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ECOS IV > Final Practical PE + OSE + Tx > Flashcards

Final Practical PE + OSE + Tx Flashcards

1
Q

CC: Asthma (exacerbation)
PE: Pulmonary
OSE: Ribs
Tx: Rib HVLA

A
  1. Hand hygeine
  2. Inspection (chest, lips, fingers)
  3. Palpation of anterior and posterior chest walls
  4. Percussion (2x anterior, 4x posterior)
  5. Auscultation 2x anterior posts
  6. Auscultation 4x posterior posts
  7. Specialty test (tactile fremitus)
  8. Rib respiratory motion
  9. Rib tenderness (name rib body, angle, ICS)
  10. Rib asymmetry
  11. Name SD (Rib x-y in/exhaled)

Seated (ribs 1-2) or supine (ribs 3-10)

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2
Q

CC: Tarsal tunnel (numbness on plantar foot)
PE: Peripheral nerve
OSE: B/L knees and ankles
Tx: MET

A
  1. Hand hygeine
  2. Sensation: 3x dermatomes of UEs and LEs
  3. UE DTR 1x bl (biceps)
  4. LE DTR 1x bl (patellar)
  5. Cerebellar: rapid alternating movement
  6. Gait: casual, tandem (2 types)
  7. Special test (romberg)
  8. Knee F/E, tenderness, symmetry (rename 3x landmarks)
  9. Ankle DF/PF/Inv/Ev, tenderness, symmetry

MET on knee or ankle

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3
Q

CC: GERD (acid refulx)
PE: Abdominal
OSE: Abdomen
Tx: MFR

A
  1. Hand hygeine
  2. Inspection (bruises, scarring, swelling)
  3. Auscultation (4 quads)
  4. Percussion of liver borders (midclavicular 10cm and sternal 6cm)
  5. Light palpation (4 quads)
  6. Deep palpation (4 quads)
  7. Specialty test: Murphy, McBurney, Heel strike, etc.
  8. Assess TART of abdomen (colon and SI for tenderness, texture changes, asymmetry)
  9. Palpate ganglion (celiac, sup mes, inf mes)
  10. Assess liver capsule for strain (ROM)

MFR tx (probs ganglion release)

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4
Q

CC: Bronchitis (cough and fever)
PE: Pulmonary
OSE: Thoracic
Tx: ST

A
  1. Hand hygeine
  2. Inspection (chest, lips, fingers)
  3. Palpation of anterior and posterior chest walls
  4. Percussion (2x anterior, 4x posterior)
  5. Auscultation 2x anterior posts
  6. Auscultation 4x posterior posts
  7. Specialty test (tactile fremitus)
  8. Pt. seated
  9. Palpate for tenderness, asymmetry, PTP (landmarks)
  10. Assess F/E
  11. Assess SB

ST tx (tapotment, rib raising, pec traction)

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5
Q

CC: Fibromyalgia (shoulder pain)
PE: Shoulder
OSE: Shoulder tenderpoints
Tx: Counterstrain

A
  1. Hand hygeine
  2. Inspection: 3x findings (bruising, erythema, scars)
  3. ROM: F, E, ABd, ADd, HABd, HADd, IR, ER (8)
  4. STR: F, E, ABd, ADd, HABd, HADd, IR, ER (8)
  5. Palpation: AC, SC, spine of scap, clavicle (4)
  6. NV: brachioradialis reflex, 3x dermatomes, pulses (3)
  7. Special test: drop arm (+ = uncontrolled drop = supraspinatus tear)
  8. Check supraspinatus, lev scap, biceps (long and short), subscapularis for TPs
  9. mention tissue texture, asymmetry, tenderness, landmarks

CS tx (ID TP, 10/10, 2/10, hold 90, return, reassess)

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6
Q

CC: Pneumonia (cough and fever)
PE: Pulmonary
OSE: Ribs
Tx: ART or pump

A
  1. Hand hygeine
  2. Inspection (chest, lips, fingers)
  3. Palpation of anterior and posterior chest walls
  4. Percussion (2x anterior, 4x posterior)
  5. Auscultation 2x anterior posts
  6. Auscultation 4x posterior posts
  7. Specialty test (tactile fremitus)
  8. Rib respiratory motion
  9. Rib tenderness (name rib body, angle, ICS)
  10. Rib asymmetry
  11. Name SD (Rib x-y in/exhaled)

Tx?

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7
Q

CC: URI (runny nose, sore throat)
PE: ENT
OSE: Cervical (OA, AA, C2-7)
Tx: MET

A
  1. Hand hygeine
  2. Ear: TM, malleus, umbo (3)
  3. Nose: external, mucosa, turbinates, septum (4)
  4. Throat: lips, oral mucosa, teeth, tongue, tonsils, pharynx (6)
  5. Thyroid: verbalize and palpate
  6. LNs: anterior cervical, submandibular (2)
  7. Sinuses: frontal and maxillary (2)
  8. Pt supine
  9. Palpate down neck for tenderness, asymmetry, PTP (landmarks)
  10. Check F/E (if not AA)
  11. Check SB (if not AA)

MET Tx

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8
Q

CC: Constipation (no bowel mvmnt 5d)
PE: Abdomen
OSE: Abdomen
Tx: MFR

A
  1. Hand hygeine
  2. Inspection (bruises, scarring, swelling)
  3. Auscultation (4 quads)
  4. Percussion of liver borders (midclavicular 10cm and sternal 6cm)
  5. Light palpation (4 quads)
  6. Deep palpation (4 quads)
  7. Specialty test: Murphy, McBurney, Heel strike, etc.
  8. Assess TART of abdomen (colon and SI for tenderness, texture changes, asymmetry)
  9. Palpate ganglion (celiac, sup mes, inf mes)
  10. Assess liver capsule for strain (ROM)

Tx MFR (probs colon release or SI scoop)

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9
Q

CC: Dizzy (dizzy after URI)
PE: Cranial Nerve
OSE: Air hands for L SB Rot and R lateral strains and verbalize axes
Tx: BMT

A
  1. Hand hygeine
  2. A&Ox4 (person, place, time, situation)
  3. CN 2: pupillary reflex and accomodation
  4. CNs 3, 4, 6: H pattern
  5. CNs 5, 7, 8: dermatome, smile/frown, hearing
  6. CNs 9, 10: open mouth swallow and say ahh
  7. CNs 11, 12: shrug, stick out tongue
  8. L SB Rot = Lt hand gets wider, Rt hand gets narrower
    - Saggital axis (same), 2x vertical axes (opposite)
  9. R Lateral strain = parallelogram, pinkies shift left
    - Parallell vertical axes (same direction)

BMT tx

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10
Q

CC: Dysmenorrhea (abd pain)
PE: Abdominal
OSE: Sacrum
Tx: MET

A
  1. Hand hygeine
  2. Inspection (bruises, scarring, swelling)
  3. Auscultation (4 quads)
  4. Percussion of liver borders (midclavicular 10cm and sternal 6cm)
  5. Light palpation (4 quads)
  6. Deep palpation (4 quads)
  7. Specialty test: Murphy, McBurney, Heel strike, etc.
  8. Seated forward bend to lateralize
  9. Feel bases, ILAs for A/P
  10. Test lumbar spring if feelin froggy

Sacral MET tx

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11
Q

CC: Thoracic outlet synd (lt hand numb)
PE: Peripheral nerve
OSE: Ribs
Tx: CS

A
  1. Hand hygeine
  2. Sensation: 3x dermatomes of UEs and LEs
  3. UE DTR 1x bl (biceps)
  4. LE DTR 1x bl (patellar)
  5. Cerebellar: rapid alternating movement
  6. Gait: casual, tandem (2 types)
  7. Special test (romberg)
  8. Rib respiratory motion
  9. Rib tenderness (name rib body, angle, ICS)
  10. Rib asymmetry
  11. Name SD (Rib x-y in/exhaled)

Rib CS tx

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12
Q

CC: TMJ pain
PE: ENT
OSE: TMJ
Tx: MET

A
  1. Hand hygeine
  2. Ear: TM, malleus, umbo (3)
  3. Nose: external, mucosa, turbinates, septum (4)
  4. Throat: lips, oral mucosa, teeth, tongue, tonsils, pharynx (6)
  5. Thyroid: verbalize and palpate
  6. LNs: anterior cervical, submandibular (2)
  7. Sinuses: frontal and maxillary (2)
  8. Palpate TMJ (3x landmarks TMJ, temporalis, ramus of mandible)
  9. Assess tenderness
  10. Open/close for asymmetry, ROM

TMJ MET tx

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13
Q

CC: HA
PE: Cranial nerve
OSE: air hands for inferior vert and left torsion strains
Tx: BMT

A
  1. Hand hygeine
  2. A&Ox4 (person, place, time, situation)
  3. CN 2: pupillary reflex and accomodation
  4. CNs 3, 4, 6: H pattern
  5. CNs 5, 7, 8: dermatome, smile/frown, hearing
  6. CNs 9, 10: open mouth swallow and say ahh
  7. CNs 11, 12: shrug, stick out tongue
  8. Inferior vert = hands rotate back
    - parallell transverse axes (same)
  9. Left torsion = hands rotate opposite (Lt index up, Rt index down)
    - saggital axis (opposite)

BMT tx

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14
Q

CC: Carpal tunnel
PE: Peripheral nerve
OSE: wrist and elbow
Tx: wrist or elbow CS

A
  1. Hand hygeine
  2. Sensation: 3x dermatomes of UEs and LEs
  3. UE DTR 1x bl (biceps)
  4. LE DTR 1x bl (patellar)
  5. Cerebellar: rapid alternating movement
  6. Gait: casual, tandem (2 types)
  7. Special test (romberg)
  8. Wrist and elbow palpation (landmarks)
  9. Wrist and elbow tenderness, ROM, asymmetry

CS tx for wrist or elbow

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15
Q

CC: Shoulder pain
PE: Shoulder
OSE: SC, AC, GH joint screen
Tx: UE CS

A
  1. Hand hygeine
  2. Inspection: 3x findings (bruising, erythema, scars)
  3. ROM: F, E, ABd, ADd, HABd, HADd, IR, ER (8)
  4. STR: F, E, ABd, ADd, HABd, HADd, IR, ER (8)
  5. Palpation: AC, SC, spine of scap, clavicle (4)
  6. NV: brachioradialis reflex, 3x dermatomes, pulses (3)
  7. Special test: drop arm (+ = uncontrolled drop = supraspinatus tear)
  8. Palpate GH, AC, SC joints
  9. Assess for tenderness
  10. Assess ROM for GH, AC (step off/on), SC (shrug, protract, etc)
  11. Mention asymmetry

UE CS Tx

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16
Q

CC: Low back pain (radiates to hip)
PE: Hip
OSE: Innominate
Tx: MET

A
  1. Hand hygeine
  2. Inspection: 3x findings (bruising, erythema, scars)
  3. ROM: F, E, ABd, ADd, IR, ER (6)
  4. STR: F, E, ABd, ADd, IR, ER (6)
  5. Palpation: ASIS, PSIS, glutes, greater trochanter, hammys (5)
  6. NV: patellar reflex, 3x dermatomes, pulses (3)
  7. Special test: Log roll
  8. Standing forward bend to lateralize
  9. Check iliac crests, ASIS height/umbilicus distance, pubic tubercles, medial malleoli
  10. Address tenderness, asymmetry, ROM

Hip MET

17
Q

CC: Sciatica (numb rt leg to knee)
PE: Peripheral nerve
OSE: Innominate
Tx: MET

A
  1. Hand hygeine
  2. Sensation: 3x dermatomes of UEs and LEs
  3. UE DTR 1x bl (biceps)
  4. LE DTR 1x bl (patellar)
  5. Cerebellar: rapid alternating movement
  6. Gait: casual, tandem (2 types)
  7. Special test (romberg)
  8. Standing forward bend to lateralize
  9. Check iliac crests, ASIS height/umbilicus distance, pubic tubercles, medial malleoli
  10. Address tenderness, asymmetry, ROM

Innominate MET

18
Q

CC: Sinusitis (pressure and neck discomfort)
PE: ENT
OSE: Cervical (OA, AA, C2-7)
Tx: BLT

A
  1. Hand hygeine
  2. Ear: TM, malleus, umbo (3)
  3. Nose: external, mucosa, turbinates, septum (4)
  4. Throat: lips, oral mucosa, teeth, tongue, tonsils, pharynx (6)
  5. Thyroid: verbalize and palpate
  6. LNs: anterior cervical, submandibular (2)
  7. Sinuses: frontal and maxillary (2)
  8. Pt supine
  9. Palpate down neck for tenderness, asymmetry, PTP (landmarks)
  10. Check F/E (if not AA)
  11. Check SB (if not AA)

BLT Tx

19
Q

CC: Costochondritis
PE: Cardiac
OSE: Ribs
Tx: MET

A
  1. Hand hygeine
  2. Inspection (chest, lips, fingers)
  3. Distal pulses (2x radial, 2x post tib)
  4. Auscultation 4x posts with diaphragm
  5. Auscultation 4x posts with bell
  6. Auscultation of abdominal aorta, renal aa, carotid
  7. Special test: edema
  8. Rib respiratory motion
  9. Rib tenderness (name rib body, angle, ICS)
  10. Rib asymmetry
  11. Name SD (Rib x-y in/exhaled)
  12. Rib direct MET
20
Q

CC: Postop knee pain
PE: Knee
OSE: Knees
Tx: LE CS

A
  1. Hand hygeine
  2. Inspection: 3x findings (bruising, erythema, scars)
  3. ROM: F, E
  4. STR: F, E
  5. Palpation: patella, fibular head, quadriceps tendon, patellar tendon (4)
  6. NV: patellar reflexes, 3x dermatomes, post tib pulses
  7. Special test: bounce home (start left then do right)
  8. Knee F/E, tenderness, symmetry (rename 3x landmarks)

LE CS Tx

ECOS IV (10 decks)

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