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
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.
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
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
5
Q
S/S of upper motor neuron diseas
A
- SLOWNESS OF MOVEMENT (BRADYKANESIA)
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
7
Q
S/S of S1 root compression
A
FOOT NUMBNESS AND PLANTAR FLEXION FOOT WEAKNESS
8
Q
Herniated disk / Sciatica
A
- ELECTRIC LOWER BACK PAIN THAT RADIATES INTO BUTTOX AND LOWER LEGS
- Positive SLR test
9
Q
Tinel’s sign
A
- test for carpel tunnel
- tap anterior wrist
- Positive: PINS & NEEDLES SENSATION IN THE MEDIAL NERVE
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
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
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
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
14
Q
Fencing Position
A
- TONIC NECK REFLEX IN INFANTS THAT DISSAPPEARS AT 4-6 MONTHS
15
Q
Acoustic blink reflex
A
- seen in infants
- BILATERAL BLINK REFLEX IN RESPONSE TO LOUD NOISE
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
17
Q
Ortolani Maneuver
A
- test for hip dislocation
- rotate hips in frog leg position. click/clunk or palpated dislocation
- INDICATES REDUCIPLE HIP DYSPLASIA
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”
19
Q
Primary headache
A
ABSENCE OF STRUCTURAL PATHOLOGY/SYSTEMIC DISEASE.
20
Q
Secondary Headache
A
ATTRIBUTED TO UNDERLYING DISEASE (sinusitis).
21
Q
Tension-type headache
A
- most common type in adults
- bandlike tightness/pressure
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.
23
Q
Migraine without aura
A
- headache is UNILATERAL and THROBBING
- most often accompanied by NAUSEA, PHOTOPHOBIA, and EXACERBATED by PHYSICAL ACTIVITY
24
Q
CN: II
A
optic
25
CN: III
oculomotor
26
CN: IV
trochlear
27
CN: V
Trigeminal
28
CN: VI:
abducens
29
CN: VII
FACIAL PARALYSIS
30
Trigeminal Neuralgia
- pain associated with CN V
| - characterized by bursts or jabs of sharp or electrical pain.
31
Diagnostic criteria of Trigeminal Neuralgia
- NO DIAGNOSTIC STUDIES
| - normal physical exam: stimulation of sensory triggers provoke pain by rubbing or touching the face and swallowing
32
Bell's Palsy
- abrupt onset of unilateral facial paralysis d/t CN VII dysfunction
- most cases resolve spontaneously
- etiology: viral, autoimmune, tumor or vessel compress nerve
33
Benign Paroxysmal Positional Vertigo
- 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
Meniere's Disease
characterized by classic triad if s/s: VERTIGO, HEARING LOSS, and TINNITIS.
- NOT CURABLE
35
Labyrinthitis
- 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
Syncopal episode
- FIRST LINE EVALUATION: EKG
37
Multiple Sclerosis
- GRADUAL PROGRESSION OF FATIGUE, GENERALIZED MUSCLE WEAKNESS, HYPERATIVE DTRs, ATAXIA, and BLURRED VISION.
- Cause: DESTRUCTIVE PROCESS OF MYELIN SHEATH
38
Parkinson's Disease
Classic 3 symptoms: TREMORS, MUSCLE RIGIDITY, AND BRADYKINESIA
39
Sinusitis
- associated with sore throat, headache worsened w/coughing or bending, cough worsened while supine, morning periorbital edema, fever, malaise, and recent URI
40
Temporal Arteritis
- TENDER, NODULAR TEMPORAL ARTERY d/t vasculitis of internal carotid artery
- ELEVATED ESR is almost always present
41
TIA
transient episode of TEMPORAY neurological deficit.
42
TIA/CVA non-modifiable risk
- AGE, AA/RACE/ETHNICITY, FAMILY HX,
43
TIA/CVA secondary risk reduction
- DIET, EXERCISE, TOBACCO & ALCOHOL CESSATION, DM/HTN/HLD MANAGEMANT
44
Bursitis
- extra-articular pain caused by inflammation of bursae
- common in shoulder, elbows, and hips
- most common cause is overuse, repetitive motions, and trauma
45
Tennis Elbow (lateral humeral epicondylitis)
- 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
Legg-calve-perthes-disease
- 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
Osgood-Schlatter Disease
- 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
Osteoarthritis
- most common arthritis caused by degeneration of joint cartilage resulting in osteophyte.
- risk: joint trauma, obesity, and DM
- NO LAB DIAGNOSTIC
49
Crepitus
may indicate osteoarthritis
50
Rheumatoid Arthritis
- systemic autoimmune disorder
| - can diagnose through lab workup: RF FACTOR & ANTI-CYCLIC CITRULLINATED PEPTIDE (best diagnostics)
51
Fibromyalgia
- characterized by chronic fatigue, generalized musculoskeletal pain, & multiple trigger points of pain on PE
- primarily effects women
- pain is worse in the morning
52
Gout
- joint inflammation caused by deposits of URIC ACID CRYSTALS IN SYNOVIAL FLIUID AND BURSAE
53
Gout risk factors:
- ALCOHOL, DIURETIC USE W/OBESITY & HTN, MEN OVER 30 W/FAMILY HX
54
Gout Diet
- avoid ALCOHOL, RED MEAT, PURINES, KIDNEY/LIVER, SWEETBREADS, SHELLFISH, TUNA, ASPARAGUS, SPINACH, and SUGARY FOOD/BEVERAGES
55
Stress Fracture
- 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
Plantar Fasciitis
- 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
Polymyalgia Rheumatica
- bilateral joint stiffness and aching in the shoulders, neck, hips, and torso
- difficulty putting on bra/clothes, getting out of chair.
58
Nursemaid Elbow (radial head subluxation)
- 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
Superficial Vein Thrombosis
- inflammation and clotting of a vein at the surface, generally arms and legs.
- skin becomes red, swollen, and painful
60
Popliteal aneurysm
- aneurysm that burst behind the knee
| - LIFE THREATENING
61
Popliteal cyst (Baker's Cyst)
- OCCURS WHEN FLUID FROM THE KNEE JOINT ENTERS THE BURSA AND BECOMES TRAP
62
Osteoporosis Risk factors
- chronic steroid use, white & Asian, thin/small frame, anorexia/bulimia, long term use of PPI, gastric bypass, celiac disease, hyperthyroidism, and RA
63
Osteoporosis in men
- HYPOGONADISM (LOW TESTOSTERONE),
| - alcohol and tobacco abuse, and glucocorticoids
64
Ottawa Rules (Ankle sprain)
```
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.
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65
Spondylolisthesis
- disruption of vertebral spinous process causing subluxation of vertebral body into adjacent structures
- usually occurs between L5 and S1
66
Lumbar (spinal) stenosis
- CHRONIC PAIN WITH WALKING OR STANDING
| - Pain relief when sitting or forward flexion of the spine.
67
Tendonitis
- DIAGNOSED BASED ON CLINICAL PRESENTATION (worsened pain w/movement, occupational/recreational hx to differentiate between overuse and trauma)
