NPTE Mnemonics by Content Area

Rotator cuff muscles

SITS

S

Supraspinatus: abduction

I

Infraspinatus: external rotation

T

Teres minor: external rotation

S

Subscapularis: internal rotation

All four compress and center the humeral head in the glenoid.

Carpal bones

Some Lovers Try Positions That They Can't Handle

Proximal row

Scaphoid, Lunate, Triquetrum, Pisiform (lateral to medial)

Distal row

Trapezium, Trapezoid, Capitate, Hamate (lateral to medial)

The trapezium sits at the base of the thumb. The scaphoid is the carpal bone most often fractured.

Tarsal bones

Tiger Cubs Need MILC

T

Talus

C

Calcaneus

N

Navicular

M, I, L

Medial, intermediate and lateral cuneiforms

C

Cuboid

Seven tarsal bones in total.

Salter-Harris growth plate fractures

SALTR

S

Type I, Straight across: through the growth plate (physis) only

A

Type II, Above: physis and metaphysis. The most common type

L

Type III, Lower: physis and epiphysis, into the joint

T

Type IV, Through: metaphysis, physis and epiphysis

R

Type V, Rammed: crush injury of the physis, with the worst prognosis for growth

Terminal branches of the brachial plexus

MARMU

M

Musculocutaneous: biceps, brachialis, coracobrachialis

A

Axillary: deltoid, teres minor

R

Radial: elbow, wrist and finger extensors. Injury causes wrist drop

M

Median: most forearm flexors and the thenar muscles. Compressed in carpal tunnel syndrome

U

Ulnar: most intrinsic hand muscles. Injury causes a claw hand

Hand muscles supplied by the median nerve

LOAF

L

Lumbricals 1 and 2 (the lateral two)

O

Opponens pollicis

A

Abductor pollicis brevis

F

Flexor pollicis brevis (superficial head)

The ulnar nerve supplies most of the other intrinsic hand muscles.

Interossei actions

PAD and DAB

PAD

Palmar interossei ADduct the fingers toward the middle finger

DAB

Dorsal interossei ABduct the fingers away from it

Both are supplied by the ulnar nerve, so weak finger spreading points to an ulnar lesion.

Pes anserinus tendons

Say Grace before Tea

S

Sartorius

G

Gracilis

T

semiTendinosus

All three insert on the anteromedial proximal tibia and flex the knee. Pes anserine bursitis hurts just below the medial joint line.

Brachial plexus structure

Robert Taylor Drinks Cold Beer

R

Roots: C5–T1

T

Trunks: upper, middle, lower

D

Divisions: anterior and posterior

C

Cords: lateral, posterior, medial

B

Branches: the terminal nerves

Cranial nerve names, I to XII

Oh Oh Oh To Touch And Feel Very Good Velvet, Ah Heaven

I–IV

Olfactory, Optic, Oculomotor, Trochlear

V–VIII

Trigeminal, Abducens, Facial, Vestibulocochlear

IX–XII

Glossopharyngeal, Vagus, Accessory, Hypoglossal

Cranial nerves: sensory, motor or both

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Sensory

I, II, VIII

Motor

III, IV, VI, XI, XII

Both

V, VII, IX, X

III, VII, IX and X also carry parasympathetic fibers.

Cardinal signs of Parkinson disease

TRAP

T

Tremor at rest, often pill-rolling, that eases with voluntary movement

R

Rigidity: lead-pipe, or cogwheel with superimposed tremor

A

Akinesia and bradykinesia: slow to start and carry out movement

P

Postural instability, with a festinating, shuffling gait

Rigidity isn't velocity-dependent, and reflexes are usually normal. Hyperreflexia suggests an upper motor neuron problem.

Broca's vs Wernicke's vs global aphasia

BWG

B

Broca's (left frontal): nonfluent, effortful speech; comprehension relatively preserved

W

Wernicke's (left temporal): fluent speech that lacks meaning; poor comprehension

G

Global: both expression and comprehension impaired, usually after a large left MCA stroke

Broca's = broken speech. With Wernicke's aphasia, use gestures and visual cues because verbal instructions may not be understood.

Bell's palsy vs stroke: the forehead test

Bell's palsy

Lower motor neuron lesion of CN VII: the whole side of the face is weak, including the forehead

Stroke

Upper motor neuron lesion: weakness of the lower face on the opposite side, with the forehead largely spared

The forehead is spared in stroke because the upper face receives input from both hemispheres. Ask the patient to raise their eyebrows.

Spinal cord injury and breathing

C3, 4, 5 keeps the diaphragm alive

C3 and above

Complete injury: little or no diaphragm function; long-term ventilatory support

C4

Partial diaphragm function; many patients can be weaned from the ventilator

C5 and below

Diaphragm works, but a weaker cough and reduced vital capacity

Left vs right heart failure

Left = Lungs, Right = Rest of the body

Left

Dyspnea, orthopnea, paroxysmal nocturnal dyspnea, crackles, pulmonary edema

Right

Peripheral edema, jugular venous distension, liver enlargement, weight gain

Rate pressure product

RPP

R

Rate: heart rate

P

Pressure: systolic blood pressure

P

Product: RPP = HR × SBP, an indirect measure of myocardial oxygen demand

Stable angina tends to appear at a similar RPP each time. Beta-blockers and endurance training both lower RPP at a given workload.

Oxyhemoglobin curve shifts

Right = Release

Right shift

Higher CO₂, temperature and 2,3-DPG, and lower pH: hemoglobin releases oxygen more easily, as in exercising muscle

Left shift

The opposite, plus carbon monoxide: hemoglobin holds oxygen more tightly

Wound bed color

RYB

R

Red = Ready to heal: granulation tissue. Keep moist and protect

Y

Yellow = slough. Cleanse and debride

B

Black = eschar. Usually debride, except stable dry eschar on an ischemic heel

Melanoma warning signs

ABCDE

A

Asymmetry

B

Border that's irregular or poorly defined

C

Color that varies within the lesion

D

Diameter over 6 mm

E

Evolving: changing in size, shape or color

Refer any suspicious lesion to a physician.

Rule of Nines for adult burns

Head and neck

9%

Each arm

9%

Front of trunk

18%

Back of trunk

18%

Each leg

18%

Perineum

1%

For children, use the Lund-Browder chart.

Braden Scale subscales

Scored 1–4

Sensory perception, moisture, activity, mobility, nutrition

Scored 1–3

Friction and shear

Total

6 to 23. Lower scores mean higher risk; 18 or below is generally considered at risk

Components of complete decongestive therapy

MCES

M

Manual lymphatic drainage: light, slow, skin-stretching strokes, clearing proximal areas first

C

Compression: short-stretch bandaging in the intensive phase, garments for maintenance

E

Exercise: rhythmic, low-intensity movement with compression on

S

Skin care: gentle cleansing, moisturizing, and treating infection promptly

Treating hypoglycemia

Rule of 15

Check

Blood glucose below 70 mg/dL, or symptoms such as shakiness, sweating or confusion

15 g

Give 15 g of fast-acting carbohydrate, such as 4 oz of juice or glucose tablets

15 min

Recheck after 15 minutes, and repeat if still below 70

Stop exercise first. Never give food or drink to a patient who can't swallow safely; call emergency services.

Signs of appendicitis

McBurney's point

Tenderness one-third of the way from the right ASIS to the umbilicus

Rovsing sign

Pressing the left lower quadrant causes right lower quadrant pain

Psoas sign

Right hip extension, or resisted hip flexion, causes pain

Obturator sign

Passive internal rotation of the flexed right hip causes pain

Suspected appendicitis needs urgent medical referral.

Types of urinary incontinence

SUMO-F

S

Stress: leakage with coughing, sneezing or lifting. Pelvic floor muscle training is first-line

U

Urge: sudden, strong urge with leakage. Bladder training and urge suppression

M

Mixed: stress and urge together. Treat the most bothersome part first

O

Overflow: incomplete emptying with dribbling. Refer for medical evaluation

F

Functional: the bladder works, but the patient can't get to the toilet in time. Prompted toileting and removing barriers

Cauda equina syndrome

SBB

S

Saddle anesthesia

B

Bladder or bowel dysfunction, often urinary retention

B

Bilateral leg pain, weakness or numbness

This is an emergency. Stop treatment and refer for emergency evaluation.

Cardioselective (beta-1) beta-blockers

A BEAM

A

Atenolol

B

Bisoprolol

E

Esmolol

A

Acebutolol

M

Metoprolol

Nonselective beta-blockers such as propranolol also block beta-2 receptors, so they carry more risk of bronchospasm. Any beta-blocker blunts the heart rate response, so use RPE to guide exercise intensity.

Communicating with the care team

SBAR

S

Situation: what is happening now

B

Background: relevant history

A

Assessment: what you think the problem is

R

Recommendation: what you need or suggest

Sensations during cold application

CBAN

C

Cold

B

Burning

A

Aching

N

Numbness

Warn patients about this sequence before starting ice massage or a cold pack.

Elements of negligence

DBDC

D

Duty: a duty of care existed

B

Breach: the standard of care wasn't met

D

Damages: the patient suffered actual harm

C

Causation: the breach caused the harm

All four must be proven.

Sensitivity and specificity

SnNout and SpPin

SnNout

A highly Sensitive test with a Negative result rules the condition out

SpPin

A highly Specific test with a Positive result rules it in

Levels of evidence

Some Really Cool Cats Collect Evidence

1

Systematic reviews and meta-analyses

2

Randomized controlled trials

3

Cohort studies

4

Case-control studies

5

Case series and case reports

6

Expert opinion

Strongest to weakest, as usually ranked for questions about treatment effects.