Systems Review Flashcards by Braden Talbert

purpose of systems review

identify non-MSK red flags

looking for COMBOS of red flags

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what kinds of systems are determined from hx and observation

i.e. aerobic exertion indicating cardio/respiratory

i.e. sx with eating indicating GI

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constitutional S&S

fever
chills
seats
weight change
N&V
dixxy/lightheaded
fatigue > 2 wks
weakness
paraesthesias
malaise
cognitive change

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functions of urinary system

filter fluid from renal blood flow (remove waste and maintain fluid/solute balance)

stimulate RBC production

BP regulation

convert vit D to active form

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Urinary S&S

p! in trunk, flank, and/or pelvic region

discoloration

urinary change (frequency, urgency, bleeding, pus)

dysfunction (flow, initiation, control)

Nocturia (wake up to urinate)

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review components for urinary system

mostly from Hx

observation of urine

P! with kidney percussion

P! with bladder palpation/percussion

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where is the flank area

costovertebral junction of T12 - L1 area

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functions of the reproductive system

produce sex cells and create sex hormones with endocrine system

maintain fertilized egg for development

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S&S of reproductive system

P! in pelvis, LB, abdominal regions, and/or sexual organs

sexual/bladder/bowel dysfunction

abnormal menstruation or discharge from sex organs

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early and unknown pregnancy indications

polyuria
breast tenderness
fatigue
N&V
heart burn
constipation
abnormal vaginal discharge

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review components for reproductive system

most from Hx

observation is unlikely

no other specific assessment

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what organs make up the metabolic system

gut, liver, adipose tissue, pancreas, kidney, and muscle

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functions of metabolic system

conversion of foods/liquids to energy and building blocks for protein, fat, carbs, etc

elimination of waste

fluid/electrolyte balance which is key for cellular metabolism

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characteristics of metabolic S&S

very varied

due to imbalance of fluid, electrolyte, and/or pH

if S&S dont match to a specific system and seem widespread, ots possibly a metabolic condition because an altered metabolism can affect multiple systems

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most common fluid and electrolyte imbalances are associated with what

polyuria and/or dehydration

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examples of things that can cause polyuria and dehydration

diabetes
kidney dysfunction
malignancy
alcoholism/liver disease
medication side affects
burns
surgery
diarrhea
N&V

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what regulates most electrolytes in the body

kidneys

followed by intestines, bone, and parathyroid

how does sodium affect fluid/electrolyte balance

maintains fluid volume and potential between cells for messages to and from CNS

hypoatremia is most frequent electrolyte disorder and contributor to neuro S&S

how does potassium affect fluid/electrolyte balance

maintain fluid volume

hypokalemia related to cardia arrhythmias

hyperkalemia related to muscle dysfunction

how does calcium affect fluid/electrolyte balance

involved in bone health, muscle action, nerve impulses, circulation, and hormones

how does phosphorus affect fluid/electrolyte balance

majority is located in bones/teeth

plays crucial role with metabolism for the growth, maintenance, and repair of all tissues

how does bicarbonate affect fluid/electrolyte balance

works as acid buffer

diarrhea is main reason for loss of bicarb

how does magnesium affect fluid/electrolyte balance

mainly involved in neuromuscular function

how does chloride affect fluid/electrolyte balance

regulates fluid in and out of cells

skin S&S of fluid and electrolyte imbalance

loss of skin elasticity warm/flushed due to vasodilation from impaired circulation and thermoregulation with metabolic acidosis or diabetes pale and cool due to vasoconstriction and hypovolemia or dehydration

neuromuscular irritabilities related to fluid and electrolyte imbalance

fatigue twitching cramping tetany

CNS involvement affected by fluid/electrolyte imbalance

memory impairement depression delusions/hallucinations seizures

cardiovascular changes affected by fluid/electrolyte imbalance

tachycardia postural hypotension altered respiration

what is normal function for pH balance

pH ideally between 7.35 and 7.45 kidneys remove acids and keep bases lungs balance the acidic CO2

four classes of pH imbalance

respiratory acidosis respiratory alkalosis metabolic acidosis metabolic alkalosis

S&S that occur with all classes of pH imbalance

confusion and fatigue S&S

what is respiratory acidosis

lowered pH due to hypoventilation and accumulation of acidic CO2 that may occur with: -disorders that affect respiration -drugs that supress respiration like opiods/muscle relaxers -sleep apnea

S&S of respiratory acidosis

HA anxiety may progress to -memory loss/personality changes -sleep disturbances -incoordination/tremors

what is respiratory alkalosis

higher pH due to hyperventilation leading to a loss of acidic CO2 that may occur with -pulmonary conditions -anxiety -anemia with less oxygenation

S&S of respiratory alkalosis

SOB is often the ONLY sign lightheadedness otherwise highly variable

what is metabolic acidosis

lowered pH MOST common acid base abnormality accululation of H+ ions that can occur with: -diabetes with a build up of ketones/acids (most common) -diarrhea/dehydration leading to greater acid conc. -kidney diseases that hold onto too many acids

S&S of metabolic acidosis

long deep breaths with a fruity smell due to ketoacidosis diabetes cardinal S&S -frequent urination -dry mouth -thirst -decreased skin turgor -blurry vision -weakness/fatigue

what is metabolic alkalosis

higher pH accumulation of bicarbonate base that can occur with: -vomitting by loss of stomach acid -kidney disorders or meds that keep too many bases -excessive antacid, laxitive, or diuretic meds -diarrhea

S&S of metabolic alkalosis

HA neuromuscular excitability -paresthesias/numbness -twitching and cramping particular in hands and feet (trousseau sign) -seizures muscle alterations due to associated lowering of calcium -skeletal weakness -cardiac arrhythmias

what is the most common metabolic condition

diabetes

metabolic review components

Hx observation -muscle twitch -altered respiration -memory loss -incoordination -dry mouth -fruity breath weak resisted/MMT possibly altered sensation with neuro abdominal assessment, pain with palpation/percussion of -liver -pancreas -kidney standard vitals -irregular heart beat -postural hypotension -altered respiratory rate palpation -loss of skin mobility -extreme skin temp