Midterm Cards Flashcards
a limited examination of the affected body area or organ system. Simple. Straightforward. Minimal history reviewed. Low medical decision-making
Problem focused
*exam only affected area
a limited examination of the affected body area or organ system and any other symptomatic or related body area(s) or organ system(s). Low, possibly moderate, medical decision-making
Expanded problem focused
*exam affected area and other symptomatic or related areas
an extended examination of the affected body area(s) or organ system(s) and any other symptomatic or related body area(s) or organ system(s). Moderate to high medical decision-making
Detailed
*exam of affected areas, similar to expanded problem focused but higher level medical decision making
a general multi-system examination (all systems are considered except for eye or psychiatric), or complete examination of a single organ system and other symptomatic or related body area(s) or organ system(s). Moderate to high medical decision-making
Comprehensive
*exam of almost all systems or complete exam of single system and other related areas/systems
Soft Tissue
Direct, Passive
Repetitive 1-2 sec, hold for inhibitory
MFR
Direct or indirect, passive
Triplanar barrier, add muscle movement for INR, may add breath assist
MET
Direct, active
post iso relaxation: take to direct barrier, pt force towards neutral and physician force toward barrier, hold 3-5 sec
BLT
Indirect, passive
Triplanar indirect barrier, test respiratory phases, hold in phase of ease to air hinger, repeat and microadjust
FPR
Indirect, passive
Flatten curve (F neck or E T-spine), compress, place in triplanar indirect barrier, hold 5 sec, return to neutral
Still Technique
Indirect and Direct, passive
Place in indirect barrier, compress, move through direct barrier
Counterstrain
Indirect, passive
- Find tenderpoint
- Establish pain scale
- Place in 70% pain reduction position
- Hold 90 sec
- Slow return to neutral
- Recheck tenderpoint
HVLA
Direct, passive
Load into direct barrier, thrust through
OA diagnosis
F or E
S and R opposite
- OA is 2 different letters so 2 different directions for S and R
i. e. OA F RlSr
AA Diagnosis
Rotation only!
i.e. AA Rr
C2-7 Diagnosis
Type 2 Mechanics
F or E
S and R same side
i.e. C3 F SrRr
Type 1 Mechanics
Neutral
Group
Opposite S and R
(TONGO = type one neutral group opposite)
Type 2 Mechanics
F or E
Single segment
S and R same direction
Innominate Diagnosis
Lateralize with STANDING forward bend test
Check landmarks (ASIS, PSIS, medial malleolus, pubic tubercle)
Innominate diagnosis:
Inferior ASIS and medial malleolus
Superior PSIS
Anteriorly rotated innominate
*anterior rotation rolls hip forward, making the leg longer
Innominate diagnosis:
Superior ASIS and medial malleolus
Inferior PSIS
Posteriorly rotated innominate
*posterior rotation rolls hip back, making the leg shorter
Sacral Diagnosis
bend, spring, sphinx, respiratory
SEATED forward bend test to lateralize
+ Lumbar spring test = resistance to springing = E sacrum
+ Backward bend test = worsened assymetry = E sacrum
Respiratory motion = E on Inhale, F on exhale
Sacral torsion bases/ILAs
Same movement on same side
Opposite movement on opposite side
i.e. L base posterior L ILA posterior R base anterior R ILA anterior
PA
PA
Sacral unilateral flexion bases/ILAs
Opposite movement on same side
Same movement on opposite side
i.e. L base posterior L ILA anterior R base anterior R ILA posterior
PA
AP
Key Rib determination
BITE
Bottom of group in Inspired Rib SD
Top of group in Expired Rib SD
Inhaled Rib Dysfunction
restricted in expiration
It is stuck up so push it down!
Ribs 1-10: depress key rib on exhalation
Ribs 11-12: quadratus lumborum
*BITE: Inhaled SD so treat bottom rib!
Exhaled Rib SD treatment
*restricted in inhalation
It is stuck down so pull it up!
Rib 1: Ant/Med scalene (pull down from forehead)
Rib 2: Post scalene (pull down from forehead)
Rib 3-5: Pec minor (adduct arm)
Rib 6-8: Serratus anterior (elbow to cieling)
Rib 9-10: Lat dorsi (elbow someone behind them)
Rib 11-12: Quad lumb
Radial Head movement
Radial head moves posterior with pronation
anterior with supination
Fibular head movement
Fibular head moves posterior with plantarflexion (also inversion)
moves anterior with dorsiflexion
Viscerosomatic Levels:
Head/Neck/Upper esophagus
T1-5
Viscerosomatic Levels:
Heart
T1-6
Viscerosomatic Levels:
Lungs
T1-7
Viscerosomatic Levels:
Upper GI
T5-10
Viscerosomatic Levels:
SI and Ascending colon
T9-11
Viscerosomatic Levels:
Ascending/Transverse colon
T10-11
Viscerosomatic Levels:
Descending/Sigmoid colon/rectum
T12-L2
Viscerosomatic Levels:
Adrenals
T5-10
Viscerosomatic Levels:
GU and Ureters
T10-L2
Viscerosomatic Levels:
Upper extremities
T2-7
Viscerosomatic Levels:
Lower Extremities
T11-12
Erysipelas vs Cellulitis vs Abscess
Erysipelas: superficial, well demarcated
Cellulitis: deep, poorly demarcated borders
Abscess: cellulitis with pus filled mass
Bacteremia vs Sepsis
Bacteremia: bacteria in the blood
Sepsis: bacteremia w/ organ dysfunction/failure
McMurray’s Test:
pain or clicking on EXTERNAL rotation of the tibia
Medial meniscus injury
McMurray’s Test:
pain or clicking on INTERNAL rotation of the tibia
Lateral meniscus injury
Definition of fever (temp)
> 38 C or 100.4 F
Febrile illness for 3 weeks or longer without an etiology despite a one-week inpatient evaluation
Fever of unknown origin
Sensitivity
Helps rule out disease
A (-) result on a sensitive test will allow you to be confident that the result is a true negative
**Leukocyte esterase is very sensitive => (-) result means WBC in urine likely not due to infection
Specificity
Helps rule in disease
A (+) result on a specific test will allow you to be confident that the result is a true positive
**Nitrate is very specific => (+) result means infection very likely
Antipyretics for fever treatment
APAP (mostly central)
NSAIDs (central and peripheral)
Aspirin
*NSAIDs risky in pts with liver dz
Esophagus chapman points
2nd ICS parasternally
Lateral to T2 spinous process
Stomach chapman point
5th and 6th ICS on the Left
Lateral to T5 and T6 spinous process on the Left
Liver chapman point
5th and 6th ICS on the Right
Lateral to T5 and T6 spinous process on the Right
Gallbladder chapman point
6th ICS on the Right
Lateral to T6 spinous process on the Right
Pancreas chapman point
7th ICS on the Right
Lateral to T7 spinous process on the Right
Small Intestine chapman point
8th, 9th, 10th ICS Bilaterally
Lateral to T8 T9 T10 spinous process Bilaterally
Orthostatic hypotension definition
Sustained drop of SBP by 20 or drop of DBP by 10, 3 minutes after standing
