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ClinSkills1
WVSOM clinical skills1
| Question | Answer |
|---|---|
| 5 parts of the Musculoskeletal exam | 1. Inspection2. Palpation3. ROM4. Muscle strength (0-5 scale)5. Integrated function and special tests |
| Spurling's test | - test for nerve root impingement in neck- spine extended, pt. looks down and to the right |
| Tinel sign | test by stiking pt's wrist with index finger where the median n. passes under the flexor retinaculum- test for carpal tunnel+ test= pain |
| Phalen test | Pt holds both hands flexed and pressed together for 60 sec- test for carpal tunnel+ test = numbness |
| Compression and Distraction | push head down - pull head up- evaluate neck pain, test for n. compression+ test = pain |
| Frozen shoulder | no glenohumeral motion, only scapulothoracic motion |
| APLEY scratch test | test for range of motion. pt puts one arm above head and reaches behind. pt reaches from below and tries to touch the other hand-screens for frozen shoulder |
| Yergason test | pt flexes forearm at R angle, clinician stabilizes elbow, rotates pt's arm.- tests stability of biceps tendon in bicipital groove+ test = tendon popping out of groove |
| Neer test | pt. internally rotates shoulder, clinician flexes pt's arm up to 150 degrees to make supraspinatus touch acromion process- screens for rotator cuff inflammation or tear+ test = pain |
| Supraspinatus test (empty can test) | abduct arm at right angle, flex arm 30 degrees, "pour the can out"- tests rotator cuff injury+ test = unable to hold arm up |
| Drop arm test | Pt fully abducts arm to the side, slowly lowers it. While arm is in abduction, push on it.+ test = pt cannot hold arm and drops it |
| Jerk test | Internally rotate arm and flex at 90 degrees with elbow flexed 90 degrees. Push humerus posteriorly at elbow.+ test= subluxation or dislocation |
| Ligamentous stability (elbow) | Pt flexes elbow, clinician cups posterior aspect. Apply valgus and varus stresses to the pt. and inspect for any gapping in resp. to stresses. |
| Tennis elbow | tests for bursitis along lateral elbowpt flexes elbow and pronates forearm. clinician holds elbow and tries to flex the pts fist.+ sign = sharp pain |
| Anatomic snuffbox | bound by extensor pollicis brevis, extensor pollicis longus, abductor pollicis longus.Tenderness here suggests scaphoid fracture. |
| Allen test | compress ulnar and radial aa. release ulnar to see if hand returns to normal colortests functioning of ulnar a. |
| Problem | perceived health threat e.g. fatigue, HTN, smoking. |
| Two types of medical records | source oriented and problem oriented |
| Source oriented med. record | information filed as it comes in, lab data, x-rays, visit notes each filed separately and independently in chart |
| Problem oriented Med. record | structures information into a sequence. includes data base, problem list, progress note, initial plan |
| Data Base | all known facts about the patient. Includes history, ROS, Physical exam, Lab data, Consults |
| Problem list | comprehensive view of patient's past and present health |
| 4 components of a progress note | SOAP - subjective, objective, assessment, plan |
| Subjective (of SOAP) | pt's present complaint |
| Objective (of SOAP) | findings - exam, x-ray, labwork |
| Assessment (of SOAP) | diagnosis/state of the problem |
| Plan (of SOAP) | Rx, Investigation, Pt. Ed. |
| Pt review of chart | Pt has legal right to review and amend their chart. They can submit a request to do so. |
| Kalamazoo Consensus Statement | 1. essential elements of dr-pt communication 2. framework for communication and standards |
| Culture | shared existence, shared values |
| function of Somatostatin | inhibit the release of GH |
| What condition does lack of GH cause? | dwarfism |
| what condition does excess of GH cause in children? | Gigantism |
| what condition does excess of GH cause in adults? | acromegaly (bone growth after epiphyseal plates have closed - note - GH cannot stimulate growth of long bones after plate closure) |
| Hypothalamus secretes these two hormones to regulate growth: | GHRH and somatostatin |
| Function of GHRH | stimulate pituitary to release GH |
| GH function | promotes protein synthesis in cells. works with IGF-I (prod. by liver) to stim. muscle and skeletal growth |
| PICA | eating substances that aren't food |
| EGA | estimated gestational age- is baby born to term or earlier? |
| How is infant weight measured? | infant is lying down on scale. weight is reported in grams. |
| What is waist to hip ratio used for? | measuring fat distribution. ratio is less than 1 in men, less than 0.85 in women. |
| Use of Recumbent length | used to measure children less than 2 years old. A toddler's recumbent length will be greater than standing height (lordosis in spine flattens when toddler is recumbent) |
| Head circumference | 2 years old, head= 2/3 of adult circumference. measure every visit until 3 years old. |
| How many weeks is considered preterm (EGA)? | less than 37 weeks |
| What is term EGA? | 37-41 weeks |
| What is postterm EGA? | EGA greater than 41 weeks |
| Thelarche | breast buds, first sign of puberty in girls. |
| Menarche | devt of menses - appears when breasts are at SMR 3-4. growth spurt starts 1 yr prior to menarche |
| What signals beginning of puberty in males? | enlargement of scrotum and testes |
| What is the mean age for male growth spurt? | 13.5 years |
| Cushing syndrome | caused by chronic excessive cortisol production by the adrenal cortex or steroid use. weight gain, weakness, hyperpigmentation, decreased testosterone |
| Acondroplasia | genetic disorder in growth of cartilage in epiphyses of the long bones and skull. Results in premature ossification and dwarfism. |
| Vital signs | Temp, Respiration, Pulse, BP, Pulse oximetry, Growth |
| respiration rate | number of cycles of inspiration and expiration in one min. |
| Pulse oximetry | indicates oxygen saturation of hemoglobin. |
| Korotkoff sound | sounds made by turbulent flow of blood in artery |
| Systolic BP | pressure at which you hear first heartbeat |
| Diastolic BP | pressure at which you hear the last sound |
| syncope | fainting |
Created by:
eegitto
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