PCMI Midterm Flashcards
Gravitational Line Landmarks
External Auditory Canal Lateral head of the Humerus Third Lumbar Vertebra Anterior third of sacrum Greater Trochanter Lateral Condyle of the knee Lateral Malleolus
Gait Cycle - Stance Phase
Initial Contact
Load Response
Heel Off
Opposite Initial Contact
Gait Cycle - Swing Phase
Toe off
Feet Adjacent
Tibia Vertical
Next Initial Contact
Subjective
Chief Complaint History of Present Illness Review of Systems Past Medical Hx Past Surgical Hx Meds Allergies Family Hx Social Hx
Objective
Exam Findings
Laboratory Data
Radiology Data
Assessment
NOT ALWAYS A DIAGNOSIS
Basic description of problem
Diagnosis
Differential Diagnosis (probable cause of the assessment, listed in order of most likely to least likely
Plan
What Doctor plans to do about problems identified
HPI
OLDCAAARTS Onset Location Duration Character Alleviating Factors Aggregating Factors Associated Symptoms Radiation Timing Severity
Social History
FEDTACOS Food Exercise Drugs - recreational Tobacco Alcohol Caffeine Occupation Spirituality/Sexuality
Exercise Recommendations
Adults:
150 min/week of moderate activity with 2 days of strength training
Children:
1 hour or more/day
Pack Years
Packs/day * years smoked= pack years
Alcohol CAGE Questions
- Has anyone suggested you CUT back?
- Are you ever ANNOYED when people talk about your drinking
- Do you ever feel GUILTY about your drinking?
- Do you ever need a drink in the morning to steady your nerves (an EYE OPENER)
Alcohol AUDIT-C Questions
-How often do you have a drink containing alcohol?
(Never, Monthly/less, 2-4 times/month, 2-3 times/week, 4+ times/week)
-How many drinks containing alcohol do you have on a typical day when you are drinking?
(1 or 2, 3 or 4, 5 or 6, 7-9, 10+)
-How often do you have 6 or more drinks on one occasion?
(Never, less than monthly, monthly, 2 or 3 times/week, 4 or more times/week)
Safe Drinking Limit
Women:
No more than 3 drinks on any single day, no more than 7 drinks/week
Men:
No more than 4 drinks on any single day, no more than 14 drinks/week
The Five Ps
Partners Practices Prevention of Pregnancy Protection from STIs Past History of STIs
Subluxation
Residual contact between 2 articular surfaces
Valgus deformity
Distal part of limb directed away midline
Genu valgus = Knock knees
Varus Deformity
Distal part of limb directed toward midline
Genu varus = Bowlegs
Grading scale of Muscle Strength
0 - no contraction
1 - barely detectable contraction
2 - Active movement of body part with gravity eliminated
3 - active movement against gravity
4 - Active movement against gravity and some resistance
5 - Active movement against full resistance without fatigue (normal)
What nerve root does triceps tendon reflex test for?
C7
What nerve root does biceps tendon reflex test for?
C5,6
What nerve roots does the brachioradialis reflex test for?
C5,6
What nerve roots does the patellar reflex test for?
L2-L4
What nerve roots does the Achilles’ tendon reflex test for?
S1
Vascular Exam rating scale
0/4 - absent
+1/4 - palpable, but thready and weak; easily obliterated
+2/4 - Normal, easily identified; not easily obliterated
+3/4 - Increased pulse; moderate pressure for obliteration
+4/4 - Full, bounding, cannot obliterate
Edema Exam Rating Scale
0: Absent
1: Barely detectable, slight pitting (2mm)
2: Slight indentation (4mm) 10-15 sec
3: Deeper indentation (6mm) >1 min
4: Very marked indentation (8mm) 2-5 min
Muscle Strength Testing:
0 - no contraction
1 - Visible contraction without motion
2 - Full range of motion with gravity eliminated
3 - Full range of motion against gravity
4 - Full range of motion against gravity and moderate resistance
5 - Full range of motion against gravity and full resistance
How do you grade reflexes?
0 - No response 1+ -Somewhat diminished 2+ - Average, normal 3+ - Brisker than average, not necessarily indicative of disease 4+ - Very brisk, hyperactive with clonus
What spinal segment is the Triceps reflex testing for?
C7
What spinal segment is the Biceps reflex testing for?
C5/C6
What spinal segment is the Brachioradialis reflex testing for?
C5/C6
What spinal segment is the Patellar reflex testing for?
L2-L4
What spinal segment is the Calcaneal Tendon Reflex testing for?
S1
Bowlegged
Varus deformity, feet directed toward from midline
Knock Knee
Valgus deformity, feet directed away from midline
