Special Exams-PE

Question 1

special procedure for blood pressure

Answer 1

Orthostatic hypotension-the “tilt” test

pg 131

Question 2

How to perform orthostatic hypotension test

Answer 2

two positions:
supine-after pt is resting for 3-10 min
standing-within three minutes

Question 3

what is considered positive on orthostatic hypertension?

Answer 3

within 3 min after standing:

drop of systolic pressure > 20 mmHg
OR
drop in dyastolic pressure > 10 mmHg

Question 4

Causes of orthostatic hypotension

Answer 4

drugs
moderate to severe blood loss
prolonged bed rest
and diseases of the autonomic nervous system

Question 5

Define strabismus

what is the special procedure to confirm this condition?

Answer 5

corneal reflections are asymetric (cross-eyed)

cover-uncover test
pg 278

Question 6

what is the condition where a dysconjugate gaze is deviated medially?

Answer 6

Estropia

Question 7

What is the condition where a dysconjugate gaze is deviated laterally?

Answer 7

Extropia

Question 8

what happens to the estropic eye when the normal gazed eye is covered in the cover-uncover eye?

what happens to the covered eye?

Answer 8

moved outward to fix on the light

moves inward to same degree

eyes will return to normal (for patient) when uncovered.

Question 9

special procedure for the head (section)

Answer 9

HEENT

Head-none
eyes-cover-uncover
ears-Webber and Rinne
nose-transilluminate and percuss frontal and maxillary sinuses
throat (and mouth)-palpation of tongue, lips buccal mucosa and floor of mouth.

Question 10

special test for suspected sinusitis?

Answer 10

transilluminate and percuss frontal and maxillary sinuses

Question 11

special test for lesion in mouth

Answer 11

palpation of tongue, lips, bucccal mucosa and floor of mouth.
(pg 256)

Question 12

special test for unilateral hearing loss?

Answer 12

Weber and Rinne

bates 247-248

Question 13

what type of hearing loss does the Weber test determine?

Answer 13

differentiating sensorineural loss
or
conductive loss

Question 14

type of hearing loss:

Sound is heard through bone as long as or longer than through air?

Answer 14

conduction hearing loss

Question 15

type of hearing loss:

sound is heard longer through air than through bone.

Answer 15

sensorineural hearing loss

Question 16

special procedure for pulmonary consolidation

Answer 16

transmitted voice sounds:
egophony
bronchophony
pectoriloquy
(pg 326-27)

Question 17

egophony

Answer 17

“ee” sounds like “A” and has a nasal bleating quality

Question 18

broncophony

Answer 18

“ninety-nine” is muffled and indistinct.

Question 19

pectoriloquy

Answer 19

whisper “ninety-nine” or “one-two-three”

sounds normally heard faintly and indistinctly

Question 20

special test if CHF suspected

Answer 20

jugular venous pressure and pulses
(pg 374-77)

Hepato-jugular reflux

Question 21

special test for arterial insufficiency in the arm or hand?

Answer 21

Allen test

Question 22

What example is given for the use of the Allen test?

Answer 22

assess arterial patency for blood samples

Arterial Blood Gas (ABG)

Question 23

special test for acites

Answer 23

fluid wave
shifting dullness

(pg 484-485)

Question 24

special test for appendicitis

Answer 24

McBurney
Rovsing
Psoas
Obtorator

(pg 485 - 486)

Question 25

evaluation for cholecystits?

Answer 25

Murphy’s sign

Question 26

Supraspinatus strength test?

Answer 26

empty can test

Question 27

supraspinatus strength (alternative to empty can test?

Answer 27

resisted raised shoulder abduction

Question 28

Infraspinatus and teres minor strength

Answer 28

elbows at side and flexed 90 degrees with thumbs up

provide resistance and the pt presses the forearms outward

Question 29

subscapularis test

Answer 29

internally rotate shoulder to low-back region and provide resistance against your pushing against their arm.

Question 30

test for inflammation of the long head of biceps tendon and possible rotator cuff tear

Answer 30

Forearm supination test:
flex forearm to 90 degrees
pronante patients wrist
provide resistance when pt supinates

Question 31

What is the drop arm sign?

Answer 31

rotator cuff tear:

abduct arms to 90 degrees and lower it slowly… if it drops=possible inflammation or rotator cuff tear.

Question 32

What is the Neer’s impingement

Answer 32

rotator cuff tear (pg 654)
hand on scapula, raise arm ,

compresses the greater tuberosity against the coracoacromial ligament

Question 33

What is the Hawkin’s impingement

Answer 33

flex shoulder and elbow to 90 degrees with palms facing down.
one hand on the forearm and one on the arm. rotate arm internally. (pg 654)

Question 34

apley scratch test

Answer 34

pt to touch opposite scapula
superior motion= abducition and external rotation
Inferior motion- tests adduction and internal rotation

rotator cuff or adhesive capsulities

Question 35

test to show medial or lateral meniscus tear?

Answer 35

McMurray test (pg 689)

Question 36

what test will show ligamentous laxity and a partial tear of the medial collateral ligament?

Answer 36

Abduction (or Valgus) Stress Test

Question 37

What test will show ligamentous laxity and a partial tear of the lateral collateral ligament?

Answer 37

Adduction (Varus) Stress Test

Question 38

What test will show ACL tear?

Answer 38

Anterior drawer sign

Question 39

What test will show PCL tear?

Answer 39

posterior drawer sign

Question 40

What is the Lachman’s test?

Answer 40

ACL tear

Question 41

Carpal Tunnel Tests

Answer 41

Thumb abduction test
Tinel’s sign
Phalen’s sign
Thenar atropy

Question 42

Test when meningitis or subarachnoid hemorrhage suspected

Answer 42

Bruzinski’s and Kernig’s signs

Question 43

Bruzinki’s sign

Answer 43

flexion of neck when patient is supine (pg 765)

Question 44

Kernig sign

Answer 44

patient supine , slowly extend leg up and straighten knee (pg 765)