Exam 4 Flashcards
(281 cards)
1
Q
fluid buildup in the ears can cause _______ issues
A
balance
2
Q
inability to communicate or understand communication
A
ahpasia
3
Q
trouble or difficulty communicating or understanding communication
A
dysphasia
4
Q
inability to swallow
A
aphagia
5
Q
difficulty or trouble swallowing
A
dysphagia
6
Q
5 steps to the neuro exam
A
mental status
cranial nerves
motor and cerebellar
sensory
reflexes
7
Q
the _____ _____ function shows us intellect, communication, and emotional behavior
A
cerebral cortex
8
Q
if you suspect any abnormalities in consciousness, use the ______ _____ scale and monitor the patient ever hour
A
Glasgow coma
9
Q
3 areas that Glasgow Coma Scale looks at
A
Eye response
Verbal response
Motor response
10
Q
sometimes a _____ _____ rub can illicit a pain response to make eyes open
A
deep sternal
11
Q
best score on Glasgow coma scale
A
15
12
Q
if the glasgow score is less than __, then the patient is comatosed
A
8
13
Q
worst score on the Glasgow coma scale
A
3
14
Q
abnormal posture when the arms are stuck brought to the core
A
decorticate
15
Q
abnormal posture when the arms are stuck extended by their side
A
decerebrate
16
Q
if the patient has trouble remembering three simple things you show them, then perform a ____ ____ _____ examination
A
mini mental state
17
Q
in the mini mental state exam, you ask the patient to name __ simple objects
A
3
18
Q
CN I
A
olfactory
19
Q
CN II
A
optic
20
Q
CN III
A
oculomotor
21
Q
CN IV
A
trochlear
22
Q
CN V
A
trigeminal
23
Q
CN VI
A
abducens
24
Q
CN VII
A
facial
25
CN VIII
vestibular/acoustic
26
CN IX
Glossopharyngeal
27
CN X
Vagus
28
CN XI
spinal accessory
29
CN XII
hypoglossal
30
olfactory nerve tests for ____ function
sensory
31
CN that tests smell
oflactory
32
optic nerve tests for _____ function
sensory
33
optic nerve tests for visual _____ and _____
acuity and fields
34
3 CN that test for the motor function of the eyes
oculomotor, trochlear, and abducens
35
3 things the oculomotor, trochlear, and abducens CN test for
eyelid elevation
cardinal fields of gaze
pupil reaction
36
to test cardinal fields of gaze, make an __ with your finger and have the pt. follow with their eyes
H
37
CN that test for both sensory and motor function
Trigeminal
Facial
Glossopharyngeal
38
the trigeminal nerve tests for _____ and _____ muscle strength by having the patient bite down
temporal and masseter
39
2 tests that test the sensory function of the trigeminal nerve
sharp and dull on face
corneal reflex
40
the facial nerve tests for ______ _____ or ______
facial drooping or asymmetry
41
CN that tests for hearing
vestibular
42
the vestibular CN also tests for ______ problems
equilibrium
43
jerky motion of the eyes caused by fluid in the ears
nystagmus
44
the glossopharyngeal and vagus nerve test for the movement of the _____ _______ and ______ and also sees if the ______ is midline by having the patient say AH
soft palate and pharynx, uvula
45
glossopharyngeal and vagus nerve test the ______ reflex
gag
46
glossopharyngeal and vagus nerve check to see if the voice is hoarse or nasally by having the patient say which 5 letter sounds?
k, q, ch, b, d
47
glossopharyngeal and vagus nerve check to see if the patient has any problems ______
swallowing
48
spinal accessory CN checks for atrophy or asymmetry in the ______ muscles
trapezius
49
2 ways to test trapezius muscle use for spinal accessory CN
shrug shoulders and turn head against resistance
50
the hypoglossal CN tests for ________ of words
articulation
51
3 tests to test articulation of words with hypoglossal CN
say la la la la
protrude tongue
move tongue side to side
52
4 tests done to test gait for cerebellar function
heel to toe walking
walk on heels
walk on tiptoes
hop
53
test done where the patient stands with feet together and eyes closed to see if they can keep balance
romberg test
54
wide-based, staggered, unsteady gait
cerebellar ataxia
55
2 things that cause cerebellar ataxia
cerebellar disease and intoxication
56
shuffling gait with stooped posture and flexed hips and knees
parkinsonian gait
57
gait with flexed arm close to body and one leg/foot is dragging behind
spastic hemiparesis
58
a ________ can cause spastic hemiparesis
stroke
59
for the sensory exam, you test the _____, _____, and ______
legs, arms, and abdomen
60
all sensory tests are done with eyes _____
closed
61
6 sensory tests
light touch
superficial pain test (sharp dull)
vibration sense
motion and position
stereogenesis
graphesthesis
62
test where you put the patients finger up or down and they have to tell you what you are doing
motion and position test
63
test where you put an easily identifiable object in the patients hand and have them identify it
stereogenesis
64
test where patient closes their eyes and you draw something in their hand and they have to tell you what you drew
graphesthesia
65
deep reflexes in the upper extremities
biceps, triceps, and brachioradialis
66
deep reflexes in the lower extremities
knees and achillies
67
grade ___ reflexes are present, but diminished
1
68
grade __ reflexes are normal
2
69
grade __ reflexes are mildly increased
3
70
grade ___ reflexes are marked hyperactive
4
71
5 things that can cause hypoactive reflexes
hypothyroidism
hypocalcemia
hypermagnesemia
sedation
increased intracranial pressure
72
3 things that can cause hyperactive reflexes
hyperthyroidism
hypercalcemia
hypomagnesium
73
______ reflex is when you run something along the bottom of the foot
plantar
74
normal plantar reflex in adults
toes curl up
75
abnormal plantar reflex in adults
Babinski's
76
meningeal irritation is caused by ______ of the meningeal lining
infection
77
_______ _____ is when the neck is stiff and patients have trouble bending chin to chest
nuchal rigidity
78
_______ sign is when there is pain when trying to extend a flexed knee
Kernig's
79
_______ sign is when the knees and hips flex when you bring your chin to you chest
Brudziniki's
80
changes in temperature control, mood, and sleep result from changes in _________
neurotransmitters
81
total brain weight _____ with age
decreases
82
memory _____ as you age and learning time ______
decreases, increases
83
CVA can occur when cerebral blood vessels become occluded by a ____ or ______
thrombus or embolus
84
CVA can happen when an intracranial hemorrhage occurs leading to ______ of the brain tissue
ischemia
85
organs in the right upper quadrant
liver and gallbladder
86
organs in left upper quadrant
spleen and pancreas
87
organs in right lower quadrant
appendix
colon
ureter
ovary
spermatic cord
88
organs in left lower quadrant
colon
ureter
ovary
spermatic cord
89
the kidneys are in the _________ area
retroperitoneal
90
kidney that is lower than the other
right
91
coffee ground emesis indicates _______
blood
92
bright red blood in feces indicates an _______ ______
external hemrrhoid
93
tarry black stool indicates a _______ ______ ______
upper GI bleed
94
fatty stool indicates problems with the __________
gallbladder
95
hepatitis risk factors
blood transfusion
tattoos
IV drugs
piercings
96
when assessing the abdomen, position the light across the abdomen at a _____ angle
right
97
position for abdominal exam
supine with knees bent
98
abdomen concaving inwards
scaphoid
99
how to test for abdomen musculature
patient lift head and shoulders off the bed
100
how to test for abdomen bulges
patient hold breath and lift head and shoulder off bed
101
color that indicates bleeding under the skin
purple
102
pale and taught abdomen indicates _______
acsities
103
ability to see food or poop moving through the GI tract
visible perstalsis
104
it is normal to see slight _______ ______ above the belly button
aortic pulsations
105
6 F's of distention
fat
fluid (ascites)
flatus (gas)
feces (constipation)
fetus
fibroids
106
ascites is usually seen in ____ _____ disease
advanced liver
107
use the _______ of the stethoscope to listen to bowel sounds and the _______ to listen to vascular sounds
diaphragm, bell
108
less than ___ sounds is hypoactive bowel sounds
5
109
greater than ___ sounds is hyperactive bowel sounds
35
110
borborygmi
growling of the stomach
111
3 reasons for hyperactive bowel sounds
gastroenteritis
diarrhea
laxative use
112
2 reasons for hypoactive bowel sounds
paritonitis and paralytic ileus
113
you must listen to bowel sounds for at least ___ minute
1
114
for you to document no bowel sounds, you must listen for ___ minutes
5
115
bruits may be normal in the _______ area of the abdomen
epigastric
116
bruit over the aorta in the abdomen may indicate an ________ or _______
aneurysm or stenosis
117
abnormal sound heard over the umbilicus
venous hum
118
venous hum may be caused by _______ ______ ________ because of liver cirrhosis
obstructed portal circulation
119
sound caused by visceral layers of the peritoneum rubbing over the liver or spleen
friction rub
120
percuss the ______ ______ quadrant under the rib cage to find the liver
upper right
121
when you percuss the liver, you should hear _______
dullness
122
liver span
6-12 cm
123
for the spleen, percuss the last ______ ______ at the ________ _____ line while the patient takes a deep breath
left interspace, anterior axillary
124
when you percuss the spleen, you should hear ________
tympany
125
if you hear dullness when percussing the spleen, it means it is _______
enlarged
126
mono can cause an enlarged _______
spleen
127
percuss the _______ _____ quadrant at the _____ ______ anterior rib cage and ________ _____ region
left upper, left lower, left epigastric
128
to percuss the kidney for pain, place your hand at the __________ ______ and strike it with the _____ surface of your other hand
costovertebral angle, ulnar
129
pyelonephritis
infection of the kidney
130
2 cases in which you will not do deep palpation
aortic aneurysm and splenomegaly
131
light palpation is ___ cm
1
132
light palpation determines _____ and _______ of skin
tenderness and temperature
133
tensing of rectus muscles during palpation that indicates pain
abdominal muscle guarding
134
abdominal muscle guarding can indicate inflammation of the _______
peritoneum
135
deep palpation is __ cm
5
136
deep palpation is used to assess for _____
masses
137
2 methods used to palpate the liver
bimanual and hook method
138
when you stand behind patient and reach under the ribs to feel for the liver
hook method
139
it is abnormal if you can palpate the liver below the _______ _____ and if there are ______ ______ and _____
costal margin, irregular borders and nodules
140
lower border of liver should descend ______ to ____ inches (_____ to ___ cm)
0.75 to 1.25 inches
2 to 3 cm
141
the spleen is felt in the _______ _____ quadrant
left upper
142
4 causes of an enlarged spleen
CHF
cancer
cirrhosis
mononucleosis
143
the kidneys and the spleen are usually not ______
palpable
144
3 reasons the kidneys may be palpable
hydronephrosis
tumors
polycystic kidney disease
145
the aortic pulsation should be no larger than __ cm
4
146
nodular or asymmetric bladder could mean there is a _____
tumor
147
if you can palpate a recently emptied bladder it could mean _______ _____
urinary retention
148
if there is urine in the bladder, you will hear ______ upon percussion
dullness
149
special test for ascites where you press down and watch for movement across stomach
fluid wave test
150
percussion test done to assess ascites
shifting dullness
151
test done to assess for abdominal inflammation
rebound tednerness
152
if there is inflammation, when performing the rebound tenderness test, the patient will feel pain when pressure is ______
released
153
in the rebound tenderness test, apply pressure at a _____ degree angle
90
154
2 tests done for appendicitis
psoas sign and obturator muscle test
155
in the psoas sign, the patient is ______ and does a ______ _____ raise against resistance
supine, straight leg
156
in the obturator muscle test, the patient is supine and flexes the leg at the ____ and ____ and does _____ and _____ rotation
knee and hip, external and internal
157
cholecystitis
inflammation of the gall bladder
158
test for cholecystitis
murphy's sign
159
in the murphys sign, you will use the _____ method and have them take a deep breath at the same time
hook
160
measure abdominal girth while patient is ______
standing
161
4 causes of liver disease
hepatitis
cirrhosis
tylenol overdose
antibiotics
162
excessive alcohol consumption can cause ______ of the liver
cirrhosis
163
abdominal pain with stomach ulcers may improve after ______ and be worse at _____
eating, night
164
a patient with a stomach ulcer may have ______ aka black poop
melana
165
5 causes of peptic ulcer disease
stress
H-pylori bacteria
NSAIDs
smoking
alcohol
166
meds for peptic ulcer disease
proton pump inhibitors
H2 blockers
167
when you age, you _____ lining becomes less elastic
mucousal
168
outpouching of intestinal wall caused by age
diverticula
169
2 infections that increases your risk of cervical cancer
human papillomavirus infection
HIV infection
170
females between ages ___ and ___ are most at risk for cervical cancer
50 and 55
171
a diet low in ____ and _____ increased risks for cervical cancer
fruits and vegtables
172
using oral contraceptives for more than _____ years increases risk for cervical cancer
5
173
3 races more likely to get cervical cancer
african america
hispanic
native american
174
you can only used _____ based lubricant for genital exams
water
175
position of patient during female genital exam
lithotomy
176
observe the mons pubis for _______ and _______
hair and infestation
177
swelling and pain or the labia can result from ______
gonorrhea
178
drainage from the urethra can be caused by ______ or _______
gonorrhea or chlamydia
179
small, painful, red ulcers on the labia are caused by ______ _____
herpes simplex
180
silvery white papules that develop into red moist ulcers are caused by ________ ______
syphilitic chancre
181
fleshy lesions on the labia are genital warts caused by _____
HPV
182
when the bladder bulges into the anterior wall of the vagina
cystocele
183
when the rectum bulges into the posterior wall of the vagina
rectocele
184
when the uterus protrudes into the vagina
uterine prolapse
185
mucopurulent yellow discharge is seen in ________ and ______
gonorrhea and chlamydia
186
yellow-green, frothy, foul-smelling discharge is seen in _______
trichomonas
187
thick, white, cheesy discharge is seen in ______
candidiasis
188
think, grey, fishy smelling discharge is seen in ________ ______
bacterial vaginosis
189
beta blockers can cause ______ ______ in men
erectile dysfunction
190
the shaft should be _____, ______, and not _____
soft, flaccid, tender
191
silvery white papule that turns into red ulcers on the penis
syphillitic chancre
192
clusters of pimple like clear vesicles that erupt and become ulcers on the penis
herpes progentitalis
193
fleshy papules on the penis
genital warts
194
hardened nodule or ulcer on the glands indicates _____
cancer
195
foreskin that cannot be retracted from the glands
phimosis
196
urethral meatus is on the bottom side of the glans
hypospadias
197
urethral meatus is on the upper side of the glands
epispadias
198
cryptorchidism
undecsended testicles
199
collection of fluid in the scrotal sac
hydrocele
200
loop of bowel in the scrotal sac
scrotal hernia
201
infection of scrotum
epididymitis
202
when blood supply is cut off from scrotum - emergency
torsion of spermatic cord
203
self testicular exam is perform once a _____ after a warm shower
month
204
ask the patient to bear down and observe for _____ around the anus
bulging
205
_______ external hemrroids contain blood and are painful
thrombosed
206
cavity of pus at anal opening
perineal abscess
207
split of anal tissue of the anal canal
anal fissure
208
a normal prostate has 2 _____ ____ and is divided by a _____
lateral lobes, sulcus
209
swollen tender prostate
prostatitis
210
enlarged, smooth, firm prostate with no sulcus
benign prostatic hypertrophy
211
hard are of prostate or hard fixed nodules
cancer
212
3 risk factors for HIV/AIDS
anal
IV drug use with shared needles
multiple sexual partners
213
3rd most common cancer in men and women
colorectal cancer
214
people over the age ____ are at risk for colorectal cancer
40
215
diets of only animal sources put you at risk for ______ cancer
colorectal
216
people from _____ ____ ____ decent have a greater risk of getting colorectal cancer
eastern european jewish
217
2nd leading cause of cancer death in men
prostate cancer
218
men over the age of _____ have a greater risk of prostate cancer
50
219
______ ____ have a greater risk for prostate cancer
african americans
220
women over the age of ___ are more at risk for breast cancer
50
221
___% of breast cancer cases are women
99
222
breast cancer death rates are higher in ______ _______ than white people
african american
223
up to ___% of breast cancer cases are thought to have a genetic link
20
224
menarche before age ___ puts you at risk for breast cancer
12
225
pregnancy after _____ or nulliparous (no pregnancy) puts you at higher risk for breast cancer
30
226
menopause after age ___ puts you at higher risk for breast cancer
55
227
2 different types of medications that can increase your risk for breast cancer
oral contraceptives
hormone replacement therapy
228
if you have average risk for breast cancer, then you should have the choice to start getting MMG between ages ___ and ___
40 and 44
229
women of average risk for breast cancer between the ages ____ and ____ should get a MMG annually
45 and 54
230
women over the age of ____ that are average risk for breast cancer should get a MMG every 2 years
55
231
for women of average risk, screening should try to continue annually as long as they are in good health and expected to live ____ years or longer
10
232
women who are a high risk for breast cancer should get a MMG and a ____ every year
MRI
233
women who are high risk for breast cancer have a lifetime risk of ___ to ___ percent or greater based on measuring tool
20 to 25
234
you are high risk for breast cancer if you have the ______ or ______ gene mutation OR you have a first degree relative with the gene mutation
BRCA1 or BRCA2
235
if you have had radiation therapy to chest between the ages ____ and ____ then you are at high risk for breast cancer
10 and 30
236
the american cancer society reccomends against MRI screening for people with a lifetime risk lower than ____%
15
237
for women of high risk for breast cancer, MMG and MRI screening should start at age ___ and continue annually
30
238
2 things that can worsen fibrocystic diseases
chocolate and caffeine
239
common cause of bump on armpit
folliculitis
240
enlargement of one or both breasts in men
gynecomastia
241
the upper outer quadrant of the brast contains the _____ ____ _____
tail of spence
242
most common area of the breast for tumors
upper outer quadrant
243
when documenting the abnormal finding of a breast, you note what quadrant and how many cm away from the _______ it is
nipple
244
it is normal for the breast on the ______ side to be bigger
dominant
245
asymmetrical deviation of the nipple can be a sign of ______
cancer
246
pigmentation of the nipple is enhanced during _______
pregnancy
247
it is normal to have ________ nipples
supernumeray
248
thickening of the skin and edema that have enlarged pores
Peau d' orange
249
infection caused by breast feeding
mastitis
250
nipple inversion is a ______ finding
normal
251
if the nipple inversion becomes broader and deeper it may indicate a _______
tumor
252
disease where there is consistent eczematous dermatitis of the areola and nipple region that is usually unilateral
Paget's Disease
253
pagets disease is caused by a ______ ______
malignant neoplasm
254
pagets disease is most common in _____ _______ women
post menopausal
255
4 positions to assess retracting or dimpling of breast tissue
arms over head
hands on hips
hand pressed together
leaning forward
256
axillary lymph nodes should be less that ___ cm, nonpainful, and mobile
1
257
nodes that are fixed, firm, irregular, and larger than 1 cm may be caused by ________ to _______ _______
metastasis or primary lymphoma
258
enlarged, painful, tender axillary nodes that are matted together can be a ______ ______ or ______
systemic infection or cancer
259
if the _________ ducts are inflamed it can cause tenderness
lactiferous
260
erythema with swelling of the breast with pitting edema can be ________
mastitis
261
mastitis is caused by ________ ______
staph aureus
262
it is best to perform BSE ___ days after menses or anytime you are not menstrating
8
263
if you are post-menopausal, perform BSE on the the ____ day every month
same
264
non-cancerous breast conditions account for ___% of clinical breast problems
90
265
atrophic changes to female breasts occur from age ___ and on
40
266
as glanduar breast tissue atrophies, it is replaced with ______ and ______ tissue
fat and connective
267
any disease that is breast related problem not related to cancer
benign breast disease
268
______ changes are multiple benign masses caused by ductal enlargement and formation of fluid-filled sacs
fibrocystic
269
fibrocystic cysts often fluctuate in size in tenderness with ______ _____
menstrual cycle
270
common benign breast tumor in young women
fibroadenoma
271
fibroadenomas are made of ______ and ____ tissue
glandular and fibrous
272
fibroadenomas are usually _______ and nontender
unilateral
273
inflammatory condition of the breast that is usally caused by a bacterial infection
mastitis
274
mastitis usually occurs in ______ women
lactating
275
in non-lactating women, mastitis can occur as a result of ______
trauma
276
term for inappropriate lactation
galactorrhea
277
galactorrhea can be caused by a ______ tumor
pituitary
278
galactorrhea can be caused by ______ failure
renal
279
gynecomastia can occur in newborns because of _________ hormones
maternal
280
gynecomastia can be caused by ______ or _______ tumors
adrenal or testicular
281
gynecomastia can be caused by ______ or ______ disease
renal or liver
