NSG500 / NSG 500 Exam 3 V1 | Latest 2026/2027 Update | Advanced Health Assessment | Wilkes | Practice Questions & Accurate Solutions

GRADED A++++++++++ NSG500 / NSG 500 Exam 3 V1 | Latest 2026/2027 Update | Advanced Health Assessment | Wilkes | Practice Questions & Accurate Solutions Q: Prostate Exam: Best Position Answer Side lying with hips and knees flexed Q: Prostate Exam: What does a prostate feel like? Answer Rubbery, smooth, round Q: Prostate Exam: What does the prostate feel like as a man ages? Answer More Rubbery Q: Prostate Exam: During exam, do you feel the posterior prostate? Answer Yes Q: Prostate Exam: What is a rectal prolapse? Answer Sliding sensation. Red Donut GRADED A++++++++++ Q: Prostate Exam: Hemorrhoids: Internal Answer Hemorrhoids above dentate line Q: Prostate Exam: Hemorrhoids: S/Sx Answer Bright red spot in toilet or paper, not mixed with stool. Feeling rectum is full Incontinence Sore, Itchy Anus Lump inside or around anus Q: Prostate Exam: Hemorrhoids: 1st Degree Answer No prolapse Q: Prostate Exam: Hemorrhoids: 2nd Degree Answer Prolapse with straining, then return inside anus GRADED A++++++++++ Q: Prostate Exam: Hemorrhoids: 3rd Degree Answer Prolapse when straining, but do not return upon relaxing, but can be pushed back. Q: Prostate Exam: Hemorrhoids: 4th Degree Answer Prolapsed permanently Q: Prostate Exam: Hemorrhoids: External Answer Hemorrhoids below the dentate line Q: Prostate Exam: Hemorrhoids: External: S/X Answer Can increase in size over time. Visible perianal mass or swelling. Pain, sudden and severe. Q: Rectal Exam: Causes of bleeding Answer Hemorrhoids, not mixed with stool. GRADED A++++++++++ Anal Fissures Wound Spasm of anal canal Q: Rectal Exam: Hemorroids: Treatment Answer Diet change Relieve constipation Fluid intake increase Fiber May go away on its own. Q: Musculoskeletal: Osteoarthritis vs. Rheumatoid Arthritis: What is the etiology of Osteoarthritis? Answer mechanical wear and tear on joints. Q: Musculoskeletal: Osteoarthritis vs. Rheumatoid Arthritis: What is the etiology of Rheumatoid Arthritis? Answer autoimmune disease GRADED A++++++++++ Q: Musculoskeletal: Osteoarthritis vs. Rheumatoid Arthritis: Which one has more fatigue and weakness? Answer Rheumatoid Arthritis Q: Musculoskeletal: Rheumatoid Arthritis : Exam findings Answer Ulnar deviation and Boutonniere deformities Q: Musculoskeletal: Carpal Tunnel: Exam Findings: What are the 3 signs? Answer Tinel Phalen Reduced Abduction of Thumb Q: Musculoskeletal: Carpal Tunnel: Exam Findings: Where is the tingling/numbnesss? Answer Thumb, index, middle, and half of ring fingers. Answer Palm is spared. GRADED A++++++++++ Musculoskeletal: Carpal Tunnel: Exam Findings: median nerve compression, positive ---- sign Answer Tinel Musculoskeletal: Carpal Tunnel: Exam Findings: The ------- test is performed by asking the patient to place both elbows on a table while keeping both forearms vertical and flexing both wrists at ----- degrees for 60 seconds. Phalen 90 Musculoskeletal: Carpal Tunnel: Exam Findings: What does a positive Phalen Test look like? A positive test is defined as the occurrence of pain or paresthesias in at least one finger innervated by the median nerve. The reverse Phalen test is performed by placing the palms and ------ together with full wrist ---------- Fingers Extension Musculoskeletal: Rotator Cuff: What tests identifies inflammation or tear? Neer test Hawkins test Musculoskeletal: Rotator Cuff: Neer Test Raising arms to maximum elevation. GRADED A++++++++++ Musculoskeletal: Rotator Cuff: Neer Test: How do you know if the test is positive? If pain is reproduced. Musculoskeletal: Rotator Cuff: Hawkins test Patient seated with arm 90 degrees forward elevation. Passive forced internal rotation at different degrees of abduction. Musculoskeletal: Rotator Cuff: Hawkins Test: How do you know if the test is positive? Pain is reproduced in the shoulder Musculoskeletal: Torn Meniscus: Exam Findings: The -------- test; any palpable or audible ------, ------, or limited --------- of the knee is a positive sign of a torn meniscus. McMurray Click Pain Extension Musculoskeletal: Anterior Cruciate Ligament Injury: What is this ligament's function? To provide anterior and posterior stability. Musculoskeletal: Anterior Cruciate Ligament Injury: Exam Findings: Lachman Test To test anterior cruciate ligament integrity GRADED A++++++++++ Musculoskeletal: Anterior Cruciate Ligament Injury: Exam Findings: Drawer test Test detects an anterior/posterior cruciate ligament tear. Musculoskeletal: Identify Scoliosis Lateral curvature of the spine. Musculoskeletal: Scoliosis: What can it lead to? May lead to back discomfort and is often associated with a leg length discrepancy. Musculoskeletal: Strength Grade: 0 No evidence of movement Musculoskeletal: Strength Grade: 1 Trace of movement Musculoskeletal: Strength Grade: 2 Full range of motion, but not against gravity* (passive mvmt) Musculoskeletal: Strength Grade: 3 GRADED A++++++++++ Full range of motion against gravity but not against resistance Musculoskeletal: Strength Grade: 4 Full range of motion against gravity and some resistance, but weak Musculoskeletal: Strength Grade: 5 Full range of motion against gravity, full resistance Musculoskeletal: ROM: Abduction: Shoulder abduction = ------ degrees 180 degrees Musculoskeletal: ROM: Adduction: Shoulder adduction = ------ degrees 50 degrees Musculoskeletal: ROM: Supination: Elbow Pronation and supination = ------ degrees 90 degrees Musculoskeletal: ROM: Pronation: Elbow Pronation and supination = ------ degrees 90 degrees Musculoskeletal: ROM: Extension: Elbow Extension = ------ degrees 180 degrees GRADED A++++++++++ Musculoskeletal: ROM: Extension: Shoulder hyperextension = ------ degrees. 50 degrees. Musculoskeletal: ROM: Flexion: Shoulder forward flexion = ------ degrees. 180 degrees. Musculoskeletal: ROM: Rotation: Internal 90 degrees Musculoskeletal: ROM: Rotation: External 90 degrees Musculoskeletal: ROM: Flexion: Elbow Flexion = ------ degrees 160 degrees Musculoskeletal: Goals of a sports physical Ensure safe participation in an appropriate physical activity and not to restrict participation unnecessarily. 1. To identify conditions that may interfere with a person's ability to participate in a sport 2. To identify health problems that increase the risk of injury or death during sports participation GRADED A++++++++++ 3. To help select an ------------- for a person's particular abilities and physical status Musculoskeletal: Older Adult: Spinal Stenosis Finding In the early stages, the neurologic examination is frequently normal. With progression, the examination may show lower extremity weakness and sensory loss. Musculoskeletal: Older Adult: Spinal Stenosis Finding: What gait might be present? Stooped forward gait Musculoskeletal: Older Adult: Spinal Stenosis Finding: When and where does pain present? Pain with walking or standing upright that often seems to originate in the buttocks and may then radiate down the legs. Musculoskeletal: Older Adult: Spinal Stenosis Finding: What makes the pain better? relief with sitting/bending forward. Musculoskeletal: Older Adult: Spinal Stenosis Finding: What makes the pain worse? prolonged standing, walking, or hyperextending the back Neuro: Cranial Nerves: 11 XI (11) : Accessory Nerve Test trapezius muscle strength (shrug shoulders against resistance) GRADED A++++++++++ 1. Test sternocleidomastoid muscle strength (turn head to each side against resistance) Neuro: Cranial Nerves: 1 Olfactory: ability to identify familiar aromatic odors, one naris at a time with eyes closed Neuro: Cranial Nerves: 2 Optic: distant and near vision1. Perform ophthalmoscopic examination of fundi2. Test visual fields by confrontation and extinction of vision Neuro: Cranial Nerves: 3 Ocularmotor: "Follow my penlight as a make a star formation." Neuro: Cranial Nerves: 5 Trigeminal 1. Inspect face for muscle atrophy and tremors Palpate jaw muscles for tone and strength when patient clenches teeth.2. Test superficial pain and touch sensation in each branch (test temperature sensation if there are unexpected findings to pain or touch)3. Test corneal reflex Neuro: Cranial Nerves: 6 Abducens: GRADED A++++++++++ Eye movement: Left and Right Neuro: Cranial Nerves: 7 Facial: inspect symmetry of facial features with various expressions (e.g., smile, frown, puffed cheeks, wrinkled forehead)1. Test ability to identify sweet and salty tastes on each side of tongue. Neuro: Cranial Nerves: 8 Acoustic: test sense of hearing with whisper screening tests or by audiometry1. Compare bone and air conduction of sound Test for lateralization of sound. Neuro: Cranial Nerves: 12 Hypoglossal 1. Inspect tongue in mouth and while protruded for symmetry, tremors, and atrophy 2. Inspect tongue movement toward nose and chin Test tongue strength with index finger when tongue is pressed against cheek 3. Evaluate quality of lingual ------ sounds (l, t, d, n) Neuro: Cranial Nerves: 9+10 1. Test ability to identify sour and bitter tastes on each side of tongue. 2. Test gag reflex and ability to swallow. Inspect palate and uvula for symmetry with speech sounds and gag reflex. GRADED A++++++++++ 3. Observe for swallowing difficulty 4. Evaluate quality of guttural speech sounds (presence of nasal or hoarse quality to voice) Neuro: Cranial Nerves: Order 1 Olfactory 2 Optic 3 Oculomotor 4 Trochlear 5 Trigeminal 6 Abducens 7 Facial 8 acoustic 9 glossopharyngeal 10 vagus 11 accessory GRADED A++++++++++ 12 hypoglossal On Occasion our trusty truck acts funny very good vehicle any how Neuro: Cranial Nerves: Sensory or motor? Mneumonic for sensory or motor? 1 Olfactory s 2 Optic s 3 Oculomotor m 4 Trochlear m 5 Trigeminal b 6 Abducens m 7 Facial b 8 acoustic s 9 glossopharyngeal b 10 vagus b 11 accessory m GRADED A++++++++++ 12 hypoglossal m Some say marry money but my brother says big butts matter more How to assess for joint effusions: Ballottement the presence of an EFFUSION from excess FLUID How to assess for joint effusions: An effusion of the knee fills the --------- pouch and the concavity below the -------- medially. Suprapatellar Patella How to assess for joint effusions: When effusion of the knee occurs, the usual indentation --------- and on the -------- side of the patella is filled out. Above Medial How to assess for joint effusions: When effusion of the knee occurs, patella is filled out. What is this called? Concave or Convex? Convex What does a patella do during an effusion? The patella will float out as if a fluid wave were pushing it. GRADED A++++++++++ Pediatrics: Leg Discrepancy: For most people, no more than a ------cm discrepancy in length and circumference between matching extremities should be found. No more than 1cm Neuro: test for balance/equilibrium Romberg's test Neuro: What does a positive Romberg sign signify? Positive sign indicates cerebellar ataxia, vestibular dysfunction, or sensory loss. Neuro: DTR and associated spinal levels: Biceps C5 & C6 Neuro: DTR and associated spinal levels: Brachioradial C5 & C6 Neuro: DTR and associated spinal levels: Triceps C6, C7, C8 Neuro: DTR and associated spinal levels: Patellar L2, L3, L4 GRADED A++++++++++ Neuro: DTR and associated spinal levels: Achilles S1 & S2 Neuro: What is Dermatome? The sensory and motor fibers of each spinal nerve supply and receive information in a specific body distribution of cutaneous innervation Neuro: What is graphesthesia and how do you test it? tests cortical sensory integration (draw figure 8) Neuro: What is Vibratory sense and how do you test it? Uses a tuning fork placed on a bony prominence Neuro: What is 2-point discrimination and how do you test it? Uses sharp objects to determine the distance at which the patient can no longer distinguish the two points. Use fingertips for short distances. Neuro: What is proprioception and how do you test it? dependent on the parietal lobe. Rapid rhythmic alternating movements, accuracy of movements, balance (Romberg test), and gait and heel-toe walking. GRADED A++++++++++ Evaluates anterior and dorsal spinocerebellar spinal tract. Neuro: What are important tests for meningitis? Brudzinski Kernig Neuro: What is the Bruzinski sign? May be present w/ neck stiffness. Involuntary flexion of the hips and knees when flexing the neck. sign and may indicate meningeal irritation. Neuro: What is the Kernig sign? Evaluated by flexing the leg at the knee and hip when the patient is supine, then attempting to straighten the leg. A positive Kernig is present when the patient has pain in the lower back and resistance to straightening the leg at the knee; may indicate meningeal irritation. Neuro: Meningitis: What is needed to confirm presence of meningitis? Lumbar puncture GRADED A++++++++++ Neuro: Headache: Migraine childhood, uni/generalized, am/pm, pulsating, throbbing, prodromal changes, twice/week, females, N/V Neuro: Headache: Cluster adult, unilateral, 0.5-2hrs, night, intense knifelike, precipitated by alcohol, males, eye watering, nasal discharge Neuro: Dementia Condition r/t brain structure. progressive, persistent, no activity change, depressed, not reversible. Neuro: Parkinson's: Are the Tremors unilateral? Sometimes Neuro: Parkinson's: When do the tremors initially occur? At rest and with fatigue Neuro: Parkinson's: When do the tremors initially disappear? With intended movement and sleep. Neuro: Parkinson's: How does the disease progress? GRADED A++++++++++ pill- rolling movement of fingers bilaterally and tremor of the head. Slowing of voluntary and automatic movements, "feel wooden," freezing or unable to continue movements. Neuro: Parkinson's: What are the muscular and sensory effects? Numbness, aching, tingling and muscle soreness occur in many patients. Difficulty swallowing, or patient may be drooling. Muscular rigidity, cogwheel rigidity with jerks. Neuro: Parkinson's: Gait, Posture, and Balance Stooped posture, balance and postural instability. Short steps, shuffling, freezing gait, gait may accelerate to maintain upright posture. Neuro: Parkinson's: Speech Slow, slurred monotonous speech, voice softening. Impaired cognition, dementia. Neuro: Multiple Sclerosis Degenerative condition; Immune system destroys myelin; Vision loss, pain, fatigue, and impaired coordination Neuro: Gait: Feet are wide based with a staggering gait, lurching from side to side, often accompanied by swaying of the trunk. GRADED A++++++++++ Cerebellar Gait (Cerebellar ataxia) Neuro: Gait: When the hip and knee are elevated excessively high to lift the plantar flexed foot off the ground. The foot is brought down with a slap and the patient is unable to walk on the heels. Steppage Gait Sign/Test for Rotator Cuff Hawkins What is the correct position when performing a rectal/prostate exam? side-lying position When doing your prostate exam, what area are you palpating? Posterior surface What should a normal prostate feel like? Rubbery and smooth How do you know that someone has rectal prolapse? GRADED A++++++++++ When the patient is experiencing sliding of the rectum, occurs during straining What do external hemorrhoids look like? small masses that are pink/red and beefy. ....If it's purple/really dark in color; that is a concern for a thrombus or necrotic tissue and a bad finding!! What do internal hemorrhoids feel like? soft masses. ....Hard is a concern and a bad finding! What are some causes of rectal bleeding? 1) Cancer - change in bowel habits, pain, blood in stool. 2) hemorrhoid's 3) Constipation/straining 4) colitis/inflammation or infection of the bowel 5) Fissures GRADED A++++++++++ 6) GI bleed 7) NSAIDS, aspirin (NOT TYLENOL) 8) Chrohn's Constipation and hemorroids Small amounts of bright red blood Intermittent or during straining Symptoms: Pain, itching, bleeding What color is the blood of a Lower GI bleed? Bright red What color is the blood of an upper GI bleed? Dark red/tarry/melanotic Sequence of musculoskeletal exam Inspect, Palpate, Passive/Active ROM, and Joint Stability/Assess GRADED A++++++++++ -Stability tests; if your pt has knee pain and you're concerned about an ACL tear, you'll do stability testing and load joint to see if joint is stable Normal musculoskeletal changes in aging decreased ROM, joint pain, stiffness, increased risk of osteoarthritis, increased bone reabsorption—this can cause instability What is the best way to assess for joint symmetry? inspection by comparing joint from one side to the other What is the best way to assess for joint effusion? Palpate; it will be feel soft an spongy (that's the fluid in the joint you are feeling) Boggy Carpel tunnel; What is the tinel test? -tapping on ulnar side and indicates if medial nerve is involved What is the phalen test? An exam that assess for carpal tunnel syndrome. GRADED A++++++++++ -Inverse praying hands. -Tingling will indicate compression of carpal tunnel nerve Lachman test A stability test that can indicate an ACL tear Distinguishing characteristics of OA During inspection you visualize heberden nodes. They will be in the distal region of extremities (bouchards will be more proximal) Risk factors for OA previous joint injuries, overuse injury (like older men who were catchers while playing baseball), old age, family hx, vitamin deficiency, smoking, obesity, runners What decreases your risk for OA? An active lifestyle and low joint impact exercises like walking and swimming GRADED A++++++++++ Differentiating between RA and OR RA: Autoimmune No overuse injury Bilateral Pain at rest Atrophy at joint What test will test for torn meniscus? McMurray test; internal and external rotation at the knee Exams for hip dislocation/displacia in an infant Ortalani and Barlow test Affected leg is shorter, possibly internally rotated S/s plantar fasciitis -Pain at the base of heel/arch, -pain is worse in the morning and bedtime (if you're standing all day) GRADED A++++++++++ Stretching and rolling foot helps What are tests for assessing rotator cuff tear? -Neer's test (pain when you lift arm up) -Drop Arm test (can't hold arm against gravity), -Hawkins test (can't push against resistance) Presentation of rotator cuff tears: -decrease ROM -decreased strength S/s with spinal stenosis pain with walking and standing upright Scoliosis lateral curving of spine GRADED A++++++++++ OA joint considerations -joint enlargement due to osteophites, -localized weakness RA pain.. does it get better with rest? -NO, the patient will experience pain at rest. -It also causes atrophy of the muscles Determining if a patient has scoliosis Have patient bend over, assessing for lateral curvature of the spine. The patient will have uneven shoulders Considerations of a red inflammed/swollen joint Infection vs. gout -You need to rule out septic arthritis vs. gout. -Gout will be able to perform ROM at the swollen site -Septic arthritis can NOT perform ROM GRADED A++++++++++ Drop arm/empty can test Reduced strength with adduction. Hands will be thumbs down How do you grade strength? 0 through 5 -0/5 is no movement (paralysis) -3/5 movement against gravity -4/5 weakness against resistance -5/5 is full strength against resistance Flexion towards the body Extension out from the body GRADED A++++++++++ Abduction away from body Adduction in towards body Supination palms upward (like you're holding soup) Pronation palms down Pt comes in for a sports physical, what are you trying to accomplish? -Making sure if patient doesn't have any joint issues or congenital anomalies Hearing, eyesight, murmurs -what's NOT included; nose, throat, you don't have if they have post nasal drip, abdominal exam ect In the older adult, what should be included in a functional assessment? GRADED A++++++++++ ADL's .. make sure living conditions are compatible with physical abilities, such as gross motor movement (not necessarily strength) what is a normal gait for an adult? -balance, coordination, feet shoulder-width apart. Natural swinging of arms when ambulating -NOT shuffling General sequence of neuro exam -LOC/mental consciousness/GCS -Cranial nerves 1-12 (olfractory, facial sensation, extraocular movement, pupilarry response, fundoscopic exam) -Sensation (upper + lower extremity) -strength -Coordination -Refluxes -Gait -Examining skull and spine/general inspection, Cranial nerve 1 Sensory - olfractory Cranial nerve 2 sensory - optic nerve GRADED A++++++++++ -visual acuity and confrontation cranial nerve 3 oculomotor nerve -Medial up lateral down -EOM (lateral eye movement) Cranial nerve 4 trochlear - down and medial -EOM (lateral eye movement) Cranial nerve 6 Abducens - lateral eye movement EOM Cranial nerve 5 Trigeminal (Sensory and motor) GRADED A++++++++++ Cranial nerve 7 facial nerve (sensory and motor) -taste -ask patient to smile and raise eyebrows Cranial nerve 8 Sensory, auditory, Vestibulocochlear (hearing and balance) Cranial nerves 9 + 10 Motor and sensory.. test both together. Ask patient to say "ah" -gag reflux for UNCONSCIOUS patient Cranial nerve 11 Motor, accessory, shoulder shrug Cranial nerve 12 Motor, hypoglossal (tongue movement), ask them to turn head Normal changes in neurosystem with aging GRADED A++++++++++ Sensory deficits; decreased vision, touch, hearing Abnormal changes in neurosystem with aging Motor, cognition What is the Romberg's test? Tests equilibrium. Ask patient to close their eyes, put feet together, arms to side, make sure they maintain their balance and not sway side to side/lose balance DTR's; what are upper extremity deep tendon reflexes? -Biceps (cervical spine damage) -Brachioradialis -Triceps DTR's; what are lower extremity deep tendon reflexes? -Patellar (lumber spine damage) -Achilles GRADED A++++++++++ Dermatone levels c6: thumb, radial aspect c7: second and third finger c8: ring finger,pinky Proprioception our sense of body position and space Graphesthesia draw on the patient's palm Sterognosis put key in patient's hand and ask them to identify object 2 point discrimination ability to distinguish the separation of 2 simultaneous pinpricks on the skin Concerning findings for meningitis unable to touch chin to chest (also known as nuchal rigidity), neck pain, fever, photosensitivity, nausea vomiting, headaches, AMS GRADED A++++++++++ Kernig's sign -a diagnostic sign for meningitis -marked by the person's inability to extend the leg completely when the thigh is flexed upon the abdomen and the person is sitting or lying down, causing pain in neck Brudzinki's sign -a diagnostic sign for meningitis -try to lean the patient's neck up, and if the patient bends their knees, it's them trying to compensate for inflammation in the neck. That would indicate a positive brudzinki's sign Straight leg test a test to indicate nerve compression or radiculopathy. Provider elevates patient's leg, if they get pain in their back that indicates lumbar root irritation/nerve compression and a positive straight leg test. Tension headaches across the temporal forehead, "banding" headache, squeezing GRADED A++++++++++ Migraine headaches unilateral, throbbing pain, aura, photophobia, throbbing, pulsating pain Cluster headaches severe pain behind 1 eye Parkinsons s/s -Pill rolling -Shuffling Gait -Tremors -Bradykinesia - slow movements due to muscle rigidity If a patient presents with altered mental status, what do you test for first? -First, you test for organic metabolic causes of AMS such as infection (like a uti) -Then, once that is ruled out, you can test for dementia Rooting reflex GRADED A++++++++++ a reflex in which a newborn turns its head in response to a gentle stimulus on its cheek -disappears after 4 months Babinski's stroking sole of foot from heel upward across ball of foot cauing toes to fan Order of a physical assessment assessing head to toe, document by system (not documenting head to toe) Best way to create primary diagnosis/differential diagnosis Considering both subjective and objective findings, listen to your patient.... don't order routine exams just to order them/rule things out. RA causes what.. atrophy Buldge sign indicates potential degenerative joint disease. GRADED A++++++++++ Effusion in the knees Gout vs arthritis Gout is RED and swollen Arthritis is not red What are the positions for the rectal examination Knees chest lithotomy left lateral with knees and hip flexed standing with hips flexed forward Normal prostate exam findings prostate feels like pencil eraser, firm, smooth and slightly moveable non-tender 4 cm diametes Hemorrhoid Exam findings swollen veins @ lower portion of rectum or anus External hemorrhoid exam findings varicose veins originating below the anorectal line GRADED A++++++++++ c/o itching, bleeding, discomfort Internal hemorrhoid exam findings varicose veins originating above anorectal junction covered by rectal mucosa no c/o discomfort or itching causes of rectal bleeding anal fissures asprin containing medications bleeding disorders colitis esophageal varicose hemorrhoids iron poisoning Ulcers polyps Normal MSK changes in the elderly bone loss with increased density r/t increased absorption reduction in total mass, tone and strength What is joint effusion? swelling from excess fluid in the joint capsule GRADED A++++++++++ Risk factors for carpal tunnel compression of the median nerve, repetitive motions, hand vibrations, local edema Tests for carpal tunnel syndrome Phalen's test and Tinel's sign s/s of carpal tunnel syndrome numbness burning tingling in hands at night what is gout a form of arthritis causes by an over accumulation of uric acid who gets gout men 40 post menopausal women What is spinal stenosis? narrowing of the spinal canal what causes spinal stenosis bone and ligament hypertrophy GRADED A++++++++++ s/s of spinal stonsis pain with walking and standing that starts at the buttock and radiates down leg stooped forward gait weakness sensory loss (late) What is RA autoimmune, chronic inflammation of synovial joints presentation of RA joint pain & stiffness occuring in arm fatigue myalgia wt loss low grade fever What is OA detoritation r/t overuse of joint bone rubbing against bone bone spur formation Identification of Scoliosis deformity of the spine S or C curve GRADED A++++++++++ scoliometer 7 Neer Test forward flexion of patient arm while depressing the scapula, assessing for rotator cuff inflammation/ tear Hawkins-Kennedy Test producing shoulder impingement with shoulder abducted 90 degrees, elbox flexed 90 degrees, internal rotation if pain felt = rotator cuff inflammation/tear how is strength graded 0-5 scale Abduction Movement away from the midline of the body Adduction Movement toward the midline of the body Supination movement that turns the palm up GRADED A++++++++++ Pronation turning the palm downward W or Reverse Tailor Position indication of in-toeing in pediatric population associated with femoral anterversion at what age does bowlegged findings in pediatrics become a problem after 18 mo Knock-knees are a common finding among pediatric patients until what age 2-4 CN 1 Olfactory Smell CN2 Optic vision acuity & fields CN3 Oculomotor eye movement GRADED A++++++++++ CN4 Trochlear downward & upward eye movements CN5 Trigeminal Motor: mastications Sensory: sensation to cornea, eye secretions, saliva CN 6 Abducens lateral eye movements CN7 Facial facial expressions CN8 Vestibulocochlear equilibrium and hearing CN9 GRADED A++++++++++ Glossopharyngeal swallowing, taste, gag reflex CN10 Vagus sensation behind ear and external ear canal GI secreations and motility CN11 accessory turn head, shoulder shrug CN12 Hypoglossal tongue movements Romber test evaluates balance with eyes opened and eyes closed. slight sway is normal, falling is not other balance tests apply slight pushing force to shoulder hop on one foot 5 seconds stand on one foot 5 seconds GRADED A++++++++++ The Bicept DTR is associated with which spinal location C5 & C6 The brachioradial DTR is associated with which spinal location C5 & C6 The Tricep DTR is associated with which spinal location C6, C 7, C8 The patella DTR is associated with which spinal location L2, L3, L4 The Achillies DTR is associated with which spinal location S1 and S2 What is meningitis inflammation of meninges in the brain Presentation of meningitis Neck stiffness, fever, chills, AMS, nucal rigidity, seizures GRADED A++++++++++ Testing for meningitis + Bruzinski & Kernig Sign What is Brudzinski's sign? Bending of the neck & knees causes pain What is the Kernig Sign patient lies supine, thigh is flexed at right angle, and it hurts to extend leg what are the 3 classic signs of Meningitis Nuchal rigidity, Brudzinkski & Kernigs sign delrium vs dementia Delrium- Sudden onset and progression, symptoms fully reversible, fluctuating lucidity, highly impaired, cannot shift or maintain attention, may take brief naps during the day and night Dementia- Slow onset and progression, may slow progression with meds, disoriented most of the time may be worse at night, distractible, short attention span, impaired sleep-wake cycle, wandering and agitation at night Parkinsons disease slowly progressive, degenerative neurologic disorder in which moto function, behavior and mood are affected. destruction of neurons that transmit dopamine GRADED A++++++++++ Parkinsons onset after 40, with 60 yo mean age of onset s/s Parkinsons tremors first starting at rest, pill rolling, feeling frozen or wooden,muscle aches, drooling, rigidity, stooped gait, slurred speech, dementia What is MS progressive, autoimmune disease, inflammation and degeneration of the myelin sheath of the brain white matter onset of MS 20-40, womenmen s/s MS fatigue, urinary changes, sexual dysfunction, emotional changes, hyperactive DTR, cognitive changes dx of MS MRI showing brain lesions Normal Elderly Gait shorter steps, less lifting of feet, shuffling may occur, flexed legs, hips, knees GRADED A++++++++++ Rooting Reflex Occurs in infants until 3-4 mo old. Palmar Grasp disappears at 3-4 months Plantar Grasp Disappears by 8 mo toe curling when touching bottom of foot Moro reflex Infant reflex where a baby will startle in response to a loud sound or sudden movement. symmetric abduction and extension of arms, fanned fingers, index and pointer finger make a C decreased at 3-4 mo, gone by 6 mo Placing child mimics stepping up onto surface when dorsal foot is touched Stepping If held so that the feet just touch the ground, an infant will show "walking" movements, alternating the feet in steps