Final Flashcards
acrus senilus
corneal acrus, thin grey circle close to the edge of the cornea
normal with aging, hyperlipoproteinemia
keratoconus
thinning disorder of cornea
aide’s tonic pupil
pupil is large, regular and unilateral
unresponsive or slow to respond to light
argyll robertson pupil
small irregular pupils, accommodate but do not react to light
common with CNS syphilis
crackles
brief
wheezes
high pitches, suggest narrowed airway
rhonchi
low pitch, suggest wide airways, heard on inspiration
stridor
high pitched inspiratory noise from subglottic or tracheal obstruction
lung resonance
normal, LHF, chronic bronchitis
lung dullness
consolidation, atelectasis, pleural effusion
lung hyper-resonance
pneumo, COPD, asthma
a-wave
JVP corresponding to atrial contraction
immediately proceeds S1
increased a-wave
increased resistance to RA emptying, decreased RV compliance, restrictive CMP, RVH, tricuspid stenosis
decreased a-wave
afib, arrhythmias
intermittent a-wave
AV dissociation, cannon a waves
grade 1 murmur
must be tuned in
grade 2
quiet but audible
grade 3
moderately loud
grade 4
loud with a thrill
grade 5
can be heard with the stethoscope slightly off the body, thrill
grade 6
can be heard with the stethoscope entirely off the body, thrill
aortic stenosis
systolic, heard at A/P
heard best with pt sitting and leaning forward
radiates to the neck
HOCM
systolic, heard at erbs
best with squatting and valsalva
radiates down L sternal border to apex
pulmonary stenosis
systolic crescendo-decrescendo, heard at P
can have thrill, radiates to L shoulder and neck
mitral regurg
holosystolic, heard at apex, can have S3
doesnt change with inspiration
radiation to axilla
tricuspid regurg
holosystolic, heard at T or apex
increases with inspiration
radiates to midclavicular line, sternum
VSD
holosystolic murmur, usually with thrill
heard at erbs or T
small defects are louder
aortic regurg
decrescendo diastolic, heard when leaning forward with exhalation
can radiate to apex
mitral stenosis
decrescendo diastolic, opening snap after S2, use bell
heard in LLD with hand grips and exhalation
heard at apex with no radiation
venous hum
continuous, heard louder in diastole, use bell
pt should be sitting
pericardial friction rub
sounds close to the stethoscope, best when leaning forward and exhalation
minimal radiation
scratchy sounding
patent ductus arteriosus
machine like, at P
S3
ventricular gallop, mid diastolic
S3 normal
children, young adults, 3rd trimester
S3 abnormal
40+, HF, volume overload
S4
atrial gallop, just before systolic beat
d/t increased resistance to V filling
L sided S4
HTN, myocardial ischemia, aortic stenosis, CMP
R sided S4
pulmonary HTN, pulmonic stenosis
visceral pain
distension of organs, typically palpable near midline
hard to localize pain
varying quality
sweating, pallor, n/v, restlessness
parietal pain
parietal inflammation
steady, aching pain
easier to localize
aggravated by coughing or movement
positive apley scratch test
rotator cuff disorder
positive arc test
subacromial impingement, RTC tendonitis
positive neers impingement
subacromial impingement, RTC tendonitis
positive hawkins impingment
RTC impingement, tendonitis
positive drop arm test
supraspinatus RTC tear
positive empty can test
supraspinatus RTC tear
positive babinski
alcohol/drug intoxication, postictal
loss of proprioception
tabes dorsalis, MS, B12 deficiency, posterior column disease, DM neuropathy
UMN lesion
hypertonia, hyperreflexia, no atrophy, no fasciculations, + babinski
LMN lesion
hypotonia, hyporeflexia, atrophy, fasciculations, - babinski
peripheral lesion of facial paralysis
bells palsy
half of the face is paralyzed including forehead
central lesion of facial paralysis
cerebral infarction
lower half od the face is paralyzed, entire forehead wrinkles and eyebrows raise, eyes close with weakness
dysdiadochokinesis
abnormal RAM with fingers touching thumb
