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NURS 203 > NURS 203 Midterm > Flashcards

NURS 203 Midterm Flashcards

1
Q

Precordium

A

Region of the chest wall that overlays the heart area (surface)

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2
Q

Mediastinum

A

Place in the chest that holds the heart (cavity)

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3
Q

Base

A

Top of the Heart

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4
Q

Apex

A

Bottom of the heart

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5
Q

Pericardium

A

Protective, fluid-filled sac that surrounds the heart to help it function properly

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6
Q

Myocardium

A

Muscles of the Heart

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7
Q

Endocardium

A

Innermost layer of the heart

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8
Q

Atrium

A

Reservoir

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9
Q

Right Atrium

A

Receives deoxygenated blood from the body

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10
Q

Left Atrium

A

Receives oxygenated blood from the lungs

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11
Q

Ventricle

A

Pump

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12
Q

Right Ventricle

A

Contracts to send deoxygenated blood to lungs

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13
Q

Left Ventricle

A

Contracts to send oxygenated blood to the body

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14
Q

Atrioventricular (AV) Valves

A

Open with diastole, close with ventricular systole)
Tricuspid (Rt) and Mitral (Lt)

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15
Q

Semilunar (SL) Valves

A

Open with ventricular systole
Pulmonic valve (Rt) and Aortic Valve (Lt)

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16
Q

How many times does the heart beat per day

A

100,000

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17
Q

How many times does the heart beat per year

A

35 million

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18
Q

How many times does the heart beat in a lifetime

A

2.5 billion

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19
Q

How many km of blood is pumped through the body

A

120 000km of blood vessels

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20
Q

How many L per minute of blood does the heart pump

A

4-6L blood/minute

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21
Q

Blood Flow

A

Head + lower body – (superior/inferior) vena cava – RA – RV – Pulmonary artery – LUNGS – Pulmonary Veins – LA – LV – Aorta – Head + body

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22
Q

Diastole

A

Relaxed ventricles

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23
Q

Systole

A

Build P in ventricles for ejection

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24
Q

S1 Heart Sound

A

AV Valves close = lub

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25
Q

S2 Heart Sound

A

SL valves close = DUP

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26
Q

Effect of respiration on heart sounds

A

Split S2 (delayed pulmonary valve closure) = T-DUP

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27
Q

Heart Murmurs

A

Gentle blowing, clocking, rushing or gurgling
r/t velocity or viscosity of blood OR valve wall defects

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28
Q

Characteristic of Heart Sounds to look for

A

Frequency (pitch)
Intensity (loudness)
Duration (more silence than sound)
Timing (systole or diastole)

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29
Q

Sinoatrial node

A

Pacemaker
60-100 BPM

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30
Q

AV node

A

40-60BPM

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31
Q

AV Bundle of His

A

Collection of heart muscle cells

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32
Q

Rt and Lt Branches - Purkinje fibers

A

20-40BPM

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33
Q

P wave

A

Atrial depolarization

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34
Q

P-R interval

A

Atrial contraction

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35
Q

QRS complex

A

Ventricular depolarization

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36
Q

Q-T Interval

A

Ventricular contraction

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37
Q

T wave

A

Repolarization of ventricles

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38
Q

Cardiac Output formula

A

HR x SV = CO

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39
Q

Preload

A

Full ventricle, stretch at the end of diastole

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40
Q

Afterload

A

P necessary to overcome high P in aorta

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41
Q

Superior and inferior vena cava

A

return deoxygenated blood to heart

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42
Q

Pulmonary trunks (arteries)

A

deliver deoxygenated blood to lungs

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43
Q

Pulmonary Veins

A

Return oxygenated blood to heart

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44
Q

Aorta

A

Delivers oxygenated blood to head and body

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45
Q

Carotid Arteries

A

Deliver oxygenated blood to head

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46
Q

Jugular Veins

A

Drain the head, deoxygenated blood (internal and external)

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47
Q

Angina

A

Chest pain/tightness

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48
Q

Dyspnea

A

Shortness of Breath

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49
Q

Orthopnea

A

Difficulty breathing when laying down

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50
Q

Order of Objective Heart exam

A
  1. Pulse and BP
  2. Extremities
  3. Neck vessels
  4. Precordium
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51
Q

Jugular venous pressure (JVP)

A

Estimate by looking at neck veins, normal = 6-8cm

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52
Q

Jugular venous distention (JVD)

A

Bulging of major veins in your neck
It is a reflection of Rt atrial pressure

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53
Q

which heart sound is louder at the apex?

A

S1 is louder than S2 at apex

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54
Q

Which heart sound is louder at the base?

A

S2 is louder than S1 at the base

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55
Q

Which heart sound coincides with carotid artery pulse

A

S1

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56
Q

Influence of lifestyle/socioeconomic factors for CVD

A

High BP
Smoking
Elevated serum cholesterol
Obesity
Diabetes

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57
Q

Myocardial Infarction (MI)

A

Heart Attack

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58
Q

Factors that affect blood flow

A
  1. Pressure differences
  2. Vascular Resistance
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59
Q

Arteries

A

Deliver oxygenated blood
Typically run deeper than veins
Muscular-elastic layer = high compliance

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60
Q

Anastomosed

A

Re-connect/ create a connection

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61
Q

Pulse Sites

A

Temporal; Carotid; Brachial; Ulnar; Radial; Femoral; Popliteal; Posterior tibial; dorsalis pedis

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62
Q

How many L do capillaries filter per day

A

20L per day

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63
Q

Capillaries

A

U-turn of CVS
Smallest blood vessels
Exchange vessels through: simple diffusion, transcytosis, and bulk flow

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64
Q

Veins

A

Carry deoxygenated blood back to the heart
More numerous than arteries
Deep and superficial
Act as a blood reservoir

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65
Q

Major deep veins

A

Brachiocephalic; Internal jugular; Brachial; Radial and Ulnar; Iliac; Femoral; Popliteal: Great/small saphenous

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66
Q

Venous Return

A

Veins have valves to stop backflow
Calf mucles - milking

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67
Q

Lymphatic functions

A
  1. Drain excess interstitial fluid - assist venous system
  2. Act in immune response - Lymph nodes filter micro-organisms; Lymphocytes (WBC)
  3. Absorb fat from the gut - Dietary lipids and fat-soluble vitamins
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68
Q

Spleen

A

Largest mass of lymph tissue

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69
Q

Thymus gland

A

Not functional in adulthood, where T-lymphocytes are sent to mature

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70
Q

Organs essential to immunity

A

Spleen; Tonsils; Thymus gland (until puberty); Bone marrow

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71
Q

Pulse Grading

A

0=absent, 1+ weak, 2+=normal, 3+=bounding

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72
Q

Epitrochlear lymph node

A

Shake hands - medial side of arm, 1-2cm above elbow

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73
Q

How to test for edema

A

Press on area firmly for 5 seconds and release

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74
Q

Edema Grading

A

1+ = mild (<2mm, disappears rapidly)
2+ = moderate (2-4mm, detectable distortion)
3+ = deep pitting (> 1 min)
4+ = Very deep pitting (2-5mins)

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75
Q

Arteriosclerosis

A

Hardening of arteries

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76
Q

Atherosclerosis

A

Build up of plaque in arteries due to increased cholesterol

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77
Q

Raynaud’s disease

A

Arteries to the hands spasm and cut off supply

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78
Q

Lymphedema (non-pitting)

A

Damage to lymph nodes that obstruct flow

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79
Q

Ischemic ulcer

A

Arterial Ulcer
Lack of O2

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80
Q

Venous Stasis Ulcer

A

Pooling of blood in venous system, causes tissue breakdown

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81
Q

Varicose Veins

A

Form from incompetent valves, veins become twisted and enlarged

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82
Q

Deep Vein Thrombosis (DVT)

A

Blood clot in the deep vein
Can lead to pulmonary embolus

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83
Q

Peripheral Artery Disease

A

Narrowing/blockage of arteries
Can cause aneurysms or occlusions

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84
Q

Virchow’s Triad

A
  1. Flow/stasis
  2. Endothelial state
  3. Hypercoaguable state
    All contribute to risk of clot formation
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85
Q

Preventing venous stasis

A

Devices used
Assess skin and pedal pulse
Remove periodically
Assess circulation of toes regularily

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86
Q

Intermittent Pneumatic Compression (IPC)

A

Air is pumped to alternate between inflation and deflation

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87
Q

Elastic Stockings Requirements

A

Proper sizing
Dry skin
Turn stockings inside out to apply
No folds/creases
2 fingers below knee and 2 fingers above toes
Apply in AM or 15 mins after rest

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88
Q

IPPA

A

Inspection
Palpation
Percussion
Auscultation

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89
Q

ADPIE

A

Assessment
Diagnosis
Planning
Implementing
Evaluating

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90
Q

Components of Central Nervous System

A

Brain + Spinal cord
Upper motor neurons

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91
Q

Components of Peripheral Nervous System

A

all nervous tissue outside of CNS; spinal nerves and cranial nerves
Lower motor neurons

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92
Q

Crossed representation

A

Left side of brain communicates with right side of body (and vice versa)

93
Q

Nervous System Functions

A
  1. Sensory - detect stimuli
  2. Integrative - processes info and decides what to do
  3. Motor - activation of muscles/glands
94
Q

Cerebrum

A

“Seat of intelligence”
Grey matter

95
Q

Frontal Lobe

A

Voluntary movement, personality, emotions or “who we are”, contains broca’s area

96
Q

Parietal Lobe

A

Primary sensation center

97
Q

Occipital Lobe

A

Primary visual receptor center

98
Q

Temporal Lobe

A

Primary auditory center, contains Wernicke’s area

99
Q

Basal Ganglia

A

Control automatic movements

100
Q

Corpus Callosum

A

Band of neural fibres connects hemispheres
Contains myolin

101
Q

Thalamus

A

Major relay station

102
Q

Hypothalamus

A

“hub between mind and body”, homeostasis, regulates hormones, temp, appetite, pleasure, pain, rage, sleep/wake

103
Q

Cerebellum

A

Blends skilled movements + posture and balance

104
Q

Parts of the brain stem

A

Midbrain
Pons
Medulla oblongata

105
Q

Midbrain

A

Connects spinal cord to thalamus and hypothalamus

106
Q

Pons

A

Ascending/descending fibre tracts (helps medulla to control breathing)

107
Q

Medulla Oblongata

A

Vitals (HR, breathing) + other (vomiting, hiccupping, coughing, sneezing) centers

108
Q

Grey Matter

A

Site of integration

109
Q

White matter

A

Dozens of sensory and motor tracts

110
Q

Spinal Cord

A

“main pathway”

111
Q

Sensory pathways in the spinal cord

A

Spinothalamic - pain, temp, crude touch
Posterior dorsal columns - vibration, sterognosis, proprioception, fine touch

112
Q

Motor pathways in the spinal cord

A

Pyramidal - direct, skilled purposeful movement
Extrapyramidal - indiriect, involuntary movement, respond to movement of head (tone, balance, locomotion), emotional expression
Cerebellum - movement

113
Q

Motor pathways in the spinal cord

A

Pyramidal - direct, skilled purposeful movement
Extrapyramidal - indiriect, involuntary movement, respond to movement of head (tone, balance, locomotion), emotional expression
Cerebellum - movement, equilibrium, posture

114
Q

Upper Motor Neurons

A

CNS - influence LMN by sending motor responses

115
Q

Lower Motor Neurons

A

PNS - Located in periphery, receives from motor “final common pathway”

116
Q

2 Divisions of PNS

A
  1. Somatic Nervous system (voluntary)
  2. Autonomic Nervous System (involuntary)
117
Q

Divisions of Autonomic NS

A

Sympathetic - fight or flight
Parasympathetic - rest and digest

118
Q

Enteric Nervous System

A

Brain of the gut - involuntary, independent functions

119
Q

Analgesic vs Anesthetic Effects

A

Analgesic = sensory function
Anesthetic = motor function

120
Q

Reflex arc

A

associated w spinal nerve
involuntary
protects NS
maintain balance
muscle tone

121
Q

Deep Tendon reflexes

A

STRETCH - knee jerk

122
Q

Superficial reflexes

A

CUTANEOUS - ABD

123
Q

Visceral reflexes

A

AUTONOMIC - pupillary

124
Q

Pathological reflexes

A

ABNORMAL - babinski response

125
Q

Screening neuro check

A

Healthy patient with no hx of neuro problems

126
Q

Complete neuro check

A

patient with a neuro complaint

127
Q

Recheck neuro

A

Known neuro deficit (diagnosed)

128
Q

Complete assessment of neuro (5)

A
  1. Mental status
  2. Testing Cranial nerves
  3. Inspect/palpate motor system
  4. Assess sensation
  5. Test reflexes
129
Q

Reinforcement

A

Distraction (clench teeth, grab arms)

130
Q

Reflex Grading

A

0 = absent
1+ = weak
2+ = normal
3 + = more brisk than normal
4+ = hyperactive

131
Q

Clonus

A

Involuntary muscle contractions

132
Q

Components of Glasgow Coma Scale

A

Eye opening response
Motor response
Verbal response

133
Q

Cerebral Vascular Accident (CVA - stroke)

A

Ischemic stroke
Hemorrhagic stroke
Transient ischemic attacks

134
Q

Modifiable Factors for Stroke

A

CVD
HTN
Smoking
Diabetes
Atrial Fibrilation
Dyslipidemia
Carotid Stenosis
Oral contraceptives
Hormone therapy
Diet and nutrition
Inactivity
Obesity

135
Q

Non-modifiable risk factors for stroke

A

Age
Gender
Low birth weight
Ethnocultural background
Genetic factors

136
Q

Stroke Prevention

A

Diet
Limit sodium intake
Moderate exercise
Maintain healthy weight
Smoking cessation
Limit alcohol intake
Manage underlying conditions

137
Q

How many spinal nerves are there?

A

31

138
Q

How many Cranial nerves are there?

A

12

139
Q

How many Sensory Nerves are there?

A

3 sensory

140
Q

How many motor nerves are there?

A

5 motor

141
Q

How many sensory/motor nerves (both) are there?

A

4 both

142
Q

Cranial Nerve Names in order

A
  1. Olfactory
  2. Optic
  3. Oculomotor
  4. Trochlear
  5. Trigeminal
  6. Abducens
  7. Facial
  8. Acoustic
  9. Glossopharyngeal
  10. Vagus
  11. Spinal Accessory
  12. Hypoglossal
143
Q

CN I Function

A

Olfactory Nerve
Controls sense of smell

144
Q

How to test CN I

A

Check patency
Have pt identify familiar scents (coffee or mint)

145
Q

CN II Function

A

Optic Nerve
Controls Central and Peripheral vision

146
Q

How to test CN II

A

Using the confrontation test

147
Q

CN III Function

A

Oculomotor Nerve (extraocular)
Position of eyelids and size of pupils

148
Q

CN IV Function

A

Trochlear Nerve (extraocular)
Supplies superior oblique muscles in the eyeball

149
Q

CN V Function

A

Trigeminal Nerve
Face Sensations

150
Q

CN VI Function

A

Abducens (extraocular)
Innervates the rectus lateral muscle (lateral movements)

151
Q

How to test CN III

A

Check eyelids for ptosis
6 cardinal positions

152
Q

How to test CN IV

A

Check pupils - measure in mm

153
Q

How to test CN VI

A

Check pupils
6 cardinal positions

154
Q

How to test CN V

A

Assess Ophthalmic, Maxillary and Mandibular areas by using cotton wisp test - LIGHT TOUCH SENSATION

155
Q

CN VII Function

A

Facial Nerve
Controls facial movements and expression

156
Q

How to test CN VII

A

Have pt to smile, frown, close eyes tightly, lift eyebrows, show teeth and puff cheeks - should be smooth and symmetrical
Use taste test only if facial nerve injury is suspected

157
Q

CN VIII Function

A

Acoustic (Vestibulocochlear)
Controls hearing

158
Q

How to test CN VIII

A

Whispered voice test
Weber and Rinne test (not routinely done)

159
Q

CN IX Function

A

Glossopharyngeal
Provides motor and sensory information to the nose and throat

160
Q

CN X Function

A

Vagus Nerve
Regulates internal organs, has some reflexes like coughing, sneezing, vomiting, etc.

161
Q

How to Test CN IX and X

A

MOTOR: Depress tongue and have pt say “ahh” - uvula and soft palate should rise midline and tonsillar pillars move medially - touch wall to elicit gag reflex
SENSORY: Taste at the back of the tongue (not routinely done)

162
Q

CN XI Function

A

Spinal Accessory Nerve
Controls neck and shoulder movement

163
Q

How to test CN XI

A

Rotate head against resistance
shrug shoulders against resistance

164
Q

CN XII Function

A

Hypoglossal Nerve
Innervates the tongue - controls the muscles that move it

165
Q

How to test CN XII

A

Ask pt to stick tongue out - thrust should be midline, no tremors
Have pt say “light, tight, dynamite”

166
Q

How to Test Spinothalamic tract

A

Pain - varied dull and sharp stimuli over various parts
Temp - 2 test tubes
Light touch - cotton wisp over various parts of the body

167
Q

How to test Posterior column tract

A

Vibration (tuning fork)
Kinaesthesia
Fine touch (tactile discrimination)

168
Q

How to test fine touch (tactile discrimination)

A

Stereognosis - ID object
Graphaesthesia - draw onto hand
Two-point discrimination - mm to determine 2 points
Extinction - bilateral perceptions
Point location - pt point to area that you touched

169
Q

Conjunctiva

A

Membrane covering the sclera
Helps lubricate eyes

170
Q

Sclera

A

“Whites” of the eye
Help in proper attachment of eye tendons
Provides stability and protection for the eye’s inner workings

171
Q

Iris

A

Colored part of the eye
Regulates how much light reaches the retina by controlling the size of the pupils
Performs accommodation reflex - ability to shift focus from nearby to distant objects

172
Q

Pupils

A

Black dot in the middle of the iris
Allows the eye to focus on the things in front of it and regulates how much light enters the eye

173
Q

Cornea

A

Clear and protective outer layer = acts as barrier against dirt/microorganisms
Enables the eye to focus on ibjects effectively

174
Q

Choroid

A

Vascular layer between sclera and retina - delivers nourishment through blood and oxygen supply

175
Q

Retina

A

Sensitive membrane that covers the eye’s rear surface
Converts images to impulses before sent to brain

176
Q

6 Eye Muscles - 4 rectus, 2 oblique

A

Superior Rectus - moves eye up
Inferior Rectus - moves eye down
Medial Rectus - moves eye toward nose
Lateral Rectus - moves eye toward temple
Superior Oblique - Rotates eye inwards and downwards
Inferior Oblique - Rotates eye outwards and upwards

177
Q

Eye Lens

A

Changes its thickness and curvature allowing the eye to focus on objects in varying distances

178
Q

Optic Nerve

A

Bundle of 1.2 million nerve fibers that transmit visual info to the CNS

179
Q

Optic Disc

A

Place at which the axons of ganglion cells join and mark the beginning of the optic nerve

180
Q

Fovea centralis

A

Houses cones that help with proper vision - located within the macula

181
Q

Caruncle

A

Moisturize the eye and protect it (fleshy pink in coner)

182
Q

Canthus

A

Provides an anchor point that allows eyelids to completely shut

183
Q

Palpebral fissure

A

allows for movement of the eye without stretching the bulbar conjunctiva

184
Q

Accessory Structures of the eye

A

eyelids, eye lashes, palpebral fissure, canthus

185
Q

Middle layer of external eye

A

pupil lens, anterior/posterior chambers

186
Q

Lacrimal apparatus

A

Lacrimal gland creates tears, and lacrimal sac releases them

187
Q

Middle layer of internal eye

A

Choroid, iris, pupil lens, anterior/posterior chamber

188
Q

Inner layer of the eye

A

retina, optic disc, vessels, macula, fovea centralis

189
Q

Damage to the LEFT side of brain

A

Affect nasal field in the left eye, and temporal field in the right eye (right sides of both eyes)

190
Q

Damage to the RIGHT side of brain

A

Affect nasal field in right eye, and temporal field in the left eye (left sides of both eyes)

191
Q

Function of the eyes

A

Light rays enter corneas and are bent (refracted) onto lens
Ciliary body controls thickness of lens
Iris = diaphragm
Pupils control amount of light entering retina

192
Q

Strabismus

A

Eyes not working in synchrony

193
Q

Diplopia

A

Double vision

194
Q

Glaucoma

A

Build up of pressure in anterior chamber

195
Q

Snellen Eye Chart

A

Stand 20ft away, read letters

196
Q

Expected ranges of peripheral vision

A

Superior = 50 degrees
Nasal = 60 degrees
Inferior = 70 degrees
Temporal = 90 degrees

197
Q

Nystagmus

A

Jerkiness of the eye

198
Q

PERRLA

A

Pupils equal, round, reactive to light and accommodate

199
Q

Ocular Fundus

A

Supply blood to retina
Should see red reflex, optic disk, retinal vessels, fundus background (orange) and macula

200
Q

Macular degeneration

A

Disorder of the retina

201
Q

Cataracts

A

Lens becomes cloudy

202
Q

Diabetic retinopathy

A

Retinal changes/hemorrhages

203
Q

Presbyopia

A

‘old eye’ - lens less flexible, can’t change shape easily

204
Q

Myopia

A

Nearsightedness

205
Q

Hyperopia

A

Farsightedness

206
Q

External Ear

A

Pinna and auricle, external auditory canal or tube

207
Q

Tympanic membrane

A

divides the middle and external ear

208
Q

Ossicles

A

3 small bones that transmit sound waves to the inner ear
- Malleus
- Incus
- Stapes

209
Q

Eustachian Tube

A

Canal that links the middle ear with the back of the nose - helps to equalize pressure

210
Q

Inner Ear (Labyrinth) parts

A

Cochlea, vestibule and semicircular canals

211
Q

Cochlea

A

contains nerves for hearing

212
Q

Vestibules

A

Contains receptors for balance

213
Q

Semicircular canals

A

Contains receptors for balance

214
Q

How does hearing work?

A

Sound made outside the outer ear and travels through auditory canal and strikes tympanic membrane - eardrum vibrates and these are passed to the ossicles which amplify the sound - they send sound waves to the cochlea - converted into electrical impulses and auditory nerve sends these impulses to the brain - brain translates the impulses as sounds

215
Q

Cone of light

A

Reflected from the otoscope - tells you that the tympanic membrane is normal (should point towards the nose)

216
Q

Bone Conduction

A

Starts at the stapes to vibrate the oval window (skips tympanic membrane)

217
Q

Air Conduction

A

More sensitive - uses the tympanic membrane which causes the stapes to vibrate the oval window

218
Q

Function of the Ears

A

Equilibrium, hearing and awareness of our orientation space

219
Q

Otosclerosis

A

‘hardening’ of the oval window

220
Q

Sensorineural

A

Nervous system damage

221
Q

Tinnitus

A

ringing/buzzing in ears

222
Q

Vertigo

A

Room spinning

223
Q

How do you pull ears when using otoscope (adult)

A

Pull pinna up and back to straighten canal

224
Q

How do you pull ears when using otoscope (children)

A

Pull straight down

225
Q

Cephalic

A

Pertaining to the head

226
Q

Cranial

A

Skull

227
Q

Syncope

A

Fainting

228
Q

Blephar/o

A

Eyelid

NURS 203 (1 decks)

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