Download Head and neck lymph nodes Thyroid: Patient swallow! Thyroid

Head and neck lymph nodes
Thyroid: Patient swallow!
Thyroid landmarks: (cricoid cartilage)
2 symptoms of hypothyroidism
1. Oral exam
Check if 32 teeth & if Tonsils present
Tongue deviation(CNXII)/ Uvula deviation(CNX) know which deviates to side of lesion
Test tongue strength w/mouth closed
Sebaceous & Parotid glands (ducts: … Wharton’s)
Gum & Tongue coloration & palpate lips and gums for tenderness
-Use penlight -use tongue depressor w/o gagging patient (CN 9+10)
2. Diagnosis
Strep throat/Subluxation/post nasal drip
-Viral or bacterial
3. Lab Test
CBC (WBC)-which should be high
Rapid strep test
*What could cause left ear pain with this?
Ortho/Neuro
myotomes for legs
Know muscle and nerve root levels (i.e.) quads S234
Cortico spinal tract – pathological reflex (Babinski)
DTRS of leg - L4 Popliteal – 5 – Achilles
Dorsal column test – positional and vibration
Micro current
3 contraindications:
Pregnancy, cancer, hemotomy, lesion, dermatitis, infection, malignancy
Pads with sponges underneath (1 red, 1 black)
No more than ??50 or 300 mil. Amps??
Polarity – Positive (acute) Negative (chronic)
10-minute treatment time
How many Hz ?10?
Low Back Pain
3 diagnoses -3 tests to distinguish
Cardio
Inner carotids – brewies
Palpate
Intercostals spaces
2nd on right and left
Tricuspid
Mitral
Diversified
Pick one card from each section: (cards are face down) pelvic/lumbar (1. Anterior illium
2. Posterior ilium 3. Superior ilium 4. Inferior illium) lumbar move (retrolithesis,
posterior disc, lateral disc, rotation, high mamillary, pisiform/thumb, thumb/pisiform,
open wedge)
-Know: Osseous and manual contacts, LOD, table setup, patient position.
Lumbar – inferior hand
Thoracic – superior
Pisiform thumb- face the bum
spondololithisis
recoil
Diversified – thoracic and extremity moves
Diversified Cervical – Know SP rotation for Cl/C2 Counter rotation
Basic: law of 13
Postural – 5 cardinal signs
Find & Set table for lordosis
Single & Double notch, Piriformis
Hand position of apex for C, T, L spine
Knee: Orthopedic Tests-Know name & Positive findings
Medial Collateral Ligament tear (Valgus stress test) pain
ACL sprain anterior drawer test-pain and excessive movement
Patella femoral-patella grinding test, Clarkson test (pain and joint effusion)
Medial meniscus (McMurray’s) pain
Shoulder Exam
- Dermatomes, myotomes (nerve level and muscle), 3 tests for shoulder DTR (nerve level
and muscle) (C5-T1)
-Three orthopedic tests for shoulder tendonitis (know difference between speeds for
shoulder and yorgason’s elbow).
Arterial insufficiency in upper extremities (below glenohumoral joint): Three tests
1. Allen’s test ulnar and radial blocking w/ hand pumping – bilaterally
2. Capillary refill: beds – squeeze all 10 fingernails
3. Pulse – amplitude would change (lower) Ulnar, radial and brachial pulse rates
4. Blood pressure-bilateral
Foraminal encroachment: 2 ortho tests
Muscular vs. ligamentous: 1 ortho test for (neck)
Positive signs associated with tests
Respiratory Exam
Posterior chest only
Chest expansion – Rib fracture
Percussion
Rom Space Station (Measuring giving normal ranges)
Cervical Extension and right lateral bending
Shoulder flexion
Hip flexion
Patient has “R” sacrolumbar pain radiating @ between 7 -10. Give three possible
diagnoses and perform three orthopedic tests to differentiate between the diagnoses
Abdominal Exam
Have patient lay supine with knees flexed and hands positioned at their side. Concentrate
on gown control, etc.
1. Auscultate all 4 regions of abdominal in relation to navel, listening for bowel
movements, listening for brewies/brewers sign. If no bowel movements, it means there is
a problem like obstruction-should be 5-34/minute.
2. Percussion of liver—listening for dull sounds going vertical and horizontal, Palpating
liver in upper “R” quadrant feeling the inf. border of liver, should feel smooth edge of
liver, warning indicator would be bumpy, nodule like surfaces. Make sure of correct
palpating technique of liver. Average size of normal liver is 6-12 cm. Ascultate the
abdominal aorta, right and left renal arteries, and right and left common illiac arteries.
3. Testing for peritonitis superficial palpation trying to illicit pain or deep
palpation/rebound tenderness trying to elicit pain.
Eye Exam
Visual inspect first. Then palpate-what are you looking for? Take off glasses first if they
have them, otherwise you fail. Diopter @ 0, large focal
1. Bilateral ocular inspection of parts of eye and surrounding areas
2. Palpation for pain, swelling, tenderness
3. Use scope set at zero with largest setting. Begin at arm and travel to eye looking for
red eye reflex. Then travel deeper to see internal structures like optic discs, fovea,
macula, etc.
4. Use light pen to check cataracts and glaucoma from lateral part of eye. If glaucoma,
Will have curved lens-creating shadow in medial corner of eye. Glaucoma - medial
shadow with penlight -Oblique lighting test