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119 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)
smell cinammon
CN I
Snellen
CNII
Papillary light reflex
CD II
What CN II
Optic nerve (Sensory)
Sight
What's CN III
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
What's CN IV
Trochlear nerve (Motor)
Innervates Superior Oblique, which Abducts, Intorts and Depresses in AID of vision..

eye movement

if damaged- diplopia with downward gaze
What's CN V
Trigeminal (V1, V2, V3) (Motor and Sensory)

Mastication
Facial sensation
What's CN VI
Abducens (Motor)
CONTRALATERAL
Innervates Lateral Rectus
if damaged, medially directed eye
What's CN VII
Facial (Motor and Sensory)facial movement
taste from anterior 2/3 of tongu
lacrimation
salivation (submandibular and lingual)
blink (orbicularis oculi)
stapedius in ear
What's CN VIII
Vestibulocochlear (Sensory)
hearing and balance
What's CN IX
Glossopharyngeal (Sensory and Motor)
taste from posterior 1/3 of tongue
swallowing
salivation (parotid)
monitoring carotid sinus chemo- and baroreceptors
What's CN X
Vagus (Sensory and Motor)
Taste from epiglottic region
swallowing, palate elevation
talking, coughing
thoracoabdominal viscera
aortic arch chemo/baroreceptors
What's CN XI
Spinal Accessory (Motor)
head turning
shoulder shrugging
What's CN XII
Hypoglossal (Motor)
Tongue movement
Which nerve controls biceps reflex
C5
Which nerve controls triceps reflex
C7
Which nerve controls Patella reflex
L4
Which nerve controls Achilles reflex
S1
What does Babinski sign mean
UMN lesion
Moro reflex
extension of limbs when startled
frontal lobe lesion
Rooting reflex - nipple seeking
Frontal lobe lesion
Palmar reflex
grasps objects in palm
frontal lobe lesion
A/E for Corneal reflex
V1 - VII
A/E for lacrimation
V1- VII
A/E for Jaw Jerk
V3 (sensory) - V3 (motor)
A/E for Pupillary reflex
II - III
A/E for gag reflex
IX - IX, X
kuh-kuh-kuh tests?
palate elevation by X
la la la tests?
tongue - XII
mi mi mi tests?
Facial
which muscles close the jaw? innervation?
Masseter
teMporalis
Medial pterygoid (M's Munch)
all innervated by V3
which muscle opens the jaw? innervation?
Lateral pterygoid (Lateral Lowers)
innervated by V3
Rinne tests?
conductive hearing loss

in normal Rinne, air is a better conductor than bone
Weber tests for?
conductive and sensorineural hearing loss

conductive hearing loss: patient hears better in affected ear
sensorineural loss: patient hears better in unaffected ear (CASU)
Lateral rectus innervated by
VI - abducens
Superior Oblique innervated by
IV - trochlear
Weakness: UMN or LMN?
both
Atrophy:UMN or LMN?
LMN
Fasciculation: UMN or LMN?
LMN
Hyperreflexia? UMN or LMN?
UMN
Hyporeflexia? UMN or LMN?
LMN
Hypertonia? UMN or LMN?
UMN
Hypotonia: UMN or LMN?
LMN
Babinski reflex: UMN or LMN?
UMN
Spastic Paralysis: UMN or LMN?
UMN
Rest tremor: brain area responsible?
basal ganglia
Chorea: : brain area responsible?
basal ganglia
athetosis: brain area responsible?
basal ganglia
truncal ataxia: brain area responsible?
cerebellar vermis
dysarthria: brain area responsible?
cerebellar vermis
contralateral hemiballismus: brain area responsible?
subthalamic nucleus
intention tremor: brain area responsible?
cerebellar hemisphere (ipsilateral)
limb ataxia: brain area responsible?
cerebellar hemisphere (ipsilateral)
'ah' tests?
IX/X
clonus: UMN or LMN?
UMN
positive Romberg means?
dorsal column problem
problem with proprioception and vibration
any ataxia is sensory
can indicate tabes dorsalis, Friedricks ataxia, peripheral neuropathy
postive pronator drift means?
spasticity due to an UMN lesion
what's an antalgic gait
painful gain where phase is shortened on injured side
pain on abduction of arm means?
rotator cuff injury
two common causes of elbow pain?
lateral and medial epicondilitis.
Lateral epicondilitis is tennis elbow
what's a sign of carpal tunnel?
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
signs of rheumatoid arthritis
swan neck and boutonniere deformity
signs of osteoarthritis
bouchard and hebredens nodes
node on PIP?
Bouchard
node on DIP?
Hebreden
DIP flexed, PIP hyperextended
swan neck deformity of RA
PIP flexed, DIP hyperextended
boutonniere deformity of RA
Hear at right sternal angle
(right 2nd interspace)
aorta
systolic murmur
- flow murmur
- aortic valve sclerosis
Hear at left sternal border
(left third interspace)
diastolic murmur
- aortic regurgitation
- pulmonic regurgitation
hear at pulmonic area
(left sternal angle)
systolic ejection murmur
- pulmonic stenosis
flow murmur (e.g., atrial septal defect)
hear at tricuspid area
(4th intercostal, left)
Pansystolic murmur
- tricuspid regurgitation
- VSD

Diastolic murmur
- tricuspid stenosis
- ASD
hear at mitral area/apex
(4th intercostal space, lateral to midclavicular)
Systolic murmur
- mitral regurgitation

Diastolic murmur
- mitral stenosis
S1 is when...
Mitral valve closes and systole starts
S2 is when...
Aortic valve closes and diastole starts
S3 is when
in early diastole during rapid ventricular filling, because of increased filling pressures, especially in dilated ventricles

(normal in kids)
S4 is when...
in late diastole there's an atricl kick due to high atrial pressure.

Associated with ventricular hypertrophy
S2 splitting happens because
inspiration increases the difference betwee the aortic valve closing and the pulmonic valve pulmonic valve closes
Splitting widens when
pulmonic valve is stenotic
There's fixed splitting when
there's ASD
There's paradoxical splitting when
there's aortic stenosis

(P2 is before A2)
Mitral/tricuspid regurg
holosystolic
high pitched
blowing murmur
mitral loudest at apex
tricuspid loudest at tricuspid area
Aortic stenosis
crescendo-decrescendo systolic ejection murmur
radiates to carotids/apex
pulsus parvus et tardus (pulses weak compared to heart sounds)
What is pulsus parvus et tardus associated with?
Aortic stenosis
VSD murmur
holosystolic
harsh
loudest at tricuspid area
Mitral prolapse sound
late systolic murmur with midsystolic click
loudest at S2
Aortic regurgitation murmur
immediate "blowing" diastolic murmur
high pitched
Mitral stenosis murmur
Follows opening snap
Delayed rumbling late diastolic
PDA murmur
continuous machine-like murmur
loudest at time of S2
technique for hearing aortic regurgitation murmur
patient leaned forward and exhaling
When to use the bell
low pitched sounds, e.g.,
S3 and S4
MS murmur
What part of stethoscope to use for friction rub
diaphragm
delayed carotid pulse indicates
AS
bounding carotid pulse indicates
aortic regurgitation
JVP increases with
RVHF
tricuspid stenosis
tricuspid regurgitation
cardiac tamponade
What grade is a murmur with Thrill
IV at least
What is RV heave or parasteral heave indicative of? when does it happen
RV enlargement or failure
heard in systole
What are grade 5 and 6 murmurs
5 is heard with steth partly off; 6 is heard with it entirely off
What to listen for in LLdecubitus
MS diastolic rumble
S3 and S4 gallop
when do you particularly want to listen to renal bruits
HTN
What does S3 indicate?
failing left ventricle and increased volume in ventricle
What does S4 indicate
atrial gallop
blood forced into a stiff ventricle due to failure or restrictive cardiomyopathy
several methods for getting peritoneal signs
Rebound
1 finger palpation
bed shake
ask patient to cough
rigid or involuntary guarding
normal liver span
6-12cm
What is the lowest interspace on the left anterior axillary line
8th or 9th
What suggests an enlarged spleen?
Tympanitic on expiration and dull on inspiration (TEDI)
when a patient with ascites is supine the center is ? and the edges are?
center is tympanitic and the edges are dull
how do you get Murphy's sign
deep palpate in right upper quadrant and then ask patient to breathe in
macule:patch :: (2 answers)
papule:plaque
vesicle:bullae
which is blanchable: erythema? petechiae?
erythema is blanchable
Where are acral lesions
head, hands and feet
What are the intertriginous areas
axilla
perineum
under breasts
at skin folds
What can clubbing indicate
ILD
lung cancer
mesothelioma
subacute bacterial endocarditis
chrons
primary biliary cirrhosis
Scale for muscular power
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
how do you test proprioception?
grab toe or finger by the sides and ask if it's being moved up or down
Grading scale for deep tendon reflexes
0 none
1+ diminised
2+ normal
3+ increased
4+ hyperactive
what can ankle jerk elicit
clonus
spinal roots for brachioradialis
C6
spinal roots for triceps
C7
how to assess for anemia
conjunctival pallor