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Chapter 13
Paramedic: Patient Assessment
369
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10/15/2012

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Cards

Term
What is a determination of what you think is the patient's problem?
Definition
Field Impression 589
Term
What is determining the dynamics of scene management begins by assessing the scene itself?
Definition
Scene Size-up 592
Term
What is the way in which traumatc injuries occur-the forces that act on the body to cause damage?
Definition
Mechanism of Injury (MOI) 594
Term
What is the general type of illness a patient is experiencing?
Definition
Nature of Illness (NOI) 594
Term
What is the part of the assessment process that focuses on identifying immediately or potentially life-threatening conditions so that you can initiate lifesaving care?
Definition
Primary assessment 597
Term
In the first ___ seconds, as you look at, talk with, and touch your patient, you should be able to identify threats to the ABCs.
Definition
60 to 90 597
Term
What is the overall intitial impression that determines the priority for patient care; based on the patient's surroundings, the MOI, signs and symptoms, and chief complaint?
Definition
General Impression 597
Term
What is the quickest and simplest way to assess the patint's mental status or level of consciousness (LOC)?
Definition
AVPU 597
Term
What does AVPU stand for?
Definition
A Alert to person, place, and day 597
V Response to Verbal stimuli
P Responsive to Pain
U Unresponsive
Term
What does sonorous mean?
Definition
Snoring Respirations 597
Term
The body's ability to deliver oxygen and nutrients at the cellular level and to remove the waste products of metabolism for elimination.
Definition
Perfusion 599
Term
A 60-90-second nonsystematic review and palpation of the patient's body to identify injuries that must be managed or protected immediately.
Definition
Rapid Exam 600
Term
What is a grating or grinding sensation or sound made when two pieces of broken bone are rubbed together?
Definition
Crepitus 601
Term
Information about the patient's chief complaint, present symptoms, and previous illnesses.
Definition
Patient History 605
Term
What is the problem for which the patient is seeking help?
Definition
Chief Complaint 606
Term
Wha is information about the chief complaint that is obtained using the OPQRST mnemonic?
Definition
History of Present Illness 607
Term
What are objective observations or measurements that you make?
Definition
Signs 607
Term
What is subjective information that the patient tells you?
Definition
Symptoms 607
Term
What gives you the opportunity to learn about any pertinent or chronic underlying medical conditions the patient may have?
Definition
Past Medical History 607
Term
A composite picture of a number of factors in a patient's life, such as dietary habits, current medications, allergies, exercise, alcohol or tobacco use, recreational drug use, sleep patterns and disorders, and immunizations.
Definition
Current Health Status 609
Term
What is a distal radial fracture?
Definition
Colles Fracture 611
Term
A lack of certain signs and symptoms one would normally expect to see specific to the illness or condition.
Definition
Pertinent Negatives 612
Term
What is redness of the skin?
Definition
Erythema 612
Term
What is double vision?
Definition
Diplopia 613
Term
What is sensitivity to light?
Definition
Photophobia 613
Term
What is ringing in the ears?
Definition
Tinitus 613
Term
What is sensation of the room spinning?
Definition
Vertigo 613
Term
What is a runny nose?
Definition
Rhinorrhea 613
Term
What is a complicated network of hormone secreting glands that help to regulate various functions in the human body?
Definition
The Endocrine System 613
Term
What is increased frequency of urination?
Definition
Polyuria 613
Term
What is increased thirst?
Definition
Polydipsia 613
Term
What is increased appetite?
Definition
Polyphagia 613
Term
What is coughing up blood?
Definition
Hemoptysis 613
Term
What is shortness of breath while lying flat?
Definition
Orthopnea 613
Term
What is blood in vomit?
Definition
Hematemesis 613
Term
What is painful urination?
Definition
Dysuria 613
Term
What is waking up in the middle of the night to urinate?
Definition
Nocturia 613
Term
What is blood in the urine?
Definition
Hematuria 613
Term
What is excessive urination?
Definition
Polyuria 613
Term
What is pain during menstration?
Definition
Dysmenorrhea 612
Term
The process of weighing the probability of one disease versus other diseases by comparing clinical findings that could account for a patient's illness.
Definition
Differential Diagnosis 614
Term
What are the 2 basic types of depression?
Definition
Situational and Chronic 621
Term
____ depression describes a reaction to a stressfull event in a patient's life.
Definition
Situational 621
Term
____depression is ongoing and does not seem to have an apparent cause.
Definition
Chronic 621
Term
What is an inner ear infection?
Definition
Otitis Media 624
Term
Related to a side effect or complication of treatment.
Definition
Iatrogenic 624
Term
The process by which more detailed, quantifiable, objective information is obtianed from a patient about his or her overall state of health.
Definition
Secondary Assessment 626
Term
What involves looking at the patient, either in general or at a specific area?
Definition
Inspection 627
Term
What is the physical touching for the purpose of obtaining information?
Definition
Palpation 627
Term
What is gently strikingthe surface of the body, typically overlying various body cavities, to detect changes in the densitites of the underlying structures?
Definition
Percussion 627
Term
What involves listening with a stethoscope?
Definition
Auscultation 627
Term
The palpation of the heartbeat by using the fingers at a point where an artery passes close to the bone.
Definition
Pulse 628
Term
What is the measurement of the force exerted against the walls of the blood vessels?
Definition
Blood Pressure 629
Term
What is created by the left ventricle while it is contracting?
Definition
Systolic Pressure 629
Term
What is the result of residual pressure in the system while the left ventricle is relaxing?
Definition
Diastolic Pressure 629
Term
What is the product of cardiac output and peripheral vascular resistance?
Definition
Blood Pressure 629
Term
What is ear wax?
Definition
Cerumen 630
Term
A assessment tool that measures oxygen saturation of hemoglobin in the capillary beds.
Definition
Pulse Oximetry 630
Term
What is a pressure meter?
Definition
Manometer 630
Term
What allows you to look into a patient's eyes and view the retina and aqueous fluid?
Definition
Ophthalmoscope 631
Term
What is used to evaluate the ears of a patient?
Definition
Otoscope 631
Term
What is the most important skill a health care provider can master in the prehospital setting?
Definition
Physical examination of a Patient 632
Term
What is a systematic head-to-toe examination that is performed during the secondary assessment of a patient who has sustained a significant mechanism of injury, is unresponsive, or is in critical condition?
Definition
Full-body Exam 632
Term
A type of physical assessment that is typically performed on patients who have sustained an isolated injury or on responsive medical patients. This type of examination is based on the chief complaint and focuses on one body system or part.
Definition
Focused Assessment 632
Term
An evaluation tool used to determine level of consciousness, which evalutes and assigns point values (scores) for eye opening, verbal response, and motor response, which are then totaled; effective in helping predict patient outcome.
Definition
Glasgow Coma Scale (GCS) 635
Term
A determination made when assessing mental status by looking at whether the patient is oriented to four elements; person, place, time, and the event itself.
Definition
Alert and Oriented (A x O) 635
Term
The tough, highly elastic layer of connective tissue underlying the epidermis.
Definition
Dermis 638
Term
The outermost layer of skin that acts as the body's first line of defense.
Definition
Epidermis 638
Term
Cells that secrete collagen, elastin, nd ground substance are found in the dermis.
Definition
Fibroblast 638
Term
What is excessive sweating?
Definition
Diaphoresis 638
Term
What is loss of elasticity in the skin?
Definition
Turgor 638
Term
Widening of a blood vessel, flused.
Definition
Vasodilation 638
Term
Narrowing of a blood vessel, such as with hypoperfusion or cold extremities.
Definition
Vasoconstriction 638
Term
What is paleness and is present when red blood cell perfusion to the capillary beds of the skin is poor?
Definition
Pallor 638
Term
A bluish-gray skin color that is caused by reduced levels of oxygen in the blood.
Definition
Cyaosis 638
Term
A blotchy pattern on the skin; a typical finding in states of severe protracted hypoperfusion and shock.
Definition
Mottling 638
Term
What is localized bruising or blood collection within or under the skin?
Definition
Ecchymosis 638
Term
A condition in which the skin slowly retracts after being pinched and pulled away slightly from the body; a sign of dehydration.
Definition
Tenting 638
Term
What are raccoon eyes?
Definition
Priorbital Ecchymosis 641
Term
What is the ability or inability to see, and how well the patient can see?
Definition
Visual Acuity 641
Term
What is unequal size of the pupils?
Definition
Anisocoria 642
Term
What percent of the population have anisocoria?
Definition
20% 642
Term
What is another name for ear drum?
Definition
Tympanic Membrane 645
Term
What is an abnormal curvature of the spine?
Definition
Kyphoscoliosis 649
Term
What is a high-pitched whistling sound that is most prominent on expiration but can be heard on inspiration in sicker patients?
Definition
Wheezing 650
Term
What is a brassy, crowing sound often heard without a stethoscope and is caused by the narrowing, swelling,m or obstruction of the upper airway and may indicate that the patient has an obstruction in the neck or upper part of the chest?
Definition
Stridor 651
Term
Congested breath sounds, are continuous sounds with a lower pitch and a rattling quality and are indicative of fluid in the larger airways in the lungs.
Definition
Rhonchi 651
Term
Rattling, bubbling, or crackling lung sounds indicative of fluid in the small airways.
Definition
Rales or Crackles 650-651
Term
Squeaking or grating sounds that occur when the pleural linings rub together, which may be heard on inspiration, expiration, or both; commonly caused by inflammation of the pleura.
Definition
Pleural Friction Rubs 651
Term
The introduction of vomit or other foreign material into the lungs.
Definition
Aspiration 651
Term
A test of decreased breath sounds performed by placing the diaphragm of the stethoscope over the area in question while the patient says "99"; a loud, clear sound indicates lung consolidation.
Definition
Bronchophony 652
Term
A test of decreased breath sounds performed by placing the diaphragm of the stethoscope over the area in question while the patient says "ee"; an "ay" sound indicates lung consolidation.
Definition
Egophony 652
Term
A test of decreased breath sounds performed by placing the diaphragm of eh stethoscope over the area in question while the patient whispers "99"; a loud, clear sound indicates lung consolidaton.
Definition
Whispered Pectoriloquy 652
Term
What are silent breath sounds?
Definition
Status Asthmaticus 652
Term
In the context of heart sounds, the situation in which events on the right side of the heart occur slightly later than those on the left side, and create two discernible sounds rather than one heart sound.
Definition
Splitting 654
Term
Sounds related to blood pressure measurement that are heard by stethoscope.
Definition
Korotkoff Sounds 656
Term
What is an abnormal whoosh-like sound that indicates turbulent blood flow moving through a narrowed artery?
Definition
Bruit 656
Term
What is an abnormal whoosh-like sound heard over the heart that indicates turbulent blood flow around a cardiac valve?
Definition
Murmur 656
Term
Distention of the veins in the neck indicating decreased venous return to the heart.
Definition
Jugular Vein Distention (JVD) 656
Term
A sensation felt upon palpation of the chest wall, in which the heart beats extremely strongly; suggests hypertrophy.
Definition
Lift or Heaves 656
Term
A humming vibration that can be palpated through the chest wall; suggests an underlying bruit or murmur.
Definition
Thrill 657
Term
What is cyanosis in the extremities?
Definition
Acrocyanosis 657
Term
Assessing vital signs in 2 different patient positions to determine the degree of hypovolemia.
Definition
Orthostatic Vital Signs 658
Tilt Test
Term
What is a collection of fluid within the peritoneal cavity?
Definition
Ascites 660
Term
Contraction of the abdominal muscles in patients.
Definition
Guarding 660
Term
What is a localized weakening of the abdominal wall musculature?
Definition
Hernia 661
Term
What is one of the most important skills you will develop as a paramedic?
Definition
Assessing a Patient 589
Term
What is the most important assessment skill for you to acquire and comes with experience?
Definition
Whether Patient is Sick or Not Sick 589
Term
Every time you assess a patient, you have to ___ whether your patient is sick or not sick, and then you must ____ how sick the patient is.
Definition
Qualify and Quantify 589
Term
What are the 2 basic categories of patient problems?
Definition
Medical and Trauma 590
Term
When you are working next to a public roadway, what should you wear at a minimum?
Definition
American National Standards Institute 207 certified high-visibility public safety vest 592
Term
What should you consider if the scene is not to your liking?
Definition
Snatch and Grab 592
Term
What is the number one way to prevent the transmission of disease?
Definition
Handwashing 595
Term
Whether the call is medical or trauma case, the first question is a ___ and the second is a ___.
Definition
Qualification and Quantification 597
Term
What could happen if you suction the patient for too long?
Definition
Hypoxia and Bradycardia secondary to vagal stimulation 598
Term
Respiratory rate multiplied by the tidal volume inspired with each breath.
Definition
Minute Volume 598
Term
___ is evaluated to assess the ability of the circulatory system to restore blood to the capillary system.
Definition
Capillary Refill 598
Term
What is it when the skin is a dusky gray or blue?
Definition
Cyanosis 599
Term
Occurs if arterial blood flow ceases to part of the body, as in the case of a blood clot or massive bleeding.
Definition
Pallor 599
Term
There are only a few conditions that cause sudden death, what are they?
Definition
Airway Obstruction, Respiratory Arrest, Cardiac Arrest, and Severe Bleeding 600
Term
On most runs, what are the 2 most important pieces of patient history information that you need to obtain?
Definition
Patient's Name and Chief Complaint 605
Term
What else should you ask a patient after you have obtained name?
Definition
Day of the Week, Time, Locations, and Events surrounding the current situation 605
Term
____ combines knowledge of anatomy, physiology, pathophysiology, and the patient's complaints to help direct questioning when you are obtainig a history.
Definition
Clinical Reasoning 614
Term
Using techniques that encourage your patient to feel open to giving you any information you need.
Definition
Facilitation 615
Term
Pausing to consider something significant that you've just been told.
Definition
Reflection 615
Term
The technique of asking your patients for more information when some aspect of the history is vague or unclear.
Definition
Clarification 615
Term
Making your patient aware that you perceive something that is not consistent with his or her behavior, the actual scene, or the information the patient is giving you.
Definition
Confrontation 615
Term
Inferring the cause of the patient's distress, then asking the patient if you are right.
Definition
Interpretation 615
Term
When the brain malfunctions, more often than not the problem is related to what two fuels that are essential to the brain, though it can store neither of them?
Definition
Glucose and Oxygen 621
Term
What are do children typically become very capable of providing history of the current problem?
Definition
3-5 years 624
Term
What do physicians typically assess when examining geriatric patients?
Definition
Instrumental Activities of Daily Living (IADLs) 624
Term
___ consists of two elements-obtaining vital signs that measure overall body function and performing a head-to-toe survey that evaluates the workings of specific body organ systems.
Definition
Secondary Assessment or Physical Examination 626
Term
What is cup-shaped and is used to listen for deep and low-pitched sounds (heart sounds)?
Definition
The Bell 627
Term
What is flat-shaped and is used to listen for high-pitched sounds (breath, bowel, and normal heart sounds)?
Definition
The Diaphragm 627
Term
What is a disposable plastic earpiece?
Definition
Speculum 631
Term
What is the most reliable and consistent method of assessing mental status and neurologic function?
Definition
Glasgow Coma Scale (GCS) 635
Term
What is it called when an infant follows your with their eyes?
Definition
Tracking 636
Term
In the GCS, what score indicates no neurologic disabilities?
Definition
15 636
Term
In the GCS, what score indicates mild dysfunction?
Definition
13-14 636
Term
In the GCS, what score indicates moderate to severe dysfunction?
Definition
9-12 636
Term
In the GCS, what score indicates severe dysfunction?
Definition
8 or less 636
Term
What are false, fixed, personal beliefs that are not shared by other members of the patient's culture?
Definition
Delusions 637
Term
What are two common methods of assessing attention?
Definition
Serial 7's and Spelling Backwards 637
Term
What is the dermis subdivided into?
Definition
Papillary Dermis and Reticualr Layer 638
Term
The vasculature inside the ____ serves two functions: provides nutrients to the epidermis and it aids in thermoregulation.
Definition
Papillary Dermis 638
Term
____ consists of dense, irregular connective tissue, which prvides both strength and elasticity.
Definition
Reticular Layer 638
Term
What is the quickest and most reliable initial way to evaluate a patient's overall degree of distress is to look at what?
Definition
The Skin 638
Term
What two parts is the head divided into?
Definition
Cranium and Face 639
Term
What is the most posterior portion of the cranium?
Definition
The Occiput 639
Term
Transverse depressions in the nail inhibiting growth.
Definition
Beau Lines 639
Term
The angle between the nail and the nail base approaches or exceeds 180 degrees.
Definition
Clubbing 639
Term
Pitting, discoloration, and subungual thickening of the nail.
Definition
Psoriasis 639
Term
Red or brown linear streaks in the nail bed.
Definition
Splinter hemorrhages 639
Term
Transverse white bands that cover the nail except for the distal tips.
Definition
Terry Nails 639
Term
What are the lateral portions on each side of the cranium?
Definition
Temples or Temporal Regions 639
Term
What lies between the temporal regions and occiput?
Definition
Parietal Regions 639
Term
What is the thick skin covering the cranium and usually bears hair?
Definition
Scalp 639
Term
What is the forehead called?
Definition
Frontal Region 639
Term
Where is CSF produced inside the brain?
Definition
Third Ventricle 639
Term
What is the tough, fibrous, out layer of the brain that resembles leather?
Definition
Dura Mater 639
Term
What distances should the finger counting test be done from?
Definition
6', 3', and 1' 641
Term
What does the diameter and reactivity of the patient's pupil reflect the brains status?
Definition
Brain's Perfusion, Oxygenation, and Condition 641
Term
Pupil size is regulated by a series of continuous motor commands that the brain automatically sends through _____ to each eye.
Definition
The Oculomotor Nerves III 642
Term
When doing an eye test, what pattern should you use when asking a patient to follow your finger?
Definition
Z or H Patteren 642
Term
What appears as opaque black areas against the red reflex?
Definition
Cataracts 643
Term
Consists of the pinna, or auricle (the part lying outside of the head).
Definition
External Ear 645
Term
What are the 3 small bones the middle ear contains?
Definition
Hammer, Anvil, and Stirrup 645
Term
Bruising over the mastoid process, which may be indicative of a skull fracture; also known as raccoon eyes.
Definition
Battle Signs 645
Term
What are the three layers of bone in each nasal chamber?
Definition
The Turbinates 645
Term
What is the pathway by which the spinal cord makes its way out of the brain and into the torso, enabling the spinal nerves to emanate to and innervate the rest of the body?
Definition
The Cervical Spine 647
Term
What are loud and harsh sounds over the trachea?
Definition
Tracheal Sounds 650
Term
What are the loud, high-pitched, and hollow sounds noted over the manubrium?
Definition
Bronchial Sounds 650
Term
What are the soft, breezy, and lower pitched sounds found at the midclavicular line?
Definition
Bronchovesicular Sounds 650
Term
What are the finer and somewhat fainter breath sounds noted in the lateral wall of the chest are from the smaller bronchioles and aveoli?
Definition
Vesicular Sounds 650
Term
What are abnormal breath sounds such as wheezes, rhonchi, rales, stridor, and pleural friction rubs?
Definition
Adventitious Breath Sounds 650
Term
What sound suggests an obstruction of the lower airway?
Definition
Wheezing 650
Term
Stridor often indicates a life threatening problem, because stridor equates to an ____ reduction in airway size.
Definition
85% 651
Term
What does percussion of the chest produce when it is full of air?
Definition
Hyperresonance 651
Term
What does percussion of the chest produce when it is full of blood?
Definition
Hyporesonance or Dullness 651
Term
What is the closure of mitral and tricuspid valves at start of systole?
Definition
S1 "lub" 655
Term
What is the closure of aortic and pulmonic valves at end of systole?
Definition
S2 "dub" 655
Term
What is a soft, low-pitched heart sound that occurs about 1/3 of the way through diastole?
Definition
S3 "da" 654
Term
What is considered a gallop rhythm, is a moderately pitched pitched sound that occurs immediately before the normal S1 sound; it is always abnormal?
Definition
S4 "bla" 654
Term
What heart sound represents either decreased stretching (compliance) of the left ventricle or increased pressure in the atria?
Definition
S4 654
Term
What includes the stomach, proximal duodenum of the small intestine, pancreas, jejunum, ileum, appendix, cecum, transverse colon, sigmoid colon, proximal rectum, liver, gallbladder, spleen, omentum, and female internal genitalia?
Definition
Intraperitoneal Organs 657
Term
What includes the mid- and distal duodenum, abd aorta, mid- and lower rectum, kidneys, pancreatic tail, adrenal glands, ureters, renal blood vessels, goadal blood vessels, ascending colon, descending colon, and urinary bladder?
Definition
Extraperitoneal Organs 657
Term
How much does the systolic pressure have to decrease to be considered a positive tilt test?
Definition
Up to 20 mm Hg 658
Term
How much does the diastolic pressure have to increase to be considered a positive tilt test?
Definition
10 mm Hg 658
Term
How much does the pulse have to increase to be considered a positive tilt test?
Definition
20 beats/min 658
Term
What occurs when abnormal forces are applied to normal bone structures, producing a fracture?
Definition
Physiologic Fracture 663
Term
What occurs when normal forces are applied to abnormal bone structures, producing a fracture?
Definition
Pathologic Fracture 663
Term
What fracture is usually caused by a high-force blunt injury?
Definition
Physiologic Fracture 663
Term
What fracture often occur as a result of decreased bone density, such as osteopenia or occult malignancy?
Definition
Pathologic Fracture 663
Term
What is the most reliable indicator of an underlying closed fracture?
Definition
Point Tenderness 663
Term
What are hard and nontender and occur with osteoarthritis?
Definition
Heberden and Bouchard Nodules 666
Term
What are the 5 P's of acute arterial insufficiency when evaluating a limb for ischemia?
Definition
Pain, Pallor, Parasthesias/Paresis, Poikilotheria, and Pulselessness 668
Term
What is the inability to maintain a constant core body temperature independent of ambient temperature?
Definition
Poikilothermia 668
Term
What is rednes and one of the classic signs of inflammation?
Definition
Rubor 668
Term
What refers to the inward curve of the lumbar spine just about the buttocks?
Definition
Lordosis 669
Term
What refers to the outward curve of the thoracic spine?
Definition
Kyphosis 669
Term
What is a sideways curvature of the spine, and is always abnormal?
Definition
Scoliosis 670
Term
What is comprised of the cerebrum, cerebellum, and the medulla (brainstem)?
Definition
The Brain 672
Term
What takes charge of all of the brain's conscious processes and is divided in to 4 lobes?
Definition
The Cerebrum 672
Term
What are the 4 lobes of the cerebrum?
Definition
Frontal, Temporal, Parietal, and Occipital 672
Term
What part of the brain is responsible for coordinating balance?
Definition
Cerebellum 672
Term
What part of the brain handles all of the unconscious deeper processes?
Definition
Medulla or Brainstem 672
Term
What runs from the spinal cord to the body outwardly?
Definition
Motor Tracts 672
Term
What runs from the body to the cord inwardly?
Definition
Sensory Nerves 672
Term
___ are not mediated by the spinal cord but rather go directl to and from the brain, originating at the medulla.
Definition
Cranial Nerves 672
Term
What are involuntary motor responses to specific stimuli, such as a tap on the knee or strokig the eyelash?
Definition
Reflexes 672
Term
What occurs when sensory input comes from receptors in the muscles, joints, and skin?
Definition
Spinal Reflexes 672
Term
Reflex reactions such as Babinski,grasping, and sucking signs normally found in young patients.
Definition
Primitive Reflexes 672
Term
What test may be used to check neuologic function and is accomplished by stimulating the sole of the foot by rubbing with your thumb or running a pen or other pointed object along the sole of the foot?
Definition
Babinski Test 673
Term
What does the mnemonic COASTMAP mean?
Definition
Consciousness, Orientation, Activity, Speech, Thought, Memory, Affect, Perception 673
Term
What is garbled or slurred speech?
Definition
Dysarthria 673
Term
What involves the paient's understanding and interpretaion of the positioning of an extremity and is a function of the cerebellum?
Definition
Proprioception 675
Term
What are distinct areas of skin that correspond to specifi spinal or cranial nerve levels where sensory nerves enter the CNS?
Definition
Dermatomes 676
Term
What is the change in mental status that is marked by the inability to focus, think logically, and maintain attention?
Definition
Delirium 677
Term
What is the slow onset of progressive disorientation, shortened attention span, and loss of congitive function?
Definition
Dementia 677
Term
What is the impairment of language that affects the production or understanding of speech and the ability to read or write?
Definition
Aphasia 677
Term
What is a tingling feeling or sensory change, which is more consistent with a spinal lesion?
Definition
Parasthesias 677
Term
What a white cheesy material?
Definition
Vernix 678
Term
What are dark or bluish pigmentation over the buttocks and lower lumbar regions in African, Asian, and Mediterranean patients?
Definition
Mongolian Spots 678
Term
What is wondering or shaking eye movements?
Definition
Nystagmus 678
Term
What is alternating convvergence for divergence creating a cross-eye appearance?
Definition
Strabismus 678
Term
What typically consists of a disposabe or electronic device that provides you with a means of showing carbon dixoide output?
Definition
Capnometry 681
Term
What not only includes a measurement of carbon dioxide output but also provides a wave form that gives you further insight into the overall ventilatory status of your patient?
Definition
Capnography 681
Term
After the primary assessment, what is the single most important assessment process you will perform?
Definition
Reassessment 685
Term
The combination of a narrowed pulse pressure, muffled heart tones, and JVD associated with cardiac tamponade; usually from penetrating chest trauma.
Definition
Beck Triad 686
Term
The combination of a slowing pulse, rising blood pressure, and erratic respiratory patterns; a grave sign for patients with head trauma or CVA.
Definition
Cushing Reflex 686
Term
What is the most important assessment skill and only comes from much experience?
Definition
Quickly determine whether the patient is sick or not sick 589
Term
Every time you assess a patient, you have to ____ whether your patient is sick or not sick, and then you must ____ how sick the patient is.
Definition
Qualify and Quantify 589
Term
What type of approach should you take when sizing up a scene for safety?
Definition
Wide-angle lens thought process 592
Term
What is a dynamic process that requires constant reassessment?
Definition
Scene Safety 592
Term
What is often one of the prime indicators of how sick the patient is?
Definition
Patient's Mental Status 597
Term
What shoud you think if you hear sonorous respiration?
Definition
Position Problem 597
Term
What should you think if you hear gurgling or bubbling sounds?
Definition
Suction 597
Term
What is the respiratory rate multiplied by the tidal volume inspired with each breath?
Definition
Minute Volume 598
Term
What is the best way to measure breathing adequacy?
Definition
Amount of air moved in and out of the lungs each minute 598
Term
What techniques are used to assess a patient's breathing status?
Definition
Assessing for chest rise and fall 598
Term
What type of pulse is a person with hypertension said to have?
Definition
Bounding 598
Term
What happens to skin temperature as blood vessels dilate?
Definition
Rises 599
Term
What happens to skin temperature as blood vessels constrict?
Definition
Falls 599
Term
What is indicative of an absent pulse in a responsive patient?
Definition
Low cardiac out put-not cardiac arrest 600
Term
What are the few conditions that cause sudden death?
Definition
Airway Obstruction, Respiratory Arrest, Cardiac Arrest, and Severe Bleeding 600
Term
What should be done after you have examined the patient's airway, breathing, and circulation and addressed any life-threatening issues?
Definition
Brief Neurologic Evaluation 600
Term
What is a quick and thorough palpation of the body?
Definition
Rapid Exam 601
Term
What is simply looking at your patient fr abnormalities and asymmetry?
Definition
Inspection 601
Term
What is the process of touching or feeling the patient for abnormalities?
Definition
Palpation 601
Term
What are best suited for detecting texture and consistency?
Definition
Fingertips 601
Term
What is best suited for noting temperature?
Definition
Back of hand 601
Term
What is the process of listening to sounds the body makes by using a stethoscope?
Definition
Auscultation 601
Term
What are one of the most common chief complaints in prehospital care?
Definition
Breathing Problems 603
Term
What is the purpose of gaining information about the patient and learn about the events surrounding the incident?
Definition
Patient History 605
Term
What should you ask the patient along with his or her name?
Definition
Day of the week, Time, Location, and Events surrounding the current event 605
Term
How should you address your patient?
Definition
By the name of their choosing 606
Term
What problem arises when EMS providers read off a list of questions to patients to fill in all the blanks on the PCR?
Definition
Making little to no eye contact 606
Term
While doing a interfacility transfer what should you take a moment to look over?
Definition
Transfer Paperwork 607
Term
What is frequently linked to the patient's current problem?
Definition
Past Medical History 608
Term
What potentially lifethreatening emergency could left lower quadrant pian and a missed mentrual cycle indicate for a woman in her 20's?
Definition
Ectopic Pregnancy 609
Term
How many of the elderly who fall and break a hip will not survive the event?
Definition
Roughly 50% 609
Term
Approximately what age will you be able start gathering patient information directly from the child?
Definition
2-3 years old 609
Term
What are most of the problems with pediatric patient you will encounter in the field?
Definition
Respiratory and Fluid related 609
Term
What should you do at the scene of an MVC when air bags have deployed?
Definition
Lift up air bags and check for steering wheel damage 610
Term
What do tender lymph nodes indicate?
Definition
Infection or Cancer 613
Term
What combines knowledge of anatomy, physiology, pathophysiology, and the patient's complaints to help direct questioning when you are obtaining a history?
Definition
Clinical Reasoning 614
Term
What is a working hypothesis of the nature of the problem?
Definition
Differential Diagnosis 614
Term
What is one step further than sympathy and is putting yourself in the patient's shoes?
Definition
Empathy 614
Term
What is using techniques that encourage your patient to feel open to giving you any information you need?
Definition
Facilitation 615
Term
What type of communication techniques are saying that's helpful, anything else you can think of, or please go on?
Definition
Facilitation 615
Term
What is pausing to consider something significant tht you've just been told?
Definition
Reflection 615
Term
What is the technique of asking your patients for more information when some aspect of the history is vague or unclear?
Definition
Clarification 615
Term
What is making your patient aware that you perceive something that is not consistent with his or her behavior, the actual scene, or the information the patient is giving you?
Definition
Confrontation 615
Term
What is inferring the cause of the patient's distress, then asking the patient if you are right?
Definition
Interpretation 615
Term
What can set your patient on a path to healing no matter what the diagnosis?
Definition
Empathy 615
Term
What is one of the most important elements of the interview process?
Definition
Be a Great Listener and a Patient Listener 617
Term
What can alcohol do to any number of signs and symptoms?
Definition
Mask them 617
Term
What should you never hesitate to do if you suspect abuse at a scene?
Definition
Call Law Enforcement 617
Term
What should you do with all of your patient's complaints?
Definition
Prioritize 617
Term
What is an early sign of physiologic shock?
Definition
High Anxiety 618
Term
What is hypoxi often misinterpreted as?
Definition
Panic 618
Term
What consists of two elements-obtaining vital signs that measure overall body function and performing a head-to-toe survey that evaluates the workings of specific body organ systems?
Definition
The Secondary Assessment 626
Term
Other than overall patient appearance, ____ provide the most objective date for determining patient status.
Definition
Vital Signs 627
Term
What will too small or tight blood pressure cuff yield?
Definition
Artificially High Pressure 629
Term
What will too large or loose blood pressure cuff yield?
Definition
Artificially Low Pressure 629
Term
What should you be aware of when using a device for measuring the tympanc membrane temperature in order to obtain a patient's body temperature?
Definition
Extrinsic Factors 630
Term
What size should the blood pressure cuff be?
Definition
1/2 to 2/3 the size of the upper arm 631
Term
What is a disposable plastic earpiece?
Definition
Speculum 631
Term
What consists of a comprehensive review of systems to determine the nature and extent of the patient's illness or injury?
Definition
The Physical Examination 632
Term
When determining if a patient is AOX4, what four areas should you look for?
Definition
Person, Place, Day of the Week, and The Event Itself 635
Term
What is the most reliable ad consistent method of assessing mental status and neurologic function?
Definition
GCS 635
Term
What are false, fixed, personal beliefs that are not shared by other members of the patient's culture?
Definition
Delusions 637
Term
What shows the patient's awareness of his or her illness and need for treatment?
Definition
Insight 637
Term
What material is the dermis composed of?
Definition
Collagen fibers, Elastic fibers, and Mucopolysaccharide gel 638
Term
What 2 layers is the dermis divided into?
Definition
Papillary Dermis and Reticular Layer 638
Term
What provides nutrients to the epidermis and it aids in thermoregulation?
Definition
Papillary Dermis 638
Term
What consists of dense, irregular connective tissue, which provides both strength and elasticity?
Definition
Reticular Layer 638
Term
What is perhaps the quickest and most reliable ititial way to evaluate a patient's overall degree of distress?
Definition
Look at skin 638
Term
What two parts are the head divided into?
Definition
Cranium and The Face 639
Term
Where is CSF produced in the brain?
Definition
The 3rd Ventricle 639
Term
What standardized fashion should you assess eyes?
Definition
Front to Back 641
Term
What is the standard device for checking visual acuity?
Definition
Snellen (E) Chart 641
Term
What distance should finger counting be done from?
Definition
6', 3', and 1' 641
Term
What is a circular opening in the center of the pigmented iris of the eye?
Definition
Pupil 641
Term
What does the diameter and reactivity of the patient's pupil reflect?
Definition
Brain's Perfusion, Oxygenation, and Condition 641
Term
What happens when you introduce light into one eye?
Definition
Both Pupils should constrict equally 641
Term
What is regulated by a serious of continuous motor commands that the brain automatically sends through the oculomotor nerves to each eye?
Definition
Pupil Size 642
Term
When the patient has asymmetric pupils, which may indicate significant ocular or neurologic pathology, what must be done?
Definition
Correlate with Patient's Overall Condition 642
Term
What appears as opaque black areas against the red reflex?
Definition
Cataracts 643
Term
What 3 small bones does the middle ear contain?
Definition
Hammer, Anvil, and Stirrup 645
Term
What is ear wax?
Definition
Cerumen 645
Term
What are the 3 layers of bone in each nasal cavity?
Definition
Turbinates 645
Term
What is the ear drum?
Definition
Tympanic Membrane 645
Term
What does frank blood or clear, watery drainage (CSF) from the ears or nose following trauma suggest?
Definition
Basilar Skull Fracture 646
Term
What is the pathway by which the spinal cord makes its way out of the brain and into the torso, enabling the spinal nerves to emanate to ad innervate the rest of the body?
Definition
Cervical Spine 647
Term
What is the single most reliable indicator of a spine injury or spinal cord injury?
Definition
Pain 647
Term
What are loud and harsh sounds over the trachea?
Definition
Tracheal Sounds 650
Term
What are the loud, high-pitched, and hollow sounds noted over the manubrium?
Definition
Bronchial Sounds 650
Term
What are the soft, breezy, and lower pitched sounds found at the midclavicular line?
Definition
Bochovesicular Sounds 650
Term
What are the finer and somewhat fainter breath sounds noted in the lateral wall of the chest from the smaller bronchioles and alveoli?
Definition
Vesicular Sounds 650
Term
What sounds suggest an obstruction of the lower airway?
Definition
Wheezing 650
Term
What should you suspect if wheezing is unilateral?
Definition
Aspirated Foreign Body or Infection 650
Term
What should you suspect if wheezing is bilateral?
Definition
Asthma 650
Term
Stridor equates to an ____ reduction in airway size.
Definition
85% 651
Term
What does percussion of the chest produce when the thorax is full of air?
Definition
Hyperresonance 651
Term
What does percussion of the chest produce when the thorax is full of blood?
Definition
Hyporesonance or Dullness 651
Term
What is the depression between the right and left atria?
Definition
Fossa Ovalis 653
Term
What is the opening between the two atria in the fetus?
Definition
Foarmen Ovale 653
Term
How should you place the patient to bring the heart closer to the left anterior chest wall?
Definition
Sitting up and leanng slightly forward, Supine, and Left Lateral Recumbent Position 654
Term
Where should you place the stethoscope to listen to heart sounds?
Definition
5th Intercostal Space over the Apex of Heart 654
Term
What sound are listening for when you ask the patient to breathe normally and hold breath on expiration?
Definition
S1 654
Term
What sound are listening for when you ask the patient to breathe normally and hold breath on inhalation?
Definition
S2 655
Term
Where should you suscultate to listen for S3 and S4 sounds?
Definition
Above Left Nipple 655
Term
What question should be asked when you see JVD?
Definition
Where is the venous obstruction the is impeding blood return to the heart 656
Term
What valve is found near the second intercostal space, to the right of the sternum?
Definition
Aortic Valve 657
Term
What valve lies near the second intercostal space and to the left of the sternum?
Definition
Pulmonic Valve 657
Term
What valve is auscultated over the lower left sternal border?
Definition
Tricuspid Valve 657
Term
What valve can be assessed over the cardiac apex, lateral to the lower left sternal border near the midclavicular line?
Definition
Mitral Valve 657
Term
What pain results when hollow organs are obstructed, thereby stretching the smooth muscle wall, which in turn produces cramping and more diffuse, widespread pain?
Definition
Visceral Pain 657
Term
What pain has its origin in a particular organ but is described by the patient as pain in a different location?
Definition
Referred Pain 658
Term
What is a bluish discoloration in the periumbilical that is indicative of intraperitoneal hemorrhage?
Definition
Cullen Sign 660
Term
What is a bluish discoloration in the flanks that is indicative of intraperitoneal hemorrhage?
Definition
Grey Turner Sign 660
Term
Waht is inflammation of the peritoneum?
Definition
Peritonitis 660
Term
What is most typically associated with ascites?
Definition
Liver Disease 660
Term
What are the acromioclavicular and glenohumeral joints?
Definition
Shoulder 663
Term
What is the olecranon?
Definition
Elbow 663
Term
What is wrist?
Definition
Radiocarpal 663
Term
What is the hip?
Definition
Acetabulum 663
Term
What is the knee?
Definition
Patellar 663
Term
What is the ankle?
Definition
Tibiotalar 663
Term
What is an intricate network of nodes and ducts of various sizes that are dispersed throughout the body?
Definition
Lymphatic System 667
Term
What are larger accumulations of lymphatic tissue, and smaller amounts of lymph are distributed by tissue throughout the body?
Definition
Lymph Nodes 667
Term
What is a cramp-like pain in the lower legs due to poor circulation or low potassium level?
Definition
Intermittent Claudication 667
Term
What is a chronic disease of the liver in which liver tissue is replaced by connective tissue, resulting in the loss of liver function?
Definition
Hepatic Cirrhosis 668
Term
What occurs with systemic conditions such as heart failure and hepatic cirrhosis?
Definition
Bilateral, dependnt, pitting edema 668
Term
What occurs with local conditions such as occlusion of a deep vein?
Definition
Unilateral Edema 668
Term
What is the 4-point scale of pitting edema?
Definition
+1= 0"-1/4" 668
+2= 1/4"-1/2"
+3= 1/2"-1"
+4= >1"
Term
What is the body's master control system?
Definition
Nervous System672
Term
What is the normal reaction with the Babinski test?
Definition
The Great Toe will Flex 673
Term
What is more consistent with an acute sudden change in mental status, secondary to some significant underlying aberration?
Definition
Delirium 677
Term
What is representative of a gradual and pervasive deterioration of cognitive cortical functions, typically secondary to the slow progression of some disease state?
Definition
Dementia 677
Term
Jandice can appear in healthy babies ___ to ___ after birth and typically disappears after about a _____.
Definition
2, 5, and week 678
Term
What should jaundice raise suspicion to if it last beyond 2-3 weeks?
Definition
Biliary Obstruction or Liver Disease 678
Term
What may a depressed anterior fontanelle indicated in an infant?
Definition
Dehydration 679
Term
What may a bulging fontanelle indicate in an infant and is usually seen when the baby cries, vomits, or has an underlying pathologic condition?
Definition
Intracranial Pressure 679
Term
What is a must in EMS for every patient who has an altered mentation?
Definition
Measuring Blood Glucose Level 682
Term
What are used to assess for the presence of damage to cardiac muscle?
Definition
Cardiac Biomarkers 683
Term
What does an elevated brain nariuretic peptide level typically indicate?
Definition
Chronic Heart Failure 683
Term
What is the single most important assessment process you will preform after the primary assessment?
Definition
Reassessment 685
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