Second Year Flashcards
What the intracranial nerves (12)
OOOTTAFVGVAH
and how to test
O- OFACTORY = ask about smell
O- OPTIC = read something, pheriphay vision
O- OCCUMOTER- pearl + accomodation
T- TRIGEMINAL - close eyes feel tongue on face
T- TROCHEAL - up and down
A- ABDUCENCE- side 2side
F- FACIAL fast
V- Vestibular - hearing
G- GHLOSPHARYGEAL - swallow
V - VAGUS - aaahhhh
A- ACCESSORY - neck arms
H- HYPIGLOSSAL - tongue wiggle
What are the test for appendicitis and how to conduct
Rosvnghs - rebound tenderness
Muphys - 1/3 rd up
Posowas - right leg raise
Obtorators sign - 90° internal rotation
Cough
Jumping - kids
What is the TST algorithm ( major incident)
- how to conduct
Waking - yes (p3)
Cat hem - yes (P1)
Talking then check
Penetrating torso - (yes P1)or (no = P2)
Not talking - breathing ( yes p1) no = dead
What is IO - what is the basic landmark for IO in WMAS
Intraosiois access - drilling into bone marrow -non collapsible vein.
2) humerous head, proximal tibia and distal femur ( Peds only)
What is the indication for IO
Emergency access - 2× failed IV or Impossible to IV
What are the conta indicator for Io
Bone disease
Infection - limb - cellulitis
Insertion in same site within 48h
Prosthetics
What is the procedure of location and insertion of proximal humorous io
1) location - internal rotation of arm so thumb point down or palm out or 2) arm across abdomen
2) find the greater tomberocity - side of hand in armpit grove other on end or arm bone - feel arm where your thumbs meet - lumpy bit is tumberocity
3) site is 1cm up and 3 cm towards chest
4) insert @45 degree angle
5) rotate - arms thumbs 1cm 3 cm 45 degrees
How do you find and insert a proximal tibia IO and angle
Find knee cap
4cm down - 2cm towards inner
90 degrees
What size io needed for different sites in the body
Red - max 40kg
Blue - 3kg + (kid and majority of adults)
Yellow - 40kg + ( large adult + p
How does a clinican confirm placement of an Io
Aspirating bone marrow - 5ml
Flush with saline - 10-20ml ( shouldn’t tissue
What is the procedure of IO insertion and prep
1) gather equipment
2) prime 3 way tap
3) select correct needle
4) locate correct placement
4)insert till bones felt
5) 5mm ( black line) visable - correct sizing
5) drill - till pop/ give felt
6) confirm placement - aspirate + flush
What are the contraindications or IV
Infection
Fractures
Previous iv sites
?stroke sides as poor blood flow
What are the different site availability for IV
Hand
Forearm - houseman / Celicac
ACF
What are the different IV sites ( based on colours
20 - pink
18 - green
16- gray
14 - oranges
How does a clinician do an IV
1) apply tourniquet
2) find vein - bouncy - not on joint, spliter or an artery (check pulse)
3) clean
4) put bleed sheet underneath - white up
5)prep cannula
6) insert max 30 degree angle
7) observe primary flashback
8) push 2mm further
9) retract needle - observe secondary flashback
10) advance
11) hold vein above cannula and cap off
11) flush for patiently
How do you test for temporal arthritis
Scalp tenderness
On the hand to neck assesment - hand = what to look 4 and what it means
Clubbing
Warmth
CBR
Splinter hemorrhage
Leiconchia - smooth nail
Tabacco staining
Skin togure
What is the advance assesment for respiratory
Bronchophony - 99 ( increased - tissue destityor decrease -fluid or air outside lung
Ephonly - say e will sound like A if consolidation present
Whispered pectoriy - whisper something in consolidate this will sound loud and clear
Tactile frepitus - 99 put hand ulner in-between ribs - consolidation present = feel vibration
Axaisis - flapping tremor
What are the advance assessment for cardiac and to conduct them and what do they mean
- Collapsing pulses - feel radial and brachial at same.time ( aerotic regurgitation)
- Apex beat ( ventricular hypertrophy)
- Heave( hypertrophy)
- thrills over heart valves
- Auscultation of the valves ( aerobic stenosis)
What is are the test for an appendicitis - 5 signs
Rosvibgs sign - left side causes right pain
McBurney point - 2/3rd up
Psoas sign - lift leg against resistance
Obturator sign - flex knee internal rotation
Blumbergs ( deep plapation and release = pain increase on release )
What is are the test for an appendicitis -
4 signs
Rosvibgs sign - left side causes right pain
McBurney point - 2/3rd up
Psoas sign - lift leg against resistance
Obturator sign - flex knee internal rotation
If you hear stridor on auscultation what does it mean and what should you do
Inspiratory noice - airway obstruction
Adjunct, repositioning and clear airway
Crackles and wheezing on inspiration is indicative of
Crackles - a body of substance is on. The lungs
Wheeze is - bronchoconstriction
? Aspiration pneumonia ( blood or vomit or fluid)
What are DDANISH symptoms ( neurological )
Signs for cerebella legions
Dysdiadochokinsea( Incontrol flipping slap hand test)
Dysmetria ( finger to nose test)
Axtaxia (no coordination - unsteady gait)
Nystagmus
Intensional tremor - worsen on movement
speech ( slurred inappropriate or slow)
Hypertonia ( muscle weakness)
What are the 6Fs of abdomen swelling
Fat
Feces
Flatus
Fluid
Fetus
Full grown tumour
What is rombergs test
Tests for balance
Conducted by : standing up feet together, eyes closed see if there is any swaying
What is rebound phenomenon ( neuro)
What does it test for
Eyes closed tell PT to put arms up
Unilaterally press on each are in turn to see if they if there arms go *“above** the start point then we are positive. ( Testes ataxia in upper limbs )
What is tandem gait test ( neuro)
Get pt to walk one foot Infront of each other
To say if they can walk in strait line ( testing ataxia )
How to you complet a needle cricothyroidomy
When is it indicated
1) indicated if you can’t ventilate by any other means
2) locate placement - thyroid cartilage ( divit)
- 14 gage canulla + 10ml syringe
- insert 45 degree angle towards feet
- stop once you hear/ feel pop or give
- aspirate needle
- remove cannula
- apply 3 way tap
- oxygen + auscultate
- 1 second vent / 3 second stop
In which patient can’t you complete a needle cricothyroidtomy
Those under 12YRS old
What are your placements for a needle decompression + what angle
2nd intercostal space next to 3rd rib mid clavicular @ 90 degrees
5th intercostal space next to 6th rib mix axilla @ 90 degree
How do you complete a needle decompression
1) what are the indicators for a needle decompress
1) indicated in PT with air in the pleral space
2) - access placement
- clean site
- 14 gage + 10ml syringe ( remove flashback chamber )
- inset @ 90 degree
- aspirate needle
- remove needle
Secure
- reassess
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