AHA Exam 2 Flashcards
(154 cards)
1
Q
Pectus carinatum
A
Sternal Protrusion
2
Q
Pectus excavatum
A
sternal cavitation
3
Q
Deep rapid respirations associate with metabolic acidosis
A
Kussmaul respiration
4
Q
Hyperpnea
A
deep breathing
5
Q
hypopnea
A
shallow breathing
6
Q
Feel increased vibration in chest over lung and indicates possible consolidation
A
Tactile fremitus
7
Q
Hyperresonance of lungs indicates what condition?
A
hyperinflation
8
Q
Dullness over lungs indicates what?
A
Bone, impaired air exchange, consolidation
9
Q
Increased resonance of the spoken voice with auscultation
A
Bronchophony
10
Q
Intelligibility of the whispered voice to auscultation in presence of consolidation
A
Pectoriloquy
11
Q
“e” sounds like “a” with auscultation in presence of consolidation
A
Egophony
12
Q
Place backs of hands on the back and have patient say “99” and feel for increased vibration
A
Tactile fremitus
13
Q
Sounds more loud and clear over one lung may indicate what condition?
A
Pneumonia
14
Q
Decreased resonance on one side of the lungs could indicate what condition?
A
Bleb
15
Q
What other exams should be done with respiratory?
A
Cardiovascular, peripheral signs with respiratory; ENT is often indicated
16
Q
What condition includes prolonged expiration and wheezing?
A
Asthma
17
Q
What condiiton is collapse of the lung?
A
Atelectasis
18
Q
What would be a significant finding of atelectasis?
A
Absence of lung sounds or very muted
19
Q
What would be significant findings of bronchitis?
A
Diminished lung sounds and hacking non productive cough
20
Q
Significant findings of pneumonia
A
febrile, crackles, rhonchi, diminished breath sounds, egophony, bronchophony, and whisper pectoriloquy, dullness over area of consolidation
21
Q
What condition may cause displacement of the trachea?
A
pneumothorax
22
Q
Significant findings of pulmonary embolism
A
pleuritic chest pain with or without dyspnea; possible low grade fever; hypoxia
23
Q
Findings of emphysema.
A
barrel shaped chest; scattered crackles or wheezes; overinflated lungs are hyperresonant; prolonged expiratory effort.
24
Q
Findings of COPD
A
rhonchi, inspirational crackles; breath sounds diminished; diminished vocal fremitus; cyanosis; distention of neck veins with right sided heart failure
25
What part of the cardiac cycle includes ventricular contraction ejecting blood?
Systole
26
What part of the cardiac cycle includes ventricular dilation and contraction of the atria draws blood into ventricles from the atria?
Diastole
27
What is the first heart sound?
mitral and tricuspid valves close
28
What is the second heart sound?
aortic and pulmonic valves close
29
What is the third heart sound?
mitral and tricuspid valves open
30
What is the fourth heart sound?
atria contract and empty
31
What heart sounds are in systole?
1,2, and 3
32
What heart sounds are in diastole?
4
33
Which EKG waves indicate atrial depolarization?
P wave
34
Which EKG waves indicate stimulation of the atria to initial stimulation of the ventricles?
PR interval
35
Which EKG waves indicate spread of a stimulus through the ventricles?
QRS complex
36
Which EKG waves indicate ventricular repolarization?
ST segment and T wave
37
Which EKG wave is sometimes seen and indicates repolarization of Purkinje fibers
U wave
38
Which electrical node is located in the right atrium?
SA
39
Which electrical node is located in the atrial septum?
AV
40
Where is the point of maximum impulse (PMI) located?
4th intercostal space
41
Where is the aortic valve area?
2nd intercostal space, right pulmonic border
42
Where is the pulmonic valve area?
2nd intercostal space, left pulmonic border
43
Where is the second pulmonic area (ERB's point)
3rd intercostal space, left pulmonic border
44
Where is the tricuspid area?
4th intercostal space
45
Where is the mitral area?
5th intercostal space
46
What is the range of intensity of murmurs?
1- barely audible to VI- loud, audible without stethoscope
47
What grade of murmurs include a thrill?
IV and V
48
Where does the mitral sound radiate to?
axilla
49
Where does the aortic and pulmonic sounds radiate to?
carotids
50
How do you differentiate between a systolic and diastolic murmur?
If carotid impulse the same as what you are hearing it is a systolic murmur
51
What is the most common cause of heart murmur in elderly?
aortic stenosis
52
What is the most common cause of heart murmur?
mitral regurgitation
53
Name the Systolic murmurs
MR ASS mitral regurgitation and aortic stenosis=systolic
54
Name the Diastolic murmurs
MS ARD (mitral stenosis and aortic regurgitation)
55
What characteristics of murmurs are assessed?
location, timing and duration, pitch and intensity; pattern; quality; radiation; variation with respiratory phase
56
What is the range for muscle grading?
1-5
57
Muscle grading: visible or palpable muscle response
1
58
Muscle grading: full or partial ROM but not against gravity
2
59
Muscle grading: full ROM but not against resistance
3
60
Muscle grading: full ROM against some reistance
4
61
Muscle grading: full ROM against full resistance
5
62
Which tests are used to evaluate rotator cuff impingement or tear?
Neer test, Hawkins test
63
Test: internally rotate and forward flex arm at the shoulder: presses supraspinatus muscle against anteroinferior acromion
Neer test
64
Test: forward flexing shoulder to 90 degrees, flex elbow to 90 degrees and then internally rotate arm to its limit
Hawkins test
65
What tests can measure strength of rotator cuff muscles?
Supraspinatus (empty can test), subscapularis, infraspinatus and teres minor
66
Test; abduct arms 90 degrees and flex shoulders forward 30 degrees; apply downward pressure on distal humerus when arms are rotated so that thumbs point down or up
Supraspinatus (empty can test)
67
Test: arm at side, elbow flexed 90 degrees; rotate forearm medially against resistance
subscapularis
68
Test: arm at side, elbow flexed 90 degrees, and rotate arm laterally against resistance
infraspinatus and teres minor
69
What tests can be done for impingement syndrome of the rotator cuff?
empty can test, neers test, painful arc, hawkins, opposition to internal and external rotation
70
What test can be done for impingement syndrome of the AC joint
cross body adduction
71
What test can be done for impingement syndrome of the bicep tendonitis?
Speed test
72
What tests can be done to indicate shoulder instability or dislocation?
Apprehension test, sulcus sign, and internal rotation greater than internal rotation
73
Test: lay on back and externally rotate arm
Apprehension test
74
Test: squaring off of shoulder; divot where ball of humerus is dislocated from AC
Sulcus sign
75
What indicates a rare posterior dislocation of the shoulder?
Internal rotation of the shoulder is greater than external rotation
76
What tests indicate thoracic outlet syndrome?
Wright's test and Adson's test
77
Test: fully abduct the arm shoulder while palpating the radial pulse; if pulse decreases, positive for thoracic outlet syndrome
Wright's test
78
Test: abduct arm to 30 degrees and hyperextend with head turned toward affected side. If pulse diminishes, sign is positive for thoracic outlet syndrome
Adson's test
79
How do you test for deQuervain's tendonitis?
Finklestien's sign
80
Test: make fist with fingers overlying thumb. provide ulnar deviation of the wrist. Pain in first compartment indicates a positive sign
Finklestien's sign
81
Carpal tunnel syndrome association tests
Tinel test; Phalen; thumb opposition
82
Test: tap on ulnar nerve of wrist; positive sign is pins and needles
Tinel test
83
Test: inverted prayer; positive sign is burning, tingling, or numb sensation over the thumb, index, middle, and ring fingers
Phalen test
84
Flexion of fingers
90 degrees
85
Hyperextension of fingers
30 degrees
86
flexion of wrist
90 degrees
87
hyperextension of wrist
70 degrees
88
radial rotation of wrist
20 degrees
89
ulnar rotation of wrist
55 degrees
90
forward flexion of shoulder
180 degrees
91
hyperextension of shoulder
50 degrees
92
abduction of shoulder
180 degrees
93
adduction of shoulder
50 degrees
94
internal and external rotation of the shoulder
90 degrees
95
Shoulder shrug tests which cranial nerve?
XI spinal accessory
96
How do you test the ulnar nerve?
OK sign
97
How do you test the medial nerve of the wrist?
crossing fingers
98
How do you test the radial nerve?
thumbs up
99
Arthritis: ulnar deviation
rheumatoid
100
Arthritis: boutonniere deformities
rheumatoid
101
Arthritis: Bouchard's nodes
PIP, osteo
102
Arthritis: Herberden's nodes
DIP, osteo
103
Swan neck deformity
rheumatoid
104
PIP hyperextension and DIP flexion
boutonniere deformity
105
Large knuckles
bouchard's nodes
106
Bony growth on the finger joints nearest the finger tip (DIP) and sometimes on PIP
Herberden's nodes
107
DIP hyperextension and PIP flexion
Swan neck
108
Back flexion
70-90 degrees
109
Back hyperextension
30 degrees
110
Back lateral bending
35 degrees
111
rotation of upper trunk
30 degrees
112
Tests for nerve rot impingement
straight leg raising test, Bragard stretch test; sitting knee extension; femoral stretch test
113
Test for shortened iliopsoas muscle
Thomas test
114
Test: examiner lifts the patient's leg while the knee is straight. Positive sign is sciatic pain when the straight leg is between 30 and 70 degrees. Could indicate herniated disc at about L5
Straight leg raising test
115
Test: straight leg lift to 60 degrees, dorsiflex the foot. Positive if pain from hip to knee. Indicates nerve involvement at L4,5, and S1
Bragard stretch test
116
Test: patient supine on exame table and holds uninvolved knee to his or her chest, while allowing the involved extremity to lie flat. Holding the knee to the chest flattens ou the lumbar lordosis and stabilizes the pelvis. If the iliopsoas muscle is shortened, or a contracture is present, the lower extremity on the involved sid will be unable to fully extend at the hip
Thomas test
117
Test: lay flat and cross ankle over the knee; may indicate contractures in hip
Ileopsoas
118
Test: test leg is flexed and the thigh abducted and externally rotated. If pain is elicited on the ipsilateral side anteriorly, it is suggestive of a hip joint disorder on the same side.
Patric test
119
Diminished patellar reflex involves which dermatome?
L4
120
Which dermatome causes weak dorsiflexion and extension of great toe?
L5
121
Which dermatome causes weak plantar flexion and diminshed Achilles reflex?
S1
122
Knee flexion
130 degrees
123
Knee extension
0 degrees
124
knee hyperextension
15 degrees
125
Test: checks for effusion; push down on patella and would be able to feel it hit the femoral head and float back up
Ballottment
126
Test: milk fluid distally from suprapatellar pouch. Repeat several times; press behind patella lateral margin; swelling reappears in knee joint effusion
Bulge sign
127
Test: knee is flexed at 20-30 degree angle with the patient supine. The examiner should place one hand behind the tibia and the other grasping the patient's thigh; Tibia is pulled forward to assess the amount of anterior motion of the tibia in comparison to the femur
Lachman's test
128
Test: have the patient lie supine and extend the knee; stabilize the femur with one hand and hold the ankle with your other hand. Apply varus or valgus force against the ankle and internal/external rotation. Laxity indicates injury to the lateral collateral ligamen
Valgus (adduction) and Varus (abduction) stress test
129
Tests for knee effusions
Ballottment; Bulge sign
130
Tests for meniscal tears
McMurray or Apley (don't do this one- can cause cartilage tear)
131
Tests for ligamental injuries
Anterior and posterior drawer test; Lachman test; Varus and Valgus stress test
132
Foot dorsiflexion
20 degrees
133
plantar flexion
45 degrees
134
Foot inversion
30 degrees
135
Foot eversion
20 degrees
136
Test: crank foot inversion
Tallar tilt test
137
What does the tib fib squeeze test for?
fracture
138
Test: When calf squeezed, calf should naturally plantar flex
Thompson test
139
What does the Thompson test check for?
achilles tendon issues
140
Pneumonic for conditions that mimic psych issues
Thinc Med
141
What are the conditions that mimic psych issues?
Tumors, Hormones; Infections and immune diseases; Nutrition; CNS; Misc (sleep apnea, CHF, anemia); Electrolyte; Drugs
142
Pneumonic for depression symptoms
SIGECAPS
143
What are depression symptoms?
Sleep disorder; Interest deficient; Guilt; Energy deficient; Concentration deficient; Appetite disorder; Psychomotor; Suicidal
144
What is the pneumonic for bipolar disorder symptoms?
DIGFAST
145
What are bipolar disorder symptoms?
Distractibility; Insomnia; Grandiosity; Flight of ideas; Activity increase; Speech; Thoughtless risk
146
Autism symptoms are usually seen by what age?
3
147
ADHD symptoms are seen by what age?
12
148
Does Delirium, Dementia, or mood disorder come on suddenly?
Delirium
149
Causes of Delirium
Dementia; Electrolyte disorders; Lung, liver, heart, kidney, brain; Infection; Rx drugs; Injury, pain, stress; Unfamiliar environment; Metabolic dementia
150
Pneumonic used for Alcohol abuse
CAGE
151
Alcohol abuse symptoms
Concern, cut down; Annoyed; Guilt; Eye-opener
152
Left affected stroke symptoms
neglect of affected side; impulsive; lack of insight regarding disability
153
Right affected stroke symptoms
often have speech/language disorder; tend to need motivation; insight usually intact
154
Lacunar stroke symptom
coordination or balance
