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LECOM MS2 > H&P PE > Flashcards

H&P PE Flashcards

1
Q

POS Rhinne AC > BC

A

normal or sensorineural hearing loss with impaired air and bone conduction

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2
Q

NEG Rhnne BC > AC

A

conductive hearing loss

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3
Q

Weber heard to one side

A

lateralization

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4
Q

Weber heard to affect side

A

conductive hearing loss

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5
Q

Weber heard to unaffected side

A

sensorineural loss

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6
Q

Inspection of Neck

A
  1. symmetry 2. lesions 3. masses 4. tracheal position 5. JVD
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7
Q

What do you do first in neck exam

A

auscultation prior to palpation of carotids and thyroid for bruits

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8
Q

Palpation of cervical lymph nodes

A
  1. anterior auricular 2. posterior auricular 3. submental 4. submandibular 5. posterior cervical chain 6. anterior cervical chain 7. supraclavicular 8. infraclavicular
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9
Q

Pt. supine, flex neck fwd - + = hips flex

A

brudzinski

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10
Q

Flex at hip and knee extend knee - pain

A

kernig

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11
Q

Order of Respiratory Exam

A
  1. inspection 2. palpation 3. percussion 4. auscultation
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12
Q

Sound transmitted louder at area of consolidation

A

bronchophony

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13
Q

e –> a at area of consolidation

A

egophony

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14
Q

whispered words louder at area of consolidation

A

whispered pectoriloquy

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15
Q

Pneumonia finding

A

inc. tactile fremitus; dec. resonance on percussion

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16
Q

Pneumothorax finding

A

dec. tactile remitus; inc. resonace on percussion

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17
Q

Pleural effusion finding

A

dec. tactile remitus & resonace on percussion

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18
Q

S1

A

closure of AV valves, marks onset of systole

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19
Q

S2

A

closure of semilunar valves (aortic, pulmonic)

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20
Q

Ejection click–early systole

A

diseased aortic valve (right after S1)

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21
Q

Opening snap–early diastole

A

mitral disease (mitral valve opening)

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22
Q

S3

A

rapid deceleration of blood; decreased compliance in adults (immediately after S2)

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23
Q

S4

A

atrial kick against decreased compliance (immediately befor S1)

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24
Q

crescendo/decresendo murmur

A

aortic stenosis

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25
Q

plateau murmur

A

mitral regurg, tricuspid regurg, VSD

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26
Q

decrescendo murmur

A

aortic regurg

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27
Q

radiation of murmur to neck (carotids)

A

aortic stenosis

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28
Q

radiation of murmur to axilla

A

mitral regurg

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29
Q

Grade 1 murmur

A

very faint, possibly not heard in all positions

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30
Q

Grade 2 murmur

A

quiet, but heard immediately after placing the stethoscope on the chest

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31
Q

Grade 3 murmur

A

moderately loud

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32
Q

Grade 4 murmur

A

loud, with palpable thrill

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33
Q

Grade 5 murmur

A

very loud, with thrill may be heard when stethoscope is partly off chest

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34
Q

Grade 6 murmur

A

very loud, with thrill; may be heard with stethoscope entirely off chest

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35
Q

Lateral decubitus increases ability to hear

A

mitral stenosis, S3, S4

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36
Q

Sitting, leaning fwd, breathe out and hold exaggerates

A

Aortic murmur

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37
Q

Standing, squatting, valsalva exaggerates

A

mitral valve prolapse, aortic stenosis

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38
Q

Aortic heard

A

2nd R ICS along sternal border

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39
Q

Pulmonic heard

A

2nd L ICS along sternal border

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40
Q

Tricuspid heard

A

4th/5th ICS along sternal border

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41
Q

Mitral heard

A

4th/5th ICS MCL

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42
Q

Allen Test

A

tests compentency of radial and ulnar arteries - done prior to ABG; ulnar first

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43
Q

Allen Test normal

A

pinks in 3 - 5 seconds

44
Q

Order of Abdominal Exam

A

inspection, AUSCULTATION, palpation (light to deep), percussion

45
Q

Rovsing sign

A

pain in RLQ with LLQ pressure = appendicitis

46
Q

Psoas sign

A

E hip making psoas muscle contract = appendicitis

47
Q

Obturator sign

A

F hip/knee, IR = appendicitis

48
Q

Murphy’s sign

A

push up under RCM, have patient take deep breath in, + = suddently halting breath

49
Q

Lloyds punch

A

CVA tenderness - nephrolithiasis, hydrophrosis, pyelonephritis

50
Q

CN II - Optic Testing

A

Visual acuity (chart), Peripheral fields, Sensory portion of direct/consensual pupillary reflex

51
Q

CN III - Occulomotr Testing

A

Motor portion of direct/consenual pupillary reflex; EOM for MR, IO, SR, IR; Ptosis

52
Q

CN IV - Trochlear Testing

A

EOM - SO ( eyes down and inward)

53
Q

CN V MOTOR- Testing

A

Clench teeth, palpating muscles of mastication

54
Q

CN V SENSORY - Testing

A

Test sensation in each branch with eyes closed

55
Q

CN VI - Abducens Testing

A

EOM LR (moves eyes lateral)

56
Q

CN VII MOTOR - Facial Testing

A

facial symmetry: raise eyebrows, smile, frown, puff cheecks, show teeth, close eyes against resistance

57
Q

CN VIII - Vestibulocochlear Testing

A

Whispered word/finger rub; Nystagmus (vestibular function)

58
Q

CN IX - Glossopharyngeal Testing

A

say ‘AH’ - symmetrical rise of uvula (deviate away from lesion); sensory of gag reflex

59
Q

CN X - Vagus Testing

A

Assess for dysphonia; (GAG - MOTOR)

60
Q

CN XI - Spinal Accessory Testing

A

Head turn against resistance (SCM); shrug shoulders (trapezius)

61
Q

CN XII - Hypoglossal Testing

A

Observe tongue for fasciculations; stick tongue out (deviates TOWARD lesion)

62
Q

Strength scale

63
Q

5/5 strength

A

Complete ROM against gravity with full resistance

64
Q

4/5 strength

A

Complete ROM against gravity with some resistance

65
Q

3/5 strength

A

Complete ROM against gravity

66
Q

2/5 stength

A

Complete ROM with gravity eliminated (rare)

67
Q

1/5 strength

A

Evidence of slight contractility with no joint movement

68
Q

0/5 strength

A

No evidence of contractility (visual or tactile)

69
Q

Shoulder abduction innervation

A

Axillary (C5-6)

70
Q

Elbow flexion innervation

A

Musculocutaneous (C5-6)

71
Q

Elbow extension innervation

A

Radial (C6-8)

72
Q

Wrist flexion innervation

A

Median (C6-7)

73
Q

Wrist extension innervation

A

Radial (C6-8)

74
Q

Grip (finger adduction) innervation

A

Median (C6-8)

75
Q

Finger abduction innervation

A

Ulnar (C8-T1)

76
Q

Thumb abduction innervation

A

Median (C8-T1)

77
Q

Hip adduction innervation

A

Obturator (L2-4)

78
Q

Hip abduction innervation

A

Superior gluteal (L4-S1)

79
Q

Knee extension innervation

A

Femoral (L2-4)

80
Q

Knee flexion innervation

A

Sciatic (L4-S1)

81
Q

Dorsiflexion innervation

A

Deep peroneal (L4-5)

82
Q

Plantarflexion innervation

A

Tibial (L5-S2)

83
Q

Proprioception

A

toe up or down

84
Q

Patient points to area touched

A

Point localization

85
Q

Asking patient if being touched on R/L/both sides

A

Extinction

86
Q

Use paper clip

A

2 point distinction

87
Q

Recognition of familiar object in palm with eyes closed

A

Stereognosis

88
Q

Recognition of # drawn on palm with eyes closed

A

Graphesthesia

89
Q

Scale of reflexes

90
Q

0 reflex

A

Absent (even with reinforcement)

91
Q

1+ reflex

A

Hypoactive

92
Q

2+ reflex

93
Q

3+ reflex

A

Hyperactive without clonus

94
Q

4+ reflex

A

Hyperactive with clonus

95
Q

Clonus

A

rapid alternating contractions and relaxations of muscle after forced stretch

96
Q

Biceps tendon reflex

97
Q

Brachioradialis tendon reflex

98
Q

Triceps tendon reflex

99
Q

Patellar tendon reflex

100
Q

Achilles tendon reflex

101
Q

Tests for cerebellar function

A

RAM, F-N, pronator drift, heel-shin, gait, tandem walk (heel-toe), romberg

102
Q

Romberg

A

test of position sense. Stand with feet together, eyes closed for 30 - 60 sec without support

103
Q

Positive Romberg

A

Cerebellar ataxia - patient has difficulty standing with feet together whether eyes are open or closed

104
Q

Pronator Drift

A

Stand 20 - 30 sec with both arms straight forward, palms up, eyes closed. Tap arms briskly downward (return to normal) - response requries muscular strength, coordination, good sense of position

105
Q

Positive pronator drift

A

pronation of one forearm - corticospinal tract lesion in C/L hemisphere

LECOM MS2 (1 decks)

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