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Patient with below knee amputation. On exam, there is s/l communication to the drainage sites. TIA

Posted By: Barbara on 2008-12-15
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Subject: Patient with below knee amputation. On exam, there is s/l communication to the drainage sites. TIA




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"rest" pain and below-knee amputation
Subject: "rest" pain and below-knee amputation

Diagnosis s/l "rest" pain and ischemia of left foot with acute gangrene (resulting in below-knee amputation).  


TKA is total knee arthroplasty, not amputation! Be careful! nm
Subject: TKA is total knee arthroplasty, not amputation! Be careful! nm

nm
Some ear exam sites for you. sm
Subject: Some ear exam sites for you. sm

Acute otitis media: Currents: UI Health Care




The diagnostic challenges of the ear exam can be greatly aided by a few ... One hand retracts the pinna and advances the tragus while the other is free to ...
www.uihealthcare.com/news/currents/vol3issue4/07acuteotitismedia.html - 21k - Cached - Similar pages

[PDF] Appendix for the Head and Neck Exam




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courses.washington.edu/medicm/benchmarks/A06headneckappendix.pdf - Similar pages


could be TKA-total knee amputation. pain could be "ghost" pain --nm
Subject: could be TKA-total knee amputation. pain could be "ghost" pain --nm

///
The patient has no discharge, drainage, or pus.
Subject: The patient has no discharge, drainage, or pus.


status post exam under anesthesia with an incision and drainage of his rectal abscess and (C-TOM)
Subject: status post exam under anesthesia with an incision and drainage of his rectal abscess and (C-TOM)

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Patient underwent s/l PPH with drainage of rectal abscess. TIA
Subject: Patient underwent s/l PPH with drainage of rectal abscess. TIA

x
S/P left total knee reconstruction. On exam, has a palpable s/l clod defect on the left knee.
Subject: S/P left total knee reconstruction. On exam, has a palpable s/l clod defect on the left knee.

:-)
HEENT: Nares thin drainage? or possibly some drainage...
Subject: HEENT: Nares thin drainage? or possibly some drainage...

sounds like she is saying thin Thanks
Nares: Mucoid drainage? Purulent drainage?
Subject: Nares: Mucoid drainage? Purulent drainage?

.
With knee exam....sm
Subject: With knee exam....sm

States minimum crepitans noted or is it crepitance.  I can never remember this. 


 


Thanks


knee exam help
Subject: knee exam help

There is some mild vague discomfort about the medial joint line, again more pronounced on the right than the left but it is not truly provocative ___ meniscal in nature.

At the blank, he just doesn't say anything. What should go in there? A comma maybe? or maybe the word "of"??
Knee exam: No evidence of s/l "aligamenesis" to
Subject: Knee exam: No evidence of s/l "aligamenesis" to

nm
RIGHT KNEE PAIN. PHYSICAL EXAM
Subject: RIGHT KNEE PAIN. PHYSICAL EXAM

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Subject: Knee Exam test s/l Belltome sm

Doc dictates Lachman's, McMurrays, anterior/posterior draw signs and s/l Beltome or bell tone test are all negative.   


ortho - knee exam, blank s/l shoulder
Subject: ortho - knee exam, blank s/l shoulder

He is now 4 days out from his left arthroscopic partial medial meniscectomy, where had probably had a bucket handle tear and debridement of loose cartilage in the trochlea, where he had a 2 cm x 1 cm lesion in the midportion with good _______ s/l shoulders, and an area where he had undoubtedly impacted the bucket handle tear tear anteriorly and had a few loose flaps of cartilage that we debrided.


I'm too tired of typing to try to think of what this word really should be.  any suggestions?


Knee exam - There is only slight s/l retropatellar crepitus. Does this sound right? nm
Subject: Knee exam - There is only slight s/l retropatellar crepitus. Does this sound right? nm


If the patient has had knee replacement,
Subject: If the patient has had knee replacement,

how about pseudomonas prosthetic knee infection?
Patient was also provided with a s/l gen-u-met-e knee brace. tia nm
Subject: Patient was also provided with a s/l gen-u-met-e knee brace. tia nm


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Subject: Patient complains of a very large, irregular, *brufus* mass to her knee....TIA

xxxx
Patient is status-post s/l ex-plan of the left total knee. nm
Subject: Patient is status-post s/l ex-plan of the left total knee. nm


The knee was debrided, closed back up and patient was initiated on IV antibiotic therapy so as to s
Subject: The knee was debrided, closed back up and patient was initiated on IV antibiotic therapy so as to s

s/l ensure infection prior to placing the prosthetic knee implant. Thanks
Could it be just communication of as in...(see inside)
Subject: Could it be just communication of as in...(see inside)

The majority of these fistulous communications involve dehiscences in the region of the fovea ethmoidalis, cribriform plate, and sphenoid sinus.
enteroureteral - a communication
Subject: enteroureteral - a communication

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Exam on patient with MS
Subject: Exam on patient with MS


Cranial nerve exam revealed left homonymous hemianopsia, as well as *slowsecots* to the left, ocular dysmetria.


Thank you so much for any ideas.  This is backup account.  Never heard this before. 


Musculoskeletal exam: The patient has good s/l RAM.
Subject: Musculoskeletal exam: The patient has good s/l RAM.

She says this twice. Clearly not sounding like range of motion.  Thanks for any help!


He has a tracheostomy with no evidence of infection. He uses s/l *super reflux* for communication.
Subject: He has a tracheostomy with no evidence of infection. He uses s/l *super reflux* for communication.

Thanks. 
Neuro exam - patient had cervicothoracic laminectomy - sm
Subject: Neuro exam - patient had cervicothoracic laminectomy - sm

Exam: Her wound is healed. She has got mild paraspinal tenderness with some evidence of spasm. No **rubo or corlora delora** noted. She is awake. She is oriented x3.


I have no idea what I am hearing or if my spaces are correct in my s/l. I'd love any help!! Thanks.


the patient is thin appearing on today’s exam, almost s/l morphonoid like.
Subject: the patient is thin appearing on today’s exam, almost s/l morphonoid like.


Are you in the hands? The back? Doing an exam or talking about a patient's test? nm
Subject: Are you in the hands? The back? Doing an exam or talking about a patient's test? nm

f
JUDE or JUTE exam. Patient has normal genitalia.
Subject: JUDE or JUTE exam. Patient has normal genitalia.

I've been listening and searching on this one - it's probably something simple.... Hope someone can help me - thanks in advance. 
There is MVDP which is the Makaton Vocabulary Development Project for acquiring communication disord
Subject: There is MVDP which is the Makaton Vocabulary Development Project for acquiring communication disorders in adults and nonspeech systems of communication...


patient has shoulder pain. On exam no cerva-chromal crepitus. nm
Subject: patient has shoulder pain. On exam no cerva-chromal crepitus. nm

thanks.
physical exam under general: the patient appeared s/l kick ectic? nm
Subject: physical exam under general: the patient appeared s/l kick ectic? nm


Patient has a positive drawer test and s/l wobble test (knee pain)
Subject: Patient has a positive drawer test and s/l wobble test (knee pain)

thanks so much!!!
there is a ray amputation....
Subject: there is a ray amputation....

according to Stedman's Orthopedic. Maybe referring to that.
toe amputation
Subject: toe amputation

This is a preop for toe amputation.


S/L "shar-pel" discrimination. 


s/l Vacugen used for amputation..
Subject: s/l Vacugen used for amputation..

stump ulcer treatment.  Patient also has osteomyelitis.  Seems to be some device attatched to the ulcer site.  Cannot find a reference to it.  Thanks! lmb
Baloney amputation. lol nm
Subject: Baloney amputation. lol nm

x
TMA ? (transmetatarsal amputation) nm
Subject: TMA ? (transmetatarsal amputation) nm


transmetatarsal amputation?
Subject: transmetatarsal amputation?


transmetatarsal amputation ?
Subject: transmetatarsal amputation ?


Amputation of phalanges of great toe
Subject: Amputation of phalanges of great toe

Or could he possibly mean:


Amputation of phalanges of right foot? 


Thanks


Le Forte fracture/amputation
Subject: Le Forte fracture/amputation

Perhaps it is this and they made a special brace for it?
Patien tis s/l "transmit" amputation.
Subject: Patien tis s/l "transmit" amputation.


The knee is pain significant because she had a total knee replacement. Make sense? nm
Subject: The knee is pain significant because she had a total knee replacement. Make sense? nm

,,
X-ray of the knee shows arthritic change within the knee, but maintained s/l tibiofemoral stasis.
Subject: X-ray of the knee shows arthritic change within the knee, but maintained s/l tibiofemoral stasis.

Thanks :-)
Starting off great today...Rheo Knee prosthetic knee???
Subject: Starting off great today...Rheo Knee prosthetic knee???


Patient with gangrene of foot. On exam, the entire foot is ulcerated with s/l us-i-nest debris.
Subject: Patient with gangrene of foot. On exam, the entire foot is ulcerated with s/l us-i-nest debris.

:-)
Knee x-ray: s/l RATTY knee joint erosions? NM
Subject: Knee x-ray: s/l RATTY knee joint erosions? NM


MRI of knee. Semimembranosus s/l pes-dens-a-ri-nus region of the knee.
Subject: MRI of knee. Semimembranosus s/l pes-dens-a-ri-nus region of the knee.

:-)