Order of Assessment - correct answer Inspection, Palpation, Percussion and Auscultation. EXCEPT with abdomen
Comprehensive Health History - correct
... [Show More] answer chief complaint, reason for visit, ROS, past medical and surgical history, social history and family history
Pediatric Body measurements - correct answer length, height, weight, head circumference fro birth to 36 months
Normal/Hypertension cut off - correct answer <130 normal 140+ hypertension
Fontanel Closure - correct answer posterior 1-2 months, anterior 9mo-2years
otoscope - correct answer adult-up and back, peds- down and back, using largest speculum that will fit comforably
tympanic membrane - correct answer Cone of light R-5 l-7
EOM testing - correct answer CN III, IV, VI
AP diameter of chest - correct answer 1:2 (AP less than transverse)
barrel chest - correct answer COPD
Flat or Dull percussion - correct answer effusion or pneumonia
normal resonant percussion - correct answer healthy lung
Hyperressonance (percussion) - correct answer trapped air
crackles/rales - correct answer high pitched, discontinuous
Wheezes - correct answer high-pitched whistling or squeaking sounds during inspiration or expiration
Rhonchi - correct answer snoring, rumbling sounds heard upon auscultation of the chest during respiration-low pitched
tactile fremitus - correct answer • INCREASED FREMITUS
- Means there is liquid or solid inside the lungs (consolidation such as with pneumonia)
- Remember Liquid or solid transmits vibrations better than air
• DECREASED FREMITUS
Means air trapping such as with emphysema or bronchial obstruction.
Bronchophony - correct answer the spoken voice sound heard through the stethoscope, which sounds soft, muffled, and indistinct over normal lung tissue, clearer over disease
Egophony - correct answer abnormal change in tone of voice that is heard when auscultating the lungs EE-->AA
UE Arteries - correct answer radial-thumb side, ulnar pinky side
Pulse grading - correct answer 0 absent
1+ weak
2+ normal
3+ increased
4+ bounding
palpate bilaterally
PMI - correct answer point of maximal impulse mid-clavicular and 5th ICS
S1 - correct answer normal, closure of AV, Start of systole, loudest at Apex, contraction of ventricles
S2 - correct answer normal, closure of semilunar, end of systole, loudest at base, filling of ventricles
S3 - correct answer third heart sound (normal in pregnant young adults, and children), gallop
S4 - correct answer extra heart sound, end of diastole, indicative of disease-AFIB
murmur grading scale - correct answer I-Barely Audible
II-Quiet, Clearly Audible
III-moderately Loud
IV-loud, thrill
V-Very loud, can palpate thrill
VI-Very loud, thrill palpable and visible
clubbing - correct answer bulbous enlargement of distal phalanges of fingers and toes that occurs with chronic cyanotic heart and lung conditions
edema scale - correct answer 1+ = disappears rapidly. 2+ = last 10-15 seconds. 3+ = lasts more than one minute. 4+ = lasts 2-5 minutes. These are signs used in what scale?
normal/abnormal findings spleen - correct answer normal=tympanic, dullness could be enlargement not normally felt on exam
Blumberg Sign: Rebound Test - correct answer peritoneal inflammation, hurts more when release from palpation
shifting dullness - correct answer a sign of free peritoneal fluid wherein the dullness of percussion shifts, generally from one side to the other, as the patient is turned from side to side.
Psoas sign - correct answer RLQ pain with extension of right thigh indicative of appendicitis
Obturator sign - correct answer RLQ on internal rotation of right thigh indicative of appendicitis
assessment of hernia - correct answer pt may report a lump. observe pt while lying and standing, hernia may disappear while lying. ask pt to strain or perform Valsalva maneuver and observe for bulging. absent bowel sounds may indicate strangulation.
cardinal signs of Musculoskeletal disease - correct answer pain, erythema, swelling, increased warmth, deformity, loss of function
Scoliosis - correct answer abnormal lateral curvature of the spine
kyphosis - correct answer excessive outward curvature of the spine, causing hunching of the back.
Knock-knee (genu valgum) - correct answer Legs curved inward so knees come together as person walks
bow-legged - correct answer knees too far apart
anatomic snuffbox - correct answer landmark depression on the radial aspect of the dorsal wrist; overlays the scaphoid bone
Impingement Sign - correct answer POSITIVE: pain in the shoulder
INDICATES: overuse injury to the supraspinatus and possibly biceps tendon
Drop Arm Test - correct answer identifies tear and/or full rupture of rotator cuff
Allen test - correct answer determining the patency of the radial and ulnar arteries by compressing one artery site and observing return of skin color as evidence of patency of the other artery
Phalen's sign - correct answer Tingling, numbness, or pain in the fingers within 60 seconds of performing Phalen's maneuver, a diagnostic test for carpal tunnel syndrome
Tinel's sign - correct answer A distal tingling sensation on percussion of median nerve of the inner wrist; characteristic of carpal tunnel syndrome
Drawer Test - knee - correct answer Patient supine, examiner flexes the hip and the knee of the patient's affected leg until the foot is flat on the table. Examiner sits on the foot of thepatient's afectedleg. Examinergrasps behindthe patient'sflexed knee and exerts a pushing and pulling pressure into the affected knee.
+(1) Gapping > 6mm (tibia moves posterior) when the leg is pushed.
+(2) same when the leg is pulled.
INDIC:(1) Torn posterior cruciate ligament.
(2) Torn anterior cruciate ligament.
Confirmation Test: Lachman'sTest
Lachman's Test - correct answer pivot shift test (ACL tear)
Ballottment sign - correct answer medical sign which indicates increased fluid over the patella at the knee joint
Straight Leg Raise Test - correct answer test often performed to determine whether a patient with low back pain has an underlying herniated disk or sciatica
Cerebrum vs cerebellum - correct answer cerebrum-mental status, cerebellum-balance gait
Cranial Nerves - correct answer I. Olfactory-smell
II. Optic-VA
III. Oculomotor-EOM, PERRLA
IV. Trochlear-EOM
V. Trigeminal-facial sensation, chewing
VI. Abducens-EOM
VII. Facial-face actions
VIII. Vestibulocochlear-hearing
IX. Glossopharyngeal-gag, tongue
X. Vagus-ahh
XI. Accessory-raise shoulders
XII. Hypoglossal-ahh
Weber test - correct answer Test done by placing the stem of a vibrating tuning fork on the midline of the head and having the patient indicate in which ear the tone can be heard. conductive in lateral side or sensory in opposite
Rinne test - correct answer hearing test using a tuning fork; checks for differences in bone conduction and air conduction
rinne usually conductive hearing loss
Muscle strength scale - correct answer 0 - no movement
1 - flicker of muscle
2 - joint movement, not against gravity
3 - moves against gravity, not resistance
4 - moves against resistance, but weak
5 - strong against resistance.
*Denominator is always 5.*
*Strength is only tested with "normal" movement*
pronator drift test - correct answer Have pt stretch out arms with palms facing up and close eyes. Positive if one arm goes downward or drifts.
Romberg test - correct answer assesses ability of vestibular apparatus in inner ear to help maintain standing balance
Reflex grading scale - correct answer 0= no response, always abnormal
1+ = diminishes/depressed response, may or may not be normal
2+ = active normal response, normal
3+ = Brisk/exaggerated response, may or may not be normal
4+ = Very brisk/hyperactive: abnormal response, always abnormal
Babinski reflex - correct answer in response to the sole of the foot being stroked, a baby's big toe moves upward or toward the top surface of the foot and the other toes fan out
Position sense (proprioception) - correct answer Passively move the great toe up and down by grasping along the sides of the interphalangeal joint only a few mms. and ask patient which direction you are moving the toe
Reduced perception (including falsely perceived motion) indicates large-fiber disease or DM
Graphesthesia - correct answer ability to recognize writing on the skin purely by the sensation of touch
Sterognosis test - correct answer identifying object with eyes closed
Two point discrimination test - correct answer provides a measure of receptive field size for touch receptors.
Moro reflex (startle reflex) - correct answer Sudden loud noise will cause symmetric abduction and extension of the arms followed by adduction and fl exion of the arms over the body. Disappears by 3 to 4 months.
■ Absence on one side: Rule out brachial plexus injury, fracture, shoulder dystocia.
■ Absence on both sides: Rule out spinal cord or brain lesion.
■ Older infant: Persistence of Moro refl ex abnormal. Rule out brain pathology.
rooting reflex - correct answer a baby's tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple, 3-4 months
palmar grasp reflex - correct answer in response to stroking a baby's palm, the baby's hand will grasp. This reflex lasts a few months gone by 3-4 months
Prostate screening - correct answer Yearly PSA blood test and digital rectal examination starting at age 50 or at age 45 if at high risk
testicular self-examination - correct answer a self-help step in early detection of testicular cancer by detecting lumps, swelling, or changes in the skin of the scrotum, 1 x per month with warm water in shower
breast self-examination - correct answer a self-care procedure for the early detection of breast cancer, raise arms for retraction or dimpling, best done 5-7 days after period
Pap smear test - correct answer microscopic examination of stained cells removed from the vagina and cervix, in order form vag pool, cervical scrape, endocervical
infant milestones - correct answer 2 months - holds up head
4 months - rolls from abdomen to back
7 months - sits alone
9 months - crawls
8 - 15 months - standing with support & walking
neonate - palmer grasp reflex
teething at 6 months
aortic stenosis murmur - correct answer second right intercostal, crescendo-decrescendo
Aortic regurgitation murmur - correct answer early diastolic murmur-high pitched "blowing"
Mitral stenosis murmur - correct answer "early to mid diastolic low pitch rumble murmur best heard at apex in left lateral decubitus position. May also have presystolic murmur."
Mitral regurgitation murmur - correct answer pansystolic murmur, loudest at the apex with radiation to the axilla
MR PASS MVP - correct answer mitral regurgitation, physiologic, aortic stenosis, systolic
MS ARD - correct answer Mitral
Stenosis
Aortic
Regurgitation
Diastolic
AS SAD - correct answer Aortic stenosis syncope, angina, dyspnea
harsh sounds murmur - correct answer stenosis
blowing sounds murmur - correct answer regurgitation
Tanner stage girls - correct answer Stage 1-Prepuberty
Stage 2-Brest bud(onset of thelarche or breast development)
Stage 3-Breast tissue and areola are in one mound
Stage 4-Areola/nipples separate and form a secondary mound)
Stage 5-Adult pattern
Tanner stage Boys - correct answer 1. Prepuberty
II. enlargement of scrotum & testes
III. lengthening of penis
IV. increase in size of penis
V. Mature stage
direct hernia - correct answer inguinal hernia does not extend into scrotum, external ring, most common men over 50
Indirect hernia - correct answer most common goes through internal inguinal ring, most common will touch finger tip, Will extend into scrotum
Fibrocystic breast disease - correct answer benign, fluid filled cysts, tender to touch, vary in size with periods, *caffeine may exacerbate*
-*estrogen and progesterone dependent* rope like
Fibroadenoma - correct answer a round, firm, rubbery mass that arises from excess growth of glandular and connective tissue in the breast
Cysts in breast - correct answer Squishy (can move and change in size during menstrual cycle)
breast cancer - correct answer a carcinoma that develops from the cells of the breast and can spread to adjacent lymph nodes and other body sites, nodular, fixed, non mobile
Cervical Motion Tenderness (CMT) - correct answer tenderness when moving the cerix (during bimanual exam) (PE GU)
pain and temperature - correct answer spinothalamic tract
position and vibration sense - correct answer posterior column
Discrimination - correct answer cortex and tract/column
breast cancer risk factors - correct answer age, family history, early menses, null/late parity, hormone replacement
testicular cancer risk factors - correct answer Cryptochordism, prior testicular cancer or family hx; race (Caucasian 5X greater risk than African American)
Baker's cyst - correct answer accumulation of synovial fluid in the knee joint [Show Less]