Exam prep Flashcards
What is the landmarks for the brachial pulse?
Antecubital fossa
Medial to the biceps tendon
What is the normal range for Blood pressure in adults?
Systolic: 90-120 (when the heart beats)
Diastolic: 60-80 (when the heart relaxes)
What is Hypertension?
Elevated high blood pressure
> 140/90mmhg
Diabetes
What is Hypotension?
Abnormally low blood pressure
< 95/60mmhg
Dehydration, emotional stress
What is the Ausculatory gap?
A brief period of time where korotkoff sounds cannot be heard.
Hypertensive patients.
What is the placement of the thermometer in anatomical terms?
Posterior sublingual pocket
Inferior to the tongue
Client is to keep the mouth closed
What is the normal range for body temperature in adults?
35.8 - 37.3
What is the purpose of taking the temperature?
To assess the body’s metabolism
What is hypothermia?
Below 35.8 degrees - decreased body temperature
Can be due to exposure to cold
What is hyperthermia?
Above 37.4 degrees - elevate body temperature
Can be due to infection
What is the landmark for taking the pulse in anatomical terms?
Lateral to the palmaris longus tendon
Medial to the radius bone
Laterally at the flexor aspect of the wrist
What is the force of the pulse?
+1 = weak, thready pulse
+2 = normal, easy to detect
+3 = full bounding, difficult to obliterate
What is the purpose of taking the pulse?
To asses the heart rate and rhythm of the pulse.
What is the normal range of the pulse in adults?
between 60-100 BPM
What is Tachycardia?
Fast pulse rate above 100+BPM
Can be caused by infection
What is Bradycardia?
Slow pulse rate, below 60BPM
Can be due to the person being a yoga practitioner or athlete
What is the purpose of assessing the respiratory rate?
To assess the oxygen status
What is the normal respiratory rate in adults?
10-20 Breaths PM
What is tachypnea?
Fast breathing rate above 20 breaths PM
Can be caused by exercise or infection
What is bradypnea?
Slow breathing rate below 10 breaths PM
Can be caused by a slow or underachieve thyroid
What is the grading scale for muscle testing?
0 = No contraction (0% normal)
1 = Slight visible contraction (10% trace)
2 = Full ROM w/ gravity eliminated (passive movements) (25% Poor)
3 = Full ROM against gravity (No resistance) (50% fair)
4 = Full ROM against gravity (Some resistance) (75% good)
5 = Full ROM (full resistance) (100% normal)
How is the respiratory rate recorded?
Respiratory rate per min, the rhythm (regular or irregular) and effort of breathing (relaxed or laboured)
What is the normal appearance of the eye?
Symmetrical in size and shape, free from any swelling, cysts, exudate or redness
What are some abnormalities of the eye?
Inflammation, cysts, swellings, excess watering, exudate, cloudy vision (cataracts)
What is the significance of the corneal light reflex?
Assesses the extra ocular muscle functions
It tests the cranial nerves 3,4 & 6
The normal response is the light is parallel in alignment in the centre of the cornea
What is esotropia and exotropia?
Esotropia is the eyes turned inwards
Exotropia is the eyes turned outward
What cranial nerves are being tested in the pupillary reactions?
Cranial nerves 2 and 3
Cranial nerve II assesses the sensory function
Cranial nerve III assesses the motor function
What is the normal response for the pupillary reactions?
Pupils Equal and Reacting to Light (PEARL)
Indirect and direct pupillary responses to light are normal and reflected directly and indirectly.
What is diagnostic position testing?
Tests cranial nerves III, IV & VI for extra ocular muscle weakness
What cranial nerves are straight temporal and down nasal?
Straight temporal is CNVI (6)
Down Nasal is CNIV (4)
What is the significance of diagnostic position testing?
Assesses the extra ocular muscle weakness as the eyes move in a 6 cardinal gaze position
What is nystagmus?
Fine involuntary oscillations of the iris
What are the four components of a complete mental status assessment?
Appearance, behaviour, cognition, thought
What is the purpose of the rombergs test?
To asses for ataxia or disequilibrium
Observe for any swaying or loss of balance
Positive test can indicate cerebellar ataxia
What is the cerebellar function? Gait test?
Tests cerebellar function as those with cerebellar ataxia will not be able to walk in a straight line
What is the significance of inspection of the upper and lower limbs?
Is to assess the limbs for muscle tone and observe any atrophy or hypertrophy.
In cases of muscle testing, it is to assess the strength of the muscles bilaterally observing any muscle weakness or deformity.
What is the significance of the sensory system assessment of the upper limb?
This assessment tests the dermatomes of C3 to T1. It tests the anterolateral spinal thalamic tract and posterior column tracts.
What is stereognosis?
the ability to perceive and recognise the form of an object in the absence of visual and auditory information (by using tactile information)
What is proprioception?
the sense that lets us perceive location, movement and action parts of the body
What does stereognosis and proprioception test?
The posterior column tracts
What is the purpose of the co-ordination and rapid alternating movements assessments?
Assess the coordination of the upper limb
What segment coordinates the biceps reflex and what is the expected response?
C5-C6
Normal reflex is flexion of the forearm
What segment coordinates the triceps reflex and what is the expected response?
C7-C8
Extension of the forearm
What needs to be described when assessing the muscles in the motor system assessment?
Size of the muscles
Muscle tone
Muscle strength
Pain or tenderness
What dermatomes does the sharp and dull test test on the lower limb?
L1, L2, L3, L4, L5, S1, S2
Tests the anterolateral spinal thalamic tract
What segment coordinates the patellar reflex and what is the expected response?
L2-L4
Extension of the lower leg
What segment coordinates the achilles reflex and what is the expected response?
L5-S2
Plantar flexion of the foot
What segment coordinates the plantar reflex and what is the expected response?
L4-S2
Withdrawing of the foot and plantar flexion of the toes
What is the babinski sign?
Toes curling backwards
Normal in children, abnormal in adults
Upper motor neuron lesions of the corticospinal tract
What is the deep tendon reflexes scale?
4+ - very brisk, hyperactive w/ clonus, indicative of disease
3+ - brisker than average, may indicate disease, probably normal
2+ - average, normal
1+ - diminished, low normal, or only occurs w reinforcement
0 - no response
In case scenario one, what tests would be completed?
Primary system: musculoskeletal examination of the neck and shoulder
Additional examination:
Mental status assessment
Visual acuity
What could be a probable diagnosis for case study one?
- Severe pain in the neck and right shoulder - pattern of pain suggests a specific region of involvement
- Limited ROM - underlying musculoskeletal issue
- Physical activity - soreness or strain
- Fatigue and disrupted sleep patterns
- Difficulty concentrating and blurred vision - could be due to the pain or sleep disturbances
What would be the expected findings from the musculoskeletal examination in case scenario one?
Inspection
Palpation
ROM
Muscle strength
What are the shapes of the abdomen could be observed during abdominal observation?
Flat - healthy abdomen, flat from the rib margin to the pubic bone, umbilicus located in the centre of the abdomen
Scaphoid - caves in giving it a sunken appearance and could indicate under nourishment, severe stagnation or terminal illness.
Protuberant - much more rounded abdomen, pregnancy or adults w/ obesity, ascites or distension from other causes
Rounded - slightly protuberant, normal abdominal contour is evenly rounded
What are striae?
Stretch marks
What does discolouration of the abdomen indicate?
May indicate jaundice or inflammation
What is the significance of abdominal inspection?
To assess for any abnormalities in the shape, colouration and other features of the abdomen.
What are normal bowel sounds?
Normal bowel sounds are irregular, high pitched, gurgling and cascading sounds
5-30 times per minute
What are hypoactive bowel sounds?
Less than 5 bowel sounds per minute. The absence of any bowel sounds for 5 mins = inactive or obstructed bowels
What are hyperactive bowel sounds?
Loud, high pitched, rushing sounds that indicate increased motility
Borboygmus = hyperactive bowel sound commonly heard as stomach growling
What is the significance of abdominal auscultation?
To determine whether the bowel sounds are normal or abnormal
What is the purpose of light and deep techniques of abdominal palpation?
Light and deep techniques to assess for any rigidity, tenderness, assess or enlarged organs
What is the significance of light palpation of the abdomen?
Helps to form overall impression of the abdomen which is warm and relaxed
What is the significance of percussion of the abdomen?
Assess the relative density of the abdominal contents and to locate organs such as Liver and Spleen
What is the significance deep palpation?
To determine the size and location of organs and masses
What is the significance of Liver palpation?
Palpated in the RUQ to determine if the Liver has enlarged and to ascertain the texture of the Liver
Enlargement or a nodular border or pain on palpation suggests Liver disease or dysfunction
What is the significance of Spleen palpation?
Enlargement of the Spleen on palpation may be linked to viral infections like EBV or mononucleosis, haemolytic anaemias or other blood disorders.
