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152 Cards in this Set
- Front
- Back
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T/F: In children, the ligaments are stronger than bone, so more fractures tend to occur than sprains
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TRUE
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When does growth end for children?
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20
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At what age is peak bone mass reached?
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35
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T/F: You do not need to check area above or below a joint that is painful
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FALSE. Check above and below a painful joint
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How is muscle strength graded?
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0-5. (ex. = 5/5).
0=absent; no contraction detected 1=trace; slight contraction 2=weak; movement with gravity eliminated 3=fair; movement against gravity 4=good; movement against gravity with some resistance 5=normal; movement against gravity with full resistance |
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How are pulses graded?
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0-4 (normal = +2/4)
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How are deep tendon reflexes graded?
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0-4 (normal = +2/4)
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Which roots does are associated with the biceps brachii?
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C5-C6
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Which roots are associated with the brachioradialis muscle?
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C5-C6
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Which roots are associated with the triceps muscle?
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C6-C8
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Which roots are associated with the patellar tendon?
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L2-L4
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Which roots are associated with the Achilles Heel tendon?
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S1-S2
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What is the grading scale for deep tendon reflexes?
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0 - no response
+1 = diminished +2 = Normal +3 = Increased +4 = Hyperactive, clonus |
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When you ask a pt. to squat and then rise, what are you testing?
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L4
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When you ask a pt. to walk on their heels, what are you testing?
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L5
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When you ask a pt. to walk on their toes, what are you testing?
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S1
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How do you test for a scoliosis?
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ask pt. to flex forward. If hum present, ask them to bend to the side of the hump. If hump disappears, its a functional scoliosis; if hump persists, its a structural scoliosis
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What does the Spurling's Test test for? What is the positive sign?
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Nerve root impingment. positive sign is pain
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What does the Compression/Distraction Test test for? What is the positive sign?
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nerve root impingement. positive sign is pain for both compression and distraction.
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What does the Valsalva Test test for? What is the positive sign?
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space-occupying lesions like disc or tumor
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What does the Straight Leg Raising Test test for? What is the positive sign?
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Tests L4, L5 and S1 radiculpathy. Pos. sign is pain extending below the knee
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What test can confirm the straight led raising test?
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bragard stretch test
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What does the Femoral Stretch Test test for? What is the positive sign?
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L1, L2, L3 radiculopathy. Pos. sign is pain extending below the knee
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What does the Trendelenburg Test test for? What is the positive sign?
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colateral weakness of abductor muscles. pos. test is when iliac crest drops on lifted leg side.
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What does the Thomas Test test for? What is the positive sign?
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tight iliopsoas muscle (flexion contractures of the hip). Pos. sign is >15% of flexion in the contralateral hip.
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What does the Patrick/FABER Test test for? What is the positive sign?
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Ipsilateral hip pain suggesting hip pathology and ipsilateral SI joint pain when pressing on ipsilateral knee and contralateral ASIS suggests SI pathology
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What does the Barlow-Ortolani Test test for? What is the positive sign?
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In Newborns --> 2 yr. olds. Posterior displaced hip. Pos. sign is click or plunk when you flex the legs to tight angles and abduct.
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What is Osgood Schlatter Disease?
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Osteocondritis of the epiphysis of the tibial tubercle. Usually occurs in active kids (9-15)
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What does the Drawer Test test for? What is the positive sign?
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Anterior drawer test for Anterior Cruciate Ligament
Posterior Drawer test for posterior cruciate ligament Pos. sign is 2 or more cm of movement |
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What does the Lachman Test test for? What is the positive sign?
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Anterior Criciate Ligament. Pos sign is increased laxity in ACL
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What does the McMurray Test test for? What is the positive sign?
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Meniscal injury. pos. test is audible/palpable clicking
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What does the Apley Compression/Distraction Test test for? What is the positive sign?
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Compression = meniscal injury
Distraction = collateral ligament injury Pos. sign is pain |
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What does the Ligament Stability Test test for? What is the positive sign?
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stability of lateral and medial collateral ligaments.
Pos. sign is abnormal lateral or medial movement |
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What does the Ballottement Test test for? What is the positive sign?
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Excessive fluid or an effusion in the knee. Pos. sign is rebound of the patella by fluid in the joint.
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What does the Thomson-Doherty Squeeze Test test for? What is the positive sign?
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Achilles tendon rupture. Pos sign is no motion of foot.
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What does the Homan's Test test for? What is the positive sign?
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DVT (Deep Vein Thrombosis). Pos. sign is pain
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What does the Drawer Sign (for Ankle, not knee) test for? What is the positive sign?
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Anterior Talofibular Ligament disruption. Pos. sign is excessive forward movement.
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What does the Apley Scratch Test test for?
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Quickest way to evaluate a pt's range of motion. Also a good screening test for adhesive capsulitis.
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What does the Drop Arm Test test for? What is the positive sign?
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Rotator Cuff Tear (SITS muscles), specifically the supraspinatus muscle. Pos sign is when pt. can't hold arm up or lower it smoothly when you tap on it.
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What does the Empty Can, Neer and Hawkins Test test for? What is the positive sign?
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Muscle/Nerve impingement. Pos. sign is pain.
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What does the Apprehension, Jerk and Sulcus Test test for? What is the positive sign?
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Apprehension = Anterior shoulder dislocation
Jerk = Posterior shoulder dislocation Sulcus = Inferior Shoulder Dislocation |
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What does the Yergason's Test test for? What is the positive sign?
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Biceps tendonitis. Pos. sign is tenderness or tendon popping out of bicipital groove
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What does the Tennis Elbow Test test for? What is the positive sign?
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Lateral epicondylitis. Pos. sign pain over lateral epicondyle.
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What does the Tinel Test test for? What is the positive sign?
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Ulnar nerve impingement. Pos. sign is parasthesia in 1/2 of 4th and 5th digits.
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What does the Ligamentous stability Test test for? What is the positive sign?
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Stability of medial and lateral collateral ligaments of elbow. Pos. sign is gapping at the joint.
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What does the Dupuytren Contracture Test test for?
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Palmar fascia of 1 or more fingers.
NOTE: Usually bilateral and hereditary. Increased incidence with age. Seen frequently in patients that suffer from diabetes, alcoholic liver disease, epilepsy. |
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What does the Tinel and Phalen'sTest test for? What is the positive sign?
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Carpal Tunnel Syndrome (median nerve). Pos. sign is parasthesia in 1st, 2nd, 3rd, and half of 4th digit. Pt. should hold Phalen's position for 1 minute to confirm neg. test result.
Note: Flick Sign - pt. shaking down a thermometer is pos. sign of carpal tunnel |
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What does the Long Finger Flexor Test test for? What is the positive sign?
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Flexor digitorum superficialis - flexion of PIP joint.
Flexor Digitorum Profundus - Flexion of DIP joint. |
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What does the Allen Test test for? What is the positive sign?
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Patency of ulnar artery. Pos. sign is if the hand doesn't return to normal coloring after release of ulnar artery.
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What does the Median Nerve Test test for? What is the positive sign?
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Tinels - tapping at flexor retinaculum. Pos. sign is parasthesia in the 1st, 2nd, 3rd, and half of 4th digit.
Phalen's - hands in reverse prayer position. Pos. sign is parasthesia in 1st, 2nd, 3rd and half of fourth digit. |
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T/F: Osteoarthritis onset usually occurs in older patients as opposed to younger patients like Rheumatoid arthritis.
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TRUE
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Is osteoarthritis onset sudden or gradual?
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gradual. Rheumatoid arthritis onset is sudden
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How long does stiffness associated with rheumatoid arthritis last?
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at least an hour. Osteoarthritis is a few minutes.
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How is pain associated with osteoarthritis relieved?
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rest. Rheumatoid arthritis pain is even at rest.
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Is fatgue associated with rheumatoid arthritis unusual?
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NO, its usually severe.
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What is the cause of rheumatoid arthritis?
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Fusiform (=tapering towards each end) soft tissue enlargement
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What is the cause of osteoarthritis?
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Bony enlargement.
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T/F: osteoarthitis gets better with use of the joint.
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FALSE. it gets worse.
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Define Baker's Cyst
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feeling of tightness/ a bulge behind knee. Pain is worse when knee is fully extended or active.
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Define Bursitis
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Inflammation of bursa. (results from constant friction between skin and tissues around joint.)
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What are some of the signs of bursitis?
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swelling, pain, point tenderness, erythema, warmth
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Define osteomyelitis
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Infection of bone, usually from open wound or systemic infection.
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What are some of the signs of osteomyelitis?
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edema, warmth, tenderness, pain with movement, spiking fevers, headache, nausea (always evaluate for this is people with fractures)
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Define sprain
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stretching or tearing of a supporting ligament of a joint by forced movement beyond its normal range.
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What are some of the signs of bursitis?
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swelling, pain, point tenderness, erythema, warmth
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What are some of the signs of a sprain?
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pain, swelling, hemmorhage, loss of function
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Define osteomyelitis
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Infection of bone, usually from open wound or systemic infection.
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Define tendonitis
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Inflammation of synovium-lined sheath around tendon. Results from repetitive actions.
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What are some of the signs of osteomyelitis?
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edema, warmth, tenderness, pain with movement, spiking fevers, headache, nausea (always evaluate for this is people with fractures)
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What are some of the signs of tendonitis?
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pain with movement, limitation of movement, tenderness.
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Define sprain
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stretching or tearing of a supporting ligament of a joint by forced movement beyond its normal range.
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Define Plantar Fasciitis
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Pain/Inflammation of plantar fascia.
One of the most common causes of heel pain. |
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What are some of the signs of a sprain?
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pain, swelling, hemmorhage, loss of function
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What are some of the signs of plantar fasciitis?
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stabbing pain that usually occurs with first steps in the morning. One of the most common causes of heel pain.
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Define tendonitis
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Inflammation of synovium-lined sheath around tendon. Results from repetitive actions.
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Define Osteoporosis
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Decrease is bone mass. Occurs because bone resorption is more rapid than bone deposition.
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What are some of the signs of tendonitis?
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pain with movement, limitation of movement, tenderness.
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Define Plantar Fasciitis
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Pain/Inflammation of plantar fascia.
One of the most common causes of heel pain. |
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What are some of the signs of plantar fasciitis?
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stabbing pain that usually occurs with first steps in the morning. One of the most common causes of heel pain.
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Define Osteoporosis
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Decrease is bone mass. Occurs because bone resorption is more rapid than bone deposition.
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What are some of the signs of osteoporosis?
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loss of height or spontaneous fracture. hallwark is dowager hump. Most common in women.
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Define Myopathy
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Muscle disease unrelated to any disorder of innervation or neuromuscular junction. Etiologies vary widely
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What are some common symptoms of myopathy?
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muscle weakness, impaired function in activities of daily life, (and sometimes muscle pain and tenderness)
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What are some of the symptoms of neuropathy?
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Pain and numbness in hands and feet. Pain is described as tingling or burning.
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Define Pes Planus
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When the arch of instep collapses and comes in contact with the ground. (in some individuals, the arch never develops while they are growing)
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Define Pes Cavus
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A high instep. Associated with claw toes.
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Define Genu Valgum
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Knock-knee.
Commonly found in children 2-4 yrs. old |
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Define Genu Varus
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bow-leg.
Commonly found in toddlers up to 18 months. |
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Define Geriatrics
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A sub-specialty of internal and family medicine
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Define Gerontology
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Study of the aging process itself
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Define Chronological Age
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A person's age in years. Used for risk assessment
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Define Biological Age
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Bodily Aging
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What is the genetic basis of aging?
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As cells age, their telomeres shorten due to damage and they divide less frequently. Since organs are made of cells, they also lose function as cells deteriorate/die with aging.
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T/F: Smoker's consume their respiratory reserve earlier than non-smokers.
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duh.
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What do elderly patients desire to maintain above all else?
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independence and self-respect
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What causes functional decline in elderly patients?
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structural effects of aging on the cells, organs and systems of the human body
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T/F: The study of gerontology and geriatric resources can assist you in focusing on the unique needs of the elderly patient
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True
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What are the four categories of impairment in regards to elderly patients?
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Immobility
Instability Incontinence Impaired Intellect/Memory |
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Aging alters absorption, effectiveness, and side effect profile due to what three things?
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1.) Dimished salivary glands (=mouth dryness/issues swallowing)
2.) Gastrointestinal changes delay emptying of solids and liquids (=decreased speed of absorption) 3.) Changes in body fat, muscle, and elimination (liver and kidneys) (= different distribution of drugs) |
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Cognitive impairment can lead to what psychological pharmacological considerations?
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1.) Poor dosage and timing regimens
2.) Noncompliance 3.) Iatrogenic (inadvertent adverse affect) issues caused by polypharmacy (use of multiple meds) |
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T/F: Elderly patients are less likely to experience side effects from drugs
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FALSE. elderly patients are more likely to experience side effects
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What are three ways to help elderly patients and their families prepare for the ethical and legal aspects of aging?
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Encourage establishment of POA (Power of Attorney), MPOA (medical power of attorney), and a living will
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What does EPSDT stand for?
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Early Periodic Screening Diagnosis and Treatment
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What does the "early" in EPSDT stand for?
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Identifying problems early, starting at birth
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What does the "periodic" in EPSDT stand for?
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Checking children's health at periodic, age-appropriate intervals
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What does the "screening" in EPSDT stand for?
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Doing physical, mental, developmental, dental, hearing, vision, and other screening tests to detect potential problems
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What does the "Diagnosis" in EPSDT stand for?
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Performing diagnostic tests to follow up when a risk is identified
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What does the "treatment" in EPSDT stand for?
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Treating the problems found
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What does the American Academy of Pediatrics recommend in terms of Periodicity for children?
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"POMPSDAH"
P - Procedures O - Oral Health M - Measurements P - Physical Examination S - Sensory Screenings D - Developmental/Behavioral Assessment A - Anticipatory Guidance H - History |
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What Questions should you ask of adolescents?
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"HEADSSS"
H - Home E - Education/Employment A - Activity D - Drugs S - Sexuality S - Suicide S - Safety |
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What are the components of the growth chart?
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Length/Height
Weight Head Circumference (infant) Weight for Length (BMI for infants) BMI |
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True or False: Blood Pressure is a part of the growth chart.
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FALSE.
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What does sensory screening in children encompass?
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vision and hearing
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What does the Denver Questionnaire or Ages and Stages Questionnaire ask?
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Gross Motor (ex. = running)
Fine Motor (ex. = coloring) Language (speech) Social Interaction (ex. = # close friends) Self Help |
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By what age should a child be screened for autism?
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3
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What is the M-CHAT?
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A validated screening for toddlers from 16-30 months of age to assess risk for autism spectrum disorders (ASD)
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What is the APGAR score?
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A scale used to determine health of a newborn. It is determined 1 minute after birth, and again at 5 minutes after birth.
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What does APGAR stand for?
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A - Appearance
P - Pulse G - Grimace A - Activity R - Respiratory Effort |
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What is the range of the APGAR score?
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0-2
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What is the Dubowitz Examination used for?
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To determine a gestational age upon birth (good if the mother had no prenatal care i.e. gestational age unknown) or if GA is undetermined prior to birth
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What is the Dubowitz Examination based on?
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Physical characteristics and neuromuscular development
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What are the acronyms used for the Dubowitz Examination of gestational age?
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SGA (small gestational age?)
AGA (average gestational age?) LGA (large gestational age?) |
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How do you note the primitive reflexes tested in infants?
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They are noted as either present or absent
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What is the rooting primitive reflex and when should this test be done?
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Touch babies cheek - baby should turn head towards that side. birth
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What is the palmar grasp primitive reflex and when should this test be done?
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baby wraps fingers around object or another's fingers. birth
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What is the plantar grasp primitive reflex and when should this test be done?
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baby wraps toes around object or another's fingers birth
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What is the moro primitive reflex and when should this test be done?
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Infant placed in semi-upright position, allow head to fall back, re-support infants head. Infant symmetrically extends and abducts arms and opens hands, then adducts and partially flexes arms as if in an embrace. birth
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What is the tonic neck primitive reflex and when should this test be done?
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Infant in supine position, turn infant's head so jaw is over shoulder. Infant extends arm and leg on side head is turned and flexes arm and leg on opposite side 2-3 months
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What is the placing primitive reflex and when should this test be done?
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Hold infant upright under arms. Touch top of foot to underside of horizontal surface (ex. = table). Infant flexes then extends leg and places foot flat. 4 days old
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What is the stepping primitive reflex and when should this test be done?
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Infant held upright with feet on floor. Infant steps forward (walking). Birth and 8 weeks.
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What is the Babinski primitive reflex and when should this test be done?
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Stroke outside of bottom of infants foot. Dorsiflexion of great toe with or without fanning of other toes. 2 years old.
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What are you checking for when you listen to an infant's heart and lungs?
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heart murmur or respiratory distress
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Define Cephalohematoma
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Collection of blood under periosteum, usually = childbirth injury
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Define Plagiocephaly
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Parallelogram heads. Frequent in twins due to position in-utero
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Define Caput Succedaneum
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Edematous swelling of scalp due to pressures experienced during childbirth
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When you check the abdomen of an infant or child, what are you looking for?
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masses and hernias. palpate the kidneys, which are more easily palpated in children than adults
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What are you looking for in checking the spine of a newborn/child?
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mobility, alignment, defects.
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What are you looking for in checking the limbs of a newborn/child?
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equal movement, muscle tone, strength, deformities
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If you see a sacral dimple, hair or opening on the back of an infant, what should you think?
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spina bifida
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What are you looking for in checking the genito-urinary systems of an infant?
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ambiguous gentalia, congenital anmalies
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Define Hypospadias
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When the urethral meatus is located in a position other than the tip of the glans penis
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What are you looking for in checking the anus of an infant?
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tone, imperforate anus (=opening of anus is missing or blocked)
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What are you looking for in checking the eyes of an infant?
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red reflexes.
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What should you think if you see a white reflection in the eyes of a newborn?
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retinoblastoma - deadly childhood cancer.
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What are you looking for in checking the Heart of an infant?
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rate, murmurs, arrhythmias
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What are you looking for in checking the hips of an infant?
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normal, dislocated, subluxable (use Ortolani and Barlow maneuvers)
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By when should dentition occur in infants?
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by 14 months
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Define bottle decay
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When babies are put to bed with a bottle and teeth decay (particularly front teeth)
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T/F: It is OK to put a baby to bed with a bottle
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FALSE
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Define Strabismus
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When eyes do not line up when focusing (wandering eye)
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What procedures are a part of caring for newborns, infants, and children?
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"SNITCH - LD"
S - Sexually Transmitted Illness Screen (unportected sex?) N - Newborn metabolic screen I - Immunizations T - Tuberculin screen C - Cervical dysplasia screen H - Hemoglobin/Hematocrit L - Lead level D - Dyslipidemia screen |
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What is the "Bright Futures" Program?
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Guidelines for health supervision of infants, children, and adolescents.
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