Other Flashcards
Peripheral Vacular Exam
TCP TCP BBB
Think scars, Colour, Pressure points (general, hands, eyes, mouth)
Temperature/sensation, Capillary refill, Pulses (aorta, femoral, popliteal, posterior tibial, dorsalis pedis)
Bruits, Burger’s, ankle-Brachial pressure index)
Lower Limb Venous Insufficiency Exam
Inspection
Tests; cough, tap, Trendelenburg’s, Perthe’s, doppler auscultation of SFJ & SPJ
Other - examine abdo
Thyroid Exam
Inspection (incl. water swallow, protrude tongue (thyroglossal cyst?), back of tongue (linguinal cyst?))
Palpation; trachea, neck, mass, water swallow, protrude tongue, cervical LN)
Percussion; upper sternum - Reterosternal goitre?
Auscultation; hold breath, bell to listen for bruits (increased blood flow)
Other; proximal weakness (stand from chair w/ arms crossed), any reflex (delayed relaxation - hypothyroid?), Pretibial myxoedema
GALS 3 Qs
Any pain/stiffness in muscles/joints/back?
Able to completely dress/undress w/out difficulty?
Able to go up/down stairs w/out difficulty?
GALS - Gait
walk towards and away from, comment on arm swing, pelvic tilt, stride length, ability to turn quickly & any antalgic gait
ask if walking is painful
GALS - Arms
Look
Feel - MCP Squeeze
Move - full fist, grip strength, opposition
GALS - Legs
Fully flex & extend knee - crepitus? Knee & hip to 90º - assess internal/external rotation Patellar Tap - joint effusion? Soles of feet inspection Tenderness - squeeze MCPs
GALS - Spine
Lumbar Flexion - place fingers on adjacent vertebrae& bend forwards
Neck Lateral Flexion (ear to shoulder) - ROM/Pain?
Hip Exam Special Tests
Gait
Thomas’s Test - hand under lumbar, fully flex ipsilateral; leg raises = fixed flexion?
Trendelenburg’s - stand on 1 leg (abductor muscle strength)
Shoulder Exam Special Tests
Empty Can - supraspinatus
Scarf - Acromioclavicular Joint
Painful Arc - 0-15 = supraspinatus, 15-90 = deltoid, futher by scapula rotation = trapedius & serratus anterior
Resisted Active Internal Rotation - subscapularis
Lift Off - Subscapularis
Resisted Active External Rotation - Infraspinatus & teres minor
Cerebellar Exam
Speech - ‘baby hippopotamus’ dysarthria?
Co-Ordination - Finger-Nose; Intention Tremour? Dysmetria?
Nystagmus (Coarse & slow)
Dysdiadokinesis
Ataxia - Truncal (vermis lesion?), Ipsilateral limb (cerebellar hemisphere?)
Stance - wide-based?
Gait - heel-to-toe walking?
Optic Nerve Exam
Acuity - Snellen chart Fields Inattention/Extinction - unable to detect both simultaneously Light Reflexes - direct & consensual Accommodation (Ophthalmoscopy)
Vestibular Cochlear Nerve Exam
Cover opposite ear & whisper no. Abnormality Suspected (512 Hz); Rinne's - on mastoid then by EAM (conductive loss = Bone>Ear, SN loss = equally decreased) Weber's - midline forehead (conductive loss = louder in abnormal, SN loss = louder in normal)
Swelling/Lump Exam
Look - location, contour, colour, skin, abnormal vessels
Feel - surface, shape, size, tender, temperature, cough impulse, consistency, compressible, fluctuant, pulsatile, thrill
Move - tethering; skin/ deeper/muscle or tendon
Special Tests - transillumination (filled w/ clear fluid?), Auscultation (bruits? bowel sounds?)
Regional LN
Ulcer Exam
Look - no., site, shape, margin, edge, floor. discharge. surrounding skin, whole limb
Feel - tender, temperature, induration of edge, bleed on gentle touch (malignant?)
Move - base w/ thumb
Special Tests - peripheral pulses, light touch/pressure sensation, nearby joint examination if evidence of bony involvement
Regional LN
