Pulse rate below 50bpm
hypothyroidism
well trained athlete
Pulse rate above 90bpm
tachycardia: hyperthyroidism caffeine nervousness exercise hypertension illness injury
Pulse missing on one side
stenosis
blocked artery
TOS
cause of increase arrhythmia
fever exercise hypothyroidism anemia aortic regrgitation arteriosclerosis
cause of decrease arrhythmia
hypervolemia
heart failure
aortic stenosis
atherosclerosis
Respiratory Rate less than 14 rpm
bradypnea: old age well trained athlete diabeteic coma increase intracranial pressure drugs
Respiratory rate higher than 20 rpm
tachypnea: hyperthermia anxiety restrictive lung disease (COPD) elevated diaphragm pleurisy exercise
temp lower than 96.4F
hypothermia: cold drink old age slow metabolism nutritional deficiency hypothyroidism hypoglycemia
Temp higher than 99.1
pyrexia: emotion infection exercise hot drink trauma acute immune disorder hyperthyroidism
140-159 systolic , 90-99diastolic BP
Stage 1 hypertension: obesity high viscosity type II diabetes high cholesterol atherosclerosis
(same for stage 2 hypertension)
hypotension
hypothyroidism
thin/ small person
hypothermia
medication
Indications for confrontation test
CNII Optic N : blind spots scotoma diminished peripheral vision glaucoma macular degeneration MS CN 2 lesion retinal disorder
Cardinal fields of gaze
tests: CN 3,4, 6
Nystagmus
Strabissmus
Accomodation Test
Tests: Oculomotor- Medial Rectus M
lesion in the oculomotor
medial rectus
Pupilary Light Reflex
CN2, CN3, EWN:
Levator Palpebrae Superioris
Tests: CN3, Oculomotor
Grade 1-5- weakness is a oculomotor N lesion
Corneal Reflex
Testing : Opthalmic Division, Facial (orbicularis Oculi)
Ophthalmoscopy
Inspecting: fovea , art. and retinal integrity
Neg red reflex- cataracts
av nicking- retinopathy
papilledema - incr intracranial pressure
incr cup:disc- glaucoma
macular degeneration - old age
cotton wool patches- diabetes
gross hearing
test: CN 8 cochlear
hearing loss
Webers
conductive loss: (lateralize to)
wax
otitis media
tympanic membrane rupture
sensory loss: presbycusis excessive loud noise cochlear damage otitis interna
Renee’s test
?
Otoscope
absence of cone of light: incracranial pressure
redness: otoitis media
bony exostoses: swimmers ear
perforated tympanic membrane : sharp object in ear
amber fluid: serous effusion
large chalky white patch: tympanosclerosis
Active infection lymph
soft
enlarged
warm
tender
past infection
not warm
not tender
enlarged
Malignancy
hard
fixed
non tender
not warm
lymphoma
rubbery
warm
non tender
larger
`gag reflex
test: glossopharyngeal & Vagus
bilateral no response- glossopharyngeal
asymmetrical elevation - vagus
one side no response - vagus
vernet rideau
Testing Vagus “aaahh”
Vagus lesion - herpes, leukopenia
rhinoscopy
redness - inflammation
blue mm- allergies
deviated septum - trauma
perforated septum- drugs
sinus transillumination
line dim - infection
warmth, tenderness, swelling- sinus infection, bact, virus, sinusitis, congestion
absence of red glow- sinusitis, tumor, thickened mucosa
Motor to CN 5
Bite test
test masseter/ ptergoid by opening jaw & resist
(+) grade 1-5, cant bite down
sensory to CN 5
Anesthesia , CN 5 lesion
hyperesthesia
CN facial M
muscles of facial expression :
damage to facial N
bells palsy
Hypoglossal N
stick out tongue - lesion on side tongue deviates to
Muscle test - lesion on weak side
Myotome- peripheral N : C5
Bicep- musculocutaneous
Delt- axillary
Myotome- peripheral N : C6
brachiradialis- radial
wrist ext- radial
Myotome- peripheral N : C7
Tricep- radial
wrist flex- median
finger ext- radial
Myotome- peripheral N : C8
Finger flexors- median
Myotome- peripheral N : T1
palmer and dorsal interossei: ulnar ????
Myotome- peripheral N : L1/2
iliopsoas: Femoral
Myotome- peripheral N : L3
quads- femoral N
Myotome- peripheral N : L4
tib anterior- deep peroneal
Myotome- peripheral N : L5
ext hallicus loongus- deep peroneal
ext digitorum brevis and longus - superficial peroneal
glut med- superior glut
Myotome- peripheral N : S1
Peroneus longus and brevis - Superficial peroneal
___N for dorsal side of the palm, ____ N for ventral side of the palm
dorsal: radial N
Ventral: median N
positive findings for deratome
anesthesia -
hypoanesthia : hyposensntive , hypoalgesia
peripheral neuropathy
spinal radiculopathy
unilateral: spinal radiculopathy
3-5 on the wexler scale will be a ___ tract lesion
corticospinal tract lesion (UMN)