Term
|
Definition
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|
Term
ID:
an chest area overlying the heart and great vessels |
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Definition
|
|
Term
|
Definition
| SVC= Superior Vena Cava; IVC= Inferior Vena Cava; PA= pulmonary artery; Pulmonary veins; Aorta |
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Term
| What are the 3 layers of the heart wall? |
|
Definition
| pericardium, myocardium, endocardium |
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Term
| What are the 2 AV valves? |
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Definition
|
|
Term
| What are the two semilunar valves? |
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Definition
|
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Term
| Describe the direction of blood flow |
|
Definition
| SVC & IVC to RA; tricuspid valve; RV; pulmonic valve, PA (blood is oxygenated), pulmonary veins, LA; mitral valve, LV; aortic valve and aorta to body |
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Term
| Describe ventricular systole |
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Definition
| contraction/ejection; isometric contraction; AV valve close, semilunar open; rapid ejection, Reduced ejection |
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Term
| Describe ventricular diastole |
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Definition
| relaxation/filling; isometric relaxation; AV valves open, semilunar valves close; Rapid filling, reduced filling; Atrial systole |
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Term
| Why is diastole longer than systole? |
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Definition
| Allows time for atrial contribution (25-30%) |
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Term
| Describe the isovolumic phase |
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Definition
| pressure changes occur that closes AV valves and let semilunar valves open |
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Term
| What is the purpose of atrial systole? |
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Definition
| Atrial kick; adds 25% to LVEDV |
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Term
| Describe the S1 heart sound |
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Definition
|
|
Term
| Describe the S2 heart sound |
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Definition
|
|
Term
| Describe the S3 heart sound |
|
Definition
| Abnormal; Rapid filling; Resistant to filling, ventricular gallop, non-compliant ventricle (over-stretched); Ventricular failure |
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|
Term
| Describe the S4 heart sound |
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Definition
| Normally silent; resistant to filling, atrial gallop, non-compliant ventricle, ventricular failure |
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|
Term
ID:
gentle, blowing swooshing sound during systole or diastole caused by turbulent blood flow |
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Definition
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Term
| What are 3 possible causes of murmurs? |
|
Definition
| increased blood velocity, structural defects in the valves (stenosis, incompetence/regurgitant [leakiness]), abnormal chamber openings |
|
|
Term
| Define the two septal defects |
|
Definition
ASD= Atrial Septal Defect
VSD= Ventricular Septal Defect |
|
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Term
| What are the 3 nodes of conduction in the heart? |
|
Definition
| SA node (intrinsic pacemaker, 60-100 BPM); AV node (back-up pacemaker,40-60 BPM); Purkinje fibers (back-up pacemaker; 20-40 BPM) |
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Term
ID aspect of ECG:
atrial depolarization |
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Definition
|
|
Term
ID aspect of ECG:
time frame between atrial and ventricular depolarization |
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Definition
|
|
Term
ID aspect of ECG:
ventricular depolarization |
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Definition
|
|
Term
ID aspect of ECG:
ventricular repolarization |
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Definition
|
|
Term
|
Definition
| blood volume ejected with systole; preload, afterload and contractility |
|
|
Term
ID aspect of Stroke volume:
filling pressure; dependent on volume (EDV) |
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Definition
|
|
Term
| ID aspect of Stroke volume: TPR (total peripheral resistance) and SVR (systemic vascular resistance), Resistance against which the ventricles pump |
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Definition
|
|
Term
ID aspect of Stroke volume:
Measure of inotropy |
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Definition
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|
Term
| The timing of the carotid pulse coincides with what heart sound? |
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Definition
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|
Term
| What area should you avoid when palpating the carotid pulse? |
|
Definition
|
|
Term
| What are some cardiac developmental considerations for the aging adult? |
|
Definition
| increased BP (systolic), LV hypertrophy, increased dysrhythmias, increased CAD |
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Term
|
Definition
| paroxysmal nocturnal dyspnea; venous return is too much for the heart and can put them in early CHF |
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Term
| What are the implications of a carotid palpation of less than 2+? More? |
|
Definition
| decreased SV; hyperdynamic state (SNS stimulation) |
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|
Term
| Auscultating a bruit can indicate a risk for ____ |
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Definition
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Term
|
Definition
|
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Term
|
Definition
|
|
Term
| When is the PMI evaluated? |
|
Definition
| Point Maximum Impulse; last step of palpation |
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Term
| What 6 things should be described if a murmur is auscultated? |
|
Definition
| Location, timing, pitch, loudness, pattern, quality |
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|
Term
| At the apex ___ is louder |
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Definition
|
|
Term
| At the base ___ is louder |
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Definition
|
|
Term
| Splits are best heard with the ____ |
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Definition
|
|
Term
| When auscultating the precordium in the left lateral position listen with the ___ held ____ at the _____ |
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Definition
|
|
Term
| When auscultating the precordium in the sitting up position listen with the ___ held ___ at the _____ |
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Definition
|
|
Term
| When auscultating the precordium if you hear a S3 it is a sign of _____ |
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Definition
|
|
Term
| When auscultating the precordium if you hear a S4 it is a sign of _____ |
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Definition
|
|
Term
| When auscultating the precordium if you hear a S3 and S4 it is a sign of _____ |
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Definition
|
|
Term
| What are the capacitance vessels? |
|
Definition
| blood volume reservoir; jugular veins, veins in arms and legs |
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|
Term
| What are the developmental consideration for the aging adult regarding the peripheral vascular system? |
|
Definition
| arteriosclerosis, enlargement of intramuscular calf veins (increased DVT risk); lymph tissue loss |
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|
Term
| Where are the epitrochlear nodes located? |
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Definition
|
|
Term
| Describe Acute Arterial Symptoms |
|
Definition
| acute blockage of arterial blood, throbbing pain of sudden onset distal to occlusion, 6Ps |
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|
Term
| What are the 6Ps of Acute Arterial Disease? |
|
Definition
| Pain, Pallor, Pulselessness, Parasthesias-altered sensation (tingling), poikilothermia (coldness), paralysis |
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Term
| What are the chronic arterial symptoms? |
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Definition
| chronic pain, dangling pain, elevation pallor, atrophy, ischemic ulcer |
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|
Term
| Describe acute venous sypmtoms |
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Definition
| DVT, Inflammation (pain, deep muscle, mild, loss of function) |
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|
Term
| What is the most common location of acute venous disease symptoms? |
|
Definition
|
|
Term
| What are the symptoms of chronic venous disease? |
|
Definition
| varicose veins (incompetent valves, on feet all day, obstruction), Chronic Venous Insufficientcy (CVI) |
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|
Term
|
Definition
| chronic venous insufficiency; firm edema, coarse skin, normal pulse, venous stasis ulcers, aching at the end of the day |
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Term
| What is the purpose of auscultating before palpating the abdomen? |
|
Definition
| so sounds are not caused from our manipulation of the body |
|
|
Term
| What is the normal state of the abdomen? |
|
Definition
|
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Term
| Define the viscera and describe its two components |
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Definition
| internal organs; solid (maintain shape; liver, spleen, kidneys) hollow (change shape depending on contents; stomach, gallbladder, colon, bladder) |
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|
Term
| What two organs of the peritoneum are not anteriorly palpable? |
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Definition
|
|
Term
| what are the 3 aspects of the midline grid? |
|
Definition
| epigastric, umbilical and suprapubic |
|
|
Term
| What is a synonym for hypogastric? |
|
Definition
| suprapubic; used more often |
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Term
| What are developmental considerations of the aging adult regarding the abdomen? |
|
Definition
| fat accumulation, salivation decreased, gastric acid and liver size decreases, gallstones and constipation increase |
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Term
| List and describe the 3 types of abdominal pain |
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Definition
| visceral (internal organ, dull and poorly localized); parietal (inflammation of peritoneum, sharp); referred (pain not over involved organ) |
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|
Term
| Where does appendix pain localize once pain becomes more specific? |
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Definition
|
|
Term
| Pancreas pain radiates to? |
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Definition
|
|
Term
| Where does kidney pain localize to? |
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Definition
|
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Term
|
Definition
| profile of rib margin to pubic bone |
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Term
|
Definition
|
|
Term
| What are 3 examples of physiologic contours? Pathologic? |
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Definition
| flat, rounded, scaphoid; Protuberant |
|
|
Term
| What are the 7 F's of distention? |
|
Definition
| Fat, feces, flatus, fluid (ascites), fetus, fibroids (benign), fatal growth |
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|
Term
| Where does auscultation for bowel sounds begin? |
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Definition
|
|
Term
| Where are you more likely to hear increased bowel sounds? |
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Definition
|
|
Term
| How man bowel sounds/min are considered active (normal)? |
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Definition
|
|
Term
| In an abdominal assessment where is the aorta located? |
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Definition
|
|
Term
| What does bruit auscultation of the aorta in an abdominal assessment indicate? |
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Definition
|
|
Term
| What is the physiologic percussion sound for the abdomen? |
|
Definition
| tympany; dullness over liver, fat tissue or fluid |
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Term
| What does percussed dullness (non-physiologic) on the abdomen indicate? Hyperresonance? |
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Definition
| distended bladder, masses; gaseous distention |
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Term
|
Definition
|
|
Term
| What is the most common cause of surgical emergency in the abdomen? |
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Definition
|
|
Term
| What is another name for rebound tenderness? |
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Definition
|
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Term
| Describe the results of rebound tenderness |
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Definition
| makes structures indented by palpation rebound suddenly; indicates peritoneal inflammation; commonly accompanies ruptured appendix |
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|
Term
| What does the palpation of a wide aortic pulse indicate? |
|
Definition
| aneurism; even if bruit was not auscultated |
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Term
| Describe breathing technique in regards to abdominal inspection |
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Definition
| using your fingers to go deeper under the rib cage as the patient exhales |
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Term
| What are the peritoneal signs of peritonitis? |
|
Definition
| Distension, paralytic ileus (decreased bowel sounds), boardlike rigidity, rebound tenderness |
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|
Term
| What is Murphy's sign indicative of? |
|
Definition
| cholecystitis; pain with inspiratory arrest when RUQ palpated |
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|
Term
| What predisposes someone for cholecystitis? |
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Definition
|
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Term
|
Definition
|
|
Term
| Grey Turner's sign is indicative of what? |
|
Definition
|
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Term
| Describe the ilopsoas muscle test and its purpose |
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Definition
| performed when appendicitis is suspected; pt is supine and lifts R leg straight up and caregiver pushed down over lower R thigh; normal= no pain |
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Term
| Describe the obturator test and its purpose |
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Definition
| performed when appendicitis is suspected; pt is supine, lifts R leg and flexes hip with 90 degrees at knee; hold ankle and rotate leg internally and externally |
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|
Term
| Circumcision removes what part of the penis? |
|
Definition
|
|
Term
| What muscle controls the size of the scrotum by responding to ambient temperature? |
|
Definition
|
|
Term
| What are two possible locations for hernias in the male reproductive anatomy? |
|
Definition
|
|
Term
| Describe transilumination |
|
Definition
| Done only when swelling or mass is detected. Darken room and shine flashlight from behind scrotum; no transilumination is normal |
|
|
Term
| describe a normal lymph node palpated in the male groin |
|
Definition
| small (1cm), soft, discrete, movable |
|
|
Term
| In what age group is testicular cancer most common? |
|
Definition
| 15-40; those with undescended testicles and whites are more at risk |
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Term
|
Definition
| Timing (once per month) Shower (warm water) Examine |
|
|
Term
| What are some penile changes that occur in older men? |
|
Definition
| thinner graying pubic hair, decreased penis and testes size, less rugae on scrotal sac, excoriated scrotal skin |
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|
Term
| What are the signs of carcinoma development on the male genitalia? |
|
Definition
| red raised warty growth or ulcer with watery discharge; painless; enlarged lymph nodes |
|
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Term
|
Definition
| foreskin does not retract |
|
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Term
|
Definition
| retracted foreskin does not return to original position |
|
|
Term
|
Definition
| urethra is on ventral surface |
|
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Term
|
Definition
| urethra is on dorsal surface |
|
|
Term
| Define/describe varicocele |
|
Definition
| varicose veins in spermaticord; bluish color, spermatic cord feels like bag of worms; impairs fertility due to increase in temp |
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|
Term
|
Definition
|
|
Term
| Define/describe testicular torsion |
|
Definition
| tangled spermaticord; surgical emergency; sudden onset with abdominal pain and vomiting; red swollen tender testis |
|
|
Term
| Define peyronie's disease |
|
Definition
| "bent nail disorder"; bending during erection; occurs in older men after 45 yo; fibrotic |
|
|
Term
| What are 3 possible causes of priapisms? |
|
Definition
| blastic crisis in leukemia, sickle cells and blunt trauma |
|
|
Term
|
Definition
| Benign prostatic hypertrophy |
|
|
Term
| What is the 2nd leading COD regarding cancer of women? first? |
|
Definition
|
|
Term
| There is an increased risk for breast cancer if ____ or 1st pregnancy is after age _____ |
|
Definition
|
|
Term
|
Definition
| number of children you have |
|
|
Term
| The recent decrease in breast cancer death rates are due to what? |
|
Definition
|
|
Term
| What is the name for the measurement of breast growth? |
|
Definition
|
|
Term
| What are the first 3 positions for visual inspection of the breast? |
|
Definition
| arms at sides, arms raised leaning forward, hands on hips flexing chest muscles |
|
|
Term
| When palpating the breast, start ___ and move ____; Why? |
|
Definition
| out; inward; sensitivity improves as you move inward |
|
|
Term
| What are the 5 Ps of Mammacare? |
|
Definition
| Palpation, pressures, pattern (lawn mower), perimeter, positions |
|
|
Term
| What 3 aspects of breast lumps are we concerned with? |
|
Definition
| large/small, hard/soft, fixed/movable |
|
|
Term
| Describe the cahan position for breast examination |
|
Definition
| Client in lateral position, roll shoulders back on pillow, arm in fainting position; |
|
|
Term
| Annual mammography for women should begin at what age? |
|
Definition
|
|
Term
| When should clinical breast exams begin? How often should they occur? |
|
Definition
|
|
Term
| When does menopause usually occur? |
|
Definition
|
|
Term
| Why does menopause usually occur and what does it cause? |
|
Definition
| estrogen and progesterone are no longer produced; vagina shortens, narrows and loses elasticity; vaginal epithelium thinner and drier |
|
|
Term
ID vaginal condition:
thick white curdy itchy discharge; associated with antibiotic use |
|
Definition
|
|
Term
| Describe bacterial vaginosis |
|
Definition
| thin fishy discharge; increased discharge after intercourse; STI or spontaneous |
|
|
Term
| What is the most common STI and its symptoms? |
|
Definition
| Chlamydia; none or bleeding/painful intercourse with friable cervix |
|
|
Term
|
Definition
| painless flesh colored growths; sngle or in cauliflower patch |
|
|
Term
| Describe uterine prolapse |
|
Definition
| with aging uterus droop and may protrude into vagina; is inside out |
|
|
Term
ID vaginal disorder:
pressure, stress incontinence, with straining bladder or rectum covered by vaginal mucosa prolapses into vagina |
|
Definition
|
|
Term
| What is the risk factors and diagnostic method for cervical cancer? |
|
Definition
| early age of intercourse, multiple partners, smoking, STI infection; pap smear and biopsy |
|
|
Term
| If a child is quiet you should begin with ___ in assessment |
|
Definition
|
|
Term
| What are the 3 fetal shunts in order of closing? |
|
Definition
| foramen ovale, ductus arteriosus, ductus venosus |
|
|
Term
| What are 3 factors that control shunt closure? |
|
Definition
| increased O2 concentration, decreased endogenous prostaglandins, acidosis |
|
|
Term
| What causes closure of foramen ovale? |
|
Definition
| cord is clamped which increases SVR |
|
|
Term
| What is the most reliable pulse in infants and young children? |
|
Definition
|
|
Term
| What type of arrhythmia is normal to find in children? |
|
Definition
|
|
Term
ID murmur type:
no anatomic abnormality exists |
|
Definition
|
|
Term
ID murmur type:
no anatomic defect; anemia is present |
|
Definition
|
|
Term
ID murmur type:
cardiac defect with or without physiologic abnormality |
|
Definition
|
|
Term
| What are the 3 types of stimulation of onset of breathing? |
|
Definition
| chemical factors, thermal stimulation, tactile stimulation |
|
|
Term
| Barrel chest is common in peds until what age? |
|
Definition
|
|
Term
| Why do infants breath twice as fast as adults? |
|
Definition
| because they have a large volume of dead space in respiratory tract |
|
|
Term
| What are the two expiratory adventitious breath sounds? |
|
Definition
|
|
Term
| How do you calculate the EDD using Naegele's rule? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Define FPAL from the Parity System |
|
Definition
| Full term deliveries; Pre term deliveries; Abortions or miscarriages; Living children |
|
|
Term
| What are the 3 types of abortion? |
|
Definition
| therapeutic, elected, spontaneous |
|
|
Term
| How soon after delivery does parity change? |
|
Definition
|
|
Term
| After what gestational age should you ask about fetal movement? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| hyper pigmented line extending from sternum to symphysis pubis |
|
|
Term
| Define leopold's maneuvers |
|
Definition
| abdominal assessment that give info about placement of fetus in utero |
|
|
Term
| How long is the post partum period? |
|
Definition
|
|
Term
| What 4 things are assessed post partum? |
|
Definition
| vitals, post anesthesia recovery, tremors and nutritional assessment |
|
|
Term
| A rise in systolic pressure post partum may indicate what? |
|
Definition
| PIH: pregnancy induced hypertension |
|
|
Term
|
Definition
| Breasts Uterus Bladder Bowel Lochia Episiotomy Homan's Sign Emotional status |
|
|
Term
| Describe involution shrinking of uterus |
|
Definition
| Uterus decreases 1 cm/day after birth in size. Initially between symphysis pubis and umbilicus |
|
|
Term
| What should be the consistency of the uterus after birth? |
|
Definition
|
|
Term
|
Definition
| soft, need to get it to contract |
|
|
Term
|
Definition
| uterus does not involute at 1cm/day; sign of infection |
|
|
Term
| How do you know if the lochia signals significant bleeding? |
|
Definition
| using more than 1 pad in an hr or less |
|
|
Term
|
Definition
|
|
Term
| When after birth can sexual activity resume? |
|
Definition
| when lochia has ceased and episiotomy has healed; 4-6 wks |
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