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68 Cards in this Set

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Ausculatory Gap
- artery collapses on itself prematurely

- heart disease as possible cause
Systolic pressure
+ pressure against arteriole walls

left ventricle contraction
Diastolic Pressure
+ pressure against arteriole walls

left ventricle RELAXATION
Lateralization
noise is heard louder in one ear than the other
Cardinal Field of Gaze
extreme range of vision; ability of eyes to track from one extreme of vision to other
Binaural
recruiting both eyes
Oculus dextra
right eye
Oculus sinestra
left eye
VBAI
vertebrobasilar artery insufficiency
Inclinometry
OBJECTIVE methods of quantifying ROM of joints in the spine; its an objective assessment tool
Pulse Characteristics (0 to +3)
3 = full and bounding
2 = normal
1 = weak and thready
0 = absent
BP - Normal Range
100/70

to

139/79

(pre - hypertensive)
BP - Stage 1 Hypertension Range
140/90

to

159/99

(Mild)
BP - Stage 2 Hypertension Range
160/100

to

179/109

(moderate)
BP - Stage 3 Hypertension Range
180/110 and higher (severe)
Korotkoff Sounds (5)
I: Tapping (systolic)
II: swooshing
III: knocking
IV: muffling
V: Silence (diastolic)

T S K M S
The purpose of the VBAI test
to determine whether or not a pt. is a candidate for a cervical adjustment
history of chief complaint

O =
Onset


- When did it start?

- Date (as specific as possible)
history of chief complaint

MP3 =
Mechanism (Cause ... How did it happen?)

Prior history

Progression

Prior care
history of chief complaint

P/P =
Palliative (what makes it better?)


Provocative (what makes it worse?)
history of chief complaint

Q =
Quality of pain.

Sharp/dull deep/superficial blunt/achy
history of chief complaint

R/R =
Radiation (nerve)

Referral (scleratogenous—muscle, tendon, ligament)
history of chief complaint

S/S =
Site (have pt. touch - don't rely on them)

Severity (What is your 10?)
history of chief complaint

T =
Timing.

Best when? Worst when?
history of chief complaint

FID =
Frequency

Intensity (least/worst/fluctuate)

Duration
Occupational History (length)
Job and duties for the past 15 years
Roland Morris Questionnaire
• For Functional disability
• By asking activities of daily living (ADL)
• Use as an Outcome assessment tool
• Score: X/24 w/ benchmark of 4
2 INHERANT PROBLEMS WITH INCLINOMETRY
1) Test should be repeated (6 times) but with each test patient will have an increased ROM (b/c “stretching tissues”)

2) Place dial in different places each time test is performed
Why do we screen w/ George's Test / Protocal?
1) Hx of sig vascular disease
2) decrease in b/l BP (thrombus ? >20mm)
3) Bruits: musical ausculatory sound
4) Signs of dizziness, nausea, vomiting, or any other neuro symptoms while head is fixed in hyperext & rotated position
What are you screening for in Georges Test?
5 D’s And 3N’s

Dizziness
Diplopia: double vision
Dropping attacks/fainting
Dysarthria: difficulty speaking
Dysphagia: difficulty swallowing

Ataxia: uncoordinated mov’ts

Nystagmus: rhym oscltns of the eyeballs
Nausea
Numbness
8 Parts to comprehensive physical exam
1. Chief complaint Hx
2. Prior health Hx
3. Family Hx
4. Occupational Hx

5. Vitals
6. Review of systems
7. Outcome Assesment Tools (OAT)
8. Inform consent

CPFO History > VROI

NO LEADING ?'s
Mnemonic for history of chief complaint
O
MP3
P/P
Q
R/R
S/S
T
FID
Prior Health History Mnemonic
I SHIP HAM

Injuries

Surgeries
Hospitalization
Infections
Psychological Disorders/Pregnancy

Headaches
Allergies
Medications
Family History Mnemonic
ABCDEFG (A - G)

Arthritis
Blood disorder
Cancer
Diabetes
Epilepsy
Fatality
Genetic disorders
NECK DISABILIY INDEX QUESTIONNARIE
10 Sections A – F

1. Pain intensity Score
2. Personal care A-0
3. Lifting B-1
4. Reading C-2
5. Headaches D-3
6. Concentration E-4
7. Work F-5
8. Driving MAX SCORE = 50
9. Sleeping If less than previous score, means improvement
10. Recreation
3 Types of Arthritides
Degenerative (DDD)

Inflamatory (RA)

Metabolic (Gout)
Types of Blood Disorders
Hypertension

High Cholesterol

Anemia
Normal Temperature Range
96.4°F – 99.1°F

< (Hypothermia)
> (Hyperthermia)
Normal Pulse Range
60 – 100 bpm
Tachycardia
pulse above 100 bpm
Bradycardia
pulse below 60 bpm
Pulse ... check what 4 things
1. Rate (bpm)

2. Rhythm (radial sync)

3. Amplitude (2 normal)

4. Compression (pal>compress>pal)
Normal vision
20/20
Snellen Eye chart keys
eye level

20 ft away

1 eye at time (cover other open)

Letters (until 3 wrong)

Colors
Jaeger Eye chart keys
portable

14 inches from pt nose
height and weight keys
shoes off

face away from scale
Webers Test
512 hz tuning fork

skull midline w. tines toward ears

Pt. hear equally?
Rinnes Test (and sound ratios)
512 hz tuning fork

Mastoid > by ear

AC/BC

2:1
VBAI Test (5)
1. blood pressure
2. radial artery palpation
3. carotid arteries auscultate & palpate
4. supraclavicular fossa auscultation
5. Test (4)

ALL B/L!!!!!!!!!!
Dyphagia
Difficulty Swallowing
Dysarthria
Difficulty Speaking
Nystagmus
Rapid Oscillations of eyes (vertically indicates CNS problem)
Maigne’s test
seated (backless chair)

extend and rotate head

1 min (every 15 "Are you with me?)

Watch eyes for nystagmus
DeKleyn’s Test
supine / head over edge of the table in ext.

Turn head and hold (1 min drill)
Hautant’s Test
seated with arms out in front

close eyes - move head into ext and rot

(1 min drill)
Underberger’s Test
stand with arms out in front

march in place with head ext and rot

(1 min drill)
Degrees of C-Spine Flexion
80-90
Degrees of C-Spine Extension
60-70
Degrees of C-Spine Lat flex
20-45
Degrees of C-Spine Rotation
70-90
Degrees of T-Spine Flexion
20-45
Degrees of T-Spine Extension
25-45
Degrees of T-Spine Lat Flex
20-40
Degrees of T-Spine Rotation
35-50
Degrees of L-Spine Flexion
40-60
Degrees of L-Spine Extention
20-35
Degrees of L-Spine Lateral Flex
15-20
Degrees of L-Spine Rotation
3-18