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4th Year Finals > OSCES > Flashcards

OSCES Flashcards

1
Q

Blood flows through the heart in what system?

A

Right Atrium > Tricuspid Valve > Right Ventricle > Pulmonary Valve > Pulmonary Artery > Pulmonary Vein > Left Atrium > Mitral Valve > Left Ventricle > Aortic Valve > Aorta

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2
Q

Veins do what?

A

Return blood to heart

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3
Q

What is systole?

A

Mitral and Tricuspid Closure

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4
Q

What is diastole?

A

Aortic and Pulmonary closure

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5
Q

Where to listen to aortic valve?

A

upper right sternal border at the level of the 2nd right intercostal space

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6
Q

where to listen to pulmonary valve?

A

upper left sternal border at the level of the 2nd left intercostal space

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7
Q

where to listen to tricuspid valve?

A

lower left sternal border at the level of the 4th left intercostal space

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8
Q

where to listen to mitral valve?

A

over the apex beat point (which is normally (if palpable) felt just within the mid-clavicular line at the level of the 5th intercostal space)

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9
Q

Features of JVP? (5)

A

Non Palpable
Multiphasic
Occludable
Varies with Head Tilt
Varies with Respiration

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10
Q

What does JVP reflect?

A

Atrial Pressure

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11
Q

When could S3 be heard?

A

Diastole

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12
Q

S4 is usually associated with?

A

Left Ventricular Hypertrophy

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13
Q

When looking at hands in cvs examination what to look for? (7)

A

Tar Stain
Warmth
Peripheral Cyanosis
Clubbing
Splinter Haemorrhages
Cap Refill
Fine Tremor

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14
Q

What to look for when assessing radial pulse? (4)

A

Rate
Rhythm
Volume
Character

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15
Q

What to look for when assessing face in cardiovascular examination? (7)

A

Malar Flush
Xanathelasmata
Corneal Arcus
Anaemia
Central Cyanosis
Angular Stomatitis
Sore Red Tongue

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16
Q

What does Malar Flush indicate?

A

Mitral Stenosis

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17
Q

What to look for when assessing back of chest for cvs exam?

A

Sacral Oedema
Crackles (Left Sided Heart Failure)

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18
Q

What to look for when assessing abdomen in cvs exam? (2)

A

Tender Liver
Ascites

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19
Q

What to look for when assessing legs in cvs exam?

A

Pitting oedema
Arterial Disease: Cold, Smooth, Hairless, Increased Cap Refill, Arterial Leg Ulcers, Gangrene
Varicose Veins
Venous Insufficiency eg Lipodermatosclerosis, Ulceration

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20
Q

What to look for when looking for arterial disease in cvs exam? (6)

A

Cold
Smooth
Hairless
Increased Cap Refill
Arterial Leg Ulcers
Gangrene

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21
Q

Where can JVP be found in cvs exam?

A

Internal Jugular Vein in Supraclavicular Area

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22
Q

What to assess in inspection of chest in cvs exam? (4)

A

Chest deformities
Scars
Cardiac Pacemaker
Visible pulsation

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23
Q

What to assess in palpation of cvs exam? (5)

A

Tracheal Position
Cardiac Pacemaker
Apex Beat
Heaves
Thrills

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24
Q

Where can apex beat be found?

A

5th Intercostal Space

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25
Q

What are heaves?

A

Right Ventricular Hypertrophy

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26
Q

What are thrills?

A

Palpable murmurs usually systolic

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27
Q

Where to palpate for thrills?

A

Both sides of sternum and apex

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28
Q

Where to assess for aortic stenosis?

A

Listen over aortic valve area again and then over both the carotid arteries with the stethoscope diaphragm for the murmur and the radiation of this high-pitched ejection systolic murmur.

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29
Q

What type of murmur is aortic stenosis?

A

high pitched ejection systolic

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30
Q

Where to listen for mitral regurgitation?

A

Listen again over the apex and then in L axilla with the stethoscope diaphragm for radiation of this high-pitched pansystolic murmur.

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31
Q

What type of murmur is mitral regurgitation?

A

Pansystolic Murmur

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32
Q

Where to listen for mitral stenosis?

A

Ask the patient to roll onto their left side and at listen at the apex with the stethoscope bell with the breath held in expiration, for this low-pitched ‘rumbling‘ mid-diastolic murmur.

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33
Q

What type of murmur is mitral stenosis?

A

low pitched rumbling mid diastolic

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34
Q

Where to listen for aortic regurgitation?

A

Ask the patient to sit up, leaning forwards, and ask them to hold their breath in expiration (“please take a deep breath in, breathe out, now hold your breath”). Listen at the lower left sternal edge with the diaphragm of the stethoscope for the high-pitched early diastolic murmur.

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35
Q

What type of murmur is aortic regurgitation?

A

High pitched early diastolic murmur

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36
Q

What peripheral pulses to palpate in cvs exam? (8)

A

Radial
Brachial
Carotid
Femoral
Radio Femoral Delay
Popliteal
Posterior Tibial
Dorsalis Pedis

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37
Q

Where to palpate for brachial pulse?

A

In the antecubital fossa, medial to biceps tendon

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38
Q

Where to palpate for carotid pulse?

A

Neck medial to Sternocleidomastoid muscle

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39
Q

Where to palpate femoral pulse?

A

Just inferior to inguinal ligament half way between ant sup iliac spine and symphysis pubis.

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40
Q

Where to palpate popliteal pulse?

A

Behind knee joint, deep in popliteal fossa. With knee flexed to 30 ensure patient relaxed and hold knee with both hands with thumbs in front

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41
Q

Where to palpate posterior tibial pulse?

A

Behind and 2cm below medial malleolus

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42
Q

Where to palpate dorsalis pedis pulse?

A

On dorsum of foot, lateral to tendon of extensor hallucis longus

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43
Q

How to estimate systolic blood pressure?

A

Palpate Brachial Pulse
Inflate until pulse not palpable and note pressure on dial = estimated systolic pressure
Deflate cuff rapidly to zero

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44
Q

How to ausculate systolic blood pressure and diastolic blood pressure accurately?

A

Stethescope to brachial artery
Refinlate up to 30mmHg more than estimated systolic pressure
Slowly open valve and release pressure from cuff
Note onset of repeated beats/tapping = systolic pressure
Continue to let air slowly out of cuff, once beats disappear = diastolic pressure

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45
Q

ECG - Where to Put V1

A

4th intercostal space to the right of the sternum

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46
Q

ECG where to put V2

A

4th intercostal space to the left of the sternum

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47
Q

ECG where to put V3

A

midway between Leads 2 and 4

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48
Q

ECG where to put V4

A

5th left intercostal space midclavicular line

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49
Q

ECG where to put V5

A

same horizontal level as Lead 4 anterior axillary line

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50
Q

ECG where to put V6

A

same horizontal level as Lead 4 mid axillary line

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51
Q

What is PR Interval on EVG

A

the time taken from atrial depolarisation to ventricular depolarisation and should be between 0.12 - 0.2 secs.

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52
Q

What is QRS complex on ECG

A

represents ventricular depolarization and should be < 0.12 secs

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53
Q

What is QT Interval on ECG

A

time spent in ventricular depolarization and repolarization – beginning of Q to end of T – max 0.42 secs*

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54
Q

How to interpret ecg?

A

Is there any electrical activity?
What is the QRS rate?
Is the QRS rhythm regular or irregular?
Are the QRS complexes broad or narrow?
Is atrial activity present?
Is there a relationship between atrial activity and ventricular activity?

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55
Q

How to calculate qrs rate on ecg

A

If the QRS complexes are at regular intervals, the rate can be calculated by counting the number of large squares between the peaks of the QRS complexes and dividing that number into 300.

If the QRS complexes are not at regular intervals, the method above cannot be used. In this case, you need to count the number of QRS complexes that occur over a fixed time (usually 6 secs) and multiply (by 10) to get a rate/minute, in the same way as you would count a pulse over 15 secs and multiply by 4.

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56
Q

How to calculate rhythm on ecg

A

Sometimes it is very obvious that an ECG shows an irregular rhythm, but to be sure, line up a strip of paper along the rhythm strip and mark 3-4 complexes. Now move the paper strip along the rhythm strip by 1 or 2 complexes and see if the following QRS complexes line up with your marks.

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57
Q

How to calculate broad or narrow qrs on ecg

A

Normally the QRS complex should be <0.12 secs (less than3 small squares). Count from the start of the Q wave to the end of the S wave.
Widened QRS complexes usually indicate that the depolarisation has begun in the ventricle itself rather that the SA node

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58
Q

How to calculate relationship between atria and ventricles on ecg

A

Look for P waves. If they are present, ask – is every P wave followed by a QRS and does every QRS have a P wave before it. What is the PR interval? (Normal = 0.12 - 0.2 seconds, 3-5 small squares). This will enable you to diagnose heart block

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59
Q

What is odynophagia?

A

painful swallow

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60
Q

what is haematochezia?

A

passage of fresh blood from anus

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61
Q

What is foetor hepaticus?

A

breath smells musky - liver problems

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62
Q

Name the nine regions of the abdomen?

A

Right Hypochondrium
Epigastrium
Left Hypochondrium
Right Flank
Umbilical Region
Left Flank
Right Iliac Fossa
Hypogastrium/Suprapubic
Left Iliac Fossa

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63
Q

Examining an abdominal mass - what do you need to describe? (10)

A

Site
Size
Shape
Surface
Edge/Outline
Tender to Palpation
Consistency
Mobility
Pulsatile
Fluctuant

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64
Q

In GI Exam, what to look at on hands? (9)

A

Tar Stain
Nail Colour: Anaemia and Leukonychia
Clubbing
Koilonychia
Palmar Erythaema
Pale Palmar Creases
Dupuytrens Contracture
Flap Tremor
Fine Tremor

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65
Q

What does Leukonychia indicate?

A

Hypoalbumininema

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66
Q

What does Koilonychia indicate?

A

Iron deficiency anaemia

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67
Q

What does flapping tremor indicate?

A

Liver Failure

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68
Q

What does fine tremor indicate?

A

Alcohol/Alcohol Withdrawal

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69
Q

What to look for in arms on GI exam? (5)

A

Bruising
Scratch Marks/Pruritus
Muscle Wasting
Track Marks
Skin Turgor

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70
Q

What can scratch marks/pruritus indicate?

A

Chronic Cholestasis

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71
Q

What to look for in face on GI exam? (5)

A

Parotid Swelling
Jaundice
Anaemia
Angular Stomatitis and Sore Red Tongue
Foetor Hepaticus

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72
Q

What does Angular stomatitis and sore red tongue indicate?

A

Fe Deficiency Anaemia

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73
Q

What would Foetor Hepaticus represent?

A

Liver Failure

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74
Q

What to look for in mouth in GI exam? (4)

A

Gum Swelling/Bleed
Dentition
Salivary Glands
Apthous Ulcers

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75
Q

Tonsilar lymph node drains where?

A

Oropharynx

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76
Q

Submandibular lymph node drains where?

A

2/3 of tongue and floor of mouth

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77
Q

Submental lymph node drains where?

A

Tip of tongue and anterior floor of mouth

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78
Q

Preauricular lymph node drains where?

A

Face including parotid

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79
Q

What to look for on chest in GI exam? (3)

A

Spider Naevi
Gynaecomastia
Loss of Body hair in Males

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80
Q

What to look for in Legs on GI Exam? (3)

A

Peripheral Oedema
Loss of Body Hair
Erythema Nodosum

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81
Q

What does Peripheral oedema in legs indicate on GI exam?

A

Hypoalbuminaemia/Liver failure

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82
Q

What to look for on inspection in GI exam? (9)

A

Scars
Visible Pulsation
Skin Lesions
Scratch Marks
Abdo Shape
Stoma
Caput Medusae
Petechiae
Striae
Distention

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83
Q

What does distended veins/caput medusae mean?

A

Portal Hypertension

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84
Q

What to feel for on palpation of abdomen in GI exam? (5)

A

Tenderness
Guarding
Rebound Tenderness
Rigidity
Masses

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85
Q

Where can the liver be palpated? upper and lower border

A

Upper: 5th Right Intercostal Space on Full Expiration
Lower: Costal Margin on Full Inspiration

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86
Q

Where can spleen be palpated?

A

9th-11th Ribs on Left Side

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87
Q

Where can kidneys be palpated?

A

Renal Angle formed by 12th rib and vertebral column from T12-L3

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88
Q

What does shifting dullness mean?

A

Ascitic Fluid >1.5 Litres

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89
Q

What to ausculate for in GI exam? (6)

A

Bowel Sounds
Abdominal Aorta
Renal Arteries
Liver
Spleen
Rubs

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90
Q

Who is screened in Bowel Cancer Screening?

A

Men and Women Age 50-74 every 2 years

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91
Q

Head and Neck Examination
- What to look for on inspection of face? (8)

A

Expression
Symmetry
Features of Cushings eg Acromegaly, Bony Changes
Swellings
Hair
Shape of Face
Scars
Skin

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92
Q

Head and Neck Examination
- What to look for on inspection of Eyes? (6)

A

Lid Lag
Proptosis
Eye Movements
Jaundice
Anaemia
Thyroid Eye Disease

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93
Q

Head and Neck Examination
- What to look for on inspection of nose? (4)

A

Front,Side and Above Nose
Discharge
Block Nostrils
Nasal Vestibule

94
Q

Head and Neck Examination
- What to look for on inspection of mouth? (6)

A

Lips
Open Mouth
Oropharynx/uvula/tonsils
Tongue
Underside of Tongue
Dentition

95
Q

Head and Neck Examination
- Where to palpate for skull and face? (6)

A

Mastoid Processes
Orbital Margins
Temporal Arteries
Maxilla
mandible
TM Joint

96
Q

Head and Neck Examination
- where to palpate nose? (2)

A

Nasal Cartilage and Bones
Paranasal Sinuses (Maxillary, Ethmoidal, Frontal)

97
Q

Upper Limb Neuro Examination
- Observation? (6)

A

Muscle Atrophy
Fasiculations
Skeletal Deformity
Scars
Tremor
Involuntary Movements

98
Q

Upper Limb Neuro Examination
- What involuntary movements to look for on observation? (4)

A

Dystonia
Chorea and Athetosis
Ballismus
Ticks

99
Q

What is Dystonia?

A

Sustained muscle contractions which are twisting and repetitive

100
Q

What is Chorea and Athetosis?

A

Writhing movements

101
Q

What is ballismus?

A

Violent Flinging movements

102
Q

Upper Limb Neuro Examination
What is spascitiy in tone? (2)

A

Hypertonia
Feature of UMNL

103
Q

Upper Limb Neuro Examination
- What to test in power (7)

A

Shoulder Abduction
Elbow Flex and Extend
Wrist Flex and Extend
Finger Flex and Extend
Intrinsic Muscles of Hand
Grip
Pronator Drift

104
Q

What does MRC Scale 5 mean?

A

Full Power

105
Q

How to assess Upper Limb Neuro Shoulder Abduction Power?

A

For the shoulders: put elbows up in the air (i.e. abduct to 90°) and “do not let me push them down” as you oppose them pushing down at the elbow.

106
Q

How to assess Upper Limb Neuro Elbow Flex and Extend?

A

For the elbows: flex elbows in front of chest “pull me towards you” as you resist (elbow flexion) and then “push me away,”(elbow extension) Be careful if they are stronger than you then it may be better to ask them to keep their arm still and not let you straighten or bend it.

107
Q

How to assess upper limb neuro wrist flexion/extension power?

A
  • For the wrists: make a fist and cock it back (extend) - while you resist this. Then ask the patient to bend the fist down against your resistance (flex).
108
Q

How to assess upper limb neuro intrinsic muscles of hand power?

A

For the hands:hold fingers out straight “keep them there” as you try to flex them at the metacarpophalangeal joint (i.e. test finger extensor muscles - radialnerve).Then as they try to flex them at MCP joint against resistance (i.e. finger flexion C8)

109
Q

How to assess upper limb neuro intrinsic finger muscles power?

A

Intrinsic hand muscles: spread fingers wide apart “don’t let me close them” as you try to push the fingers together (i.e. test finger abductor muscles, innervated by ulnar nerve), then to turn hand over (supinated) and push thumb up in the air against your finger (i.e. test thumb abduction - abductor pollicis brevis. Median nerve)

110
Q

How to assess upper limb neuro grip power?

A

Grip – “Squeeze my fingers” (Median & ulnar nerves)

111
Q

How to assess upper limb neuro pronator drift?

A

ask patient to hold arms out straight in front of them, palms up to the ceiling, and close their eyes. Watch for any drifting of the arms downwards or into pronation. This is a sign of weakness. NB This is a sign of a cerebral hemisphere problem, rather than a limb problem.

112
Q

What does finger flexion power assess eg what dermatome?

113
Q

Finger abductor muscles are innervated by?

A

Ulnarn erve

114
Q

Finger abduction muscles are innervated by?

A

Median Nerve

115
Q

Testing hand power grip in neuro upper limb examination tests what nerves?

A

Median and Ulnar Nerves

116
Q

Pronator Drift being positive is a sign of what?

A

Cerebral Hemisphere issue

117
Q

What to test in upper limb neuro coordination? (2)

A

Finger-Nose
Dysdiachokinesis

118
Q

What reflexes to test in upper limb neuro examination? (3)

A

Biceps
Supinator
Triceps

119
Q

What dermatomes are being tested in biceps reflex?

120
Q

What dermatomes are being tested in supinator reflex?

121
Q

What dermatomes are being tested in Triceps reflex?

122
Q

Where to hit for Triceps reflex?

A

Tendon directly about 2cm above olecranon

123
Q

What dermatomes are being tested in upper limb neuro light touch? (5)

A

C5,C6,C7,C8 and T1

124
Q

What to test in upper limb neuro sensation? (4)

A

Light Touch
Pinprick
Vibration
Joint Position (Proprioception)

125
Q

Fibres for fine touch, proprioception and vibration are carried in what column/tract?

A

Dorsal Column

126
Q

Fibres for pain and temperature are carried in what column/tract?

A

Spinothalamic Tract

127
Q

Dorsal column carries what fibres?

A

Fine touch, proprioception and vibration

128
Q

Spinothalamic Tract carries what fibres?

A

Pain and Temperature

129
Q

What to assess in Neuro Lower Limb Examination observation? (5)

A

Muscle Atrophy
Fasiculations
Skeletal Deformity
Scars
Tremor
Involuntary Movement

130
Q

What to assess in Neuro Lower Limb Examination tone? (4)

A

Hip Rotation
Hip Flexion
Knee Flexion
Ankle Colnus

131
Q

What to assess in Neuro Lower Limb Examination Power? (7)

A

Hip Flexion
Hip Extension
Knee Flexion
Knee Extension
Ankle Dorsiflexion
Ankle Plantarflexion
Big Toe Extension

132
Q

Big toe extension in neuro lower limb examination looks at what muscle?

A

Extensor Hallucis LOngus

133
Q

Neuro Lower Limb Examination
How to test Hip Flexion and Extension?

A

Hip: straight leg raise pushing thigh up against your hand “keep it there do not let me push it down”(flexion) and then pushing down against your hand(extension)

134
Q

Neuro Lower Limb Examination
How to test knee flexion and extension?

A

Knee: bend one knee “pull heel towards your bottom” (flexion) and then to straighten the knee (extension) “push me away”.

135
Q

Neuro Lower Limb Examination
How to test ankle dorsiflexion and plantarflexion?

A

Ankle: pull foot back towards them keeping their knee straight (dorsiflexion) against your hand and then push their foot down against your hand (plantarflexion

136
Q

Neuro Lower Limb Examination
How to test extensor hallux longus?

A

pull big toe towards them (keeping leg straight)

137
Q

Neuro Lower Limb Examination
How to test coordination? (2)

A

Heel-Shin Test
Gait

138
Q

Neuro Lower Limb Examination which reflexes to check? (3)

A

Knee
Ankle
Plantar Response

139
Q

How to test knee reflex?

A

Knee reflex: place your left forearm under one knee and gently lift the leg off the bed - you should do the lifting and the patient’s heel should stay resting on the bed. Strike the patellar tendon, just below the lowest point of the patella.

140
Q

How to test ankle reflex?

A
  1. For the right ankle reflex, ask the patient to flex their right knee and externally rotate the right hip, they can cross their ankles if this helps. Hold the right foot with your left hand in such a way that you stretch the Achilles tendon and you have a clear view of the calf muscles. Strike the Achilles tendon and look for calf muscle contraction. Then perform the same manoeuvre on the left. You may need to put your left arm in a slightly awkward position in order to hold the foot while not obstructing your view of the left calf.
141
Q

What does knee reflex test?

142
Q

What does ankle reflex test?

143
Q

What dermatomes does Lower Limb Neuro sensation test? (5)

A

L2,L3,L4,L5,S1

144
Q

What to to test in Lower Limb Neuro Sensation? (5)

A

Light Touch
Pinprick
Vibration
Joint Position
Romberg Test

145
Q

What is Romberg Test

A

Stand with feet close together
Close eyes

146
Q

Positive Romberg Test indicates what?

A

Proprioception issues

147
Q

How to assess gait in lower limb neuro examination? (4)

A

Walk and Turn
Heel to toe
Rise from Sit
Walk on Tiptoes and on heels

148
Q

How to test proximal lower limb power in lower limb neuro examination?

A

Rise from chair without using arms

149
Q

How to test distal lower limb power in lower limb neuro examination?

A

Walk on heels and stand on tip toes

150
Q

For neuro examination reflexes what does +++ mean?

A

Increased/Exaggerated/Brisk

151
Q

For neuro examination reflexes what does ++ mean?

152
Q

For neuro examination reflexes what does + mean?

153
Q

For neuro examination reflexes what does + with a _ underneath mean?

A

Only present with reinforcement

154
Q

for neuro examination reflexes what does
- mean

155
Q

If large toe extends in plantar response what does that mean?

A

Abnormal Plantar Response

156
Q

If large toe extends and other toes abduct in plantar response what does that mean?

A

Positive babinski sign

157
Q

A positive babinski sign is a sign of what?

A

Likely UMNL

158
Q

What does MRC 0 mean

A

No muscle contraction visible

159
Q

What does MRC 1 mean

A

Flicker of contraction with no movement

160
Q

What does MRC 2 mean?

A

Joint movement when effect of gravity eliminated

161
Q

What does MRC 3 mean?

A

Movement against gravity but not against examiner resistance

162
Q

What does MRC 4 mean?

A

Movement against resistance but weaker than normal

163
Q

What does MRC 5 mean?

A

Normal Power

164
Q

How to test olfactory nerve (I)

A

Change in smell

165
Q

How to test optic nerve II? (6)

A

Visual Acuity with Snellen Chart
Pupil response to light
Visual fields
Visual inattention
Accomodation
Fundoscopy

166
Q

If a pupil response to light is afferent which nerve is affected?

A

CN II Optic

167
Q

If a pupil response to light is efferent which nerve is affected?

A

CN III Occulomotor

168
Q

How to test pupil responses in optic nerve

A

First in side the light is shining (Ipsilateral) - direct response constriction

Second in opposite side from where light is shining (contralateral) indirect response constriction

169
Q

Bitemporal Hemianopia is a sign of

A

Cranial nerve problem

170
Q

Homonymous Hemianopia is a sign of

A

Hemisphere problem

171
Q

Right sided inattention in visual inattention would only notice what side movement?

A

Left Sided

172
Q

Visual inattention is a sign of

A

Hemisphere problem

173
Q

What should happen to pupils in accomodation when testing Optic Nerve

A

Constrict as eyes converge

174
Q

What does Oculomotor Nerve (III) innervate (7)

A

Superior, Medial and Inferior Rectus Muscles
Inferior Oblique
Levator Palpaebrae Superioris
Parasympathetic innervation of constrictor pupillae and ciliary muscle (accomodation)

175
Q

How to test occulomotor nerve (III) (3)

A

Pupil Abnormality
Ptosis
H- Nystagmus

176
Q

What does the Trochlear Nerve (IV) innervate?

A

Superior Oblique muscle of eye

177
Q

What does Trigeminal Nerve (V) innervate

A

Sensation to face and motor function to muscles of mastification

178
Q

How to test trigeminal nerve (v) (4)

A

Sensation
Palpate Massester Muscle and Clench Teeth
Open Jaw against Resistance for Pterygoid Muscles
Corneal Reflex

179
Q

How to test for Trigeminal V1?

A

Touch opthalamic (forehead) area for sensation

180
Q

How to test for Trigeminal V2?

A

Touch maxillary area

181
Q

How to test for Trigeminal V3

A

Touch Mandibular (lower jaw area)

182
Q

The abducens nerve (VI) innervates what muscle

A

Lateral rectus

183
Q

The facial nerve (VII) innervates what muscle? (3)

A

Muscles of facial expression
Taste to Anterior 2/3 of Tongue
Secretormotor to submandibular and sublingual glands

184
Q

Facial nerve (VII) how to test? (3)

A

Inspection
Facial Movement: Wrinkle Forehead, Screw eyes, smile, puff out cheeks
Taste Sensation

185
Q

How to test vestibulochlear nerve (VIII) (3)

A

Check for Nystagmus
Check for Balance
Hearing tests

186
Q

Glossopharyngeal Nerve (IX) does what (3)

A

carries sensation from pharynx and tonsils and sensation and taste from posterior 1/3 of tongue and innervates stylopharyngeus

187
Q

Vagus nerve (X) does what? (2)

A

Carries sensation and innervates paletine pharyngeal and laryngeal muscles

188
Q

How to test Glossopharyngeal and Vagus Nerves? (3)

A

Open mouth say ahh
Cough
Gag reflex

189
Q

Accessory Muscle innervates (2)

A

Upper trapezius and sternocleidomastoid

190
Q

Hypoglossal Nerve (XII) innervates

A

Muscles of tongue

191
Q

How to test Hypoglossal nerve? (3)

A

Inspect mouth
Check tongue
speech

192
Q

How to do whispered voice test?

A

Stand 60cm from ear and rub tragus of opposite ear

193
Q

Rinne’s Test does what?

A

Compares air conduction to bone conduction

194
Q

Rinnes test is positive if?

A

Air Conduction > Bone Conduction

195
Q

What does Bone Conduction > Air Conduction mean in Rinne’s?

A

Conductive Deafness

196
Q

In Weber’s Test if there is a conductive deafness what will happen?

A

Sound will be heard loudest in that ear

197
Q

In Weber’s test if there is a sensorineural deafness what will happen?

A

Sound will be referred to good (unaffected) ear

198
Q

Absence of red reflex on fundoscopy indicates?

199
Q

Fundoscopy: what to look for on fundus (4)

A

Optic Disc: shape, colour, definition, vessels
Vessels: arteries, veins
Retina: colour, haemorrhages, exudates, detachment, tears
Macula

200
Q

GCS - Eye Opening? (4)

A

Spontaneous 4
Speech 3
Pain 2
No response 1

201
Q

GCS Verbal Response? (5)

A

Orientated 5
Confused talks in sentences but disorientated 4
Verbalises words 3
Vocalises sounds not words 2
No vocalisation 1

202
Q

GCS Motor Response (6)

A

Obeys Commands 6
Localises to Pain 5
Normal Flexion to Pain 4
Abnormal Flex to Pain 3
Extension to Pain 2
No Response 1

203
Q

What are the 10 parts of Abbreviated Mental Test?

A
  1. Age
  2. Time
  3. Address
  4. Year
    5 Name of this place
  5. Identity two people
  6. DOB
  7. Date of first world war
  8. Name of present monarch
    10 Count backwards 20-1
204
Q

What is a myotome?

A

Group of muscles that single spinal nerve root innervates

205
Q

What is dermatome?

A

Area of skin supplied by single spinal nerve

206
Q

Clinical features of UMN lesion (4)

A

Increased Tone
Hypereflexia
Upgoing Plantars
Weakness

207
Q

Clinical features of LMN lesions (4)

A

Muscle Fasiculation
Reduced Tone
Hyporeflexia
Weakness/Muscle Atrophy

208
Q

What is polyuria?

A

Frequency of urine

209
Q

What is oliguria?

A

Reduced urine output

210
Q

what is anuria?

A

no urine output

211
Q

Urinary Examination
- What to look for on hands and nails? (4)

A

Nail Pigmentation
Beau Lines
Splinter Haemorrhages
Flap Tremor

212
Q

Causes of Haematuria? (7)

A

Glomeruelonephritis
UTI
Renal Stones
Tumour of Kidney, Ureter, Bladder, Prostate
Acute Tubular Necoris
Severe Exercise

213
Q

Prostate Examination
- Inspection (6)

A

Pubic Hair
Scrotal Skin
Scrotal Contours for Swelling/Scars/Veins
Urethral Meatus and Foreskin
Glans Penis

214
Q

How does prostate gland feel in BPH Prostate exam?

A

Enlarged, Smooth and Soft

215
Q

Right Lung has how many lobes?

216
Q

Normal respiratory rate

217
Q

Stony Dullness on respiratory examination means what?

A

Fluid present

218
Q

Respiratory examination

Increased vocal resonance means what

A

Consolidation or cavity formation

219
Q

Respiratory Examination

What to look for on hands and nails (7)

A

Tar Staining
Warmth
Peripheral Cyanosis
Clubbing
Cap Refill
Fine Tremor
Flap Tremor

220
Q

How to assess for clubbing? (4)

A

Loss of Nail Angle
Increased Nailbed Fluctuation
Increase in Longitudinal nail curvature
Increase bulk of soft tissues over terminal phalnges

221
Q

FIne tremor may indicate?

A

Overuse of Beta Agonists

222
Q

Name all the lymph nodes? (8)

A

Supraclavicular
Anterior Cervical
Tonsilar
Submanidbular
Submental
Pre and Post Auricular
Posterior Cervical

223
Q

Name the 5 areas that need to be percussed in respiratory exam?

A

Apices
Upper
Middle
Lower
Axilla

224
Q

Signs expect to see on examination in COPD?(5)

A

Wheeze
Raised JVP
Pursed Lip Breathing
Hyperinflated Chest
Use of Accessory Muscles

225
Q

Signs expect to see on examination in Acute Lobar Pneumonia? (5)

A

Tachypnoea
Tachycardia
Reduced Expansion
Dull Percussion
Bronchial Breathing

226
Q

Signs expect to see on examination in Pneumothorax (4)

A

Reduced Expansion
Hyper Resonance
Raised Resp Rate
Tachycardia

227
Q

Signs expect to see on examination in collapse of lung?

228
Q

Signs expect to see on examination in pleural effusion? (3)

A

Decreased Expansion
Stony Dull Percussion
Diminished Vocal Resonance

229
Q

Signs expect to see on examination in acute severe asthma (3)

A

Tachycardia
Tachypnoea
Inability to complete sentences in one b

230
Q

How many pairs of spinal nerves

231
Q

What does the Superior oblique muscle do? (innervated by trochlear nerve)

A

moves eye down and out

232
Q

What does the lateral rectus muscle do (innervated by abducens nerve)

A

Abducts eye

4th Year Finals (37 decks)

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