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PCM Sadness > OSCE for Abd, C spine, L spine > Flashcards

OSCE for Abd, C spine, L spine Flashcards

1
Q

what is the joint between vertebral articular processes?

A

zygapophyseal joint “facet”

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2
Q

what does an increased jugular venous pressure indicate?

A

right sided heart failure

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3
Q

what does a non midline trachea indicate?

A

tension pneumothorax

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4
Q

what can be observed doing thyroid palpation?

A

goiter, tenderness

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5
Q

what does a positive c spine compression/spurlings maneuver test indicate?

A

central neuropathy

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6
Q

what does a neck distraction test indicated?

A

central neuropathy

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7
Q

what does a positive valsalva test indicate?

A

+ is when sx are reproduced with valsalva

indicates space occypying lesion in cervical canal

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8
Q

what is a positive Roos/east test and what does it indicate?

A

+ reproduction of sx

thoracic outlet due to subclavian compresion

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9
Q

what does a positive adson test indicate?

A

+ loss or change in pulse
when looking away=thoracic outlet due to scalenes
when looking towards=thoracic outlet due to 1st rib

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10
Q

what does wrights hyperabduction test indicate?

A

+ loss or change in pulse

indicates thoracic outlet syndrome via pec minor

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11
Q

what does a costoclavicular/halstead test indicate?

A

+ loss or change in pulse

thoracic outlet due to 1st rib

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12
Q

what does a kerning sign (nuchal rigidity) indicate?

A

+neck stiffness

indicates meningitis

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13
Q

what does a brudzinski sign indicate?

A

+flexion in both hips and knees

indicates meningitis

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14
Q

what does a kernig sign indicate?

A

+ increased resistance to hip flexion and pain behind knee

indicates dural irritation

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15
Q

what is a jefferson fracture? cuase?

A

C1 compression fracture

head on hit like football

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16
Q

what is a wedge fracture?

A

flexion and compression injury of c spine

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17
Q

what is a dens fracture?

A

C2 odontoid process fracture needs surgury

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18
Q

what is a hangmans fracture?

A

hyperextension C2 bilateral arch fracture

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19
Q

spinous process fracture?

A

hyperextension or avulsion force from muscle contraction

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20
Q

what is clay shovelers fracture?

A

C6 or C7 fracture

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21
Q

whaat is a teardrop fracture?

A

flexion/compression injury –> anterior/inferior teardrop fragment

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22
Q

what is a burst fracture?

A

idk

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23
Q

what causes anterior subluxation?

A

facet dislocation without fracture

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24
Q

what is the order of an abdominal exam?

A

inspect, auscultate, percuss, palpate

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25
Q

what is cullens sign?

A

eccymosis around the umbilicus indicating hemmorhage

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26
Q

what is grey turners sign?

A

flank ecchymosis secondary to hemmorhage

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27
Q

what are normal bowel sounds? abnormal?

A

5-34 clicks,

high pitched, decreased, absent

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28
Q

what sound do you want to hear upon percussion of the abdomen? when will you hear dullness?

A

tympani

over the liver and spleen

29
Q

where do you percuss the liver?

A

6-12 cm down at the mid clavicular line on the right

30
Q

where do you percuss the spleen?

A

ribs 6-10, mid axillary line on left

31
Q

how do you want to palpate the abdomen?

A

light 1cm then moderate 2-3cm then deep 3 cm. all in all 4 quadrants

32
Q

what is rebound tenderness? what does it indicate?

A

pain upon removal of pressure rather than the application of pressure

peritonitis

33
Q

where is mcburneys point and what does tenderness here indicate?

A

1/3 distance between ASIS and umbilicis

+pain indicates appendicitis

34
Q

what does rosvigs sign indicate?

A

appendicitis

35
Q

what does a positive iliopsoas test indicate?

A

indicates irritation of the psoas muscle from the appendix

36
Q

what does a positive obturator test indicate?

A

irritation of the obturator muscle from the appendix

37
Q

what does a positive heel strike indicate?

A

appendicitis or peritonitis

38
Q

how do you palpate the liver?

A

palpate liver edge during patient inhalation

39
Q

what does a positive murpheys sign indicate?

A

cholecystitis or cholelithiasis

40
Q

what is courvoisiers sign and what does it indicate?

A

enlarged non tender gallbladder, indicates pancreatic disease/cancer

41
Q

what does a positive lloyds punch indicate?

A

infection around kidney, pyelonephritis, kidney stone

42
Q

how do you palpate the aorta?

A

just above umbilicus, slightly left of midline, should be less than 3cm

43
Q

where do lumbar roots exit the vertebra?

A

below whatever one theyre named for

44
Q

where does the spinal cord end?

A

L1-L3ish

45
Q

where does the cauda equina begin?

A

L2-L3

46
Q

what do you want to look for when observing a low back pain complaint?

A

slumped over, erect, assymetry, lordosis, gait changes

47
Q

what could a slumped over stance indicate?

A

depression, muscle spasm, reactive effort to relieve impinging lumbar nerves in intervertebral foramen

48
Q

what could an erect stance indicate?

A

protecting herniated discs or effects of spinal stenosis

49
Q

what could asymmetry indicate?

A

short leg, sacral base problem, scoliosis

50
Q

what could gait changes indicate?

A

listing-disc herniation, muscle weakness
foot drop-fibular nerve injury
shuffling-parkinsons

51
Q

what do you want to palpate when examining the low back? and what are you looking for at each landmark

A

spinous processes (step offs, fracture, dislocation, arthritis)

SI joint- sacroiliitis, ankylosing spondylitis

paravertebral muscles-MSK a normalities, strain, overuse, SD

palpate area over symptoms-herniated disc may produce tenderness pretty much anywhere near it

palpate for sciatic nerve tenderness-could indicate herniated disc or mass lesion

palpate the skin

52
Q

what does the straight leg test tell you? (lasegue test)

A

+ test is worsening radicular pain at 30-60 degrees
indicates lumbosacral radiculopathy (usually from herniated disc)

+ at >70 is more likely mechanical issue
>15 could be IT band

53
Q

what are other signs or symptoms of radiculopathy?

A

muscle weakness and dermatomal sensory loss

54
Q

where do most disc herniations occur?

A

L5-S1

55
Q

what does the cross straight leg test tell you?

A

+ pain in the contralateral leg

indicates lumbosacral radiculopathy

56
Q

what does a positive hoovers sign indicate?

A

+ no downward force of unaffected leg when they “attempt” to life the affected leg

indicates malingering

57
Q

what does a postive thomas test indicate?

A

iliopsoas contracture, causes a lot of LBP

58
Q

what does the gaenlen test indicate?

A

+ pelvic pain

SI joint dysfunction

59
Q

what can a valsalva test indicate?

A

+ reproduction of sciatic symptoms

indicates sciatica

60
Q

what can a stork test indicate?

A

+ low back pain

indicates pars defect/stress fracture

61
Q

what are symptoms of cauda equina syndrome? is this emergent?

A

yes its emergent

low back pain, bowel/bladder dysfunction, sensory loss of perineum, bilateral sciatica

62
Q

what is spina bifida?

A

split in vertebrae with no spinal protrusion

63
Q

what is a meningocele?

A

meninges forced out between vertebrae

64
Q

what is a myelomeningocele?

A

spinal cord protrudes through opening

65
Q

what is fergusons angle? what is normal?

A

the angle between the planes of the most fucked up vertebrae in scoliosis i guess
30-40 degrees

66
Q

what is spondylosis?

A

degenerative change in vertebrae, osteoarthritis pretty much

67
Q

what is spondylolysis?

A

scotty dog pars interarticularis fracture of vertebrae

68
Q

what is spondylolisthesis?

A

anterior displacement of vertebrae

PCM Sadness (2 decks)

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