ben Shared "PT" - 85 Picmonics

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PT

Clinical Reflexes
Achilles reflex
Patellar reflex
Biceps and brachioradialis reflexes
Triceps reflex
Cremasteric reflex
Anal wink reflex
Jaw jerk reflex
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Nerve Palsies - Erb's Palsy (Waiter's tip)
Nerves
C5-C6 Roots
Superior (Upper) Trunk
Causes
Lateral Traction on Neck during Delivery
Trauma in Adults
Functional Deficit
Deltoid
Infraspinatus
Biceps Brachii
Presentation
Waiter's Tip Deformity
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2 mins
Actions of Hip Muscles
Abductors
Gluteus medius, gluteus minimus
Adductors
Adductor magnus, adductor longus, adductor brevis
Extensors
Gluteus maximus, semitendinosus, semimembranosus, biceps femoris (long head)
Flexors
Iliopsoas, rectus femoris, tensor fascia lata, pectineus
Internal rotation
Gluteus medius, gluteus minimus, tensor fascia latae
External rotation
Iliopsoas, gluteus maximus, piriformis, obturator
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Branches of Brachial Plexus
Musculocutaneous Nerve
Flexion
Supination
Axillary Nerve
Abduction of shoulder
Posterior circumflex artery
Fracture of surgical neck
Radial nerve
Extensors of arm, wrist, fingers
Supinator
Sensory back of arm and hand
Saturday night palsy
Fracture of humerus shaft
Ulnar Nerve
Ulnar claw
Lumbricals
Interosseus Muscles
Median Nerve
Wrist and finger flexion
Pronation
Hand of benediction
Carpal tunnel
Lumbricals
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Brachial Plexus
Roots
Long Thoracic nerve (C5-C7)
Dorsal Scapular nerve (C5)
Trunks
Subclavian Nerve (C5-C6)
Suprascapular Nerve (C5-C6)
Suprascapular innervates supraspinatus and infraspinatus
Cords
Lateral Pectoral Nerve
Lateral pectoral innervates pec major
Upper and lower subscapular nerves
Upper and lower subscapular nerves innervate subscapularis muscle
Thoracodorsal nerve (AKA middle subscapular n)
Thoracodorsal innervates latissimus dorsi
Medial Pectoral nerve
Medial Brachial Cutaneous Nerve
Branches
Median nerve (C5-C6)
Axillary Nerve
Axillary nerve innervates deltoid and teres minor
Musculocutaneous nerve
Radial nerve
Ulnar Nerve
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Leg Nerves
Femoral
Saphenous
Posterior Femoral Cutaneous
Sciatic
Tibial
Common Peroneal
Superficial Peroneal
Deep Peroneal
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1 min
Adhesive Capsulitis (Frozen Shoulder)
Pain, loss of shoulder motion, especially external rotation
Causes
Diabetes
Breast/lung surgery
Thyroid disorders
Extended use of sling
Treatment
NSAIDS
Steroids
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Scoliosis
Assessment
S Shaped Lateral Spinal Rotation
Unequal Shoulder and Scapula Height
Uneven Gait
Impaired Oxygenation
Hump when Bending Forward
Interventions
Body Braces
Worn 23 Hours/Day
Surgery
Considerations
Adolescent Screening
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3 mins
Dermatomes - Cervical
C2 - Posterior Cap Distribution
C3 - High Turtleneck
C4 - Low Collar Shirt
C5 - Anterolateral Shoulder
C6 - Thumb
C7 - Middle Finger
C8 - Pinky Finger
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1 min
Rotator Cuff
External Rotation
Teres Minor
Infraspinatus
Internal Rotation
Subscapularis
Abduction
Supraspinatus
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1 min
Juvenile Idiopathic Arthritis (JIA)
Most common cause of Arthritis in Children. Onset before Age 10.
More common in females
Persistent joint swelling (synovial thickening, accumulation of synovial fluid)
Subtypes
Polyarticular JIA
Severe symmetrical arthritis
Dactylitis
Pauciarticular JIA
Typically involves large joints (shoulders, elbows, hips and knees)
20-25% have Uveitis. Increased risk of blindness in children.
Systemic-onset JIA
Also known as Still's disease
Begins with systemic symptoms (fever, rash, elevated WBC, anemia, hepatosplenomegaly, lymphadenopathy). Described as "spikes of rash and fever."
Arthritis begins later in the course of the disease
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Diabetes Insipidus
Excess urinary loss of water
Deficiency/insensitivity to vasopressin
Hypernatremia
Low urinary sodium excretion
Treat with desmopressin
Patient should drink to thirst
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Paracentesis
Performed on patients with severe ascites
For procedure patient should be sitting on side of the bed or in high fowlers position
Provides only temporary relief
Uses a syringe to extract fluid
Patient must void immediately before procedure
Look for signs of electrolyte imbalance and hypovolemia after procedure
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Angina Diagnostics
Resting EKG
Normal in stable angina
Q Wave= previous MI
ST or T changes + chest pain= unstable angina
Cardiac stress EKG
Indicated if normal resting EKG
ST Depression= positive test
Patients with positive stress EKG or Echo should undergo catheterization
Stress echocardiogram
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Autosomal Recessive Diseases
Albinism
AR Polycystic Kidney Disease
Cystic fibrosis
Von Gierke's Disease
Pompe Disease
Cori Disease
McArdles Disease
Hemochromatosis
Kartagener's Syndrome
Hurlers Syndrome
Phenylketonuria (PKU)
Sickle Cell Disease
Gauchers Disease
Niemann-Pick Disease
Tay-Sachs Disease
Krabbe Disease
Metachromatic Leukodystrophy
Thalassemias
Wilson's Disease
Friedreich's Ataxia
Fructose Intolerance
Hartnup Disease
Leukocyte Adhesion Deficiency
Essential Fructosuria
Galactokinase Deficiency
Alkaptonuria
Ataxia Telangiectasia
5 Alpha Reductase Deficiency
Bernard-Soulier Syndrome
Classic Galactosemia
Orotic Aciduria
Crigler-Najjar Syndrome Type 1
Pyruvate Kinase Deficiency
Homocystinuria
Glanzmann Thrombasthenia
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Cancer pain
Mild
Mild
Acetaminophen
NSAIDS
Moderate
Moderate
Weak opioids ± nonopioids
hydrocodone
Codeine
Tramadol
Severe
Severe
Strong short-acting opioids
Morphine and Hydromorphone
daily dose and convert to long-acting formulation
Fentanyl patch
Oxycodone
PLUS Short-acting opioids for breakthrough pain
increase should be done via titration (50% every 24 hours)
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prerenal acute kidney injury
no underlying kidney disease
Cause
intravascular volume depletion
Heart Failure
Cirrhosis
Sepsis
Pancreatitis
stenosis
NSAID (afferent arteriole vasoconstriction)
increased serum creatinine (eg 50% from baseline)
Oliguria
BUN/creatinine ratio >20:1
fractional excretion of Na < 1 %
unremarkable urine sediment
Treatment
IV Fluids
Metformin should be stopped
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Burns Assessment
Stage and Extent of Burn
Dyspnea
Singed Nasal Hairs
Pain
Initial Decrease Urinary Output
Paralytic Ileus
Signs of Inadequate Hydration
Shock
Hypothermia
Hyperkalemia
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2 mins
Diabetes Education
Self-Monitoring (Blood Glucose)
SubQ Injection Technique
Lifestyle Changes
Symptoms of Hyperglycemia and Hypoglycemia
Sick Day Care
Foot Care
Exercise Therapy
Medication
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1 min
Acute Respiratory Distress Syndrome (ARDS) Interventions
Interventions
Closely Monitor Patient
ABG's (Arterial Blood Gases)
Oxygen
Assess for O2 Toxicity
Mechanical Ventilation
PEEP
Assess for Pneumothorax
Permissive Hypercapnia
Considerations
High Mortality Rate
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2 mins

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