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Neuro, Musc, Abdomen

Health Assessment Final

Neer Test Performed by having patient internally rotate shoulder while examiner forward flexes arm to 150 degrees (Rotator cuff tear)
Thumb Abduction Test Pt hand palm up and raise thumb perpendicular. Apply downward pressure on thumb to test strength. (Carpal Tunnel Syndrome)
McMurray Pt supine and flex one knee while other leg rotated to medial position. Positive sign is audible click, grind, or pain. (Torn Medial/Lateral meniscus)
Bragard Stretch Lumbar disk herniation test
Barlow-Ortolani Maneuver Detect hip dislocation
Gower Sign Child uses hand to push off floor into standing position (Muscular dystrophy)
Allis Sign One knee appears lower than other is positive sign (Hip dislocation or shortened femur)
Tinel When striking pt's wrist with index finger, where median nerve is, tingling sensation results as positive sign (Carpel tunnel syndrome)
Phalen Ask patient to hold both wrist s in palmar flexed position for 1 minute, positive sign in tingling and numbness (Carpel Tunnel Syndrome) "praying"
Hawkins Test Flex shoulder to 90 degrees, then elbow 90 degrees, then internally rotating to maximum limit. Positive sign is pain (Rotator cuff inflammation or tear)
Flick Test If movement of wrist, similar to shaking thermometer, causes hand pain or discomfort is positive test
Ballotment Determines presence of fluid of an effusion in knee through extension, applying downward pressure on suprapatellar pouch with thumb and forefinger then pushing patella downward against femur with finger of other hand
Bulge Sign Determines presence of excess fluid in knee by having pt extend knee while examiner milks medical aspect of knee upward two or three times, and then taps lateral side of patella
Trendelenburg Sign A/w testing of weak hip abductor muscles
Lachman Test Evaluates anterior cruciate ligament integrity
Frontal Personality, behavior, emotions, intellectual function, voluntary movement
Broca's Area Speech formation (if damaged = expressive aphasia)
Parietal Processes senses (touch, pain, etc)
Occipital Visual receptor and interpretation
Spinal Cord Mediates reflexes
Temporal Sounds interpreted
Wernicke's Area Gives meaning to spoken/written language
Brain Stem Controls involuntary functions
Cerebellum Coordination of voluntary movements, equilibrium, and muscle tone
Aging Decreases in light adjustment, corneal reflex, gag reflex, color discrimination, upward gaze, taste buds
Sequence for Neuro Exam Mental status, cranial nerves, motor system, sensory system, reflexes
Romberg Test Positive if looses balance (look for swaying with closed eyes)
Proprioception Move up or down, will see abnormal with peripheral neuropathies
Stereognosis Tactile discrimination using common objects
Graphesthesia Drawing letter or number on patients hands with continuous motion
Clonus Hyperactive Reflexes - check with foot
DTR 0 No response
DTR 1+ Sluggish
DTR 2+ Expected
DTR 3+ More brisk than expected
DTR 4+ Hyperactive
Decorticate Posture pulls in to core, indicates cerebral damage
Decerebrate Posture pulls out from core, indicates brainstem damage (pronation of arms and plantar flexion)
Nuchal rigidity stiff neck a/w meningitis and intracranial hemorrhage
Brudzinski Involuntary flexion of hip/knees when examiner flexes patients neck
Kernig Flex the leg @ hip and knee while supine. Pain in lower back and resistance to straighten leg is + sign.
Synovial Joint Freely moveable joints
Bursae Fluid filled sacs in spaces of CT btwn tendons, ligaments, and bones to reduce friction
Nonsynovial Joint Bones connected by fibrous tissue or cartilage and not moveable
Osteoarthritis Risk Factors Obesity, family hx, lax ligaments w/ postural joint abn, & age >40
Osteoporosis Risk Factors White, Asian, Native Americans, light body frame, family hx, menopause before 45, diabetes, poor teeth, smoking, alcohol, lack of weight bearing activities
Sports Injury Risk Factors Poor physical conditioning, lack of warm-up exercises, intense competition, contact sports, rapid growth, joint overuse
Scoliosis One shoulder will be higher and arms different lengths when bent over
Lordosis Accentuated normal lumbar curve, normal in pregnancy, and common with obesity
Kyphosis Hunch back
Rotator Cuff Tendonitis Inability to raise arms up
Ganglion Cyst Round cystic, nontender nodule over tendon sheath or joint capsule (benign)
Genu Valgum Knock Knees
Genu Varum Bow legs
Pes Planus Flat feet
Pes Cavus High Arch
Hallux Valgus Great toe deviated laterally and may overlap 2nd toe
Bunion Inflammed bursa usually on medial side
Gout Increased uric acid
Rotator Cuff Tests Neer & Hawkins
Carpal Tunnel Tests Phanel, Tinel, Thumb Abduction, Flick
Knee Tests Ballotment, Bulge McMurray, Lachman, Drawer
Hip Tests Barlow-Ortolani, Allis, Trendelenburg, Thomas
Constipating Medications Iron and Opiods
Children Abdomen Considerations Constipation, toilet training, pica, rectal bleeding, abdominal pain
Infant Abdomen Considerations Birth weight, meconium stool passage, jaundice, vomiting, diarrhea, abdomen enlargement
Pregnancy Abdomen Considerations Urinary symptoms (1&3rd trimester), fetal movements (20 weeks), constipation (bc colon higher and more lateral/posterior)
Older Adult Abdomen Considerations Blunted manifestations: symptoms less severe, signs less pronounced, pain diminished/absent
Scaphoid Hollowed out appearance
Intestinal Obstruction, paralytic ileus, peritonitis Reasons for changes in bowel sounds
Created by: TedMed