is overuse, repetitive motions, and trauma
45
Q

Tennis Elbow (lateral humeral epicondylitis)

A
  • inflammation of the bone-tendon junction d/t repetitive concentric contractions that transmit force via muscles to the origin on the lateral epicondyle
  • tennis players, bowlers, hockey players, and non-athletes who have occupations w/repeated contractions of extensor and supinator muscles are most at risk
46
Q

Legg-calve-perthes-disease

A
  • osteochondritis of the femoral head epiphysis characterized by period of avascular necrosis of femoral head.
  • most common in boys 3-11 years old
  • loss of medial hip motion
47
Q

Osgood-Schlatter Disease

A
  • painful swelling of the anterior aspect if the tibial tubercle d/t strenuous activity (especially quads)
  • GENERALLY OCCURS IN YOUNG MALES W/A RAPID GROWTH SPURT
  • treatment: stop activity
48
Q

Osteoarthritis

A
  • most common arthritis caused by degeneration of joint cartilage resulting in osteophyte.
  • risk: joint trauma, obesity, and DM
  • NO LAB DIAGNOSTIC
49
Q

Crepitus

A

may indicate osteoarthritis

50
Q

Rheumatoid Arthritis

A
  • systemic autoimmune disorder

- can diagnose through lab workup: RF FACTOR & ANTI-CYCLIC CITRULLINATED PEPTIDE (best diagnostics)

51
Q

Fibromyalgia

A
  • characterized by chronic fatigue, generalized musculoskeletal pain, & multiple trigger points of pain on PE
  • primarily effects women
  • pain is worse in the morning
52
Q

Gout

A
  • joint inflammation caused by deposits of URIC ACID CRYSTALS IN SYNOVIAL FLIUID AND BURSAE
53
Q

Gout risk factors:

A
  • ALCOHOL, DIURETIC USE W/OBESITY & HTN, MEN OVER 30 W/FAMILY HX
54
Q

Gout Diet

A
  • avoid ALCOHOL, RED MEAT, PURINES, KIDNEY/LIVER, SWEETBREADS, SHELLFISH, TUNA, ASPARAGUS, SPINACH, and SUGARY FOOD/BEVERAGES
55
Q

Stress Fracture

A
  • occur often in weight-bearing bones of lower leg and foot
  • common in adolescents who’s bodies are not able to accommodate an increase in intensity of training and in adults who engage in high-intensity training.
56
Q

Plantar Fasciitis

A
  • condition caused by chronic weight-bearing
  • tendons and joints become inflamed and muscles spasm d/t misalignment
  • heel pain is worse upon wakening and relieved with non-weigh bearing
57
Q

Polymyalgia Rheumatica

A
  • bilateral joint stiffness and aching in the shoulders, neck, hips, and torso
  • difficulty putting on bra/clothes, getting out of chair.
58
Q

Nursemaid Elbow (radial head subluxation)

A
  • rapid upward pulling of a child’s hand or wrist caused by subluxation of the radial head
  • radial head is pulled out of the annular ligament
59
Q

Superficial Vein Thrombosis

A
  • inflammation and clotting of a vein at the surface, generally arms and legs.
  • skin becomes red, swollen, and painful
60
Q

Popliteal aneurysm

A
  • aneurysm that burst behind the knee

- LIFE THREATENING

61
Q

Popliteal cyst (Baker’s Cyst)

A
  • OCCURS WHEN FLUID FROM THE KNEE JOINT ENTERS THE BURSA AND BECOMES TRAP
62
Q

Osteoporosis Risk factors

A
  • chronic steroid use, white & Asian, thin/small frame, anorexia/bulimia, long term use of PPI, gastric bypass, celiac disease, hyperthyroidism, and RA
63
Q

Osteoporosis in men

A
  • HYPOGONADISM (LOW TESTOSTERONE),

- alcohol and tobacco abuse, and glucocorticoids

64
Q

Ottawa Rules (Ankle sprain)

A 
Grade 1: mild; able to weight bear
Grade 2: moderate; ecchymosis, moderate swelling & pain
GRADE 3: COMPLETE RUPTURE OF LIGAMENTS
- referral to ED for fx
- inability to weigh bear or ambulate.
65
Q

Spondylolisthesis

A
  • disruption of vertebral spinous process causing subluxation of vertebral body into adjacent structures
  • usually occurs between L5 and S1
66
Q

Lumbar (spinal) stenosis

A
  • CHRONIC PAIN WITH WALKING OR STANDING

- Pain relief when sitting or forward flexion of the spine.

67
Q

Tendonitis

A
  • DIAGNOSED BASED ON CLINICAL PRESENTATION (worsened pain w/movement, occupational/recreational hx to differentiate between overuse and trauma)

Advanced Health Assessment (5 decks)

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