test 3 Flashcards
(405 cards)
1
Q
what makes up the thoracic cage
A
sternum, 12 pairs of ribs, 12 thoracic vertebrae, and the diaphragm
2
Q
what is the suprasternal notch
A
U-shaped depression just above the sternum, between the clavicles
3
Q
what are the three parts of the sternum
A
manubrium, body, xiphoid process
4
Q
what is the sternal angle
A
angle of Louis, articulation of the manubrium and body of the sternum
5
Q
what is the costal angle
A
right and left costal margins form an angle where they meet at the xiphoid process
6
Q
where do you start counting ribs
A
vertebra prominens
7
Q
what are the spinous processes
A
knobs on the vertebrae, which stack on the spinal column
8
Q
where is the lower tip of the scapula usually
A
7th or 8th rib
9
Q
where is the midclavicular line
A
bisects the center of each clavicle, between the sternoclavicular and arcomioclaviclular joints
10
Q
what does the mediastinum contain
A
esophagus, trachea, heart, and great vessels
11
Q
what contains the lungs
A
right and left pleural spaces
12
Q
what is the highest point of the lungs
A
apex
13
Q
what is the lower base of the lungs
A
base
14
Q
where does the base rest
A
about 6th rib, midclavicular line
15
Q
where does the apex rest
A
about 3-4 cm above the inner third of the clavicles
16
Q
which lung is the shorter lung
A
the right lung is shorter
17
Q
why is the right lung shorter
A
the underlying liver
18
Q
what lung is narrower
A
the left lung is narrower
19
Q
why is the left lung narrower
A
the heart bulges to the left
20
Q
how many lobes does the right lung have
A
3
21
Q
how many lobes does the left lung have
A
2
22
Q
what separated the lobes of the lungs
A
fissures that run obliquely through the chest
23
Q
the posterior of the lungs is mostly made of what lobe
A
lower lobe
24
Q
what is pleurae
A
serous membrane that form an envelope between lungs and chest wall
25
what is visceral pleurae
lines the outside of the lungs
26
what is parietal pleurae
lines the inside of the chest wall and diaphragm
27
what is the purpose of the pleurae
lubricating fluid, is a vacuum that holds the lungs tightly against the chest wall
28
what is the job of the trachea and bronchi
transport gases between the environment and the lungs
29
what are the four functions of the respiratory system
1. supply oxygen to the body for energy production
2. removing carbon dioxide as a waste product
3. maintaining homeostasis (acid-base balance) of arterial blood
4. maintaining heat exchange
30
what does hypoventilation cause
the shallow breathing cause carbon dioxide to build up in the blood
31
what does hyperventilation cause
the rapid deep breathing causes carbon dioxide to be blown off
32
where is the respiratory center
brainstem: pons and medulla
33
what is increase of carbon dioxide called
hypercapnia
34
what is the decrease of oxygen in the blood called
hypoxemia
35
as air rushes into the lungs the chest size ____
increases
36
as air rushes out of the lungs the chest ____
recoils
37
during inspiration the diaphragm
descends and flattens
38
during expiration the diaphragm
relaxes, causing it to dome up
39
during pregnancy, what helps relax the chest cage ligaments
increase in estrogen levels
40
what happens to thorax as a person ages
it becomes less mobile due to the costal cartilage becoming calcified
41
what is considered a chronic cough
a cough lasting longer than 2 months
42
what is dyspnea
shortness of breath
43
what is orthopnea
difficulty breathing when supine
44
what is paroxysmal nocturnal dyspnea
awakening from sleep with shortness of breath and needing to be upright to achieve comfort
45
what is the ratio for anteroposterior diameter to transverse diameter
1:2
46
how do you test for symmetric chest expansion
placing your hands sideways on the posterolateral chest wall with thumbs pointing together, pinch up a fold of skin with your thumbs and when the person breaths out your thumbs so go out an equal amount
47
when does unequal chest expansion occur
atelectasis, lobar pneumonia ,pleural effusion, thoracic trauma(pneumothorax)
48
what is causes pain when deep breathing
inflamed pleurae
49
what is tactile fremitus
palpable vibration
50
what words do you have the patient repeat in order to feel tactile fremitus
ninety nine
51
what type of sound should tactile fremitus be
resonant
52
where is fremitus most palpable
between the scapulae and around the sternum, usually decreases as you go down
53
what causes decreased fremitus
obstructed bronchus, pleural effusion or thickening, pneumothorax, or emphysema
54
what causes increased fremitus
compression or consolidation of the lung tissue
55
when is rhonchal fremitus palpable
with thick bronchial secretions
56
when does a pleural friction fremitus palpable
inflammation of the pleura
57
what is crepitus
coarse, crackling sensation palpable over the skin surface
58
when does crepitus occur
subcutaneous emphysema when air escapes from the lung and enters the subcutaneous tissue (after open thoracic surgery or chest tube placement)
59
what is resonance
low-pitched, clear hallow sounds that predominates in healthy lung tissue
60
what is hyperresonance
lower pitched, booming sound; found when too much air is present
61
what does it mean if there is a dull note over the lungs
signals abnormal density in the lungs(pneumonia, pleural effusion, atelectasis, or tumor)
62
what is a dull note
soft, muffled thud
63
what is diaphragmatic excursion
estimate of the level of the diaphragm separating the lungs from the abdominal viscera
64
where is the best position to listen to breath sounds
have the patient lift there arms over their head or have them rest their arm on your shoulder
65
what are the three normal breath sounds
bronchial, bronchovesicular, vesicular
66
where do you hear bronchial breath sounds
trachea and and larynx
67
what do bronchial breath sounds sound like
high pitched, loud, harsh, hollow, greater with expiration
68
where do you hear bronchovesicular sounds
over major bronchi where few alveoli are located, between scapulae, around the sternum
69
what do bronchovesicular sounds sound like
moderate pitch, moderately loud, mixed quality, equal with inspiration and expiration
70
where do you hear vesicular breath sounds
over peripheral lung sounds where air flows through smaller bronchioles and alveoli
71
what do vesicular breath sounds sound like
low pitched, soft, rustling sound, inspiration is greater than expiration
72
when do decreased or absent breath sounds occur
1. when the bronchial tree is obstructed
2. loss of elasticity in the lung fibers and decreased force of inspired air
3. when anything obstructs transmission of sound between the lungs and your stethoscope
73
what does a silent chest mean
that no air is moving in or out
74
what are adventitious breath sounds
added sounds that are NOT normally heard
75
what are crackles in the lungs
discontinuous popping sounds heard over inspiration
76
what are wheezes
are continuous musical sounds heard mainly over expiration
77
what are atelectatic crackles
short, popping, crackling sounds that only last a few breaths
78
what do you need to note about the skin color and condition, when inspecting the thorax or lungs
that the lips and nail beds are free of cyanosis or unusual pallor
79
what is normal for respirations
automatic and effortless, regular and even, produces no noise
80
what is a barrel chest
ribs are horizontal instead of downward
81
what is pectus excavatum
sunken sternum and adjacent cartilages
82
what is pectus carinatum
forward protrusion of the sternum
83
what is scoliosis
a lateral S-shaped curvature of the thoracic and lumbar spine,
84
what is kyphosis
exaggerated posterior curvature of the thoracic spine(humpback)
85
what is tachypnea
rapid shallow breaths, > 24 per minute
86
what is bradypnea
slow breathing,
87
what is Cheyne-stokes respirations
increasing in rate and depth and then decreasing, periods lasting 30-45 seconds
88
what is Biot respiration
similar to cheyne-stokes respirations but irregular, period lasting from 10 seconds to 1 minute
89
What is chronic obstructive breathing
normal inspiration and a prolonged expiration
90
what is a fine crackle
discontinuous, high-pitched, short crackling, popping sounds heard during inspiration that are not cleared by coughing
91
what are coarse crackles
loud, low-pitched bubbling and gurgling sounds that start early in inspiration and may be present in expiration
92
what are atelectatic crackles
sound like fine crackles but do not last and clear withing the first few breaths
93
what is a pleural friction rub
very superficial sound that is coarse and low-pitched
94
what is stridor
high-pitched, monophonic, inspiratory, crowing sound, louder in the neck than over the chest wall
95
what do you do with bronchophony
ask the person to repeat the word ninety nine
96
what should you hear with bronchophony
soft, muffled, and indistinct, you can hear but cant make out what they are saying
97
what is abnormal for bronchophony
you shouldn't be able to clearly hear the words ninety nine
98
what is egophony
listening to the chest while the person says eeeeee
99
what is normal with egophony
normally you should hear eeee
100
what is abnormal with egophony
hearing aaaa
101
what is the whispered pectoriloquy
listening while the patient says 1,2,3
102
what is normal to hear while performing whispered pectoriloquy
faint, muffled, and almost inaudible sounds
103
what is abnormal to hear while performing whispered perctoriloquy
very clear, very audible but still somewhat faint
104
what is a atelectasis
collapsed lung
105
what causes atelectasis
airway obstruction, compression of the lung, and lack of surfactant,
106
what should you expect to inspect with atelectasis
cough, lag on expansion, increased respirations and pulse
107
what should you expect to palpate with atelectasis
chest expansion decreased on affected side, tactile fremitus decreased or absent,
108
what should you expect with percussion with atelectasis
dull over the area
109
what should you expect to hear with atelectasis
breath sounds decreased vesicular or absent over the area
110
what adventitious sounds should you hear with atelectasis
none if bronchus is obstructed
111
what is lobar pneumonia
infection in the lung parenchyma leaves alveolar membrane porous
112
what is expected with inspection of pneumonia
increased respirations of greater than 24 per minute, guarding or lag on expansion
113
what is expected with palpation with pneumonia
chest expansion decreased on affected side, tactile fremitus increased if bronchus patent, decreased if the bronchus is obstructed
114
what is expected with percussion w/ pneumonia
dull over lobar pneumonia
115
what is expected when listening to a patient with pneumonia
tachycardia, loud bronchial breathing with patent bronchus, voice sounds have increased clarity,
116
what adventitious breath sounds are normal with lobar pneumonia
crackles, find to medium
117
what is acute bronchitis
an acute infection of the trachea and larger bronchi characterized by cough lasting up to 3 weeks
118
what is expected when inspecting a patient with acute bronchitis
cough is productive or non-productive, sore throat, low-grade temp, postnasal drip, fatigue
119
what is expected when palpating a patient's thorax when they have acute bronchitis
no pain, no increased fremitus
120
what is expected when percussing the lungs of a patient with acute bronchitis
resonance predominates
121
what is expected when listening to the lungs of a patient with acute bronchitis
may be clear bilaterally, no egophony
122
what adventitious breath sounds are expected if the patient has bronchitis
no crackles,
123
what is chronic bronchitis
proliferation of mucus glands in the passageways resulting in excessive mucus secretion.
124
what do you expect to inspect w/ a patient with chronic bronchitis
hacking, rasping couch that is productive of thick mucoid sputum, chronic fatigue, cyanosis, and clubbing of nails
125
what is expected in palpating a thorax of a patient w/ chronic bronchitis
tactile fremitus is normal
126
what is expected in percussing a thorax of a patient w/ chronic bronchitis
resonant
127
what is expected when listening to the lungs of a patient w/ chronic bronchitis
normal vesicular, voice sounds normal, chronic-prolonged expiration
128
what adventitious breath sounds do you expect to hear in a patient w/ chronic bronchitis
crackles of deflated area, may have a wheeze
129
what is emphysema
permanent enlargement of air sacs distal to terminal bronchioles and rupture of interaleolar walls
130
what is expected when inspecting a patient w/ emphysema
increased AP diameter, barrel chest, accessory muscles used in respiration, shortness of breath, tachypnea
131
what is expected when palpating a patient w/ emphysema
decreased tactile fremitus and chest expansion,
132
what is expected when percussing a patient w/ emphysema
hyperresonant, decreased diaphragmatic excursion
133
what is expected when listening to the lungs of a patient with emphysema
decreased breath sounds, may have prolonged expiration, muffled heart sounds resulting from over distention of the lungs
134
what adventitious lung sounds do you expect to hear in a patient w/ emphysema
usually none, may have a wheeze
135
what is asthma
allergic hypersensitivity to certain inhaled allergens, irritants, microbes, stress, or exercise; produce a bronchospasm and inflammation, greatly increases airway resistance
136
what is pleural effusion
collection of excess fluid in the intrapleural space,
137
what is expected to be heard with pleural effusion
breath sounds decreased or absent, voice sounds decreased or absent,
138
what is heard in the lungs with heart failure
crackles at lung bases
139
what is pneumothorax
free air in the pleural spaces causes partial or complete lung collapse
140
what is pneumocystis jiroveci pneumonia
associated with AIDS
141
what is tuberculosis
inhalation of tubercle bacilli into the alveolar wall: initial complex is acute inflammatory response, scar tissue forms, reactivation of previously healed lesions, extensive deconstruction as lesion erodes,
142
where is the heart's right ventricle
right behind the sternum
143
where is the base of the heart
top of the heart
144
where is the apex of the heart
bottom of the heart
145
what does the pulmonary artery do
leaves the right ventricle, bifuricates, and carries the venous blood to the lungs
146
what does the pulmonary veins do
return the freshly oxygenated blood to the heart
147
what does the aorta do
carries the blood to the body
148
what is the pericardium
a rough, fibrous, double-walled sac that surrounds and protects the heart
149
what does the pericardial fluid do
ensures smooth, friction-free movement of the heart muscle
150
what is the myocardium
muscular wall of the heart
151
what does the myocardium do
it does the pumping
152
what is the endocardium
the thin layer of endothelial tissue that lines the inner surface of the heart chambers and valves
153
what valves separate the atria and the ventricles
atrioventricular valves (AV) valves
154
what is the right AV valve
tricuspid valve
155
what is the left AV valve
bicuspid valve
156
what attaches the valves to the ventricle floor
chordae tendinae
157
what is the heart's filling phase
diastole
158
what is the heart's pumping phase
systole
159
what happens during diastole
the valves open allowing the ventricles fill with blood
160
what happens during systole
AV valves close to prevent regurgitation of blood back into the atria
161
what are between the ventricle and the arteries
semilunar valves (SL) valves
162
when do the SL valves open
during systole or the pumping phase, to eject the blood from the heart
163
what part of the cardiac cycle makes up two thirds of the cycle
diastole or the filling phase
164
what is the first heart sound made or S1
when the AV valves close
165
what signals the the beginning of systole
S1 or the first heart sound
166
when does S2 take place
whe the SL valves close
167
what signals the end of systole
S2
168
where is S1 the loudest
the apex of the heart
169
where is S2 heard the best
the base of the heart
170
is S3 usually heard
no, but may be on some people
171
when does S3 take place
at the beginning of diastole when the ventricle are filling
172
when does S4 take place
at the end of diastole, when the ventricle is resistant to filling, just before S1
173
what is a murmur
a gentle, blowing, swooshing sound that can be heard on the chest wall
174
what can cause a murmur
1. velocity of blood increase(exercise)
2. viscosity of of blood decreases(anemia)
3. structural defects in the valves (narrowed valve) or unusual opening occur in the chambers(dilated chamber)
175
how are all heart sounds described by:
frequency, intensity, duration, and timing
176
what is frequency
pitch, high or low
177
what is intensity
loud or soft
178
what is duration
very short for heart sounds, silent periods are longer
179
what is timing
systole of diastole
180
what is the P wave
depolarization of the atria
181
what is the PR interval
from the beginning of the P wave to the beginning of the QRS complex (time necessary for atrial depolarization plus time for the impulse to travel through the AV node to the ventricles)
182
what is the QRS complex
depolarization of the ventricles
183
what is the T wave
repolarization of the ventricles
184
what is the cardiac output
equals the volume of blood in each systole (stroke volume)
185
what is preload
venous return that builds during diastole, the length to which the ventricular muscle is stretched at the end of diastole just before contraction
186
what is afterload
the opposing pressure the ventricle must generate to open the aortic valve against the higher aortic pressure
187
where is the carotid artery located
in the groove between the trachea and the sternomastoid muscle
188
is the carotid artery or jugular vein palpable
carotid artery
189
what does the jugular vein do
empty unoxygenated blood directly into the superior vena cava
190
which jugular vein is more superficial: internal or external
external
191
what does the pulse of a jugular vein look like
a wave
192
during pregnancy __rises and ___decreases
pulse rises and BP decreases
193
what do you not want to do when palpating the carotid arteries
palpate both arteries at once
194
what is a venous hum
continuous, ,low-pitched, soft hum, that is heard throughout the cycle, caused by turbulence blood flow in the jugular venous system
195
what is a carotid bruit
benign murmur heard just above the clavicles
196
what is orthostatic hypotension
a sudden drop in BP when rising to sit or stand
197
what is a normal heart rate
50-90 beats per minute
198
What sound should S1 make
lub
199
what sound should S2 make
dup
200
what are factors of loud S1
valves wide open and no time to drift together, calcification of valve,
201
what are factors of a faint S1
delayed conduction from atria to ventricles-mitral valve drifts shut before the ventricular contraction closes it, extreme calcification, more forceful atrial contraction into noncompliant ventricle
202
what are factors of a varying intensity of S
position of AV valve varies before closing from beat to beat , atria and ventricles beat independently
203
what are factors of a split S1
mitral and tricuspid components are heard separately
204
what are condition that contribute to an accentuated S2
higher closing pressure, exercise and excitement increase pressure in aorta, pulmonary hypertension, semilunar valves calcified but still mobile
205
what conditions that contribute to a diminished S2
a fall in systemic blood pressure causes a decrease in valve strength, semilunar valves thickened and calcified, with decreased mobility
206
what is a normal split S2
occurs during inspiration
207
what is a fixed split of S2
unaffected by respirations
208
what is a paradoxica split of S2
occurs during expiration
209
what is a wide split of S2
wide on inspiration and still present with expiration
210
what is an ejection click
sound of the SL valve opening; best heard with the diaphragm,
211
what is a aortic prosthetic valve sound
early systolic sound
212
what is a midsystolic click
associated with the mitral valve prolapse, sound is short and high pitched, best hear with the diaphragm at the apex
213
what are examples of extra early diastole
opening snap and mitral prosthetic valve sound
214
what is opening snap
sharp, high-pitched sound of opening of the AV valves
215
what is a mitral prosthetic valve sound
loud sound of the opening click just after S2, heard over all of the pericardium
216
what are examples of extra mid-diastole sounds
third heart sound
217
what is the third heart sound
ventricular filling sound, low pitched, sounds like distant thunder
218
what is physiologic third heart sound, S3
frequently heard in children and young adults, disappears when sitting up
219
what is pathologic third heart sound, S3
ventricular gallop
220
what are example of extra late diastolic sounds
fourth hear sound
221
what is the fourth heart sound
S4, ventricular filling sound, soft and low pitched
222
what is a physiologic fourth heart sound
found in adults older than 40
223
what is a pathologic fourth heart sound
atrial gallop
224
what is a pericardial friction rub
inflammation of the pericardium, high-pitched and scratchy best heard with diaphragm
225
what do you need to note about murmurs
where they are heard on the chest, where they occur in the cardiac cycle, loudness, pitch, variation in loudness
226
what are examples of systolic murmurs
aortic stenosis, pulmonic stenosis, mitral regurgitation, tricuspid regurgitation
227
what is aortic stenosis
calcification of he aortic valve: loud, harsh, midsystolic, loudest at the 2nd intercostal space
228
what is pulmonic stenosis
calcification of the pulmonic valve: medium, coarse, systolic, loudest at the apex
229
what is mitral regurgitation
stream of blood goes back into the left atrium: loud, blowing, loudest at apex
230
what is a tricuspid regurgitation
backflow of blood into the right atrium
231
what are examples of diastolic murmurs
mitral stenosis, tricuspid stenosis, aortic regurgitation, pulmonic regurgitation
232
what is mitral stenosis
calcified mitral valve: low pitched, diastolic, best hear at apex
233
what is tricuspid stenosis
calcification of tricuspid valve: rumbling, diastolic, best heard at left lower sternal boarder, louder on inpsiration
234
what is aortic regurgitation
stream of blood goes back into the left ventricle: soft, high pitched, blowing best heard at 3rd left intercostal space at the base
235
what is pulmonic regurgitation
backflow of blood back into the right ventricle: soft, high pitched, ,blowing
236
what is the normal heart rate of a baby
120-140 beats per minute
237
what are signs of heart disease in children
poor weight gain, developmental delay, persistent tachycardia, tachypnea, dyspnea
238
what are signs of heart failure
dilated pupils, pale of cyanotic skin, anxiety, dyspnea, orthopnea, cough, crackles in lungs, weak pulse, decreased BP, nausea and vomiting, edema, fatigue, decreased urine output
239
what are some congenital heart defects
atrial septal defect, ventricular septal defect, tetralogy of fallot, coarctation of the aorta
240
what is atrial septal defect
abnormal opening of the atrial septum
241
what is ventricular septal defect
abnormal opening in the septum between ventricle
242
what is tetralogy of fallot
shunts venous blood into the aorta, blood is not being oxygenated
243
what is coarctation of the aorta
severe narrowing of the aorta
244
what is in the vascular system
vessels in the body, tubes that transport fluid, either lymph or blood
245
what do arteries do
carry oxygenated blood to all the tissues
246
where are veins in reference to arteries
parallel to arteries but closer to the skin
247
what do veins do
return deoxygenated blood and waste to the heart
248
what does the lymphatic system do
retrieve excess fluid from the tissue spaces and return it to the bloodstream, prevent fluid from building in the interstitial spaces and producing edema, assist in in elimination of foreign pathogens, and cellular debris, immune function
249
where does the right lymphatic duct drain into
right subclavian vein
250
what does the right lymphatic duct drain
the right side of the head, neck, arm, thorax, pleura, heart, and upper section of the liver
251
what does the thoracic duct empty into
the left subclavian vein
252
what does the thoracic duct drain
the rest of the body
253
what are lymph nodes
small, oval clumps of lymphatic tissue located along vessels
254
what do lymph nodes do
filter the fluid before it is returned to the blood stream and filter out microorganisms
255
what are the major groups of lymph nodes
cervical, axillary, epitrochlear, inguinal
256
where are the cervical nodes
head and neck
257
where are the axillary nodes
breast and upper arms
258
where are the epitrochlear nodes
hand and lower arm
259
where are the inguinal nodes
inner hip
260
wheat does the spleen do
destroys the old red blood cells, ,produces antibodies, stores RBCs, filters out microorganisms from the blood
261
what do the tonsils do
respond to local inflammation
262
what does the thymus do
important in developing T lymphocytes of the immune system
263
what do you need to ask the patient about when assessing the vascular and lymphatic system
if they have leg pain or cramping, skin changes in the arms or legs, swelling, lymph node enlargement, and what medications they are on
264
what do we need to ask about leg pain and cramps
what makes it better or worse
265
what is important about asking what medications they are on
want to know if they are on blood thinners
266
what do we want to know about the color of arms and legs
if it is uniform, if they have sores or ulcers, if the temp is the same bilaterally
267
what do we want to know about swelling
if it is in one limb or both, what time of day it occurs, if it comes and goes or if it is constant,
268
what do we want to know about lymph node enlargement
where they are at, how long they have been there, if they are hard or soft
269
what do we need to note about pulses
rate, rhythm, elasticity of vessel wall and equal force,
270
what is the grading scale for a pulse
```
0= absent
1+= weak
2+= normal
3+= increased, full, bounding
```
271
what pulses can we palpate
carotid, brachial, radial, ulnar, femoral, popliteal, posterior tibial, dorsalis pedis
272
are epitrocheal lymph nodes usually palpable
no
273
what is the allen test
occlude both radial and ulnar arteries until hand turns white, then let go of the ulnar pulse and it should return to color within 2-5 seconds
274
is the popliteal pulse usually palpable
no
275
what is a normal ankle-brachial index
between 1.0-1.2
276
how do you find the ankle-brachial inde
divide the systolic # of the ankle by the systolic # of the brachial artery
277
are lymph nodes commonly palpable and large in infants and children
yes
278
what causes vasodilation in pregnant women
hormonal changes
279
what happens to the blood vessels are you grow older
they become rigid
280
what is a water-hammer pulse
greater than normal force, then collapses suddenly
281
what is pulsus bigeminus
coupled rhythm, every other beat comes early which makes the force decrease
282
what is pulsus alernans
regular rhythm, force varies with alternating beats
283
when does pulsus alernans occur
with severe left ventricular failure, caused by ischemic heart disease, valvular heart disease, chronic hypertension, or cardiomyopathy
284
when does pulsus bigeminus occur
premature ventricular contraction, premature atrial contraction
285
what is pulsus paradoxus
beats are weaker with inspiration, stronger with expiration
286
what is pulsus paradoxus associated with
cardiac tamponade and in severe bronchospasm of acute asthma
287
what is pulsus bisferiens
pulse has two strong systolic peaks
288
what is pulsus bisferiens associated with
aortic valve stenosis plus regurgitation
289
what are the 6 P's or arterial disease
pain, pallor, pulsenessess distal, parestesia, poikilothermic(temperature like a lizard) paralysis
290
what is raynaud's phenomenon
pallor, cyanosis, then rubor
291
what is lymphedma
high swelling of the limb
292
what causes lymphedma
damage to the lymph nodes and vessels or surgical removal of the lymph nodes
293
what are superficial varicose veins
incompetent valves permit reflux of blood
294
what is deep vein thrombosis
occulsion by a thrombus
295
what is virchow's triad
stasis, hypercoagulability and endothelial dysfunction
296
what in an aneurysms
sac formed by dilation in the artery wall
297
what is a saccular aneurysm
pouching on one side
298
what is a fusiform aneurysm
pouching of both sides
299
what is an arterial ischemis ucler
cause by atherosclerosis and arteriosclerosis: ulcers on the toes, heals, ankles, (no bleeding)
300
what is a venous stasis ulcer
after DVT's or chronic incompetent valves: ulcers on legs(bleeding)
301
what is the abdomen
a large oval cavity from the diaphragm to the brim of the pelvis
302
what are the rectus abdominus
set of abdominal muscles from a strip extending the length of midline(six pack)
303
what are the internal and external oblique muscles
lateral muscles of the abdomen
304
what is the viscera
internal organ
305
what are the solid viscera or firm organs
liver, pancreas, spleen, adrenal glands, kidneys, ovaries, and uterus
306
is the liver palpable
it may be palpable
307
where is the liver
RUQ
308
is the spleen palpable
not normally
309
wher is the spleen
LUQ
310
what is the hollow viscera
non usually palpable organs , unless contents are present
311
what are the hollow viscera organs
stomach, gallbladder, small intestine, colon and bladder
312
where is the abdominal aorta
left to midline
313
where are the renal arteries
4 cm below the epigastric area and above the iliac arteries
314
when does the aorta split into two
right below the belly button
315
what does the abdominal aorta turn into
the right and left common iliac arteries
316
how do you find out if an infant has a food intolerance
introduce one food at a time
317
what are common abdominal problems in adolescents
anorexia and bullema
318
what do you need to keep pin find when assessing the abdomen of an elderly patient
their ability to acquire and prepare foods, social isolation
319
how often should bowel sounds happen
every 5-15 seconds
320
where are superficial masses
1/2 to 1 cm
321
what is deep palpation
2-3 cm
322
what is rebound tenderness
after you push your finger tips into the abdomen , you release them and that is when rebound tenderness happens
323
what happens to the older adults with their digestive system
salvation decreases, esophageal emptying is delayed, gastric acid secretion decreases, liver size and function decrease, constipation
324
how long do you have to listen if you think bowel sounds are absent
5 minutes
325
what is the predominant percussion not in the abdomen
tymphany
326
what is the normal liver span
6-12 cm
327
what is light palpation used for in the abdomen
muscle tone, tenderness, superficial masses
328
what do we use deep palpation for in the abdomen
check for enlarged organs and rebound tenderness
329
what do we note if we feel an abnormal mass
note locations, size, shape, consistency, surface, mobility, pulsatilty and tenderness
330
what are some possible causes for pain in the abdomen
appendicitis, peritonitis, cholecystitis, pancreatitis, ovarian cyst rupture, pelvic inflammatory disease
331
what may cause abdominal distension
obesity , air/gas, ascites(abnormal accumulation of fluid , cyst/mass/tumor, pregnancy
332
what is a hernia
protrusion of abdominal content through the abdominal wall muscles but beneath the skin
333
what is inspiratory arrest or Murphy's sign
indicates cholecystitis
334
how do you check inspiratory arrest
hold fingers under the liver borer and hat the patient inhale, if this is painful and inspiration is stopped due to pain it is positive
335
what is iliopsoas muscle test used for
tests for appendicitis
336
what is the obturatory test used for
suspected appendicitis
337
what does the musculoskeletal system contain
bones, muscles, joints, ligaments, tendons,
338
what are the functions of the musculoskeletal system
movement, support, protections, blood production in the bone marrow
339
how many bones does the body have
206
340
what do ligaments do
hold bone to bone
341
what is a tendon do
hold muscle to bone
342
what is bursae
fluid filled sacs that helpp with cushionin
343
what is a synovial joint
freely moving joint(knee shoulder)
344
what is a non-synovial joint
can move slightly but not a lot (skull)
345
what does cartilage do
cushions the bones
346
is cartilage vascular or avascular
avascular
347
what is a joint
where two bones come together
348
what are types of joints
pivot, hinge, ball and socket, saddle, plane joint, condyloid joint
349
what is an example of a hinge joint
elbow
350
what is an example of a saddle joint
thumb
351
what is an example of a pivot joint
between C1 and C2
352
what is an example of a ball and socket joint
hip
353
what is an example of a condyloid joint
between the radius and the carpal bones
354
what is an example of a plane joint
between tarsal bones
355
what movement can the ball and socket joint do
flexion, extension, adduction , abduction, circumduction, internal and external rotation
356
what are the two movements that the hinge joints can do
flexion and extension
357
what movements can the mandible do
protraction and retraction
358
what movements can the scapula do
elevation and depression
359
do we have more muscles or bones
bones
360
what are the three types of muscles
smooth, striated or skeletal and cardiac
361
with the musculoskeletal system, where is usually the only lace you do percussion
along the vertebrate to illicit tenderness
362
what are you inspecting for with the musculoskeletal system
joint symmetry/deformity, size, contour
363
with palpation the musculoskeletal system should
move freely and be stable
364
what is the strength test scale
```
0= no contraction of muscle
1+= slight contraction of muscle
2+= full ROM without gravity(passive ROM)
3+= Full ROM with gravity(active)
4+= full ROM against gravity and some resistance
5+= full ROM against gravity and full resistance
```
365
how do you asses the TMJ(temporal mandibular joint)
open and close mouth, protrusion and retraction and side to side movemnt
366
what do you do strength testing on in the cervical spine
trapezius and sternocleidomastoid muscles
367
what is the normal angel of the cervical spine with flexion
45 degrees
368
what is the normal angle of the cervical spine with extension
55 degrees
369
what is the normal angle of the cervical spine with lateral bending
40 degrees
370
what is the normal angle of cervical spine with rotation
70 degrees
371
what is the angle the spine should be able to move with flexion
90 degrees
372
what is the angle the spine should be to move with extension
30 degrees
373
what is the angle the spine should be able to move with lateral bending
both sides 35 degrees
374
what is the angle the spine should be able to move with rotation
waist lint 30 degrees
375
what do the intervertebral discs do
they are shock absorbers for compression
376
what is the angle that the hip should reach with flexion
90 degrees
377
what is the angle that the hip should reach with extension
30 degrees
378
what is the angles the hip should reach with abduction
45 degrees
379
what is the angle the hip should reach with adduction
30 degrees
380
what is the angle the hip should reach with internal rotation
40 degrees
381
what is the angle the hip should reach with external rotation
45 degrees
382
what muscles do you strength test in the hips
gluteals, ,quadriceps, and bicep femoris
383
what movements do you need to test in the ankle and foot
dorsiflexion and plantar flexion, eversion, inversion,
384
what are the muscles you strength test in the ankle and foot
gastrocnemius and tibialis anterior
385
what shaped spine do infants have
C shaped
386
what is genu varum
bow legged
387
when is genu varum normal
up to one year after the child starts walking
388
what is genu valgum
knock knee
389
when is genu valgum normal
normal between 2 1/2 - 3 years
390
what is scoliosis
abnormal curvature of the spine
391
what is osteoporosis
weakening of the bones
392
who is osteoporosis common in
elderly females
393
how can you help prevent ostoporosis
weight bearing exercise, good nutrition, and good calcium intake
394
what is kyphosis
hyper-convex curvature in elderly patients
395
what is musclular atrophy
loss of muscle mass due to disuse, damage, or motor nerve damage
396
what is lordosis
leaning back, wider stance, wider gate,
397
who is lordosis common for
pregnant women
398
what is rheumatoid arthritis
immune disease where joints are attacked
399
what are symptoms of rheumatoid arthritis
pain, swelling, deformity, loss of function, progressive
400
what is a swan neck deformity
flexion contracture in the metacarpophangeal joint
401
what is ulnar deviation or drift
fingers drift to the ulnar side because of stretching of the articular capsule and muscle imbalance
402
what is osteoarthritis
wearing out or over use of joints
403
where is osteoarthritis most common
hips, shoulder, fingers
404
what does phalen's test test for
carpal tunnel
405
what happens when you have carpal tunnel and do phalen's test
numbness, tingling , burning
