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PCM 1 > PCM > Flashcards

PCM Flashcards

1
Q

4 things to gain objective information

A

Inspection
Auscultation
Percussion
Palpation

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2
Q

Inspection

A

look at your patient
are they responsive?
are they agitated
do they look sick?

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3
Q

Auscultation

A

heart lungs abdomen, vessels

Lungs: deep breath in and out through mouth at each lung lobe location

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4
Q

Percussion

A 
Dull = fluid
Flat= solid
Tympanic = air
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5
Q

Palpation

A

always check bilaterally

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6
Q

How to use opthalmoscope

A

r eye to r eye, start lateral and move medial. look for red reflex

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7
Q

Direct pupil light reflex

A

that pupil constricts vs consensual: light in eye 1 -> constriction of eye 2

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8
Q

Otoscope

A

Adults: pull ear up out and away
kids- pull down out and away
look for cone of light on tympanic membrane

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9
Q

Snellen chart

A

visual acuity hold at 14 inches from eyes

normal is 20/20

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10
Q

BP cuff

A

wrap cuff over brachial artery, 1st sound = systole or 1st korotkoff sound- 2nd sound is diastole or 2nd korotkoff sound

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11
Q

Tuning fork

A

air conduction should be greater than bone conduction
=rinne test
can also be used on the knee cap to test vibratory sense b/l

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12
Q

reflex hammer

A 
Graded from 0 to 4 
2 is normal
hypo and hyper
UE: C5 C6 C7
LE: L4 and S1
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13
Q

stethoscope

A 
bell= bruits (low pitched sounds)
diaphragm= high pitched sounds
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14
Q

Gloves

A

always use clean gloves

wash hands before and after

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15
Q

Coronal plane

A

front and back halves

AP axis

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16
Q

Transverse plane

A

top and bottom

Longitudinal axis

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17
Q

Sagittal plane

A

left and right halves

transverse plane

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18
Q

gravitational line

A

external auditory meatus, lateral head of the humerus, 3rd lumbar vertebra, anterior 3rd of sacrum, greater trochanter, lateral condyle of the knee, lateral malleolus

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19
Q

scoliosis

A

s shaped body curve (lateral curve)-> sidebending = coronal plane and AP axis

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20
Q

Rotated spine

A

looking a different direction, bent forward/flexion = transverse plane and longitudinal axis

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21
Q

Lordosis and kyphosis

A

exaggerated curves in the sagittal plane and transverse axis

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22
Q

pectus excavatum

A

funnel chest or abnormal depression in sternum

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23
Q

pectus carinatum

A

pigeon chest

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24
Q

what curves do the cervical and lumbar spine have?

A

Lordosis

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25
Q

what curves do the thoracic and sacrum have

A

Kyphosis

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26
Q

What does OPPQQRST-A stand for

A 
Onset
palliative factors
provocative factors
quality
quantity
Rating
severity
timing
associated symptoms
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27
Q

What does OLD CAAARTS stand for

A 
Onset
location
duration
characterization
associated symptoms
aggravating
alleviating
radiation
timing
severity
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28
Q

What goes into the subjective portion of the soap note?

A

Anything you got from talking to the patient

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29
Q

What goes into the objective portion of the soap note?

A

anything you got from the physical exam or you see

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30
Q

What goes into the assessment portion of the soap note?

A

relating it to diagnosis

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31
Q

What goes into the plan portion of the soap note?

A

what you will do for them

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32
Q

what does NURS stand for?

A

Name the emotion
Understanding statement
Respect the patient
Offer support

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33
Q

What does CAGE stand for?

A

ever need to Cut down?
ever feel Annoyed?
ever felt Guilty about drinking?
ever need a morning Eye opener

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34
Q

5Ps of sexual history

A 
Partners
Prevention of pregnancy
Protection from STDs
Practices
Past history of STDs
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35
Q

SAFE questions

A

Stress/ safety
Afraid/ Abused
Friends/Family
Emergency Plan

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36
Q

Faith: FICA

A

Faith and believe : do you consider yourself a religious person
Importance: what importance does faith have in your life?
Community: are you a part of a spiritual or religious community?
Address in care: asking them if they want you to address these issues in their care

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37
Q

repeated stresses can result in the breakdown of a structure. What is this called?

A

Fatigue

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38
Q

What are the chronic somatic dysfunction characteristics?

A

Fibrosis, Contracture, Skin is thin, dry, cool. Muscles may feel fibrotic

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39
Q

What is the SAID principle?

A

Specific Adaptation to Imposed Demand

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40
Q

Three sub segmented units

A

Core
Shoulder girdle
Pelvic girdle

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41
Q

Borelli

A

Center of gravity
Measured inspired and expired air volumes
Muscle driven inspiration

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42
Q

Four ways machines function

A

Balance multiple forces
Enhance force in an attempt to reduce total force needed to overcome resistance
Enhance range of motion and speed of movement so that resistance may be moved further or faster than applied force
Alter resulting direction of the applied force

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43
Q

Three type sod machines

A

Levers - torque and length
wheel axles- function as a form of a lever
Pulleys- single pulleys function to change effective direction of force application

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44
Q

Relaxation

A

As the matrix of a segment reaches equilibrium or a neutral position the load necessary to maintain the length of a segment will decrease = relaxation

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45
Q

Strength

A

Amount of force needed to contract a muscle
dependent on degree of resistance experienced (load)
Produces rotation (torque)

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46
Q

Joint reaction force

A

The sum of the separate moments together with the force of the contraction muscle directed into the joint

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47
Q

External applied force

A

Produced from outside the body, and originate from gravity inertia or direct contact
Ground reaction forces- the force exerted by the ground on a body in contact with the ground
Tissue deformation may result from external forces but can result from internally generated forces
Magnitude and combination of vectors leads to a resultant applied force

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48
Q

Internal applied force

A

Force generated to achieve limb movement ie muscle contraction
Vertical load- summative weight transmitted through the kinetic chain to the ground
Friction- force that results from the resistance between surfaces of two objects from moving upon one another

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49
Q

To prevent injury

A

The body must absorb and dissipate energy from both internal and external forces

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50
Q

moment

A

Force being applied plus the moment arm (work = force x distance)

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51
Q

stiffness

A

The amount fo force necessary to bend an object

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52
Q

viscosity

A

Related to its water content- rapid stretch has increased resistance, slower stretch (creep) has decreased resistance

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53
Q

Load

A

The sum of stresses on an object- can result in tissue deformation

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54
Q

Fibrous joints

A 
Connected by dense fibrous tissue
Motion is greatly limited
Tow suture edge types
squamous (overlapping)
Serrated (interlocking)
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55
Q

cartilaginous joints

A 
Two surfaces united by fribrocartilaginous discs
Small amount of rocking and sliding
Two subtypes
hyaline
fibrocartilage
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56
Q

synovial

A

Most common joint
Separated by fluid contain joint cavity
Freely mobile
Articular surfaces are covered with healing cartilage
synovial membrane lines joint capsule and secretes a viscous fluid to nourish and lubricate the healing cartilage

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57
Q

Plane joint

A

Minimal sliding

triquetrum pisiform

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58
Q

hinge joint

A

ginglymus
Allows large degree of freedom in one plane
Elbow joint

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59
Q

saddle/sellar

A

One concave and one convex bone allowing motion in all planes
thumb

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60
Q

Ellipsoid-

A

head is ellipsoid: greater motion than condylar butyl less spheroid ie radiocarpal

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61
Q

condylar

A

Partial flattening of both articular surfaces that limits motion is metacarpal/phalangeal

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62
Q

Ball and socket

A

Greatest range of motion- hip

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63
Q

Pivot/ trochoid

A

Primary motion is rotation

Ie atlas and axis

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64
Q

Hiltons law

A

Nerves supplying a joint also supply muscles mocint the joint and the skin covering the attachments of those muscles

65
Q

Where are nerve endings found?

A

Articular surfaces

66
Q

Inflammatory arthritis

A

Most common of these is RA
Auto immune- attacks synovium and cartilage
Found in women 30-60
Inflammatory agents damage cartilage and bone

67
Q

osteoarthritis

A

Joint disease that gets worse over time NOT INFLAMMATORY
Middle aged and older
Cartilage is eroded away

68
Q

Traumatic

A

From an injury leading to avascular necrosis
In people who have experienced injury or fracture
Cartilage deteriorates leading to bone on bone rubbing

69
Q

fibrillation

A

Due to loss of proteoglycans
Unmasks collagen fibers and increases water content in chondrocytes
Basically erosion of cartilage
Ground glass appearance

70
Q

Eburnation

A 
Complete loss of articular cartilage
Accompanied by thickening of subchondral bone - osteosclerosis
Bone is hard and polished
Permanent lesion
pain on weight bearing
71
Q

Joint mice

A

Fragments of cartilage or bone floating synovial fluid
Occurs when pieces of degenerating cartilage detach
Associated with catching or locking of joint
Commonly seen in degenerative joint disease

72
Q

What is Gait?

A

One gait cycle is from a heel strike to heel strike on same foot

73
Q

Two main phases

A

Stance phase: when the foot is on the ground

Swing phase: foot not on the ground

74
Q

At contact

A

lateral aspect of calcaneous strikes the ground
tibia internally rotates and calcaneus everts
= pronation
extensor digitorum longus and tibialis anterior relax

75
Q

midstance

A

the rearfoot is fully pronated
metatarsals hit the ground and the bodys center of gravity is over the foot
the subtalar joint resupinates
posterior tibialis prevents over pronation and is an active supinator

76
Q

propulsion

A

heel life becomes toe off
the center of gracity passes over the metatarsasl and begins to pull the heel up
supination means we have a rigid lever and can push off
phase ends with the body weight moving over great toe before all weight is transferred to the other foot

77
Q

swing

A 
foot dorsiflexes to keep other toes from hiting the ground
foot supinates( gets it further away from the gorun stabilizes it in preparation for the first jarring movement of heel strike)
78
Q

Stance Phase

A

from heel strike to toe off
approx. 60% of cycle
foot is on the ground and bearing weight
this is when most problems occur

79
Q

Swing phase

A

from toe off to heel strike

foot is moving forward and is non weight bearing

80
Q

requirements for gait

A 
stability in stance
foot clearance in swing
pre position for initial contact
adequate step length
energy conservation
81
Q

Pathologic gaits

A 
antalgic
arthrogenic
ataxic
Parkinson
steppage
hemiplegic
82
Q

Antalgic gait

A

painful

83
Q

arthrogenic

A

stiff

84
Q

ataxic

A

unstable (imagine a dizzy person staggering)

85
Q

parkinson

A

festinating: shuffling, slow

86
Q

steppage

A

high knees to compensate for foot drop

87
Q

hemiplegic

A

no flexion of knee ankle, semicircle made with hip

88
Q

Spine of scapula

A

T3

89
Q

inferior angle of scapula

A

T7

90
Q

GH joint movements

A

Flexion: coracobrachialis

deltoid

91
Q

extension

A

lats and teres major

92
Q

abduction

A

supraspinatus and mid deltoid

93
Q

adduction

A

pec major and lats

94
Q

external rotation

A

infraspinatus and teres minor

95
Q

Apley scratch test

A

abduction and external rotation

adduction and internal rotation

96
Q

lift off test

A

internal rotation and adduction
try to lift off
if cannot +

97
Q

UE muscle reflexes

A

C5: biceps tendon
C6: brachioradialis
C7: triceps tendon

98
Q

Tinels sign

A

test for ulnar nerve entrapment
tap between the olecranon and medial epicondyle groove
positive sign- tingling down the forearm

99
Q

tennis elbow

A

extensors attached to lateral epicondyle

test extension of wrist against resistance pain at lateral epicondyle +

100
Q

golfers elbow

A

flexors attached at medial epicondyle
test flexion of wrist against resistance
pain at medial epicondyle +

101
Q

Coupled motions at wrist

A

flexion: posterior carpal glide
extension: anterior carpal glide
ulnar deviation: ulnar abduction
radial deviation: ulnar adduction

102
Q

OK sign

A

pt cannot make an OK sign with thumb and index

sign of anterior interosseous path (branch of median n)

103
Q

tinels sign wrist

A

tap over transverse carpal L. pain or tingling= positive CTS

104
Q

Phalens sign

A

dorsum of hands together hold for 60 seconds

pain or tingling= +CTS

105
Q

De Quervains tensosynovitis

A

possible inflammation for overuse of a muscle (abduction pollicis longus or extensor pollicis brevis
use finkelsteins test

106
Q

Finkelsteins Test

A

have Pt make fist encompassing thumb
then ulnar deviate
Positive sign is pain

107
Q

Flexion of hip innervation

A

L2-L4

108
Q

Extension of hip innervation

A

L5-S2

109
Q

Adduction of Hip innervation

A

L2-L4

110
Q

abduction of hip innervation

A

L5-S1

111
Q

Ant fem cutaneous nerve

A

L2-L4

112
Q

lat fem cutaneous nerve

A

L2-L3

113
Q

post fem cutaneous nerve

A

S2

114
Q

Central hip compartment contents

A

labrum, ligamentum teres, articular surfaces

115
Q

Central hip compartment tests

A

Log roll, scour, labral distraction and loading, FABER, c sign

116
Q

Peripheral hip compartment contents

A

Rectum femoris, femoral neck, synovial lining

117
Q

Peripheral hip compartment test

A

Rectum femoris, Elys

118
Q

Lateral hip compartment contents

A

Glut med, glut min, piriformis, IT band, trochanteric bursae

119
Q

Lateral hip compartment tests

A

Jump sign, Piriformis, FABER, Trendelenburg, Obers, straight leg raise

120
Q

Anterior hip compartment contents

A

iliopsoas, iliopsoas bursae

121
Q

Anterior hip compartment tests

A

FABER, Thomas, psoas test

122
Q

MCL Test

A

valgus stress testing

123
Q

LCL test

A

Virus stress testing

124
Q

ACL test

A

Anterior drawer

Lachmans

125
Q

PCL test

A

Posterior drawer

Reverse lachmans

126
Q

Patella test

A

Laxity, apprehension compression glide

127
Q

Menisci test

A

McMurray and Apley

128
Q

Apley test

A

Compression and distraction of knee

129
Q

Unhappy triad

A

ACL MCL and lateral meniscus

130
Q

chondormalacia

A

No cartilage, bone on bone

131
Q

Hamstring strain

A

Quick explosive motions

132
Q

ITBS

A

overuse

133
Q

Patellar tendonitis

A

Jumpers knee and quadriceps tendon

134
Q

Osgood Schlatters

A

Adolescents 11-14 slight avulsion of tibia tuberosity (inflammation of patellar ligament)

135
Q

Achilles tendon reflex

A

S1

136
Q

Sensation innervation for foot

A

L4 L5 S1 medial to lateral

137
Q

Anterior drawer test Ankle

A

Indicates ATF (anterior talofibular ligament strain)

138
Q

Talar tilt test

A

Indicates calcaneofibular ligament strain

139
Q

Eversion test

A

Indicates deltoid ligament strain

140
Q

squeeze test/ cross leg

A

indicates high ankle strain (syndesmosis injury)

141
Q

Thompson test

A

Achilles tendon rupture

142
Q

venous thrombosis

A

homans and moses sign

143
Q

mortons neuroma

A

walking on a marble

144
Q

plantar fasciitis

A

plantar aponeurosis

145
Q

turf toe

A

1st toe hyperextension

146
Q

Achilles tendonitis

A

pain inflammation at base of tendon

147
Q

calf strains

A

gastroc and soleus
knee flexion removes gastroc from plantarflexion
pain or inability to plantar flex is soleus

148
Q

Acute bacterial rhinosinusitis

A

10 days w/o improvement high fever, purulent discharge
amoxicillin (if allergic doxycycline)
flush sinuses

149
Q

Dizziness

A

ENT, Resp, Neuro causes

diff between vertigo, lightheadedness, imbalance if possible

150
Q

Lightheadedness

A

usually from hypotension/ CV causes or hyperventilation

151
Q

Vertigo

A

ENT dx - menieres BPPV labyrinthitis

152
Q

Menieres disease

A

Vertigo and tinitis and hearing loss

153
Q

BPPV

A

Episodic vertigo ( perform Dix hallpike to help diagnose, epley maneuver to tx)

154
Q

labyrinthitis

A

Hearing loss, vertigo (non episodic) often assoc w/ infxn

155
Q

Streptococcal pharyngitis

A

Grp A beta hemolytic strep (S. pyogenes)
Red inflamed throat, fever inflamed tonsils with exudate.
Important to completely dx/tx since sequella include Rheumatic Fever RHD MS

156
Q

Earaches

A

OM OE OME(SOM)

157
Q

Otitis media

A

Behind ear drum, due to infection. Looks red swollen angry, kids have poor drainage, Eustachian tube is more horizontal. Need Antibiotics

158
Q

Otitis Externa

A

Swimmers ear, in ear canal

159
Q

Serous Otitis media (Otitis media w effusion)

A

Don’t give antibiotics, fluid buildup due to poor drainage. Mainly cause by allergies, not red, just bulging

PCM 1 (1 decks)

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