Exam 3 Blueprint Flashcards

Question

Temporomandibular joint (TMJ) assessment

Answer 1

Formed by the fossa and articular tubercle of the temporal bone and the condyle of the mandible. TMJ Functions Hinge: Open & close Gliding: Protrusion & retraction Gliding: Side-to-side at lower jaw (Lateral)

Answer 2

Joint (Size and contour) Color (red, pale, echymotic) Swelling Deformity including masses Crepitus (audible grinding of the bone)

Answer 3

Orientation: what is today's date? Registration: i'll say three words and you say them back to me Naming: what is this? Reading: can you read this and do what it says?

Answer 4

Less mobility than shoulder but stronger, has greater weight bearing ability Landmarks: - Anterior superior iliac spine (ASIS) - Ischial tuberosity - Greater trochanter

Answer 5

Startle infant by jarring crib, making a loud noise, or supporting head and back in semi-sitting position and quickly lowering infant to 30 degrees (when they fan limbs out) Present at birth; disappears at 1-4 months

Answer 6

- feel each testicle with thumb and first two fingers - contents should slide easily - testes feel oval, firm, rubbery, sooth, equal, freely movable

Answer 7

Midbrain - Thalamus/hypothalamus (actually part of diencephalon) relay center and hormone regulation, respectively Pons - Respiratory centers Medulla - Ascending and descending tracts - Autonomic centers (respiration, heart, GI) - regulates breathing, BP, HR, swallowing Central core

Answer 8

Abducens: Eye movement (Motor) * EOMs of cardinal gaze -- technically testing lateral eye movement * Nystagmus? (back and forth movement) -- Unilateral or bilateral? -- Frequency? -- Plane of movement? * Strabismus? (One eye wonky) * Ptosis? (droopy eye lid)

Answer 9

Optic * Vision * Requires ophthalmoscope * Sensory

Answer 10

- establish a routine - best time: right after menstrual period (breasts smallest and least congested) -- advise pregnant or menopausal women to select familiar date - stress it will familiarize woman with own breast and variation -- encourage to report unusual findings - describe correct technique, rational, and expected findings - at home: can palpate in shower w soap and water - then should also be performed when lying supine - encourage woman to palpate own breasts while you monitor technique (teach back method)

Answer 11

flexion (bending), extension (straightening), abduction (movement away from the midline), adduction (movement towards the midline), rotation (circular movement), circumduction (circular movement of a limb), the most movement occurring in ball-and-socket joints, while hinge joints only allow for flexion and extension in one plane.

Answer 12

pins and needles

Answer 13

progressive weakness and loss of muscle mass

Answer 14

cranial nerves? A&O x3?

Answer 15

- palpate the breasts -- tuck small pad under side to be palpated; raise arm over head to flatten breast tissue and displace; lumps more distinct - vertical strip pattern recommended -- start high in axilla -- palpate down to lateral to breast, overlap vertical lines, end at sternal edge - use pads of first 3 fingers - palpate 4 quadrants of breast and nipple (depress nipple and check for discharge) normal breast: firm, smooth, elastic premenstrual: engorgement, slight enlarged

Answer 16

- outer layer of hrain made up of nerve cells- controls most of the conscious processes. -Center of functions governing though, memory, reasoning, sensation and voluntary movement.

Answer 17

uncontrollable movements

Answer 18

- puberty begins between ages 9.5-13.5 - first sign is enlargement of testes - next, pubic hair appears then penis size increases - complete change in development from preadolescent to adult takes around 3 years - normal range is 2-5 years

Answer 19

Breast changes start during 2nd month of pregnancy; are early sign for most women - breasts enlarge and feel more nodular; nipples are larger, darker, and more erectile Colostrum may be expressed after 4th month - thick yellow fluid: precursor for milk - contains same amount of protein and lactose, but practically no fat Lactation: milk production begins 1-3 days postpartum (colostrum first)

Answer 20

Synovial: freely movable, filled with fluid Ex. Knee, shoulder Non-synovial: Joined by fibrous tissue or cartilage. Immovable

Answer 21

connect muscle to bone

Answer 22

 Breast changes start during the second month of pregnancy and are an early sign for most women  Breasts enlarge and feel more nodular, nipples are larger, darker, and more erectile  Colostrum may be expressed after fourth month  Thick yellow fluid-precursor for milk  Contains same amount of protein and lactose, but practically no fat  Lactation: milk production begins 1 to 3 days post partum (colostrum first)

Answer 23

-- palpate inguinal lymph nodes *- palpate horizontal chain along groin inferior to inguinal ligament and - * -vertical chain along upper inner thigh - normal to palpate an isolated node on occasion -- small, 1cm, soft, discrete, movable -- enlarged, hard, matted, fixed nodes are abnormal findings

Answer 24

Puberty: estrogen stimulates breast changes  Breast development  Between 8 and 9 years for African-American girls and by 10 years for Caucasian girls  Beginning of breast development precedes menarche by about 2 years  Breasts of nonpregnant woman change with movement and flow of hormones during monthly menstrual cycle

Answer 25

- woman sitting up facing examiner - when woman is supine, cover one breast with gown while examining other - after exam: teach breast self-examination

Answer 26

BREAST B: breast mass R: retraction E: edema A: axillary mass S: scaly nipple T: tender breast

Answer 27

inspection: breasts look pendulous, flat, and sagging Nipples may be retracted but can be pulled outward Palpation: breasts feel more granular; terminal ducts around nipple feel more prominent and stringy

Answer 28

bone to bone connective tissue

Answer 29

Physiologic changes: - general atrophy of neurons -- brain usually decreases in weight -- cerebral cortex thins - Leads to decreased CBF (cognitive brain function), CSF - Neural connections slower - Loss of muscle mass and tone - Decrease in sensory abilities Consequences: - Dizziness -- syncope - Tremors develop - Strength (grip) less strong High risk for falls!

Answer 30

Headache Mental status change - confusion, lethargy, agitation, restlessness Dizziness, vertigo, syncope Numbness or loss of sensation Deficits of the 5 senses

Answer 31

(sensation)

Answer 32

- gait - Romberg test: arms at side and legs together, close eyes and assessed for signs of imbalance - Hop in place - rapid alternating movements - finger to nose - finger to finger - heel to shin

Answer 33

Ball-and-socket Rotator cuff (the most sports injuries) - Four muscles (supraspinatus, infraspinatus, subscapularis, teres minor) - Tendons - Glenohumeral joint Palpable landmarks - Acromion process - Greater tubercle

Answer 34

-Inflammatory conditions Rheumatoid arthritis -Degenerative conditions Osteoarthritis Osteoporosis -Dislocation -Subluxation -Fracture -Effusion -Torn rotator cuff -Tennis elbow -Carpal tunnel syndrome -Scoliosis

Answer 35

Sensory assessment: - Superficial -- pain, temperature, light touch (cotton ball) - Deep Sensation -- vibration -- position (kinesthesia) -- tactile discrimination -- stereognosis: identify item in hand -- graphesthesia: drawing number Motor: motor damage related to level of lesion injury - assess muscle strength and tone -- test balance -- assess coordination and skilled movement -- test reflexes

Answer 36

("auto pilot", voluntary movement, equilibrium, coordination)

Answer 37

note: - location - size: width, length, thickness - shape: oval, round, lobulated, indistinct - consistency: soft, firm, hard - movable or fixed - distinctness: solitary or multiple - nipple: displaced or retracted - skin over lump: erythematous, dimpled, retracted? - tenderness: lump tender to palpation? - lymphadenopathy: are any regional lymph nodes palpable?

Answer 38

Largest joint in the body - Three bones involved Femur Tibia Patella -Hinge joint -Landmarks Patella Tibial tuberosity Quadriceps muscle Ligament supports

Answer 39

- inspect and palpate axillae - inspect skin; note rash or infection; lift woman's arm and support it so muscles loose and relaxed - use right hand to palpate left axillar - reach fingers high into axilla; move them firmly down in four directions

Answer 40

damage that occurs to the developing brain, usually in utero

Answer 41

Paresis Paralysis Myoclonus Fasciculation/tic/tremor - resting - intention: tic when moving - chorea: Tourette's - athetoid: cerebral palsy

Answer 42

skin, muscles, tendons, mucous membranes, viscera: afferent fibers spinothalamic tract: sensory fibers transmit pain, temperature, touch posterior columns: position, vibration, fine touch

Answer 43

Hypoglossal Motor * Tongue movement

Answer 44

- pain - light touch - vibration

Answer 45

Total weight of the body is transmitted through the ankle and foot Balance the body and absorbs the impact of walking -Hinge joint Tibia, fibula, and talus -Landmarks Medial malleolus and lateral malleolus

Answer 46

- prenatally: testes develop in abdominal cavity near kidneys - at birth: testis measure 1.5-2 cm long and 1 cm wide - only slight increase in size occurs during prepubertal years

Answer 47

 Osteoporosis  Postural change  Loss of height & sub-Q fat  Postural changes  Decreased height  Kyphosis  Decreased fat in periphery with re-deposition to abdomen and hips  Bony prominences become more obvious Aging changes in the bones - muscles - joints Information  Decreased muscle strength and decreased bone strength  Increased risk for weakness which leads to reduced ability to function  Person less willing to walk  Results in immobility issues  Walking: one of the most important methods of sustaining independence

Answer 48

Pathologic reflexes * Babinski * Brudzinski: flex the neck - meningitis * Kernig: extension of the knee - meningitis Abnormal postures * Decorticate rigidity (turned in and up) * Decerebrate rigidity (neck back/knees up) * Flaccid quadriplegia * Opisthotonus (back/neck arches back)

Answer 49

Glossopharyngeal Both Sensory and Motor * Sensory: taste (posterior tongue) * Motor: pharyngeal muscles (swallowing)

Answer 50

Concern for damage to epiphyseal plate (growth plate)

Answer 51

Babinski: toes fanning out Brudzinski: flex the neck - meningitis Kernig: extension of the knee - meningitis

Answer 52

should be without lesions discharge: collect for microscopic exam

Answer 53

* General atrophy of neurons * Brain actually decreases in weight * Cerebral cortex thins * Leads to decreased CBF, CSF * Neural connections slower * Loss of muscle mass and tone * Decrease in sensory abilities Consequences * Dizziness * Syncope * Tremors develop * Strength (grip) less strong High risk for falls

Answer 54

Memory: - cerebral function - recent vs remote memory - immediate memory test (repeating 3 words back that were just given) Intellectual: - learning - computation - ability to read - insight - judgment

Answer 55

Flaccidity Spasticity Rigidity Cogwheel rigidity: gradual halting in movement like a ticking clock

Answer 56

(Auditory, hearing, taste, smell, Wernicke's area)

Answer 57

Hold infant on flat surface - note regular alternating steps Reflex disappears before voluntary walking

Answer 58

With baby supine, turn head to one side with chin over shoulder; note ipsilateral extension of arm and leg, and flexion of opposite arm and leg "the fencing position" Appears by 2-3 months; decreases 3-4 months; disappears by 4-6 months

Answer 59

enlarged, hard, matted, fixed nodes firm, painless lump hard area enlarged testicle

Answer 60

Epiphysis: Muscle to bone Diaphysis: Shaft Metaphysis: Between epiphysis and diaphysis Epiphysial plate (Growth plate) Periosteum: Thin membrane

Answer 61

Temperature Swelling Masses Only an abnormal synovial membrane is palpable (inflamed or warm)

Answer 62

Pulses Pallor Pain Paresthesia Paralysis Poikilothermia (the inability to maintain a constant core temperature independent of ambient temperature_

Answer 63

-Breasts lie anterior to pectoralis major and serratus anterior muscles. -Between 2nd and 6th rib- from side of sternum to midaxillary. -Superior lateral corner or breast called TAIL OF SPENCE -Areola surrounds nipples with sebaceous glands called MONTGOMERYS GLANDS

Answer 64

fluid filled sacs that act as cushions to reduce friction

Answer 65

Three bony articulations Hinge action Landmarks Medial epicondyle (humerus) Lateral epicondyle (humerus) Olecrenon process (ulna)

Answer 66

have a solid oval shape, suspended vertically by spermatic cord left testis is lower because left spermatic cord is longer

Answer 67

- Pain -- pain, tenderness, when noticed, where, cyclic, brought on by activity? - Lump, mass, swelling -- when noticed, changes, relation to period, changes in overlying skin? - Discharge from nipples -- when noticed, color, consistency, odor? - Rash -- when noticed, when did it start, where? - Trauma -- any trauma or injury, result in swelling, lump or break in skin? - Swelling -- one spot, all over, related to period, pregnancy, or breastfeeding, any change in bra size? - History of breast disease -- any in family? yourself? age? - Surgery

Answer 68

Touch your thumb at ball of baby's foot; note that toes curl down tightly Reflex present at birth; disappears at 8-10 months

Answer 69

Olfactory * Smell * Non-noxious smells * Sensory

Answer 70

Appears at birth; disappears at 3-4 months Brush the infant's cheek near mouth; note whether infant turns head toward that side and opens mouth

Answer 71

Facial Motor * Facial muscles for expression * Have client “smile, frown, close eyes tight, lift brows, show teeth, puff cheeks Sensory * Taste on anterior tongue * Tested only if injury occurs or is suspected * Salt, lemon juice, sugar

Answer 72

Flexion Extension Abdution Adduction External/Internal Rotation

Answer 73

Complex motor coordination for movement, equilibrium, posture

Answer 74

- inspect as male holds penis out of way; you could also do so with back of hand - size varies with ambient room temp; asymmetry is normal (left scrotal half lower) - spread rugae out between fingers, lift sac to inspect posterior surface -- normally: no scrotal lesions present -- common: sebaceous cysts - yellowish 1cm nodules: firm, nontender, multiple - palpate gently each scrotal half between thumb and first two fingers - palpate each spermatic cord between thumb and forefinger, along length from epididymis up to external inguinal ring

Answer 75

Classified as long, short, flat, or irregular.

Answer 76

memory loss losing track forgetting words getting lost poor judgment abstract failing losing things mood swings personality change growing passive

Answer 77

 After menopause  Ovarian secretion of estrogen and progesterone decreases, causing breast glandular tissue to atrophy  Decreased breast size makes inner structures more prominent  A breast lump may have been present for years but is suddenly palpable https://www.cmsschicago.org/news-blog/moderate-walking- can-reduce-the-risk-of-breast-cancer-in-older-women/

Answer 78

Acoustic / Vestibulocochlear Sensory * Sensory for hearing and equilibrium - requires special equipment to full assess - bedside assessment with conversation * Balance

Answer 79

Clavicle scapula acromiclavicular joint acromion Glenohumeral joint Head of humerous Humerous

Answer 80

Spinal accessory Motor * Trapezius and sternomastoid movement - have patient turn head and apply resistance - assess shoulder shrug

Answer 81

increased sensitivity

Answer 82

hold infant up next to table - able to place foot on table Reflex appears at 4 days after birth

Answer 83

Kyphosis- (hump) top curvature Lordosis (lower back curvature) scoliosis (spinal curvature)

Answer 84

Corticospinal (pyramidal) tract Motor fibers travel from motor cortex to brainstem, where they cross and go down the opposite (contralateral) side

Answer 85

Assessing balance and gait/coordination Romberg test- make sure they dont fall (Stand still for 30 seconds and not lose balance) Finger-to-nose test Heel to shin- to test for neurological vs weakness Rapid alternating movements - flip hands back and forth (how fast pt can do it)

Answer 86

- encourage self care: teach every male 13-14 - testicular cancer most common in young men 20-35 -- males with undesended testicles at greatest risk; white males 4x more likely to contract cancer - early detection of cancer enhanced if male is familiar with normal consistency - points to include during teaching (TSE): -- T: timing, once a month -- S: shower, warm water relaxes scrotal sac -- E: examine, check for and report changes immediately - shower or bath - hold scrotum in palm of hand - feel each testicle with thumn and first two fingers -- testicle: egg-shaped and movable, feels rubbery with smooth surface - report abnormal findings

Answer 87

 Hormones increase joint mobility  Lordosis (low back curvature and pain)

Answer 88

Muscle Tone * Flaccidity * Spasticity * Rigidity * Cogwheel rigidity (watch-hand arm ticking) Movement * Paresis * Paralysis * Myoclonus * Fasciculation/Tic/Tremor * Resting * Intention * Chorea * Athetoid (cerebral palsy)

Answer 89

made up of connective tissue. Provides structure and support. Allows bones to glide over eachother.

Answer 90

Rooting reflex: (brush cheek, infant should turn head toward side) Palmar Grasp (tight grasp around finger/toe) Tonic neck reflex (baby supine, "fencing position" Moro reflex- scare baby Placing Reflex- place foot on table Stepping Reflex- should alternate steps

Answer 91

(Personality, emotions, intellect, Broca's area)

Answer 92

Vagus Both sensory and motor Sensory: viscera of thorax and abdomen motor: pharyngeal muscles (swallowing) - consider the patient with stroke - assess gag Vagus is also important during the Valsalva maneuver - bearing down and the HR drops

Answer 93

a tool used to measure the severity of brain injury and impaired consciousness in patients 15 point scale

Answer 94

- After menopause: ovarian secretion of estrogen and progesterone decreases, causing breast glandular tissue to atrophy - Decreased breast size makes inner structures more prominent - breast lump may be present for years but is suddenly palpable

Answer 95

Screening tool - max score is 30 - 23 or less: cognitive impairment Used primarily with elderly - dementia - delirium

Answer 96

Midline: over the spinal processes of the vertebrae Off the midline: in the paraspinal muscles surrounding the spine

Answer 97

Internal Anatomy  Breast is composed of * Glandular tissue * Fibrous tissue including suspensory ligaments * Adipose tissue  Glandular tissue contains 15 to 20 lobes radiating from nipple, and these are composed of lobules

Answer 98

 Provides structure  Provides protection  Enables voluntary movement  Store minerals: calcium  Produce blood cells: hematopoiesis

Answer 99

Probable decline in cranial nerve function Senile tremors - Benign: intention - Dyskinesia: no rigidity; can't really be controlled Grip remains intact Rapid alternating movements more difficulty to perform DTRs less brisk Generally, stronger stimuli may be needed to elicit response

Answer 100

Note symmetry of size and shape: common to have slight asymmetry in size - often left slightly larger than right Skin: - normally smooth and of even color - note any localized areas of redness, bulging, or dimpling; any lesions or focal vascular pattern - fine blue vascular network visible during pregnancy; pale linear striae (stretch marks) follow pregnancy - normally no edema present Lymphatic drainage areas: - observe axillary and supraclavicular regions; note bulging, discoloration, edema Nipple: - should be symmetrical on same plane - usually protrude; some inverted or flat - normal nipple inversion may be unilateral; can be pulled out - note any dry scaling, fissure, ulceration, bleeding, discharge 3rd nipple is normal variation; along "milk line"

Answer 101

- irregular shape - firm to stony hard - poorly defined (no clear margins) - single in number - fixed, nonmobile - usually nontender, but can be tender - positive skin retraction - constant growth

Answer 102

flashlight, cotton, object with sharp and dull sides, vibration (tuning) fork, reflex hammer

Answer 103

upper outer quadrant (Tail of spence)

Answer 104

- Loose protective sac; continuation of abdominal wall - after adolescence: scrotal skin deeply pigmented and has large sebaceous follicles - scrotal wall consists of thin skin lying in folds (rugae) and underlying cremaster muscle - septum inside separates sac into halves; in each is a testis which produces sperm

Answer 105

- Breast is composed of: -- glandular tissue -- fibrous tissue including suspensory ligaments -- adipose tissue - Glandular tissue contains 15-20 lobes radiating from nipple; composed of lobules Can be divided into 4 quadrants intersecting at nipple - upper outer quadrant is site of most breast tumors

Answer 106

Most common joint disease Slowly progressive, non-inflammatory disorder Cartilage damage -Secondary synovitis Aging women Systemic and local signs and symptoms

Answer 107

sensory checks "feeling" and motor checks "movement.".

Answer 108

Cervical (C1-C7) Thoracic (T1-T12) Lumbar (L1-L5) Sacral (S1-S5) Coccyx

Answer 109

Oculomotor (Motor) * Pupil dilation and constriction * PERRLA

Answer 110

- completed with thorax exam - inspect - palpate nipple area - palpate axillary lymph nodes - Gynecomastia: growth of breast tissue, can occur during puberty - normal and temporary - breast cancer in men is less than 1% worldwide (most often in older men)

Exam 3 Blueprint Flashcards

(135 cards)