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Advanced health assessment > Final demonstration testing > Flashcards

Final demonstration testing Flashcards

1
Q

Demonstrate EOM testing

A

6 cardinal fields are tested

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2
Q

What does EOM testing test for?

A

Nystagmus and CN 3,4,6

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3
Q

Describe nystagmus

A

motion of the eyes during EOMs related to the function of the vestibular brach of the acoustic nerve

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4
Q

What sinuses can you transilluminate?

A

maxillary and frontal

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5
Q

What do you look for when you transilluminate the sinuses?

A

symmetrical red glow

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6
Q

What does transillumination of the sinuses help diagnose?

A

sinusitus

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7
Q

How would you test the trigeminal nerve?

A

motor: clench teeth; sensory; forehead and cheek or corneal reflex

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8
Q

Demonstrate a thyroid exam

A

anterior or posterior position with swallow as well as visual inspection

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9
Q

What should the thyroid feel like?

A

smooth, passing fingers with swallow, no lumps

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10
Q

If thyroid exam is abnormal, what other testing could you do?

A

TSH, ultrasound

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11
Q

Where do you palpate the anterior cervical and submental lymph nodes?

A

anterior sternocleidomastoid and anterior jaw/chin

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12
Q

What does swollen lymph nodes indicate?

A

inflammation or infection

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13
Q

What findings regarding lymph nodes is of most concern?

A

painless, hard, immobile

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14
Q

HOw do you test for TMJ?

A

palpation of the jaw with opening and closing mouth

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15
Q

What constitutes a positive test for TMJ?

A

clicking, locking, crepitus

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16
Q

What symptoms can TMJ cause?

A

Ear pain, often worse in the morning

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17
Q

Demonstrate auscultation of the heart

A

Five positions in proper order: aortic, pulmonic, 2nd pulmonic, tricuspid, mitral

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18
Q

When might you check heart tones in the left lateral position?

A

When extra heart sounds are heard

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19
Q

When are you most likely to hear a normal split S2?

A

During inspiration

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20
Q

Demonstrate bronchophony

A

patient is to verbalize when auscultating lung fields: include anterior and posterior auscultation of upper and lower lungs

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21
Q

Auscultate for aortic aneurysm

A

2 inches above the umbilicus, midline with the bell

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22
Q

What do you listen for when auscultating for aortic aneurysm?

A

bruit, turbulence, whooshing sound

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23
Q

What other physical findings might a person with AAA have?

A

unequal pulses in the lower extremities

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24
Q

Demonstrate Murphy’s sign

A

patient asked to take a breath during palpation of RUQ

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25
Q

What is a positive Murphy’s sign?

A

patient halts breath, pain elicited

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26
Q

What does a positive Murphy’s sign mean?

A

cholecystitis

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27
Q

What does increased bronchophony mean?

A

consolidation

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28
Q

What is it called when the whispered voice is auscultated?

A

Whispered petoriloquy

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29
Q

Demonstrate Rosvig sign

A

palpate deeply in left side of abdomen

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30
Q

What is a positive Rosvig sign?

A

patient complains of pain on right side

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31
Q

What does positive Murphy’s sign mean?

A

appendicitis or perotinitis

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32
Q

Demonstrate CVA tenderness

A

percuss with fist on flat hand or directly on flank

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33
Q

What is a positive CVA tenderness test?

A

patient complains of tenderness

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34
Q

What does a positive CVA tenderness test mean? mean?

A

pyelonephritis or kidney stone

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35
Q

Demonstrate forward flexion of the shoulder and hyperextension.

A

Domonstrate passively or actively raising arm forward

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36
Q

What is the ROM for shoulder forward flexion?

A

180 degrees

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37
Q

What should be amount of ROM for shoulder hyperextension?

A

50 degrees

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38
Q

What do you use to measure range of motion?

A

goniometer

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39
Q

Demonstrate Phalen’s test

A

wrists flexed with backs of hands together

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40
Q

How long should a patient perform the Phalen test?

A

1 minute

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41
Q

What is a positive Phalen test?

A

numbness and tingling of hands and fingers

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42
Q

What does a positive Phalen test mean?

A

carpal tunnel

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43
Q

Demonstrate empty can test

A

Shoulder flexed 90 degrees, 30 degree abduction, with thumb down, exert downward pressure

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44
Q

What is a positive empty can test?

A

pain in shoulder

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45
Q

What does a positive empty can test indicate?

A

rotator cuff inflammation or tear (supraspinatus)

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46
Q

Demonstrate McMurray’s test

A

patient supine, knee flexed, external rotation with extension and internal rotation with extension

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47
Q

What is a positive McMurray’s test?

A

palpable or audible clicking, pain, or locking

48
Q

What does a positive McMurray’s test mean?

A

meniscus tear

49
Q

Demonstrate the anterior and posterior drawer test for the knee

A

Flex knee 45 to 90 degrees and anchor with foot flat on table, exert anterior and posterior pressure to the tibia

50
Q

What are you looking for when doing anterior posterior drawer test for the knee?

A

Movement of the knee more than 5 mm

51
Q

What could a positive anterior posterior drawer test mean?

A

movement anteriorly means anterior cruciate ligament injury, movement posteriorly means posterior cruciate ligament injury

52
Q

Test movement and sensation for C5

A

Motor: test deep tendon reflex of bicep
Sensation: anterior shoulder

53
Q

Which reflex would respond to test for movement of C5?

A

radial

54
Q

How would you rate flexion of the bicep that brings the arm through full range of motion but no resistance?

A

3/5

55
Q

Demonstrate movement and reflex for L-4

A

Have them extend knee against resistance, elicit patellar reflex

56
Q

How would you rate a reflex that is less than expected?

A

1+

57
Q

How would you rate strength in the quads that was able to extend knee fully and resist opposition partially?

A

4/5

58
Q

Demonstrate the standard straight leg lift and the modified (sitting) straight leg lift

A

Have patient lay on back and raise leg to at least 60 degrees, have patient sit with back straight and straighten leg to 90 degrees

59
Q

What is a positive straight leg test?

A

Pain radiating from buttock to knee

60
Q

What does it mean if there is pain in the opposite buttock with the straight leg lift?

A

This is a more sensitive indication of nerve root impingement

61
Q

Demonstrate biceps reflex

A

percuss with hammer the biceps tendon either directly or over finger

62
Q

Demonstrate triceps reflex

A

percuss posterior elbow with arm flexed

63
Q

How would you rate a response that wsa greater than expected but no clonis?

A

3+

64
Q

What level of the spinal cord does the triceps reflex evaluate?

A

C 6-7-8

65
Q

Demonstrate the Romberg test

A

have patient stand with feet close together and close eyes

66
Q

What is a positive Romberg test?

A

inability to balance or swaying enough to fall (slight swaying is normal

67
Q

What does a positive Romberg test mean?

A

cerebellar ataxia, vestibular dysfunction

68
Q

Demonstrate Kernig’s sign

A

Flex knee and hip and then extend rapidly

69
Q

What is a positive Kernig sign?

A

back pain and resistance to extension

70
Q

What does a positive Kernig sign mean?

A

menningeal irritation

71
Q

Demonstrate the cover/uncover test

A

Have patient focus on object, cover eye and watch uncovered eye for movement or adjustment, uncover and watch the uncovered eye for the same

72
Q

What is a positive cover/uncover test?

A

movement or adjustment of the eyes

73
Q

What does a positive cover/uncover test indicate?

A

strabismus

74
Q

Demonstrate Thomas test

A

Patient supine with one leg extended and the other hip and the knee are flexed to 120 degrees

75
Q

What is a positive Thomas test?

A

The extended leg raises off the table

76
Q

What does a positive Thomas test mean?

A

hip flexion contracture of extended leg

77
Q

Demonstrate Neer test

A

Internally rotate and forward flex shoulder to 180 degrees

78
Q

What is a positive Neer test?

A

pain in shoulder beyond 150 degrees

79
Q

What does a positive Neer test mean?

A

rotator cuff inflammation or tear

80
Q

Demonstrate hip flexion (knee flexed and extended)

A

Patient supine, flexes hip with leg extended, then with knee bent

81
Q

What is normal range of motion of the extended leg?

A

90 degrees

82
Q

What is normal range of motion of the flexed knee?

A

120 degrees

83
Q

Palpate the liver

A

Demonstrate deep palpation of RUQ with inspiration positioned either below ribs or crooked over costal margin

84
Q

When palpating liver, what is considered normal?

A

Usually not palpable except the edge which should be smooth, firm, and non-tender

85
Q

What would happen if the patient had cholecystitis with palpation of liver?

A

they would halt inspiration

86
Q

Demonstrate forearm pronation and supination

A

Show from neutral position, rotate palm down and palm up (respectively)

87
Q

What is expected ROM with forearm pronation and supination?

A

90 degrees for both

88
Q

How would you test for lateral epicondylitis?

A

Supination against resistance

89
Q

Demonstrate the Achilles reflex

A

Percuss Achilles tendon

90
Q

What is the expected finding of Achilles reflex

A

plantar flexion

91
Q

Rate reflex response correctly with explanation

A

0: absent; 1+: trace; 2+: normal; 3+: brisk; 4+: repetitive vibratory movement; 5+: sustained clonus

92
Q

Demonstrate ankle anterior posterior drawer

A

With knee at 90 degrees flexion, grasp tibia and the back of the heel pulling forward on the heel

93
Q

What is a positive ankle anterior posterior drawer?

A

Forward glide greater than on the opposite side

94
Q

What does a positive ankle anterior posterior drawer mean?

A

damage to the talofibular ligament

95
Q

Demonstrate shoulder internal and external rotation

A

demonstrate from neutral position with 90 degree abduction and elbow at 90 degrees

96
Q

What is the expected ROM for internal and external rotation of the shoulder?

A

90 degrees with both

97
Q

How might you prevent scapular winging with internal external rotation of the shoulder?

A

hold scapular area with your hand or perform test with patient supine

98
Q

Test for anterior shoulder dislocation

A

Have patient lay on back and abduct shoulder to 90 degrees and externally rotate

99
Q

What is a positive test for anterior shoulder dislocation

A

Patient apprehension or resistance to the maneuver

100
Q

What is the name of the test for anterior shoulder dislocation?

A

Apprehension test

101
Q

You suspect your patient has appendicitis. Demonstrate 2 tests you could do to check this

A

McBurney’s Point, Markle Heel Jar test, or Rosvig

102
Q

What are positive tests for appendicitis?

A

McBurney’s- pain with palpation of RLQ, Markle- RLQ pain with heel jar, Rosvig- pain in RLQ with deep palpation of LLQ

103
Q

What diagnostic tests could you do to help confirm appendicitis?

A

CBC, CT scan of abdomen (or ultrasound but this is less sensitive)

104
Q

Demonstrate testing of all knee ligaments

A

Demonstrate anterior/posterior drawer (flex knee at 90 degrees and push and pull on tib/fib looking for 5mm movement); or Lachman (leg at 20-30 degrees and push and pull on tib/fib looking for 5mm movement)
Demonstrate varus and valgus stress (put pressure on ankle and knee in opposite directions and check for laxity in either direction)

105
Q

When performing knee ligament tests, what is a positive test?

A

increased laxity in either direction

106
Q

What diagnostic test would you order to confirm a ligamental tear?

A

MRI

107
Q

Demonstrate the procedure for an ophthalmic examination

A

Start at 70 degree angle to get red reflex and then move in closely to visualize fundus

108
Q

With an ophthalmic examination, what might you see if the patient has a long standing uncontrolled hypertension?

A

AV nicking, copper wiring, cotton wool spots

109
Q

What would macular degeneration look like?

A

yellow spots in the retina

110
Q

Demonstrate a method for checking for lumbar nerve root impingement

A

may do straight leg lift with patient supine or sitting

111
Q

What is a positive finding of lumbar nerve root impingement?

A

Pain radiating from buttock to knee at 60 degrees or radiating pain at 90 degrees with sitting

112
Q

What is more sensitive for disc herniation than a positive test in the ipsilateral buttock and leg?

A

Pain in the opposite one

113
Q

Demonstrate visualization of the TM

A

Pull back and up on pinna and observes the TM

114
Q

What might you see if the patient has an ear infection?

A

Red dull bulging TM

115
Q

What might you find if there is an effusion?

A

Air bubbles, air fluid levels, lack of TM mobility with insufflation

Advanced health assessment (11 decks)

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