Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

307 Health Assessment > TEST 3 > Flashcards

TEST 3 Flashcards

1
Q

abdomen location

A

from the diaphragm to the brim of the pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what makes up the abdominal wall

A

four layers of muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

linea alba

A

midline seam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

rectus abdominis

A

muscle with palpable midline strip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

solid viscera of the abdomen

A

liver, pancreas, spleen, adrenal glands, kidneys, ovaries, & uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

hollow viscera of the abdomen

A

stomach, gallbladder, small intestine, colon, & bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the spleen made of

A

lymphatic tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

where is the spleen located

A

Located on posterolateral region of the abdominal cavity beneath the diaphragm, from the 9th to 11th rib lateral to the midaxillary line (approximately 7 cm in length)
TOP LEFT SIDE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

is the spleen palpable

A

not normally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

where is the aorta located

A

left of the midline in the upper region of the abdomen
*BEGINS AT LEFT VENTRICLE, EXTENDS UP, ARCHES AND CONTINUES DOWN TO WHERE IT BRANCHES RIGHT ABOVE THE PELVIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what does the aorta bifurcate into

A

the right and left iliac arteries opposite the 4th lumbar vertebrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what do the right and left iliac arteries turn into

aorta

A

the right and left femoral ateries in the groin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what about the aorta is palpable

A

aortic pulsations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

pancreas

A

A soft gland consisting of lobules
*BIG ROLL IN DIGESTION PRODUCES ENZYMES THAT BREAK DOWN SUGARS, STARCHES, AND FATS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

where is the pancreas located

A

Lies obliquely across the posterior abdominal wall, behind the stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the kidneys shaped like

A

beans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how are the kidneys positioned

A

Positioned in the retroperitoneal region of the abdominal cavity
*JUST BELOW THE RIB CAGE ON EITHER SIDE OF THE SPINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

costovertebral angle

kidneys

A

angle formed by the joining of the 12th rib and the vertebral column

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

where is the left kidney located

A

at the 11th & 12th ribs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

where is the right kidney located

A

1 to 2 cm lower than the left due to position of the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

abdoman anatomic locations

A

RUQ
LUQ
RLQ
LLQ
MIDLINE
EPIGASTRIC
UMBILICAL
HYPOGASTRIC
SUPRAPUBIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

UMBILICAL CORD IN INFANTS

A

more prominent in newborn,
contains two arteries and one vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

LIVER IN INFANTS

A

proportionally takes up more space at birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

URINARY BLADDER IN INFANTS/CHILDREN

A

positioned higher in the abdomen, between the symphysis and the umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

ABDOMINAL WALL IN INFANTS/CHILDREN

A

less muscular, easier to palpate abdominal organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

morning sickness

pregnant women

A

Cause ? Thought due to human chorionic gonadotropin (hCG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

abdominal considerations for pregnant women

A

Heartburn (pyrosis) from esophageal reflux
- Decreased GI motility, longer time for gastric emptying
- Constipation & hemorrhoids
- Skin changes: striae & linear nigra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

abdominal considerations for older adults

A
  • Females: decreased estrogen –>suprapubic fat
    • Males: “spare tire”
    • Relaxed abdominal muscle
    • Decreased salivation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

abdominal considerations in older adults (cont)

A
  • Delayed emptying of esophagus
    • Decreased gastric acid secretion
    • Increased risk of gallbladder disease
    • Decreased liver size
    • Constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

appetite

abdominal subjective data

A

any changes, anorexia, change in weight, dieting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

dysphagia

abdominal subjective data

A

any disorder of throat or esophagus that makes it difficult to swallow. can be painful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

food intolerance

abdominal subjective data

A

lactose intolerance, pyrosis (heartburn), eructation (belching)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

abdominal pain

subjective data

A

any pain ?, location, quality, severity, precipitating, aggravating & alleviating factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

visceral pain

A

relating to the organ
dull, general, poorly located

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

parietal pain

A

peritoneum
sharp, precisely located, increased with movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

referred pain

A

caused by pathology in another site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

nausea and vomitting
n&v

abdominal subjective data

A

Frequency, amount, color, odor hematemesis (bloody emesis), any associated S/S, diet for the last 24 hrs, food poisoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

bowel habits

abdominal subjective data

A

normal pattern, frequency, color, odor, consistency, any diarrhea or constipation, any recent change in bowel habits, use of laxatives (type & frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

past abdominal Hx

abdominal subjective data

A

any GI problems, gallbladder disease, any abdominal surgery or diagnostic procedures (and results)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

medications

abdominal subjective data

A

nsaids
alcohol
cigarettes (packs per day/years)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

nutritional assessment

A

part of the abdominal subjective data

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

abdominal assessment objective data order

A

Inspection
Auscultation
Percussion
Palpation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

where to stand in order to inspect the abdomen

A

Stand on the patient’s right side while inspecting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

inspecting the contour of the abdomen

A

describe as one of the following:
- Flat
- Scaphoid
- Rounded
- Distended
- Protuberant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

inspect the symmetry of the abdoment

A

assess for bulges, masses, asymmetry, hernias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

inspect the umbilicus of the abdomen

A

midline, inverted or everted, Cullen’s sign (bluish periumbilical color from intraabdominal bleeding)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

inspect the skin of the abdomen

A

homogeneous color, redness, jaundice, striae, scars, lesions, angiomas, rashes, dilated veins, skin turgor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

inspect the aortic pulsation or peristaltic movement in the abdomen

A

looking for intestinal obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

inspect the demeanor while assessing the abdomen

A

relaxed, signs of pain such as restlessness, absolute stillness (with peritonitis), knees flexed up, facial grimacing, uneven respirations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

how to auscultate bowel and vascular sounds

A

Hold stethoscope lightly against skin using the diaphragm endpiece

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

where to assess bowel sounds

A

in the following order: RLQ at ileocecal area, RUQ, LUQ, LLQ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

considerations for auscultating bowel sounds

A

Note frequency & character:
Hypoactive or hyperactive

If silent bowel sounds, listen for 5 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q
  • Borborygmus
A

“stomach growling” from
hyperactive bowels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

listen for bruits

A

with the bell of the stethoscope over the abdominal aorta, renal arteries, iliac and femoral arteries
* Normal finding: absence of bruits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

percuss the four quadrants of the abdomen

A
  • Normal finding: tympany
    • Dullness heard over adipose tissue,
      distended bladder, fluid or a mass
    • Hyperresonance with gaseous distension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

percuss the liver span

A
  • At the midclavicular line, measure height of the liver
    • Start with lung resonance to liver dullness, than liver dullness to abdominal tympany
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

liver span

A
  • Normal liver span in adult: 6–12cm
    • Mean liver span:
      * Males: 10.5 cm
      * Females: 7 cm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

hepatomegaly

A

liver enlargement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

normal finding of percussion of spleen

A

dull note from 9th to 11th intercostal space just below the left midaxillary line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

spleen percussion that indicates enlargement

A

dull note forward of the midaxillary line (with mononucleosis, trauma, & infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

where to percuss the spleen

A

Percuss in lowest interspace in left anterior axillary line during inspiration: normally tympany
* Positive spleen percussion sign: dullness with splenomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

how to assess costovertebral angle tenderness

A

Use indirect fist percussion to vibrate over the 12th at the costovertebral angle (CVA)
* Hold one hand over the CVA, then thump hand with the ulnar edge of your other fist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

findings in assessment of costovertebral angle tenderness

A

Normal finding: patient feels only the thud but no pain
* Sharp pain (costovertebral angle tenderness) indicates inflammation of the kidney or paranephric region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

when palpating the abdoment, you should note

A

size, location, and consistency of any abnormal masses or tenderness
Review the measures for relaxation of abdominal muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

light versus deep palpation of the abdomen

A

Start with light palpation: depress skin 1 cm & use gentle rotating motion in clock-wise pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

order of palpation of the abdomen

A

Palpate tender areas last (avoids pain & muscle guarding)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

voluntary vs involuntary guarding of the abdomen

A

Distinguish between voluntary guarding & involuntary guarding of abdominal muscles
* Involuntary guarding (constant board-like hardness): sign of peritonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

deep palpation of the abdomen

A

depress skin 5-8cm using same technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

abnormal findings of palpation of the abdomen

A

muscle rigidity, muscle guarding, masses, tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

if any mass is found in the abdomen, what should you first distinguish

A

if it’s associated with a normal palpable organ or an enlarged organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

if any mass is found in the abdomen, what should you note

A
  1. Location 6. Mobility
    1. Size 7. Pulsatility
    2. shape 8. Tenderness
    3. Consistency
    4. Surface
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

palpation of the liver

A

refer to page 547)
- Remember to ask the pt. take a deep breath as you palpate
- Alternate method: hooking technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

abnormal finding in palpation of the liver

A

liver palpated more than 1-2 cm below the right costal margin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

when can you palpate the spleen

A

when it’s 3x the normal size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

do you continue to palpate an enlarged spleen

A

Do not continue to palpate an enlarged spleen as it is friable (bleeds easily) & can rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

what should you note about an enlarged spleen

A

Note how many centimeters it extends below the left costal margin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

how to palpate the kidneys

A
  • Use deep palpation with bimanual “duck- bill technique
  • Ask the patient to take a deep breath as you palpate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

how are the kidneys positioned

A

Left kidney is positioned 1 cm higher than the right kidney, so you are more apt o palpate the lower pole of the right kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

abnormal findings when palpating the kidney

A

enlarged kidney,

   kidney mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

where do you palpate the aorta pulsation

A

located in the upper abdomen slightly left of the midline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

findings in palpating the aorta pulsation

A

Normal finding: aorta pulsation 2.5-4cm in adult; pulsation in an anterior direction
- Abnormal finding: prominent lateral pulsation, indicates aortic aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

rebound tenderness
blumberg’s sign

A
  • https://www.youtube.com/watch?v=1weCV9pGqFM
    • Perform when pt. complains of any abdominal pain or has tenderness with palpation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

findings of palpating rebound tenderness

A
  • Negative or normal finding: no pain on release of pressure
    • Abnormal finding: pain on release of pressure; sign of peritoneal inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

inspiratory arrest
murphy’s sign

A
  • https://www.youtube.com/watch?v=w4_D0peTmw8
  • PAIN- INFLAMMATION- ABRUPTLY STOPS INHALING
    - Press up against the liver’s lower border as the pt. takes a deep inspiration (liver pushes up against the gallbladder)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

findings of assessing for inspiratory arrest

A
  • Normal finding: complete inspiration without any pain
    - Abnormal finding/positive test: pt. abruptly stops inspiration midway due to pain; sign of gallbladder inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

external ear

A

auricle or pinna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

6 landmarks of the ear

A

helix
antihelix
external auditory meatus
tragus
antitragus
lobule
mastoid process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

internal anatomy of the ear

A

tympanic membrane
cone of light
manubrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

middle ear

A
  • Tiny air-filled cavity located inside the
    temporal bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

what does the middle ear contain

A
  • Contains tiny bones (auditory ossicles): malleus, incus, stapes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

openings to the inner ear

A
  • Eustachian tube
    * Round & oval windows
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

3 functions of the middle ear

A
  • The three functions of the middle ear
    1. Conducts sound vibrations from the outer ear to the inner ear
    2. Protects the inner ear
    3. Equalization of air pressure on each side of the TM by the eustachian tube
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

purpose of the inner ear

A
  • Sensory organs for equilibrium & hearing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

vestibule and semicircular canals

inner ear

A

Vestibule & Semicircular canals (in the bony labyrinth) make up the vestibular apparatus

SENSE OF BALANCE AND BODY POSITION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

cochlea

inner ear

A

snail shell
contains the central hearing apparatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

3 levels of the auditory system

A
  1. Peripheral
    2. Brainstem
    3. Cerebral cortex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

how is sound transmitted

A

Sound is transmitted & converted to vibrations TM  middle ear ossicles to oval window  cochlear basilar membrane that contains the organ of Corti hair cells (sensory organ of hearing)  electrical impulses  the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

pathways of hearing

A

air conduction (ac)
bone conduction (bc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

air conduction (ac)

A

normal pathway of hearing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

bone conduction (bc)

A

alternate pathway of hearing that directly transmit vibrations to inner ear and to CN VIII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

conductive hearing loss

A

from mechanical dysfunction of external or middle ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

cause of conductive hearing loss

A

*Causes: impacted cerumen, foreign bodies,
perforated TM, fluid in the middle ear,
otosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

sensorineural (perceptive) hearing loss

A

from pathology of inner ear or cerebral cortex (auditory center)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

causes of sensorineural (perceptive) hearing loss

A

*Causes: Presbycusis, ototoxic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

labyrinth in the inner ear

equalibrium

A

establishes verticality & depth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

inflammation

equilibrium

A

inaccurate information received by the brain -> staggering gait, vertigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

infant/child

hearing/ear developmental considerations

A
  • maternal rubella can result damage to the organ of Corti and impaired hearing
    - increased risk of otitis media due to shorter, wider & more horizontal, plus lymphoid tissue surrounds the lumen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

adult

ear/hearing developmental considerations

A

conductive loss from otosclerosis between ages 20 and 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

aging adult

hearing/ear developmental considerations

A

risk of decreased hearing due to:
- coarse stiff cilia in the ear canal
- drier cerumen
- scarring of TM (long history of frequent ear
infections)
- presbycusis:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

presbycusis

A

gradual sensorineural hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

earache

ear subjective data

A

any earache, pain in ears (otalgia); note the specific characteristics of any pain; history of trauma or URI infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

infections

ear subjective data

A

history of ear infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

discharge

ear subjective data

A

any discharge from the ears (otorrhea) and its appearance & any odor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

hearing loss

ear subjective data

A

onset (sudden or slow); characteristics of loss
* Refer pt. if sudden onset not related to upper respiratory infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

observe for signs of hearing loss

A

lip reading, frowning or straining forward, posturing of head, misunderstanding of questions or frequent requests for you to repeat, irritability or startle reflex to your voice (recruitment), garbled speech, inappropriately loud voice, voice has a flat, monotonous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

environmental noises

ear subjective data

A

any exposure to loud noises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

tinnitus

ear subjective data

A

ringing, crackling, or buzzing in ears; medications currently taking (ototoxic meds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

vertigo

ear subjective data

A

true vertigo (from dysfunction of labyrinth) versus dizziness or lightheadedness
* Objective vertigo: rooms appears to be spinning
* Subjective vertigo: feels like the person is spinning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

self care behaviors

ear subjective data

A

method for cleaning ears (cotton-tipped applicators can cause impaction of cerumen); last hearing test, hearing aid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

infants/children

ear subjective data

A

risks for ear infections:
- exposure to passive smoke
- attendance at group day care centers
- bottle fed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

inspect/palpate the external ear for size and shape

ear objective data

A

microtia, macrotia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Inspect and palpate the external ear for:
skin condition

ear objective data

A

redness, heat, crusts, scaling, enlarged lymph node, frostbite, tophi, sebaceous cysts, keloid, carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Inspect and palpate the external ear for:
tenderness

ear- objective data

A

pain with movement of tragus or pinna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

Inspect and palpate the external ear for:
external auditory

ear-objective data

A

meatus: atresia (closure or
absence of ear canal), discharge, cerumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

how to perform otoscopic exam in an adult

ear-inspect with the otoscope

A
  • Adults - pinna is pulled up & back
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

how to perform otoscopic exam in a child under 3

ear-inspect with the otoscope

A

pinna is pulled straight down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

inspection of the ear with the otoscope

A

Inspect the external canal for any redness, swelling, lesions, foreign objects, or discharge
* Watery drainage indicates CSF from head
trauma (basal skull fracture)
* Purulent otorrhea indicates otitis externa or otitis
media (with ruptured drum)
* Frank blood (from trauma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

normal appearance of the tympanic membrane (drum)

A

Normal appearance is shinny, translucent, pearly gray color

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

cone of light reflex (COL) from the reflection of the otoscope light on the drum

A
  • In the right ear: it is at 5 o’clock
  • In the left ear: it is at 7 o’clock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

note the specific landmarks of the tympanic membrane

A

The umbro, manubrium, and short process of the malleus should be visible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

abnormal eardrum colors

A

Yellow-amber drum indicates serous otitis media
* Redness indicates acute otitis media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

absent or distorted landmarks in assessment of the eardrum

A

Absent or distorted landmarks: bulging drum with increased pressure in otitis media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

what causes a retracted eardrum

A

obstructed eustachian tube from vacuum in middle ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

air/fluid level or air bubbles behind the eardrum indicate what

A

serous otitis media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

abnormal findings of assessment of the eardrum

A

perforations or vesicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

whispered voice test

ear-objective data

A

test one ear at a time, whisper two syllable word as you mask hearing in the other ear
* Abnormal finding: pt. unable to hear whispered words

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

tuning fork tests

ear-objective data

A

weber test
rinne test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

weber test

ear-objective data

A

tests bone conduction of tone through the skull:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

rinne test

ear-objective data

A

compares air conduction and bone conduction sound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

findings of the weber test

ear-objective data

A

Normal – sound is heard the same in both ears
Conductive loss – sound goes toward the poorer ear
Sensorineal loss – sound lateralizes to the unaffected or better ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

findings of the rhinne test

A

Normal – sound is heard twice as long by air conduction (AC) as bone conduction (BC)
AC>BC
Conductive loss – BC>AC
Sensorineal – AC>BC but reduced overall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

vestibular apparatus

A
  • Aids in maintaining standing balance
    • Assessed with the romberg test (included in the neuro assessment- discussed later in semester)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

considerations with children

ear-objective data

A
  • Low set ears or deviation in alignment seen with developmental delays (Down’s syndrome)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

external anatomy of the eye

A

Bony orbit
Eyelids
Palpebral fissure
Eyelashes
Limbus
Canthus
Caruncle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

external anatomy of the eye (cont)

A

Conjunctiva clear
- Palpebral
- Bulbar
Lacrimal apparatus
Puncta
Lacrimal Gland
Six muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

review visual guides in eye powerpoint

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

what do the extraocular muscles do

A

Provide straight & rotary movement of the eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

how do the extraocular muscles work

A

The muscle is coordinated with the one in the other eye so that the eyes movement is on a parallel axis (conjugate movement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

Six muscles (innervated by cranial nerves):

eye

A

Superior rectus (CN III)
- Inferior oblique (CN III)
- Medial rectus (CN III)
- Superior oblique (CN IV)
- Inferior rectus (CN III)
- Lateral rectus (CN VI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

why do the eyes move together

A

(conjugate gaze/movement) b/c humans can only focus on one item at a time (i.e. right eye and left eye should be looking at the same object)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

eom

eye

A

extra ocular muscles

153
Q

how do the 6 eom work together

A

to attach the eyeball to its orbit and to direct eye to points of interest

154
Q

how are the 6 eom stimulated

A

stimulated by 3 cranial nerves, we will go into more details about the jobs on the cranial nerves when we complete the neuro chapter

155
Q

3 concentric layers

internal eye anatomy

A
  • Sclera
    • Choroid
    • Retina
156
Q

outer layer

internal eye anatomy

A
  • Sclera
    • Cornea
157
Q

middle layer
aka choroid

eye

A

dark pigment and vascular

158
Q

cilliary body and iris

choroid of the eye

A

varies the opening of the pupil

159
Q

Pupil:

choroid of the eye

A

opening in the iris, normally round & regular

160
Q
  • Lens:

choroid of the eye

A

biconvex disc posterior to the pupil,
functions as a refractory medium
(thickness controlled by the ciliary body)

161
Q
  • Anterior chamber:

choroid of the eye

A

posterior to the cornea, contains the aqueous humor (produced by the ciliary body, its amount & outflow determine intraocular pressure)

162
Q

inner layer of the eye

A

retina

163
Q

retina

A

inner layer provides for visual reception; light waves are converted into nerve impulses here.

164
Q

optic disc

retina

A

oval or round shape, located in the nasal side of the retina, this is where the retinal fibers converge to form the optic nerve
* Color varies from creamy yellow-orange to pink
* Margins normally distinct & sharply demarcated
* Physiologic cup: smaller, inner circular area, site where blood vessels exit & enter

165
Q

general background of the retina

A

varies in color with skin tone

166
Q

macula and fovea centralis

retina

A

located temporally ( site of keenest vision)

167
Q

pupillary light reflex

A

normal constriction of the pupils when bright light shines on the retina
can be direct or consensual

168
Q

direct light reflex

A

constriction of that pupil exposed to the bright light

169
Q

consensual light reflex

A

simultaneous constriction of the other pupil

170
Q

accomodation

eye

A

refers to the adaptation of the eye from far to near vision
- Results from the increased curvature of the lens by movement of the ciliary muscles
- Normal finding: convergence of the axis of the eyeball & pupillary constriction

171
Q

infants/children developmental considerations at birth

eye

A
  • Limited eye movement at birth but peripheral vision is intact; iris less pigmented
    • Macula is absent at birth; developing by age 4 months & mature by 8 months
172
Q

infants/children developmental considerations

eye

A
  • Binocularity and the ability to fixate on a single object by 3-4 months
    • Eyeball is adult size by age 8
173
Q

aging adult

eye-developmental considerations

A
  • Lacrimal glands involute
    • Arcus senilis: infiltration of degenerative lipid material around the limbus
    • Pupil size decreases
    • Loss of elasticity of the lens
174
Q

presbyopia

Common causes of decreased visual functioning in the aged adult

A

the lens decreased ability to change shape in order to accommodate for near vision

175
Q

senile cataract

Common causes of decreased visual functioning in the aged adult:

A

lens opacity, fibers of the lens thickens & yellows (nuclear sclerosis)

176
Q

floaters

Common causes of decreased visual functioning in the aged adult:

A

from debris accumulating in the vitreous

177
Q

glaucoma

Common causes of decreased visual functioning in the aged adult:

A

increased ocular pressure

178
Q

macular degeneration

Common causes of decreased visual functioning in the aged adult:

A

loss of central vision (area of clearest vision); inability to read fine print; peripheral vision is unchanged
* Most common cause of blindness (greater incidence in woman)

179
Q

eye: subjective data

A

Visual difficulties (decreased acuity, blurring, blind spots)
History of ocular problems
Pain
Photophobia
Night blindness
Halos

180
Q

eye subjective data (cont)

A

Floaters
Scotoma
Stabismus or diplopia
Redness or swelling
Use of glasses/contact lens
Self-care behaviors
Watering or discharge

181
Q

Test for central visual acuity:

A

Top number (numerator) notes the distance the person is standing from the chart; the bottom number (denominator) gives the distance at which a normal eye could read that particular line

182
Q

snellen chart

A

for far vision: normal vision is 20/20 (you can read at 20 feet what the normal eye could read at 20 feet)
* Refer to an ophthalmologist or optometrist anyone with vision poorer than 20/30

183
Q

when to test for near vision

A

for persons over age 40 or anyone complaining of increasing difficulty reading

184
Q

how to test for near vision

A

with a handheld vision screener (Jaeger card) held 14 inches from the eye
* Use magazine or newspaper if a near vision card unavailable

185
Q

results of near vision test

A
  • Normal vision is 14/14 in each eye
    * Moving the card farther away suggests Presbyopia
186
Q

what is a jaeger card used for

A

testing near vision

187
Q

Test visual fields with the confrontation test

A

Indication of peripheral field loss: person unable to see the object as the examiner does

188
Q
  • Corneal light reflex (Hirschberg test)

Inspect extraocular muscle (EOM) function:

A
  • Assess the parallel alignment of the eye axes
    • Asymmetry of the light reflex indicates deviation in alignment from muscle weakness or paralysis perform the cover test
189
Q

cover test

Inspect extraocular muscle (EOM) function:

A

detects small degrees of deviated alignment
* Abnormal finding: eye jumps to fixate on the designated point (indicates muscle weakness)

190
Q

details of the confrontation test

A

assesses peripheral vision, client covers one eye and examiner covers opposite eye so when they are facing each other it is a mirror image, examiner slowly moves fingers to midline from several different directions, examiner and client should see fingers at approximately the same time. Remember this is to assess peripheral vision so you must be looking forward focused on an object for this to work.

191
Q

details of the hirschberg test

A

have client stare straight ahead, shine light towards client’s eyes, you should see the light reflex at the same spot on both corneas (symmetrical

192
Q

details of the cover test

A

frequently done on children, have child stare straight ahead at your nose or some object to focus on, using opaque card (think index card) cover one eye, the uncovered eye should stay steady and fixed on object if the uncovered eye started jumping/moving this is an abnormal finding, shows EOM weakness)

193
Q
  • Diagnostic position test (Six cardinal positions of gaze)
    normal vs abnormal
A
  • Normal response: parallel tracking of the object with both eyes
    • Abnormal finding: unparallel movement of the eyes (indicates extraocular muscle weakness or dysfunction of the cranial nerve)
194
Q

nystagmus

A

(fine oscillating movement, observed best near the iris), normal to have mild nystagmus with extreme lateral gaze

195
Q

lid lag

eye

A

(normally should not see sclera above the iris)

196
Q

strabismus

A

crossed eye, one eye deviates off fixation point, can disconjugate vision

197
Q

general

Inspect external ocular structures:
objective data

A

Initially observe the person’s ability to move around the room

198
Q

eyebrows

Inspect external ocular structures:
objective data

A

abnormal findings include absent lateral third of brow (seen with hypothyroidism), scalling, unequal movement

199
Q

eyelids and lashes

Inspect external ocular structures:
objective data

A

abnormal findings include lid lag, incomplete closure; drooping of upper lid (ptosis)

200
Q

eyeballs

Inspect external ocular structures:
objective data

A

abnormal findings include protrusion (exophthalmus) and sunken eyes

201
Q

Conjunctiva and sclera

eye
objective data

A

normally conjunctiva are clear & pink over lover lids and white over the sclera; sclera is normally china white (dark-skinned persons may have gray-blue or muddy color)

202
Q

abnormal findings of conjunctiva and sclera

A

reddened, cyanotic or pale conjunctiva; scleral icterus (yellowing of sclera); tenderness, foreign body, discharge, lesions

203
Q

lacrimal apparatus

A

observe for any redness or swelling of lacrimal gland and puncta

204
Q

anterior eyeball structures

A

cornea
lens
iris
pupil (pupillary light reflex)

205
Q

cornea and lens

A

abnormal findings include corneal abrasion, opacity (arcus senilis is normal with aging)

206
Q

how to assess the cornea and lens

A

shine penlight from the side across the cornea checking for smoothness and clarity

207
Q

iris and pupil

inspection

A

iris is normally flat, round regular shape with even coloration; abnormal finding is irregular shape “anisocoria” (normal in only 5% of people)

208
Q

pupillary light reflex

A

include both direct and consensual light reflex
*Abnormal: dilated, dilated & fixed, or constricted pupils

209
Q

how to test pupillary light reflex

A

-have room darkened and have client look into the distance to dilate pupil, shine light from side you should see constriction of the same side pupil (direct light reflex) and simultaneous constriction of the other pupil (consensual light reflex) Ballpark measure the pupil size in millimeters

210
Q

test for accomodation

A

Normal response=
1. pupillary constriction and
2. convergence of the axis of the eyes
* Abnormal finding: absence of constriction or convergence, asymmetric response
* Record normal response as PERRLA

211
Q

PERRLA

A

Pupils
Equal, Round, React to Light and Accommodation

212
Q

Study how to use the ophthalmoscope

A

Direct the beam of light through the pupil to illuminate the inner structures
Select the large round aperture with white light
Match sides with patient (ex. use your right eye for viewing pt’s right eye
Start at 10 inches away from pt. at an angle 15% lateral to the pt’s person’s line of vision
Note the red reflex filling the pt’s pupil and steadily move closer to the eye, keeping sight of the red reflex

213
Q

diopters

opthalmoscope

A

unit of strength of each lens
* black (positive): focus on closer objects
* red (negative): focus on distant objects

214
Q

myopia

A

nearsighted (able to see near objects); use a negative diopter (red numbers)

215
Q

hyperopia

A

farsighted (able to see objects in the distance); use a positive diopter (black numbers)

216
Q

retinal structures

A

optic disc
retinal vessels
macula

217
Q

general background

retina

A

color varies from light red to dark brown (depends on skin color)

218
Q

optic disc
(nasal side)

retina

A

normally oval or round, creamy, yellow- orange to pink with distinct margins; physiologic cup is brighter yellow-white with a width ½ the disc diameter; abnormal: blurred margin

219
Q

retinal vessels

A

paired artery & vein pass to each quadrant (straighter at the nasal side)
- arteries are brighter and smaller in diameter (A:V ratio is 2:3 or 4:5)

220
Q

macula

retina

A

(located on the temporal side); is 1 DD in size

221
Q

foveal light reflex

retina

A

tiny glistening dote within the macula

222
Q

Abnormal findings of the ocular fundus include:

A

abnormal lesions,
hemorrhages, exudates, microaneurysms

223
Q

abnormal findings of the optic disc

A

pallor, irregular color, blurred margins, cup extending to disc border

224
Q

abnormal findings of blood vessels

ocular fundus

A

absence of major vessels, focal constriction, dilated veins, nicking, extreme tortuosity, engorgement

225
Q

periorbital edema

eyelid abnormalities

A

swelling around the eye

226
Q

exopthalmos

eyelid abnormalities

A

protrusion of eyes

227
Q

enophthalmos

eyelid abnormalities

A

sunken eyes

228
Q

ptosis

eyelid abnormalities

A

drooping eyelid

229
Q

anatomical structures of the head/neck

A

Skull
Cranial bones (frontal, parietal, occipital, temporal)
Sutures
Facial bones
Cervical vertebra
Salivary glands (parotid, sublingual, submandibular)
Temporal artery

230
Q

structures and landmarks of the head/neck

A

Carotid artery
Jugular veins (internal/external)
Neck muscles
Trapezius
Trachea
Thyroid cartilage

231
Q
  • Sternomastoid

neck muscle

A

two triangles- anterior &
posterior

232
Q

review graphics in head/neck powerpoint

A
233
Q

preauricular lymph node

A

right in front of your ears

234
Q

posterior auricular (mastoid) lymphnodes

A

right behind your ears

235
Q

occiptal lymph node

A

base of skull

236
Q

submental lymph node

A

base of chin

237
Q

submandibular lymph node

A

down your jawline

238
Q

jugulodigastric (tonsilor) lymph nodes

A

like when you have strept throat– at your neck

239
Q

superficial cervical lymph node

A

down your neck
turn your head to side
there is a muscle band, these are on top of it

240
Q

deep cervical lymph nodes

A

down your neck
turn your head to side
there is a muscle band, these are below it

241
Q

posterior cervical lymph nodes

A

back of neck

242
Q

supraclavicular

A

clavicle
hunch shoulders up

243
Q

infants/children

developmental considerations of the head/neck

A

Sutures & fontanels “soft spots” enables growth of the brain & safe passage thru birth canal

head size: head size is larger than chest circumference at birth; grows to 90% of adult size by age 6

244
Q

anterior fontanel

A

normally closes between 9 months and 2 yrs

245
Q

posterior fontanel

A

normally closes by 1-2 months

246
Q

lymphoid tissue

infants/children

A
  • Well developed at birth
    * Reaches adult size by age 6
    * Rapid growth until age 10-11 (larger than adults & normally palpable)
    * At puberty, slowly atrophies
247
Q

facial hair on boys

A
  1. above lips
  2. cheeks and below lip
  3. chin
248
Q

thyroid gland

infants/children

A

enlarges at puberty with deepening of the voice

249
Q

pregnant female

head/neck

A

Changes in the thyroid gland: hyperplasia of the tissue & increased vascularity results in an enlarged gland

250
Q

aging adult

head/neck

A

Facial bones & skin changes: sagging of the skin & more prominent appearance of facial bones and orbits from decreased elasticity & subcutaneous fat & moisture of the skin

251
Q

headache

subjective data

A

onset, location, character, severity, course & duration, precipitating factors, associated factors, other diseases, efforts to treat, coping strategies
* Migraines, cluster HA, tension HA or CVA (review symptoms of each type)
* Red flag: a severe headache of new onset

252
Q

head injury

subjective data

A

onset, setting, loss of consciousness, associated symptoms, pattern, effort to treat

253
Q

dizziness

subjective data

A

Dizziness: vertigo or lightheaded, onset, assoc. symptoms

254
Q

other subjective data of the head/neck

A

neck pain
decreased rom
Hx of head/neck surgery

255
Q

lumps/swelling

head/neck subjective data

A

tenderness, persistent, hard or soft, fixed or mobile, thyroid problem, dysphagia

256
Q

Inspect and palpate the skull:

A

Size,shape (normacephalic, microcephalic or macrocephalic)
- Symmetry

257
Q
  • Temporal area for the temporal artery

Inspect and palpate the skull:

A

abnormal finding if tortuous, hardened or tender (signs of temporal arteritis)

258
Q

Temporomandibular joint (TMJ):

Inspect and palpate the skull:

A

Palpate for crepitation, tenderness, limited range of motion

259
Q

Inspect the face

A

note facial expression, appropriateness to behavior or mood, signs of anxiety, pain, embaressment, hostility

260
Q

symmetry

inspect the face

A

asymmetry with central brain lesion, damage to the CN VII (Bell’s palsy)

261
Q

abnormalities

inspect the face

A

note any abnormal facial structures, edema, involuntary movements (tics, fasciculations, excessive blinking, grinding of jaws)

262
Q

Inspect and palpate the neck:

A
  • Symmetry
    • Range of motion
    • Thyroid enlargement (unilateral or diffuse)
263
Q

lymph nodes

Inspect and palpate the neck:

A

(use gentle, circular motion with your fingerpads; start with preauricular)

264
Q

deep cervical chain

inspect/palpate the neck

A

tip pt’s head toward side being examined

265
Q

supraclavicular nodes

inspect/palpate the neck

A

tell pt to hunch shoulders & elbows forward

266
Q

abnormalities of the lymph nodes

palpate/inspect the neck

A

Abnormal to palpate nodes in adults; when palpable, note location, size, shape, delimitation (discrete or matted), mobility,consistency, and tenderness

267
Q

Lymphadenopathy

A

enlargement of lymph nodes (>1cm)

268
Q

when lymph nodes are palpable, you should note

A

location, shape, size, discrete or matted, mobility, consistency, and tenderness
* Note the source by check the area they drain
* Refer pt for follow-up care
* Abnormal findings:
Pay particular Attention to differences between acute infection & cancer or HIV

269
Q

Inspect and palpate the trachea for any tracheal shift:

A
  • Normal finding: trachea is midline
    • Note any deviations: abnormal finding
270
Q

Inspect and palpate the thyroid:

A

Initially inspect the neck as the pt. swallows a sip of water
- Posterior approach (preferred method)
- Anterior approach (alternate method)

271
Q

other areas to inspect/palpate when checking the thyroid

A
  • Locate the isthmus and the lobes & note enlargement, consistency, symmetry, nodules or lumps
    - Abnormal findings: enlarged lobes, tender, presence of nodules or lumps
272
Q

auscultate the thyroid for

A

bruit with bell: abnormal for presence of bruit

273
Q

Head: Abnormalities of Size and Contour in Infants

A

Caput succedaneum
Cephalhematoma
Hydrocephalus (macrocephaly)
Macrocephaly
Microcephaly
Torticollis (Wryneck)
Fetal Alcohol Syndrome
Down Syndrome

274
Q

caput succedaneum and cephalhematoma

A

similar
both due to trauma at birth

275
Q

caput succedaneum

A

presenting part of the head is swollen and red and possible bruising. resolves over the first few days. no Tx needed

276
Q

cephalhematoma

A

hemmorhage
difference is timeline
can keep building in size for days and then is absorbed
generally no Tx needed

277
Q

macrocephaly

A

enlarged skull

278
Q

hydrocephalus

A

common cause of macrocephaly
due to fluid buildup

279
Q

microcephaly

A

small head
associated with a syndrome
child will have developmental problems because brain is limited or not fully developed

280
Q

torticollis aka wryneck

A

head is tilted to the side and stuck in that position
no full rom
can be Tx over time through pt

281
Q

fetal alcohol syndrome
down syndrome

A

distinct facial characteristics

282
Q

fetal alcohol syndrome characteristics

A

short palpebral fissures
flat midface
short nose
indistinct philitrum
thin upper lip
epicanthal folds
low nasal bridge
minor ear anomalies
micrognathia

283
Q

Head/Neck Abnormalities in Adults

A

Parotid Gland Enlargement
Hyperthyroidism
Goiter
Atopic (Allergic) Facies
Allergic Crease

284
Q

parotid gland enlargement

A

one of the main saliva glands
in front of ear at cheek
due to infection, virus, mumps

285
Q

hyperthyroidism
goiter

A

associated with thyroid gland
easier to see at neck

286
Q

atopic (allergic) facies
allergic crease

A

kids with allergies

287
Q

atopic (allergic) facies

A

discoloration around the eyes
looks like makeup– pink/blue discoloration

288
Q

allergic crease

A

line across bridge of the nose from them rubbing their nose and pushing up on it

289
Q

external anatomy of the nose

A

Bridge
Tip
Nares
Vestibule
Collumella

290
Q

nose internal anatomy

A

septum
turbinatos
paranasal sinuses

291
Q

paranasal sinuses

A

frontal
maxillary
ethmoid
sphenoid

292
Q

anatomy of the mouth

A

lips
Hard & soft palate, uvula, buccal mucosa
tongue
teeth
gums

293
Q

frenulum

tongue

A

tissue fold, midline on floor of mouth
Salivary glands

294
Q

parotid

tongue

A

Stenson’s duct (located opposite second molar)

295
Q

submandibular

tongue/salivary glands

A

Wharton duct (located on either side of frenulum)

296
Q

teeth and gums

A

32 permanent, 20 deciduous (temporary)

297
Q

throat

A

tonsils
nasopharnyx
oropharnyx

298
Q

tonsils

A

masses of lymphoid tissue, located between the anterior & posterior pillars

299
Q

grading the size of tonsils

A

1+: visible
2+: halfway between tonsillar pillars & uvula
3+: touching the uvula
4+: touching each other

300
Q

nasopharnyx

A

continuous with the oropharynx, behind the nasal cavity (location of adenoids & eustachian tube)

301
Q

oropharnyx

A

located behind the anterior tonsillar pillars

302
Q

Developmental Considerations- mouth/nose/throat

A
  • Salivation begins at 3 months
    - Drooling- occurs from inability to swallow, not from eruption of teeth
303
Q

pregnant females
developmental considerations

mouth/nose/throat

A
  • Increased occurrence of nasal stuffiness & epistaxis (from increased vascularity in the upper respiratory tract
    - Hyperemic & softened gums: bleeding of the gums can occur with brushing of the teeth
304
Q

The aging adult:

developmental consideration of the nose/mouth/throat

A
  • More prominent appearance to nose from decreased subcutaneous fat
    • Coarser, stiffer nasal hairs: decreased filtering, hairs may protrude
    • Decreased sensation of smell from a decrease in olfactory nerve fibers
    • Atrophy of soft tissue & epithelium in oral cavity–>decreased taste buds & decreased saliva –>decreased taste
305
Q

Continued changes with the aging adult:

nose/mouth/throat

A
  • Changes in gums: recede–>erosion of teeth
    - Loss of teeth malocclusion
    - Increased bone resorption
    - TMJ
    - Changes in mastication–>risk of nutritional deficits
306
Q

Transcultural Considerations

nose/mouth/throat

A

bifid uvula
cleft lip/palate
oral hyperpigmentation
thorus palatinus
leukodema

307
Q

bifid uvula

A

increased occurrence in Asians & Native Americans

308
Q

cleft lip/palate

A

increased occurrence in Asians & Native Americans

309
Q

oral hyperpigmentation

A

varies with race

310
Q

torus palatinus

A

bony ridge in middle of the hard palate, increased occurrence in Native Americans, Inuits, & Asians

311
Q

leukoedema

A

a grayish white benign lesion on the buccal mucosa, occurs more in Blacks

312
Q

Continued transcultural considerations:

nose/mouth/throat

A

newborns with teeth
poor dental hygiene
oral and pharyngeal cancer

313
Q

newborns with teeth

A

rare occurrence, higher incidence in the Tlingit Indians (1 in 11) & the Canadian Inuits (1 or 2 in 100)

314
Q

poor dental hygiene

A

increased incidence in Blacks, Hispanics, Native Americans, and Alaska Natives

315
Q

oral and pharyngeal cancer

A

higher incidence in Blacks

316
Q

nose: subjective data

A

Discharge- any rhinorrhea (nasal discharge), watery, mucoid, purulent, or bloody
Frequent or severe colds
Sinus pain – sinusitis, postnasal drip
Trauma – deviated nasal septum with obstruction

317
Q

nose (cont)

subjective data

A

Epistaxis – nosebleeds, amount, frequency, one or both nostrils, nose picking, difficulty in stopping
Allergies – or hay fever, allergens, medications used
Altered smell – any decrease in smell

318
Q

epistaxis

A

– nosebleeds, amount, frequency, one or both nostrils, nose picking, difficulty in stopping

319
Q

mouth and throat

subjective data

A

Sores or lesions – note history, precipitating factors & any treatment
Sore throat – frequency, precipitating factors, strep throat, treatment
Bleeding gums
Toothache
Hoarseness

320
Q

mouth and throat (cont)

subjective data

A

dysphagia
altered taste
smoking/alcohol consumption
self care behaviors

321
Q

dysphagia

A

any difficulty swallowing
painful

322
Q

smoking/alcohol consumption

mouth/throat subjective data

A

note packs per day, how many years, amount of alcohol consumption, last drink

323
Q

sell care behaviors

mouth/throat subjective data

A

dental care, last dental visit, dentures & their fit, any sores or irritation from dentures

324
Q

infants and children

mouth/throad subjective data

A

thumb sucking, use of bottle, eruption or loss of teeth, temporary or permanent teeth

325
Q

Inspect and palate the nose

A

external nose
test patency of the nostrils (absence of sniff with obstruction)
assess smell
nasal cavity

326
Q

external nose

Inspect and palate the nose

A

for any deformity, symmetry, midline or deviated, inflammation, lesions

327
Q

assess smell

inspect/palpate the nose

A

(not routinely done) unless suspect dysfunction of cranial nerve I (olfactory); discussed in neuro assessment)

328
Q

nasal cavity

inspect/palpate the nose

A

inspect for any swelling, discharge, bleeding, or foreign object

329
Q

mucosa

inspect/palpate the nose

A

Note if discharge is watery, purulent or bloody (epistaxis usually from anterior septum)
* Swollen, boggy, pale and gray mucosa with chronic allergy
* Assess for deviated septum, perforation
* Inspect turbinates (able to view the inferior & middle turbinate but the superior turbinate is not visible)

330
Q

palpate the sinus area

A

Tender to palpation indicates chronic allergies and acute sinusitis

331
Q

inspect the mouth

A

lips
teeth
gums
tongue
palate
uvula
vagus nerve

332
Q

lips

Inspect the mouth

A

for color, moisture, cracking, or lesions
* Bluish lips are normal finding with Black persons

333
Q

teeth

inspect the mouth

A

for any missing teeth, caries (decay), malocclusion

334
Q

gums

inspect the mouth

A

for gingival hypertrophy, retraction, bleeding, lesions, swelling
* Dark melanotic line near gingival margin is a normal finding with Black persons

335
Q

tongue

inspect the mouth

A

for color, surface characteristics, and moisture
* Normal appearance of dorsal surface is roughened with papillae with a pink even color
* Ventral surface is normally smooth, glistening with visible veins

336
Q

dry mouth indicates

inspect the mouth

A

dehydration
fever

337
Q

large tongue seen in what

inspect the mouth

A

mental retardation, hypothyroidism, acromegaly; small tongue with malnutrition

338
Q

when do you see excess saliva and drooling

A

neurologic dysfunction & gingivostomatitis

339
Q

buccal mucosa

inspect the mouth

A

(normally pink, smooth and moist)
* Patchy hyperpigmentation normal finding in dark- skinned persons

340
Q

stensen’s ducts

inspect the mouth - buccal mucosa

A

normally small dimple appearance (opposite upper second molars)

341
Q

fordyce’s granules

inspect the mouth- buccal mucosa

A

small white or yellow painless papules (little sebaceous cysts on mucosa),not significant

342
Q

leukoplakia

inspect the mouth- buccal mucosa

A

a chalky white raised patch, abnormal & precancerous lesion

343
Q

palate

inspect the mouth

A

anterior hard palate normally whitish with irregular ridges; soft palate normallly pinkish color
* Yellow with jaundice

344
Q

torus palatinus

inspect the mouth- palate

A

benign nodular bony ridge down middle of hard palate (a normal variation)

345
Q

bruiselike, dark red/violet confluent macule indicates what

inspect the mouth-palate

A

oral kaposi’s sarcoma

346
Q

uvula

inspect the mouth

A

normal appearance is fleshy pendant hanging down on the midline on soft palate

347
Q

how to test the vagus nerve

inspect the mouth

A

aka cranial nerve x
by having patient say ahhh

348
Q

abnormal finding of inspection of the uvula

inspect the mouth

A

Abnormal finding: deviation of uvula to the side or absence of movement (from damage to CN X)

349
Q

tonsils

inspect the throat

A

normally same pink color as oral mucosa with indentations (crypts) without any exudate

350
Q

tonsil size grading scale

A

1+ Visible just beyond the anterior pillar (normal)
2+ Halfway between tonsillar pillars and uvula
3+ Touching the uvula
4+ Touching each other

351
Q

abnormalities of inspecting the tonsils

A

Bright red swollen (2+, 3+, 4+) tonsils indicate an acute infection; white membrane covering tonsils indicate mononucleosis, leukemia, and diptheria

352
Q

Inspect the posterior pharyngeal wall

A

for color, exudate, or lesions

353
Q

eliciting of the gag reflex

A

by touching the posterior pharyngeal wall; generally not performed in the routine exam

354
Q

CN IX

A

MAKE SURE TO TEST
GLOSSOPHARYNGEAL

355
Q

CN X

A

MAKE SURE TO TEST
VAGUS

356
Q

TEST THE CN XII

A

HYPOGLOSSAL
normal finding is the pt. ability to stick his/her tongue out straight without any deviations or tremors

357
Q

INFANTS/YOUNG CHILD

CONSIDERATIONS IN EARS/NOSE/THROAT

A

remember to examine ears, nose, & throat towards the end of the examination

358
Q

NOSE

Assessment of Abnormalities

A

Epistaxis
Foreign body
Acute rhinitis
Allergic rhinitis
Sinusitis
Nasal polyps

359
Q

LIPS

Assessment of Abnormalities

A

Cleft Lip
Angular Chelitis
Herpes Simplex I

360
Q

oropharynx

Assessment of Abnormalities

A

Cleft palate
Bifid Uvula
Oral Kaposi’s sarcoma
AcuteTonsilitis/Pharyngitis

361
Q

teeth/gums

Assessment of Abnormalities

A

Baby bottle tooth decay
Malocclusion
Dental caries
Gingival hyperplasia
Gingivitis
Aphthous ulcers
Koplik’s spots
Leukoplakia
Candidiasis (Monilial) infection

362
Q

tongue

Assessment of Abnormalities

A

Fissured or scrotal tongue
Geographic tongue
Smooth, glossy tongue (Atrophic glossitis)
Black hairy tongue
Enlarged tongue (macroglossia)
Carcinoma

363
Q

ORGANS OF THE RUQ

A

LIVER
GALLBLADDER
DUODENUM
COMMON BILE DUCT

364
Q

ORGANS OF THE RIGHT LOWER QUADRANT

A

TRANSVERSE COLON
ASCENDING COLON
CECUM
APPENDIX

365
Q

ORGANS OF LEFT UPPER QUADRANT

A

STOMACH
PANCREATIC DUCT

366
Q

ORGANS OF THE LEFT LOWER QUADRANT

A

SPLEEN
ILEUM
DESCENDING COLON

367
Q

EPIGASTRIC

A

SPLIT ABDOMEN IN THIRDS
MIDDLE TOP SECTION

368
Q

HYPOGASTRIC

A

MAKE TIC TAC TOE
;THE VERY CENTER

369
Q

HYPOGASTRIC

A

MAKE TIC TAC TOE
MIDDLE BOTTOM

370
Q

SUPRAPUBIC

A

AKA HYPOGASTRIC

371
Q
A

HEARTBURN

372
Q

LINEA NIGRA

A

PREGNANCY LINE
DARK LINE FROM BELLY BUTTON TO PUBIC AREA

373
Q

LINEA ALBA

A

BAND OF CONNECTIVE TISSUE THAT RUNS FROM A PERSON’S STERNUM TO THEIR PUBIC BONE

374
Q

cullen’s sign

A

superficial oedema with bruising in the peri umbilical region. sign of haemorrhagic pancreatitis

375
Q

helix

A

OUTER BACK EDGE THAT ROLLS IN

376
Q

antihelix

A

RIGHT INSIDE HELIX
PROTRUDES OUT

377
Q

external auditory meatus

A

OUTER PASSAGE TO THE CANAL

378
Q

tragus

A

TONGUE LIKE PROJECTION THAT YOU CAN PUSH AND COVERS EAR CANAL

379
Q

antitragus

A

HARD PART RIGHT OVER WHERE PIERCING WOULD BE

380
Q

lobule

A

EAR LOBE

381
Q

mastoid process

A

BONE RIGHT BELOW/BEHIND EAR

382
Q
A

307 Health Assessment (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions