exam 3 Flashcards
1
Q
is eye pain possible with upper resp issues
A
yes
2
Q
what is a large parotid artery associated with
A
mumps
3
Q
how to tell the difference between drooping from stroke or bells palsy
A
bells palsy is typically just eye drooping
4
Q
life threatening causes of headaches
A
meningitis
hemorrhage
tumor
5
Q
primary headache
A
the problem is the headache
6
Q
secondary headache
A
arises from something else. a symptom of another issue
7
Q
SNOOP- red flags headaches
A
S- systemic signs, symptoms, or illness (stiff neck, hiv, cancer, “worst headache of life”
N- neurologic deficits (altered mental status, seizures)
O- onset (new or sudden)
O- other associated conditions (any head trauma? worse when lower/lifting head?)
P- prior history (Is it different than past headaches)
8
Q
primary headaches
A
migraines, tension, cluster
9
Q
migraines
A
could be unilateral (most common), bifrontal or global
throbbing
moderate to severe intensity
photophobia likely, nausea common
aura
rapid onset
last 4-72 hours
reoccurs weekly/monthly, family history
10
Q
tension headaches
A
bilateral (forehead and back of head and neck)
tightening feeling, non throbbing, scalp tenderness, photophobia can occur
mild to moderate severity
gradual onset, last 30 min - 7 days
triggers: stress, muscle tension, sleep disturbance
relieving factors- massage, relaxation
11
Q
cluster headaches
A
unilateral. typically around eye or temple
sharp, continuous
severe intensity
last 15 min-3 hours
could have several per day
rhinorrhea/ptosis/eyelid edema
12
Q
meningitis
A
inflammation of meninges
could be life threatening
severe and sudden headache
stiff neck is a common sign
13
Q
Traumatic brain injury
A
blow to head that interferes with brain function
-symptoms may take time to develop
14
Q
goiter
A
enlarged thyroid gland
thyroid function may be increased, decreased, or normal
15
Q
pharyngitis relation with lymph nodes
A
enlarged lymph nodes are common with sore throat
16
Q
macrocephaly
A
big head. possible brain issues
17
Q
microcephaly
A
small head. possible brain issues
18
Q
cushing syndrome signs
A
rounded moon face, red cheeks, buffalo hump, hirsutism
from increased cortisol
19
Q
nephrotic syndrome
A
periobital edema, puffy and pale face, swollen lips
20
Q
anosmia
A
not being able to smell
21
Q
rhinorrhea
A
runny nose, clear liquid
22
Q
xerostomia
A
dry mouth
23
Q
dysphagia
A
difficulty swallowing
24
Q
dysphasia
A
difficulty speaking
25
palpebral fissures
opening between eye
26
torus palatinus
growth on top of mouth. usually benign. not painful but can cause dysphagia
27
leukoplakia
white patch on tongue that cant be removed by scraping. can cause cancer
28
thrush
thick white plaque from yeast. usually due to prolonged antibiotics. can be scraped/removed. usually painful
29
if parotid gland is only swollen on one side it could be
neoplasm or cancer
30
acromegaly facial abnormalities
prominent jaw and brow, enlarged soft tissues
from too much growth hormone
31
parkinson's disease facial abnormalities
stare, inability to move face, oily skin
32
where are preauricular lymph nodes
in front of ears
33
where are posterior auricular lymph nodes
behind ear, near mastoid process
34
where are occipital lymph node
back of head, near occipital bone of skull
35
where are tonsillar lymph nodes
below ears near jaw bone
36
where are submandibular lymph nodes
where submandibular gland sits. about midway of jaw bone between chin and ear
37
where are submental lymph nodes
below chin
38
where are superficial cervical lymph nodes at
lateral neck, about inch below ear near jugular veins
39
where are posterior cervical lymph nodes
back of neck behind jugular veins. between sternomastoid and trapezius muscle
40
where are the deep cervical chain lymph nodes
close to internal jugular. deep in
41
where are subclavicular lymph nodes
above clavicle
42
what do hard and fixed lymph nodes suggest
malignancy
43
how to inspect thyroid- not paplate
ask patient to sip water and swallow
44
hyperthyroidism signs and symptoms
nervousness, weight loss, palpitations, tremors, sweating, warm skin, fine hair, exophthalmos, increased systolic, decreased diastolic BP, frequent bowel movements
45
hypothyroidism signs and symptoms
fatigue, weight gain, dry cold skin, myexdema, constipation, decreased systolic, increased diastolic BP, bradycardia, hypothermia, impaired memory, coarse hair, nonpitting edema
46
angular chelitus
side of mouth gets cracked
47
angio edema
lips, mouth, tongue swollen
48
angioedema
swelling of mouth, lips, tongue
49
gritty eye
feeling of sand in eye, irritation
50
diplopia
double vision
51
cranial nerve II
Optic. vision
52
cranial nerve III
oculomotor. eye movement and pupil reflex
53
cranial nerve IV (4)
trochlear. Superior oblique eye movement
54
cranial nerve VI (6)
abducens. to lateral rectus eye muscles
55
Strabismus
cross eyed
56
prothesis
artificial eye
57
hyperopia
farsighted
58
presbyopia
gradual loss of ability to focus eye. impaired near vision
59
myopia
nearsighted
60
scotomas
blind spot in vision
61
how does smoking effect eyes
vasoconstriction
62
numerator/denominator on snellen chart
numerator- distance away the patient is. always 20 feet
denominator- distance at which normal eye could see letters. larger denominator, worse the vision
63
how many letters can a client miss on snellen chart to pass a line
2
64
jaegar chart
held 14 inches from clients eye.
read the smallest line possible
this helps identify needs for bifocals
- dont use corrective lenses
65
confrontation test
tests peripheral view
66
entropian
eyelid and lashes inverted in. irritation
67
ectropion
eyelid and lashes turn out, dryness
68
ptosis
droopy eyelid
69
pale sclera can indicate
anemia
70
anisocoria
uneven pupil
71
accomodation test
bringing a object near and far from eye
the pupil should constrict and converge as objects move near and dialate as they move farther away
72
direct pupil reaction
light shined in pupil, pupil constricts
73
consensual pupil reaction
when light is shined in pupil of one eye, the other pupil should still constrict
74
cardinal movement in eye
H pattern
test for extraocular movements
test cranial nerve 3,4 and 6
75
amblyopia
lazy eye
76
can medication affect ears
yes. they can be ototoxic
77
otalgia
earache
78
conductive loss
problems w/ external or middle ear. noisy environments may help
79
sensorineural loss
problems w inner ear. people w this may have trouble understanding speech. noisy environments make hearing worse
80
vertigo
the room around you is spinning
81
meniere's disease
hearing loss, tinnitus, and vertigo
82
how to move ear for otoscope
pull pinna upward, back and away from head
83
where is cone of light on ear drum when using otoscope
right ear- 5 o'clock position
left ear- 7 o'clock position
84
where should cone of light be on eardrum when using otoscope
right ear- 5 o'clock position
left ear- 7 o'clock position
85
whisper test
stand 2 feet behind client and don't let them see your lips
ask them to repeat what you say as you whisper
they should hear at least 4/6 things you say
86
weber test
tuning fork on top of head, ask where they hear sound
87
rinne test
place tuning fork on mastoid process until they cant hear then place it in front of ear (don't reactivate) and see how long they can hear
air conduction should be heard longer than bone. If not, could indicate conductive hearing loss
88
what does nasal speculum do
open nasal passageway for us to see. shouldn't cause pain
89
what causes polyps in nose
chronic conditions such as cystic fibrosis, asthma, etc
90
what sinuses do we palpate
frontal and maxillary
91
malocculsion
teeth don't align properly
92
tongue expected findings
pink with papillae, moist, slightly rough, thin white coating
93
+1 tonsil
visable
94
+2 tonsil scale
between tonsillar pillars and uvula
95
+3 tonsil scale
touching uvula
96
+4 tonsil scale
touching eachother
97
mydriasis
extreme dilation of pupil
98
where is oral cancer most likely to be found
under the tongue
99
what part of brain is affected by alcohol
cerebellum
can affect coordination and balance
100
glascow coma scale
measures motor response, verbal response and eye opening
scale goes up to 15,
3-8 comatose
under 3 - no response
101
what makes up CNS
brain and spinal cord
102
PNS
nerves that branch off the spinal cord and extend to body
103
what are the most common nuero symptoms
headaches and dizzy
104
what is described as "worst headache of life"
hemorrhage
105
POUND acronym for migraines
P= pulsatile or throbbing
O= one day duration or last 4-72 hours
U= unilateral
N= nausea or vomiting
D= Disabling or intensify causing interruption of ADLs
106
presyncope
about to fall
107
what can cause motor weakness
CNS issue or muscle
108
weakness w abrupt onset of motor and sensory deficits
TIA or stroke
109
paresthesia
pins and needles feeling (tingling)
110
dysesthesia
sensation isnt perceived in normal way
ex- light touch feels like burning sensation
111
complete loss of consciousness, postural tone, and loss of perfusion to brain
syncope
112
tonic clonic seizure
also called grand mal. loss of consciousness and violent muscle contraction, loss of bladder, decreased level of consciousness after
113
pseudoseizure
looks like seizure but isn't associated with electrical charge
114
absence seizure
seizures that cause a lack of awareness. stares into space
115
generalized seizure vs focal seizure
generalized starts in both sides of the brain
focal the electrical charge starts on one side of brain, but could spread
116
atonic seizure
causes person to go limp and fall to floor
117
tremor
involunary movements
118
low frequency, unilateral tremor, moving at rest
parkinsons disease
119
high frequency, bilateral in upper extremites, occurs with movement, subsides with rest
essential tremor
120
does leg restlessness get better with rest or activity
activity
121
2 common things causing restless leg that are revirsable
pregnancy and iron deficiency
122
0 muscle scale
can't move/contract muscle, totally flaccid
123
1+ muscle scale
muscle contracts slightly
124
2+ muscle scale
able to move a joint when gravity is eliminated. cant lift up in air but can bend on something
125
3+ muscle scale
can move joint against some gravity
126
4+
can move joint w some resistance throughout full range of motion
127
5+
joint can move with full resistance thru whole range of motion
128
flaccid
complete loss of muscle tone
129
rigidity
muscles are very contracted, very tense
130
spasticity
muscles are tight and stiff but not completely contracted
131
hypotonia
decreased muscle tone
132
hypertonia
increased muscle tone and strength. can result in injury of upper neurons
133
hemiparesis
one sided decreased muscle tone
134
paraplegia
paralysis of lower body from spinal cord injury at or below thoracic
135
quadriplegic
movement and sensation loss of entire body, happens from spinal cord injury in cervical vertebrae
136
decorticate posturing
internal rotation of feet, arms adducted
137
decerebrate posturing
arms stiffly extended and hyperpronated, legs hyperextended
138
posture and rhythmic movements
cerebellar
139
vestibular
balance and coordination
140
point to point movement
assess cerebellar function coordination
141
dysmetria
inability to perform point to point movements
142
ataxia
loss of position sense
143
romberg test
person stands still with eyes closed, check for swaying
144
pronator drift test
ask person to extend both arms, see if arms pronate and return to horizontal position when tapping arms down
145
sensory tests
temp
dull/sharp pain
vibration (tuning fork)
proprioception (ask what way your moving toe)
light touch
146
stereognosis
small object in palm- identify
147
graphesthesia
number identification
close eyes and trace number in their palm
148
two point discrimination
2 points touching at once, where are they
149
dermatone
band of skin innervated by the sensory root of a spinal nerve
150
point localization
can patient identify where you tested?
151
extinction
checks for patients ability to point to both sides
152
tendons
muscle to bone
153
why test reflexes
assess status of CNS
154
4+ reflex
very brisk, hyperactive, with clonus
155
3+ reflex
brisker than avg but not necessarily indication of disease
156
2+ reflex
average, normal
157
1+ reflex
somewhat diminished, low normal
158
0+ reflex
no response
159
bicep reflex
thumb on tendon, strike your own finger
160
tricep reflex
flex arm downwards, strike above elbow
161
achilles reflex
dorsiflex foot at ankle, strike
162
plantar reflex
move hammer from heel to toe
toes should curve inward
163
babinski response
dorsiflexion of great toe, fanning of others
164
FAST
Face drooping
Arm weakness
Speech difficulty
Time
165
FAST
Face drooping
Arm weakness
Speech difficulty
Time
166
what causes hemorrhagic stroke
bleeding in brain
167
what causes ischemic stroke
loss of blood supply to brain
168
thought process
how is it thought thru
169
mood
sustained emotion, changes perception of things around you
170
insight
awareness that what they are feeling is normal/abnormal
171
higher cognitive functions
things that actually require thought, interpretation
172
judgement
comparing options to make decision
173
perception
being aware of things in enviroment
174
thought content
what patient thinks about
175
ability to focus
attention
176
affect
outward expression: tone, facial expression
177
somatoform symtoms
lack medical or physical explanation
178
functional syndromes
change overall quality of life and ability to function normally
179
mental exam of speech
quantity, rate, loudness, articulation of words, fluency
could it be cultural
180
tests for aphasia
word comprehension, repetition, naming, reading comprehension, writting
181
illusion
misinterpretation of real stimuli
182
hallucination
no real stimuli
183
speech w unnecessary detail, doesn't get to point
circumstantiality
184
sudden interruption of speech in mid sentence
blocking
185
everything said is one long sentence
flight of ideas
186
facts/events are fabulated, made up
confabulation
187
speech is illogical, does not make sense
incoherence
188
association between topics are unrelated but patient does not realize
derailment
189
inverted/distorted words- made up
neologisms
190
persistent repetition of words or ideas
perseveration
191
repeating words of someone else
echolalia
192
choosing words based on sound not meaning
clanging
193
new learning ability test
give 3-4 words, ask them to tell you 3-5 mins later
194
abstract thinking test
proverbs, similarities
195
constructional ability test
have them draw a clock
196
mini mental exam screen
max score 30 (good)
anything under 17 is severe cognitive impairment
197
alcohol CAGE
cutting down?
annoyed?
guilty?
eye openers?
198
olfactory nerve (what it does and roman numeral)
I. sensory
smell
199
optic nerve (what it does and roman numeral)
II sensory
vision, pupil assessment
200
oculomotor (what it does and roman numeral)
III. motor
pupil assessment
extraocular moevements
201
trochlear (what it does and roman numeral)
IV. motor
extraocular movements
202
abducens (what it does and roman numeral)
VI. motor
extraocular movements
203
trigeminal (what it does and roman numeral)
V motor and sensory
motor, sensory, corneal reflex
204
facial (what it does and roman numeral)
VII. motor and sensory
controls muscle of facial expression
205
Acoustic (what it does and roman numeral)
VIII. sensory
hearing
206
glossopharyngeal (what it does and roman numeral)
IX. motor and sensory
voice/swallowing
207
vagus (what it does and roman numeral)
X. motor and sensory
Voice/swallowing.
208
spinal accessory (what it does and roman numeral)
XI. motor
move shoulder and neck muscles
209
hypoglossal
XII. MOTOR
movements of tongue
210
dementia test
slums tool
211
disorientation when looking at amsler chart
macular degeneration
212
largest chamber of eye
vitreous
213
Transforms light rays into nerve impulses that are conducted to the brain
retina
214
innermost bone in ear
stapes
