Examinations Flashcards

(38 cards)

1
Q

What is the general structure of an examination of a lump or ulcer?

A

Look
Feel
Move
Specific tests - transillumination/auscultation
Regional lymph nodes

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2
Q

What would you do to complete a respiratory examination?

A

Sputum sample, peak flow, sats, CXR

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3
Q

What would you do to complete a cardiovascular examination?

A

Femoral pulses, ophthalmoscopy, 12 lead ECG, lying and standing BP, sats

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4
Q

Which tuning fork do you use for vibration?

A

128Hz

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5
Q

What do you do in the coordination section of the upper limb neuro exam?

A

pronator drift, finger to nose test, finger to own nose with eyes closed, thumb to fingers, dysdiadokinesis, identify coin in hand

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6
Q

What do you do in the coordination section of the lower limb neuro examination?

A

Heel-shin test, gait, rhomberg’s test (eyes open, arms out in front, then eyes closed), ankle clonus

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7
Q

What would you do to complete an upper and lower limb neuro examination?

A

Pain and temperature sensation, nerve conduction studies if indicated, MRI brain/spine, vascular exam of the area

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8
Q

What tuning fork is used for hearing?

A

512Hz

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9
Q

What would would you do to complete a cranial nerve examination?

A

Jaw-jerk reflex, gag reflex, corneal reflex, colour vision, ophthalmoscopy, upper and lower limb neuro exam, cerebellar exam, pain and temperature sensation

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10
Q

What are the components of a cerebellar exam?

A

Speech (british constitution), finger to nose test, H test for nystagmus, dysdiadokinesia, ataxia, stance, heel to toe test, rhombergs

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11
Q

What is murphy’s sign?

A

Gallbladder inflammation - press on right costal margin during expiration - patient inspires and it is painful. Repeat on left side and there should be no pain

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12
Q

What are cullens and grey turners signs?

A

Cullens = bruising around the umbilicus, grey turners - bruising around the flanks

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13
Q

What would you do to complete an abdominal examination?

A

Inguinal lymph nodes, stool sample, hernial orifices, rectal examination, urinalysis, genitalia

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14
Q

What do you do in a GALS exam?

A
  • screening questions
  • inspection
  • gait
  • spine (lumbar spine flexion, neck lateral flexion)
  • shoulders (hands behind head)
  • wrist and hands (MCPs, fist, grip strength, finger to thumb)
  • legs (knee flexion, internal and external rotation of the hip, patella tap)
  • feet (squeeze MTPs)
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15
Q

How would you complete a gals examination?

A

Do a full examination of any areas that were highlighted as abnormal on the screening test. Do a neurological examination of that area and imaging if required

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16
Q

What is Thomas’s test?

A

Assessment of a fixed flexion deformity of the contralateral hip. Put hand under spine while lifting leg

17
Q

What is Trendelenburg’s test?

A

Ask patient to stand on one leg and feel the hips and look for hip drop

18
Q

What would you do to complete a hip/knee examination?

A

Neurological and vascular examination of the lower limb, appropriate imaging, msk exam of adjacent joints

19
Q

What is McMurray’s test?

A

A test for a torn meniscus, straighten leg in external and internal rotation

20
Q

What do you do in a spine examination?

A
  • Look, feel spine
  • cervical spine - up, down, left right, ear to shoulder
  • thoracic - left and right rotation
  • lumbar - flexion, extension, lateral flexion
  • schober’s test (10cm above PSIS and 5cm below)
  • percuss spine
  • gait
  • straight leg raise, bowstring test, femoral stretch test
21
Q

How would you complete a spine examination?

A

Neurological examination of the upper and lower limbs, msk exam of adjacent joints

22
Q

Which muscles abduct the arm?

A

first 15 - supraspinatus
15-90 - deltoid
90 + - serratus anterior and trapezius

23
Q

What muscle does the lift-of test test for?

A

subscapularis

24
Q

How would you complete a shoulder examination?

A

Msk exam of elbow and spine, neurological and vascular exam of the upper limb

25
What do you have to do in a hand examination?
-Look, feel hands and elbow, temp, muscles, joints - sensation - dermatomes and nerves - vascular - allen's test, both pulses - move - fingers, thumb wrist (active then passive) - function - grip strength, pinch grip, precision
26
What median nerve special tests do you do?
- median nerve sensation - thumb abduction - power - tinels - tap - phalens - upside down prayer - 1 min - compression test
27
What ulnar nerve special tests do you do?
- ulnar nerve sensation - cross middle and index finger - pick up paper - abduct fingers against resistance
28
What radial nerve special tests do you do?
- sensation in anatomical snuffbox - wrist and finger dorsiflexion against resistance
29
How do you do a peripheral vascular examination?
- hands (radial, ulnar pulses, allen's test) - face: carotid pulses (listen then feel), eyes, lips, tongue - examine abdomen and limbs - palpate: aorta, femoral, popliteal, dorsalis pedis and posterior tibial pulses - fine touch and cap refill in toes - power in foot - auscultate: carotids, subclavian, aorta, femoral arteries - buerger's test 2 mins
30
What is a buerger's test?
Patient lying down, elevate legs to 45 degrees, hold for 2 mins, patient then hangs legs over the bed, look for colour changes
31
How would you complete a peripheral vascular examination?
Blood pressure in upper and lower limbs, sats, doppler, ankle-brachial pressure index (highest BP at ankle, divided by highest BP in arms)
32
How do you do a varicose vein examination?
- inspect legs standing and lying - identify sapherofemoral junction (4cm lateral and inferior to public tubercle) - cough test with finger over SFJ - tap on SFJ
33
How would you complete a varicose vein examination?
Tourniquet test, perthes test, dopper US of leg, vascular and neuro exam of lower limb
34
What do you do in a thyroid examination?
Hands, tremor, pulses, forearm muscles face - eyes from all angles, H test, visual acuity inspect neck from front - water and tongue palpate - trachea, thyroid, tongue, water lymph nodes percuss upper sternum auscultate for bruits proximal muscle weakness ankle reflexes and oedema
35
How would you complete a thyroid examination?
Thyroid panel bloods, fundoscopy, CXR - thymoma
36
What do you do in a diabetic foot examination?
- gait, SHOES, feet and legs - palpate bones and joints of the foot and ankle - temperature - pulses - knee, 2 feet - capillary refill - ankle reflex - light touch, pressure, vibration and proprioception
37
How would you complete a diabetic foot examination?
pin prick and temp sensation, femoral pulses, neurological and vascular examination of the lower limb
38
How do you structure the presentation of findings?
Today I performed a ... exam on ... a ... year old M/F, on general inspection they looked comfortable at rest. There was nothing around the bedside to indicate ... pathology.