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assessment > MS/CNs > Flashcards

MS/CNs Flashcards

1
Q

thoracic outlet syndrome

A

Compression of brachial plexus and subclavian vessels near the first rib, usually when arms are extended over head in superman position, - associated with proning

  • “be certain pt can work or sleep with arms elevated over their head before putting arms beside head in prone positioning”
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2
Q

Lithotomy Positioning ROM Qs

A
  1. Lying supine, flex knee to chest/abdomen, check for flattening of lumbar spine
  2. Lying supine, stabilize anterior superior iliac spine and abduct the extended leg until the iliac spine moves - find limit
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3
Q

Cranial Nerve 1 Assessment

A

Cranial Nerve 1: Olfactory

Identify small with eyes closed

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4
Q

Cranial Nerve 2 Assessment

A

Cranial Nerve 2: Optic

Assessment:

  • Sight:
    • Confrontation Test
      • can indicate defects in visual field
      • pituitary tumor?
    • Pupillary Reaction to Light
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5
Q

Cranial Nerve 3 Assessment:

A

Cranial Nerve 3: Oculomotor

“SO by 4, LR by 6, all others by 3.”

  • 3: Pupillary reaction to light, occular movements
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6
Q

Cranial Nerve 4 Assessment:

A

Cranial Nerve 4 Asessment: Trochlear

“SO by 4, LR by 6, all others by 3”

  • SO4: Superior Obliqu
  • Extraocular Movements
  • Diagonal Motion
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7
Q

Cranial Nerve 5 Asessment

A

Cranial Nerve 5: Trigeminal

“Muscles of Mastication”

  • Motor: ask patient to clench his/her teeth as you palpate temptoral, masseter muscles.
  • Sensory: check sensation in forehead, cheek, chin (V1, V2, V3)
  • Corneal reflex
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8
Q

Cranial Nerve 6 Assessment

A

Cranial Nerve 6: Abducens

“SO4 , LR 6, all others by 3”

  • 6 = Lateral Rectus
  • Extraoccular movements side to side
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9
Q

Cranial Nerve 7 Assessment:

A

Cranial Nerve 7: Facial Nerve

Ask Patient To (Motor):

  • Raise Both Eyebrows
  • Frown
  • Close eyes tightly so you can’t open them
  • Show teeth
  • Smile
  • Puff Out Both Cheeks
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10
Q

Cranial Nerve 8 Asssessment:

A

Cranial Nerve 8: Acoustic

Hearing

  • usually done by audiology in depth
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11
Q

Cranial Nerve 9 Assessment

A

Cranial Nerve 9 Assessment:

  • Tested with cranial nerve 10
  • Cranial Nerve 9: Glossopharyngeal Nerve
  • Cranial Nerve 10: Vagus Nerve

Voice Hoarseness?

Gag Reflex

Phonation -> palate should rise rise symmetrically

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12
Q

Cranial Nerve Assessment 11

A

Cranial Nerve 11: Spinal Accessory

  • Ask patient to turn head against resistance
  • Ask patient to shrug both shoulders upward against your hand
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13
Q

Cranial Nerve 12 Assessment

A

Cranial Nerve 12: Hypoglossal

  • tongue movement
  • Ask them to move tongue side to side
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14
Q

Important Sensory Dermatomes:

A

Important Sensory Dermatomes:

  • T4 = Nipple Line
  • T10 = umbilicus
  • C8 = ring finger, pinky finger
  • C6 = thumb
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15
Q

Numbness in fingers is suspicious of

A

High spinal block

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16
Q

Elbow flexion is

A

C5, C6

17
Q

Elbow Extension nerve

A

C5, C6, C7

18
Q

Grip is nerves

A

C7, C8, T1

19
Q

Finger Abduction is controlled by

A

C8, T1, Ulnar nerve

20
Q

Opposition of the thumb is contolled by

A

C8, T1, median nerve

21
Q

Hip Flexion and Adduction is controlled by

A

L2, L3, L4

22
Q

Hip Abduction is controlled by

A

L4, L5, S1

23
Q

Hip Extension is controlled by

A

S1

24
Q

Knee Extension is controlled by

A

L2, L3, L4

25
Q

Knee Flexion is controlled by

A

L4, L5, S1, S2

26
Q

Dorsiflexion is controlled by

A

L4, L5

27
Q

Plantar Flexion is controlled by

A

S1

28
Q

Glasgow Coma Scale Range

A

3 - 15

Less than 8 = severe coma. Require inubation for controlled ventilation, ICP control, airway control

29
Q

any patient who has received corticosteroid therapy (suppression of pituitary-adnreal axis) for at least one month in the past 6-12 months

A

needs exogenous supplementation during surgery

30
Q

MAO-Is:

A

Iproniazid, phenelzine, isocarboxazid, moclebmide, befloxatone, brofaromine, selegiline, trancycopramine.

nardil, parnate, eldepryl, marplan

31
Q

Indications for Methotrexate:

A

Indications for Methotrexate:

Methotrexate:

  • Anti-Metabolite Drug, used as chemotherapy and immunosuppresant.
  • MS
  • Ankylosing Spondylitis
  • Rheumatoid Arthritis
32
Q

Methotrexate SE:

A

Methotrexate SE:

  • Immunosuppresion
  • Anemia
  • Thrombocytopenia
  • Pulmonary Toxicity (8%)
  • Renal toxicity -> usually permanent
  • Hepatotoxicity (can be reversible)
33
Q

Things to Order for pts on methotrexate :

A

Things to Order for pts on methotrexate :

  • CBC
  • Chemistry Panels
  • Consider PFTs- pulm toxicity
  • LFTs - if history warrants it
34
Q

Common drugs for MS patients

A
  1. Interferon B
  2. NSAIDs for SE
  3. Methotrexate
  4. Steroids
  5. *Mitoxantrone
35
Q

Mitoxantrone

A

severe myelosuppresion and cardiac toxicity, reduced EF, may need echo work up.

Similar to Adriomycin.

36
Q

Pergolide therapy in Parkinson’s

A

Peroglide Therapy:

  • Older drug, caused a lot of cardiac valve problems, now off market.
  • must ask if pt has been on it previously
  • Aortic or mitral regurg?
37
Q

Co-Existing symptoms to evaluate in Ankylosing Spondylitis

A

Co-Existing symptoms to evaluate in Ankylosing Spondylitis

  1. Vasculitis
  2. Aortitis
  3. Aortic Insufficiency
  4. Pulmonary Fibrosis
  5. Severity of kyphosis
38
Q
A
39
Q
A

assessment (5 decks)

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