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65 Cards in this Set
- Front
- Back
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Signs of right heart failure?
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Hepatomegaly (nutmeg liver), peripheral edema, JVD
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Signs of bronchitis?
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Cough, hoarsness, non-specific pulmonary/general findings, no consolidation
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Signs of bronchiectasis?
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"Chronic cough, large volumes of purulent sputum
Halitosis, abnormal breath sounds, fever Clubbing, hypoxemia, pulmonary HTN -> right heart failure in severe cases" |
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Where does the spinothalamic tract cross?
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Within 2 segments of the nerve root
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What sensations does the spinothalamic tract cary?
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Pain, temperature
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Which gyrus of the brain does the spinothalamic tract project?
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Post-central gyrus
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Where does the cortico spinal tract originate? (what gyrus)
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Pre-central gyrus
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Where does the corticospinal tract cross?
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Medulla pyramids
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What does the corticospinal tract control?
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Voluntary movement
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Describe (not symptoms) what anterior cord syndrome is
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damage to the anterior spinal artery
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Tracts involved in the anterior cord syndrome
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Corticospinal tract, anterior columns (spinothalamic tract, and the lesser known spinoreticular and spinotectal tracts)
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Symptoms of anterior cord syndrome
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Loss of motor, pain, and temperature sense, while sparing fine touch & proprioception
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Describe (not symptoms) what brown-sequard syndrome is
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Spinal hemisection - due to many reasons
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Tracts damaged in brown-sequard syndrome
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"Ipsilateral loss of corticospinal and dorsal/posterior columns
Contralateral damage to the spinothalamic tract May also have ipsilateral loss of spinothalamic tract fibers that are not yet crossed " |
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Symptoms of brown-sequard syndrome
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"Ipsilateral - loss of motor, fine touch, proprioception below lesion
Contralateral - loss of pain and temp sensation 1-2 levels below lesion" |
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Describe (not symptoms) what central cord syndrome is
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Damage to the central region of the spinal cord
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What tracts are affected by central cord syndrome, and how does this produce symptoms?
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"Corticospinal tract - upper extremities are affected first, since they are carried in the medial part of the spinothalamic tract
Anterior columns (spinothalamic tract) - cape like loss of pain/temperature - impact on the crossing spinothalamic fibers" |
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What is conus medullaris syndrome + symptoms?
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"Damage to bottom of spinal cord
Painless Symmetric Bladder symptoms early Sacral roots only affected (only sacral reflexes affected)" |
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What is cauda equina syndrome + symptoms?
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"Involves nerve roots below spinal cord
Radicular pain Asymmetric Bladder symptoms late in clinical course Lumbar and sacral roots affected (all leg reflexes affected!)" |
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What does the tibial nerve do (motor + sensory)?
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"Motor - posterior component of leg
Sensory - Posterior aspect of leg (via sural nerve), and sole of foot (medial/lateral plantar nerves)" |
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What do you see in tibial neuropathy?
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"Loss of plantar flexion, loss of toeflexion, weakened inversion of the foot
Sensory loss over back of leg, bottom of foot" |
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What does the peroneal nerve do?
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"Almost opposite of tibial nerve
Motor - ankle dorsiflexion, toe extension, ankle eversion Sensation - area between 1st and 2nd toes (deep peroneal), dorsal foot, anterior leg" |
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What does the femoral nerve do?
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"Motor - extension of the leg (quadriceps), patellar reflex
Sensory - anterior thigh" |
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What does the sciatic nerve do?
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"Motor - flexion of the leg (also gives off the fibular and tibial nerves)
Sensory - back of thigh and butt" |
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What does the superior gluteal nerve do?
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"Stabilize the pelvis - innervates gluteus medius
absence -> trendelenburg's sign" |
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What are the effects of diabetic neuropathy?
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"Pain and loss of sensation in the extremities, autonomic features
Progresses to more proximal areas" |
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What are the findings of axillary neuropathy?
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Reduction of shoulder abduction, pain
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What innervates the gastrocnemius?
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Tibial nerve
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What does the gastrocnemius do?
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Plantar flexion of the foot, flexion of the leg
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What innervates the peroneus longus?
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Superficial fibular / peroneal nerve
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What is the action of the peroneus longus?
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Eversion / plantar flexion of the foot
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What innervates the tibialis anterior?
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Peroneal (deep fibular) nerve
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What does the tibialis anterior do?
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Dorsiflexion / inversion of the foot
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What does the tibialis posterior do?
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Plantar flexion and inversion of the foot
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What innervates the tibialis posterior?
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Tibial nerve
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What does the peroneus tertius do?
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Dorsiflexion and eversion of the foot
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What innervates the peroneus tertius?
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Peroneal (deep fibular) nerve
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What are heberden's nodes?
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Bony swelling of DIP, osteoarthritis
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What are bouchard's nodes?
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Bony swelling of the PIP, osteoarthritis
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What is a boutonnier deformity? (what happens to the PIP and DIP, flex or extend?)
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PIP flexes, DIP extends (RA)
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What is a swan neck deformity? (what happens to the PIP and DIP, flex or extend?)
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PIP extends, DIP flexes (RA)
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Joints involved in RA?
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"Hand: MCP, PIP - not DIP
Extremities: everything from wrist - shoulder and ankle - knee Spine: Cervical spin, not T/L spine" |
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Joints involved in OA?
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DIP > Knee > Hip, also affects C-Spine, L-Spine, CMC, PIP, 1st metatarsal phalangeal joint
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What is a palatal tori
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Bony protrusion of the hard palate
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A tear of what tendon causes a characteristic shoulder shrug?
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Supraspinatus
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What murmur is BEST heard when the patient is sitting up and leaning forward?
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Aortic regurgitation
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When you listen to the lungs posteriorly, you are examining
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The lower lobes, with a bit of the upper lobes
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Forced expiratory time in patients with chronic obstructive pulmonary disease is ____
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Is increased
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Tenderness over the anatomic snuffbox suggests _____
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Scaphoid injury / fracture
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Where is a baker's cyst found?
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Popliteal fossa
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A midline lower abdominal mass in a 24 year-old woman would MOST LIKELY represent
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Uterine enlargement
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Crampy pain that starts near the umbilicus and then moves to the right lower quadrant is suggestive of
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Appendicitis
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Rheumatoid nodules are MOST commonly seen on
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Extensor surfaces
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What is the pulmonary flow murmur?
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Innocent murmur in kids + adolescents, SEM @ LUSB
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What is the Still's murmur
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Vibratory / Music SEM @ LLSB, louder when supine
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What is the peripheral pulmonary stenosis murmur?
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Soft SEM heard along LUSB and radiation to both axillae, in newborns to 4 months
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What is a Venous hum murmur?
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Continuous murmur caused by turbulent flow in jugular *veins* - best heard supra/infraclavicular while seated
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What are intercostal retractions?
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Reduced air pressure in the chest - sucks the intercostal muscles inward
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What grade strength is no contraction/movement?
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0/5
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Signs of horner's syndrome
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"Partial ptosis due to loss of innervation of superior tarsal/muller's muscle
Anhidrosis Miosis Loss of ciliospinal reflex (mydriasis in response to face/neck pain)" |
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Causes of horner's syndrome
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"Anything affecting smpathetic innervation to pupil
Some examples: Cluster headache Lateral medullary syndrome Tumors (pancoast tumor on apex of lung, thyroid cancer) Compression by vasculature / infarct - aortic aneurysm, carotid dissection, cavernous sinus thrombosis" |
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Diopter setting on fundoscope for someone with normal eyes?
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0
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What is splinting (breathing)?
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Patient knowingly or unknowingly restricts respiratory effort due to discomfort
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Are retinal arteries thinner or thicker than retinal veins?
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Thinner
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Are retinal arteries darker red or lighter than retinal veins?
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Lighter
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