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Primary Care > Examination Process > Flashcards

Examination Process Flashcards

1
Q

Examination Process

A

-Hx
-observation
-Scanning exam
-ROM
-Muscle
-Joing
-Palpation
-Special Tests

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2
Q

SINSS

A

-severity
-irritability
-nature of complaint
-stage
-stability

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3
Q

Severity

A

-clinician assessment of intensity of symptoms in terms of function

Fracture: high
Sprain: low

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4
Q

Irritability

A

-ease with which symtoms can be provoked
1. Amount of activity needed to trigger s/s
2. Severity of s/s
3. What activity and amount of time for symptoms to subside

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5
Q

Nature of Complaint

A

Describe assessment of:
-structures, syndromes
-caution things
-character of problem

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6
Q

Stage of Pathology

A

-stage of injury

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7
Q

Stability

A

-progression of s/s over time

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8
Q

Pt Hx Red Flags

A

-trauma: Fx
-age >50: cancer, AAA, fx, infection
-Hx cancer
-fever,chills, sweats: infection, cancer
-unexplained weight loss: cancer
-infection
-immunosuppression
-rest/night pain: cancer, infection, AAA
-saddle anesthesia: cauda equina
-B/B dysfunction: cauda equina
-LE neuro deficit: cauda equina

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9
Q

Pain Referral: Heart

A

-Left side of chest, arm, jaw, neck
-middle of upper back

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10
Q

Pain Referral: Lungs

A

-neck and shoulders

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11
Q

Pain Referral: Esophagus

A

-front of chest

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12
Q

Pain Referral: Liver and Gallbladder

A

-front and back right side of back/abdomen
-front and back of right side of chest and neck

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13
Q

Pain Referral: Stomach

A

-middle of chest
-middle of back

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14
Q

Pain Referral: Pancreas

A

-anterior, middle abdomen

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15
Q

Pain Referral: Kidney

A

-hips and thighs

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16
Q

Pain Referral: Small Intestine

A

-anterior lower abdomen

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17
Q

Pain Referral: Appendix

A

-right, anterior, lower mid to low abdomen and pelvis

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18
Q

Pain Referral: Ovaries

A

-bilateral pelvic

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19
Q

Pain Referral: Colon

A

-anterior pelvis

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20
Q

Pain Referral: Bladder

A

-Anterior and posterior pelvis
-genital
-back of thighs

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21
Q

MSK Symptom Investigation

A

-pain that changes over 24h
-motions change pain

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22
Q

Non-MSK Symptom Investigation

A

-referral from organ systems
-pain doesn’t fluctuate with mmt
-insidious onset
-vague pain
-during eating or urinating

Unusual:
-throbbing, pounding, pulsating (vascular)
-shooting, burning, shocking (neuro)
-aching, squeezing, cramping (visceral)

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23
Q

Sequence of Symptom Questions

A

-what interferes most w/ normal function
-describe it
-behavior of s/s
-intensity
-s/s elsewhere

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24
Q

Low Back Red Flags

A

-Tumor
-Infection/Osteomyelitis
-Cauda Equina
-Fx
-Abdominal Aneurysm

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25
Q

Back Related Tumor Red Flags

A

Hx:
->50
-Hx Cancer
-unexplained weight loss
-failure of treatment

Exam:
-Constant Pain
-worse at night

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26
Q

Back Related Infection/Osteomyelitis Red Flags

A

Hx:
-infection/drug use
-immunosuppressed

Exam:
-deep constant pain
-fever, malaise, swelling
-spine rigidity

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27
Q

Cauda Equina Red Flags

A

Hx:
-spinal stenosis
-DDD

Exam:
-urinary retention
-fecal incontinence
-saddle anesthesia
-weakness of LE
-sensory issues

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28
Q

Spinal Fx Flags

A

Hx:
-trauma
-steroid use
->70

Exam:
-tender with palpation
-edema

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29
Q

Abdominal Aneurysm Flags

A

Hx:
-back, groin pain
-PVD or CAD
-s/s not related to movement

Exam:
-Abnormal width of aortic or iliac arterial pulses
-bruit

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30
Q

Pelvis, Hip, and Thigh Red Flags

A

-colon cancer
-femoral neck Fx
-Osteonecrosis
-Legg- Calve Perthes
-SCFE

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31
Q

Colon Cancer Red Flags

A

Hx:
->50
-Bowel Disturbances
-Hx cancer in immediate fam
-pain unchanged by position

Exam:
-hypo or hyperactive bowel
-tenderness in abdomen
-ascites
-metastases to liver,lung, brain, bone

32
Q

Femoral Neck Fracture

A

Hx:
-older women
-hip, groin, thigh pain
-Hx of fall

Exam:
-severe, constant pain
-shortened LE

33
Q

Osteonecrosis

A

Hx:
-corticosterioid
-Hx of osteonecrosis
-trauma

Exam:
-gradual onset
-stiff joint, restricted 1 deg IR or Flx

34
Q

Legg-Calve-Perthes

A

Hx:
-5-8 yr old boys
-groin/thigh pain

Exam:
-antalgic gait
-pain worse with hip mmt (hip abd/IR)

35
Q

Slipped Capital Femoral Epiphysis

A

Hx:
-overweight child
-Hx of growth spurt

Exam:
-aching in groin
-leg in ER
-ROM IR limitations

36
Q

Knee, Leg, Ankle, Foot Red Flags

A

-PAD
-DVT
-Compartment Syndrome
-Septic Arthritis
-Cellulitis

37
Q

Peripheral Arterial Occlusive Disease

A

Hx:
->60
-DM
-H of ischemic HD
-Smoking
-sedentary
-claudication

Exam:
-cool extremity
-prolonged capillary fill time
-decreased pulses
-prolonged vascular fill time

38
Q

DVT

A

Hx:
-surgery
-trauma
-pregnancy
-immobilization

Exam:
-pain
-edema
-warmth/redness
-relieved by rest and elevation

39
Q

Compartment Syndrome

A

Hx:
-blunt trauma

Exam:
-severe leg pain
-swelling/tenderness
-paresthesia, pallor, pulselessness

40
Q

Septic Arthritis

A

Hx:
-recent infection
-surgery
-immunosuppressive

Exam:
-constant aching
-joint swelling
-warmth
-elevated body temp

41
Q

Cellulitis

A

Hx:
-recent skin ulceration
-abrasion
-venous insufficiency
-Cirrosis
-CHF

Exam:
-pain
-skin swelling
-warmth
-irregular redness
-fever, chills, weakness

42
Q

Thoracic Spine and Rib Cage Regions Red Flags

A

-MI
-Angina (stable and unstable)
-Pericarditis
-PE
-Pleurisy
-Pneumothorax
-Pneumonia
-Cholecystitis
-Peptic Ulcer
-Pyelonephritis
-Kidney stones
-Spinal Fx

43
Q

Myocardial Infarction

A

Hx:
-risk factors for CAD

Exam:
-chest pain
-pallor, sweating, dyspnea
-not relieved by nitroglycerin

44
Q

Unstable Angina

A

Hx:
-Hx CAD

Exam:
-outside of the predictable pattern
-not responsive to nitroglycerin

45
Q

Stable Angina

A

Hx:
->65
-Hx CAD

Exam:
-predictable exertion
-predictably alleviated or w/rest or nitroglycerine

46
Q

Pericarditis

A

Hx:
-autoimmune diseases
-MI
-Renal failure
-open heart surgery
-radiation

Exam:
-sharp feeling in chest that might be referred to neck or shoulder
-increased pain with sidelying
-releived by sitting forward

47
Q

Pulmonary Embolism

A

Hx:
-risk factors
-immobility
-trauma
-cancer

Exam:
-chest, shoulder and upper abdominal pain
-dyspnea
-tachypnea
-tachycardia

48
Q

Pleurisy

A

Hx:
-respiratory disorder
-infection
-pneumonia
-tumor
-TB

Exam:
-severe, sharp pain with inspiration
-dyspnea
-decreased chest wall excursion

49
Q

Pneumothorax

A

Hx:
-coughing
-strenuous exercise
-trauma

Exam:
-chest pain with inspiration
-difficulty breathing
-hyperresonance
-decreased breath sounds

50
Q

Pneumonia

A

Hx:
-infections

Exam:
-pleuritic pain
-fever, chills, HA, nausea

51
Q

Cholecystitis

A

Hx:
-most common in middle age women
-WBC elevated

Exam:
-colicky pain in R upper abdomen
-worsen w/ ingestion of fatty foods
-s/s don’t increase with activity or decrease with rest

52
Q

Peptic Ulcer

A

Hx:
-burning pain in epigastrium
-symp relieved by food
-infection
-stressors

Exam:
-tenderness at R epigastriumm
-constipation, bleeding, vom, tarry colored stools, coffee ground emesis

53
Q

Pyelonephritis

A

-kidney infection

Hx:
-women
-UTI
-Kidney stones

Exam:
-fever, chills, malaise, flank pain
-enlarged prostate
-murphy’s sign

54
Q

Nephrolithiasis

A

Hx:
-hot and humid climate
-Hx kidney stones

Exam:
-severe back or flank pain
-chills, fever, vom
-renal colic
-UTI symptoms

55
Q

Spinal Fx

A

Hx:
-trauma
-osteoporosis
-steroid
->70
-loss of function/mobility

Exam:
-midline tenderness
-T11-L1
-bruising
-LE neuro defects
-increased thoracic kyphosis

56
Q

Head, Face and TMJ Regions Red Flags

A

-meningitis
-brain tumor
-Subarachnoid hemorrhage

57
Q

Meningitis

A

Hx:
-infection
-Skull fx

Exam:
-Positive slump sign
-HA
-Fever
-GI signs
-photophobia
-confusion

58
Q

Primary Brain Tumor

A

Hx:
-20-64 yrs

Exam:
-HA
-altered mental status
-ataxia
-speech
-sensory issues
-GI signs
-Seizures

59
Q

Subarachnoid hemorrhage

A

Hx:
-smoking, HTN
-sudden HA (worst of pt life)

Exam:
-LOC
-tumor signs
-rigidity, fever, photophobia, vom

60
Q

Cervical Ligament Instability/Cord compromise

A

Hx:
-trauma
-RA or AS
-contraceptive

Exam:
-long tract neuro signs
-dizziness, nystagmus, vertigo
-clonus/Babinski

61
Q

Cervical/Shoulder Entrapment/Neuropathies

A

Hx:
-Paresthesias
-pain at rest
-retrograde distribution

Exam:
-muscles tender to palpation
-muscle and sensory issues in specific nerve patterns

62
Q

Spinal Accessory Nerve Issues

A

Hx:
-penetrating injury
-direct blow
-surgery around neck

Exam:
-asymmetry of neck line and dropping of shoulder
-inability to shrug
-lack of scapular stabilization
-weakness of shoulder abduction

63
Q

Axillary Nerve Issues

A

Hx:
-shoulder dislocation
-traction force
-trauma
-brachial neuritis

Exam:
-weakness of shoulder abduction and flx
-lack of later sensation of arm

64
Q

Long Thoracic Nerve Issues

A

Hx:
-sport playing that involves arms

Exam:
-serratus anterior weakness w/ scapular winging
-loss of scapulohumeral rhythm

65
Q

Suprascapular Nerve Issue

A

Hx:
-deep, poorly localized pain
-fx of scap
-traction MOI
-direct compression

Exam:
-similar to RC tear w/ wasting of supra and infra
-loss of strength in shoulder abd and ER

66
Q

Pancoast’s Tumor (apical lung tumor)

A

Hx:
-men >50
-smoking

Exam:
-nagging type pain in shoulder
-burning pain
-ulnar nerve distribution

67
Q

Elbow, Wrist, and Hand Red Flags

A

-fx
-radial head fx
-Distal radius fx
-Scaphoid fx
-Lunate fx/dislocation
-TFCC tear
-Space infection of hand
-Long Flexor Tendon rupture
-Raynaud’s Disease
-Complex Regional Pain Syndrome

68
Q

Fx’s

A

Hx:
-trauma
-osteoporosis
-steroids

Exam:
-signs of inflammation

69
Q

Radial Head Fx

A

Hx:
-FOOSH

Exam:
-antero lateral pain at elbow
-cant supinate or pronate
-elbow held at side at 70 flx, slightly sup

70
Q

Distal Radius (Colles’) Fx

A

Hx:
-FOOSH with extension
->40y
-osteoporosis

Exam:
-wrist in neutral
-swelling
-extension of wrist is painful

71
Q

Scaphoid Fx

A

Hx:
-FOOSH

Exam:
-swelling
-held in neurtral
-pain in snuffbox

72
Q

Lunate Fx/Dislocation

A

Hx:
-FOOSH
-diffuse synovitis

Exam:
-wrist swelling and pain
-decreased motion and grip strength

73
Q

Triangular Fibrocartilaginous Complex tear

A

Hx:
-fall after FOOSH pronated
-ass with colles’ fx

Exam:
-ulnar side wrist pain
-tenderness and clicking during ulnar dev
-weak grip strength
-dorsal ulnar head sublux

74
Q

Space infection of hand

A

Hx:
-skin puncture
-bite
-abscess
-tenosynovitis

Exam:
-inflammation in palm
-infection

75
Q

Long Flexor Tendon Rupture

A

Hx:
-RA
-corticosteroid
-trauma

Exam:
-strain s/s
-inflammation
-decreased motion
-defect

76
Q

Raynaud’s Phenomenon

A

Hx:
-RA
-oocclusive vascular disease
-smoking
-beta blockers

Exam:
-hands or feet that blanch or cyanotic then turn red
-pain and tingling

77
Q

Complex Regional Pain Syndrome

A

Hx:
-trauma
-pain that does not respond to analgesics

Exam:
-pain not consistent with typical injury
-hypersensitivity
-swollen area

Primary Care (7 decks)

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