Physical Diagnosis Final

  1. Patient with popping on opening

    Where is disc when closed?
    Where is disc when opened?
    • closed: anterior
    • opening: back in place

    anterior disk displacement WITH reduction
  2. Clicking on opening and closing is
  3. Superior division of the facial nerve crosses the ___ ____ ____ mms from the anterior edge of the bony _____ _____
    • zygomatic arch
    • 8-35 mm
    • auditory canal
  4. If having spasms after pop in the back the patient most likely has
    herination nucleus pulposus (HNP)
  5. Innervation of the index finger is supplied by
    median nerve

    median covers index, thumb, middle and half of ring fingers
  6. Innervation of the fifth finger is supplied by
    ulnar nerve
  7. Innervation of the dorsal webspace of thumb and index finger is supplied by
    radial nerve
  8. carpal tunnel syndrome is caused by
    median nerve compression
  9. A patient with a positive phalen's test experiences what and has what most likely?
    Tingling and numbess with wrist in acute flexion 

    carpal tunnel syndrome
  10. A patient with a positive tinel's test experiences what and has what most likely?
    Electrical sensation when percussing over carpal tunnel 

    carpal tunnel syndrome
  11. Hard, painless nodes in the DIP are called
    herberden's nodes (osetoarthritis)
  12. Hard, painless nodes called bouchard's nodes are located in the ____
  13. RA over a long time can cause panes which is
    Swelling of synovium and is a soft tissue mass of the joint the is attacking normal joint tissues
  14. First gout attack will most likely be where and what is it called?
    In the big toe (podagra)

    tophaceous gout
  15. infection of the enclosed fascial space of the finger pad that required emergency attention
  16. What is usually harvested for the CABG
    Great saphenous vein
  17. intermittent claudication, pale, decreased pulses and ulcers at tips are characteristics of
    Chronic arterial vascular insufficiency
  18. aching or painless, brown discoloration on inside of lower calf and medial ulceration are characteristics of
    Chronic venous vascular insufficiency
  19. polynerupatjy 
    microvascular insufficiency 
    decreases phagocytic function are characteristic of what?
    Diabetic neuropathy
  20. diabetic neuropathy can cause what?
    Foot ulcers

    no good blood supply, can't feel it, and can't heal from it because shitty phagocytes
  21. the noise heard when listing to the heart is what?
    valves CLOSING 

    normally dont hear them opening
  22. physiological murmur that you outgrew
    Benign systolic ejection murmur

  23. flow across disease or stenotic valves
  24. back flow over insufficient valves
  25. what is the S1 sound "lub"
    closing of mitral and tricuspid valves

  26. what is the S2 sounds "dub"
    closing of aortic and pulmonic valves

  27. Characteristics of physiologic splitting (5)
    • S2 sound
    • A2 comes earlier
    • P2 is delayed 
    • deep inspiration augments it 
    • normal variation
  28. intercostal spaces are named
    for the rib above it
  29. what is the sternal angle
    where the sternum meets the manubrieum at the second rib
  30. If you hear a heart sound at the RIGHT 2nd interspace it is
  31. If you hear a heart sound at the LEFT 2nd interspace it is
  32. If you hear a heart sound at the lower left sternal border it is
  33. If you hear a heart sound at the apex/PMI/5th LEFT interspace it is
  34. Order of valve involvement with rheumatic fever
    • Mitral alone (most)
    • mitral and aortic
    • Aortic alone (least)
  35. What murmur is best heard at the right second intercostal space during systole?
    Aortic stenosis
  36. What murmur is best heard at the left second to fourth intercostal space (but actually BEST at the right second intercostal)  during diastole?
    Aortic Regurgitation

    on the exam he will say right intercostal space for this because still heard BEST here
  37. What murmur is best heard at the apex second  during systole?
    Mitral regurgitation
  38. What murmur is best heard at the apex during diastole?
    Mitral stenosis
  39. Difference between diastolic and systolic pressure?
    Pulse pressure
  40. As you get hypertension and more regurgitation occurs the diastolic pressure goes up and what happens to pulse pressure?
    Is it widened 

    **sign that the disease is progressing (more stress on the heart and worsening regurgitation)
  41. Systemic congestion with jugular distention pedal and pitting edema and an enlarged liver  is characteristic of
    Right congestive heart failure
  42. pulmonary congestion with dyspnea and orthopnea and mitral value insufficiency are characteristic of
    left congestive heart failure
  43. T/F: CABG require prophylaxis

    rapidly re-endotheliazes so no AB

    dont need it for stenting either
  44. Elevated Creatanine Phosphate Kinase in the blood  can tell you want
    that the person has had a heart attack and not just ischemia

    increase in CPK and MB fraction in the blood indicate heart attack because cells die and enzymes leak out
  45. Waterhammer pulse are caused by?
    stenotic vessels
  46. 1 mg= ___ cc
    1 cc
  47. EKG parallel flow towards the positive end of the lead results in
    strong deflection upwards
  48. EKG parallel flow towards the negative end of the lead results in
    strong downward deflection
  49. EKG perpendicular flow of the lead results in
    flat tracing (cancels out)
  50. P wave indications what?
    atrial depolarization

    SA node impulse
  51. where is atrial depolarization best seen?
    Lead II
  52. The T wave represents what
    The depolarization of the ventricles
  53. Why is atrial depolarization not on the EKG?
    hidden pithing the larger QRS complex
  54. ventral depolarization is shown with what?
    QRS complex
  55. a small block is how many seconds?
    0.04 sec
  56. a large block is how many seconds?
    0.2 sec
  57. Normal axis is positive in which leads (2)
    • Lead I 
    • Lead aVF
  58. a beat that came form a spot some where in ventricle that fired early-- looks wide (>0.2 sec) and bizarre

    <6 is ok
  59. ST depression on an EKG means what
  60. ST elevation on an EKG means what and in what leads?
    infarction (acute)

    • II
    • III
    • aVF
  61. A Q wave that is >0.08 sec or > small blocks tall or wide indicates
    Old MI 

    is significant
  62. leads for anterior (LAD) (4)
    • I
    • V2
    • V3
    • V4
  63. leads for anteriolateral (LAD) (4)
    • I
    • aVL
    • V5 
    • V6
  64. leads for inferior (RCA) (3)
    • II
    • III 
    • aVF
  65. No p waves
    irregularly irregular (no pattern)
    ventricular rate?
    A fib
  66. how many seconds (max) is the QRS interval
    0.1 sec (2.5 blocks)
Card Set
Physical Diagnosis Final
Final Exam Material