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NMS > Case history, etc. > Flashcards

Case history, etc. Flashcards

1
Q

list the components for a case history

A

details of chief complaint
comprehensive health history
review of systems

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2
Q

components of examination process

A 
general inspection
vitals
CN exam
visceral exam
cerebellar and proprioception exam
multimodal exam
sensory exam
muscle strength exam
DTR exam
superficial, pathological, visceral reflexes
ROM
orthopedic test (standardized)
orthopedic test (specific)
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3
Q

chiropractic examination

A 
instrumentation
static palpation
motion palpation
leg lengths
x rays
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4
Q

synthesis/assessment

A

group together clues from history, exam, special studies and procedures performed
create a problem list in order of priority

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5
Q

therapeutic program

A 
chiropractic management plan
adjustments
support procedure
physical therapy
work instruments
sleep and activity instructions
exercise instructions
diet instructions
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6
Q

concurrent care

A

recommending consulting with another healthcare provider while under care

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7
Q

referral

A

referring patient to another healthcare provider before any other chiropractic care

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8
Q

recommendations

A

review findings with patient and explain your findings

recommend therapeutic program

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9
Q

when are re-evaluations done?

A

at predetermined intervals or as the case demands

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10
Q

patient status/current plan

A

continue with therapeutic program
modify therapeutic program
recommend consultation or referral OR
dismiss patient if they have reached maximum medical improvement

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11
Q

as a chiropractic physician one of our duties to the patient is to…

A

formulate a diagnosis

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12
Q

history process and gathering of information by the interview process, what types of questions are preferred? what are the other types of questions you could ask?

A

open ended questions
direct questions
leading question

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13
Q

Questions to ask about the onset.

A

can you point to where it is?
when did you first notice it? Gradual or sudden?
what was the exact day you noticed it?
do you know what caused your symptoms?
have the symptoms changed over time?
are there any new symptoms associated with it?
has it gotten worse or better?
how long has it been since you have felt well?

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14
Q

provoke examples

A

lifting, bending, reaching, sitting

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15
Q

palliative examples

A

anti-inflammatory drugs, ice, rest, adjustments

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16
Q

joint quality of pain

A

sharp pain on motion, constant pain

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17
Q

nerve quality of pain

A

constant pain, burning, hot, tingle

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18
Q

peripheral nerve quality of pain

A

numbness, tingling, burning (multidermatomal)

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19
Q

muscle quality of pain

A

dull ache, cramping, knot, spasm

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20
Q

sceratogenous quality of pain

A

radiating dull or deep ache

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21
Q

ligament quality of pain

A

deep burning or dull pain

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22
Q

vascular quality of pain

A

throbbing

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23
Q

unilateral radiating pain that follows a dermatome indicates?

A

NR irritation/compression

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24
Q

unilateral radiating pain that follows a multi-dermatomal pattern indicates?

A

peripheral N irritation/compression, vascular, brachial plexus injury

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25
Q

bilateral radiating pain that involves the upper extremities only indicates?

A

cervical myelopathy C6-T2

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26
Q

bilateral radiating pain that involves the upper and lower extremities indicates?

A

spinal cord lesion C5 and above

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27
Q

bilateral radiating pain that involves the lower extremities indicates?

A

lumbar spinal cord lesion, spinal cord stenosis

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28
Q

visual analog scale

A

patient marks on a 10 cm line how much pain they are in

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29
Q

borg scale

A

ask patient on a scale of 1-10 how bad their pain is

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30
Q

minimal pain

A

pain is annoying, no impairment with activity

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31
Q

slight pain

A

pain is tolerable, impairment with activity

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32
Q

moderate pain

A

pain causes marked impairment with activity

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33
Q

marked pain

A

pain keeps patient from doing any acitivities

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34
Q

increased pain that occurs at night and the patient reports having unexplained weight loss suggests?

A

cancer

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35
Q

intermittent pain

A

less than 25% of the time

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36
Q

occasional pain

A

25-50% of the time

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37
Q

frequent pain

A

50-75% of the time

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38
Q

constant pain

A

75-100% of the time

39
Q

benefits of a good examination

A

determine that a musculoskeletal lesion is present
location of the problem
pathological conditions that could cause these problems
analyze the history, examination and testing

40
Q

dermatome pain pattern

A

radiating, sharp, stabbing, well demarcated

41
Q

myotogenous pain pattern

A

pain referral within muscular or fascial tissue

42
Q

scerotogenous pain pattern

A

dull, achy, diffuse, difficult to pinpoint

43
Q

vascular pain pattern

A

throbbing

44
Q

visceral pain pattern

A

referred pain, deep

45
Q

components of vital signs

A 
respiration
blood pressure
temperature
height and weight
mental status
46
Q

active ROM importance

A

helps determine if there is subluxation, muscle spasm, muscle strain, ligament sprain, general arthritic condition, post surgical condition, obesity

47
Q

passive ROM importance

A

tests end of ROM for any pathologies or subluxationsf

48
Q

bone to bone passive ROM

A

abrupt stop when two hard surfaces meet

49
Q

capsular end feel

A

“leathery” slight give at end of ROM

50
Q

springy block

A

usually pathological, generally represents interarticular displacement

51
Q

empty feel

A

usually pathological

52
Q

your static and motion palpation examination findings reveal that the patient experiences pain before end range can be reached you with your passive ROM. what does this suggest?

A

acute condition

53
Q

your static and motion palpation exam findings reveal that the patient experiences pain as the end range can be reached you with your passive ROM. what does this suggest?

A

subacute condition

54
Q

your static and motion palpation exam findings reveal that the patient experiences pain after the end ROM reached you with your passive ROM. what does this suggest?

A

chronic condition

55
Q

resisted muscle testing that is painless and strong

A

normal

56
Q

resisted muscle testing that is painful and strong

A

grade I strain

57
Q

resisted muscle testing that is painful and weak

A

grade II strain

58
Q

resisted muscle testing that is painless and weak

A

grade III strain

59
Q

decreased RBCs mean..?

A

anemia, neoplasm of bone, lupus

60
Q

increased RBCs mean..?

A

polycythemia, severe diarrhea, dehydration, poisoning

61
Q

total WBC count

A

shifts in differential may be present in infections

62
Q

increased ESR

A

infection, neoplasm and other necrotic processes

63
Q

alkaline phosphatase

A

increase in primary and secondary osseous neoplams

64
Q

acid phosphatase

A

increased in prostatic tumors

65
Q

decreased serum proteins

A

edema, liver disease, malabsorption, diarrhea, starvation

66
Q

increased serum proteins

A

lupus, RA, chronic infection, multiple myeloma

67
Q

what are the indications for Xray?

A 
soft tissue injury
bony misalignment
loss of integrity/osseous structures and joint space
dislocation
fracture
certain tyes pf stress injuries
metastatic disease
degenerative disease
abnormalities in growth plate
some primary tuors
metabolic disease
68
Q

red flags for xray and other lab studies

A

prior cancer or recent infection, fever over 100, IV drug abusee, prolonged steroid use, low back pain worse with rest, unexpected weight loss

69
Q

indications for CT

A

fracture, IVD protrusions or herniations
facet disease
central canal and lateral recess stenosis
metabolic bone disease

70
Q

indications for MRI

A 
IVD protrusion, herniation
early stages of DDD
spinal cord tumors
intracranial disease
CNS disease
metastatic bone disease
spinal stenosis
cerebral edema
meniscal tear
soft tissue tumor
71
Q

when do you order MRI with contrast?

A

patietn with acutre low back apin and have had recent surgery

72
Q

indications for bone scan

A

spinal tumor
infection
occult fracture

73
Q

indications for electromyography

A

muscle issues

74
Q

indications for nerve conduction velocity exam

A

sciatica

75
Q

indications for angiography

A

intercranial aneurysms, vascular disorders, hematomas, tumors

76
Q

indications for thermography

A

NR compression

77
Q

instrumentation beak to the right along with radiating pain to the right suggests?

A

nerve compression

78
Q

instrumentation break to the left along with radiating pain to the right suggests

A

nerve irritation

79
Q

what patient would benefit from a cranial nerve exam?

A

trauma, stroke, etc

80
Q

control all motor and sensory functions of the head, face and neck as well as..?

A

special senses

81
Q

___pain may be the greatest cause of headaches

A

cervicogenic

82
Q

___vertigo may be the greatest cause of dizziness

A

cervicogenic

83
Q

CN abnormalities may arise from…

A

specific lesions to the nerve
lesion in nucleus
communicating pathways to and from cortex, diencephalon, cerebellar or other parts of brainstem
generalized problems with nerves or muscles

84
Q

more than one CN may be affected by a generalized disorder like…?

A

myasthenia gravis

85
Q

multiple lesions may be noted with…?

A

MS, cerebral vascular disease

86
Q

unilateral cranial nerve syndrome affection V, VII, VIII…

A

cerebellopontine angle lesion

87
Q

unilateral cranial nerve syndrome affecting III, IV, V and VI…

A

cavernous sinus lesion

88
Q

combined unilateral cranial nerve syndrome affection IX, X and XI…

A

jugular foramen lesion

89
Q

the most common cause of instrinsic brainstem lesion in younger patient is..? older patient?

A

young: MS
old: vascular disease

90
Q

hypoalgesia

A

area of greatest sensory loss

91
Q

hyperalgesia

A

area where sensory increases

92
Q

alganesthesia/analgesia

A

insensitive to pain

93
Q

hypalgesia

A

decreased sensitivity

94
Q

hyperalgesia

A

increased sensitivity

NMS (16 decks)

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