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Clinical Medicine I > Physical Diagnosis 1 > Flashcards

Physical Diagnosis 1 Flashcards

1
Q

Winged Scapula

A

paralysis of serratus anterior via long thoracic n.

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2
Q

ROM Shoulder Testing

A

Active and Passive

  1. Forward Flexion/Extension
  2. Abduction/Adduction
  3. Internal/external rotation
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3
Q

rotator cuff function

A

Abduction: supraspinatus

External rotation: 20% teres minor, 80% infraspinatus

Internal rotation: subscapularis

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4
Q

Painful Arc Test

A
  1. Tests for: Shoulder Impingement
  2. Positive: pain between 60 and 120 degrees
  3. DDx: subacromial impingement, rotator cuff tendonitis
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5
Q

Neer’s

A
  1. Tests for: Shoulder Impingement
  2. Positive: pain w/ internal rotation. (90: mild, 60-70: moderate, 45: severe)
  3. DDx: supraspinatous impingement, rotator cuff tendonitis
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6
Q

Hawkins

A
  1. Tests for: Shoulder impingement
  2. Positive: pain
  3. DDx: supraspinatus impingement, rotator cuff tendonitis
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7
Q

External lag

A
  1. Tests for: rotator cuff tear
  2. Positive: inability to maintain external rotation
  3. DDx: supraspinatus pathology
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8
Q

external rotation resistance

A
  1. Tests for: rotator cuff tear
  2. Positive: pain or weakness
  3. DDx: infraspinatus pathology
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9
Q

Gerber Lift Off

A
  1. Tests for: Subscapularis tear
  2. Positive: inability to resist
  3. DDx: subscapularis pathology
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10
Q

Empty Can (Jobe’s Test)

A
  1. Tests for: supraspinatus tear
  2. Positive: weakness or pain
  3. DDx: rotator cuff tear, tendinopathy
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11
Q

Drop Arm Test

A
  1. Tests for: rotator cuff tear
  2. Positive: weakness, difficulty with smooth ROM
  3. DDx: rotator cuff tear, tendinopathy
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12
Q

Apley Scratch Test

A
  1. Tests for: rotator cuff tear, adhesive capsulitis
  2. Positive: asymmetry in comparing ROM
  3. DDx: Rotator cuff pathology, labral pathology, arthritis, adhesive capsulitis
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13
Q

Apprehension, relocation and release

A
  1. Tests for: Shoulder instability
  2. Positive: pain/apprehension relieved by relocation
  3. DDx: shoulder laxity, instability
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14
Q

Sulcus sign

A
  1. Tests for: shoulder instability
  2. Positive: 2cm or more depression of humeral head
  3. DDx: inferior shoulder instability, subluxation
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15
Q

Yergason

A
  1. Tests for: biceps tendon injury
  2. Positive: pain, popping, clicking
  3. DDx: biceps tendonitis, biceps subluxation
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16
Q

Speeds

A
  1. Tests for: biceps tendon injury
  2. Positive: pain
  3. DDx: biceps tendonitis
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17
Q

Cross-body adduction

A
  1. Tests for:
  2. Positive:
  3. DDx: AC pathology
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18
Q

O’Brien’s Test

A
  1. Tests for: Labral, AC, biceps injury depending on location
  2. Positive: pain
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19
Q

Elbow ROM and Strength testing

A

Passive and active:

  1. Flexion/Extension
  2. Supination/pronation
  3. Radial/Ulnar deviation
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20
Q

Epicondylitis

A
  1. golfer’s elbow: medial epicondyle with flexion

2. tennis elbow: lateral epicondyle with extension

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21
Q

Olecranon bursitis

A
  1. Inflammation of bursa w/ fluid accumulation

2. pain suggests trauma or infection

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22
Q

Tinel’s sign at elbow:

A
  1. Cubital Tunnel Syndrome (percuss ulnar nerve)

2. Positive: shooting electric sensation or paresthesia over ulnar n. distro

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23
Q

Subcutaneous Nodules (forearm)

A
  1. suggests gouty tophi, rheumatoid arthritis
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24
Q

Colles’ Fracture

A
  1. Distal radius fracture

2. Dinner fork deformity

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25
Q

Carpal Tunnel Syndrome

A
  1. median n. compression

2. results in neuropathy, paresthesias, thenar atrophy

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26
Q

Tinel’s sign at wrist

A
  1. Tests for carpal tunnel syndrome, palpation of median nerve with extended wrist
  2. Positive: shooting electric sensation, paresthesia in median n. distro
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27
Q

Phalen’s Test

A
  1. Carpal tunnel Syndrome

2. Positive: paresthesia in the distro of median n.

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28
Q

de Quervain’s Tenosynovitis

A
  1. inflammation of 1st dorsal compartment involving abductor pollicis longus and extensor pollicis brevis
  2. Caused by overuse, gripping
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29
Q

Finkelstein Test

A
  1. test for de Quervain’s

2. positive: pain along 1st dorsal compartment

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30
Q

Ganglion cysts

A
  1. dorsal radial and volar aspects of wrist
  2. palpate for soft mobile mass
  3. may restrict motion or become painful
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31
Q

anatomic snuffbox palpation

A
  1. test for scaphoid fracture
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32
Q

Radial deviation of hand

A
  1. test for osteoarthritis
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33
Q

ulnar deviation of hand

A
  1. test for rheumatoid arthritis
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34
Q

Swan Neck

A
  1. hyperextension of PIP joints with fixed flexion of DIPs
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35
Q

Boutonniere

A
  1. Flexion of PIP joint w/ hyperextension of DIP
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36
Q

Heberden’s nodes

A
  1. Degenerative osteoarthritis

2. on DIPs

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37
Q

Bouchard’s nodes

A
  1. swelling of PIP, RA
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38
Q

Neuro check of hands

A
  1. brachial pulse
  2. radial pulse
  3. sensory over radial n. (over post. thumb)
  4. sensory over median n. (distal ant. digit 2)
  5. sensory over ulnar n. (distal ant. digit 5)
  6. Motor of median: “ok” sign, opposition
  7. motor of ulnar: extend digits, cross digit 2 over digit 1
  8. motor of radial n.: flex fingers w/ thumb abducted.
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39
Q

CN V tests

A
  1. Sensory: light touch over ophthalmic, maxillary, mandibular nn.
  2. Motor: palpate masseter
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40
Q

CN VII tests

A
  1. facial symmetry w/ eyebrows raised, eyes squeezed shut, puff out cheeks, smile
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41
Q

Temporal a. auscultation

A
  1. bruits indicates giant cell (temporal) arteritis
    - adults over 50
    - jaw claudication
    - elevated ESR
    - polymyalgia rheumatica
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42
Q

Rosenbaum pocket chart

A
  1. screens for presbyopia (impaired near vision)

2. bedside screen @ 14 in.

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43
Q

EOMs

A

LR6, SO4, AO3

LR: CN 6

SO: CN 4

All others: CN 3

44
Q

Corneal Light Reflection

A

tests for conjugate gaze, strabismus

45
Q

Ptosis

A
  1. Eye droop, CN III problem

2. Incomplete closure CN VII problem

46
Q

Chalazion

A

nontender, blockage of meibomian gland, points inside lid

47
Q

Hordeolum

A
  1. tender, margin of eyelid, Staph aureus
  2. Inner eyelid = meibomian gland obstruction
  3. outer eyelid - obstructed follicle or tear gland
48
Q

Dacrocystitis

A
  1. lacrimal sac inflammation between base of nose and eye
49
Q

Entropion v. Ectropion

A

Lid eversion

Entro: inward, ectropion, outward

50
Q

Pingueculum vs. Pterygium

A

Pingueculum: growth of bulbar conjunctiva, harmless

Pterygeum: triangular thickening of bulbar conjunctiva, may impair vision

51
Q

Xanthelasma

A

raised, yellow cholesterol filled plaques around eyelids

assoc. w/ hyperlipidemia

52
Q

exophthalmos

A

eyeball protrusion, grave’s disease

53
Q

Episcleritis

A

localized ocular inflamation of episcleral vessels, usuall around central nodule

assoc. w/ autoimmune

54
Q

Subconjungtival hemorrhage

A
  1. Hx of strain, blood thinner use

2. harmless bleeding in conjunctiva

55
Q

Hyphema

A

blood visible in anterior chamber, emergent.

56
Q

Hypertensive vascular changes in eye

A
  1. Copper wire: tortuous vessels w/ increased light reflex
  2. Silver wire: vessel wall opaque, stenosis, no blood visible
  3. AV nicking: appears as break in vein when artery and vein cross
57
Q

Hypertensive retinopathy

A
  1. Cotton Wool Patches: white lesions w/ irregular borders.

2. Hemorrhage: microaneurysm

58
Q

Diabetic retinopathy

A
  1. visible neovascularization

2. hard exudates appear creamy/yellow/bright

59
Q

Detached retina

A
  1. curtain like shadow over vision, floaters, flashes
60
Q

Papilledema

A

sharp borders of disc no longer present

HA, NV may be present

61
Q

Strabismus

A
  1. esotropia: light displaced laterally

2. exotropia: light displaced medially

62
Q

Corneal Reflex

A

CN V sensory and CN VII motor. Tests blink reflex

63
Q

Weber Test

A

Normal: sound in both ears equally

Abnormal: Lateralization

  • conductive loss: lateralization to bad ear
  • sensoneural: lateralize to good ear
64
Q

Rinne Test

A

Compares air and bone conduction

  1. normal = AC > BC
  2. BC > AC = conductive loss
  3. AC > BC = normal or sensorineural loss
65
Q

Ear: Serous effusion w/ air bubbles

A

indicative of barotrauma or viral URI

66
Q

Common area of epistaxis

A

Kisselbach’s plexus, 90% of epistaxis

67
Q

Septal hematoma

A

All nasal trauma must rule out septal hematoma

increased nasal obstruction, pain tenderness

common in peds following trauma

68
Q

Rhinitis/sinusitis types and findings

A

AR: swollen, pale blue, boggy turbinates. Shiners, eye sxs

Sinusitis and URI: erythematous turbinates

Sinusitis: tenderness to palpation

69
Q

torus palantinus

A

benign midline mass in hard palate

70
Q

Group A Strep

A
  1. ST, fever, known exposure
  2. no cough, congestion or fatigue
  3. bilateral exudative tonsillitis
71
Q

Epstein Barr

A
  1. ST, fever, fatigue
  2. bilateral exudative tonsillitis
  3. slight splenomegaly
72
Q

Peritonsilar abscess

A
  1. unilateral peritonsilar swelling and shifted uvula

2. hot potato voice, drooling

73
Q

Lymph node examination

A

small, mobile, nontender nodes are common

74
Q

Goiter

A
  1. enlarged thyroid
  2. multiple forms of thyroid dysfunction
  3. palpation while pt swallows
75
Q

Cells of epidermis

A
  1. keratinocytes
  2. melanocytes
  3. merkel cells
  4. langerhans cells
76
Q

Terms for distribution of lesions

A
  1. localized: one small area
  2. regional: specific region of body
  3. disseminated: widely distributed in multiple areas
77
Q

Terms to describe shape or arrangement

A
  1. round/discoid: coin shaped, no central clearing, umbilicated
  2. Oval: ovoid, found w/ pityriasis rosea
  3. Annular: round, active margins w/ central clearing
  4. Dermatomal
  5. target
  6. linear
  7. serpinginous
  8. morbilliform: measles like
78
Q

Terms to describe borders

A
  1. distinct: well defined
  2. indistinct: border merge w/ normal skin
  3. irregular
  4. Raised
79
Q

Terms to describe color

A
  1. flesh colored
  2. erythematous: red
  3. violaceous
  4. tan-brown
  5. black or blue-black
  6. hyper/hypopigmented
80
Q

Macule

A

flat, non palpable

less than 1cm

81
Q

patch

A

flat, non palpable

greater than 1 cm

82
Q

papule

A

elevated, palpable, firm, circumscribed

< 1cm

83
Q

Plaque

A

elevated, palpable, firm, circumscribed

> 1cm

84
Q

Nodule

A

elevated, circumscribed, deep, firm

> 1.5 cm

85
Q

tumor

A

Large nodule deep in dermis

> 2 cm

86
Q

Wheal

A

irregular, transient, superficial edema

87
Q

Vesicle

A

elevated, well circumscribed, fluid containing

< 1cm

88
Q

Bulla

A

elevated, well circumscribed, fluid filled

> 1cm

89
Q

Pustule

A

Elevated, superficial, well circumscribed, pus filled

90
Q

Petechiae

A

< .5cm, non blanchable, variable distro

91
Q

purpura

A

> .5 cm, non blanchable, variable distro

92
Q

Ecchymosis

A

purple lesion, blood outside vessels due to trauma or disorder

93
Q

Spider angioma

A

blanchable, face, neck, arms, upper trunk

seen w/ liver disease, pregnancy

94
Q

Cherry angioma

A

bright red papule, 1-6mm in size

non blanchable

95
Q

Hemangioma

A

benign vascular neoplasm common in infancy

spontaneous involution by age 5-10

96
Q

Papulosquamous lesions

A
  1. papules, plaques, scales
97
Q

Benign nodular lesions

A
  1. nevi, cherry angioma, epidermoid cyst
98
Q

Malignant nodular lesions

99
Q

Vesiculobollous lesions

A
  1. vesicles and bullae

2. impetigo, herpes, pemphigus

100
Q

Maculopapular lesions

A
  1. macules, papules

2. viral exanthems, drug eruptions

101
Q

Beau’s lines

A

transverse depressions in nail secondary to trauma or acute illness

102
Q

Onychocryptosis

A

ingrown nail, nail grows into dermis, can be infected

103
Q

terry’s nails

A

mostly white with a distal band of reddish brown

“ground glass” appearance

104
Q

leukonychia

A

trauma caused white discoloration

105
Q

koilonychia

A

spoon nail

Clinical Medicine I (25 decks)

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