Exam Mistakes Flashcards
What do you do after assessing gait in lower limb neuro?
Romberg’s test (!)
What do you do to test tone in lower limb neuro
- leg roll
- leg drop
- Passively move each joint
- Ankle clonus (!)
what actions to test power in lower limb neuro (movement of each joint)
- Hip: flexion, extension, abduction, adduction
- Knee: flexion, extension
- Ankle: dorsiflexion, plantar flexion, eversion (!), inversion (!)
- Big toe: plantar flexion, dorsiflexion
Completion of lower limb neuro?
- Cranial nerve examination
- Upper limb neuro
Upper limb neuro: what do you do to start?
ask which dominant hand (!)
What do you do for inspection of upper limb neuro?
- Posture
- SWIFT
- Pronator drift (!)
What do I keep forgetting to inspect in abdo exam?
- Chest wall inspection (!)
GALS: after hand inspection, what do you do with hands?
- Screening movements (arms up, and behind back)
- Hand out, fingers spread
- Turn over
- Make a fist
- Grip strength
- MCP joint squeeze (!)
- Piano fingers (!)
GALS: What actions do you do to check tone in legs?
- Fully flex and extend
- internally and externally rotate hip (!)
GALS: What do you do with the feet?
- Inspect well (!)
- MTP joint squeeze (!)
GALS completion?
- focused exam of joints with suspected pathology
- further imaging if indicated
Completion of upper limb neuro?
- Cranial nerve examination
- Lower limb neuro
Completion of GI exam?
- Inguinal lymph nodes
- Stool sample
- Hernial orifices
- Rectal exam
- Urine sample
- Genital (external) exam
Knee exam: What do you do for feel?
- Temperature
- Palpate borders
- Palpate behind (popliteal fossa)
- Effusions (bulge + swipe)
- flex knee to (90)
- Measure and compare quadricep circumference (!)
Completion of knee exam?
- Hip exam
- Ankle exam
- Neurovascular examination of both exams
Spine exam: what do you do after inspecting the person standing?
Assess gait
Spine exam: Where do you feel on palpation?
- Whole length of spine
- Paraspina muscles
- Supraclavicular fossa (!)
- Sacroilliac joints (!)
What movements do you do for lower spine exam?
- Lumbar: flexion, extension (!), lateral flexion
- Thoracic: Rotation
Spinal exam completion
- Full neurological exam
Hip exam: What do you do for feel?
- Temp
- Palpate joint
- Apparent vs actual leg length (!)
Thyroid exam: what do you look for on hand inspection?
- Just look: sweating, palmar erythema…
- Clubbing (!)
- Fine tremor
Thyroid exam completion?
- Thyroid function test
- ECG (!)
What do test CN VIII ?
- Has your hearing changed?
- Clicking in ears
- Rinne’s + weber’s (!)
What do you do on completion of Cerebellar exam?
- Full neurological exam including CN and upper + lower limbs
- Any appropriate neuroimaging
- Formal hearing assessment
Diabetic foot exam: what do you palpate
- Palpate bones and joints (while watching patients face)
What pulses for diabetic foot exam?
- Posterior tibial
- Dorsalis pedis
- (popliteal of foot pulses absent)
Diabetic foot: what do you do for neuro bit?
- Reflexes: ankle jerk (!)
- Sensation: light, pin-prick, proprioception, vibration
Cardiac completion?
- BP: both arms (!), lying and standing (!)
- Ophthalmoscopy (!)
- 12-lead ECG
What do you do while pulses in resp?
RR (!)
Resp exam completion?
- Sputum sample
- Assess peak flow
- BP
Shoulder exam: what things to I keep forgetting for move?
- Screening movement (!)
- Question: do you have any problems dressing yourslef/washing hair (!)
Completion of shoulder exam?
- Examine cervical spine and elbow
- Assess neurological and vascular status of the limb
Varicose vein: what do you do for further assessment of lower limb?
- Pulses: lower limb 4 (!)
- Pitting oedema (!)
Varicose vein (chronic venous insufficiency exam) completion?
- Doppler ultrasound
- Venous duplex scanning
- ABPI
- Peripheral arterial exam (!)
- Abdominal examination (!)
Peripheral vasc exam: what do you do fo feel (leg)?
- Temp (!)
- Cap refill (!)
- Pulses: all 4
- Sensation: light touch
What special tests for peripheral vasc exam?
Buergers test
Peripheral vasc exam completion?
- BP
- ABPI
- Upper and lower limb neurological examination
