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Physical Dx > Final practical specialized exams > Flashcards

Final practical specialized exams Flashcards

1
Q

hepatojugular reflex

A
  • firm pressure to RUQ

- observe for JVD

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2
Q

auscultate leaning forward at cardiac base with diaphragm

A
  • patient leans forward, exhales, holds breath in expiration
  • listening for soft murmurs
  • use firmer pressure
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3
Q

auscultate laying on side for cardiac apex with bell

A
  • patient on left side (left lateral decubitus)
  • listening for low-pitched murmurs, S3/ S4
  • use lighter pressure
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4
Q

auscultate for bruits (CV and abd)

A

CV

  • auscultate at carotid, aortic, renal, (verbalize iliac and femoral)
  • if HTN or other relevant concerns

ABD
-renal and iliac arteries

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5
Q

palpate for pulses

A

-palpate carotid, brachial, aortic, femoral, poplitea, posterior tibialis, dorsalis pedis pulses

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6
Q

allen test

A
  • occlude radial and ulnar arteries
  • patient makes tight fist then opens hand
  • release ulnar artery and check blood flow
  • checking for: ulnar artery patency
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7
Q

homan sign

A
  • dorsiflex patients food and assess for pain

- positive = pain in calf (DVT)

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8
Q

fluid wave

A
  • ulnar aspect of hand on mid-abdomen
  • tap one side of abdomen and feel for transmitted impulse on other side
  • testing for: ascites
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9
Q

rebound tenderness

A
  • more tender with pushing in or letting go quickly

- testing for: peritoneal signs (ex. intraperitoneal infection)

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10
Q

psoas sign

A
  • patient supine, hand against R knee
  • ask patient to flex right hip against resistance
  • postitive= RLQ pain
  • testing for: peritoneal signs (ex. intraperitoneal infection)
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11
Q

obturator sign

A
  • patient supine, flex hip and knee, internal rotation at hip
  • positive= RLQ pain
  • testing for: peritoneal signs (ex. intraperitoneal infection)
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12
Q

rovsing sign

A
  • press deeply in LLQ
  • positive= referred pain to RLQ
  • testing for: peritoneal signs (ex. intraperitoneal infection)
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13
Q

murphy sign

A
  • fingers of R hand under R costal margin and apply pressure while having patient take deep breath
  • positive= pain in RUQ during inspiration
  • testing for: hepatic or GB inflammation
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14
Q

costovertebral angle tenderness (CVA)

A

-one hand over CBA and other fist for gentle percussion bilaterally

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15
Q

measure for pitting edema

A
  • press firmly with thumb 2+ seconds over dorsum of feet and over shins
  • compare bilaterally assessing for pitting
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16
Q

straight leg raising test (passive)

A
  • patient supine and leg straight
  • raise 1 leg off table and note angle to which it can be raised before patient complains of back or leg pain
  • dorsiflex if pain not elicited
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17
Q

flip back

A

-similar to straight leg raise but patient seated and extending at knee

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18
Q

stability of pelvis

A
  • patient supine

- hands to lateral pelvis and push toward table

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19
Q

FABER

A
  • hip at 45 deg. of flexion with knee at 90 deg.

- externally rotate and abduct hip while placing ankle above knee of contralateral leg

20
Q

FADIR

A

-place hip into full flexion then internally rotate and adduct

21
Q

bulge sign

A
  • slide one hand down distal anterior thigh (displacing fluid from prepatellar bursa into joint space)
  • sweep along medial and lateral knee to observe for fluid bulge
22
Q

ballottement sign

A
  • slide one hand down distal anterior thigh (displacing fluid from prepatellar bursa into joint space)
  • press patella directly toward knee joint
23
Q

valgus stress test

A
  • stabilize lateral knee and apply lateral pressure to ankle/ foot
  • tests MCL
24
Q

varus stress test

A
  • stabilize medial knee apply medial pressure to ankle/ foot

- tests LCL

25
Q

anterior drawer sign @ knee

A
  • patient supine, knee bent at 90 deg., stabilize foot
  • pull proximal tib/fib toward you
  • checking for: ligament laxity of ACL
26
Q

posterior drawer sign

A
  • patient supine, knee bent at 90 deg., stabilize foot
  • push proximal tib/fib toward patient
  • checking for: ligament laxity of PCL
27
Q

mcmurray test

A
  • flex patient knee
  • with one hand, palpate joint line, hold heel of foot in other hand with ball of foot on wrist
  • lateral rotation of foot followed by extension of leg tests posterior horn of medial meniscus (for tear)
  • medial rotation with extension tests posterior horn of lateral meniscus (for tear)
  • positive= palpable click at knee joint
28
Q

apley distraction test

A
  • patient prone with knee flexed to 90 deg.
  • stabilize posterior thigh with hand or knee
  • distract at ankle, while internally and externally rotating the foot
  • observing for: increased motion/ laxity = collateral ligament injury
29
Q

compression grind test

A
  • pressure on heel, while internally and externally rotating foot
  • providing compression of tibia against femur while stressing meniscus
  • positive= pain/ clicking = possible meniscal pathology (positive in ER = medial meniscus or positive in IR = lateral meniscus)
30
Q

lachman test

A
  • knee in 20-30 deg. flexion
  • grasp distal femur with one hand and upper tibia with other
  • move femur back and tibia forward and estimate degree of forward excursion
31
Q

pivot test

A
  • flex hip to 20 to 30 deg., knee extended
  • proximal hand applying anterior pressure of tibia and fibula, distal hand placing lower leg in internal rotation while flexing knee
32
Q

thompson test

A
  • patient kneel on stool with knee bent at 90 deg.

- squeeze calf and look for plantar flexion of foot

33
Q

anterior drawer sign @ ankle

A
  • stabilize distal tibia; grasp posterior calcaneus and pull forward
  • checking for: ligamentous laxity
34
Q

rapid alternating movements

A

-pt to rapidly pronate and supine their hand, tapping their distal thigh

35
Q

vibration (tuning fork)

A

-place vibrating tuning fork on bony prominence

36
Q

proprioception (position of joints)

A
  • gently hold finger laterally and medially, and move it up or down
  • ask pt. to describe the direction it is moving
37
Q

stereognosis

A

-ask pt to identify objects placed in his hand

38
Q

2-point discrimination

A

-use 2 ends of paper clip or two wooden ends of Q-tip to determine whether pt detects one or two items

39
Q

extinction (double simultaneous stimulation)

A
  • pt’s eyes closed; touch pt in same place on both sides of body
  • ask whether pt detects one or two touches
40
Q

graphesthesia

A

-write letter or number in palm of pt’s hand; identify it

41
Q

ankle clonus reflex

A

-forcefully dorsiflex pt’s foot to see if it “beats” >2 times

42
Q

abdominal reflex

A
  • use Q-tip
  • gently stroke toward the umbilicus in all 4 quadrants
  • observe for abdominal wall muscular contractions toward stimulus
43
Q

kernig’s sign

A
  • flex pt’s leg at hip and knee, then straighten leg
  • positive= back pain/ resistance to straightening
  • if finding is bilateral it suggests meningeal irritation
  • checking for: signs of meningeal irritation/inflammation
44
Q

brudzinski’s sign

A
  • pt supine; flex pt’s neck
  • positive= hip & knee flexion occurs
  • checking for: signs of meningeal irritation/inflammation
45
Q

nuchal rigidity

A
  • test for ease of neck flexion, extension, & rotation

- checking for: signs of meningeal irritation/inflammation

Physical Dx (14 decks)

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