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12 Cards in this Set

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Rinne test
The Rinne test should be performed on each ear in turn. The base of the fork is placed against the patient's mastoid process on one side. When the patient can no longer hear the vibration, the tuning fork is placed next to their ear on the same side. The test may be interpreted as follows:

* If the sound is now heard, the Rinne test is positive, meaning that air conduction is better than bone conduction and there is:
- no hearing loss
- perceptive hearing loss.
* Conductive hearing loss may be diagnosed if the test is negative (i.e. bone conduction is better than air conduction)
* A misleading false negative Rinne result may occur when one ear is totally deaf. Here, bone conduction appears to occur but in fact the sound waves are transmitted to the opposite cochlea. One way to detect this is to flood the good ear with white noise while carrying out the test.
(answer and image from http://www.geriatricsyllabus.com/syllabus/main.jsp?cid=SGS-EAR-4-2)
Weber test
The vibrating fork is placed anywhere on the midline of the patient's skull. The patient has to say where they hear the vibration. Interpretation of results is as follows:

* The vibration will be heard on the midline or equally in both ears if the hearing is normal
* The sound is heard better by the intact ear in perceptive loss
* The sound is heard better by the affected ear in conductive loss.
(answer and image from http://www.geriatricsyllabus.com/syllabus/main.jsp?cid=SGS-EAR-4-2)
Tinel's sign
Carpal Tunnel Syndrome

"pain or dysesthesia in the distribution of the median nerve in the hand may be reproduced by tapping over the media nerve on the volar aspect of the wrist"
(from http://www.meddean.luc.edu/lumen/MedEd/Medicine/Rheumatology/Hands/Hand13/Hand13dx.html)
Phalen's sign
Carpal Tunnel Syndrome

"Pain or dysesthesia in the distribution of the median nerve in the hand may be reproduced by...maintaining the wrist in full flexion for 30 to 60 seconds"
(from http://www.meddean.luc.edu/lumen/MedEd/Medicine/Rheumatology/Hands/Hand13/Hand13dx.html)
FABERE test
Flexion
Abduction
External Rotation
Extension

Can add internal rotation and adduction
Patrick Test
Same as FABERE test
Romberg Test
"Have the patient stand with heels and toes together. Ask the patient to remain still and close their eyes. To achieve balance, a person requires at least two out of three of the following: 1) visual confirmation of position, 2) non-visual confirmation of position (including proprioceptive and vestibular input), and, 3) a normal functioning cerebellum. Therefore, if a patient loses balance after standing still with their eyes closed, but maintains balance with their eyes open, then there is likely to be a lesion in the cerebellum."
(from http://opt.pacificu.edu/ce/catalog/COPE9462/Neuro_Zelczak.html)
Marcus Gunn pupil
Apparent dilation of denervated (CN II) pupil on swinging flashlight test
(image from http://www.neurology.arizona.edu/Training/c10.html)
Kussmaul breathing
Deep hyperventilation associated with diabetic ketoacidosis
(image from http://www.rsu.ac.th/therapy/pornpimol/chestpt6.htm)
Cheyne-Stokes breathing
Periodic increased and decreased tidal volume followed by periods of apnea compensating for changing PaCO2 and PaO2 due to brain tumors, injuries, or strokes
Biot breathing
Clusters of similar-sized rapid, shallow inspirations followed by periods of apnea from damage to the medulla caused by trauma, strokes, or masses.
Spurling's Test
have the patient sit in a chair in front of you. Place an axial load on his C-spine by pressing on the top of his head. Now have the patient rotate and laterally flex his head. If the patient has cervical nerve root compression, he will experience radiating pain with this maneuver.
(answer and image from http://meded.ucsd.edu/isp/2005/orthopedic/H&P%20Spine.htm)