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Health Assessment > Module 9 Part 2 > Flashcards

Module 9 Part 2 Flashcards

1
Q

AKA 6 cardinal fields of gaze

A

Extraocular Movements (EOM)

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2
Q

cranial nerves related to EOM

A

Cranial Nerves III (Oculomotor), IV (Trochlear), and VI (Abducens)

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3
Q

how do you check EOM

A

Stand or sit 3 to 6 feet in front of the person
Ask the person to follow your finger with their eyes without moving their head
Check gaze in the six cardinal directions using a six-sided cross or “H” pattern

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4
Q

how do you check convergence

A

by moving your finger toward the bridge of the person’s nose

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5
Q

how do you check for nystagmus

A

Hold gaze in the 4 corners momentarily

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6
Q

what cranial nerve is related to pupillary reactions

A

cranial nerve II

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7
Q

how do you check for pupillary reaction

A

Dim the room lights as necessary
Ask the person to look into the distance
Shine a bright light obliquely into each pupil in turn
Observe for constriction

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8
Q

how do you record the pupils

A

size in mm and any asymmetry or irregularity

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9
Q

how to check far-to-near reaction accommodation

A

Have the person look across the room
Then have her/him look at your finger about 10” in front of their nose
Watch for pupillary constriction

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10
Q

how to check near-to-far accommodation

A

Have the person look at your finger about 10” in front of their nose
Then have her/him look across the room
Watch for pupillary dilation

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11
Q

what is a common abbreviation for normal findings in pupils

A

PERRLA (Pupils Equally Round and Reactive to Light and Accommodation)

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12
Q

the fundus of the eye includes

A

retina, macula, fovea, optic disc and retinal vessels

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13
Q

the fundus of the eye is only visible with what

A

use of the ophthalmoscope

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14
Q

how do you use the ophthalmoscope

A

Darken the room as much as possible
Adjust the ophthalmoscope so that the light is no brighter than necessary
Adjust the aperture to a plain white circle
Set the diopter dial to zero unless you have determined a better setting for your eyes

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15
Q

how should you examine the person’s left eye

A

Use your left hand and left eye

vice versa for right eye

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16
Q

when using the ophthalmoscope…

A

Place your free hand on the person’s shoulder for better control.
Ask the person to stare at a point on the wall or corner of the room.

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17
Q

what should you see when you shine the light of the ophthalmoscope (shine about 2 ft away)

A

should see the retina as a “red reflex.“
A “glow” coming from the pupil
May not always be “red”

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18
Q

what cranial nerve is affiliated with auditory acuity

A

Cranial Nerve VIII (Acoustic)

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19
Q

how do you perform the whisper test

A

Ask the person to occlude the ear canal of one ear by pushing in and out on the tragus
Stand 1-2 feet behind the person
Whisper unrelated monosyllabic and bisyllabic words 1 at a time
Ask her/him to tell you what was heard
Should be able to identify the words

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20
Q

how do you perform the weber test

A

Strike tuning fork and place on top of the head
Ask
“Can you hear the sounds better in the right, better in the left, or the same in both ears?”
Sound should be heard equally well in both ears

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21
Q

how do you perform the rinne test

A

Strike tuning fork and place on mastoid (bone conduction)
Ask her/him to tell you when the sound is no longer heard (time it in seconds)
When sound no longer heard – move tuning fork in front of the ear (air conduction)
Do not strike the tuning fork again)
Ask her/him to tell you when the sound is no longer heard (time it in seconds)
AC should be more than 2x > BC
When the person has heard it 1 second longer in front of the ear than behind, you can stop timing

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22
Q

how do you inspect the external ears

A

Inspect the auricles (should be aligned) and move them around gently
Ask the person if this is painful
Palpate the mastoid process for tenderness or deformity

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23
Q

otoscopic exam

A

Hold the otoscope with your thumb and fingers so that the ulnar aspect of your hand makes contact with the person
Straighten the canal
Insert the otoscope to a point just beyond the protective hairs in the ear canal
Use the largest speculum that will fit comfortably (usually 4 mm for adults)
Inspect the ear canal noting redness, drainage, or foreign body

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24
Q

how do you straighten canal in adults vs children

A

Adults: Pull the ear upwards and backwards
Children: Pull the ear downwards and backwards

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25
Q

what do you inspect the lips for

A

Color, Moisture, Ulcers, Lesions, Cracking, Edema

26
Q

what do you inspect the buccal mucosa for

A

Color, Ulcers, White patches, Plaques, Nodules

27
Q

what cranial nerve is affiliated with oropharynx

A

Cranial Nerve XII (Hypoglossal)

28
Q

how do you inspect Cranial Nerve XII (Hypoglossal)

A

Tongue movement for speech and articulation (l, t, n)

Swallowing

29
Q

what do you inspect the teeth for

A

Occlusion

Condition and number

30
Q

what do you inspect the gums for

A

Color
Edema
Bleeding

31
Q

what do you inspect the hard and soft palates for

A

Color

Configuration

32
Q

what do you inspect the tonsillar area for

A 
Presence
Color
Uvula position
Swelling
Exudate
33
Q

how do you inspect the Cranial Nerve X (Vagus)

A

Hard and soft palate rise with phonation

34
Q

how do you inspect the Cranial Nerve IX (Glossopharyngeal)

A

Gag reflex
Taste: posterior 1/3 of tongue
Swallowing and phonation

35
Q

how do you inspect the external structures

A

Symmetry
Size
Septal deviation

36
Q

what does Cranial Nerve I (Olfactory) check for

A

Sense of smell

37
Q

In the absence of a nasal speculum use what

A

use only a light source – do not introduce anything into the nostril

38
Q

how do you inspect the internal structures of the nose

A

Tilt person’s head backward

Push up slightly on the tip of the nose

39
Q

what do you examine the internal structures of the nose for

A 
Color
Exudate
Polyps
Sites of recent bleeding
Septal deviation
40
Q

what are the variations in infants and neonates

A

Skull bones are soft and separated

41
Q

when does ossification of sutures begin

A

begins at around 6 years of age

42
Q

what are the three sutures

A

Sagittal
Coronal
Lambdoidal

43
Q

Ossify by around 18-24 months of age

A

anterior fontanels

44
Q

Ossify by around 2-3 months of age

A

posterior fontanels

45
Q

Neonatal Variations at Birth

A

molding, Caput Succedaneum, Cephalhematoma

46
Q

Overlapping cranial bones

A

molding

47
Q

Soft tissue swelling

Crosses the suture lines

A

Caput Succedaneum

48
Q

Bleeding into the periosteum

Does not cross the suture lines

A

Cephalhematoma

49
Q

neotate and infant variations

A 
Head circumference very important up to two years of age
Drooling is common up to on year of age
Check for cleft lip and palate
Neonates are obligatory nose breathers
Maxillary and ethmoid sinuses very small
50
Q

in infants the Eustachian tube is

A

wide, short, and more horizontal

Prone to otitis media

51
Q

deciduous teeth appear when

A

between 6 and 24 months

52
Q

when do children achieve visual acuity of 20/20

A

by 6 years of age

53
Q

children have subtle changes in what

A

facial appearance throughout

54
Q

bruits are common in who

A

common in children up to age 5 or in children with anemia

55
Q

thyroid of a young child…

A

may be palpable

Should not be tender

56
Q

Crease at the juncture between the cartilage and bone of the nose

A

allergic salute

57
Q

what may be palpated in children

A

maxillary sinuses

58
Q

variations in adolescent males

A

The nose and cricoid cartilage enlarge

Facial hair develops

59
Q

variations in pregnancy

A 
Thyroid often enlarges
May hear a thyroid bruit
Chloasma (melasma)
Edema and erythema of the nose and pharynx are common
Hypertrophy of the gums
60
Q

variations in older adults

A

Thyroid may feel more nodular or irregular on palpation
Be careful with range of motion
Skin changes on the face and neck
Buccal and nasal mucosa dryer
Increased coarse nasal hairs (especially in men)
Presbyopia (change in accommodation)

Health Assessment (28 decks)

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