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NBCE Part 2 Chest Pain Tests
Clinical Diagnosis
9
Health Care
Professional
04/09/2013

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Cards

Term
Stand behind the patient and instruct them to bend forwards. If one side of the thorax remains higher than the other = structural scoliosis
Definition
Adam
Term
Ask the supine patient to lift his head off of the table. If this action causes the umbilicus to deviate to one side = damage to the spinal cord between T7 and T10
Definition
Beevor
Term
Place a tape measure around the chest at the level of the 4th intercostal space and note the measurement. Instruct the patient to take a deep breath and measure the expansion. If the difference is less than 1½ inches = ankylosing spondylitis
Definition
Chest expansion
Term
Ask the standing patient to bend laterally to one side. If this causes the ipsilateral paraspinal muscles to tighten and contract = ankylosing spondylitis
Definition
Forestier bowstring
Term
Ask the patient to stand on their toes and drop their weight suddenly on their heels. If this action causes midline thoracic spine pain = thoracic vertebral fracture. Lateral thoracic spine pain = facet syndrome
Definition
Heel drop
Term
Clenched fist over the precordium when asked to describe the chest pain is indicative of angina pectoris or myocardial infarction
Definition
Levine’s sign
Term
Ask the patient to bend laterally with the hands held over the head. If this action causes pain on the convex side = strain/sprain, myofasciits or pleurisy. If this causes pain on the concave side = intercostal neuritis
Definition
Schepelmann
Term
Percuss the spinous processes from T1 downwards. If there is localized midline pain = vertebral fracture or osteomyelitis.
Definition
Spinal percussion
Term
Place the ulnar edge of one of your hands over the sternum of the supine patient and push downwards. If this action causes localized lateral pain = rib fracture.
Definition
Sternal compression
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