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Physical Diagnosis Block III > Mental Status/Neurologic Exam/Pelvic/Peds/Geriatric > Flashcards

Mental Status/Neurologic Exam/Pelvic/Peds/Geriatric Flashcards

1
Q

Can evaluate this with the MMSE:

A

Cognitive Abilities

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2
Q

Ability to draw clock, A/O x4?

A

cognitive abilities

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3
Q

crying, depression, bipolar

A

Emotional Stability

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4
Q

repeating words, word salads, made-up words

A

Speech and language skills

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5
Q

Making up words just for yourself

A

Neologisms

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6
Q

Takes you 20 minutes to tell something very simple, round about way of explanation

A

Circumlocution

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7
Q

What are signs and symptoms of Wernickes?

A

Patient doesn’t realize they have a disorder, words don’t make sense together, nonsensical, neologisms, motor skills are perfect

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8
Q

What are the sign and symptoms of Brocas?

A

They know they have a problem, broken production of speech, takes them a long time, still in sensical words.

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9
Q

A/O x 4?

A

person, place, time, event

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10
Q

Limitation of the MMSE?

A

only checks cognitive abilities, ie. slowly progressing Dementia

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11
Q

5 areas tested on MMSE?

A

orientation (what times is it?), registration (3 words), attention and calculation (count backwards from 100 by 7), recall (3 words later), language (point to a pencil, what is this?)

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12
Q

Maximum score of the MMSE?

A

30 (24-26 are a positive screen)

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13
Q

Drawing 2 pentagrams test what?

A

Tests language (following directions)

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14
Q

Where is the motor cortex located?

A

Frontal Lobe

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15
Q

Where is proprioception processed?

A

Parietal Lobe

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16
Q

Postive Babinski sign shows a problem in which motor neuron?

A

Upper

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17
Q

Dysarthria

A

difficult or labored speech, listen for when testing Hypoglossal nerve (12)

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18
Q

Superficial reflex to evaluate T12, L1 and L2 spinal nerves

A

Cremasteric reflex in males

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19
Q

Superficial reflex to evaluate T8-T10 spinal nerves

A

upper abdominal reflex

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20
Q

Superficial reflex to evaluate T10-T12 spinal nerves

A

lower abdominal reflexes

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21
Q

Abnormal response to plantar reflex?

A

Babinski = dorsiflexing. Unless under 2 years of age

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22
Q

Where are you more likely to feel the 2 points as separate?

A

Finger tips easier than back

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23
Q

Sustained clonus is a sign of?

A

Upper Motor Neuron Disease

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24
Q

Difference between delirium and dementia?

A

Delerium can be acute, dementia cannot (is progressive). Delerium more perception, dementia more confusion.

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25
Difference between Stupor or Lethargy?
Stupor responds to pain or verbal, where as lethargy respond appropriately when aroused. Stupor both slow to respond and doesn't to 4 questions. Lethargy answers questions but slowly.
26
Absence of reflexes
Areflexia, may also indicate neuropathy
27
Total number of deliveries (not babies) after 20 weeks
Parity (twins are 1)
28
Total number of pregnancies (regardless of when, where, etc)
Gravida
29
Easily irritated or inflamed cervical tissue
Friable cervix
30
Chadwick's sign
Bluish color in cervix which is a sign of increased vascularity, appears 8-12 weeks
31
Until which age do you measure head circumference?
2 years
32
At which age do you start taking BPs in kids?
3 years
33
At which age do you start testing vision?
3 years
34
At which age do you switch to BMI?
2 years
35
Screen for specific developmental milestones?
9, 18, 30 months
36
When should the posterior fontanelle close?
2 months
37
When should the anterior fontanelle close?
9-18 months
38
When should primitive reflexes be gone?
by 6 months
39
What is the cerebrum responsible for?
Higher order thinking (general movement, visceral functions, perception, behavior) Contains the frontal, parietal, occipital, temporal lobes.
40
What is the cerebellum responsible for?
Works with the motor cortex (located in frontal lobe) and processes sensory info and sends it to cerebrum. Does fine muscle control, balance, posture.
41
What does the frontal lobe do?
contains motor cortex, and is associated with voluntary skeletal movement and fine repetitive motor movements. Also, executive functions, thinking, planning. Contains prefrontal cortex.
42
What kind of symptoms would you expect with someone with prefrontal cortex damage? Think Phineas Gage...
Can't control behavior, has outbursts, is impulsive, lack of social norms.
43
What does the parietal lobe do?
Perception - making sense of the world.Visual, gustatory, olfactory, auditory, proprioception.
44
Which lobe is the primary vision center?
Occipital lobe
45
Which lobe is responsible for the interpretation of sounds?
Temporal lobe
46
If damage to Temporal lobe and Wernicke's area, which symptom may you except from a patient?
Fluent aphasia. aka Sensory aphasia. Produce speech without grammatical error, but cannot comprehend (speaking russian)
47
Name all the cranial nerves in order I-XII:
Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Acoustic (vestibulocochlear), Glossopharyngeal, Vagus, Spinal Accessory, Hypoglossal
48
Which cranial nerves are classified as strictly sensory?
Olfactory (smell), optic (sight), acoustic (hear)
49
Which cranial nerves are classified as motor?
Oculomotor (eye moves), Trochlear (eye moves), Abducens (eye moves), Facial (face moves), Spinal Accessory (turn head, shrug) , Hypoglossal (tongue moves)
50
Which cranial nerves are both motor and sensory?
Trigeminal (jaw moves and eye and face feels), Facial (mostly motor), Glossopharyngeal (swallowing and gag reflex), Vagus (peristalsis, heart and senses behind ear)
51
Which spinal tract carry info from the external environment?
Ascending tract
52
Which spinal tract conveys impulses to various muscle groups, control muscle tone, posture and precise movements?
Descending tract
53
What structures receive info for the various dermatomes?
the sensory and motor fibers of the sensory nerves
54
A patient is believed to have a motor neuron disorder and is symptomatic on the contralateral (opposite) side. Which Type?
Upper Motor Neuron above the brainstem. (if below the brainstem then same side)
55
A cervix that points anteriorly is positioned how?
Retroverted
56
A cervix that points posteriorly is positioned?
Anteverted
57
If the cervix appears pale, that could be a sign that the patient is?
anemic
58
What type of pressure is applied when inserting the spec?
downward
59
Swelling, redness, or tenderness of the labia majora may indicate;
infection of the Bartholin's glands.
60
Friable cervix
red patchy ares, granular areas, and white patches that could indicate cervicitis, infection or carcinoma
61
The normal texture of the vaginal walls in a premenopausal women
Rugae
62
When can a cystocele or rectocele be visible on pelvic exam?
when the patient "bears down"
63
After 2 attempts in 2 positions to feel for the fundus of the uterus, and you didn't, you could assume the uterus is in which position?
midline
64
If unable to palpate adnexa on vaginal bimanual exam, when should you try to locate them again?
During the rectovaginal exam
65
An uterus palpable during the rectovaginal exam is in what position?
retroverted
66
A woman who has been pregnant more than once
multigravida
67
uterine descent
when the cervix itself protrudes out of the vaginal opening
68
inside out vagina
vaginal prolapse
69
Why are young women more likely to get HPV?
Because transition zone is still ectropic (not turned in) and is an area of actively growing cells and prone to become cancerous
70
Cervical motion tenderness
pain elicited when the cervix is manipulated. Suggests inflammatory process or ectopic pregnancy
71
5 components of pediatric exam?
nutritional, elimination, development, immunization, sleep
72
4 things you check on a newborn visit:
weight, heart, jaundice, metabolic screen
73
Amount of days babies take to regain birthweight:
10-14 days
74
Muscle tone of a "floppy baby":
hypotonic
75
Muscle tone of a baby whose legs are hard to spread agart?
Hypertonic
76
Rooting reflex
stroke perioral skin at the corners of the mouth
77
Palmar grasp
baby will flex all fingers to grab on
78
Plantar grasp
Toes curl around
79
Moro (startle) reflex
arms with abduct and extend, hands open, legs flexed
80
Placing/Stepping reflex
sole touch ground and hip and knee will flex upward and other foot will step forward
81
Truncal Incarvation (galant's reflex)
in prone position, spine will curve to stroked side
82
Asymmetric tonic neck reflex
turn head to the side and arm and leg from that side will extend and the opposite side will flex
83
Cephalohematoma
within periosteum of bone and cannot cross the midline. Does not involved blood. Usually result of birth trauma, usually benign.
84
Caput succedaneum
can cross the midline
85
frontal bossing
premature closing of suture lines
86
Anticipatory guidance
educating parents on the development and growth of their child.
87
Hemangiomas are usually resolved within
1 year
88
Flat, blue, or gray skin markings near the buttocks, back, and shoulders
Mongolian spots
89
esotropia
one eye looks in
90
exotropia
one eye looks out
91
hypertropia
looks up
92
hypotropia
looks down
93
IADLs
instrumental activities of daily living - higher level of functioning: telephoning, shopping, cooking, finances, taking meds. Poor scores on IADLs indicate independence is eroding and may need more help or move to a home
94
ADLs
basic activities required of adults to be independent - arising, continence, dressing, eating, etc.
95
Functional Assessment
takes 45 minutes, includes comprehensive history, physical exam, and social assessment
96
Hippocratic facies
the face of someone who is chronically ill (hollowing of the cheeks, loss of muscle tone)
97
What are the 3 things associated with the alcohol stigmata?
palmar erythema, gynecomastia in males, and testicular atrophy in males

Physical Diagnosis Block III (2 decks)

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