HDC DOCS Flashcards
These are the first two pieces of information you get from the patient
Identifying information, Chief Complaint
What is involved in medication history?
Name of drug, dose, prescribed frequency and actual frequency
What is involved in Allergy history?
Specific allergies with reactions to each
What is involved in PMHx?
Adult Illnesses
Health maintenance - immunizations, cancer screenings, etc
What is involved in PSHx?
Procedure, date/year, indication, complications
What is involved in FHx?
Medical conditions of first degree relatives (one up, one down)
If living - current age and health status
If deceased - age of death and cause
What is involved in SocHx?
Personal Geographic Map and travel history
Significant relationship and support systems
Occupation and Education
Substance Use History
Safety Measures
What is involved in ROS?
System of concern + 2 additional systems w/ at least 2 common symptoms per system:
Constituional (general)
Hematologic/Lymphatic
ENMT
Allergic/Immuno
What is involved in the upper extremity neuro exam?
Sensation:
Superior shoulders - C4
Lateral upper arms - C5
Lateral forearms/thumbs - C6
Middle finger - C7
Pinky finger - C8
Medial forearm - T1
Strength:
Shoulder abd
Elbow F/E
Wrist E
Grip
Finger Abd
Thumb opposition
DTRs:
Biceps: C5-6
Brachioradialis: C5-6
Triceps: C6-7
What is involved in the MSK exam of the Cervical Spine
Inspection
Palpation
ROM (seated)
Special tests
What is involved in the Inspection of the MSK Cervical Spine exam?
Head, neck, shoulders, UE
Muscle tone/bulk, posture, deformities
Edema, erythema, ecchymosis, derm findings
What is involved in the Palpation of the MSK Cervical Spine exam?
Landmarks:
Mastoid processes; angles of mandible; C2-C7 spinous processes; paravertebral muscles; C2-C7 articular pillars; T1 spinous process; external occipital protuberance
TART
What is involved in the ROM of the MSK Cervical Spine exam?
Active and Passive ROM
Flexion, Extension, Side-bending, Rotation
What is involved in the Special Tests of the MSK Cervical Spine exam?
Cervical:
Cervical Distraction Test
Cervical Compression or Spurling’s Test
Vertebral Artery Challenge Test
Thoracic Outlet Testing:
Military Posture, Wright’s or Adson’s Test
Describe the Anterior Neurolymphatic (Chapman’s) Reflexes
Middle ear - superior to middle clavicles
Sinuses - inferior to middle clavicles
Pharynx - inferior to sternoclavicular joints
Tonsils - medial to 1st intercostal space
Tongue - medial to 2nd ribs