High yield Flashcards
what are the borders of the anterior triangle of the neck?
superior mandable lateral by the medial border of the sternocleidomastoid m, medially by the midline
border of posterior triangle
medial border is sternocliedomastoid m, clavicle is inferior border and trap is lateral border/ the spinal accesory nereve runs through the posterior triangle
what is a virchows node and what does it suggest
left sided enlarged supraclavicular lymph node that suggest malignancy of thorax or abdoman
what does a right sided englarged supraclacicular lymph node suggest
malignancy of lungs, mediasteinum, esophogus
what muscle attaches to the labrum of the shoulder
biceps
what does O’Brians test test for?
O’Brien’s test: positions the arm for resistance testing in a way that specifically targets a SLAP (superior labrum anterior to posterior) labral tear.
Flex arm to 90°and adduct across the chest
Internally rotate with the thumb pointing down and push down on the arm
what does the apprehesnsion test test for?
Apprehension test: positions the shoulder in abduction and external rotation that reduces stability of the joint and can promote anterior dislocation. Patient may become apprehensive in this position.
Drop arm test
Drop arm: used to assess a severe tear or full rupture of the supraspinatus tendon. ROM 0-90° = supraspinatus, 90-120° (or so) = deltoid. When a full supraspinatus tear exists, the patient cannot hold the arm in a position between 0-90° .
speeds test
Speed’s test: resisted bicep flexion reproduces pain localized to the tendon suggesting tendonitis.
cervical compression test
aka Axial/Vertical Compression Test
Apply direct vertical compression without sidebending or rotation to provoke symptoms of a pinched nerve.
spurlings maneuver
**Sidebending to the affected side with compression down along the spinal axis. Reproduces radicular symptoms
distraction test
Alleviates radicular symptoms and supports a diagnosis of radiculopathy pull up on head
Roo’s test
Arms abducted to 90°, externally rotated
Elbows flexed at 90°
Patient slowly opens and closes his hands for 3 minutes.
tests for thoracic outlet syndrome
Adson’s test
The arm of the standing (or seated) patient is abducted 30 degrees at the shoulder and maximally extended.
• The radial pulse is palpated and the examiner grasps the patient’s wrist.
• The patient then extends neck and turns the head toward the symptomatic shoulder and is asked to take a deep breath and hold it.
• The quality of the radial pulse is evaluated in comparison to the pulse taken while the arm is resting at the patient’s side.
• Some clinicians have patients turn their heads away from the side tested in a modified test.
lift off test
: With arm internally rotated so dorsum of hand rests on low back, have patient lift the hand off their low back posteriorly against your resistance.
tests for subscap injury
crossover test
Adduct the arm across the chest which compresses the acromioclavicular joint and causes pain if there has been disruption of the AC joint or arthritis.
neers impingement sign
Stabilize scapula Internally rotate and flex arm Subacromial impingement Supraspinatus pathology hail hitler one
Hawkins impingment sign
The patient is examined while sitting with their shoulder flexed to 90° and their elbow flexed to 90°. The examiner grasps and supports proximal to the wrist and elbow to ensure maximal relaxation, the examiner and the patient then quickly rotate the arm internally. Pain located below the acromioclavicular joint with internal rotation is considered a positive test result for subacromial impingement or rotator cuff tendinitis
medial epicondylititis test what
flex wrist
lateral epicondylitits test what
extend wrist
finkelsteins test
Patient grips thumb inside fist. Examiner gently ulnar-deviates the wrist. If pain occurs along the thumb or wrist, the test is positive for tenosynovitis of the extensor pollicis brevis and abductor pollicis longus (De Quervain’s Disease).
tinels test or sign
tap over median nerve
phalens sign
median nerve impingment
reverse phalens sign
median nerve impingemnt
Describe visceral pain
source is usually hollow organ caused by distension or stretching. Comes and goes, crescendo/decrescendo pattern. Not well localized
describe parietal pain
Caused by inflammation of the peritoneum. Steady aching pain that is usually well localized.
what refers pain to the right shoulder?
glabladder/liver
what refers pain to the back?
aorta/pancreas
What refers pain to the left shoulder?
spleen
What refers pain to the flank and groin?
kidney
what is adequate exposure of the abdomen
xiphoid to the pubis
what is rovsings sign?
deep palpation of llq cause pain in rlq
What is lloyds sign?
tenderness as CVA striking of back
Condyloma acuminata caused by ?
HPV
Condylomata lata caused by?
syphilis
five f’s of acute cholyctstitis
The 5 “f’s” – female, fat, fertile, fair, flatulent.
what is murpheys sign?
RUQ pain and sudden arrest of inspiration during palpation of the liver and gallbladder.
what is the diagnostic triad for acute cholectystits?
RUQ pain, fever and leukocytosis.
presentation of chlaymdyia?
elevated WBC non gonococcal urethritis
presentation of Gonhearra
WBC with Gm(-) intracellular diplococci
hypospadias def
congenital displacement of the urethral meatus on the inferior surface of the penis along the urethral groove.
Important in a new born exam. Maybe associated with congenital renal abnormalities.
epispadias def
congenital displacement of the urethral meatus on the superior surface of the penis
causative organism and path of primary syphilis
Treponema pallidum – causative organism
Syphilitic Chancre – painless round or oval erosion or ulcer. Non-tender enlarged inguinal lymph nodes are common.
RPR and VDRL are positive, screening test, many false positives.
FTA- ABS is positive or Dark Field Microscopy, confirmatory test.
gentital herpes pathology?
cluster of small vesicles. Burning and painful. Progress to ulcers on a erthymic base. Dx – viral culture of the fluid in the vesicle.
Herpes simplex virus 1 and 2 – causative organism
what causes venereal warts?
HPV
gonococcal urethritis gram stain
Gram-negative intracellular diplococci of GC
WBC = neutrophils
abrupt incubation period
non-gonococcal urethritis gram stain
polymorphonuclear leukocytes NGU=chlamydia
define menorrhagia
excessive bleeding
define Metrorrhagia –
Metrorrhagia – bleeding between periods