Final Exam Flashcards
What is the Valgus test for?
MCL stability
What is the Varus test for?
LCL
What is the Anterior Drawer test for?
ACL
What is the Lachman test for?
ACL
What is the Posterior Drawer test for?
PCL
What is the McMurray test for?
Meniscus (medial and lateral)
What is the Patellar Apprehension test for?
Patellar subluxation or dislocation
What movement is spinal level C5 responsible for?
shoulder abduction
What movement is spinal level C6 responsible for?
biceps
What movement is spinal level C7 responsible for?
triceps
What movement is spinal level C8 responsible for?
finger flexion
What movement is spinal level T1 responsible for?
finger intrinsic motions
What movement is spinal level L1 responsible for?
hip flexion
What movement is spinal level L2 responsible for?
hip adduction
What movement is spinal level L3 responsible for?
lower leg extension
What movement is spinal level L4 responsible for?
foot dorsiflexion
What movement is spinal level L5 responsible for?
big toe dorsiflexion
What movement is spinal level S1 responsible for?
foot plantarflexion
What spinal level is responsible for shoulder abduction?
C5
What spinal level is responsible for biceps?
C6
What spinal level is responsible for triceps?
C7
What spinal level is responsible for finger flexion?
C8
What spinal level is responsible for finger intrinsics?
T1
What spinal level is responsible for hip flexion?
L1
What spinal level is responsible for hip adduction?
L2
What spinal level is responsible for lower leg extension?
L3
What spinal level is responsible for foot dorsiflexion?
L4
What spinal level is responsible for big toe dorsiflexion?
L5
What spinal level is responsible for foot plantarflexion?
S1
What muscle(s) are responsible for shoulder abduction?
deltoid and supraspinatus (C5, C6)
What muscle(s) are responsible for elbow flexion?
brachialis and biceps (C5, C6)
What muscle(s) are responsible for elbow extension?
triceps (C7)
What muscle(s) are responsible for finger flexion?
FDS, FDP, and lumbricals (C8)
What muscle(s) are responsible for finger intrinsics?
dorsal and palmar interossei (T1)
What muscle(s) are responsible for hip flexion?
iliopsoas (L1-L3)
What muscle(s) are responsible for hip adduction?
adductor longus (L2-L4)
What muscle(s) are responsible for lower leg extension?
quadriceps (L2-L4)
What muscle(s) are responsible for foot dorsiflexion?
anterior tibialis (L4)
What muscle(s) are responsible for big toe dorsiflexion?
extensor hallucis longus (L5)
What muscle(s) are responsible for foot plantarflexion?
soleus and gastrocnemius (S1-S2)
What is another name for the submandibular salivary duct?
Wharton’s duct
What is another name for the parotid salivary duct?
Stenson’s duct
Where is Stenson’s duct located?
Opposite the 2nd maxillary molar
What is the tooth number for the right upper incisor?
8
What is the tooth number for the left upper incisor?
9
What is the tooth number for the right lower incisor?
25
What is the tooth number for the left lower incisor?
24
What ligament(s) are found on the lateral aspect of the ankle?
posterior talofibular ligament, anterior talofibular ligament, and calcaneofibular ligament
What ligament(s) are found on the medial aspect of the ankle?
deltoid ligament
In an optho exam, you note an increased cup to disc ratio. What does this indicate?
Glaucoma
What does an absent red reflex in a child suggest?
Retinoblastoma (or congenital cataract)
What 3 symptoms are seen in Horner’s Syndrome?
Miosis, ptosis, anhydrosis
What is the Kernig test for?
meningeal irritation
What is the Brudzinski test for?
meningeal irritation
How do you perform a Kernig test?
Passively flex hip and knee to 90 degrees then extend slowly, noting pain or resistance
How do you perform a Brudzinski test?
Passively flex the patient’s neck and look to see if they lift their legs off the table to reduce pain
What is anisicoria?
Traumatic mydriasis (dilation of pupil)
What is hyphema?
A collection of blood in the front of the eye, between the iris and the cornea. It’s usually caused by trauma.
What does PERLA stand for?
Pupils equal and reactive to light and accommodation
What condition(s) result in dull percussion of the lungs?
Consolidation/atelectasis or pleural effusion
What condition(s) result in hyperresonant percussion of the lungs?
emphysema or pneumothorax
What condition(s) result in increased fremitus of the lungs?
consolidation/atelectasis
What condition(s) result in decreased fremitus of the lungs?
emphysema, pneumothorax, pleural effusion
What is the normal breath sound at the lung base?
Vesicular
What condition(s) result in bronchial breath sounds at the base of the lungs?
consolidation/atelectasis
What condition(s) result in decreased breath sounds at the base of the lungs?
emphysema, pneumothorax, pleural effusion
What condition(s) result in crackles when listening to the lungs?
consolidation/atelectasis
What condition(s) do not result in crackles when listening to the lungs?
Normal lungs, emphysema, pneumothorax, pleural effusion
In a transillumination test of a swollen scrotum, what will appear as translucent?
hydrocele or spermatocele
In a transillumination test of a swollen scrotum, what will not appear as translucent?
hernia or tumor
What is the Obturator test for?
inflammation, appendicitis, peritoneal irritation
What is the Psoas test for?
intra-abdominal inflammation, appendicitis, psoas abscess
What is the Rovsing test for?
appendicitis (special peritoneal irritation test)
What cranial nerves are needed for the Gag reflex test?
CN IX and X
What type of sound should you hear when you percuss the lung?
resonant
What type of sound should you hear when you percuss the heart or another solid organ?
dull
What type of sound should you hear when you percuss the stomach or a gas-filled intestine?
tympany
What type of sound should you hear when you percuss bone or a thick muscle?
flat
What type of sound should you hear when you percuss an emphysematous lung?
hyperresonant
What grade of murmur is very faint and can only be heard in a very quiet room?
Grade I
What grade of murmur is quiet but recognizable?
Grade II
What grade of murmur is moderately loud?
Grade III
What grade of murmur is loud with a palpable thrill?
Grade IV
What grade of murmur has a thrill that can be heard with the rim of a stethoscope?
Grade V
What grade of murmur can be heard with the stethoscope off the chest?
Grade VI
What type of breath sound is loud and high pitched and with i=e?
tracheal (heard over trachea)
What type of breath sound is loud and high pitched and with i
bronchial (heard over manubrium)
What type of breath sound is soft and low pitched and with i>e?
vesicular (heard over lung periphery)
What type of breath sound is moderate and with i=e?
bronchovesicular (between carina and mainstem bronchi in 1st and 2nd interspace)
What type of breath sound is moderate and with i=e?
bronchovesicular (between carina and mainstem bronchi in 1st and 2nd interspace)
What spinal level does the patellar reflex test?
L4 (L2-L3)
What spinal level does the Achilles reflex test?
S1-S2
What spinal level does the anal wink reflex test?
S2-S4
What spinal level does the anal wink reflex test?
S2-S4
How do you perform Rovsing’s sign test?
push on patients LLQ, noting pain present on other side (RLQ/McBurney’s Point)
How do you perform the Obturator sign test?
With the patient lying supine, flex the patient’s leg at the hip with knee bent, then rotate the leg internally, noting pain
How do you perform Psoas sign test?
With the patient lying on the unaffected side, passively extend the affected hip, noting the presence of abdominal pain
What is Murphy’s sign indicative of?
Acute cholecystitis
What is Murphy’s sign indicative of?
Acute cholecystitis
What is the dermatome level for the umbilicus?
T10
What is the dermatome level above the inguinal ligament?
T12
What is the dermatome level below the inguinal ligament?
L1
What is the dermatome level for the anterior middle thigh?
L2
What is the dermatome level for the patella?
L3
What is the dermatome level for the buttocks?
L1-L3
What is the dermatome level for the popliteal fossa?
S2
What is the dermatome level for the anus?
S2-S4
What is the dermatome level for the dorsum of the foot?
L5 (peroneal nerve)
What is the dermatome level for the lateral foot?
S1 (Sural nerve)
What is the dermatome level for the medial foot?
Saphenous nerve
What is the presentation of someone with a positive Trendelenberg sign?
They lean towards the affect side while the opposite hip sags
What is the dermatome level for the round patch of skin on the lateral deltoid?
C5 (Axillary nerve)
What is the dermatome level for the medial aspect of the arm?
T1 (medial brachial cutaneous nerve)
What is the dermatome level for the nipples?
T4
What does the shoulder arc test indicate?
Pain between 60-120 degrees = subacromial pathology; pain >120 degrees = acromioclavicular pathology
What does the impingement test indicate?
rotator cuff tendon impingement (between greater tuberosity and acromion)
What does the drop arm test indicate?
torn rotator cuff tendon (supraspinatus)
What does the Tinel sign indicate?
ulnar or median nerve compression
What is the Allen test used for?
blood supply to hand (palmar arch collateral circulation between ulnar and radial arteries)
What is the spinal level for sensation over the deltoid?
C5
What is the spinal level for sensation of the thumb?
C6
What is the spinal level for sensation of the middle finger?
C7
What is the spinal level for sensation of the pinkie?
C8
What is the spinal level for sensation of the axilla?
T1
What is the motor spinal level for hip flexion?
L2
What is the motor spinal level for knee extension?
L3
What is the motor spinal level for ankle dorsiflexion?
L4
What is the motor spinal level for big toe extension and hip extension?
L5
What is the motor spinal level for plantarflexion?
S1
What is the motor spinal level for the anal sphincter?
S2-S4
What is the motion performed by the supraspinatus?
Abduction
What is the motion performed by the infraspinatus?
external rotation
What is the motion performed by the subscapularis?
internal rotation
What is the motion performed by the teres minor?
extension and external rotation
What is the motor spinal level for shoulder abduction?
C5
What is the motor spinal level for elbow flexion and wrist extension?
C6
What is the motor spinal level for elbow extension and finger extension?
C7
What is the motor spinal level for finger flexion?
C8
What is the motor spinal level for finger abduction and adduction?
T1
At what incline do you measure a supine patient’s jugular venous pressure?
Between 30 and 90 degrees (starting at 30)
What happens during the jugular venous A wave? What part of the heart cycle does this mark?
right atrial contraction; end of diastole
What happens during the jugular venous X descent wave?
right atrial relaxation, ventricular contraction
What happens during the jugular venous V wave?
right atrial filling
What happens during the jugular venous Y descent wave?
opening of tricuspid valve and passive right ventricular filling
Which heart sound is heard at the beginning of systole?
S1
Where can a murmur from aortic stenosis be heard? What volume quality does it have? (crescendo, decrescendo, etc.)
upper sternal border, radiating to carotid; crescendo to decrescendo
Where can a murmur from aortic regurgitation be heard? What volume quality does it have? (crescendo, decrescendo, etc.)
left parasternal border; decrescendo
Where can a murmur from mitral stenosis be heard? What volume quality does it have? (crescendo, decrescendo, etc.)
radiating to axilla; decrescendo (may have an opening snap)
Where can a murmur from mitral regurgitation be heard? What volume quality does it have? (crescendo, decrescendo, etc.)
left axilla; is holosystolic
Where can a murmur from tricuspid stenosis be heard? What volume quality does it have? (crescendo, decrescendo, etc.)
left sternal border; has a split S1
Where can a murmur from tricuspid regurgitation be heard? What volume quality does it have? (crescendo, decrescendo, etc.)
right sternal border, radiating up; is holosystolic
Where can a murmur from pulmonic stenosis be heard? What volume quality does it have? (crescendo, decrescendo, etc.)
2nd intercostal space and left sternal border, radiating to back; crescendo to decrescendo
Where can a murmur from pulmonic regurgitation be heard? What volume quality does it have? (crescendo, decrescendo, etc.)
left lower sternal border; descrescendo
What conditions are suggested by decreased tactile fremitus?
conditions that block sound flow - mass, pleural effusion
What conditions are suggested by increased tactile fremitus?
conditions that enhance sound flow - alveolar pneumonia
What conditions are suggested by decreased percussion?
consolidation, mass, pleural effusion
What conditions are suggested by increased percussion?
COPD, pneumothorax
What conditions are suggested by increased bronchophony/whispered pectoriloquy/egophony?
consolidation (fluid in air spaces)
What is stridor? What is indicated by it?
high-pitched, inspiratory, upper airway sound caused by turbulent flow in upper airway; due to airway obstruction from mass, swelling, tumors, croup, or foreign bodies
What is wheezing? What is indicated by it?
continuous, musical, high-pitched sounds during expiration; due to narrowing of bronchi by swelling, secretion, foreign body, tumor, asthma, COPD, pulmonary edema
What is rales? What is indicated by it?
aka crackles; short, discontinuous nonmusical sounds on inspiration; caused by opening of collapsed distal airways and alveoli
What is rhonchi? What is indicated by it?
low pitched; associated with mucus plugging, poor movement of secretions, and bronchitis
Where is McBurney’s point located?
2/3 between umbilicus and right anterior superior iliac spine
What is the difference between visceral and parietal pain?
Visceral pain is crampy, vague, diffuse, and poorly localized; parietal pain is sharp, localized pain
Which testicle tends to hang lower in males?
left
What are the 5 parameters of speech?
amount, speed, volume, clarity, fluency
What are the 3 parameters of language?
complexity, comprehension, coherence
What is thought process? What may be seen with an abnormal thought process?
relevance and logical connections between thoughts; tangential thoughts or loosening of associations
What is thought content? What may be seen with an abnormal thought content?
what the patient thinks about; delusions or obsessions
Alcohol withdrawal is a cause of [delirium/dementia]
delirium
Uremia is a cause of [delirium/dementia]
delirium
Acute hepatic failure is a cause of [delirium/dementia]
delirium
Acute cerebral vasculitis is a cause of [delirium/dementia]
delirium
Atropine poisoning is a cause of [delirium/dementia]
delirium
Vitamin B12 deficiency is a cause of [delirium/dementia]
dementia
Thyroid disorders are a cause of [delirium/dementia]
dementia
Multiple strokes are a cause of [delirium/dementia]
dementia
Head trauma is a cause of [delirium/dementia]
dementia
In someone with [delirium/dementia], attention is usually normal.
dementia
What is the Weber test for?
hearing lateralization/hearing loss (conductive hearing loss - sound heard more on affected side; sensorineural hearing loss - sound heard more on unaffected side)
What is the Rinne test for?
determining if hearing loss is conductive or sensorineural (conductive - bone conduction is better than air conduction; sensorineural - air conduction is better than bone conduction (this is the same as normal))
What are the 4 parameters of motor activity covered by the mental status exam?
amount, speed, posture, gait
What is the difference between hyperactivity and agitation?
Both involved increased activity, but hyperactivity is goal-directed and agitation is purposeless
What is the difference between bradykinesia and psychomotor retardation?
Bradykinesia is slowed movement; psychomotor retardation is slowed movement and speech
What is sterotypy?
Frequent, repetitive, seemingly driven, nonfunctional motor behavior (ex - head banging)
What is the difference between mood and affect?
Mood is the patient’s self-described emotional state whereas affect is the observed emotional state
What are the 5 parameters of affect covered by the mental status exam?
range, intensity, stability, appropriateness, relatedness
Awareness and understanding of internal or external sensory information is defined as ___.
perception
Awareness that symptoms are normal or abnormal is defined as ___.
insight
The cognitive process of evaluating and comparing alternatives is defined as ___.
judgment
The general ability of the patient to think and reason is defined as ___.
cognition
___ is defined as a mental disturbance of usually short duration, usually reflecting a toxic state, marked by illusions, hallucinations, delusions, excitement, restlessness, and incoherence.
Delirium
___ is an organic mental syndrome characterized by a general loss of intellectual abilities, involving impairment in memory, judgment, and abstract thinking as well as changes in personality, but not including that due to clouding of consciousness, depression, or other functional mental disorder.
Dementia
What is the ability of the eye to focus at near called?
Accommodation
What is pupillary constriction called?
miosis
What is pupillary dilation called?
mydriasis
What is anisocoria?
Difference in pupil diameter not greater than 1 mm
What are the afferent and efferent nerves involved in the pupillary light reflex?
efferent - CN II
afferent - CN III
What is a relative afferent pupillary defect?
When an eye is unable to react to light; both eyes will remain dilated
What is the normal appearance of the tympanic membrane?
Pearly-gray, ovoid, and semi-transparent
How do you test CN I?
Have patient smell something or ask about recent changes in smell
How do you test CN II?
test visual acuity
How do you test CN III?
have patient open eye and look up + test for pupillary light reflex
How do you test CN IV?
have patient look downward and inward
How do you test CN V?
have patient clench teeth and feel temporal and masseter muscles + sensation testing on forehead, cheeks, and jaw + corneal reflex (tests V and VII)
How do you test CN VI?
have patient look laterally
How do you test CN VII?
ask patient to smile, puff out cheeks, and close eyes against resistance + have patient taste salty/sweet/sour/bitter substances on the anterior tongue
How do you test CN VIII?
complete auditory and bone and air conduction tests + test balance by asking patient to stand on one foot and close eyes
How do you test CN IX?
test gag reflex + ask patient to say “ahhh” and watch palate elevation
How do you test CN X?
listen to patient speak
How do you test CN XI?
ask patient to shrug shoulders against resistance
How do you test CN XII?
ask patient to stick out tongue, looking for deviation to one side
What nerve provides taste to the anterior 2/3 of the tongue?
CN VII
What nerve provides taste to the posterior 1/3 of the tongue?
CN IX
What are the afferent and efferent nerves involved in accommodation?
afferent - CN II
efferent - CN III
What are the afferent and efferent nerves involved in the gag reflex?
afferent - CN IX
efferent - CN X
What is the Romberg test for?
test for sensory ataxia (position sense)
What is the Pronator Drift test for?
position sense and corticospinal lesions
