HA Final Flashcards
(150 cards)
1
Q
artery is somewhat obstructed, increased risk of stroke (don’t mistake this w/ murmur), swooshing sound
A
bruits
2
Q
nail abnormality due to chronic hypoxia to distal fingers (pts w/ COPD, emphysema, congestive heart failure)
A
clubbing
3
Q
nail abnormality d/t chronic renal failure (proximal white, distal brown)
A
half and half nails
4
Q
nail abnormality d/t slowed or halted nail growth (w/ deep horizontal line) in response to illness, physical trauma, or poisoning
A
Beau’s line
5
Q
what causes longitudinal ridging nails
A
aging
6
Q
nail abnormality d/t lesions from psoriasis, crating on nail bed
A
pitted nails
7
Q
nail abnormality that is spoon-like (indentation) d/t trauma, iron deficiency aka hemochromatosis (may be normal in infants) or anemia .. nail is lifted along edgers, indented near center
A
Koilonychia
8
Q
nail abnormality where nail plate and nail bed separation d/t trauma, fungal infections, topical irritants, psoriasis, sublingual neoplasms or warts
A
Onycholysis
9
Q
what causes yellow nails
A
lung disorders or lymphedema
10
Q
this nail abnormality is normal in dark-skinned pts
A
Dark longitudinal streaks
11
Q
this nail abnormality is d/t damaged capillaries supplying the nail matrix caused by micro emboli
A
splinter hemorrhages
12
Q
s/s of hypothyroidism
A
weight gain, fatigue, constipation, cold, large neck goiters, dysthymia (depression), dry skin, brittle nails, low b/p, low HR,
high TSH, low T3/T4
13
Q
s/s of hyperthyroidism
A
weight loss, heat intolerance, tachy (high HR), high bp, warm aka heat intolerance, oily skin/hair, anxious, energetic, hyper,
low TSH, high T3/T4
14
Q
method used to test peripheral vision
A
Confrontation
15
Q
this is used to test near vision
A
jaeger chart
16
Q
this is used to test color blindness
A
Ishihara chart
17
Q
this is used to test distance vision, most common eye exam
A
Snellen chart
18
Q
referred to as lazy eye
A
Amblyopia
19
Q
term for eye strain
A
Asthenopia
20
Q
exposure to UV can cause this (foggy/cloudiness/dull), it obstructs light that is going through the eyes
A
cataracts
21
Q
normal part of aging for eyes
A
decreased depth perception & decreased night vision
22
Q
this is nearsightedness aka can only see close up
A
Myopia
22
Q
this is term for far sighted, so pt can only see far, due to aging
A
Presbyopia
23
Q
2 types of hearing loss
A
conductive- blockage in ear like cerumen, hearing loss can be reversed .. middle/external ear
sensorineural- due to loud noises, hearing loss can’t be reversed, inner ear
24
Webber vs. Rinne Test
Webber: tuning fork goes on the middle of the head.. evaluates unilateral hearing loss.. determines if someones has SNHL or conductive HL
Rinne: tuning fork is placed behind the ear on the MASTOID PROCESS once , evaluates AC & BC (AC should be twice as long as BC)
25
epistaxis
nose bleeds
26
anosmia
loss of smell
27
3 sinus locations
frontal, maxillary, ethmoid
28
pt w/ allergies might have hx of what?
frequent upper respiratory infections
29
6 Ps of acute arterial occlusion
1. Pain
2. pallor (pale)
3. poikilothermia
4. paresthesia (tingly)
5. pulselessness
6. paralysis
30
coolness of an extremity may indicate this
other s/s include: pain, paresthesia (tingly), pallor (pale)
arterial occlusion
31
difference between DVT vs acute arterial occlusion
DVT- clot that forms in vein
erythema (red)
acute arterial occlusion- blockage in peripheral artery impacting flow to limbs
pallor (pale)
32
this is the result of a DVT, when the DVT breaks free & starts traveling which could lead to a PE (to lung) or MI (to heart) or stroke (to brain)
VTE (venous thromboembolism)
33
This is louder in aortic and pulmonic areas
S2
34
This is louder in mitral and tricuspid areas
S1
35
S1 & S2 are equal at this location
Erb's pt
36
the amount of pressure in the great vessels, arteries/arterioles, the resistance
Afterload
37
the volume in the right atrium at the end of diastole, an indicator of how much blood will be forward to & ejected from the ventricles. More blood in the RV causes a stronger force of contraction
Preload
38
amount of blood ejected from LV each minute. It can be calculated by multiplying HR x stroke volume (How much blood is ejected with each beat or stroke)
cardiac output
39
3 layers of heart
Endocardium: thin; lines interiors of chambers, valves
Myocardium: thick; muscular for pumping
Epicardium: thin; muscle, exterior layer
40
dark brown leg due to old blood, warm and pink leg
venous insufficiency
41
pale, cold, pulseless leg
arterial insufficiency
42
this is the change in arterial blood flow d/t plaque, resulting in coolness, paleness, lower HR, paresthesia (tingling), hypoesthesia (numb)
PVD (peripheral vascular disease)
43
how does the PVS work (Peripheral vascular system)
blood vessels that carry oxygenated blood away from the heart to the periphery and carry deoxygenated blood back to the heart and to the lungs for reoxygenation
44
diastole vs systole
diastole: where the heart chamber is in a state of relaxation and fills with blood that receives from the veins
systole: where the heart chambers are contracting and pumps the blood towards the periphery via the arteries
45
abdominal vs lung assessment
abdominal:
1. inspect
2. auscultate
3. percuss
4. palpate
lung:
1. inspect
2. palpate
3. percuss
4. auscultate
46
DTR grading
*0 no response
*1+ diminished, low normal
*2+ average, normal
*3+ brisker than average
*4+ very brisk, hyperactive with clonus
47
RA vs OA
RA- systemic s/s include fatigue, fever, rash, splenomegaly, subcutaneous rheumatoid nodules, lymphadenopathy. Joints are more symmetrical, often in smaller joints, ulnar deviation, joint pain/tenderness, redness, swelling, joint deformity, worse in the AM and gets better with movement.
OA- not systemic s/s joints are less symmetrical, minimal redness, heat and swelling of joints. worsens throughout day and worsens with movement.
48
venous vs arterial ulcer
Venous ulcer- develops from chronic pooling of blood in extremity. Usually painless. Larger, more shallow.
Arterial ulcer- result from chronic ischemia as a consequence of impaired arterial circulation to an extremity. Usually located distally, such as at the ends of toes or fingers. Painful and usually infected. Smaller, deeper.
49
branden scale
tool used to assess pt's risk for developing pressure ulcer
higher score (over 18) = less at risk
lower score (under 9) = high risk
50
sign of Lyme disease
bull's eye rash
51
main 2 female hormones
estrogen and progesterone
52
this test tests for collateral circulation of radial & ulnar arteries, performed prior to drawing ABGs or insertion of an arterial line
Allen test
53
3 things GCS evaluates ...?
what does the score mean?
1. eye response (do their eyes respond to voice, pain, touch, nothing, etc)
2. motor response (what movement do they make)
3. verbal response (do they talk/nonverbal)
** 3 = deep coma, 15 = normal
54
burn classifications (fine to worst)
1. superficial (brisk bleeding, pain, rapid cap refill)
2. superficial dermal (brisk bleeding, pain, slow cap refill)
3. dermal (delayed bleeding, no pain, no cap refill)
4. full thickness (worst one, not painful and no bleeding)
55
3 layers of skin
1. Epidermis, the top layer (protective barrier)
2. Dermis, the middle layer (collagen/elastin, produces sweat/oil)
3. Hypodermis, the bottom or fatty layer (cushions muscles and bones)
56
what kind of pt would have ascites?
pts with cirrhosis secondary to chronic alcoholism
57
location of appendix pain
McBurney's point , near RLQ umbilical and ileac crest ... this would be painful for appendicitis
58
what are the 2 signs for appendicitis?
Psoas sign: place hand right above pt’s right knee and ask them to raise that thigh against your hand, extend the right leg at the hip to stretch the iliopsoas muscle (if painful then positive for appendicitis)
Obturator sign: flex the pt’s right thigh at the hip w/ the knee bent and rotate the leg internally at the hip stretching the internal obturator muscle (if painful then positive for appendicitis)
59
what does it mean for a positive Murphy's sign?
cholecystitis
60
pt is having right abdominal pain that radiates to the right scapula .. what could be wrong?
cholecystitis
61
vibration, have pt say "99" and feel for vibrations using ulnar surfaces
Tactile fremitus /
Bronchophony
62
breath sounds
Bronchial BS– over the trachea and larynx, loud, coarse high pitch
Broncho vesicular BS – over major bronchi
Vesicular BS – soft, low-pitched, found at distal airways
63
PNA, fluid in lung, or collapse of lung, consolidation
atelectasis
64
feels like Rice Krispies or bubble wrap, can't see it but CAN feel this air leak
crepitis
65
what part of lungs is responsible for gas exchange?
Bronchioles and alveoli responsible for gas exchange
66
PNA will congregate where?
lower lobes first then go up, more common in right lung!
67
boney ridge that joins the sternum to the manubrium
sternal angle AKA Angle of Luis or Manubrio
68
S3 vs S4
S3 = ventricular gallop
Kentucky
S4 = Atrial gallop
Tennessee
69
normal BMI
19 - 24
underweight = less than 18
obese = over 30
extreme obese = over 40
70
how would you measure fluid volume overload?
by obtaining jugular venous pressure (JVP)
71
what is the main trigger for breathing?
increased level of CO2 in blood
*(but not COPD pts due to them already having increased CO2 in their blood
72
pneumonia is more likely to be found in which lung?
right lung bc it's larger
73
mitral & tricuspid valve closure, occurs during systole
S1
74
sounds like balloons high pitched, scratching, grating. Heard at the left sternal border.
pericardial friction rub
75
diastole, the relaxation phase
S2
76
Systole, the contraction phase
S1
77
what is the carina?
where the bronchi bifurcate
78
aortic & pulmonic valve close. this occurs during diastole
S2
79
mitral stenosis, quickly after S2, hard to differentiate, sudden bulge of aortic or pulmonic valve
snaps
80
heart disease, aortic or pulmonic valve, quickly after S1
clicks
81
heart sound heard in pregnant women or athletes, S3 gallop happens before S2, S4 gallop occurs before S1
gallops
82
continuous, coarse, low pitched snoring sound, results from secretions moving around, may clear w/ coughing
rhonchi
83
musical & high pitched, narrowing or partially obstructed airway, typically occurs w/ inspiration
wheezes
84
fluid in airway, velcro sound, chest hair can sound like this too
crackles, rales
85
percussion sounds
-resonance (loud, low pitched heard over lung tissue)
-tympany (loud, higher pitched sound over air filled spaces)
-dullness (heard over solid spaces)
-flat (higher pitched over dense tissue like pleural effusions & ascites)
86
sympathy vs empathy
sympathy = feeling what the pt feels, you're not being therapeutic bc you're interpreting the situation as YOU perceive it
empathy = feeing what the pt is feeling from THEIR perspective, keeps the focus on the pt & what they're feeling
87
Pain in the epigastric area that radiates to the scapula with SOB aka dyspnea , sharp and stabbing pain!
this might be a sign of an aortic aneurism (ruptured aorta)
88
skin of elderly
dry, no hair, shiny due to poor venous blood flow
89
pitting vs non pitting edema, what's the scale
pitting- leaves fingerprint
non pitting- does not leave mark
pitting scale:
1+ slight pitting, 2mm depression
2+ increased pitting, 4mm depression
3+ deeper pitting, 6mm depression, obvious edema of extremity
4+ severe pitting, 8mm depression, extremity appears very edematous
90
what can lead to odynophagia (painful swallowing) or dysphagia (difficulty swallowing)
GERD, Parkinson’s disease, hiatal hernia, stroke pts
91
pinpoint of cervical/spine
C7
92
Need to assess respiratory first if this area is injured
C4 and above
93
where is the Dorsalis pedis pulse
top of foot lateral to extensor longus tendon
94
what can cause enlarged spleen and enlarged liver
spleen - EBV
liver- cirrhosis or hepatitis
95
s/s of a PE resulting from a DVT
acute dyspnea (SOB), chest pain, tachycardia (high HR), diaphoresis (sweating), anxiety
96
difference between Dysphagia vs Odynophagia
Odynophagia - painful swallowing
Dysphagia - difficulty swallowing
97
s/s of venous stasis?
swelling/edema in legs, shiny skin, no hair growth, red/brown color due to old blood
pt can also get ulcers due to impaired skin integrity
98
what is a pt at risk for if venous stasis occurs?
at risk for impaired skin integrity which can cause ULCERS
**due to lack of O2 rich blood flow to capillaries in tissue (slow death of tissues)
99
how to assess thyroid gland
1. thyroid cartilage (at top)
2. cricoid cartilage (aka Adam's apple)
3. thyroid gland (at bottom)
100
3 types of sweat glands
-Eccrine: sweat secretion, assist in thermoregulation
-Apocrine: located in axillae and genital areas, active during puberty- the stench! decreases w/ age
-Sebaceous: secrete sebum (oily substance that hydrates skin), decrease w/ age
101
clear/slightly yellow tinged fluid filled blisters less than 1cm (small!)
aka serous fluid filled vesicles
chicken pox
102
type of rash that is clear/blister like appearance
vesicular rash
103
refers to a pattern of skin lesions that resemble the distribution of herpes zoster (shingles), distributed along dermatome, specific area of skin that is innervated by a single spinal nerve root
*unilateral on one side of body
*vesicular (blister-like) rash, serous fluid
Zosteriform
104
ABCDE of Melanoma detection
-Asymmetric
-Borders (irregular)
-Color (coffee, multicolor, blue, green)
-Diameter (more than 6mm aka bigger than pencil erase)
-Evolution (change is bad)
105
high pressure in eye, causes tunnel vision, damage to optic nerve
glaucoma
106
involuntary twitching
fasciculation
107
involuntary/ voluntary contraction
tremor
108
what causes ptosis?
stroke, MS
109
intentional vs resting tremors
intentional - worse w/ movement, better at resting
resting tremor - Parkinson's , tremors get better w/ movement.. worse w/ rest
110
this is caused primarily by brain edema, tumors, trauma
symptoms include mobility issues, severe case of this is stiff neck before going unconscious
cerebellar herniation
111
this is irregular gait...
what can cause this?
-ataxia is irregular gait
-can be caused by vestibular abnormality aka inflamed labyrinth which causes vertigo
112
this is known as "sway back", the spine is curved inward
Lordosis
113
most common site of anterior nosebleeds aka epistaxis
Kiesselbach plexus
114
dry mouth
xerostomia
115
this test evaluates high pitched hearing loss
whisper test
116
this is thought to be an inability to filter internal noise from the external input of sound.. ringing in the ear
tinnitus
117
this is the sensation of the room spinning, indicates dysfunction of the bony labyrinth in the inner ear
vertigo
118
these may indicate barotrauma from pressure changes or a basilar skull fracture
hemotympanum, otorrhea, or TM rupture
119
the term for unequal pupils
anisocoria (defect in oculomotor nerve)
120
this condition causes blurred distance and near vision
astigmatism
121
this condition is where your eyes make rapid, repetitive, uncontrolled movements
nystagmus
122
How many spinal nerves are there? What are the 5 regions?
31 spinal nerve pairs
1. Cervical (C1-8)
2. Thoracic (T1-12)
3. Lumbar (L1-5)
4. Sacral (S1-5)
5. Coccygel (Co1)
123
What is the name of the fall risk scale?
Morse Palmer Scale
124
This is what connects the muscle to the bone
tendon
125
what are physical signs of dehydration
-dry skin
-cracked/dry lips
-increased HR
-lower B/P
126
what separates the middle and external ear?
the tympanic ear drum
127
the test evaluates cortical sensory function and is not usually done. ask the pt to close the eyes and identify a familiar object (coin, key) placed in their palm
stereognosis
128
a pt will have control of their legs and walk, but may have loss of bowel and bladder control with this type of injury
S4-5 (sacral) injury
129
a pt will have arm movement and sensation, but no leg movement & will be in a wheelchair with this type of injury
T5 (thoracic) injury
130
a pt will not be able to cough or breathe on their own with this type of injury
C3 (cervical) injury
131
what can cause herniation of the brain which can lead to change in basic vital functions such as breathing, reduced LOC, death
increases in CSF
132
what is global aphasia
both expressive and receptive aphasia
133
a pt that has damage to their Broca area (frontal lobe) causes what?
problems with speaking or finding words aka expressive aphasia
134
a pt w/ a stroke in the brain's left hemisphere/temporal are more likely to have what?
damage to the wernicke area so will have language deficits- difficulty understanding verbal communication aka receptive aphasia
135
broca vs wernicke
wernicke- integrates understanding of spoken and written words (language is processed).. temporal lobe/ left hemisphere
broca- regulates verbal expression and writing ability.. the frontal lobe
136
this area regulates verbal expression and writing ability, the frontal lobe
broca area
137
this area integrates understanding of spoken and written words, language is processed here in the temporal lobe/left hemisphere
wernicke area
138
type of flexion that moves the foot so that the toes move away from the heel
plantar flexion
139
type of flexion that is bending the ankle so that toes move toward the heel
dorsiflexion
140
these are synovial (diarthrotic) joints known as the gliding joints
intervertebral
**Gliding joints are numerous, mostly small, allow very little motion.
Ex: carpal joints of the wrist, the tarsal joints of the ankle, and the facet joints of the spine
141
these are synovial (diarthrotic) joints known as saddle joint
thumb
142
these are synovial (diarthrotic) joints known as the condyloid joint
wrists
Condyloid joints perform flexion, extension, abduction, and adduction movements.
143
these are synovial (diarthrotic) joints that are known as the pivot joints
***allows bone rotation about another bone
atlas & axis
**this is the 1st & 2nd cervical vertebrae directly under the skull... allows for turning of the head from side to side
144
these are synovial (diarthrotic) joints that are known as the ball and socket joints
hip and shoulder
145
these are synovial (diarthrotic) joints that are known as the hinge joints & only perform flexion and extension
knee and elbow
**extension - increases angle
**flexion- decreases angle between bone or brings bones together
146
what is the area where two bones come together, what is it's function
joint, provides mobility to the skeleton
147
if a patient had a hip replacement, what should they not do when it comes to ROM? & why?
they should not test adduction or flexion greater than 90 degrees b/c it could cause dislocation
148
what are signs of meningeal irritation? (spinal cord meninges / intracranial hemorrhage)
-Flexion of the knee when the leg is pulled up, pt will also have stiffness in neck (nuchal rigidity) w neck pain (kernig and brudzinski signs)
-photophobia
-headaches
-fever
149
A condition that affects the arteries, causing them to narrow or become blocked.
Peripheral arterial disease (PAD)
