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Advanced Health Assessment > Quiz 3 > Flashcards

Quiz 3 Flashcards

1
Q

correct position for prostate exam

A

Sims (side lying) position

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2
Q

digital rectal/prostate exam, what area of prostate palpating?

A

posterior aspect

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3
Q

what should normal prostate feel like

A

rubbery and smooth

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4
Q

how do you know rectal prolapse

A

see sliding of rectum, especially when straining during BM or bearing down

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5
Q

external hemorrhoid appearance

A

external= small mass, PINK or red/beefy normal. Purple/dark is concerning (thrombos hemorrhoid) and is more urgent, need hemorrhoidectomy

pts will feel like they’re sitting on something

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6
Q

internal hemorrhoid feeling/sx

A

blood in stool
rectum= soft mass inside/protrusion. Patient may feel like “grapes” are inside

HARD= concern

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7
Q

causes of rectal bleeding

A
  • hemorrhoid
  • cancer (change in bowel habits, pain, blood) need f/u
  • fissures (from constipation, etc)
  • colitis/inflammation/infection of bowel (Crohn’s, c-diff, etc. bleeding to be expected)
  • GI bleed (lower= bright red, upper= black/tarry)
  • medications (NSAIDs, ASA)

Tylenol, iron, thyroid supp. DO NOT cause bleeding

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8
Q

sequence of MSK exam

A

inspect, palpate, passive then active ROM, stability tests, specialized tests

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9
Q

normal changes with aging in MSK

A

-joint stiffness pain
-osteoarthritis risk
-increased bone resorption so not as much surface area= instability
decreased ROM

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10
Q

joint symmetry technique

A

INSPECT and compare both sides

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11
Q

assess for joint effusion

A

palpate
soft, spongy feeling

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12
Q

Tinel test

A

It is performed by lightly tapping (percussing) over the nerve on ulnar side to elicit a sensation of tingling or “pins and needles” in the distribution of the nerve.

Tells you if medial nerve is involved in carpal tunnel

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13
Q

Phalen test

A

inverse praying hands, if pt gets tingling then= compression of carpal tunnel nerve

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14
Q

Lachman test

A

stability testing that looked for ACL tear

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15
Q

characteristics of osteoarthritis

A

heberden nodes
distal joints
enlarged joints

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16
Q

characteristics of rheumatoid arthritis

A

buchards nodes
proximal joints

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17
Q

risk factors for OA

A

old age
family hx
vitamin D deficiency
smoking
obesity
previous joint injury (runners, overuse)

DECREASED risk w/ more active lifestyle (nonimpact,
not overuse bc overuse=risk)

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18
Q

tests that will look at meniscus

A

MRI
McMurrays

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19
Q

McMurray

A

internal & external rotation of knee to see if any laxity to test for meniscus tear

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20
Q

infant test for hip displasia

A

ortolani and barlow tests

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21
Q

dx plantar faciitis

A

pain to base of heel, bottom of arch
pain worse in MORNING before stretch ligament then worse right at night before bed

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22
Q

tests for rotator cuff tear

A
  1. Neers test (raise arm=tingling/pain)
  2. drop arm test (no strength to hold arm up against gravity)
  3. Hawkin’s test (can barely push against resistance when abduct shoulder)

decreased ROM
traumatic or atraumatic
reduced strength

tx= sling, rest, ROM/PT, maybe surgery

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23
Q

sx spinal stenosis

A

*pain w/ walking and standing upright

24
Q

OA vs RA

A

OA= joint enlargement, localized weakness

RA= not overuse injury so doesn’t improve if rest joint, atrophy of muscles

25
Q

scolioisis dx

A

bend over and look for lateral curvature of spine

when standing upright, shoulders will be uneven

26
Q

red, swollen joint dx

A

infection (septic arthritis) vs gout

mobility is biggest difference. infection will COMPLETELY inhibit ROM, gout will be painful but will still move

SV fluid tap is most definitive to dx infection

27
Q

gout

A

distal, small joints
uric acid

28
Q

shoulder injury tests

A

empty can test (adduct test, thumbs down, reduced strength)
drop arm test
hawkins (abduct)

29
Q

strength grading

A

0-5

  • 0= no movement (paralysis)
    1= movement but just flicker of muscle
    2= movement not against gravity
    3= movement against gravity
    4= weakness against resistance
    *5= full strength against resistance
30
Q

ROM positions

A

flexion= towards body
extension= out from body
abduction= away from body
adduction= toward body
supination= upward (palms up)
pronation= downward

31
Q

goals sports physical

A

risk of injury

CV (*murmur), MSK (bones/joints), *sensory (vision, hearing etc), congenital anomalies

NOT looking for= Nose, throat, focussed. (PND etc)

32
Q

functional assessment older adult

A

ADLs (can they perform?)
make sure living conditions compatible with physical ability
GROSS motor movement not strength

DONT care about- able to move heavy boxes, etc. only basic ADLs

33
Q

normal gait for older adult

A

slower, balance, field shoulder width apart, regular arm swing, even step

NOT shuffling

34
Q

neuro sequence

A

NO auscultation, palpation, percussion

*inspect & special tests
#1 mental status, CN (2-12), sensation (upper/lower), strength (upper/lower), coordination (rapid alt. movements), reflexes, gait, skull & spine general inspection

35
Q

CN

A

1= sensory (olfactory- smell something)
2= sensory (optic nerve- visual acuity/confrontation)
**3= motor (medial up/lateral down EOM)
**4= motor (trochlear (down/medial) EOM)
5= both motor/sensory (trigeminal- face sensation and chewing)
**6= motor (abducens, LATERAL*, EOM)
*7= both (facial nerve taste, motor *smile, raise eyebrows)
8= sensory (auditory)
9/10= both (gag reflex (not in awake adult), glossopharyngeal, vagus, uvula rises, swallowing, taste)
**11= motor (shoulder shrug, accessory)
12= motor (turn head against resist, hypoglossal move tongue side to side)

36
Q

normal/abnormal neuro in aging

A

normal= sensory deficits (touch, taste, hearing, eyesight)

abnormal= motor and cognition deficits

37
Q

testing equilibrium

A

*Romberg= stand w/ eyes closed, feet together, arms by side
should be able to keep balance without swaying

38
Q

DTRs

A

upper= bicep, brachioradialus, tricep

lower= patellar, ankle

39
Q

deficit in lumbar spine, where decreased DTR?

A

patellar

40
Q

deficit in cervical spine where decreased DTR?

A

higher cervical= tricep/bicep
lower= brachioradialus

41
Q

dermatome levels

A

sensory test & if concerned about CNS; most often unilateral

thumb= C6 radial aspect
2nd/3rd (middle) fingers= C7
ring finger/pinky= C8

42
Q

proprioception-what is it and how to test

A

awareness of body position in space
have person close eyes, you move their toe up/down and see if they know position

43
Q

graphesthesia

A

type of proprioception test
draw in palm and pt tells you what you drew

44
Q

stereognosis

A

type of proprioception test
ID object in hand

45
Q

2 point discrimination

A

how long it takes to feel two different points

46
Q

concerning findings meningitis

A

neck pain
unable to touch chin to chest (*nuccal rigidity)
fever
n/v
HAs
altered mental status
kernig sign= lay flat, lift leg causes pain in neck
brudzinski sign= can’t flex knees and neck at same time, wont be able to, so lay flat lift head up and they will try to bend knees

47
Q

straight leg test

A

spinal stenosis with radiculopathy (irritation of nerve root)
lumbar root irritation

lay flat, lift leg up, shooting pain down other side

48
Q

tension HA

A

band like, tight, across head, squeezing

49
Q

migraine

A

unilateral, n/v, photophobia, stabbing, throbbing, pulsing

50
Q

cluster HA

A

behind one eye, severe pain, lacrimation

51
Q

parkison’s s/s

A

shuffling gait
pill rolling finger movements
tremors

52
Q

altered MS change older adult

A

*** have to r/o organic causes of altered mental status changes older adult (metabolic etc)

dementia r/o comes after

53
Q

reflexes in pediatrics

A

normal= babinski (toes flare/opposite for adult), rooting reflex (stop 4 months), startle reflex

54
Q

sequence of physical exam

A

head to toe
document by system

55
Q

best way to get dx ddx

A

subjective & objective data, come up with dx and ddx, THEN order tests that confirm/refute, use test results to make ultimate dx

56
Q
A

Advanced Health Assessment (3 decks)

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