OSCE 2- tests Flashcards
Rust’s sign procedure
patient spontaneously grasps the head with both hands when lying down or when rising from a recumbent position
Rust’s sign indicates…
severe sprain
RA
fracture
severe cervical subluxation
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
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
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
Findings of Bakody sign
nerve root irritation
not the location of the pain; it will help to identify the etiology of the pain
Reverse Bakody sign findings
pain of the patient’s chief complaint is exacerbated
indicates TOS from interscalene compression
negative Bakody sign findings
patient experiences no change in pain or there is no pain complaint in the neck and/or upper arm
clinical indications of negative Bakody sign
differentiate a NR encroachment from a TOS
Bikele’s sign procedure
abduct shoulder to 90 degrees and then elbow is put into full extension
purpose of Bikele’s sign
patient is being placed in a position that will traction the brachial plexus and its nerve roots
function of Bikele’s sign
stressing the brachial plexus
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
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
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
Dejerine’s sign procedure
coughing, sneezing and straining during defecation may cause aggrevation of radiculitis symptoms
Dejerine’s sign findings
indicates herniated or protruding IVD, spinal cord tumor (SOL) or spinal compression fracture
Epigastric reflex segmental innervation
T5-7
epigastric reflex peripheral nerve
intercostal
epigastric reflex procedure
stimulate from sternum toward the umbilicus
epigastric reflex response and indications
contraction of upper abdominal muscles
upper abdominal reflex segmental innervation
T7-9
upper abdominal reflex peripheral nerve
intercostal nerve
upper abdominal procedure
stimulate the upper abdominal muscles by starting in the upper quadrant corners and go down toward the umbilicus
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