The whole thing Flashcards
What classifies isolated systolic hypertension?
Systolic BP >140, diastolic BP <90
At what temperature does someone have hyperpyrexia?
Above 106 F or 41.1 C
At what temperature does someone have hypothermia?
Below 95 F or 35 C
What is the near reaction?
Pupillary constriction when looking at close objects and dilation when looking at far objects
What is horizontal defect?
Occlusion of a branch of the central retinal artery that causes loss of half of field of vision
What is damaged in blind right eye?
Right optic nerve
What is bitemporal hemianopsia?
Loss of outer fields of vision in both eyes (problem with optic chiasm where nerves cross to opposite hemispheres)
Homonymous hemianopsia
Same half of field of vision is lost in both eyes (problem with optic tract, after optic chiasm)
Homonymous quadrantopsia
Loss of same quadrant of visual field in both eyes
What is dysconjugate gaze?
Eyes don’t move in the same direction
What’s nystagmus?
Rapid oscillation of the eyes, normal to be observed during extreme lateral gaze
What’s lid lag?
Immobility of the upper eyelid on downward rotation of the eye
What is Cheyne-Stokes breathing?
Periods of deep breathing (hyperpnea) and apnea
What is Hamman’s Sign?
Precordial crackles synchronous with heartbeat
What are the four features of PMI?
Location
Duration*
Diameter
Amplitude
What’s the grading scale for reflexes?
- No reflex
- Weak reflex
- Normal
- Hyperreflex
- Clonus
What is the grading scale of murmurs?
- Very faint
- Faint, but heard with stethoscope
- Loud
- Loud and palpable thrill
- Loud and audible with only part of stethoscope on chest
- Audible without stethoscope
What is the grading scale for edema?
- 1-3 seconds for pitting to go away
- 4-6 seconds for pitting to go away
- Longer than 6
- Doesn’t go away or something like that
What causes the S3 heart sound?
Decreased compliance of the ventricles, rapid deceleration of blood entering the ventricles
What causes the S4 sound?
Atrial contraction
What is pulsus alternans?
When pulse rhythm is normal but force of arterial pulse alternates between strong and weak, most often due to left-sided heart failure
What is paradoxical pulse?
3-4 mmHg drop in systolic BP during inspiration
What is the Allen test?
Tests patency of the ulnar artery.
Have patient make a tight fist, then compress both ulnar and radial arteries. Have patient relax hand, and release the ulnar artery. If patent’s ulnar artery is patent, 3-5 seconds later the hand flushes.
What does the Trendelenberg test assess?
Valvular competency in the leg
What is Rovsing’s sign?
Pressing left lower quadrant causes referred pain in the right lower quadrant - test for appendicitis
What is an obturator sign?
Pain during flexion and internal rotation of the hip - test for appendicitis
What is cutaneous hyperesthesia?
Pain when lifting skin of abdominal wall
How do you test for acute cholecystitis?
Look for Murphy’s Sign - hook fingers of hand under costal margin, ask patient to breathe in
Pain/tenderness at a certain point of inspiration is a positive Murphy’s sign
What is Tinel’s sign?
Pins and needles when tapping over area of palm innervated by median nerve
What is Phalen’s sign?
Tingling or numbness when hands fully flexed against each other
What nerve roots comprise the sciatic nerve?
L4-S3
What abnormalities are present in goudy arthritis?
Painful swelling of the MTP joint of the big toe, extending to the ankle, tarsal joints, and knee
What is hallux valgus?
Lateral deviation of the big toe, more common in women
What is Morton’s neuroma?
Tenderness over plantar surface of the 3rd and 4th metatarsal heads and associated numbness or pain
What nerve roots are involved in biceps reflex?
C5, C6
What nerve roots are involved in triceps reflex?
C6, C7
What nerve roots are involved in abdominal reflex?
T8-10 upper, T10-T12 lower
What nerve roots are involved in knee reflex?
L2-L4
What nerve roots are involved in ankle reflex?
S1
What nerve roots are involved in plantar reflex?
L5, S1
What is Brudzinki’s sign?
Hip and knee reaction on neck flexion
What is Kernig’s sign?
Discomfort behind the knee on extension
How is asterixis tested?
Have patient outstretch arms and extend hands, holding for 1-2 minutes. Twitching of hands = asterixis, indicating problem with diencephalic motor centers of brain