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Cardio-Pulmonary > Manual - Non-Specific Evaluation > Flashcards

Manual - Non-Specific Evaluation Flashcards

1
Q

skipped past all the introduction and set up bullshit portion of the manual (page 17-25)

A

what the fuck are we even doing in this class? who knows? maybe this helps? probably wont

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2
Q

sequential steps of non-specific evaluations

A

assess vitals
assess hinderances / deficits
evaluate gross ROM
evaluate gross strength
evaluate trunk stability in sitting
assess functional ability
assess transfer ability
assess gait
assess sensation

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3
Q

when assessing vitals, which vitals are being observed

A

HR
BP
O2 sat
RR
temperature

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4
Q

when assessing vitals, what are we looking to observe

A

various trends in vitals

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5
Q

how to assess vision in a very general sense

A

have patient track object in H test

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6
Q

how to assess hearing in a general sense

A

rub fingers near one ear and compare to the other

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7
Q

how to assess cognition/communication in a general sense

A

alert and oriented questions

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8
Q

what is important to document when assessing ROM

A

if active or passive

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9
Q

when assessing bed mobility, which motions should be tested

A

scooting up / down
rolling side to side
supine to sit or side to sit
sitting to supine

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10
Q

when assessing gait, what should be observed before actually walking

A

assistance needed for sit to stand

static standing ability (need for assistance)

pre-gait activities (marching or weight shifts)

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11
Q

upon general survey of patient, what are you looking for observationally

A

signs of distress
facial expressions of pain
splinting/guarding of body parts
skin color
stature / posture
weight
grooming personal hygiene
speech/ state of awareness

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12
Q

when observing breathing, what can be noted

A

accessory muscles recruited
irregular breathing
labored breathing
frequent positional changes

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13
Q

when observing obesity, what can you ask that is more sensitive

A

asking what types of activities that individual is involved in

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14
Q

when observing cachexia, what can be asked that is more sensitive

A

labored breathing
signs of cancer? unexplained weight loss
diet or food availabilty

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15
Q

what can indicate cushing’s disease

A

central obesity
fatty pads near collar bone or back of the neck

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16
Q

what could diaphoresis indicate

A

extra breath work to compensate for reduced cardiac output

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17
Q

what could asymmetry indicate in breathing

A

atrophy/hypertrophy mismatch
impaired motor function
underlying pathology

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18
Q

explain head sizes

A

normocephalic = normal
microcephalic = smaller
hydrocephalic = larger

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19
Q

skin colors and their indications
- pale
- yellow
- ruddy
- dusky

A

anemic

jaundice (liver disorder, alcoholism)

elevated temperature, polycythemia, sun exposure

anoxic

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20
Q

when testing visual tracking, how can normal vs abnormal be documented

A

norm = EOMI–> extra-oculomotion intact

abnormal = EOML –> extra-oculomotion limited

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21
Q

PEARL means and indicates

A

pupils equal and reactive to light
normalcy

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22
Q

doll’s eyes means and indicates

A

pupils remain fixed and dilated

hypoxia

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23
Q

pinpoint pupils mean and indicate

A

pupils remain fixed and constricted

decreased neuro function

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24
Q

xanthelasma means and indicates

A

small flat yellow fat deposit on upper/lower eyelid

hyperlipidemia / premature heart disease

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25
corneal arcus means and indicates what? and is common in which populations
grayish white ring at junction of cornea and sclera caused by lipid deposits associated with hyperlipidemia common in elders and black people (she says Blacks, which seems aggressive)
26
cataracts are described as
an opacity of the crystalline eye lens, sometimes with a bluish tint
27
jaundice is detected where? and can indicate what
sclera due to increased destruction of RBCs can be caused by liver congestion, hepatitis, gall bladder disease of bile duct obstruction
28
what is strabismus
where the eyes do not align properly when focusing on an object
29
exophthalmos is ____ and indicates
outward bulging of entire orbit indicates hyperthyroidism
30
what to ask about when observing hearing ability
tinnitus earaches infections hearing aid
31
when observing the nose, what to look for
nasal flaring deviated septum evidence of trauma epistaxis, nosebleeds
32
when observing someone's breath, what can be found? what do these indicate
halitosis via - ketosis = sugary smell, possible DM2 - alcohol, you guessed it! being a drunk
33
abnormalities of the tongue and their indications
black - dehydration white - fungal infection bluish - cyanosis, anemia, respiratory distress
34
decreased skin turgor may indicate
dehydration
35
pallor of skin color can indicate
systemic chronic disease, possible anemia
36
flushed skin color can indicate
fever polycythemia emotion exertion
37
what color skin can be seen in those with CHF
cyanotic discoloration
38
how to estimate anemia
color of fingernail beds -- more reliable than skin color
39
where can pallor be seen best? why is this?
palms of hands -- hemoglobin levels falling will affect palms
40
what is presence of cyanosis dependent upon
absolute amount of un-oxygenated hemoglobin - not the ratio of oxygenated to un-oxgenated hemoglobin
41
explain presence of cyanosis in an anoxic patient vs polycythemic patient
anoxic patient may be impossible to be cyanotic polycythemic patient may appear cyanotic even though the O2 content of blood is normal
42
what causes peripheral cyanosis
slowed circulation through peripheral vascular beds capillaries will give away more oxygen than normal
43
what are the most frequent causes of cyanosis
cold and nervous tension low cardiac output -- possible peripheral vascular disease or deep vein thrombosis
44
why does central cyanosis occur? what can cause this?
low arterial oxygen saturation causing face and mucous membranes to be blue congenital heart disease / emphysema
45
petechiae is described as
tiny red or purple hemmorhagic spots caused by capillary bleeding with leakage of blood into the skin
46
how does petechiae occur / where does it typically occur? what can it indicate
in clusters / ankles and feet most often can be a sign of thrombocytopenia (low platelet count)
47
explain the pathophys of petechiae
low platelet counts = no clotting no clotting = blood escaping from capillaries blood from cap = blood into skin
48
what medications / disorders can cause petechiae
meds: anticoagulants aspirin steroids disorders: infection leukemia lupus scleroderma
49
jugular vein distension indicates
lying at 45° or higher indicates high venous pressure via CHF cor pulmonale vena cava obstructions
50
how to screen for increased venous pressure
observe veins in dorsum of hands with arms in dependent position - lying at angle of 30° or greater one arm is gradually and passively elevated to height of angle of louis note the point at which veins collapse in hands
51
interpretation of increased venous pressure screen
venous pressure increased if veins do not collapse when raised to angle of louis
52
explain transverse diameter to Anterior Posterior relationship of the chest
2:1 should be more laterally than depth
53
explain the normal angle of the ribs and abnormal angle
norm - 45° between ribs and spine ab - anything above that will indicate flattening of the ribs
54
paradoxical vs normal breathing
normal - inhalation will cause growth in size, exhalation will cause decrease in size paradoxical - inhalation causes decrease, exhalation causes increase
55
what is the point of maximal impulse? vital sign associated?
movement of heart against the chest wall where a rhythmic sharply localized thrust can be visualized best place of pulse rate
56
where is the point of maximal impact
mid clavicular line in 5th ICS
57
what is a quick screen for clubbing of the nails
having patient put DIP of contralateral fingers together and noting the shape of the space between should make a diamond, if not clubbing may be indicated
58
what is the pathophys of clubbing? where is it generally seen
cardiopulm disease tissue hypoxia and increased blood flow to extremities out of proportion to the needs of the issue increased blood will produce accelerated tissue growth thumb and index finger
59
explain angular differences in digital clubbing screen
angle between base of nail and skin next to cuticle normal = obtuse angle of 160° abnormal = angle of ≥180°
60
heberden's nodes are described as and indicate
firm fibrous nodules about DIP joints causing mushrooming of joints OA
61
what may indicate rheumatoid arthritis
bony disfigurement / displacement of MP and PIPs
62
tophi-fibrous node is described as and can indicate
articulation of great toe joints gout

Cardio-Pulmonary (21 decks)

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