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Health Assessment > Module 9 Part 2 > Flashcards

Module 9 Part 2 Flashcards

1
Q

AKA 6 cardinal fields of gaze

A

Extraocular Movements (EOM)

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2
Q

cranial nerves related to EOM

A

Cranial Nerves III (Oculomotor), IV (Trochlear), and VI (Abducens)

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3
Q

how do you check EOM

A

Stand or sit 3 to 6 feet in front of the person
Ask the person to follow your finger with their eyes without moving their head
Check gaze in the six cardinal directions using a six-sided cross or “H” pattern

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4
Q

how do you check convergence

A

by moving your finger toward the bridge of the person’s nose

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5
Q

how do you check for nystagmus

A

Hold gaze in the 4 corners momentarily

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6
Q

what cranial nerve is related to pupillary reactions

A

cranial nerve II

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7
Q

how do you check for pupillary reaction

A

Dim the room lights as necessary
Ask the person to look into the distance
Shine a bright light obliquely into each pupil in turn
Observe for constriction

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8
Q

how do you record the pupils

A

size in mm and any asymmetry or irregularity

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9
Q

how to check far-to-near reaction accommodation

A

Have the person look across the room
Then have her/him look at your finger about 10” in front of their nose
Watch for pupillary constriction

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10
Q

how to check near-to-far accommodation

A

Have the person look at your finger about 10” in front of their nose
Then have her/him look across the room
Watch for pupillary dilation

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11
Q

what is a common abbreviation for normal findings in pupils

A

PERRLA (Pupils Equally Round and Reactive to Light and Accommodation)

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12
Q

the fundus of the eye includes

A

retina, macula, fovea, optic disc and retinal vessels

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13
Q

the fundus of the eye is only visible with what

A

use of the ophthalmoscope

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14
Q

how do you use the ophthalmoscope

A

Darken the room as much as possible
Adjust the ophthalmoscope so that the light is no brighter than necessary
Adjust the aperture to a plain white circle
Set the diopter dial to zero unless you have determined a better setting for your eyes

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15
Q

how should you examine the person’s left eye

A

Use your left hand and left eye

vice versa for right eye

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16
Q

when using the ophthalmoscope…

A

Place your free hand on the person’s shoulder for better control.
Ask the person to stare at a point on the wall or corner of the room.

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17
Q

what should you see when you shine the light of the ophthalmoscope (shine about 2 ft away)

A

should see the retina as a “red reflex.“
A “glow” coming from the pupil
May not always be “red”

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18
Q

what cranial nerve is affiliated with auditory acuity

A

Cranial Nerve VIII (Acoustic)

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19
Q

how do you perform the whisper test

A

Ask the person to occlude the ear canal of one ear by pushing in and out on the tragus
Stand 1-2 feet behind the person
Whisper unrelated monosyllabic and bisyllabic words 1 at a time
Ask her/him to tell you what was heard
Should be able to identify the words

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20
Q

how do you perform the weber test

A

Strike tuning fork and place on top of the head
Ask
“Can you hear the sounds better in the right, better in the left, or the same in both ears?”
Sound should be heard equally well in both ears

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21
Q

how do you perform the rinne test

A

Strike tuning fork and place on mastoid (bone conduction)
Ask her/him to tell you when the sound is no longer heard (time it in seconds)
When sound no longer heard – move tuning fork in front of the ear (air conduction)
Do not strike the tuning fork again)
Ask her/him to tell you when the sound is no longer heard (time it in seconds)
AC should be more than 2x > BC
When the person has heard it 1 second longer in front of the ear than behind, you can stop timing

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22
Q

how do you inspect the external ears

A

Inspect the auricles (should be aligned) and move them around gently
Ask the person if this is painful
Palpate the mastoid process for tenderness or deformity

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23
Q

otoscopic exam

A

Hold the otoscope with your thumb and fingers so that the ulnar aspect of your hand makes contact with the person
Straighten the canal
Insert the otoscope to a point just beyond the protective hairs in the ear canal
Use the largest speculum that will fit comfortably (usually 4 mm for adults)
Inspect the ear canal noting redness, drainage, or foreign body

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24
Q

how do you straighten canal in adults vs children

A

Adults: Pull the ear upwards and backwards
Children: Pull the ear downwards and backwards

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25
what do you inspect the lips for
Color, Moisture, Ulcers, Lesions, Cracking, Edema
26
what do you inspect the buccal mucosa for
Color, Ulcers, White patches, Plaques, Nodules
27
what cranial nerve is affiliated with oropharynx
Cranial Nerve XII (Hypoglossal)
28
how do you inspect Cranial Nerve XII (Hypoglossal)
Tongue movement for speech and articulation (l, t, n) | Swallowing
29
what do you inspect the teeth for
Occlusion | Condition and number
30
what do you inspect the gums for
Color Edema Bleeding
31
what do you inspect the hard and soft palates for
Color | Configuration
32
what do you inspect the tonsillar area for
``` Presence Color Uvula position Swelling Exudate ```
33
how do you inspect the Cranial Nerve X (Vagus)
Hard and soft palate rise with phonation
34
how do you inspect the Cranial Nerve IX (Glossopharyngeal)
Gag reflex Taste: posterior 1/3 of tongue Swallowing and phonation
35
how do you inspect the external structures
Symmetry Size Septal deviation
36
what does Cranial Nerve I (Olfactory) check for
Sense of smell
37
In the absence of a nasal speculum use what
use only a light source – do not introduce anything into the nostril
38
how do you inspect the internal structures of the nose
Tilt person’s head backward | Push up slightly on the tip of the nose
39
what do you examine the internal structures of the nose for
``` Color Exudate Polyps Sites of recent bleeding Septal deviation ```
40
what are the variations in infants and neonates
Skull bones are soft and separated
41
when does ossification of sutures begin
begins at around 6 years of age
42
what are the three sutures
Sagittal Coronal Lambdoidal
43
Ossify by around 18-24 months of age
anterior fontanels
44
Ossify by around 2-3 months of age
posterior fontanels
45
Neonatal Variations at Birth
molding, Caput Succedaneum, Cephalhematoma
46
Overlapping cranial bones
molding
47
Soft tissue swelling | Crosses the suture lines
Caput Succedaneum
48
Bleeding into the periosteum | Does not cross the suture lines
Cephalhematoma
49
neotate and infant variations
``` Head circumference very important up to two years of age Drooling is common up to on year of age Check for cleft lip and palate Neonates are obligatory nose breathers Maxillary and ethmoid sinuses very small ```
50
in infants the Eustachian tube is
wide, short, and more horizontal | Prone to otitis media
51
deciduous teeth appear when
between 6 and 24 months
52
when do children achieve visual acuity of 20/20
by 6 years of age
53
children have subtle changes in what
facial appearance throughout
54
bruits are common in who
common in children up to age 5 or in children with anemia
55
thyroid of a young child...
may be palpable | Should not be tender
56
Crease at the juncture between the cartilage and bone of the nose
allergic salute
57
what may be palpated in children
maxillary sinuses
58
variations in adolescent males
The nose and cricoid cartilage enlarge | Facial hair develops
59
variations in pregnancy
``` Thyroid often enlarges May hear a thyroid bruit Chloasma (melasma) Edema and erythema of the nose and pharynx are common Hypertrophy of the gums ```
60
variations in older adults
Thyroid may feel more nodular or irregular on palpation Be careful with range of motion Skin changes on the face and neck Buccal and nasal mucosa dryer Increased coarse nasal hairs (especially in men) Presbyopia (change in accommodation)

Health Assessment (28 decks)

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