Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Examination > Procedures > Flashcards

Procedures Flashcards

1
Q

Lumbar punture contraindications

A

Raised ICP
Back infection or contamination
Back malformation or surgery
Anticoagulation / antiplatelet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Landmarkings for lumbar puncture

A

Supracristal plane - Spinous process of L4 should be marked.
Intervertebral space of L4
Insert 90 degrees, slightly cranial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Lumbar puncture measurements

A

Measure pressure
3x tubes:
Micro for cell count, serology and culture
Biochem for protein and glucose, cytology
Immunology for antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

DPL - contraindication

A

Existing need for laparotomy
Previous abdominal operations, morbid obesity, advanced cirrhosis, coagulopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

DPL - indication

A

To facilitate diagnosis of intra-abdominal perforation or bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

DPL results indicating need for surgery

A

> 10ml frank blood or obvious enteric contents on aspirate
100000 RBC
500 WCC
+ gram stain for bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Complications of DPL

A

Haemorrhage secondary to skin incision - false positive
Intestinal perforation
Laceration of bladder
Injury to other abdominal structure
Wound infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Paracentesis location

A

USS + percuss out
Aim 2cm below umbilicus, 5cm superior and medial to ASIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Complications of paracentesis

A

Failure
Leak
Infection
Haemoperitoneum
Perforation of hollow viscous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pericardiocentesis location

A

1-2cm inferior and to the left of xiphochondral junction
Advance towards tip of left scapula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Complications of pericardiocentesis

A

Aspiration of ventricular blood
Lac ventricular myocardium
Laceration of coronary artery or vein
New haemopericardium
VF
Pneumothorax
Puncture of great vessels and worsening tamponade
Puncture of oesophagus and mediastinitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

LA doses

A

Ropivocaine 0.75% - 2mg/kg
Marcaine 0.5% - 3mg/kg
Lignocaine 1% - 4mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Landmark for intercostal nerve block

A

Angle of the rib, 6-8cm from the spinous process, inject below rib, aiming for NV bundle.
Inferior scapula = 7th rib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

SPC insertion contraindications

A

Previous lower abdominal / pelvic surgery
Anticoagulation
Bleeding risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Process of SPC insertion

A

LA 2 fingers above PS
Insert spinal needle with syringe, caudally
Aspirate until urine flows, advance 1cm further
Remove syringe, place guidewire
Remove needle
Skin nick
Dilator
Guidewire out, trochar out
Catheter in, aspirate urine
Inflate balloon with 10ml sterile water
Peel away tube
Attach urine bag, monitor UO
Document, dispose of sharps in sharp bin
Change at 3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Process of SPC insertion

A

LA 2 fingers above PS
Insert spinal needle with syringe, caudally
Aspirate until urine flows, advance 1cm further
Remove syringe, place guidewire
Remove needle
Skin nick
Dilator
Guidewire out, trochar out
Catheter in, aspirate urine
Inflate balloon with 10ml sterile water
Peel away tube
Attach urine bag, monitor UO
Document, dispose of sharps in sharp bin
Change at 3 weeks

17
Q

Process of SPC insertion

A

LA 2 fingers above PS
Insert spinal needle with syringe, caudally
Aspirate until urine flows, advance 1cm further
Remove syringe, place guidewire
Remove needle
Skin nick
Dilator
Guidewire out, trochar out
Catheter in, aspirate urine
Inflate balloon with 10ml sterile water
Peel away tube
Attach urine bag, monitor UO
Document, dispose of sharps in sharp bin
Change at 3 weeks

18
Q

Femoral nerve block landmark

A

Lateral to femoral artery
Midpoint ASIS and pubic tubercle, then 2cm lateral and 2-3cm below this
2 clicks - skin and sheath

19
Q

Intravascular injection of local

A

CNS - circumoral paraesthesia, tinnitus, tremor, decreased LOC, seizure
CVS - decreased BP, arrhythmia

20
Q

Saphenous vein cutdown landmarking

A

2cm anterior and superior to medial malleolus

21
Q

Complications of saphenous vein cutdown

A

Haematoma
Phlebitis
Cellullitis
Saphenous nerve division - loss of sensation to medial aspect of foot
Thrombosis
Embolism

22
Q

NG insertion length

A

Measure from tip of nose, to ear lobe, then to just below the xiphisternum

23
Q

How to confirm positioning of NG

A

Tube aspirate gastric contents
Tube aspirated pH below 5
CXR
Capnography

24
Q

Contraindications to NG insertion

A

Base of skull fracture
Mid face trauma
Choanal atresia
Recent nasal / adenoid surgery
Oesophageal atresia
Oesophagectomy
Caustic ingestion

25
Q

Breast FNA - Risks

A

Infection
Haematoma
Repeat FNA / biopsy
False negative

26
Q

Breast FNA - procedure

A

Consent, hand hygiene, introduce etc
Prep skin
Fix lump between thumb and finger of one hand
Use 25G needle and insert into lesion, pass back and forward at multiple trajectories, no need for syringe
Attach syringe with 10ml air
Gentle express needle contents onto slide
Use other slides to smear sample
If not enough - use 21G needle again

27
Q

Digital extensor tendon splint

A

Apply for extensor tendon injury
Long aluminium splint with foam
Apply to dorsal aspect of digit over hand and wrist
Tape before and after it crosses each joint

28
Q

Mallet splint application and management

A

Patient lying flat on table
Slip mallet splint over
Tape proximal end around finger

Can bath and shower with it on
Afterwards - rest hand flat on table next to sink
Slip splint off and sponge wash hand while keeping it still
Replace and tape

Needs to be on for 6 weeks
Will review in clinic with hand therapist and repeat XR

29
Q

Cervical collar application

A

Measure from trap to angle of jaw
Place back on first and then front
Secure

30
Q

Arthrocentesis general procedure

A

Skin prep
22G needle and syringe with LA
18G needle and 30ml syringe with aspirate
Wash hands + gloves

31
Q

Knee arthrocentesis procedure

A

Position supine, knee flexed slightly with towel underneath
Needle placed at superolateral aspect of patella heading into joint space

32
Q

Shoulder arthrocentesis procedure

A

Position: sitting
Needle placed inferolateral (~1cm) to coracoid process heading into joint space
Direct needle posteriorly toward glenoid rim

33
Q

Wrist arthrocentesis procedure

A

Position sitting, wrist resting on towel roll on the table face down
Needle placed distal to Lister’s tubercle (radius), ulna to EPL

34
Q

1st MTP arthrocentesis

A

Foot on bed, knee flexed
Needle placed medial to EHL on dorsal aspect, towards joint space which is opened up by applying axial traction (pull on the big toe)

35
Q

Femoral nerve block losses

A

Loss of anterior-medial thigh and medial leg and medial malleolus sensation
Loss of quadriceps, pectineus and psoas muscles
Loss of hip joint sensation

36
Q
A

Clinical Examination (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions