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Quarter 2 > Phys Dx Final > Flashcards

Phys Dx Final Flashcards

1
Q

Spinothalamic tract

A

crude touch, pain, temperature

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2
Q

Spinothalamic tract

A

from periphery to spinal cord, crosses to CONTRALATERAL side before getting to brain

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3
Q

Posterior (dorsal) column

A

vibration, proprioception, fine touch

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4
Q

Posterior (dorsal) column

A

stays on SAME side until reaching brain stem, then crosses

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5
Q

Spinal injury to the spinothalamic tract

A

Contralateral loss of crude touch, pain, temp BELOW injury

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6
Q

Spinal injury to the posterior column

A

Ipsilateral loss of fine touch, vibration, proprioception BELOW injury

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7
Q

SENSORY cortex injury to either Spinothalamic tract OR Posterior column

A

both are Contralateral loss if it’s a sensory cortex injury (rather than at a spinal injury)

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8
Q

Upper motor neurons originate in

A

pre central gyrus and cross over in the medulle

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9
Q

Axons of upper motor neurons descent to synapse with the Lower motor neuron at the

A

anterior horn, then exit spinal cord

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10
Q

Upper motor neuron

A 
Spasticity
HYPERtonia
HYPERreflexia
Disuse atrophy (later on)
\+ Babinski
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11
Q

Lower motor neuron

A 
Flaccid
HypOtonia
HpOflexia
Denervation atrophy
- Babinski
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12
Q

Tandem gait

A

Heel to toe

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13
Q

Steppage gait

A

AKA Neuropathic gait

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14
Q

Steppage gait/Neuropathic gait

A

“Foot drop”
Pt drags foot or lifts it high, then foot SLAPS on floor

Unilateral –> Peroneal nerve injury, spinal nerve ocmpression

Bilateral –> amyotrophic lateral sclerosis (ALS),C harcot-Marie- Tooth disease and peripheral neuropathies

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15
Q

Spastic Hemiparesis

A

Drag toe, circumduct outward and forward

Arm flexed, immobile, held close to the side (all UE joints flexed)

Corticospinal tract lesions

Stroke

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16
Q

Scissor Gait

A

thighs tend to cross
advance legs slowly
stiff gait and short steps
Spasticity disorders like Cerebral Palsy

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17
Q

Sensory Ataxia

A

everything is shaky. unsteady gait and wide based stance

throw feet forward and outward with DOUBLE TAP

watch ground

d/t loss of proprio

  • Peripheral neuropathy
  • Posterior column damage
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18
Q

Parkinson Gait

A

Stooped posture with head, arm hip, and knee flexion

Decreased arm swing, stiff turns

d/t Basal Ganglia abn, Parkinson

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19
Q

Trendelenburg Gait

A

AKA Myopathic gait

Pelvic drop leads to waddling gait

Hip aBductor

Unilateral –> spinal nerve compression, superior gluteal nerve injury

Bilateral –> muscular dystrophy

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20
Q

Romberg test fail

A

Posterior column dz

Neuropathy

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21
Q

Pronator drift fail

A

Upper motor neuron lesion

Possible Stroke

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22
Q

Heel to shin fail

A

Heel overshoots knee: Cerebellar dz

Heel lifts too high: Position sense

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23
Q

Finger to nose fail

A

Dysmetria/past pointing

Intention tremor- Multiple sclerosis
Cerebellar dz

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24
Q

Rapid alternating movements

A

Dysdiadokinesia- slow,clumsy, irreg movements

Cerebellar dz

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25
Q

Recent memory

A

3 words, repeat in 5 min

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26
Q

Remote memory

A

3 presidents

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27
Q

CN4

A

Trochlear

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28
Q

CN9

A

Glossopharyngeal

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29
Q

CN12

A

Hypoglossal

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30
Q

Asosmia

A

loss of smell

Head trauma, Parkinson

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31
Q

Loss of optic fx

A

Visual field defect 2 degree retinal emboli, optic neuritis, Pituitary tumor, Stroke

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32
Q

Occulomotor

A

Eye movement

Abnormal: Vertical and horizontal diplopia

CN3 palsy= Ptosis

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33
Q

CN4 Trochlear

A

Function: downward, internal movement of eye

Abnormal: vertical diplopia

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34
Q

CN6 Abducens

A

Function: lateral deviation of eye

Abnormal: horizontal diplopia, esotropia

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35
Q

CN7 Facial

A

Abnormal:
Peripheral- Bell’s palsy
Central- Cerebral infarct

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36
Q

CN9 Glossopharyngeal

A

Abnormal:

no gag reflex, loss of taste posterior 1/3 tongue

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37
Q

CN10 Vagus

A

Abnormal:

Hoarseness, dyspnea, dysarthria, loss of gag reflex

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38
Q

CN12 Hypoglossal

A

Abnormal:
Central lesion: tongue deviates away
Peripheral lesion: tongue deviates to weak side

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39
Q

_____thesia

A

touch

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40
Q

_____gesia

A

pain

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41
Q

Allodynia

A

pain elicited from non painful stimulus

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42
Q

Sensory SCREENING exam

A

routine physical

Check sharp, dull, and vibratory sense distally, then move proximally as needed

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43
Q

Sensory PROBLEM FOCUES exam

A

Pt c/o intermittent neck pain and N/t travelling into RUE:

evaluate sensation BILATERALLY in a DERMATOMAL PATTERN

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44
Q

Lateral upper arms

A

C5

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45
Q

Radial forearm and thumb

A

C6

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46
Q

Middle finger

A

C7

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47
Q

Ring and little finger

A

C8

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48
Q

Ulnar forearm

A

T1

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49
Q

Nipple line

A

T4

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50
Q

Umbilicus

A

T10

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51
Q

Inguinal region

A

L1

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52
Q

Anterior/proximal thigh

A

L3

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53
Q

Knee/medial shin

A

L4

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54
Q

Lateral shin, dorsal foot to great toe

A

L5

55
Q

Lateral and plantar foor

A

S1

56
Q

Stereognosis

A

ask pt to recognize familiar object

SterEOG OBJect

57
Q

Graphesthesia

A

number identification

58
Q

Mono or hemiparesis

A

indicative of STROKE

59
Q

Static tremor (seen at rest)

A

Parkinson (pill rolling tremor)

60
Q

Postural tremor (seen when affected area maintains posture)

A

Hyperthyroid, anxiety, fatigue, essential tremor

61
Q

Intention tremor (absent at rest, appears with movement)

A

Multiple Sclerosis

62
Q

Tics: brief, repetitive, twitching

A

Tourette syndrome, medications

63
Q

Dystonia: twisted posture of large body parts

A

Medications, spasmodic torticollus

64
Q

Dyskinesias: bizarre, rhythmic, repetitive movements

A

Parkinson, psychoses, medications

65
Q

Akathisisa: inability to sit still

A

Medications (antipsychotics, Compazine)

66
Q

Chorea: brief, jerky, rapid, unpredictable movements

A

Huntington dz, Rheumatic fever

67
Q

Athetosis: slow, twisting, writhing

A

Cerebral Palsy

68
Q

Hypotonia/flaccid

A

Central and peripheral causes

69
Q

Spasticity

A

Central corticospinal tract dz

70
Q

Rigidity

A

Cog wheel rigidity: Parkinson

71
Q

Muscle strength ranking

A

0: no contraction
1: contraction, no joint move
2: joint motion, but not against gravity
3: mov against gravity only
4: mov w some resistance
5: full strength with full resistance

72
Q

Shoulder aBduction

A

C5 root

Axillary nerve

73
Q

Elbow flexion

A

C5-6 root

Musculocutaneous nerve

74
Q

Elbow extension

A

C6-7

Radial nerve

75
Q

Wrist extension

A

C6-7

Radial nerve

76
Q

Wrist flexion

A

C7-8 root

Meidan nerve

77
Q

Finger aBduction

A

C8-T1 root

Ulnar nerve

78
Q

Thumb opposition

A

C8-T1 root

Median nerve

79
Q

Deep tendon reflex

A

2+ is normal

80
Q

Hypoactive DTRs

A

Dz of spinal NERVE ROOTS or PERIPHERAL NERVES

may also see: weakness, atrophy, fasciculations

81
Q

Hyperactive DTRs

A

lesions along descending CORTICOSPINAL TRACT

may also see: weakness, spasticity, + Babinski

82
Q

Biceps DTR

A

C5,C6

83
Q

Brachioradialis DTR

A

C5, C6

84
Q

Triceps DTR

A

C6, C7

85
Q

Patella DTR

A

L4

86
Q

Achilles DTR

A

S1

87
Q

Clonus

A

abnormal up and down

Upper motor neuron dz

88
Q

Babinski

A

abnormal: CNS lesion affecting corticospinal tract

89
Q

Superficial abdominal reflex

A

abnormal: Central and peripheral pathologies

90
Q

Cremasteric reflex

A

Abnormal: UMN, LMN
L1,L2 injury
Ilioinguinal injury s/p hernia repair

91
Q

Order for abdominal exam

A

Inspection
Auscultation
Percussion
Palpation

92
Q

Exam abdomen from

A

Pt’s Right side

93
Q

Approach to abdominal exam

A

Clockwise rotation

94
Q

Diastasis Recti

A

separation of rectus abdominis muscles

abdominal contents form midline ridge

obvious with flexion of the neck

95
Q

Increased peristalsis waves can be indicitave of

A

intestinal obstruction

96
Q

Ecchymosis

A

can be seen in intraperitoneal or retroperitoneal hemorrhage

97
Q

Portal hypertension

A

from cirrhosis

98
Q

Portal HTN

A

promotes collateral venous circulation radiating from umbilicus to abdominal wall

“Caput medusa”

99
Q

Borborygmi

A

stomach growling

100
Q

High pitched, tinkling bowel sounds

A

can be associated with OBSTRUCTION

101
Q

Hyperactive bowel sounds

A

Diarrhea

Peritonitis

102
Q

Distended abdomen that is tympanic throughout

A

Intestinal obstruction

Paralytic Ileus

103
Q

Bladder volume must be >400-600 mL before

A

dullness appears

104
Q

Guarding is

A

voluntary contraction

105
Q

Rigidity is

A

involuntary reflex contraction of abdominal wall

persists over several exams

106
Q

Acute cholecystitis

A

Inflammation of gall bladder

+Murphy’s sign, tender RUQ

107
Q

Acute pancreatitis

A

Epigastric pain often radiating to back

108
Q

+Psoas, obturator, Rovsing sign

A

Acute appendiciti

109
Q

Acute diverticulitis

A

LLQ pain

110
Q

normal Aorta size

A

<3 cm

111
Q

Brawny edema

A

non pitting edema

112
Q

FABer “Patrick’s test”

A

External rotation

113
Q

Trendelenburg test

A

have pt raise one knee

weak hip aBductors on other side

114
Q

FadIR

Internal rotation

A

test for: IMPINGEMENT

115
Q

Palpable cord of lower leg

A

thrombosed vein

116
Q

Popliteal artery aneurysm

A

usually d/t Atherosclerotic vascular dz
Males&raquo_space; females
>65 YO

Most common aneurysm of peripheral vascular system

Bilateral over 50% time!

Pulsatile swelling behind knee

117
Q

Bulge sign test of knee

A

Minor effusion

118
Q

Ballotement test of knee

A

MAJOR effusion

119
Q

Valgus test

A

MCL

120
Q

Varus test

A

LCL

121
Q

Lachman

A

most useful, grab both femur and tibia and shift in opposite directions

for ACL

122
Q

Mcmurray test

A

flex and extent with external and internal rotation of foot

external rotation: MEDIAL meniscus

internal rotation: LATERAL meniscus

123
Q

Hinge joints of ankle

A

Tibiotalar

Subtalar (talocalcaneal)

124
Q

Pes Planus

A

flat foot

125
Q

Pes Cavus

A

high arch

126
Q

Where to test for edema

A

Dorsum of foot, behind medial malleolus, on shins

127
Q

Palpation of pedal pulse

A

over 1-2nd metatarsals

128
Q

2+ brisk

A

normal pulse

129
Q

Thompson test

A

squeeze calf

foot should Plantar flex

130
Q

Adams forward bend test

A

always evaluate for LLD to determine if discrepancy is from spine or true LLD is causing curvature

131
Q

Glaeazzi test

A

LLD

132
Q

Straight leg raising test

A

test for lumbosacral radiculopathy, sciatic neuropathy

133
Q

Positive straight leg raising

A

Lasegue’s test

134
Q

Seated straight leg test

A

also called “flip sign” pt will flip back when leg is straightened

Quarter 2 (16 decks)

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