Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/125

Click to flip

125 Cards in this Set

  • Front
  • Back
Chief Complaint
statement of why they are here
Presenting Illness
description of why they are here
LMNOPQRST
L = Location of pain/problem
M = Mechanism of injury
N = Nature of symptoms
O = Onset
P = Palliative/Provocative
= Past History of similar
Q = Quality (stabbing/burning)
R = Radiation/Referral
S = Severity/Symptoms (ADL)
T = Temporal/Timing
Unexplained Weight Change
change of 7%/year is significant
Ideal Body Weight
Female
Male
female = 100#'s + 5#'s/inch over 60 inches

male = 106#'s + 6#'s/inch over 60 inches
Weight Increase
hypothyroid = Hashimoto's
hyperadrenalism = cushing's
fluid retention = chf, kidney failure, ascites
Weight Decrease
hyperthyroid = grave's
hypoadrenalism = addison's
diabetes
fever
malabsorption = crohn's/celiac
anorexia = malignancy, infections, hepatitis, nervosa
Types of Temperature and Degrees
Axillary = 1 degree low (97.6)
Rectal = 1 degree higher (99.6)
Aural = 98.6
Types of Fever
Intermittent
Remittent
Continuous
Relapsing
Intermittent Fever
High spikes, returns to normal in 24 hr period
Remittent Fever
high spikes, not returning to normal
continous fever
sustained; doesn't return to normal until it ends
relapsing fever
fever for days/weeks with periods of normal temperature
facticious fever
above 106 for an extended period
rapid fall in temp without sweating
lack of diurnal variation
change in heart rate with temp
10 BPM/ 1 degree temp
FUO (fever of undetermined origin)
fever for weeks with failure to diagnose cause
ex. meds, hodgkin's, TB, mono, CA, collagen disorders
Tachycardia
> 100 bpm
Bradycardia
< 60 bpm
Pulse Regularity
Regularly Irregular
Irregularly irregular
Regularly Irregular = 2nd degree heart block
Irregularly Irregular = PVC
Dyspnea
difficulty with breathing
bradynea
decreased rate (<12 cpm)
tachynea
increased rate (>20 cpm)
apnea
cessation of breath
hyperpnea
increased depth
hyperventilation
increased rate and depth
orthopnea
difficulty breathing laying down
cheyne stokes
alternating hyperpnea and apnea
medulla not signalling property
Karotkoff Sounds
K1
K4
K5
K1 = systole (1st tapping sound; ventricular contraction)
K4 = muffled sound
K5 = no sound (diastole)
Change between R and L
change of 10-15 mmHg
False Low Reading
cuff too wide
arm below heart
deflate cuff too rapidly
auscultatory gap
false high reading
anxiety
cuff to narrow
deflating cuff too slowly
arm below heart
Children
Pulse
Systolic BP
Pulse = higher
Systolic BP = lower
Orhtostatic Hypotension
Systolic decreases by
diastolic decreases by
systolic = 20 mmHg or more
diastolic = 10 mmHg or more
Hyper adrenal problem
increase BP
Hypo adrenal problem
decrease BP
Ectomorph body type
fragile, thin, tall, flat chest, delicate, high energy, light muscled
Mesomorph body type
athletic, muscular body, lose fat easily, gain myo easily
Endomorph body type
flabby, gain weight easily, under-developed muscle, slow metabolism
Linea nigra
linea alba turns dark (pregnancy)
chloasma
mask of pregnancy (similar to portwine stain)
Addison's disease
dark spots over bucal mucosa, skin folds, stretch marks
destruction of adrenals
bp low
weight loss/loss of appetite
hypoglycemia
dehydration
intolerance to cold
fatigue
cushing's disease
purple striae
hypercortisolism
pituitary tumor
bp increase
elevated glucose level
weight gain
truncal obesity
moon face
buffalo hump
Pallor
anemia
shock
Syndrome X
increase trigs
truncal obesity
increase BP
Adrenal Gland Cortex
glucocorticoids
mineral coricoids
sex hormone
Endocrine
cortisol (increase sugar)
aldosterone (increase salt)
dhea/pregnanalone (decrease sex)
Adrenal Gland Medulla
Adrenaline
Neuroendocrine
epinephrine
DHEA
increase sensitivity to insulin
Insomnia
increase cortisol
Cafe' au lait spots
>5-6 spots
neurofibromatosis (VonReckinghausens Dz.)
Acromegally
excess production of endogenous growth hormone
pituitary tumor
weight gain
hirtuism
Halitosis (causes)
peptic ulcer
GERD
Diabetes
Liver disorders
Kidney disorder
Hirsutism
cushings
acromegally
excessive hair growth
Alopecia
hypothyroidism = coarse, dry
hyperthyroidism = fine, velvety
Koilonychia
spoon shaped nails
plummer vinson syndrome
IDA
hemochromatosis
Clubbing
chronic respiratory conditions
lung ca
hypertrophic pulmonary osteoarthropathy
cardiac failure
hepatic cirrhosis
Lindsay's Nails
half/half nails
renal failure
Mee's Lines
transverse white band
arsenic intoxication
renal failure
hodgkins
pneumonia
Terry Nail
all white
hepatic cirrhosis
CHF
RA
Beau Lines
transverse depression
coronary occlusion
skin disorder
trauma
oncholysis
separation of distal nail
psoriasis
trauma
thyroid dz.
pitting
psoriasis
eczema
alopecia areata
onychomycosis
fungal infection
trauma
heat
moisture
diabetes
yellow nail syndrome
edema
defective lymph drainage
chronic bronchitis
Splinter hemorrhage
SBE
SLE
Rheumatoid
Trauma
Paronychia
infx of cuticle
Ataxic sensory
loss of posterior columns
propulsion
parkinson's
steppage
anterior crural myo deficit
can't dorsiflex foot
poliomyelitis
staggering (reeling)
cerebellar ataxia
MS
Scissors (spastic)
MS
Trendelenburg Gait
Weak glut
hip pathology
Exam of Neck Lymph Nodes
1 - superficial (ant)
2 - posterior cervical nodes
3 - deep cervical nodes
4- supraclavicular areas
Exam of Head Lymph Nodes
1 - occipital
2 - postauricular
3 - preauricular
4 - parotid
5 - tonsillar
6- submandibular
7 - submental
Lymph Node drainage
Ant. cervical
Post. cervical
tonsillar
sub-mandibular
sub-mental
preauricular
postauricular
occipital
supraclavicular
Ant. cervical - throat, post. pharynx, tonsils, thyroid
Post. cervical - skin on back of head
tonsillar - post. pharynx
submandibular - floor of mouth
submental - teeth
preauricular - eyes
postauricular - scalp
occipital - skin back of head
supraclavicular - thoracic cavity, Virchow's node
Thyroid Evaluation
Hypothalamus
Pituitary Gland
Thyroid Gland
Hypothalamus - thyroid releasing factor
Pituitary Gland - thyroid stimulating factor
thyroid gland - secretes T4
Thyroid Evaluation
Primary
Secondary
Tertiary
Primary - thyroid problem (thyroid gland is over/under producing T4)
Sedondary - pituitary problem (pituitary gland is over/under producing TSH)
Tertiary - hypothalamic problem
Graves Dz.
hyperthyroidism
autoimmune
antibodies against TSH
continuous secrestion of T4/T3
Hashimotos Dz. (chronic thyroiditis)
aka Auto immune thyroiditis
antithyroid peroxidase Ab
takes up receptor sites and doesn't secrete T3/T4
Thyroid Physical Exam
diffuse enlargement
single nodule
multiple nodules
thyroiditis (tenderness)
Benign Lymph Node
elastic
regular mass
movable
painful
Barnes Test (thyroid self test)
evaluates basal metabolic rate
Tracheal Tug
aortic aneurysm
Auscultation of the Head
ocular
temporal (olymyalgia rheumatica)
occipital
Sinusitis (referral patterns)
Maxilla
frontal
ethmoid
sphenoid
maxilla - cheek
frontal - forehead
ethmoid - upper face & retro orbital
sphenoid - head or occiput
aggravated by bending forward
TMJ (ROM)
3-6 cm space between upper/lower jaw
1-2 cm laterally
press inside the external auditory meatus on the anterior aspect of the canal
Mental Status
orientation x3
(time, person, place)
Pupillary Reactions
accomodation
light
convergence
PERLA
pupils equal, reactive to light & accomodation
Miosis
iridocyclitis (small pupil)
Mydriasis
large pupil (acute glaucoma)
Argyll Robertson
fails to constrict with light
3 syphyllis
Anisocoria
unequal pupils
adie pupil
tonic pupil
Peripheral fields of gaze
superior
medial
inferior
lateral
superior - 50
medial - 60
inferior - 70
lateral - 90
dorsal column
proprioception, vibration, 2 pt. touch, light touch
pyramidal
reflexes
spinothalamic
sharp pain, temp, crude touch
Trigeminal (CN V)
Sensory
Motor
sensory - opthalmic, maxillary, mandibular
motor - temporalis, masseter, open mouth, clench teeth
Corneal Reflex
afferent 5
efferent 7
Facial Nerve (CN VII)
frown, smile, puff out cheeks, show teeth, close eye
Hearing Loss (line of demarcation)
oval window
(window out is conduction)
(window in is sensorineural)
Weber Test
(lateralizes to one side)
conduction block on same side
sensory/neuro deficit on opposite side
Glossopharyngeal (CN 9)
uvula pulled to opposite side
Vagus (CN 10)
gag reflex
Spinal Accessory (CN 11)
trapezius
scm
Hypoglossal (CN 12)
tongue to same side
Pronator Drift
UMN lesion with general weakness
LMN
decreased tone
flaccid paralysis
UMN
increase tone
rigidity spasticity
rigidity
extrapyramidal tract
spasticity
pyramidal tract
Indicator Muscles
c5
c6
c7
c8
t1
l4
l5
s1
c5 - deltoid
c6 - biceps, wrist extension
c7 - triceps, wrist extension, finger extension
c8 - finger flexion
t1 - finger abduction/adduction
l4 - tib anterior (dorsiflex/invert)
l5 - extensor hallicus longus
s1 - plantar flexors
Deep Tendon Reflex needs what 5 things
1 - sensory nerve fibers
2 - function synapse in cord
3 - intact motor fibers
4- functional nm jxn.
5 - competent muscle fibers
Reflexes
c5
c6
c7
l4
s1
c5 - biceps
c6 - brachioradialis
c7 - triceps
l4 - patellar
s1 - achilles
Plantar Response (babinski)
normal response
abnormal response
normal - flexion
abnormal - extension (UMN lesion)
abdomen superficial reflex
upper t7-9
lower t10-11
cremasteric reflex
T12, L1, L2
plantar reflex
L4,L5,S1
anal reflex
S2-4
gag reflex
CN 9&10
Hoffman response
press nail downward
abduction of thumb or flexion of fingers
Tromner's Sign
tapping palmar surface of tip 3rd digit
abduction of thumb and flexion of fingers
UMN lesion
clonus
UMN lesion
Weber
Normal
Conductive Hearing Loss
Sensorineural Loss
Normal - no lateralization
Conductive - lateralization to deaf ear
Sensorineural - lateralization to better ear
Rinne
normal
conductive hearing loss
sensorineural hearing loss
normal - AC>BC
conductive hearing loss- BC>AC
sensorineural hearing loss - AC>BC but reduced