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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
Back Related Tumor Red Flags
Hx: ->50 -Hx Cancer -unexplained weight loss -failure of treatment Exam: -Constant Pain -worse at night
26
Back Related Infection/Osteomyelitis Red Flags
Hx: -infection/drug use -immunosuppressed Exam: -deep constant pain -fever, malaise, swelling -spine rigidity
27
Cauda Equina Red Flags
Hx: -spinal stenosis -DDD Exam: -urinary retention -fecal incontinence -saddle anesthesia -weakness of LE -sensory issues
28
Spinal Fx Flags
Hx: -trauma -steroid use ->70 Exam: -tender with palpation -edema
29
Abdominal Aneurysm Flags
Hx: -back, groin pain -PVD or CAD -s/s not related to movement Exam: -Abnormal width of aortic or iliac arterial pulses -bruit
30
Pelvis, Hip, and Thigh Red Flags
-colon cancer -femoral neck Fx -Osteonecrosis -Legg- Calve Perthes -SCFE
31
Colon Cancer Red Flags
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
Femoral Neck Fracture
Hx: -older women -hip, groin, thigh pain -Hx of fall Exam: -severe, constant pain -shortened LE
33
Osteonecrosis
Hx: -corticosterioid -Hx of osteonecrosis -trauma Exam: -gradual onset -stiff joint, restricted 1 deg IR or Flx
34
Legg-Calve-Perthes
Hx: -5-8 yr old boys -groin/thigh pain Exam: -antalgic gait -pain worse with hip mmt (hip abd/IR)
35
Slipped Capital Femoral Epiphysis
Hx: -overweight child -Hx of growth spurt Exam: -aching in groin -leg in ER -ROM IR limitations
36
Knee, Leg, Ankle, Foot Red Flags
-PAD -DVT -Compartment Syndrome -Septic Arthritis -Cellulitis
37
Peripheral Arterial Occlusive Disease
Hx: ->60 -DM -H of ischemic HD -Smoking -sedentary -claudication Exam: -cool extremity -prolonged capillary fill time -decreased pulses -prolonged vascular fill time
38
DVT
Hx: -surgery -trauma -pregnancy -immobilization Exam: -pain -edema -warmth/redness -relieved by rest and elevation
39
Compartment Syndrome
Hx: -blunt trauma Exam: -severe leg pain -swelling/tenderness -paresthesia, pallor, pulselessness
40
Septic Arthritis
Hx: -recent infection -surgery -immunosuppressive Exam: -constant aching -joint swelling -warmth -elevated body temp
41
Cellulitis
Hx: -recent skin ulceration -abrasion -venous insufficiency -Cirrosis -CHF Exam: -pain -skin swelling -warmth -irregular redness -fever, chills, weakness
42
Thoracic Spine and Rib Cage Regions Red Flags
-MI -Angina (stable and unstable) -Pericarditis -PE -Pleurisy -Pneumothorax -Pneumonia -Cholecystitis -Peptic Ulcer -Pyelonephritis -Kidney stones -Spinal Fx
43
Myocardial Infarction
Hx: -risk factors for CAD Exam: -chest pain -pallor, sweating, dyspnea -not relieved by nitroglycerin
44
Unstable Angina
Hx: -Hx CAD Exam: -outside of the predictable pattern -not responsive to nitroglycerin
45
Stable Angina
Hx: ->65 -Hx CAD Exam: -predictable exertion -predictably alleviated or w/rest or nitroglycerine
46
Pericarditis
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
Pulmonary Embolism
Hx: -risk factors -immobility -trauma -cancer Exam: -chest, shoulder and upper abdominal pain -dyspnea -tachypnea -tachycardia
48
Pleurisy
Hx: -respiratory disorder -infection -pneumonia -tumor -TB Exam: -severe, sharp pain with inspiration -dyspnea -decreased chest wall excursion
49
Pneumothorax
Hx: -coughing -strenuous exercise -trauma Exam: -chest pain with inspiration -difficulty breathing -hyperresonance -decreased breath sounds
50
Pneumonia
Hx: -infections Exam: -pleuritic pain -fever, chills, HA, nausea
51
Cholecystitis
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
Peptic Ulcer
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
Pyelonephritis
-kidney infection Hx: -women -UTI -Kidney stones Exam: -fever, chills, malaise, flank pain -enlarged prostate -murphy's sign
54
Nephrolithiasis
Hx: -hot and humid climate -Hx kidney stones Exam: -severe back or flank pain -chills, fever, vom -renal colic -UTI symptoms
55
Spinal Fx
Hx: -trauma -osteoporosis -steroid ->70 -loss of function/mobility Exam: -midline tenderness -T11-L1 -bruising -LE neuro defects -increased thoracic kyphosis
56
Head, Face and TMJ Regions Red Flags
-meningitis -brain tumor -Subarachnoid hemorrhage
57
Meningitis
Hx: -infection -Skull fx Exam: -Positive slump sign -HA -Fever -GI signs -photophobia -confusion
58
Primary Brain Tumor
Hx: -20-64 yrs Exam: -HA -altered mental status -ataxia -speech -sensory issues -GI signs -Seizures
59
Subarachnoid hemorrhage
Hx: -smoking, HTN -sudden HA (worst of pt life) Exam: -LOC -tumor signs -rigidity, fever, photophobia, vom
60
Cervical Ligament Instability/Cord compromise
Hx: -trauma -RA or AS -contraceptive Exam: -long tract neuro signs -dizziness, nystagmus, vertigo -clonus/Babinski
61
Cervical/Shoulder Entrapment/Neuropathies
Hx: -Paresthesias -pain at rest -retrograde distribution Exam: -muscles tender to palpation -muscle and sensory issues in specific nerve patterns
62
Spinal Accessory Nerve Issues
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
Axillary Nerve Issues
Hx: -shoulder dislocation -traction force -trauma -brachial neuritis Exam: -weakness of shoulder abduction and flx -lack of later sensation of arm
64
Long Thoracic Nerve Issues
Hx: -sport playing that involves arms Exam: -serratus anterior weakness w/ scapular winging -loss of scapulohumeral rhythm
65
Suprascapular Nerve Issue
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
Pancoast's Tumor (apical lung tumor)
Hx: -men >50 -smoking Exam: -nagging type pain in shoulder -burning pain -ulnar nerve distribution
67
Elbow, Wrist, and Hand Red Flags
-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
Fx's
Hx: -trauma -osteoporosis -steroids Exam: -signs of inflammation
69
Radial Head Fx
Hx: -FOOSH Exam: -antero lateral pain at elbow -cant supinate or pronate -elbow held at side at 70 flx, slightly sup
70
Distal Radius (Colles') Fx
Hx: -FOOSH with extension ->40y -osteoporosis Exam: -wrist in neutral -swelling -extension of wrist is painful
71
Scaphoid Fx
Hx: -FOOSH Exam: -swelling -held in neurtral -pain in snuffbox
72
Lunate Fx/Dislocation
Hx: -FOOSH -diffuse synovitis Exam: -wrist swelling and pain -decreased motion and grip strength
73
Triangular Fibrocartilaginous Complex tear
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
Space infection of hand
Hx: -skin puncture -bite -abscess -tenosynovitis Exam: -inflammation in palm -infection
75
Long Flexor Tendon Rupture
Hx: -RA -corticosteroid -trauma Exam: -strain s/s -inflammation -decreased motion -defect
76
Raynaud's Phenomenon
Hx: -RA -oocclusive vascular disease -smoking -beta blockers Exam: -hands or feet that blanch or cyanotic then turn red -pain and tingling
77
Complex Regional Pain Syndrome
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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