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119 Cards in this Set
- Front
- Back
- 3rd side (hint)
smell cinammon
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CN I
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Snellen
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CNII
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Papillary light reflex
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CD II
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What CN II
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Optic nerve (Sensory)
Sight |
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What's CN III
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Oculomotor nerve (Motor)
Eye movement Innervates all but superior oblique and Lateral Rectus Pupil constriction/accommodation Eyelid opening (levator palpebrae) If damaged eye looks down and out |
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What's CN IV
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Trochlear nerve (Motor)
Innervates Superior Oblique, which Abducts, Intorts and Depresses in AID of vision.. eye movement if damaged- diplopia with downward gaze |
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What's CN V
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Trigeminal (V1, V2, V3) (Motor and Sensory)
Mastication Facial sensation |
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What's CN VI
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Abducens (Motor)
CONTRALATERAL Innervates Lateral Rectus if damaged, medially directed eye |
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What's CN VII
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Facial (Motor and Sensory)facial movement
taste from anterior 2/3 of tongu lacrimation salivation (submandibular and lingual) blink (orbicularis oculi) stapedius in ear |
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What's CN VIII
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Vestibulocochlear (Sensory)
hearing and balance |
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What's CN IX
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Glossopharyngeal (Sensory and Motor)
taste from posterior 1/3 of tongue swallowing salivation (parotid) monitoring carotid sinus chemo- and baroreceptors |
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What's CN X
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Vagus (Sensory and Motor)
Taste from epiglottic region swallowing, palate elevation talking, coughing thoracoabdominal viscera aortic arch chemo/baroreceptors |
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What's CN XI
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Spinal Accessory (Motor)
head turning shoulder shrugging |
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What's CN XII
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Hypoglossal (Motor)
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Tongue movement
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Which nerve controls biceps reflex
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C5
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Which nerve controls triceps reflex
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C7
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Which nerve controls Patella reflex
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L4
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Which nerve controls Achilles reflex
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S1
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What does Babinski sign mean
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UMN lesion
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Moro reflex
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extension of limbs when startled
frontal lobe lesion |
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Rooting reflex - nipple seeking
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Frontal lobe lesion
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Palmar reflex
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grasps objects in palm
frontal lobe lesion |
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A/E for Corneal reflex
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V1 - VII
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A/E for lacrimation
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V1- VII
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A/E for Jaw Jerk
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V3 (sensory) - V3 (motor)
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A/E for Pupillary reflex
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II - III
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A/E for gag reflex
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IX - IX, X
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kuh-kuh-kuh tests?
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palate elevation by X
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la la la tests?
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tongue - XII
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mi mi mi tests?
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Facial
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which muscles close the jaw? innervation?
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Masseter
teMporalis Medial pterygoid (M's Munch) all innervated by V3 |
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which muscle opens the jaw? innervation?
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Lateral pterygoid (Lateral Lowers)
innervated by V3 |
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Rinne tests?
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conductive hearing loss
in normal Rinne, air is a better conductor than bone |
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Weber tests for?
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conductive and sensorineural hearing loss
conductive hearing loss: patient hears better in affected ear sensorineural loss: patient hears better in unaffected ear (CASU) |
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Lateral rectus innervated by
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VI - abducens
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Superior Oblique innervated by
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IV - trochlear
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Weakness: UMN or LMN?
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both
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Atrophy:UMN or LMN?
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LMN
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Fasciculation: UMN or LMN?
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LMN
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Hyperreflexia? UMN or LMN?
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UMN
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Hyporeflexia? UMN or LMN?
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LMN
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Hypertonia? UMN or LMN?
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UMN
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Hypotonia: UMN or LMN?
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LMN
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Babinski reflex: UMN or LMN?
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UMN
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Spastic Paralysis: UMN or LMN?
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UMN
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Rest tremor: brain area responsible?
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basal ganglia
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Chorea: : brain area responsible?
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basal ganglia
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athetosis: brain area responsible?
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basal ganglia
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truncal ataxia: brain area responsible?
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cerebellar vermis
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dysarthria: brain area responsible?
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cerebellar vermis
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contralateral hemiballismus: brain area responsible?
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subthalamic nucleus
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intention tremor: brain area responsible?
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cerebellar hemisphere (ipsilateral)
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limb ataxia: brain area responsible?
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cerebellar hemisphere (ipsilateral)
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'ah' tests?
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IX/X
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clonus: UMN or LMN?
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UMN
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positive Romberg means?
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dorsal column problem
problem with proprioception and vibration any ataxia is sensory can indicate tabes dorsalis, Friedricks ataxia, peripheral neuropathy |
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postive pronator drift means?
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spasticity due to an UMN lesion
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what's an antalgic gait
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painful gain where phase is shortened on injured side
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pain on abduction of arm means?
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rotator cuff injury
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two common causes of elbow pain?
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lateral and medial epicondilitis.
Lateral epicondilitis is tennis elbow |
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what's a sign of carpal tunnel?
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atrophy of thenar prominence
Tinel's sign (percuss over carpal tunnel) Phalen's Test (parasthesias after maximal flexing at wrist and holding for up to a minute |
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signs of rheumatoid arthritis
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swan neck and boutonniere deformity
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signs of osteoarthritis
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bouchard and hebredens nodes
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node on PIP?
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Bouchard
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node on DIP?
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Hebreden
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DIP flexed, PIP hyperextended
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swan neck deformity of RA
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PIP flexed, DIP hyperextended
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boutonniere deformity of RA
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Hear at right sternal angle
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(right 2nd interspace)
aorta systolic murmur - flow murmur - aortic valve sclerosis |
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Hear at left sternal border
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(left third interspace)
diastolic murmur - aortic regurgitation - pulmonic regurgitation |
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hear at pulmonic area
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(left sternal angle)
systolic ejection murmur - pulmonic stenosis flow murmur (e.g., atrial septal defect) |
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hear at tricuspid area
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(4th intercostal, left)
Pansystolic murmur - tricuspid regurgitation - VSD Diastolic murmur - tricuspid stenosis - ASD |
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hear at mitral area/apex
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(4th intercostal space, lateral to midclavicular)
Systolic murmur - mitral regurgitation Diastolic murmur - mitral stenosis |
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S1 is when...
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Mitral valve closes and systole starts
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S2 is when...
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Aortic valve closes and diastole starts
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S3 is when
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in early diastole during rapid ventricular filling, because of increased filling pressures, especially in dilated ventricles
(normal in kids) |
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S4 is when...
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in late diastole there's an atricl kick due to high atrial pressure.
Associated with ventricular hypertrophy |
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S2 splitting happens because
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inspiration increases the difference betwee the aortic valve closing and the pulmonic valve pulmonic valve closes
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Splitting widens when
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pulmonic valve is stenotic
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There's fixed splitting when
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there's ASD
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There's paradoxical splitting when
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there's aortic stenosis
(P2 is before A2) |
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Mitral/tricuspid regurg
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holosystolic
high pitched blowing murmur mitral loudest at apex tricuspid loudest at tricuspid area |
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Aortic stenosis
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crescendo-decrescendo systolic ejection murmur
radiates to carotids/apex pulsus parvus et tardus (pulses weak compared to heart sounds) |
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What is pulsus parvus et tardus associated with?
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Aortic stenosis
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VSD murmur
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holosystolic
harsh loudest at tricuspid area |
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Mitral prolapse sound
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late systolic murmur with midsystolic click
loudest at S2 |
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Aortic regurgitation murmur
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immediate "blowing" diastolic murmur
high pitched |
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Mitral stenosis murmur
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Follows opening snap
Delayed rumbling late diastolic |
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PDA murmur
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continuous machine-like murmur
loudest at time of S2 |
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technique for hearing aortic regurgitation murmur
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patient leaned forward and exhaling
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When to use the bell
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low pitched sounds, e.g.,
S3 and S4 MS murmur |
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What part of stethoscope to use for friction rub
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diaphragm
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delayed carotid pulse indicates
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AS
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bounding carotid pulse indicates
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aortic regurgitation
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JVP increases with
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RVHF
tricuspid stenosis tricuspid regurgitation cardiac tamponade |
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What grade is a murmur with Thrill
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IV at least
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What is RV heave or parasteral heave indicative of? when does it happen
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RV enlargement or failure
heard in systole |
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What are grade 5 and 6 murmurs
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5 is heard with steth partly off; 6 is heard with it entirely off
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What to listen for in LLdecubitus
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MS diastolic rumble
S3 and S4 gallop |
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when do you particularly want to listen to renal bruits
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HTN
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What does S3 indicate?
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failing left ventricle and increased volume in ventricle
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What does S4 indicate
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atrial gallop
blood forced into a stiff ventricle due to failure or restrictive cardiomyopathy |
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several methods for getting peritoneal signs
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Rebound
1 finger palpation bed shake ask patient to cough rigid or involuntary guarding |
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normal liver span
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6-12cm
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What is the lowest interspace on the left anterior axillary line
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8th or 9th
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What suggests an enlarged spleen?
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Tympanitic on expiration and dull on inspiration (TEDI)
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when a patient with ascites is supine the center is ? and the edges are?
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center is tympanitic and the edges are dull
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how do you get Murphy's sign
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deep palpate in right upper quadrant and then ask patient to breathe in
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macule:patch :: (2 answers)
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papule:plaque
vesicle:bullae |
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which is blanchable: erythema? petechiae?
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erythema is blanchable
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Where are acral lesions
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head, hands and feet
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What are the intertriginous areas
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axilla
perineum under breasts at skin folds |
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What can clubbing indicate
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ILD
lung cancer mesothelioma subacute bacterial endocarditis chrons primary biliary cirrhosis |
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Scale for muscular power
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0 - absent
1 - slight contraction 2- movement with gravity eliminated 3 - movement against gravity 4- movement against gravity with some resistance 5 - movement against gravity and full resistance |
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how do you test proprioception?
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grab toe or finger by the sides and ask if it's being moved up or down
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Grading scale for deep tendon reflexes
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0 none
1+ diminised 2+ normal 3+ increased 4+ hyperactive |
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what can ankle jerk elicit
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clonus
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spinal roots for brachioradialis
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C6
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spinal roots for triceps
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C7
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how to assess for anemia
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conjunctival pallor
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