Term
| Golgi Tendon Receptors are what type? |
|
Definition
|
|
Term
| What do golgi tendons pirmarily respond to? |
|
Definition
| force of active contraction of the muscle; only slightly with an applied stretch. |
|
|
Term
| Group IB afferent nuerons |
|
Definition
| make polysynaptic connections in the spinal cord. |
|
|
Term
| Stimulation of golgi tendon organ --> |
|
Definition
| Inhibiitis motor firing to muscle; stimulates firing to its antagonist |
|
|
Term
|
Definition
| Safeguarding of the anatomic integrity of the joint structure. |
|
|
Term
| 2 Mechanisms that influence muscle tension are: |
|
Definition
| 1. Muscle Spindle Apparatus 2. Golgi Tension Receptors |
|
|
Term
| Over stimulation of a muscle spindle results in --> |
|
Definition
| increased afferent activity; reflex contraction |
|
|
Term
| Reciprical Inhibition Process --> |
|
Definition
| 1. Activation from CNS 2. Alpha Motoneuron 3. Agonist Muscle stimulated 4. Interneurons stimulated 5. Anatgonist muscle inhibited. |
|
|
Term
|
Definition
| Disrupt balance between proprioceptors and CNS. Leads to increased sympathetic nervous system firing @ somatic dysfunction level. |
|
|
Term
| Joint Capsule Mechanoreceptors are sensitive to: |
|
Definition
| 1. Joint angle extremes 2. Inflammation 3. Elevated Fluid Concentration |
|
|
Term
| Slow Twtich Muscle Fibers |
|
Definition
| 1. Small 2. More Mitochondria/Blood Capillaries 3. High Myoglobin 4. Red Color 5. Posture Muscles 6. Low Fatigue 7. More Muscle Spindles 8. Shorten Length. |
|
|
Term
| Fast Twitch Muscle Fibers --> |
|
Definition
| 1. Ballistic Use 2. Glycolytic Pathway 3. Greater Sarcoplasmic Reticulum 4. Easier Fatigue |
|
|
Term
| Articular Restriction --> |
|
Definition
| Increases sensitivity of the mechanoreceptors -->inhibition of slow tiwtich muscle fibers -->Lack of synchronicity between slow and fast twitch fibers. |
|
|
Term
| What happens in Isometric Contraction?? |
|
Definition
| Change in Tension --> Patient Force = Physician Force -->Resets proprioceptors |
|
|
Term
| What is post-isometric relaxation ?? |
|
Definition
| patient's activation fo the restrictred muscle against the physicians's counterforce. |
|
|
Term
| What is reciprocal inhibition??? |
|
Definition
| When the patient's acitvation of the anatagonist muscle to the restricted muscle aginst the physicians counterforce is used. |
|
|
Term
| 2 Types of Contraction to Build Muscle ??? |
|
Definition
| Concentric - Contraction of muscle resulting in approximation of origin and insertion Eccentric - lengthening of the muscle during contraction. |
|
|
Term
| Isokinetic Contraction ---- What is it? |
|
Definition
| Constant Velocity during either conenctric or eccentric contraction. --> used to build muscle strength. |
|
|
Term
| What is an Isolytic Contraction???? |
|
Definition
| Contraction of a muscle against resistance while an external force lengthnes the msucle. --Works through activation of golgi receptors. -->Tears down adhesions ---> Ability to cause Injury |
|
|
Term
| What is the Definition of Muscle Energy?? |
|
Definition
| OMT in which the patient voluntarily moves the body as specifically directed by the physician. -->precisely controlled position --->uses counterforce. |
|
|
Term
| What is muscle energy used for? |
|
Definition
| 1. Mobilization of Joints 2. Stretch tight muscles and fascia 3. Improve local circulation and respiratory effort 4. Balance Neurovascular relationships. |
|
|
Term
| Muscle Energy Requires What??? |
|
Definition
| Patient's full cooperation. |
|
|
Term
| Muscle Energy cannot be performed on who?? |
|
Definition
| Patient's in coma; uncooperative, unresponsive |
|
|
Term
| What are the Treatment Steps for Muscle Energy??? |
|
Definition
| 1. Accurate Structural Diagnosis 2. Enagae the Barrier in planes of restriction 3. Have patient exert minimal, precise musclar contraction 4. Patient relaxes 5. Restrictive barrier is approached and slack is taken up and repeated. |
|
|
Term
| What is the Feather Edge? |
|
Definition
| It means to not forece into the restrictive barrier, this causes guarding. |
|
|
Term
| Unyielding Counterforce--> |
|
Definition
| Means you functionally reverse the orgin and inssertion of the muscles utilized for the treatment. |
|
|
Term
| Common Failures of Muscle Energy?? |
|
Definition
| 1. Inaccurate Diagnosis 2. Inaccurate Positioning 3. No Unyielding Counterforce 4. Incorrect Muscle Effort Utilized 5. Incomplete Patient Relaxation |
|
|
Term
| Left Pectoralis with R3-5 may mimick what??? |
|
Definition
|
|
Term
| In a mechanical problem things aren't….. |
|
Definition
|
|
Term
|
Definition
| Restricted within normal range of motion by a restrictive barrier. |
|
|
Term
| What are some Causes of mechanical problems??? |
|
Definition
| 1. Increased Energy Demands 2. Increased Circulation 3. Neurological 4. Ventilation 5. Venous and Lymphatic |
|
|
Term
| What are some types of restrictive barriers? |
|
Definition
| (-->Pain -->Edema -->Muscle Spasm -->Fibrotic Changes -->Osteoarthiritis -->Fusion) |
|
|
Term
|
Definition
| Transverse Axis and the Sagittal Plane |
|
|
Term
|
Definition
| Vertical Axis and the Transverse Plane |
|
|
Term
|
Definition
| Anteroposterior axis and the coronal plane |
|
|
Term
| The cervical spine has….. |
|
Definition
| Lots of rotation, extension and a moderate amount of flexion and sidebending. |
|
|
Term
|
Definition
| Moderate flexion, rotation, and very limited sidebending. |
|
|
Term
|
Definition
| lots of flexion and extension with limited sidebending and less rotation. |
|
|
Term
| The cervical spine has what qualities? |
|
Definition
| Bifid spinous process, blunt transverse processes, and superior an dinferior articular processes. |
|
|
Term
| The thoracic spine has what qualities? |
|
Definition
| Spinous processses that point inferiorly, transverse processes with facet to articulate with rib, and the articular facets face anteroposteriorly. |
|
|
Term
| Group A Thoracic Spine --> |
|
Definition
| T1 - T3 , T12 -->Spinous process @ level of transverse process |
|
|
Term
| Group B Thoracic Spine --> |
|
Definition
| T4 - T6, T11 - Spnous process halfway between same transverse process and the one below. |
|
|
Term
| Group C Thoracic Spine --> |
|
Definition
| T7-T9, T10 -->Spinous process at the lvel of the transverse process one level below. |
|
|
Term
| The Lumbar spines has what qualities? |
|
Definition
| Blunt spinous process, thicker body, and articular pillars tht point mediallly and laterally. |
|
|
Term
| Cervial Spine Superior Facet Orientation --> |
|
Definition
| BUM (Backward, Upward, Medial) |
|
|
Term
| Thoracic Spine Superiror Facet Orientation --> |
|
Definition
| BUL (Backward, Upward, Lateral) |
|
|
Term
| Lumbar Spine Superior Facet Orientation --> |
|
Definition
|
|
Term
| What is Fryette's 1st Law?? |
|
Definition
| 1. Group curves 2. Neutral Compartment 3. T and L spine 4. Rotation and Sidebending in opposite directions 5. Long Restrictors |
|
|
Term
| What is Fryette's 2nd Law?? |
|
Definition
| 1. Single Vertebral Segment 2. Non Neutral (Flexion vs Extension) 3. Sidebending and rotation to the same side (concavity) 4. Small Restrictors 5. Trauma |
|
|
Term
| Fryettes 3rd Principle??? |
|
Definition
| Initiating motion of a segment in any plane will modify or reduce movement of that segment in all other directions. |
|
|
Term
|
Definition
| Thums glid cephalad, Facet pairs open |
|
|
Term
|
Definition
| Thumbs glide caudada, Facet pairs close |
|
|
Term
| What is the active range of Motion??? |
|
Definition
| Patient movemnt by themselves. |
|
|
Term
| What is passive range of motion?? |
|
Definition
| Range of motion without the patient rying, but provided by assisstance. -->This can be by the physician or the patient helping themselves. |
|
|
Term
| Passive range of motion is ….. |
|
Definition
| Greater than the active range of motion. |
|
|
Term
| What is the Elastic Barrier??? |
|
Definition
| The end of passive ligamentous and appositional mucle and tendon stretching. |
|
|
Term
| What is important for every muscle and structure? |
|
Definition
|
|
Term
| What is a somatic dysfunction?? |
|
Definition
| it is the loss of harmony or tension in a strcutre, oor can be just loss of motion or function w/o damage. |
|
|
Term
|
Definition
| Accomplished by palpating for sensattion at endpoint of muscle, Feels spingWhat is the osteopathic restirciity and Resilent as motion approaches restrictive barrier. |
|
|
Term
|
Definition
| Ligamentous Injyr or laxity. Look for bilateral asymmetry. |
|
|
Term
| What is ligamentous scaring?? |
|
Definition
| Sudden stop of joint motion without elasticity. |
|
|
Term
|
Definition
| Joint held together by fibrous connective tissue --> Minimal Motion -->Radioulnar articulatin. |
|
|
Term
| What is a Cartilaginous Joint? |
|
Definition
| Bones held together by cartilage --> Small amount of motion -->Intervertebral Disks |
|
|
Term
| What is a Synovial Joint --> |
|
Definition
| Surfaces surrounded by a synovial membrane and synovial fluid inside ---->Greatest amount of motion. -->Ball and Socket is the greatest. |
|
|
Term
| What is the osteopathich Restricitive Barrier?? |
|
Definition
| It is a barrier restricting normal physiological range of motion. |
|
|
Term
| What is active treatment?? |
|
Definition
| Carried out with the patient assisting. |
|
|
Term
| What is passive treatment? |
|
Definition
| Carried out without the patient voluntarily assisting. |
|
|
Term
|
Definition
| Delivered into the restrive barrier, movment is directly through the restrictive barrier. |
|
|
Term
|
Definition
| Delivered into the position of ease, the movement is away from the restrictive barrier and in the direction of freedom of motiion. -->Indirectly treats the restriction. |
|
|
Term
| When Palpation of the skin, Look for ---> |
|
Definition
| Normal degree of turgor or elasticity. |
|
|
Term
|
Definition
| Dehydration or aging, or certain metabolic conditions. |
|
|
Term
| Increased sympathetic tone can cause --> |
|
Definition
| Localized increases in sweating and decrease in skin elasticity. |
|
|
Term
| What is the drag reaction? |
|
Definition
| A sense of resistant to light traction applied to the skin --> Related to the degree of moisture and degree of SNS acivity. --> Should have no drag |
|
|
Term
|
Definition
| Indicates congestion and underlying somatic dysfunction. |
|
|
Term
|
Definition
| Grab a pinch of skin and pull the skin away. |
|
|
Term
| Skin should be tight in areas with: |
|
Definition
|
|
Term
| Subcutaneous tissue is comprised of???? |
|
Definition
| Connective tissue, fascia, and fat |
|
|
Term
| What is a common location to find fluid collections? |
|
Definition
|
|
Term
| Finding in subcutaneous tissue results in --> |
|
Definition
| Puffy, boggy, and rubbery skin. |
|
|
Term
| Long Muscles receive innervation from: |
|
Definition
|
|
Term
| Short Muscles receive innervation from? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| The shortest muscles are : |
|
Definition
|
|
Term
| Muscles anywhere can be palpated for tone (True or False) |
|
Definition
|
|
Term
| Increased muscle tone may be the result of --> |
|
Definition
| anxiety or increased sympathetic outflow. |
|
|
Term
|
Definition
| an uncontrolled, excessive hypertonic state. |
|
|
Term
| Upper motor neuron dysfunction causes --> |
|
Definition
| spastic paralysis (stroke, paraplegic, and flaccid stage) |
|
|
Term
|
Definition
| fibroelastic strands of connective tissue -->have a unique characteristic feel. Tense and Smooth |
|
|
Term
|
Definition
| Tough fibrous bands that connect bone to bone. Difficult to palpate unless torn. |
|
|
Term
|
Definition
| A connective tissue that lines, divides, separates, and suppots the internal organ, muscles, and body cavities. |
|
|
Term
| What does fascia feel like? |
|
Definition
| To feel fascia, you must have the ability to sense an inherent release in the tissues -->Can be described as butter melting or pulling of warm taffy. |
|
|
Term
| What is acute somatic dysfunction? |
|
Definition
| Immediate or short term imapriment or altered function of related components of the somatic body. --> Diagnosed by TART. |
|
|
Term
| What are findings of Acute Somatic Dysfunction? |
|
Definition
| Rubor - Red; Calor - Warm, Dolor - Pain; Tumor - Swollen |
|
|
Term
| Tissues may stay red after plapation in ACD (True or False) |
|
Definition
|
|
Term
| What is chronic Somatic Dysfunction? |
|
Definition
| Impariemtn or altered function of related components of the somatic system. |
|
|
Term
| What are some characteristics of CSD? |
|
Definition
| Tenderness, itiching, fibrosis, paresthesias, contracture --->skin slick, dry, and cool |
|
|
Term
| The posterior transverse process is always….. |
|
Definition
| the closest side -->does not mean that it is the dysfunctional facet pair. |
|
|
Term
| If asymmetry is palpated during flexion --> |
|
Definition
| Posterior side will not open. |
|
|
Term
|
Definition
| Asymmetry palpated during extension --> side opposite the posterior thum will not close --->Posterior side is closing. |
|
|
Term
|
Definition
| Asymmetry palplated during flexion --> side opposite anterior thumb will not open ---> anterior side is opening. |
|
|
Term
| Define: Accessory Movements: |
|
Definition
| Movements used to potentiaties accentuate or compensate for an impairment. |
|
|
Term
|
Definition
| A self reversing and non persisitent adaptation. |
|
|
Term
|
Definition
| A positional descriptior used to identify the side of reference when rotation of a vertebra has occurreed. |
|
|
Term
|
Definition
| Refers to the columnar arrangement of the articular portions of the cervial vertebra. |
|
|
Term
|
Definition
| The place of unio or juntion between two or mor ebones of the skeleton. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| An imaginary line about which motion occurs. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Relative plapable resistance to motion of an articulation or tissue. |
|
|
Term
|
Definition
| Mechanical principles applied to the study of biological functions. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| A term that describes the application of steay pressure to soft tissues to effect relatxation and normalize reflex activity. |
|
|
Term
|
Definition
| Relative motion taking place between tow adjacent vertebra segments. |
|
|
Term
|
Definition
| The sense by which musclular mtion, weight, position are perceived. |
|
|
Term
|
Definition
| The body of knowledge that deals eih the effects of forces that produce or modify body motion. |
|
|
Term
|
Definition
| A spinal curve pattern combining kyphosis and scoliosis. |
|
|
Term
|
Definition
| Exaggerated AP curve of the T spine. |
|
|
Term
|
Definition
| The anterior convexity in the curvature of the lumbar and cervial spine as viewed from the base. |
|
|
Term
|
Definition
| The range of sagittal plane spinal postioning in which the first principle of physciological motion of the spine applies |
|
|
Term
|
Definition
| The range of sagittal plane spinal positioning in which the second principle of physiological motion of the spine applies. |
|
|
Term
|
Definition
| A peripheral nerve organ or mechanism for the appreciation and transmission of painful or injurious stimuli. |
|
|
Term
|
Definition
| Whne the throacic and lumbar spine is in a nuetral position. The sidebending and rotation occur in opposite direction |
|
|
Term
|
Definition
| When the thoracic and lumbar spine is sufficeintntly forward or backward bent, the coupled motions of sidebending and rotation ina single vertebral unti occur in the same direction. |
|
|
Term
|
Definition
| Motion introduced in one plane restricts the other two planes of motion. |
|
|
Term
|
Definition
| A positional descritpor used to identify the side of reference when rotation of a vertebral segment has occurred. |
|
|
Term
|
Definition
| The inhibition of anatagonist muscle when the agonist is stiumalted |
|
|
Term
|
Definition
| A portion of a large body or structure set off by natural or arbitrary established boundries |
|
|
Term
|
Definition
| The final stage of the spinal somatic examination in which the nature of the somatic dysfunction is deatiled at the segmental level. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Specific Joint dysfunction. |
|
|
Term
|
Definition
| Movement in a coronal axis. Also called lateral flexion |
|
|
Term
| The superior vertebra is described as moving on the |
|
Definition
|
|
Term
| What happens if trauma, muscle spasms, or abnormal stress occurs in flexion |
|
Definition
| The right articular facet locks openn. |
|
|
Term
| Why are more abnormalities present in the thoracic region than in the cervical region? |
|
Definition
| Increased weight beariing of the thoracic spine. |
|
|
Term
|
Definition
| The amount of force or energy applied may vary from a nearly imperceptible muscle twitch to a firm maximum contraction. |
|
|
Term
|
Definition
| By convention, contractions last 3-5 seconds to reset the spindle pparatus. |
|
|
Term
|
Definition
| A total of 3-5 repetitions has been taught as optimal. |
|
|
Term
|
Definition
| The direction necessary varies in response to evaluation. |
|
|
Term
|
Definition
| A point of restriction felt when the joint is put through its range of motion. |
|
|
Term
|
Definition
| The result of reptitive efferent input. The high frequency of the efferent signal is, in trun, perpetuated by intense afferent discharge from the muscular tendonous junction. |
|
|
Term
|
Definition
| Much like resistance strength training. |
|
|
Term
|
Definition
| Attached to manubrium, cephalad to superior border of scapula. |
|
|
Term
|
Definition
| Manubrium and body of sternnum @ sternal angle. |
|
|
Term
|
Definition
| Located approximately at the median aspect of the spine of the scapula. |
|
|
Term
|
Definition
| Costal cartilage attaches to the sternal body and xiphoid process -->Angle of the rib sits near the tip of the scapula's inferior angle. |
|
|
Term
|
Definition
| Cartilage palpated at lowest aspect of the thoracic cage in mid clavicular line. |
|
|
Term
|
Definition
| Almost horizontal; found by palpating in the soft tissues posteriorly above iliac crest. |
|
|
Term
|
Definition
| 1. Thin and flat body 2. Costal groove on inferior edge 3. anterior costochondral articulation with the sternum. |
|
|
Term
|
Definition
| Flat, greatest curvature and shortest length. No angle of costal groove. |
|
|
Term
|
Definition
| Longer than rib one, and not as flat…. 2 demifacets on rib head, articulations with T1 and T2. |
|
|
Term
|
Definition
| Typical in every respect except the costovertebral articulation. |
|
|
Term
|
Definition
| Neither neck nor tubercle, ventral ends float freely. 12th rib does not have a costal groove |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| if the term restriction is not used, you have ………. |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| False Ribs; attach to the sternum indirectly |
|
|
Term
|
Definition
| Diaphragm, intercostals, SCM, Scalenes, Subclavius, Pec. Minor, Serratus Anterior & Posterior, Levatores Costarum |
|
|
Term
| 2 Basic patterns of Rib Movement: |
|
Definition
| 1. Pump Handle Mechanics 2. Bucket Handle Mechanics |
|
|
Term
|
Definition
| (-->upper ribs 1-5, coronal axis, increased longitudinal dimension) anterior posterior diameter |
|
|
Term
|
Definition
| Lower ribs (6-10), Sagittal Axis, Increased lateral dimension transverse diameter |
|
|
Term
|
Definition
| Ribs 11-12, Flare in and out. |
|
|
Term
| Upper Ribs have more _________ Lower Ribs have more ________ |
|
Definition
| Pump handle, bucket handle |
|
|
Term
| As you move down the throacic spine, the spinous process and the transverse process angle |
|
Definition
|
|
Term
|
Definition
| As inspiration occurs, anterior rib head moves cephalad, posterio rib head moves caudad. |
|
|
Term
|
Definition
| Locked down ribs, rib is depreseed anteriorly; anterior part of rib moves cuadad on expiration and restircted on inspiration. |
|
|
Term
|
Definition
|
|
Term
| Definition of Professionalism |
|
Definition
| Commitment to carrying out professiional responsiblities, adhereance to ethical principles, and sensitivity to diverse populations. |
|
|
Term
| How can you demonstrate respect? |
|
Definition
| Speaks to patient as an equal --->Maintains eye contact --->Introduce self with correct title --->Don't use medical jargon --->Respect Dignity of patient. |
|
|
Term
| how can you demonstrate compassion? |
|
Definition
| Comforting, empathetic comments, slow to interrupt, avoid derogatory comments, touch the patient, coommunicates with family. |
|
|
Term
|
Definition
| Admit errors and omissions; follows through on commitments, answer pages and calls, informs others, don't withhold information. |
|
|
Term
| How can you show responsiveness to societal needs? |
|
Definition
| Be invooled in community; care for socially disadvantaged, attentive to needs family, |
|
|
Term
| Professions maintain autonomy by…… |
|
Definition
|
|
Term
| How can you be accountablle bo patients? |
|
Definition
| Follow up on commitments, be truthful, make sure patients understand them. |
|
|
Term
| Your personal life should always reflect ….. |
|
Definition
|
|
Term
| What are some ways that you can maintain excellency? |
|
Definition
| Don't cut corners, legible handwriting, all reading, don't repeat mistakes, do more than expected, be timely. |
|
|
Term
| what are some ethical principles? |
|
Definition
| Explain what will happen, involve the family, don't talk about patients, avoid inappropriate humor, ask for help |
|
|
Term
| Always leave your troubles at…….. |
|
Definition
|
|
Term
| We should never self prescribe (True or False) |
|
Definition
|
|
Term
| What are the steps in an Adult Complete History??? |
|
Definition
| 1. Chief Complaint 2. HPI 3. PMH 4. PSH 5. Health Maintenance 6. Occupational and Environmental History 7. Allergies 8. Family History 9. Social History 10. Review of Systems |
|
|
Term
| What is the chief complaint? |
|
Definition
| What the patient says ins the reason for the visit. |
|
|
Term
| Can the chief complaint be documented as direct quote? |
|
Definition
|
|
Term
|
Definition
| The recent prooblems that made the patient come to the physician. |
|
|
Term
| PMH (Past Medical History) & PSH (Past Surgical History) |
|
Definition
| The overall assessment of the patient's previous health history. |
|
|
Term
|
Definition
| Includes how the patient has hangled illness in the past. Includes patient's immunization history. |
|
|
Term
|
Definition
| exposure to toxic and disease-producing substances. |
|
|
Term
|
Definition
| Exposure of the patient to toxic substances |
|
|
Term
| What should alllergies include: |
|
Definition
| medication, seasonal, and food <-- What type of reaction |
|
|
Term
|
Definition
| Immediate family members; grandparents, parents, siblings, children. |
|
|
Term
| What is included in Social hx? |
|
Definition
| Living conditions, education, life experiences |
|
|
Term
| Tobacco Use should be detailed as: |
|
Definition
|
|
Term
| If the patient has used drugs: |
|
Definition
| need to know what, how muc, how long. |
|
|
Term
|
Definition
| Cut down, Asked to Avoid, Give Up Alcohol, Eye opener <-- any two of these defines a problem. |
|
|
Term
|
Definition
| 1. General, 2. HEENT 3. Neck, 4. Breasts, 5. Respiratory, 6 Cardiovascular, 7. Gastrointestinal, 8. GUI, 9. Peripheral Vascular, 10 Musculoskeletal, 11 Psychiatric, 12. Neurologic, 13. hematologic, 14. Endocrine, 15. Skin |
|
|
Term
| Document only the things: |
|
Definition
|
|
Term
|
Definition
| Subjective (what the patient tells you), Objective ( What you find), Assessment (Differential Diagnosis), Plan (what you will do) |
|
|
Term
| HPI (history of present illness) |
|
Definition
| OPPQQRSTA ---> O - Osteophatic complaints, P - Palliiation. P - Provocation, Q -Quality, Q- Quanity, R-Radiation, S-Setting, T-Timing, A-Associated Findings. |
|
|
Term
| Physical examination should address the ….. |
|
Definition
| areas which are relevant to the chief complaint. |
|
|
Term
| Vital signs should be done before examination, and should include: |
|
Definition
| height and weight, Temperature, Blood Pressure, Pulse Rate, Respirations. |
|
|
Term
| What are the Steps in Clinical Reasoning? |
|
Definition
| 1. Identify the abnormal findings, 2. localize these finds, 3. interpret these in terms of the probable process, 4. come up with a hypothesis, 5. Establish a working diagnosis, 6. Develop a plan. |
|
|
Term
| VINDICATEDO = Working Diagnosis Steps: |
|
Definition
| V-vascular, I-infectious or idiopathic, N-neoplastic, D-degenerative, I-Inflammatory(Iatrogenic), C - Congenital, A-autoimmune, T-traumatic, E-endocrine, D-drugs, O-osteopathic |
|
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Term
|
Definition
| you must do for the patient…. |
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|
Term
| What does the plan include? |
|
Definition
| Includes labs and x-rays, Treatment plans, Education <---- Must be fluid and easily adapted to a change in the patient's condition or test results. |
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Term
|
Definition
|
|
Term
| You should date and time stamp ….. |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
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Term
|
Definition
|
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Term
|
Definition
| It is someone else's problem. |
|
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Term
|
Definition
| A return to a better time in life. |
|
|
Term
| What is the average oral temerature? |
|
Definition
| 37 degrees C or 98.6 degrees farenheit |
|
|
Term
| What is the variation in oral temperature? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What should you look for with a Fever? |
|
Definition
| Duration, Localizing symptoms, Onset, Chills & Sweats, Impact on Daily Activity |
|
|
Term
| If a person has a prolonged fever, what should you think? |
|
Definition
| inflammatory, autoimmune, or cancer. |
|
|
Term
|
Definition
| Heigh is a measured stocking feet, and is how tall a person is. Notice the body symmetry. Note any deformities. |
|
|
Term
| Weight should be measured in……… |
|
Definition
|
|
Term
| If a person is obese, we should look too see if the fat is…… |
|
Definition
| distributed envenly, or if it isllocated in one area. |
|
|
Term
| The 3 types of body types are? |
|
Definition
| Ectomorphic, mesomorphic, and endomorphic. |
|
|
Term
|
Definition
| A calculation based on height and weight. |
|
|
Term
| What are the BMI Classifications? |
|
Definition
| Underweight, Normal, Overweight, Obese, Extremelly Obese |
|
|
Term
| In muscular people, what should we go by to suppliment BMI?? |
|
Definition
|
|
Term
| If a person gains weight rapidly, this suggests…… |
|
Definition
|
|
Term
| If a person gradually accummulates weight…… |
|
Definition
| it should be due to nutrition, organic causes, psychosocial causes. |
|
|
Term
| Optimal Conditions for Blood Pressure……. |
|
Definition
| Avoid caffeine and smoking for 30 minutes prior, make room quiet, Seated with foot flat on floor x 5 mintues, free from clothing, |
|
|
Term
| The blood pressure cuff should be at……. |
|
Definition
|
|
Term
| Before we fully check blood pressure, we should………. |
|
Definition
| check the radial artery and observe when it is diminished ---> pump up 30 after this pressure. |
|
|
Term
| What is the Ascultatory Gap? |
|
Definition
| It is a silent interval that may be present between the sytsolic and diastolic blood pressures. |
|
|
Term
| What is the systolic pressure? |
|
Definition
| the point at which you hear the first two consecutive beats. |
|
|
Term
| What is the subclavian steal syndrome? |
|
Definition
| When the subclavian artery is stenosed or blocked. This causes retrograde blood flow of vertebral arteries to supply upper extremity. |
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|
Term
|
Definition
|
|
Term
| When was turbulence in blood pressure first described? |
|
Definition
| 1905 by Nikolai Korotkoff. |
|
|
Term
|
Definition
| Phase 1 = systolic value (when pulse becomes clear) Phase 2 = Murmurs Phase 3= Tapping Sound Phase 4 = within 10 mmHG above the diastolic blood pressure, this is the muting. Phase 5 = Silence as the cuff pressure dorps below the diastolic blood pressure. This is considered the diastolic blood pressure. |
|
|
Term
| The aorta has compliance, which results in --> |
|
Definition
| mitigation of the pressure exerted by the heart. |
|
|
Term
| We should use a bare arm for blood pressure because --> |
|
Definition
| it provides the most accurrate, reproducible readings. |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is the white coat syndrome? |
|
Definition
| Occurs in 10 - 20% of all patients, when patients are scared of being in the doctors office. |
|
|
Term
| How should we measure orthostatic blood pressure? |
|
Definition
| Have the patient lay supine and take the blood pressure, wait 3 minutes, then have the patient stand up and repeat. |
|
|
Term
| If systoolic blood pressure drops slightly --> |
|
Definition
| No orthostatic hyoptension. |
|
|
Term
| If diastolic raises slightly --> |
|
Definition
| NO orthostatic hypotension. |
|
|
Term
| If systolic blood pressure drops greater than 20 mm Hg --> |
|
Definition
|
|
Term
| If diastolic BP drops less than 10 mm Hg --> |
|
Definition
|
|
Term
|
Definition
| Dizziness, Irregular Pulse, Tachycardia, Low BP, Tachypnea, Fever, Altered Mental State |
|
|
Term
| What is a common site to measure the heart rate? |
|
Definition
|
|
Term
| If Heart Rate is normal, count for |
|
Definition
| 30 seconds and multiply by 2. |
|
|
Term
| If heart rate is abnormal, count for….. |
|
Definition
|
|
Term
| What is the normal heart rate? |
|
Definition
|
|
Term
| What is the normal respiratory rate? |
|
Definition
|
|
Term
|
Definition
| Indirect measurement of the oxygen saturation of the blood (%hemoglobin in the oxyhemoglobin) |
|
|
Term
| What is the functiion of the skin? |
|
Definition
| Boundary for fluid, -->Protects underlying tissues, -->Maintains Body Temperature |
|
|
Term
| The skin comprises how much % of body weight? |
|
Definition
|
|
Term
|
Definition
| Short, fine, less pigmentation |
|
|
Term
|
Definition
| Coarser, Pigmented --> Found on the scalp and eybrows. |
|
|
Term
| What is the function of nails? |
|
Definition
| Protection of the distal ends of the digits |
|
|
Term
| Sebaeous glands are found where? |
|
Definition
| Present in all surfaces --->Except the Palms and Soles of the feet. |
|
|
Term
|
Definition
|
|
Term
| What is the function of Eccrine Glands? |
|
Definition
| Widely distributed, help control body temperature. |
|
|
Term
| Where are apocrine glands? |
|
Definition
| Found in the axilla and groin --->Stimulated by emotiional stress. |
|
|
Term
| What are the 3 layers of the tissue? |
|
Definition
| 1. Epidermis 2. Dermis 3. Subcutaneous |
|
|
Term
| Cellulitis is found where? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What kind of light should we inspect the patient in? |
|
Definition
| Natural Light --> Most Accurate Coloring. |
|
|
Term
| What is clubbing of the fingernails? |
|
Definition
| Distal part of the finger is englardged compared with the proximal part. |
|
|
Term
| What are some diseases that present with clubbing? |
|
Definition
| Pulmonary Disorders (Pulmonary Fibrosis, Coal Worker's Pneumocconiosis), Cardiac Disease, GI, Skin, Cannabis Use, Pregnancy, Malignancies. |
|
|
Term
|
Definition
| Distal digital vasodilation. |
|
|
Term
| What are basal cell carcinomas? |
|
Definition
| 80% of skin cancers, shiny and translucent -->grow slowly and rarely metastize |
|
|
Term
| What are squamoous cell carcinoma? |
|
Definition
| 16% of skin cancers --> crusted, scaly, and ulcerated --->can metastize |
|
|
Term
|
Definition
| 4% of skin cancers -->Spreads rapidly |
|
|
Term
| What causes basal cell carcinomas? |
|
Definition
|
|
Term
| What causes squamous cell carcinoma? |
|
Definition
| UV, age, chronic skin irritation, light colored skin. |
|
|
Term
| When screening moles for melanoma, what should you look for? |
|
Definition
| Asymmetry, Irregular Borders, Variation in Color, Diameter that is >6mm, Elevation or Enlargement |
|
|
Term
| What are the risk factors for Melanoma? |
|
Definition
| Hx of previous melanoma, >50 years of age, no regular dermatologist, Mole changing, Male gender,1-4 atypica moles, red hair, UV exposure, light eye, family HX of melanoma. |
|
|
Term
|
Definition
| superficial epidermal cells that are dad and cast off from the skin. |
|
|
Term
|
Definition
| Nonpalpable lesions that vary in pigmentatioon from the surrounding skin. |
|
|
Term
|
Definition
| palpable, discrete lesion measuring ,5. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Palpable, discrete lesions measuring >6mm diameter. Deeper in skin. |
|
|
Term
|
Definition
| Enclosed cavities wiith a lining that can contain a liquid or semisolid material. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Small, contain serous material. |
|
|
Term
|
Definition
| erythematous plaques with sharply defined margins that are raised aboove the surrounding normal skin. |
|
|
Term
| How many seconds do you have to make a first impression? |
|
Definition
|
|
Term
| What are the 7 steps to make a good impression? |
|
Definition
| 1. Adjust your attitude, 2. Straighten your posture, 3. Smile, 4. Make eye Contact, 5. Raise your eyebrows, 6. Shake hand, 7. Lean in Slightly. |
|
|
Term
| How much percentage of communication is non verbal? |
|
Definition
|
|
Term
| How much percentrage of communication is of your face? |
|
Definition
|
|
Term
| How much percentage of communication is of the voice? |
|
Definition
|
|
Term
| What are some nonverbal communications |
|
Definition
| 1. Gestures, 2. Body Language, 3. Facial Expression, 4. Eye Contact, 5. Conversation Distance |
|
|
Term
| In Eye contact, make sure you focus on ……. |
|
Definition
| what the patient is showing you. |
|
|
Term
| What is an acceptable distance of conversation? |
|
Definition
| An arm's length to 4 feet. |
|
|
Term
| What can be a physician's greatest skill? |
|
Definition
|
|
Term
| it takes a good medical knowledge for a clinicians to be a ….. |
|
Definition
|
|
Term
| Always start history with ……… |
|
Definition
|
|
Term
| Components of a History are: |
|
Definition
| HPI, PMH, PSH, Medications, Allergies, Social History, Family History, Review of Systems, Health Maintenance. |
|
|
Term
| Review of Symptoms (Correct Order) |
|
Definition
| 1. Constitutional Symptoms, 2. HEENT, 3. Cardiovascular, 4. Respiratory, 5. GI, 6. GUI, 7.Musculoskeletal, 8. Integumentary, 9. Neurological, 10 Psychiatric, 11. Endocrine, 12. hematologic/Lymphatic, 13. Allergic |
|
|
Term
| We should learn to utilized ……… |
|
Definition
|
|
Term
| The physical exam allows us to ………… |
|
Definition
| make a better differential diagnosis. |
|
|
Term
| The Physical Exams (Correct Order) ----> |
|
Definition
| 1. General, 2. HEENT 3. Neck, 4. Respiratory, 5. Chest/Breast, 6 Cardiovascular, 7. Abdomen, 8. Back, 9. Genitourinary, 10 Musculoskeletal, 11. Neurologic System, 12. Psychiatric, 13. Skin, Hair, and Nails, 14. Lymphatic System |
|
|
Term
| We should always drape the patient (True or False) |
|
Definition
|
|
Term
| The patient must always be the …….. |
|
Definition
|
|
Term
| The patient should always be …….. |
|
Definition
| comfortable at all times; Help the patient lie down, help the patient up froom the table; Make sure the patient's legs are supported while they are lying down. |
|
|
Term
|
Definition
| the most likely cause for all of the data you have taken in. Relate it to the patient's in normal language. |
|
|
Term
| Your plan must line up with ……… |
|
Definition
|
|
Term
| If you discuss smoking cessation…… |
|
Definition
| your diagnosis must be nicotine dependance. |
|
|
Term
| If you want to treat with OMM…….. |
|
Definition
| you must diagnosis with somatic dysfunction. |
|
|
Term
|
Definition
| The termination of the visit: 1. assessment, 2. Work up, 3. Treatment, 4. Disposition, 5. Education, 6. Enunciation of plan from patient. |
|
|
Term
| incorporate the cranial nerve exam with …… |
|
Definition
|
|
Term
| We should begin our exams by looking at the……. |
|
Definition
|
|
Term
| We should iinspect the head by looking at the: |
|
Definition
| 1. Position (Tilted, Tremor) 2. Hair, 3. Rashes or Lesions, 4. Swelling or Masses, |
|
|
Term
| Battle signs may indicate…….. |
|
Definition
| fracture of the base of the skull. |
|
|
Term
| Raccoon eyes may indicate……. |
|
Definition
|
|
Term
| When we palpate the head, we should look for……. |
|
Definition
| Tenderness, Masses, Shape, and Temporal Artery Tenderness |
|
|
Term
| When inspecting the neck, we should look….. |
|
Definition
| for masses or rashes; thyroid enlargement; scars, tracheal deviation; distended veins. |
|
|
Term
| When palpating the neck……… |
|
Definition
| 1.Anterior and posterior lymphatic ducts, 2 anterioa nd psoterior triangle, 3. Salivary Glands, 4. Midline Trachea, 5. Supraclavicular Areas, 6. Thyroid. |
|
|
Term
| What can a virchow signal node represent…… |
|
Definition
| Metastasis from abdominal cancer. |
|
|
Term
| When you palpate the thyroid, your should……. |
|
Definition
| palpate during swallowing; characterize and document by size, consistency, tenderness, nodules. |
|
|
Term
| What are some ear symptoms? |
|
Definition
| 1. Pain, 2. Drainage, 3. Tinnitus, 4. Hearing Loss, 5. Vertigo |
|
|
Term
|
Definition
| False perception oof movement or spinning while at rest. |
|
|
Term
| What should we use to examine the ears? |
|
Definition
| Otoscope and 512Hz tuning fork. |
|
|
Term
| What should we first do when inspecting the ears? |
|
Definition
| The auricles and Mastoid Region; and then palpate this area. |
|
|
Term
| When performing otoscopy, what should we do? |
|
Definition
| 1. patient seated, 2. ask them not to move, 3. tip oof speculum in external canal under direct vision, 4. Gently pull back on top of ear 5. Advance scope slowly as you look thru window. |
|
|
Term
| What should you not do in otoscopy? |
|
Definition
| Fast, excessive movement. |
|
|
Term
| What are the two hearing acuity tests? |
|
Definition
| Whisper Test and Audiometry |
|
|
Term
| What is conductive Hearing Loss? |
|
Definition
| Impeded amplification or transmission of sound to cochlea ----->Can involve external ear canal, tympanic membrane, middle ear space or contents. |
|
|
Term
| What is sensorineural Hearing Loss? |
|
Definition
| Involves inner ear acoustic nerve and/or central auditory pathways. |
|
|
Term
| Can the otoscopic exam may be completely normal? |
|
Definition
|
|
Term
| How to you perform a weber test? |
|
Definition
| place the tuning fork in midline of patient's scalp or forehead ---->Ask where sound is heard |
|
|
Term
|
Definition
| Normal = hear equally bilaterally, Conductive Loss = Laterlizes to affected ear, Sensorineural Loss = Lateralizes to unaffected ear. |
|
|
Term
|
Definition
| Place a tuning fork on mastoid process and ask the atient when the sound canot be heard any longer -->then place the tuning fork in front of ear and ask if sound can still be heard. |
|
|
Term
|
Definition
| Air conduction being louder than bone conduction. |
|
|
Term
| What is a conductive loss on the Rinne? |
|
Definition
| Bone is greater than air conduction. |
|
|
Term
| What is a sensorineural loss on the Rinne? |
|
Definition
| Air conduction better than bone. |
|
|
Term
| How should we perform a Nose and Paranasal Sinus Exam? |
|
Definition
| 1. Inspect the external Nose, 2. Palpate the ridge and soft tissue sof the nose, 3. Evaluate patency of nares, 4. Inspect nasal muscosa and septum, 5. Inspect and palpate regions of the sinuses. |
|
|
Term
| What is hutchinson's sign? |
|
Definition
| Herpes zoster of nasolciliary branch of the 1st triigenminal nerve ----> Easy to miss. |
|
|
Term
| What are some hypopharynx symptoms? |
|
Definition
| Pain, Mass, stridor, hoarseness (dysphonia) |
|
|
Term
| What should we inspect in an oropharyx examination? |
|
Definition
| Inspection: Lips, Gingiva, Teeth, Tongue, Pharynx, Tonsils, Floor of the Mouth; Palpation: Tongue, Floor of the Mouth. |
|
|
Term
| What are the classes of Mallampati Classification? |
|
Definition
| Class 1: Full visibility oof tonsils, uvula, and soft palate; Class 2: Visibility of hard and soft palate, upper portion of tonsils and uvula; Class 3: Soft and hard palate and base of the uvula are visible; Class 4: Hard Palate Visible |
|
|
Term
|
Definition
| Loss of vision, diplopia, tearing, redness, discharge. |
|
|
Term
| What should we evaluate in an eye examination? |
|
Definition
| Gaze, puils, ocular movements, visual acuity, external eye structures, visual fields, ophthalmoscopic examination. |
|
|
Term
|
Definition
| The patient reads the smallest line with each eye, then both ---> first 20 = how far patient is from chart, Second number = how far a normal person could read this. |
|
|
Term
|
Definition
| enlargment of the actual globe or protrusion resulting from trauma/swelling behind the globe. |
|
|
Term
|
Definition
| An infection around the globe of the eye. |
|
|
Term
|
Definition
| A process that is caused by blockage of the melbomian glands. |
|
|
Term
|
Definition
| Often called a stye……… A staph infection of the glands in the eye lid. |
|
|
Term
| What is infectious conjuctivitis? |
|
Definition
| Purulent discharge and injected conjuctiva. |
|
|
Term
| What is allergic conjunctivitis? |
|
Definition
| Edematoous conjunctiva of allergic conjunctivitis. |
|
|
Term
| What is sclearal icterus? |
|
Definition
|
|
Term
| What is the corneal reflex test? |
|
Definition
| The patient is direted to look at light held directly in front of the eyes at 2 feet. ---->Observe the locations of the light reflextions on the cornea. |
|
|
Term
| Disconjugate Gaze occurs when……. |
|
Definition
| asymmetrical light reflections occur in the cornea. |
|
|
Term
|
Definition
| Disconjugate Gaze ( when the eyes doo not focus on the same point) |
|
|
Term
|
Definition
| A fixed disconjugacy which is detected by a Cover Test |
|
|
Term
|
Definition
| Occurs when an eye fixates properly on an object, but wanders when fixation is interrupted. |
|
|
Term
| How do you perform a cover test? |
|
Definition
| Ask the patient ot fix gaze on an object ---> cover focused eye ----> observe uncovered eye for movement. |
|
|
Term
| How do you perform a cover, uncover test? |
|
Definition
| Ask the patient to fix gaze on an object -->cover one eye --->Observe unvovered eye ----> remove cover and observe covered eye for movement back to correct position. |
|
|
Term
| When you test the extra ocular space, how should you do this? |
|
Definition
| Ask the patient to follow an object with their eyes (finger)…..Move their eyes through a pattern that resembles of an H |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| have the patient focus on a distant object and then at a test object 10cm from nose. |
|
|
Term
| What does a panoptic opthalmoscope show? |
|
Definition
| more of the funsu in one view, easier to uses and see the discs ---->Great for non dilated eye exams. |
|
|
Term
|
Definition
| It is the head of the optic nerve……should be the first object to evaluate. |
|
|
Term
| What is the hallmark of a papilledema |
|
Definition
|
|
Term
|
Definition
| Cataracts are cloudy or opaque structures wihtin the lens……… |
|
|
Term
| How doo you identify cataracts…… |
|
Definition
| Shine a light through the eye and look for an obstruction of red reflex. |
|
|
Term
|
Definition
Senses muscle length and rate of change
-->Very sensitive
-->Discharge rate increases as sensory ending is stretched.
-->Induces reflex contraction and helps in reciprocal inhibition.
--Postural Muscles |
|
|
Term
|
Definition
--Located in musculotendinous area @ distal ends
-->measures muscle tendon & sensitive to stretch |
|
|
Term
| Sufficient impulses from Golgi Tendon will result in........ |
|
Definition
Inhibition of the muscle it occupies and its synergists
-->Facilitates the Antagonists |
|
|
