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Flashcards

EXAMINATION FINDINGS

Katie Palmer English 108 cards

EXAMINATION FINDINGS

Cards in this deck (108)

  1. 1Label the muscles of the eye and their innervationLabel the muscles of the eye and their innervationLabel the muscles of the eye and their innervation
  2. 2Which muscles are responsible for each eye movement?SO4LR6: superior oblique = CN4, lateral rectus = CN6. All the rest are CN3Which muscles are responsible for each eye movement?
  3. 3Outline the divisions of the trigeminal nerveOutline the divisions of the trigeminal nerve
  4. 4How does forehead sparing work in relation to UMN and LMN lesions?UMN lesions = forehead is spared (forehead is spUred). LMN lesion = forehead is affected
  5. 5Outline Rinne and Weber's testsRinnes = does this sound louder in front of or behind the ear?
    Webers = put tuning fork on forehead (REMEMBER: this girl has a WEB on her FOREHEAD) -> which ear does it sound louder in? Normal = both the same. Localises to one ear = conductive hearing loss in the ear that it localises to OR sensorineural hearing loss on the opposite side. REMEMBER: I was to GO TOWARDS the SEA (localises towards = Conductive hearing loss)
  6. 6Outline the dermatomes in the upper limbOutline the dermatomes in the upper limb
  7. 7Outline the muscle innervation of the upper limbMuscle innervation
    • Shoulder abduction = C5
    • Elbow flexion = C6
    • Elbow extension = C7
    • Wrist extension = C7
    • Finger extension = C7
    • Finger flexion = C8
    • Finger abduction = T1
    • Thumb abduction = T1
  8. 8What does pronator drift indicate?UMN lesion
  9. 9What does increased tone indicate?a. Rigidity = Parkinson’s disease or UMN lesion
    b. The way to differentiate Parkinson’s and UMN lesion is that Parkinson’s will have cogwheel rigidity (where the movements stop and start) whereas UMN lesion won’t
  10. 10Spinal tract associated with soft touch = ......Dorsal column
  11. 11Spinal tract associated with vibration sensation = ......Dorsal column
  12. 12Spinal tract associated with pain = ......Spinothalamic
  13. 13Spinal tract associated with proprioception = .......Dorsal column
  14. 14What is the difference between Parkinson's disease and cerebellar disease in terms of co-ordination?Dysdiadochokinesia = indicates cerebellar pathology. Parkinson’s disease = SLOW but CORRECT movements
  15. 15What does a positive Babinski sign indicate?UMN lesion
  16. 16UMN lesion vs LMN lesion• UMN lesion = lesion in the brain or spinal tract. LMN lesion = lesion in the peripheral nerves (outside of the brain / spinal cord)
    • Features:
    o UMN signs = spastic paralysis, hyperreflexia, upgoing plantars (Babinski positive) REMEMBER: SHUUM
    o LMN signs = flaccid paralysis, muscle wasting, fasciculations
  17. 17Outline the MRC gradesOutline the MRC grades
  18. 18Outline the innervation of the lower limb• Hip flexion = L2 / L3
    • Hip extension = L4 / L5
    • Knee extension = L3 / L4
    • Knee flexion = L5 / S1
    • Ankle dorsiflexion = L4/L5
    • Ankle platarflexion = S1/S2
    • Big toe extension L5
  19. 19Outline the reflexes and the nerves associated with them• REMEMBER: 12345678 = All Koalas Bite TreesOutline the reflexes and the nerves associated with them
  20. 20Image showing the dermatomes for the lower limbImage showing the dermatomes for the lower limb
  21. 21Respiratory causes of clubbingAbscess, Bronchiectasis, Cancer, Don’t say COPD, Empyema, Fibrosis
  22. 22What does fine tremor of the hands in a resp exam indicate?Beta-agonist use (e.g. salbutamol)
  23. 23What does a CO2 retention flap (in a resp exam) indicate?CO2 retention (e.g. COPD)
  24. 24What is a normal respiratory rate12-20 breaths/minute
  25. 25Cause of raised JVPRaised JVP is caused by venous hypertension (blood is not flowing quickly enough back into the right side of the heart) --> this is caused by right-sided heart failure --> this is caused by pulmonary hypertension
    Cardiac causes of pulmonary hypertension = left-sided heart failure, tricuspid regurgitation, constrictive pericarditis
    Respiratory causes of pulmonary hypertension = COPD, lung fibrosis
  26. 26What does conjunctival pallor indicate?Anaemia
  27. 27Causes of tracheal deviationa. Trachea deviated TOWARDS affected side = collapse, pneumonectomy, fibrosis
    b. Trachea deviated AWAY from affected side = tension pneumothorax, pleural effusion, malignancy / consolidation
  28. 28What is the normal cricosternal distance?3-4 fingers
  29. 29What does it indicate if the cricosternal distance is reduced?Chest hyperexpansion (e.g. COPD, asthma)
  30. 30What causes a deviated apex beat?Deviated apex beat indicates mediastinal shift  shows that there is something on one side of the lungs which is ‘pushing’ the mediastinum away e.g. one-sided pleural effusion, pneumothorax, mass in the lung, right ventricular hypertrophy (e.g. pulmonary hypertension, COPD, interstitial lung disease)
  31. 31Outline what you are listening for when you percuss the lungsa. Normal = resonant
    b. Dull = something solid/liquid in the lungs/pleural space, e.g. consolidation / collapse / effusion
    c. Hyper-resonant = excess air in the lungs, e.g. pneumothorax, emphysema
  32. 32What is the name for 'normal' breath sounds heard on auscultation of the lungs?Vesicular breath sounds
  33. 33Causes of enlarged lymph nodesInfection, malignancy, sarcoidosis
  34. 34What is the name of the following scar? What does it indicate?Midline sternotomy scar --> indicates cardiac surgery (e.g. CABG, cardiac transplant, correction of congenital cardiac defects)What is the name of the following scar? What does it indicate?
  35. 35What is the name of the following scar and what does it indicate?Posterolateral thoracotomy -> used for lobectomy (removal of lung lobe), biopsy of lung, lung reduction surgeryWhat is the name of the following scar and what does it indicate?
  36. 36What is the name of the following scar and what does it indicate?Anterolateral thoracotomy -> used for lobectomy (removal of lung lobe), biopsy of lung, lung reduction surgeryWhat is the name of the following scar and what does it indicate?
  37. 37What is this scar called and what are the indications?Clamshell -> used when you need complete exposure to the thoracic cavity (heart, mediastinum and lungs) e.g. in traumatic chest injuryWhat is this scar called and what are the indications?
  38. 38What is this scar called and what are the indications?Subclavicular scar -> pacemakerWhat is this scar called and what are the indications?
  39. 39Causes of wheezeAsthma, allergic reaction, COPD, cystic fibrosis, congestive heart failure ..... (lots of others)
  40. 40What does stridor indicate?Upper airway obstruction
  41. 41Wheeze vs stridorWheeze = usually heard at lung bases, stridor = usually heard in neck
  42. 42What type of oedema is associated with left and right-sided heart failure?• Pulmonary oedema = caused by LEFT-sided heart failure
    • Peripheral (ankle vs sacral) = caused by RIGHT-sided heart failure. Peripheral occurs if they have been standing up, sacral occurs if they have been lying down
  43. 43What does leukonychia indicate?Hypoalbuminaemia (e.g. liver cirrhosis, enteropathy)
  44. 44What does palmar erythema in a GI exam indicate?Liver disease
  45. 45What does dupuytren's contracture seen in a GI exam indicate?Liver disease / alcoholism
  46. 46What does asterixis indicate if seen in a GI exam?Hepatic encephalopathy + uraemia
  47. 47What does acanthosis nigricans indicate?indicates insulin resistance (obesity, diabetes, metabolic disorders, PCOS
  48. 48What does xanthelasma indicate?Hyperlipidaemia
  49. 49What does spider naevi indicate?Liver disease
  50. 50What does gynaecomastia indicate when seen in a GI exam?Liver disease
  51. 51What is rebound tenderness? What does it indicate?Rebound tenderness = when the abdomen hurts when you remove your hand
  52. 52What does this image show?KoilonychiaWhat does this image show?
  53. 53What does this image show?LeukonychiaWhat does this image show?
  54. 54What does this image show?Palmar erythemaWhat does this image show?
  55. 55What does this image show?Dupuytren's contractureWhat does this image show?
  56. 56What does this image show?Acanthosis nigricansWhat does this image show?
  57. 57What does this image show?XanthelasmaWhat does this image show?
  58. 58What does this image show?Spider naeviWhat does this image show?
  59. 59What does this image show?Caput medusaeWhat does this image show?
  60. 60What does this image show?Caput medusaeWhat does this image show?
  61. 61Outline the 9 regions of the abdomenOutline the 9 regions of the abdomen
  62. 62What type of scar does this image show? What does it indicate?Midline laparotomy scar -> used for:What type of scar does this image show? What does it indicate?
  63. 63What does the following scar indicate?AppendectomyWhat does the following scar indicate?
  64. 64What does this scar indicate?Indicates nephrectomyWhat does this scar indicate?
  65. 65Outline the different types of stoma bags and how to tell them apart• Telling them apart:
    o Location (see diagram)
    o Spouted or flush to skin  colostomy in flush to skin whereas ileostomy is spouted (because contents of the small bowel are damaging to skin whereas contents of large bowel are not)
    o Contents: colostomy = stool, ileostomy = liquid contents
    • Permanent vs temporary:
    o A stoma can be permanent (e.g. following removal of cancer / dead bowel) or temporary (e.g. following bowel surgery where the bowel needs to rest). Just because it is an end-stoma doesn’t indicate that it is permanent
    o Loop stoma = usually indicates that it is a temporary stoma (because it is easier to reverse than an end-stoma)
    • What do they indicate?
    o Permanent = tumour, volvulus, obstruction, ischaemic bowel, bowel injury (trauma, toxins), precancerous polyps, severe IBD
    o Temporary = following surgery when the bowel needs to ‘rest’    Outline the different types of stoma bags and how to tell them apart
  66. 66What do splinter haemorrhages indicate?Infective endocarditis
  67. 67What does xanthomata indicate?Hypercholesterolaemia
  68. 68What does tar staining of the fingers indicate?Patient is a smoker
  69. 69What do Osler's nodes indicate?Infective endocarditis
  70. 70What do Janeway lesions indicate?Infective endocarditis
  71. 71Cardiac causes of clubbing = .......CIA = congenital heart disease, infective endocarditis, atrial myxoma
  72. 72How long is the normal capillary refill time?< 2 seconds
  73. 73What does radio-radial delay indicate?Coarctation of the aorta
  74. 74What does a collapsing pulse indicate?Aortic regurgitation
  75. 75What is radio-radial delay?When the two radial pulses are out of time with each other
  76. 76What is a carotid bruit? What does it indicate?Carotid bruit = whooshing sound over the carotid arteries
    carotid bruit indicates turbulent blood flow through the carotid arteries  if it is due to atherosclerosis then it can increase the risk of stroke
  77. 77What does corneal arcus indicate?Hyperlipidaemia
  78. 78What does a high-arched palate indicate?Marfan's syndrome
  79. 79What is a collapsing pulse?Collapsing pulse = when you lift the hand upwards, the pulse becomes very weak
  80. 80What are cardiac heaves? What do they indicate?Abnormally strong beat of the heart. Indicate right ventricular hypertrophy
  81. 81What are thrills? What do they indicate?Thrills = murmurs that you can feel (vibration)
  82. 82What does this image show?Splinter haemorrhagesWhat does this image show?
  83. 83What does this image show?XanthomataWhat does this image show?
  84. 84What does this image show?Osler's nodes and Janeway lesionsWhat does this image show?
  85. 85What does this image show?Osler's nodes and Janeway lesionsWhat does this image show?
  86. 86List the names of each of the cranial nerves1 = olfactory
    2 = optic
    3 = oculomotor
    4 = trochlear
    5 = trigeminal
    6 = abducens
    7 = facial
    8 = vestibulocochlear
    9 = glossopharyngeal
    10 = vagus
    11 = accessory
    12 = hypoglossal
    OOOTTAFVGVAH
  87. 87Outline how to use a Snellen chart• Process:
    o Patient stands 20 feet from Snellen chart
    o Ask patient “do you wear glasses?”  if patient says yes then ask them to KEEP THEIR GLASSES ON for this test
    o Cover one eye, get the patient to read out loud from the biggest letters
    o Repeat this on the other side
    o Repeat this with both eyes uncovered
    o The number next to the line shows what the vision is in that particular eye    Outline how to use a Snellen chart
  88. 88Image showing optic pathwaysImage showing optic pathways
  89. 89Outline the muscle innervation to the lower limb• Shoulder abduction = C5
    • Elbow flexion = C6
    • Elbow extension = C7
    • Wrist extension = C7
    • Finger extension = C7
    • Finger flexion = C8
    • Finger abduction = T1
    • Thumb abduction = T1
  90. 90Conductive vs sensorineural hearing lossConductive = there is an issue with the transfer of sound into the ear. Causes = ear wax, middle ear effusion, perforated tympanic membrane
    Sensorineural = there is an issue with the hearing apparatus within the inner ear. Causes = presbycusis, head trauma, virus, autoimmune disease,
  91. 91In a respiratory exam, what does bruised / thin skin indicate?Long term steroid use (asthma, COPD)
  92. 92Causes of bilateral and ipsilateral reduced chest expansionIpsilateral = pneumothorax, pneumonia, pleural effusion
    Bilateral = pulmonary fibrosis
  93. 93What are you listening for with the '99' thing?Comparing how loud the voice is on both sides
    Sound vibrations are conducted better through solids compared to liquids so if the voice is louder = mass / pleural effusion in lung, if area is quieter = pneumothorax / collapsed lung
  94. 94What is bronchial breathing? What does it indicate?Bronchial breathing = harsh-sounding (similar to auscultating over the trachea), inspiration and expiration are equal and there is a pause between.
    Associated with consolidation.
  95. 95What are 'reduced breath sounds' and what do they indicate?Reduced breath sounds = one area of the lung which is much quieter when you auscultate it compared to other areas
    Represents an area of reduced air entry
    Causes = pleural effusion, pneumothorax
  96. 96What do fine-end inspiratory crackles indicate?Pulmonary fibrosis
  97. 97Which respiratory conditions are most associated with wheeze?Asthma, COPD, bronchiectasis
  98. 98Which respiratory conditions are most associated with coarse crepitations?Pneumonia, bronchiectasis and pulmonary oedema
  99. 99Respiratory conditions associated with fine-end inspiratory cracklesPulmonary fibrosis
  100. 100What does bronchial breathing indicate?Consolidation
  101. 101What does this image show? What does it indicate?Non-invasive ventilation --> think obstructive sleep apnoeaWhat does this image show? What does it indicate?
  102. 102In a resp exam, which conditions should you think of if you see inhalers around the bed?COPD, asthma
  103. 103In a resp exam, which conditions should you think of if you see nebulisers around the bed?Acute exacerbation of asthma / COPD
  104. 104In a resp exam, which conditions should you think of if you see an NIV machine around the bed?Obstructive sleep apnoea
  105. 105In a resp exam, which conditions should you think of if you see cigarettes around the bed?Lung cancer, COPD, fibrosis,
  106. 106In a resp exam, which conditions should you think of if you see fine tremor of the hands?COPD, asthma
    (fine tremor is caused by long-term beta-agonist use)
  107. 107In a resp exam, which conditions should you think of if you see a CO2 retention flap?COPD, obstructive sleep apnoea
  108. 108—

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Flashcards on EXAMINATION FINDINGS, created by Katie Palmer on 28/03/2022.
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