OSCE 2- tests Flashcards by Rachael Beverage

Rust’s sign procedure

patient spontaneously grasps the head with both hands when lying down or when rising from a recumbent position

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Rust’s sign indicates…

severe sprain
RA
fracture
severe cervical subluxation

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Libmann’s test procedure

examiner applies thumb pressure to the mastoid process and gradually increases the pressure until the patient states that it is becoming noticably uncomfortable

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Libmann’s test reporting statement

unusually low, high or normal threshold for pain in the patient, useful for interpretation of palpation findings later in the exam

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Bakody sign procedure

patient in a seated position and will place the hand of the affected extremity on top of their head, raising the elbow to the level of the ear

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Findings of Bakody sign

nerve root irritation

not the location of the pain; it will help to identify the etiology of the pain

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Reverse Bakody sign findings

pain of the patient’s chief complaint is exacerbated

indicates TOS from interscalene compression

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negative Bakody sign findings

patient experiences no change in pain or there is no pain complaint in the neck and/or upper arm

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clinical indications of negative Bakody sign

differentiate a NR encroachment from a TOS

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Bikele’s sign procedure

abduct shoulder to 90 degrees and then elbow is put into full extension

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purpose of Bikele’s sign

patient is being placed in a position that will traction the brachial plexus and its nerve roots

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function of Bikele’s sign

stressing the brachial plexus

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findings of Bikele’s sign

pain is radicular in nature and goes into the arm

note location of pain, it will help identify the etiology of the pain

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brachial plexus tension test procedure

paitent is asked to abduct both shoulders to 90 degrees and place the hands behind head. doctor pulls elbows back

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findings of brachial plexus tension test

pain is radicular in nature and goes into the arm

note the location of the apin; it will help to identify the etiology of the pain

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Dejerine’s sign procedure

coughing, sneezing and straining during defecation may cause aggrevation of radiculitis symptoms

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Dejerine’s sign findings

indicates herniated or protruding IVD, spinal cord tumor (SOL) or spinal compression fracture

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Epigastric reflex segmental innervation

T5-7

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epigastric reflex peripheral nerve

intercostal

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epigastric reflex procedure

stimulate from sternum toward the umbilicus

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epigastric reflex response and indications

contraction of upper abdominal muscles

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upper abdominal reflex segmental innervation

T7-9

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upper abdominal reflex peripheral nerve

intercostal nerve

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upper abdominal procedure

stimulate the upper abdominal muscles by starting in the upper quadrant corners and go down toward the umbilicus

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upper abdominal response

contraction of upper abdominals | move umbilicus up and out

middle abdominal segmental innervation

T9-11

middle abdominal peripheral nerve

intercostal

middle abdominal procedure

start in outer middle quadrants and go toward the umbilicus

middle abdominal response

contraction of teh middle abdominals | move umbilicus laterally

lower abdominal segmental innervation

T11-12

lower abdominal peripheral nerve

intercostal iliohypogastric ilioinguinal

lower abdominal procedure

start in outer lower quadrant and go up toward umbilicus

lower abdominal response

contraction of lower abdominals | move umbilicus down and out

cremasteric segmental innervation

L1-2

cremasteric peripheral nerve

ilioinguinal | genitofemoral

cremasteric procedure

stroke inner thigh from above down direction

cremasteric sign

ipsilateral elevation of the testicle | may be absent in lederly or hydrocele and varicocele

gluteal segmental innervation

L4-S2

gluteal peripheral innervation

ingerior gluteal

gluteal procedure

stroke skin over gluteus maximus

gluteal response

contraction of gluteal muscle

plantar segmental innervation

L4-S2

plantal peripheral nerve innervation

tibial

plantar procedure

stroke plantar surface of the food from the heel to metatarsals to the big toe

plantar response

``` normal= plantal flexion of toes and feet abnormal= dorsiflexion of great toe and flaring of other toes ```

anal segmental innervation

S2-5

anal peripheral nerve innervation

inferior hemorrhoid

anal procedure

stroke skin of perianal area

anal response

contraction of external sphincter

hoffmann sign segmental level

lesion above C5 in corticospinal tract

hoffmann sign procedure

sharp forcible flick of doctor's thumb against the patient's middle finger

hoffmann sign response

flexion of fingers and adduction of the thumb UMNL

Tromner sign segmental level

lesion above C5 in corticospinal tract

rossolimo sign segmental level

corticospinal tract

rossolimo sign procedure

tap the ball fo teh foot or tap the tips of the toes

rossolimo sign response

plantar flexion of toes UMNL | ONLY ONE THAT PLANTAR FLEXES

babinski sign segmental level

corticospinal tract

babinski sign procedure

stroke plantar foot from heel to metatarrsal to big toe

babinski sign response

``` normal= plantar flexion abnormal= dorsiflexion of great toe and flaring of the other toes UMNL ```

tromner sign procedure

tap volar surface of the middle finger

tromner sign response

flexion of fingers and adduction of the humb UMNL

chaddock sign segmental level

corticospinal tract

chaddock sign procedure

stroke lateral malleolus from heel to toe

chaddock sign response

``` normal= no motion abnormal= dorsiflexion of great toe and flaring of the other toes UMNL ```

oppenheim sign segmental level

corticospinal tract

oppenheim sign procedure

stroke anterior tibial surface from superior to inferior

oppenheim response

normal- no motion | abnromal- dorsiflexion of great toe and flaring of the other toes

gordon sign segmentla level

corticospinal tract

gordon sign procedure

squeeze the calf | gastrocnemius

gordon sign response

normal- no motion | abnormal- dorsiflexion fo great toe and flaring of the other toes UMNL

schafer sign segmental level

corticospinal tract

schafer sign procedure

squeeze achilles

schafer sign response

normal-no motion | abnormal- dorsiflexion of great toe and flaring of the other toes UMNL

ciliospinal reflex segmental level

afferent: cervicals and CN V efferent: cervical sympathetics

ciliospinal reflex procedure

painful stimulation to the skin of the neck

ciliospinal reflex response and indications

dilation of the pupil on the painful side of stimulation. if absent, may be lesion of the cervical sympathetics

oculocardiac reflex segmental level

afferent: CN V efferent: CN X

oculocardiac relfex procedure

thumb pressure on eyeballs

oculocardiac reflex response

decrease in heart rate and fall in blood pressure

carotid sinus relfex segmental level

afferent: CN V efferent: CN X

carotid sinus reflex procedure

pressure on carotid sinus (unilateral or bilateral)

carotid sinus reflex response

decrease in heart rate and a fall in blood pressure

bulbocavernosus reflex segmental level

S3-4

bulbocavernosus relfex procedure

stroke, prick, pinch the dorsum of the glans of the penis

bulbocavernosus reflex response

contraction of the bulbocevernosus muscle and urethral constriction contraction of external anal sphincter