Exam 2 Flashcards
(131 cards)
1
Q
- Describe blood flow through the heart
A
deoxygenated blood from body → vena cava → R atrium → Tricuspid valve → R ventricle → pulmonic valve → lungs for oxygenation → oxygenated blood via Pulmonary Veins → L atrium → mitral/bicuspid valve → L ventricle → aortic valve → aorta → the body
2
Q
S1
A
Normal heart sound
“LUB”
closing of Tricuspid & Mitral valves
@ Apex
3
Q
S2
A
Normal heart sound
“DUB”
closing of Pulmonic & Aortic valves
@ Base
4
Q
S3
A
extra heart sound right after S2
closing of Semilunar valve
5
Q
S4
A
extra heart sound during systole
bc flow to ventricles met w/ resistance
6
Q
pitting edema scale
A
1+ = slight 2mm
2+ = increased 4mm
3+ = deep 6mm & edema
4+ = severe 8mm & very edematous
7
Q
systole/diastole
A
contract/relax
8
Q
arterial insufficiency vs venous insufficiency
A
ARTERIAL:
better w rest
atrophic change
pale shiny skin , hair loss
smooth ulcers at tip of toe
Painful wound surrounded by healthy skin
delayed cap refill
VENOUS:
better by elevating
warm , edema
brown pigment (blood pools & cant come bk up)
irregular bleeding ulcers
9
Q
RUQ organs
A
“LGD”
Liver
Gallbladder
Duodenum
ascending & transverse colon
pancreas
kidney
ureter
10
Q
RLQ organs
A
“RAC”
Rectum
Appendix
Cecum
ascending colon
bladder
sex organs
small intestine
11
Q
LUQ organs
A
“SS”
spleen
stomach
transverse & descending colon
kidneys
pancreas
ureter
12
Q
LLQ organs
A
sigmoid & descending colon
bladder
sex organs
small intestine
ureter
13
Q
7 P’s
A
- pain
- poikilothermia (cant regulate temp)
- paresthesia
- paralysis
- pallor
- pulseless
- perfusion (cap refill)
14
Q
unilateral edema vs bilateral edema
A
unilateral = lymphatic issue
bilateral = cardiac issue
15
Q
Auscultate heart sounds, in order
A
“APETM” / “All Pigs Eat Too Much”
1. Aortic
2. Pulmonic
3. Erb’s point
4. Tricuspid
5. Mitral
16
Q
where is apical pulse? AKA?
A
5th ICS MCL
PMI (point of max impulse)
17
Q
claudication
A
leg / arm pain during physical activity, better w rest
due to poor blood flow
sx of PAD
18
Q
DVT & sx
A
blood clot in deep vein of legs
s/sx: erythema, warmth, edema, pain
Anti-coag ASAP
19
Q
murmur
A
“SWOOSH”
valve issue
20
Q
bruit
A
artery issue
due to plaque build up in neck vessel
abd: swishing sounds from turbulent blood flow
21
Q
angina pectoris & sx
A
stable
substernal or retrosternal
pressure-like pain (tight / squeeze) w/ activity, better w rest
radiate to jaw, neck, arms
sx: diaphoresis, N/V, dyspnea
22
Q
Prinzmetal / variant angina
A
retrosternal
pressure-like discomfort @ rest & early AM
radiate to jaw, neck, L arm
sx: palpitation, syncope
23
Q
Acute coronary syndrome & sx
A
unstable angina / MI
heavy / viselike / squeeze / burn / pressure
poorly local pain lasting >30m
doesn’t resolve w rest
sx: indigestion, N/V, dizzy, flushed, perspiration, palpitation, dyspnea
24
Q
L side heart failure
A
“Left sided = Lungs”
“DROWNING”
D = Dyspnea (nocturnal & on exertion)
R = Rales / crackle / wheeze
O = Orthopnea
W = weak / fatigue
N = nagging Cough (bloody pink, frothy sputum)
I = increased HR
N = noticing confusion
G = got cyanosis
25
R side heart failure
"Right sided = body"
"SWELLING"
S= super high venous pressure
W= with Ascites
E= enlarged liver / spleen
L= large neck veins (JVD)
L= lots of wt changes
I = irregular HR
N= note dependent edema
G = GI issues
26
artherosclerosis
buildup of plaque in arteries → narrowing / blockage → reduces blood flow
sx of PAD
27
PAD / peripheral artery disease
circulatory condition where narrowed blood vessels reduce blood flow to limbs
sx: leg pain while walking
28
ABI / ankle-brachial index
screening for PAD
ankle systolic / brachial systolic
<0.90 = arterial insufficiency
<0.70 = perfusion issue
<0.41 = limb threatening
29
Thrill
vibrations felt by palpation
caused by turbulent blood flow w/ incompetent valves, pulmonary HTN, or septal defects
30
Peripheral Pulse Scale
0 = absent, unpalpable
1+ = weak, thready, diminished
2+ = normal
3+ = increased, strong
4+ = bounding
31
ABD assessment steps, in order
inspection → auscultation (start RLQ) → percussion → palpation (start RUQ, painful area last)
32
norm liver span
MCL: 6-12 cm
midsternal: 4-8 cm
33
stress incontinence
happens w/ coughing, sneezing, or increased intra-abd pressure
34
urge incontinence
sudden urge to pee w/o warning then leak before reaching rr
35
total incontinence
can't hold urine
36
hyperactive bowel sounds / borborygmi
heard above partial obstruction or w diarrhea
37
hypoactive bowel sounds
heard below partial obstruction or w constipation
38
venous hums
innocent murmur by auscultation in kids & teens
39
Indirect percussion for CVA tenderness
percuss to assess kidneys
40
Murphy sign
Apply mild pressure to liver border, tell pt to breathe deeply. Pain = gallbladder inflam (cholecystitis)
41
Blumberg sign
sharp, stabbing pain when pressure from ABD is released / rebound tenderness =
appendicitis
42
cremasteric reflex
stroking the upper thigh, which causes the ipsilateral testicle to rise
43
Cryptorchidism
undescended testicle at birth
risk factor for testicular cancer
44
Varicocele
abnorm L-sided dilation of veins in sperm cord.
Feels like bag of worms on palpation
45
BPH / Benign prostatic hyperplasia & sx
W/ age, fibromuscular structures of prostate gland atrophy → gradually replaced by collagen → enlargement
sx: cant empty bladder / frequency / weak stream / dribbling / nocturia
46
abd arteries
-aorta (mid)
-renal (R side)
-iliac
-femoral
47
Iliopsoas muscle test
pt supine, R leg straight up, keep knee straight.
Push down on lower R thigh while pt push up
pain = appendicitis
48
Sex hx: 5 P's
* Partners
* Practices
* Protection
* Past STI hx
* Pregnancy prevention
49
Gravida / Para
of pregnancies / # births > 20wks
50
genital warts
HPV
fleshy painless lesions
51
cystocele
bladder prolapse into vag frm thickened pelvic muscle
52
syphilitic chancre
start at perianal area as silver/white papules
turns into red ulcers
painless
53
blue / pale cervix indicates?
blue = pregnant
pale = post menopause
54
chandelier sign
pain w/ movement of cervix = infection
55
urethritis sx
cant empty fully
hematuria
urgency
weak stream
56
chlamydia
bacterial
no sx
invades urinary tract
bleeds easily, esp after sex
57
gonorrhea
bacterial
dysuria - male, no sx- female
penis & pus vag d/c
cause pelvic inflam & infertility
58
genital herpes
virus
no cure - present for life
periodic outbreaks of lesions
59
norm testes
3.5 - 5 cm long
2.5 cm wide
2.5 cm deep
60
hernia
bulging of tissue / organs thru a weakened muscle wall
straining to increasing intra-abd pressure cause hernia to protrude
Pain w/ straining & bowel sounds in scrotum = indirect hernia
heaviness / dragging feeling in scrotum
61
ectopic pregnancy sx
delayed menstruation (1 - 2 wks)
spotting
sharp colicky pain
62
testicular exam rec time?
every 3y
63
brain: frontal lobe
"front motor of car"
motor
executive (plan, decision, judgment)
64
brain: parietal lobe
"4 P's - sensation frm opposite side of body"
proprioception
position
pain
pressure
65
brain: occipital lobe
"binOCulars"
vision
66
brain: temporal lobe
"TEMPO - music"
auditory, taste, smell
67
cranial nerves 1-12 = sensory or motor / function / exams
"Some Say Marry Money But My Brother Says Big Brains Matter More"
"Shes Very Elegant, Ppl
Vie For, Chance;
Look That, Face
Her, Beauty
Timeless & Sweet
Tough & Strong
Her, Neck
& Tongue"
CN 1 = sensory / smell / identify smell
CN 2 = sensory / vision / snellen chart
CN 3 = motor / eye mvmnt, pupil / PERRLA
CN IV = motor / vertical eye mvmnt / 6 cardinal positions (EOM)
CN V = both / face sensation, chew / clench teeth, palpate TMJ
CN VI = motor / lateral eye mvmnt / EOM
CN VII = both / taste, face expression / puff cheeks, smile
CN VIII = sensory / hearing, balance / Romberg's test, tuning fork
CN IX = both / tongue, swallow / say "ah"
CN X = both / throat sensation, speech / gag reflex
CN XI = motor / head, neck mvmnt / shrug, turn head
CN XII = motor / tongue mvmnt / stick out tongue
68
APGAR
APGAR & NB exams occurs at birth
norm score: 7-10
how well infant is adjusting to environment outside womb
calculated at 1 min and again at 5 min of life
A= appearance
P= pulse
G=grimace
A=activity
R=respiration
69
Pronator drift
pt close eyes and outstretch arms straight ahead w palms up for 10 sec
* Pronation of hands and downward drift of arm = weakness
subtle UMN (upper motor neuron) disorder
70
muscle strength scale
0—No muscle contraction
1+—Barely detectable
flicker
2+—Active movement w no gravity
3+—Active movement against gravity
4+—Active movement against some resistance
5+—Active movement against full resistance
norm: 4-5
71
Cerebellar function test
gait, balance, romberg's test, finger-to-nose, heel-to-shin
72
Pyramidal trac vs Extrapyramidal tracts
pyramidal = “higher” motor system → voluntary movements
extrapyramidal = “lower” motor system → maintain muscle tone, involuntary mvmnt
73
Mini-Mental State Examination (MMSE)
Screen for dementia in older adults
-time, place
-registration (repeat named prompts)
-attention & calculation (serial 7s, spell "world" backward)
-recall
-lang
-repetition
-complex commands
74
Mini-Cog
Screens for dementia/cognitive impairment
-recite 3 words
-draw clock
-recall 3 words
75
Rating Deep Tendon Reflexes (DTRs)
0 No response
1+ diminished
2+ normal
3+ More brisk
4+ Abnormal; very brisk, hyperactive;
rhythmic oscillations (clonus)
76
Glasgow Coma Scale/ GCS
test consciousness
*Eye opening
4= norm
3=opens to speech
2=opens to pain
1=cant open
*Verbal response
5=norm
4=confused but coherent
3=inappropriate words
2=incomprehensible sounds
1=no response
*Motor response
6=obeys command
5=local pain
4=withdraw frm pain
3=abnorm flexion / decorticate
2=abnorm extension / decerebrate
1=no response
<7= coma
77
Ataxia
Impaired balance or coordination
78
Hypoesthesia
Numbness
79
Hypoalgesia
reduced sensitivity to pain
80
Clonus
involuntary, rhythmic muscle contractions
81
Myoclonus
Muscle jerks
82
Tic
compulsive, repetitive sound or movement that’s often difficult to control
83
Alzheimer disease
progressive, degenerative disorder of cerebral cortex
50% of all dementia
Brain cells & their connections die, destroying memory and other mental functions.
84
Parkinson disease
progressive neuro disorder that affects movement, balance, and coordination
starts as tremor in 1 hand
85
Huntington disease
inherited
nerve cells in brain gradually break down and die
uncontrolled movements, cognitive decline, and psych sx
86
Epilepsy/seizure
uncontrolled bursts of electrical activity that change sensations, behaviors, LOC and muscle movements
87
Ischemic Stroke vs. Hemorrhagic Stroke (CVAs)
ischemic stroke
*thrombotic: plaque builds up in artery /arteriosclerosis
*thromboembolic: clot breaks off frm plaque and blocks flow
*embolic: clot travels to brain frm elsewhere in body
hemorrhagic stroke
*blood vessel in brain bursts → bleeding → increase ICP, dmg nerve cells, collapse small vessels
88
Meniere’s disease
inner ear disorder causing episodes of vertigo, tinnitus, hearing loss, and fullness/pressure in ear
89
peripheral Neuropathy
Weakness, numbness, and pain from nerve dmg outside the brain/spinal cord, usually in the hands and feet.
90
SAD personas
assess suicide risk
91
SLUMS exam
for mild cognitive impairment & dementia
92
CAM / Confusion Assessment Method
screening for cognitive impairment
distinguish delirium from others
93
HOPE tool
assess spirituality & sense of meaning
94
FAST
stroke indicator
*rapid response
F= face (drooping)
A= arm (weakness)
S= speech
T= time (call emergency services)
95
Multiple Sclerosis
chronic, autoimmune disease
immune system eats away at the protective covering of nerves → disrupt communication btwn brain & body
vision loss, pain, fatigue, and impaired coordination
96
Amyotrophic lateral sclerosis (ALS)
weakens muscles and impacts physical function
nerve cells break down, reducing function in muscles they supply
97
toxic metabolic coma
arousal centers poisoned / critical substrates depleted
98
structural coma
lesions destroy/compress arousal areas bc hemorrhage
99
CAGE
screens for alcohol abuse
Cut = Have u ever felt u should cut down on drinking?
Annoyed = Have ppl annoyed u by criticizing ur drinking?
Guilty = Have u ever felt bad / guilty abt drinking?
Eye-opener = Have u ever had a drink 1st thing in the AM to steady nerves / fix a hangover?
100
cerebellum
balance & coordination
101
ascending tracts
carries sensory info to CNS
102
descending tracts
carries motor info frm brain to body
103
spinal nerves
Cervical: C1 - C8
Thoracic: T1 - T12
Lumbar: L1 - L5
"Candy at 8, Take lunch at 12, Leave at 5"
104
decorticate rigidity
abnorm flexor response
= destructive lesion of corticospinal tract
105
decerebrate rigidity
abnorm extensor response
occurs spontaneously or in response to external stimuli
= lesion in brain / hypoglycemia / hypoxia
106
cheyne stokes respiration / spindle pattern
breathing pattern w periods of apnea followed by increasing, then decreasing depth & freq.
=poor brain stem perfusion
107
central veurogenic hyperventilation
rapid >40/min
= medulla/pons malfunction
108
apneustic breathing
sustained inspiratory effort <12/min
=medulla/pons dmg
109
gasping
rapid, quick, difficult breaths, irregular
=extensive pons dmg, severe hypoxia
110
biot breathing / cluster pattern
several short breaths followed by long periods of apnea
= pons malfunction, increased ICP
111
apnea
no breathing
=brain death
112
function of the lymphatic system
-drain excess fluid and proteins from tissues and return it to the venous system
-Traps and destroys microorganisms and foreign materials filtered from lymph
-Absorbs fats from the small intestine into the bloodstream
113
ECG waveforms (T, P, QRS, ST)
T wave = vent repolarization
P wave = atrial depolarization
QRS = vent depolarization
ST = period btwn vent depolarization and vent repolarization
114
cataracts & sx
opacities in lens interfering w/ focus
s/sx: blurry, double vision
due to aging or systemic disease
115
macular degeneration & sx
degeneration of central vision, cant see in front of them
s/sx: difficult reading, straight lines look wavy, pigment change
due to diabetes, head injury, infection
116
Glaucoma & sx
increased IOP → nerve dmg & vision loss
s/sx: halos, headache, aching, blind spots
117
retinal detachment & sx
separation of retina frm neurosensory layer
emergency
sx: seeing shade in 1 eye, cobweb, floaters, bright flashing light
due to diabetic retinopathy, trauma, myopia
118
conductive hearing loss
vibrations aren't sent to inner ear due to blockage
119
sensorineural / perceptive hearing loss
dmg to inner ear
120
otitis media & sx
inflammation of the middle ear
TTP behind ear, d/c
121
otitis externa & sx
inflammation of external ear canal AKA swimmers ear
itchy, red, swollen, scaling, tender tragus
122
characteristic of cerumen
Keeps TM soft
bacteriostatic
defense against FB
sticky
123
Rinne test
put vibrating tuning fork on mastoid process to assess hearing thru bone conduction
if bone conduction heard longer than / equal to air conduction = conductive hearing loss
124
Weber test
put vibrating tuning fork on top of the head to differentiate the cause of unilateral hearing loss
125
consensual reaction
pupil constricts in the opposite eye
126
Myopia
cant see far
127
Presbyopia
cant see near
128
direct reaction
pupil constricts in the same eye
129
eustachian tube function
Equalizes pressure in the mid ear w atmospheric pressure
130
Darwin tubercle
Small painless nodules on the helix, norm
131
heave or lift
inspection- appears as a forceful thrusting on the chest as a result of an enlarged ventricle.
R heave is seen at lower left sternal border; L heave is seen at the apex.
