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Summer Final PDNA > Quiz Number 2 And Things Like It > Flashcards

Quiz Number 2 And Things Like It Flashcards

1
Q

What is the proper order technique to examine the abdomen?

A

Inspection, auscultation, percussion, palpation

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2
Q

Things to looks at on inspection

A

Overall appearance

  • contours, bulges
  • movement: peristalsis, pulsation
  • skin
  • umbilicus
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3
Q

What information does auscultation provide us with

A

Bowel motility

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4
Q

What do you always do before percussion/palpation and why

A

Auscultation

-if you start palpating you might mess up the bowel sounds

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5
Q

Normal bowel sound on auscultations

A

5-34 clicks and gurgles per minute

Borborygmi

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6
Q

Changes of bowel movements and auscultation

A

Any type of illness (inflamamtion;l diarrhea, etc)

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7
Q

Bruits on auscultation of bowel

A

Noticeable in HTN or some blockage, turbulent flow

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8
Q

Friction rubs on aucultation of bowel

A

Liver and spleen

-can happen in infection, cancer, infarction around these organs

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9
Q

What information does percussion tell us

A

Amount of distribution of gas in the abdomen and viscera

  • masses (solid, fluid filled)
  • size (liver, spleen)
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10
Q

Tympany vs dullness on percussion of abdomen

A

Left side with by tympani and the right side will have dullness

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11
Q

Palpation tells us what information

A
  • tenderness
  • muscular resistance (infection, guarding)
  • masses and superficial organs
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12
Q

Light palpation

A
  • one hand and forearm on horizontal plane
  • fingers together and flat
  • palpate with light gentle dipping motion
  • raise it just off the skin as you switch to the next quadrant
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13
Q

Deep palpation

A
  • two hands and forearm on horizontal plane
  • fingers together and flat
  • palpate with deep gentle dipping motion
  • raise it just off the skin as you switch to the next quadrant
  • this lets us detect liver edge, kidneys, abdominal masses
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14
Q

Percussion of the liver

A

We can get an estimate of the size of the liver this way

  • measure vertical span of liver dullness in right midclavicualr line
  • light moderate percussion
  • start under umbilicus in RLQ percussing upwards
  • stop at midclavicualr line where the border is
  • move from nipple line downward
  • stop at midclavicualr line again finding upper border
  • measure distance between the two points
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15
Q

Normal liver on palpation

A

Soft, sharp, regular with a smooth surface

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16
Q

Hooking technique for palpating the liver

A

Used in obese

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17
Q

Dullness of percussion of spleen

A

Positive plenty pressure sound

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18
Q

How common is it to be able to palpate the spleen?

A

Not very

Only 5% of adults can you feel it on

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19
Q

When is the spleen more palpable

A

When there are abnormal findings

-8x more likely if palpable

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20
Q

When should you be able to palpate a normal bladder

A

Only if bladder is disenteded

Cannot feel the bladder in normal people

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21
Q

Risk factors for AAA

A

Males
Smokers
>65
First degree relative

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22
Q

Palpating the aorta

A

Identify aortic pulsation and width of aorta

23
Q

Normal width of aorta

A

3cm wide

24
Q

Findings suggestive of AAA

A
  • periumbilical/upper abdominal mass
  • expansile pulsation
  • > 3cm: as AAA increases, palpation pain increases
  • > 4cm: risk factors + pain= 15x more likely with a 85-90% mortality rate
25
Q

Distribution of tension type HA

A

Band across forehead, down the back of the neck

Constant pain

26
Q

Distribution of migrain type HA

A

Unilateral

Irregular pattern with variable remission periods

27
Q

Distribution of cluser type HA

A

Multifocal, vascualrity
Could be right around the eye
Occur in several daily bouts with long remission periods

28
Q

Sound enters the external acoustic meatus and vibrates the

A

Tympanic membrane

29
Q

Vibration is transmitted by the tympanic membrane to the

A

3 ossicles in the middle ear

30
Q

The sound wave is detected by specialized sensory neurons in the

A

Cochlea

31
Q

Otitis externa

A
  • canal is often swollen, narrowed, moist, pale, and tender. It may be reddened
  • in chronic otitis externa, the skin of the canal is often thickened, red, and itchy
  • pain experienced during inspection and manipulation of the article or tragus is associated with inflammation/infection of the external ear
32
Q

Nontender nodular swellings covered by normal skin deep in the ear canals

A

Suggests exostoses

-these are nonmalignant overgrowths which may obscure the ear drum

33
Q

Tympanic membrane is retracted

A

Appears bowed inward toward, ossicles more prominent than normal
-associated with blockage of Eustachian tube

34
Q

Membrane is bulging externally

A

Indicates increased pressure/material in middle ear, such as excess serous fluid, infection, pus build up

35
Q

Color changes in the tympanic membrane

A
  • amber or yellow color suggests serous fluid build up
  • white suggests infection
  • red suggests blood in the middle ear
  • all assocauted with otitis media
36
Q

Perforation of the tympanic membrane, often followed by closure and scarring are associated with

A

Otitis media

37
Q

What shape is the tympanic membrane in otitis media

A

Convex

38
Q

Frequency specific hearing loss

A

Age related loss if high frequency sensitivity suggests selective loss of hair cells in cochlea

39
Q

Generalized hearing loss

A

Not frequency specific
Can originate from pathology at various levels: external ear, middle ear, non specific damage to hair cells across cochlea

40
Q

Unilateral hearing loss

A

Localization from external ear to ipsilateral medial (auditory nucleus). Lesions further along auditory pathway in the brain do not result in unilateral deafness

41
Q

Sensorineural vs conductive hearing loss

A

Sensorineural hearing loss involves cochlea or neurological pathology.

Conductive hearing loss is a problem involving tympanic membrane and ossicles.

Can be distinguished using the Rinne test or Webers test, involving a tuning fork

42
Q

Transillumination of sinuses is used to detect

A

Obstruction, inflamamtion, infection

  • if these are present, there will be less transillumination
  • dull=reduced transillumination
  • opaque=no transillumination
43
Q

Normal vs abnormal tonsils

A

Can be large without pathology
Suspicious is they are displaced such that the uvula deviates
Also note if posterior pharyngeal surface protrudes into pharynx
Must depress the tongue to see epiglottis

44
Q

Where is the thyroid situated

A

Between the cricoid cartilage and the sternum

45
Q

To locate and palpate the TMJ

A

Place the tips of the index fingers just in front of the tragus of each ear and ask the patient to open their mouth. The fingertips should drop into the joint spaces as the mouth opens

46
Q

What are we checking for when looking at the TMJ

A

Smooth range of motion; note any swelling or tenderness

Snapping or clicking may be felt or heard in normal people

Swelling, tenderness, reduced ROM indicates inflammation or arthritis

Chronic pain is associated with HA and stress

Pain during chewing occurs with local pathology: trigeminal neuralgia, temporal arteritis

47
Q

Forward flexion of spine

A

The lumbar concavity should flatten out

48
Q

Bony landmarks for tenderness/pain/swelling for shoulders

A

Acromion
Acromioclavicualr joint
Coracoid

49
Q

Bony landmarks for tenderness/pain/swelling for the elbow

A

Olecranon process, ulna
Epicondlyes of humerus
Assessing for bursitis or artheritis

50
Q

Bony landmarks for tenderness/pain/ swelling for wrist and hand

A
  • radius and ulna at the wrist
  • carpal bones and MCP, PIP, DIP joints
  • anatomic snuffbox (between 2 tendons of thumb
51
Q

Bony landmarks and bursa for tenderness/pain/swelling for the hip

A
  • inguinal ligament (region) for inguinal lymph nodes
  • bursa: trochanteric bursa, ischigluteal bursa

GREATER TROCHANTER

52
Q

Bony landmarks and bursa for tenderness/pain/swelling for knee

A
  • femoral epicondyles
  • medial and lateral collateral ligaments
  • patella, tibial tuberosity, insertion of patellar tendon to tibia
  • bursa: trochanteric bursa, ischiglureal bursa
53
Q

Bony landmarks and bursa for tenderness/pain/swelling for ankle and foot

A
  • anterior surface of ankle joint
  • medial and lateral malleolus
  • metatarsophalangeal joints and compress squeeze forefoot
  • heads of the metatarsals and spaces between them

Summer Final PDNA (6 decks)

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