Term
What could cause weight loss? |
|
Definition
-Anorexia -Dysphagia -Vomiting or Diarrhea -Inability to absorb nutrients from GI tract -Increased metabolic needs -Food allergies -Problems chewing -Peer pressure |
|
|
Term
What do you ask about during a nutritional ROS? |
|
Definition
Ask about weight changes, fatigue, allergies, or problems in GI |
|
|
Term
What should you ask about regarding health patterns and nutrition? |
|
Definition
Ask about nutrition and exercise patterns |
|
|
Term
What are some common or concerning symptoms related to nutrition? |
|
Definition
-Changes in weight (unintended) -Anorexia -Changes in sense of taste or smell -Difficulty chewing and swallowing |
|
|
Term
A detailed nutrition history includes: |
|
Definition
1. Food pattern 2. Personal food preferences 3. Food preparation 4. Finances 5. Accessibility 6. Patient health 7. Exercise Pattern 8. Body Image 9. Family health 10. Family dietary problems |
|
|
Term
What are some ways you can do a nutrition screening? |
|
Definition
-Admission nutrition screening tool -24-hour diet recall -Food frequency questionnaire -Food diaries -Direct observation |
|
|
Term
What are the types of equipment you need to for a nutrition-related physical exam? |
|
Definition
-Skinfold calipers -Measurement tape -Nutrition assessment form |
|
|
Term
What is skinfold thickness exam? |
|
Definition
Technique of measurement in which you repeat three measurements and then take an average |
|
|
Term
|
Definition
Body mass index = weight in kg divided by height (m)2 or weight in lbs divided by height (in)2 x 703 |
|
|
Term
What are some signs of dehydration? |
|
Definition
-Tachychardia -Weak pulse -Turgor on abdomen |
|
|
Term
What should you look for during cardiovascular and peripheral vascular exam r/t nutrition? |
|
Definition
-Measure pulse rate and amplitude -Inspect arms and legs for edema (protein deficiency) -Petechiae and ecchymoses (lack of vitamin A) |
|
|
Term
What should you look for during HEENT exam r/t nutrition? |
|
Definition
-Note dark circles under eyes -Inspect mucus membranes for dryness, color, and intactness -Enlarged thyroid gland |
|
|
Term
What should you look for during GI exam r/t nutrition? |
|
Definition
-Distension and ascites (protein deficiency) -Turgor on abdomen (dehydration) -Measure waist circumference (measure of central body fat) |
|
|
Term
What should you look for during MSK exam r/t nutrition? |
|
Definition
-Muscle wasting and flaccidity (protein deficiency) -Bone pain and bowing of legs (lack of vitamin D) |
|
|
Term
What should you look for during Neurologic exam r/t nutrition? |
|
Definition
-Changes in mental status, irritability, inability to concentrate, paresthesias (dehydration and lack of vitamins) |
|
|
Term
What are some signs of protein deficiency? |
|
Definition
-Edema in arms and legs -Distension/ascites of abdomen -Muscle wasting and flaccidity |
|
|
Term
What are the measurements of BMI? |
|
Definition
Underweight: <18.5 Normal: 18.5-24.9 Overweight: 25.0-29.9 Obesity I: 30.0-34.9 Obesity II: 35.0-39.9 Extreme Obesity III: >40 |
|
|
Term
What laboratory studies are important in nutritional assessment? |
|
Definition
-Hemoglobin -Hematocrit -Cholesterol -Triglycerides -Total Lymphocyte count -Skin Testing -Serum Proteins -Nitrogen balance -Creatinine-height index |
|
|
Term
|
Definition
Protein-calorie malnutrition |
|
|
Term
|
Definition
|
|
Term
Abnormal findings caused by nutritional deficiencies |
|
Definition
-Scorbutic gum: Vit C deficiency -Follicular hyperkeratosis: Vit A deficiency -Bitot's Spots: Vit A deficiency -Rickets - Vit D, Calcium deficient |
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|
Term
How would you write a chief complaint for an Adult Health History? |
|
Definition
Make every attempt to quote the patient's own words |
|
|
Term
What is the difference between signs and symptoms? |
|
Definition
Signs = Objective; Symptoms = Subjective |
|
|
Term
What are the 7 components of a Comprehensive Adult Health History? |
|
Definition
1. Identifying data and source of history 2. Chief Complaints 3. Past History 4. Family History 5. Review of Systems 6. Health Patterns 7. History of present illness |
|
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Term
|
Definition
Cutting down, Annoyance if criticized, Guilty feelings, Eye-openers (2 or more of these suggest misuse) |
|
|
Term
What are ways to approach sensitive topics that call for specific approaches? |
|
Definition
1. Be nonjudgemental 2. Explain why you need to know certain info 3. Find opening questions 4. Consciously acknowledge whatever discomfort you're feeling |
|
|
Term
|
Definition
-Unexplained abuse -Delayed getting treatment for trauma -Past history of repeated injuries or "accidents" -Person close to pt. has history of alcohol and drug abuse -Partner tries to dominate interview or will not leave room |
|
|
Term
What are the 7 critical attributes for symptom analysis? |
|
Definition
OLDCART Onset Location Duration Characteristic Symptoms Associated Manisfestations Relieving/Aggravating factors Treatments tried |
|
|
Term
|
Definition
Pictorial display of a person's family relations and medical history |
|
|
Term
|
Definition
-Address each body system, from head to toe -Most questions pertain to symptoms -May uncover problems patient has overlooked -Do not use medical terms, use plain English |
|
|
Term
What do you ask about when discussing Health Patterns? |
|
Definition
Self-perception/self-concept Value-Belief Activity-exercise Sleep-rest Nutrition Role-relationship Coping-stress-tolerance |
|
|
Term
How should you discuss a patient's mental health history? |
|
Definition
-Be aware of cultural constructs -Be sensitive to mood changes or symptoms of possible depression -Aks open-ended questions initially, then move to more specific -If patient seems depressed, ask about thoughts of suicide |
|
|
Term
What are the functions of skin? |
|
Definition
1. Protection 2. Temperature Regulation 3. Perception 4. Absorption and excretion 5. Synthesizes vitamin D 6. Identification |
|
|
Term
Why do we do a skin assessment? |
|
Definition
Look for lesions and underlying systemic disease or disorders |
|
|
Term
What are the 2 kinds of cyanosis? |
|
Definition
1. Central: oxygen level in arterial blood is low 2. Peripheral: Oxygen level is normal, cutaneous blood flow decreases and slows and tissues extract more oxygen than usual from blood flow |
|
|
Term
What are the 2 types of hair? |
|
Definition
1. Vellus hair: short, fine, inconspicuous, relatively unpigmented 2. Terminal hair: coarser, thicker, more conspicuous, pigmented |
|
|
Term
What are we trying to identify when taking an integumentary history? |
|
Definition
1. Diseases of the skin 2. Systemic diseases that have skin manisfestations 3. Physical abuse 4. Risk for pressure ulcer formation 5. Risk for skin cancer 6. Need for health promotion education regarding skin |
|
|
Term
What are common or concerning symptoms when taking an integumentary history? |
|
Definition
-Rash -Nonhealing lesions -Moles -Lesions -Bruising (ecchymosis) -Hair loss |
|
|
Term
What are some external variables that can influence skin color? |
|
Definition
-Emotional states -Temperature -Cigarette smoking -Prolonged elevation/dependent position of extremities -Prolonged inactivity |
|
|
Term
What do we look at when doing a physical examination of the skin? |
|
Definition
1. Color 2. Moisture 3. Vascularity 4. Temperature 5. Texture 6. Mobility or turgor 7. Lesions 8. Nails 9. Hair |
|
|
Term
What are the two types of edema? |
|
Definition
1. Pitting: interstitial fluid mobile - pitting edema scale 1-4 2. Nonpitting: local infection or trauma; brawny edema |
|
|
Term
What should you note when you examine a skin lesion? |
|
Definition
1. Color 2. Elevation or flat; and texture 3. Pattern or shape 4. Size 5. Location and distribution on body (generalized v. localized) 6. Exudate (wet or dry, color, consistency) 7. Bleeding from lesion |
|
|
Term
What are the different lesion patterns of arrangement? |
|
Definition
-Discrete -Annular or circular -Grouped or clustered -Linear -Gyrate or snakelike -Confluent or run together -Target or Iris -Nerve root distribution or dermatomal |
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|
Term
What are the 3 degrees of a burn? |
|
Definition
1st Degree: red, painful, blanches with pressure, no blistering 2nd Degree: blisters, redness, pain, raw surfaces (partial thickness or to dermis layer) 3rd degree: skin white or charred, not painful (full thickness, all skin elements destroyed) |
|
|
Term
|
Definition
small flat spot, up to 1.0cm |
|
|
Term
|
Definition
flat spot 1.0cm or larger |
|
|
Term
|
Definition
elevated superficial lesion 1.0cm or larger |
|
|
Term
|
Definition
elevated spot, up to 1.0cm |
|
|
Term
|
Definition
marble-like lesion larger the 0.5cm, often deeper and firmer than papule |
|
|
Term
|
Definition
Nodule filled with expressible material, either liquid or semisolid |
|
|
Term
|
Definition
Somewhat irregular, relatively transcient, superficial area of localized skin edema |
|
|
Term
|
Definition
Up to 1.0cm, filled with serous fluid |
|
|
Term
|
Definition
1.0cm or larger, filled with serous fluid |
|
|
Term
|
Definition
Thin flake of dead exfoliated epidermis |
|
|
Term
|
Definition
Dried residue of skin exudates such as serum, pus, or blood |
|
|
Term
|
Definition
visible and palpable thickening of the epidermis and roughening of the skin wih tincreased visibility of normal skin furrows |
|
|
Term
|
Definition
Nonscarring loss of superficial epidermis, surface is moist but does not bleed |
|
|
Term
What are the factors that influence how an individual experiences pain? |
|
Definition
-Age -Previous pain experience -Cultural norms -Unknown expectations -History of drug abuse -Perception of pain |
|
|
Term
What are the types of pain? |
|
Definition
-Nociceptive: pain r/t tissue damage; responsive to inflammatory mediators -Neuropathic: Direct or indirect injury to peripheral or CNS -Idiopathic: without etiology |
|
|
Term
What are the 3 types of nociceptive pain? |
|
Definition
Visceral: large or deep interior organs Deep somatic: blood vessels, muscle, joints, tendons, bone Cutaneous: skin |
|
|
Term
|
Definition
A way to assess pain in patients who cannot talk. Stands for Face, Legs, Activity, Cry, Consolability |
|
|
Term
When do you use numeric faces? |
|
Definition
When the patient can speak, but has trouble verbalizing pain, usually a small child. |
|
|
Term
What are common acute pain behaviors? |
|
Definition
-Guarding -Grimacing -Vocalizations -Agitation -Stillness -Diaphoresis -Change in vital signs |
|
|
Term
What are common chronic pain behaviors? |
|
Definition
-Bracing -Rubbing -Diminished activity -Sighing -Change in apetite -Movement -Exercise -Praying -Sleeping -Agitation |
|
|
Term
What are types of joints? |
|
Definition
Immovable joint (ex: skull sutures) Slightly movable (pivot and gliding) Freely movable (synovial) |
|
|
Term
What are the types of synovial joints? |
|
Definition
-Hinge: flat or planar: moves on one plane (flexion and extension only) -Condylar: convex or concave (knee or TMJ) -Ball and socket: (hip) |
|
|
Term
|
Definition
Rest, Ice, Compression, Elevation |
|
|
Term
What is the most active joint in the body? |
|
Definition
|
|
Term
What do you do for a screening MSK exam? |
|
Definition
-Inspect -Palpate -ROM -Strength Check for symmetry |
|
|
Term
What is passive exercise? |
|
Definition
-Carried out by the nurse, without assistance from patient -Will not preserve muscle mass or bone mineralization because there is no voluntary contraction, lengthening of muscle, or tension on bones |
|
|
Term
What is active assistive exercise? |
|
Definition
-These exercises are performed by the patient with assistance from the nurse -Exercises encourage normal muscle function while the nurse supports the distal joint |
|
|
Term
|
Definition
Performed by patient without assistance, to increase muscle strength |
|
|
Term
What is resistive exercise? |
|
Definition
Active exercises performed by the patient by pulling or pushing against an opposing force |
|
|
Term
What is an isometric exercise? |
|
Definition
-Performed by the patient by contracting and relaxing muscle while keeping the part in a fixed position -Done to maintain muscle strength when a joint is immobilized -Full patient cooperation is required |
|
|
Term
What is the order of the MSK physical examination? |
|
Definition
1. TMJ 2. Neck (cervical spine) 3. Upper Extremities: -shoulders -elbows -hands, wrists, fingers 4. Lower Extremities -Hips -Knees -Ankles, feet, toes 5. Spine |
|
|
Term
What should you do when examining the TMJ? |
|
Definition
-Observe lateral motion and protrusion forward -Palpate while opening and closing the jaw |
|
|
Term
What should you do when examining the cervical spine? |
|
Definition
-Palpate spinous processes and paravertebral muscles -Flexion/Extension/Hyperextension -Lateral bending or abduction and adduction -Rotation |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Test for carpal tunnel, have patient put hands in praying upside down, if they feel numbness before 1 min it is positive |
|
|
Term
|
Definition
Ask patient to fully abduct the arm to shoulder level; if cannot hold arm fully abducted, test is positive indicating rotator cuff tear |
|
|
Term
What should you think if you notice joint(s) that is/are hot, red, or swollen? |
|
Definition
Injury, Immune, Infected, Inflammation |
|
|
Term
What is the purpose of ROM exercises? |
|
Definition
-Maintain joint mobility -Stimulate circulation, preventing thrombus and embolus formation -Improve coordination -Increase tolerance for more activity -Maintain and build muscle strength -Prevent contracture and atrophy of muscles |
|
|
Term
|
Definition
-Abnormal, usually permanent condition of a joint, characterized by flexion and fixation -Possibly caused by atrophy and shortening of muscle fibers resulting from immobilization -Can be from loss of the normal elasticity of connective tissues or the skin, as from the formation of extensive scar tissue over a joint |
|
|
Term
Which side of the lungs has 3 lobes? |
|
Definition
|
|
Term
What is the leading cause of preventable death? |
|
Definition
|
|
Term
What are two reference lines you would use on the anterior thorax? |
|
Definition
Midsternal line (MSL) Midclavicular line (MCL) |
|
|
Term
What are two reference lines you would use on the posterior thorax? |
|
Definition
Vertebral line Midscapular line |
|
|
Term
What are the two reference lines you would use on the lateral thorax? |
|
Definition
Anterior axillary line (AAL) Midaxillary line (MAL) Posterior axillary line (PAL) |
|
|
Term
What anterior rib do the lower lungs rest near? |
|
Definition
|
|
Term
Inspiration is primarily facilitated by which muscles? |
|
Definition
Diaphragm and intercostal |
|
|
Term
|
Definition
difficulty breathing while recumbent |
|
|
Term
|
Definition
|
|
Term
Paroxysmal Nocturnal Dyspnea |
|
Definition
difficulty breathing that awakens patient |
|
|
Term
What should you ask about during the respiratory history? |
|
Definition
Vaccinations Environmental Factors Exposure History: inhalants, carcinogens Past respiratory illnesses |
|
|
Term
What should you ask children during a respiratory history? |
|
Definition
History of prematurity History of vent support Recurrent hospitalizations for pulmonary infection |
|
|
Term
What should you ask about during family history? |
|
Definition
TB Allergies Asthma Genetic disorders: cystic fibrosis |
|
|
Term
|
Definition
Use of accessory respiratory muscles |
|
|
Term
What does it mean when fremitus is decreased during palpation? |
|
Definition
When anything obstructs transmission of vibrations (e.g. obstructed bronchus, pleural effusion, pneumothorax, or emphysema) |
|
|
Term
What does it mean when fremitus is increased during palpation? |
|
Definition
Occurs with compression or consolidation of lung tissure (e.g. lobar pneumonia, tumor, Atelectasis, pulmonary fibrosis) |
|
|
Term
Name the different types of percussion notes. |
|
Definition
Resonance: over normal lung Hyperresonance: over hyperinflated lung Flatness/Dullness: over dense tissue or bone Tympany: thing "tight drum" |
|
|
Term
|
Definition
Sounds are louder and clearer over airless tissue (pleural effusions, thickening, areas of consolidation) |
|
|
Term
|
Definition
"ee" changes to "aa" over areas of consolidation |
|
|
Term
|
Definition
Whispered words sound clearer over areas of consolidation |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
gook in big airways; like snoring or clearing mucous |
|
|
Term
|
Definition
low grating noise in peripheral and lateral chest; cough does not clear, noticed on inspiration/expiration; Plurisy |
|
|
Term
A patient coughing at night signifies what respiratory disease? |
|
Definition
|
|
Term
What does coughing up "grayish-black" mucous signify? |
|
Definition
|
|
Term
|
Definition
|
|
Term
What coud cause hoarseness? |
|
Definition
|
|
Term
What are some symptoms of TB? |
|
Definition
Weight loss, night sweats, bloody sputum |
|
|
Term
|
Definition
Collapsed alveoli that open back up after person has been shallow breathing and then takes a deep breath |
|
|
Term
What would breath and voice sounds sound like when listening to an airless lung (ex: lobar pneumonia)? |
|
Definition
-Spoken words would sound louder and clearer -Spoken "ee" would change to "aa" -whispered words would be louder and clearer |
|
|
Term
|
Definition
High-pitched harsh sound that is entirely or predominately inspiratory |
|
|
Term
What are the anatomical landmarks for the lungs on the anterior chest? |
|
Definition
-Lung apices (apex) is 3-4cm about clavicle -Lower lungs rest on diaphragm at 6th rib, midclavicular line |
|
|
Term
What are the anatomical landmarks for the lungs on the posterior chest? |
|
Definition
-Apices near C7 -Lower lungs near T10 -Trachea bifurcates at T4 |
|
|
Term
How would you evaluate respiratory excursion? |
|
Definition
-place hands on each side near 10th rib -have pt. take deep breath -measure distance between thumbs and expiration |
|
|
Term
List the percussion note, adventitious sounds and tactile fremitus/transmitted voice sounds in early left sided HF. |
|
Definition
1. Resonant 2. Late inspiratory crackles in dependent portion of lungs, possibly wheezes 3. Normal |
|
|
Term
List the percussion note, adventitious sounds, and tactile fremitus/transmitted voice sounds in consolidation. |
|
Definition
1. Dull over the airless area 2. Late inspiratory crackles over involved area 3. Increased over area with bronchophony, egophony, and whispered pectoriloquy |
|
|
Term
List the percussion note, adventitious sounds, and tactile fremitus/transmitted voice sounds for atelectasis (Lobar obstruction). |
|
Definition
1. Dull over airless area 2. None 3. Usually absent when bronchial plug persists |
|
|
Term
List the percussion note, adventitious sounds, and tactile fremitus/transmitted voice sounds in pleural effusion. |
|
Definition
1. Dull to flat over fluid 2. None, except possible pleural rub 3. Decreased to absent, but may be increased toward top of effusion |
|
|
Term
List the percussion note, adventitious sounds, and tactile fremitus/transmitted voice sounds in pneumothorax. |
|
Definition
1. Hyperresonant or tympanic over pleural air 2. None except possible pleural rub 3. Decreased to absent over pleural air |
|
|
Term
List the percussion note, adventitious sounds, and tactile fremitus/transmitted voice sounds in COPD. |
|
Definition
1. Diffusely hyperresonant 2. None, or crackles, wheezes, and rhonchi of associated chronic bronchitis 3. Decreased |
|
|
Term
List the percussion note, adventitious sounds, and tactile fremitus/transmitted voice sounds in asthma. |
|
Definition
1. Resonant to diffusely hyperresonant 2. Wheezes, possibly crackles 3. Decreased |
|
|
Term
|
Definition
Alveoli fill with fluid or blood cells, as in pneumonia, pulmonary edema, or pulmonary hemorrhage |
|
|
Term
|
Definition
Fluid accumulates in the pleural space and separates air-filled lung from the chest wall, blocking the transmission of sound |
|
|
Term
|
Definition
When air leaks into the pleural space, usually unilaterally, the lung recoils from the chest wall. Pleural air blocks transmission of sound |
|
|
Term
|
Definition
Slowly progressive disorder in which the distal air spaces enlarge and lungs become hyperinflated. Chronic bronchitis also associated |
|
|
Term
|
Definition
Widespread narrowing of the tracheobronchial tree diminishes air flow to a fluctuating degree. During attacks, air flow decreases further, and lungs hyperinflate |
|
|
Term
What should you ask about during cardiac history? |
|
Definition
Chest pain Palpitations Dizzy Syncope Dyspnea Orthopnea - How many pillows? +/- cough +/- sweats +/- nausea Peripheral edema SMOKING |
|
|
Term
How would you know that edema is related to cardiac system? |
|
Definition
If swelling is bilateral and worse in evening |
|
|
Term
What are 5 major risk factors of heart disease? |
|
Definition
1. Smoking history 2. Diabetes Mellitus 3. Hypertension 4. Obesity (BMI >30 kg/m2) 5. High Cholesterol levels |
|
|
Term
How do you measure for JVD? |
|
Definition
-Position bed at 30-45 degree angle and look for pulsations and fullness -A normal reading the vein goes down as the head goes up = not stressed |
|
|
Term
What would central cyanosis indicate? |
|
Definition
Poor arterial circulation |
|
|
Term
What would periperal cyanosis indicate? |
|
Definition
Peripheral vasoconstriction |
|
|
Term
What are you hearing during the "Lub (S1)" part of the heart sound? |
|
Definition
The closure of the tricuspid and mitral vavle (AV valves) |
|
|
Term
What are you hearing during the "Dub" (S2) part of the heart sound? |
|
Definition
Closure of aortic and pulmonary valves (SL valves) |
|
|
Term
What is a Split S2 (physiologic split)? |
|
Definition
Aortic valve closes earlier than pulmonic valve during inspiration |
|
|
Term
What is normal for Split S2? |
|
Definition
-It is normal to hear in athletes < 40 y.o. -Best heard at base of heart (Mitral, Pulmonic) -Louder on reclining and disappears during slow breathing or holding breath |
|
|
Term
What is normal for Split S2? |
|
Definition
-It is normal to hear in athletes < 40 y.o. -Best heard at base of heart (Mitral, Pulmonic) -Louder on reclining and disappears during slow breathing or holding breath |
|
|
Term
What is an abnormal split? |
|
Definition
-Occurs in expiration -Stays when sitting up |
|
|
Term
|
Definition
-S3 occurs when ventricles are resistant in early rapid filling phase = protodiastole -Not varying with respiration; persists when sitting upright, increases with isotonic exercise |
|
|
Term
Who would you expect to have an S3 sound? |
|
Definition
-Young adults, children -Increased heart rate -Late pregnancy |
|
|
Term
What would indicate an abnormal S3 sound? |
|
Definition
-Older adult -Hypertension -Volume overload (CHF) -Mitral Regurg -High output states (thyroid, anemia) |
|
|
Term
|
Definition
Occurs from resistance to filling at end of disatole (at prestole) |
|
|
Term
List the heart murmur grades: |
|
Definition
I - Very hard to hear II - Quiet but heard with stethoscope III - Moderately loud, without a thrill IV - Loud, may have thrill V - Very loud, definite thrill, can be heard with stethoscope partly off chest VI - Heard without stethoscope on chest, obvious thrill |
|
|
Term
What is intermittent claudication? |
|
Definition
Pain in leg aggravated by walking or activity |
|
|
Term
What does Homen's test look for? |
|
Definition
DVT (but is only 35% accurate) |
|
|
Term
What would be worrisome findings during inspection and palpation of lymph nodes? |
|
Definition
-Prolonged swelling over 1.5 cm -widespread adenopathy -multiple positive history points |
|
|
Term
What does an orthostatic reading show? |
|
Definition
How the heard accommodates when the patient changes position |
|
|
Term
|
Definition
Problem with blood oxygen going to the muscle |
|
|
Term
|
Definition
Problem with blood going back to the heart |
|
|
Term
What are the symptoms of PAD? |
|
Definition
-Pain upon limb elevation (arterial blood cannot get to muscle) -Pain increased with walking (intermittent claudication) -Can tell how bad PAD is by how far they can walk -Increase of pain at at night -Increase of pain with cool temperature |
|
|
Term
What would hair loss on a patient's legs be indicative of? |
|
Definition
Loss of oxygen to the area (can happen with PAD or PVD) |
|
|
Term
What are the anterior landmarks for location of the normal adult heart? |
|
Definition
From the 2nd to 5th intercostal space and from the right border of the sternum to the left mid-clavicular line |
|
|
Term
Where is the anatomical location of the apical impulse? |
|
Definition
5th intercostal space, mid-clavicular line |
|
|
Term
In which of the 4 auscultatory will the S1 sound be loudest? |
|
Definition
|
|
Term
In which of the 4 auscultatory areas will the S2 sound be the loudest? |
|
Definition
|
|
Term
List the 4 precordial areas for ascultation and their anatomical landmarks. |
|
Definition
1. Aortic: Right 2nd intercostal space 2. Pulmonic: Left 2nd intercostal space 3. Tricuspid: Left 5th intercostal space 4. Mitral (PMI): Left 5th intercostal space at midclavicular line |
|
|
Term
When checking the different peripheral pulses of the arm, what 3 arteries are we feeling? |
|
Definition
1. Brachial 2. Radial 3. Ulnar |
|
|
Term
When we are feeling the different peripheral pulses of the leg, which 4 arteries are we feeling? |
|
Definition
1. Femoral 2. Popliteal 3. Dorsalis Pedis 4. Posterior tibial |
|
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Term
Which pulse do we feel to check peripheral pulses on the neck? |
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Definition
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Term
What are the functions of the lymphatic system? |
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Definition
1. Recycle and conserve fluids and plasma proteins 2. Part of immune system pathway: lymph nodes 3. Absorb lipids from the intestinal tract |
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Term
List the superficial lymph nodes available for direct examination. |
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Definition
-Cervical -Axillary -Inguinal: upper and lower |
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Term
What would be worrisome findings during a lymphatic assessment? |
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Definition
-Prolonged swelling over 1.5cm wide -Widespread adenopathy -Multiple positive history points |
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Term
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Definition
fatty thickening in walls of arteries |
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Term
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Definition
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Term
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Definition
Alternating force of pulse; almost always indicates severe left-sided heart failure and is usually best felt by applying light pressure on radial or femoral arteries |
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Term
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Definition
Greater than normal drop in systolic pressure during inhalation |
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Term
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Definition
3 factors that set stage for venous thrombosis 1. Venous stasis 2. Hypercoaguability 3. Vessel wall damage |
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Term
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Definition
Develops when lymph channes are obstructed by tumor, fibrosis, or inflammation, and in cases of axillary node dissection and radiation. |
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Term
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Definition
Edema is soft in early stages, then becomes hard and nonpitting. Skin is thickened, ulceration is rare, no pirgmentation and is usually found bilaterally on extremities. |
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Term
Why might the PMI be felt in the xiphoid process or epigastric area? |
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Definition
Results from right ventricular hypertrophy, usually as a result of obstructive pulmonary disease |
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Term
False high blood pressure |
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Definition
Cuff too small Cuff too loose or uneven Arm below heart Inflating or deflating too slow Deflating cuff too quickly |
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Term
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Definition
Cuff too large Repeating BP too quickly Inaccurate level of inflation Pressing stethoscope too tightly |
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Term
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Definition
- Normal <120, <80 - Prehypertension: S: 120-139, D: 80-89 - Stage 1: hypertension: S: 140-159, D: 90-99 - Stage 2: hypertension: S: 160+, D: 100+ |
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Term
What would you ask for a patient for a head and scalp history? |
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Definition
-Headaches -Dizziness -Lumps or masses -Surgery -Allergies -Medications and/or treatments used |
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Term
What does the patient do during a facial motor exam? |
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Definition
-Smile -Puff cheeks -Show teeth -Wrinkle brow -Squeeze eyes shut against resistance |
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Term
During a neck exam, what are you palpating for when the patient swallows? |
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Definition
Isthmus, left and right lobes of thyroid, feel for any nodules, enlargement or tenderness |
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Term
How do we measure how swollen tonsils are? |
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Definition
Look inside mouth, measure from 1+(slightly swollen) to 4+ (swollen to tip of uvula) |
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Term
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Definition
common physical disorder of the nose, involving displacement of the nasal septum |
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Term
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Definition
sac-like growths of inflamed tissue lining the nose; people with nasal polyps often complain of having cold-like symptoms that have lasted for months or years |
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Term
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Definition
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Term
URI (Upper Respiratory Infection) symptoms |
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Definition
-Nasal Congestion -Feverish -Sore throat -Toothache |
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Term
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Definition
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Term
What is the difference between doing an ear exam on an adult and an ear exam on a child? |
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Definition
In adults you pull the ear up and back to straighten the ear canal while in children you pull the ear down and back |
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Term
What is the function of the middle ear? |
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Definition
Conducts sound, equalizes air pressure and reduces loudness |
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Term
What are the auditory ossicles? |
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Definition
Composed of the malleus, incus, and stapes, it transmits vibration from the TM to the inner ear |
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Term
What is the eustachian tube and how does it differ in adults v. children? |
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Definition
It equalizes aie pressure form middle ear to nasopharynx and is more horizontal in child, more angled in adult |
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Term
What makes up the inner ear? |
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Definition
Cochlea - converts vibrations and sends through cochlear nerve to the brain Labyrinth - responsible for balance |
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Term
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Definition
-Mechanical dysfunction in external or middle ear -Foreign object in canal, perforated TM, otosclerosis -Can still hear if sound is loud enough |
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Term
Sensorineural hearing loss |
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Definition
-Cochlear, CN VIII or auditory area of cerebral -Presbycusis -Inner ear disease, ototoxic drugs |
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Term
What is pupil accomodation? |
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Definition
Pupillary constriction and convergence towards center when looking from far to near |
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Term
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Definition
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Term
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Definition
Pupils Equal Round Reacts to Light Accommodates |
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Term
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Definition
Visual accuity chart -chart is 20 feet away from the patient -Cover one eye during testing, then switch to other eye, then both eyes -The larger the denominator, the poorer the vision -Person is legally blind if vision is 20/200 and cannot be corrected |
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Term
What are amblyopia, diplopia, myopia, hyperopia, and prebyopia? |
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Definition
Amblyopia: lazy eye Diplopia: double vision Myopia: nearsightedness Hyperpopia: farsighted Presbyopia: decreased accommodation with aging |
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Term
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Definition
A condition in which eyes make repetitive uncontrolled movements. It is normal at extremes of gaze but in Labyrinth disorder, it will be present after eye moves back to normal position |
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Term
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Definition
A condition in which the eyes are not properly aligned with each other |
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Term
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Definition
Buildup of fluid inside the skull, "water heads" usually found in children |
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Term
What is the number one thing you monitor for after a tonsilectomy and what is the sign for that? |
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Definition
Bleeding and a sign in constant swallowing is a sign |
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Term
What should you look for when examining the TM? |
|
Definition
Color should be pearly gray and you should make you see cone-of-light to be sure the TM is not bulging |
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Term
What two tests should you perform to test conductive hearing loss? |
|
Definition
Weber: Vibrating fork in middle of client's head Rinne: Vibrating fork on mastoid bone, then in front of ear (air conduction should be greater than bone conduction) |
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Term
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Definition
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Term
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Definition
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Term
What are 3 types of primary headaches? |
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Definition
1. Migraines 2. Tension 3. Cluster |
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Term
What are the processes of Migraines, Tension headaches, and cluster headaches? |
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Definition
M: Primary neuronal dysfunction T: Unclear-muscle contraction or vasoconstriction unlikely C: Unclear-possibly extracranial vasodilation from neural dysfunction |
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Term
What are the different locations of Migraines, tension headaches, and cluster headaches? |
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Definition
M: Usually unilateral T: Usually bilateral; may be generalized or localized C: Unilateral; usually behind or around eye |
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Term
What are the different qualities and their severities in migraines, tension headaches, and cluster headaches? |
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Definition
M: Throbbing or aching, variable in severity T: Pressing or tightening pain, mild to moderate intensity C: Deep, continuous, severe |
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Term
Describe the Timing (onset, duration, course) for migraines, tension headaches, and cluster headaches. |
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Definition
M: Onset is fairly rapid reaching peak in 1-2 hrs, lasts 4-72 hours and peak incidence is in early to mid adolescence, usually in women, usually monthly T: Onset is gradual, lasts minutes to days, and is often recurrent or persistent over long periods C: Onset is abrupt, peaks within minutes, lasts up to 3 hours, and is episodic, clustered in time with several each day for 4-8 wks, then relief for 6-12 mos. More common in men. |
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Term
What are the different associated factors for migraines, tension headaches, and cluster headaches? |
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Definition
M: Nausea, vomiting, photophobia, phonophobia, visual auras, motor auras affecting hand or arm, sensory auras T: Sometimes photophobia; phonophobia; nausea absent C: Lacrimation, rhinorrhea, miosis, ptosis, eyelid edema, conjunctival infection |
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Term
What are the different aggravating/provoking factors for migraines, tension headaches, and cluster headaches? |
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Definition
M: Alcohol, certain foods, or tension may provoke, more common premenstually, aggravated by noise/bright light T: Sustained muscle tension, as in driving or typing C: During attack, sensitivity to alcohol may increase |
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Term
What are the relieving factors for migaines, tension headaches, and cluster headaches? |
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Definition
M: Quiet, dark room; sleep; sometimes transient relief from pressure on the involved artery, if early in the course T: Possibly massage, relaxation C: ? |
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|
Term
What type of headaches are sinusitis headaches and those related to meningitis? |
|
Definition
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|
Term
What are the different processes for headaches related to sinusitis and meningitis? |
|
Definition
S: Mucosal inflammation of the paranasal sinuses M: Infection of the meninges surrounding the brain |
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Term
Where are the different locations common to headaches related to sinusitis and meningitis? |
|
Definition
S: Usually above the eye or over the maxillary sinus M: Generalized |
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Term
Describe the quality and severity of headaches related to sinusitis and meningitis. |
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Definition
S: Aching or throbbing; variable in severity; consider possible migraine T: Steady or throbbing, very severe |
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Term
Describe the Timing (onset, duration, course) for headaches related to sinusitis and meningitis. |
|
Definition
S: Variable onset, often lasts several hours at a time, recurring over days or longer; often recurrent in a repetitive daily pattern M: Fairly rapid onset, duration is variable, usually days; it is a persistent headache in an acute illness |
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Term
Describe the associated factors in the headaches related to sinusitis and meningitis. |
|
Definition
S: Local tenderness, nasal congestion, discharge, and fever M: Fever, stiff neck |
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Term
Describe the aggravating/provoking factors in headaches related to sinusitis and meningitis. |
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Definition
S: May be aggravated by coughing, sneezing, or jarring the head M: none? |
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Term
Describe the factors that relieve headaches related to sinusitis and meningitis. |
|
Definition
S: Nasal decongestants, antibiotics M: N/A? |
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Term
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Definition
Increased adrenal cortisol production produces a round or "moon" face with red cheeks. Excessive hair growth may be present on face. |
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Term
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Definition
Increased growth hormone produces enlargment of both bone and soft tissue. Head is elongated, with bony prominences fo the forehead, nose, and lower jaw. Facial features appear coarsened. |
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Term
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Definition
Decreased facial mobility blunts expression. A masklike face may result with decreased blinking and a characteristic stare. Neck and upper trunk flex forward, facial skin becomes oily, and drooling may occur. |
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|
Term
What are the symptoms of hyperthyroidism? |
|
Definition
-Nervousness -Weight loss despite increased appetite -Excessive sweating and heat intolerance -Palpitations -Frequent bowel movements -Proximal muscle weakness and tremor |
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Term
What are the signs of hyperthyroidism? |
|
Definition
-Warm, smooth, moist skin -Increased systolic and decreased diastolic BP -Tachycardia or A. Fib -Hyperdynamic cardiac pulsations with an accentuated S1 -Tremor and proximal muscle weakness -With Graves disease, eye signs such as stare, lid lag, and exopthalmos |
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Term
What are the symptoms of hypothyroidism? |
|
Definition
-Fatigue, lethargy -Modest weight gain with anorexia -Dry, coarse skin and cold intolerance -Swelling of face, hands, and legs -Constipation -Weakness, muscle cramps, arthralgias, paresthesias, impaired memory and hearing |
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Term
What are the signs of hypothyroidism? |
|
Definition
-Dry, coarse, cool skin, sometimes yellowish from carotene, with nonpitting edema and loss of hair -Periorbital puffiness -Decreased systolic and increased diastolic BP -Bradycardia and, in late stages, hypothermia -Intensity of heart sounds sometimes depressed -Impaired memory, mixed hearing loss, somnolence, peripheral neuropathy, carpal tunnel syndrome |
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Term
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Definition
Drooping of the upper lid. Causes can include myasthenia, gravis, damage to the oculomotor nerve, and damage to the sympathetic nerve supply. Senile ptosis can occur with age. |
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Term
|
Definition
The eyeball protrudes forward. When bilateral, can indicate infiltrative ophthalmopathy of Graves hyperthyroidism. Unilateral is seen in Graves disease or a tumor or inflammation of the orbit. |
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Term
|
Definition
Pattern of redness: diffuse dilatation of conjunctival vessels with redness that tends to be maximal perpherally Pain: mild discomfort Vision: unaffected except for temporary blurring due to discharge Discharge: watery, mucoid, or mucopurulent Pupil: Not affected Cornea: Clear Significance: Bacterial, viral, and other infections; allergy; irritation |
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Term
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Definition
Opacities of the lenses visible through the pupil. Most common in old age. Nuclear cataract looks gray when seen by a flashlight. |
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Term
|
Definition
Unequal pupils. When greater in bright light causes could include blunt trauma to eye, open-angle glaucoma, and impaired parasympathetic nerve supply to iris. When greater in dim light caused by interruption of sympathetic nerve supply. |
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Term
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Definition
A painful, tender red infection in a gland at the margin of the eyelid |
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Term
|
Definition
Spinning sensation accompanied by nystagmus and ataxia |
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|
Term
|
Definition
a near faint from feeling faint or lightheaded |
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|
Term
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Definition
unsteadiness or imbalance when walking, especially in older patients |
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|
Term
What would be the results of a Weber and Rinne test for an ear that has conductive hearing loss? |
|
Definition
W: Sound lateralizes to impaired ear-room noise not well heard, so detection of vibrations improves R: Bone conduction longer than or equal to air conduction |
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|
Term
What would be the results of a Weber and Rinne test for an ear with sensorineural hearing loss? |
|
Definition
W: Sound lateralizes to good ear-inner ear or cochlear nerve damage impairs transmission to affected ear R: Air conduction longer than bone conduction |
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Term
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Definition
Produces recurrent and painful vesicular eruptions of the lips and surrounding skin. A small cluster of vesicles first develops. As these break, yellow-brown crusts form, and healing ensues within 10-14 days. |
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Term
|
Definition
A diffuse, nonpitting, tense swelling of the dermis and subcutaneous tissue. It develops rapidly, and typically disappears over subsequent hours or days. Although usually allergic in nature and sometimes associated with hives, it does not itch. |
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Term
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Definition
Yeast infection in the mouth. Thick, white plaques are somewhat adherent to the underlying mucosa. Predisposing factors include: prolonged treatment with corticosteroid or antibiotics; AIDS. |
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Term
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Definition
Common in teenagers and young adults. Gingival margins are reddened and swollen, adn the interdental papillae are blunted, swollen and red. Brushing teeth often makes the gums bleed. Plaque is not readily visible. |
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Term
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Definition
Benign. Dorsum of tongue shows scattered smooth red areas denuded of papillae. Gives a maplike pattern that changes over time |
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Term
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Definition
Hairy yellowish to brown or black elongated papillae on tongue's dorsum. Benign condition may follow antibiotic therapy or occur spontaneously. |
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Term
|
Definition
Fissures appear with age. Food debris may accumulate in crevices and irritate, but condition is benign |
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Term
Smooth tongue (atrophic glossitis) |
|
Definition
Smooth and often sore tongue that has lost it's papillae. Suggest deficiency in riboflavin, niacin, folic acid, vitamin B12, pyridoxine, or iron, or tx with chemo |
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Term
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Definition
Candida albicans infection of the tongue that is seen in immunosuppressed conditions |
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Term
|
Definition
These whitish raised areas with a feathery or corrugated pattern most often affect the sides of the tongue. Unlike candidiasis, these areas cannot be scraped off. They are seen in HIV and AIDS |
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Term
|
Definition
early symptom (or set of symptoms) that might indicate the start of a disease before specific symptoms occur |
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|
Term
Name the physical borders for the anterior triangle of the neck |
|
Definition
1. Mandible above 2. Sternomastoid laterally 3. Midline of the neck medially |
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|
Term
What are the anatomical borders for the posterior triangle of the neck? |
|
Definition
1. Sternomastoid muscle 2. Trapezius muscle 3. The clavicle |
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|
Term
What does the thyroid feel like in Grave's Disease, Hashimoto Thyroidectomy, malignancy, and thyroiditis? |
|
Definition
Soft in Grave's Disease; Firm in Hashimotos; Firm in malignancy; tenderness in thryroiditis |
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Term
|
Definition
Tests near vision and helps identify the need for reading glasses or bifocals in patients older than 45 |
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|
Term
What area of the male anatomy is a potential hernia site? |
|
Definition
Juncture of lower abdomen wall and thigh is a potential hernia site in which a loop of bowel (colon) portrudes though a weak spot in musculature |
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|
Term
What do the lymphatics of the penis and scrotal surfaces drain into? |
|
Definition
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|
Term
What do the lymphatics of the testes drain into? |
|
Definition
The abdominal lymph nodes (which aren't accessible to exam) |
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|
Term
What are the anatomical borders of the inguinal area? |
|
Definition
The anterior superior iliac spine and symphysis pubis |
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|
Term
How long is the inguinal canal and what are the openings called? |
|
Definition
4-6 cm in an adult and the two openings are called the internal ring and the external ring |
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|
Term
What are 6 important components of a reproductive health history in men? |
|
Definition
1. What may have brought the patient in 2. Sexual preference and sexual response 3. Penile discharge or lesions 4. Scrotal pain or swelling 5. Inguinal pain or swelling 6. Problems with urination |
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|
Term
What are the 3 main topics to include in reproductive health promotion for men during visit? |
|
Definition
1. Prevention of HIV/STI's 2. Testicular Cancer Screening 3. Prostate Cancer Screening |
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|
Term
What do you ask about when taking male fertility history? |
|
Definition
-Number of children -Infertility evaluation |
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|
Term
What should you ask about when assessing male sexual activity history? |
|
Definition
-Erection and ejaculation history (impotence, dysfuction) -Partners -Practices, Protection, Past history of STD/STI |
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|
Term
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Definition
|
|
Term
What is the Tanner scale? |
|
Definition
Scale of physical development in children, adolescents, and adults |
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|
Term
List the Tanner scale stages of pubic hair |
|
Definition
Tanner I: no pubic hair at all Tanner II: small amount of long down pubic hair with slight pigment Tanner III: Hair becomes more coarse and curly Tanner IV: adult-like hair quality, extending across pubis but sparing medial thighs Tanner V: hair extends to medial surface of the thighs |
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|
Term
What should you do if you notice a mass during a scrotal examination? |
|
Definition
Transilluminate it: By holding a light behind the scrotum one can easily determine whether the mass is cystic (light shines through) or solid (light blocked by the mass) |
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|
Term
What is the concern if abnormalities are noted in the epididymis and spermatic cord? |
|
Definition
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|
Term
|
Definition
Pathological accumulation of serous fluid in the scrotum. The main symptom is a painless swollen testicle which feels like water balloon |
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|
Term
|
Definition
Inflammation of the testes |
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|
Term
|
Definition
The involuntary contraction of the cremaster muscle when the inner thigh is lightly stroked. It can be overactive during adolescence but it's absence in adulthood can indicate health problems (such as testicular torsion or spinal injury) |
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|
Term
|
Definition
Abnormal location of the urethral opening |
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|
Term
What are the signs of testicular cancer? |
|
Definition
unilateral, hard, painless mass |
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|
Term
Self exams for testicular and breast cancer are now a Class D recommendation. What does this mean? |
|
Definition
There is moderate to high certainty that the service has no benefit or that harm outweighs the benefit |
|
|
Term
What positions can the patient be in during an anal and colorectal exam? |
|
Definition
-L lateral recumbent (left side lying) -Lithotomy -Standing |
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|
Term
During a prostate exam, what would be considered abnormal findings? |
|
Definition
-greater than 2.5cm - irregular -"boggy"/very mushy -very hard -tender |
|
|
Term
Fecal Occult Blood Test (FOBT) |
|
Definition
This at home test detects blood in the stool by placing a small sample of stool on a chemically treated card, pad, or wipe. Two separate BMs are tested since cancerous tumors can bleed intermittently. |
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|
Term
How frequently should a patient get: 1. FOBT 2. Flex Sig 3. Colonoscopy |
|
Definition
1. Once a year (unless done in combo with Flex Sig, then every 3 years) 2. Every 5 years 3. Every 10 years |
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|
Term
|
Definition
Doctor looks for polyps/cancer in rectum and lower third of colon with a small, thin, lighted tube inserted into rectum. Pt. must take enema/laxative night before procedure |
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|
Term
|
Definition
Similar to flex sig, except the doctor uses longer lighted tube, checks for polyps/cancer in rectum and entire colon, and during test doctor can find and remove most polyps and some cancers. Pt. is slight sedated during test. |
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|
Term
A young man feels a sharp pain in his testicle. At what point does he go to a doctor? How long does he have before serious damage occurs? How much time is too long? |
|
Definition
1. If the pain lasts for more than one hour 2. If he does not see a doctor within 6 hours, chances that his testicle will have permanent damage rise 3. If he does not go to a doctor within 24 hours |
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|
Term
What is the most current US Preventative Services Task Force stance on prostate-specific antigen (PSA) based screening for prostate cancer? |
|
Definition
It recommends against it, stating the potential benefit does not outweigh the risk. Only 1 out of 1000 men every 10 years are thought to be helped by PSA screeening, yet 120 out of every 1000 men receive a false-positive test, thereby leading to overdiagnoses and overtreatment. |
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|
Term
What is the most common cancer in men? |
|
Definition
|
|
Term
What does the prostate do? |
|
Definition
Produces fluid that makes up a part of the semen |
|
|
Term
How does the prostate change as men age? How does this relate to urination? |
|
Definition
It enlarges and causes the urethra to narrow, thereby decreasing urine flow |
|
|
Term
What are some of the symptoms of prostate cancer? |
|
Definition
-Difficulty starting urination -Weak or interrupted urine flow -Frequent urination, especially at night -Difficulty emptying the bladder completely -Pain or burning during urination or ejaculation -Pain in the back, hips, or pelvis that doesn't resolve |
|
|
Term
What are risk factors for prostate cancer? |
|
Definition
1. Age: the older the man, the higher the risk 2. Family History 3. Race: more common in African Americans |
|
|
Term
What are symptoms of colon cancer? |
|
Definition
There may not be any, but if there are: 1. Blood in or on stool 2. Stomach pains, aches, or cramps that don't resolve 3. Unexplained weight loss |
|
|
Term
What are the risk factors associated with colon cancer? |
|
Definition
1. Age: 90% cases occur in 50 yrs of age or older 2. Inflammatory Bowel Diseaes 3. Family History 4. Lifestyle Factors: low fiber/high fat intake, low physical activity; alcohol/tobacco use |
|
|
Term
What is the best way to prevent colorectal (colon) cancer? |
|
Definition
Screening. Precancerous polyps can be present in the colon for years before they turn into cancer, and we can find these polyps and destroy them before that during a screening. |
|
|
Term
How would you set a comfortable environment while taking a female reproductive history? |
|
Definition
1. Collect history while patient is dressed 2. Understand anxieties, discomfort, embarrassments 3. Treat patient with respect and patience |
|
|
Term
What structural and functional changes occur in a woman's body during pregnancy? |
|
Definition
1. Breast enlargement and milk production 2. Uterine size increases 3. Changes in vaginal secretions, mucosa, and color |
|
|
Term
What structural and functional changes occur in an elderly woman druing/after menopause? |
|
Definition
1. Pubic hair gradually decreases 2. Skin is thinner and fat deposits decrease, leaving mons pubis smaller, and labia flatter 3. Clitoris size also decreases after age 60 4. Uterus reduces in size |
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|
Term
Who should be screened for cervical cancer and how often should screening be done? |
|
Definition
Women 21 to 65 years old with Pap smear every 3 years; For women 30-65 who want to lengthen screening time, they can get a combination HPV test/Pap smear every 5 years |
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|
Term
|
Definition
|
|
Term
|
Definition
Occurs when the wall between a woman's bladder and her vagina weakens and allows the bladder to droop into the vagina |
|
|
Term
|
Definition
Occurs when the end of the large intestine (rectum) pushes through the back wall of the vagina |
|
|
Term
|
Definition
Falling or sliding of the womb (uterus) from its normal position into the vaginal area. Symptoms: Feeling like you are sitting on a small ball; Difficult or painful sexual intercourse |
|
|
Term
|
Definition
Gravida: total number of pregnancies Para: total number of deliveries after 20 wks gestational age Abortus: Number of pregnancy losses (elective, spontaneous before 20 weeks gest. age, induced) |
|
|
Term
Benign Breast Disease (formerly Fibrocystic Breast Disease) |
|
Definition
-Multiple tender masses -Cyclic discomfort -Lympiness |
|
|
Term
Concerning signs that may indicate breast cancer? |
|
Definition
-Signs of retraction -Abnormal contours -Skin dimpling -Nipple retraction/deviation -Edema of the skin -Paget disease of the nipple |
|
|
Term
Paget's disease of the nipple |
|
Definition
Rare form of breast cancer in which the nipple and areola become scaly, red, itchy, and irritated |
|
|
Term
What are the anatomical borders of the average female breast? |
|
Definition
Extends from clavicle down to the 6th rib and from the sternum to the midaxillary line |
|
|
Term
Which axillary lymph nodes are most palpable? |
|
Definition
|
|
Term
When is nipple retraction concerning? |
|
Definition
When it is a recent change because it could indicate breast cancer or adhesions below the surface |
|
|
Term
While doing a breast exam, you notice a nodule. What characteristics do you document? |
|
Definition
Location (which breast, quadrant or clock site, cm from nipple) Size (in centimeters) Shape Consistency Delineation (well circumscribed or not) Tenderness Mobility |
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|
Term
What are the 3 most common kinds of breast masses? |
|
Definition
1. Fibroadenoma 2. Cysts 3. Breast Cancer |
|
|
Term
What is the usual age for a woman to have a fibroadenoma, cyst, and breast cancer? |
|
Definition
F: 15-25; usually puberty and young adulthood, but up to 55 Cyst: 30-50, regress after menopause except with estrogen therapy Cancer: 30-90; most common over age 50 |
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Term
What is the usual number of fibroadenomas, cysts, or cancerous lumps found at one time? |
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Definition
F: Usually single, may be multiple Cyst: Single or multiple Cancer: Usually single |
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Term
What is the common shape of fibroadenomas, cysts, or cancerous masses found in the breast? |
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Definition
F: Round, disc-like, or lobular Cyst: Round Cancer: Irregular or stelate |
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Term
What is the usual consistency of fibroadenoma, cyst, or cancerous mass found in the breast? |
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Definition
F: May be soft, usually firm Cyst: Soft to firm, usually elastic Cancer: Firm or hard |
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Term
Of the 3 most common breast masses (fibroadenoma, cyst, and cancerous) which one is not clearly delineated upon examination? |
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Definition
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Term
Of the 3 most common breast masses (fibroadenoma, cyst, and cancerous) which one is usually immobile and fixed to underlying tissues? |
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Definition
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Term
Of the 3 most common breast masses (fibroadenoma, cyst, and cancerous) which one is often tender? |
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Definition
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Term
Of the 3 most common breast masses (fibroadenoma, cyst, and cancerous) which one may show signs of retraction? |
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Definition
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Term
What are indications for a pelvic examination during adolescence? |
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Definition
-Amenorrhea -Excessive bleeding -dysmenorrhea -Unexplained abdominal pain -Bacteriologic and cytologic studies in sexually active girl -prescription of contraceptives -Patient's own desire for assessment |
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Term
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Definition
pain or discomfort during intercourse |
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Term
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Definition
|
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Term
What are the 5 phases of a women's reproductive health? |
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Definition
1. Prepuberty (premenstruation) 2. Puberty (menarche) 3. Childbearing (menstruation) 4. Perimenopausal 5. Menopausal |
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Term
What are the 3 types of hernias during reproductive examination? |
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Definition
1. Indirect inguinal hernia (most common) 2. Direct inguinal hernia 3. Femoral hernia (more common in women) |
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Term
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Definition
Membrane lining the walls of the abdominal and pelvic cavities |
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Term
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Definition
Refers to the space near the posterior abdominal wall and the peritoneum |
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Term
List the 3 abdominal quadrants. |
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Definition
1. Epigastric 2. Umbilical 3. Hypogastric/Suprapubic |
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Term
Organs by Quadrant: Right Upper Quadrant |
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Definition
Ascending colon Duodenum Gallbladder Right kidney Liver Pancreas (head) Transverse colon Ureter (right) |
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Term
Organs by quadrant: Left Upper Quadrant |
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Definition
Descending Colon Left kidney Pancreas (body and tail) Spleen Stomach Transverse colon Ureter (left) |
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|
Term
Organs by quadrant: Right Lower Quadrant |
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Definition
Appendix Ascending Colon Bladder Cecum Rectum Ovary, uterus and fallopian tube (female) Prostate and spermatic cord (male) Small intestine Ureter (right) |
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Term
Organs by quadrant: Left Lower Quadrant |
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Definition
Bladder Descending Colon Ovary, uterus, fallopian tube (female) Prostate and spermatic cord (male) Small intestine Sigmoid colon Ureter (left) |
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Term
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Definition
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Term
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Definition
|
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Term
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Definition
bright red blood in stool |
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Term
What is the "normal" range for bowel elimination frequency? |
|
Definition
2-3 times a day to 3 times a week |
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Term
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Definition
Inflammation of the GI tract (mouth, esophagus, stomach, and intestines) |
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Term
What are the causes and symptoms of gastroenteritis? |
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Definition
-Multiple causes such as: virus, bacteria, parasite, medications, food intolerances -Symptoms include: Nausea and/or vomiting Diarrhea Abdominal cramping Fever |
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Term
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Definition
These are organs that maintain a characteristic shape. Liver Pancreas Kidney Adrenal glands Spleen Ovaries and Uterus |
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Term
|
Definition
Organs whose shape depends on their contents. Stomach Gallbladder Colon Small intestine Bladder |
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Term
What is the order of an abdominal assessment exam? |
|
Definition
Inspect Auscultate Percuss Palpate |
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|
Term
What are the 4 contours of the abdomen? |
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Definition
1. Flat 2. Scaphoid 3. Rounded 4. Protuberant |
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Term
What are the 6 F's of a protuberant abdomen? |
|
Definition
1. Fat 2. Fluid 3. Flatus 4. Fetus 5. Feces 6. Fatal growths |
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Term
What kind of sound would you hear upon percussion of a protuberants abdomen due to ascitic fluid? |
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Definition
With the patient in a supine position, you would hear tympany in the center of the abdomen and dullness along the sides (where the fluid is). |
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Term
What are abnormal bowel sound classifications? |
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Definition
-Absent (obstruction): listen for full 4-5 min -Hypoactive (decreased motility): Low gurgling <4 in 1 min -Hyperactive (increased motility): High pitched, loud |
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Term
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Definition
Turbulent flow or stenosis |
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Term
What is the normal span of the liver? |
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Definition
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Term
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Definition
-Push on LLQ then quickly remove hand -Rebound tenderness in RLQ or pain in RLQ durring LLQ pressure (appendicitis) |
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Term
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Definition
Pt. lays supine and examiner pushes down on patient's right thigh and asks pt. to raise leg. Pt. has pain in RLQ (appendicitis) |
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Term
Murphy's sign/Inspiratory arrest |
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Definition
Sharp pain upon inspiration when examiner's hand is palpating the liver (cholecystitis) |
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Term
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Definition
If ascites is present, the push will generate a fluid wave through the abdomen and you will feel a positive fluid wave. Distention is due to gas or adipose tissue, you will feel no change. |
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Term
What are classes physical findings of alcohol abuse? |
|
Definition
1. Hepatosplenomegaly (HSM) 2. Ascites 3. Caput medusa 4. Spider angiomas 5. Peripheral edema 6. Palmar erythema 7. Erythematic or bulbous nose |
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Term
What should you teach someone at risk for Hep A? |
|
Definition
-Transmission via fecal-oral -Children often asymptomatic -Vaccine available -Prophylaxis: serum globulin -Stess good handwashing techniques |
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|
Term
What are the 3 risk categories for Hep B? |
|
Definition
1. Sexual contacts 2. People with percutaneous or mucosal exposure to blood 3. Others: travelers, patients with chronic liver disease or HIV infection |
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|
Term
Who does the CDC recommend get Hep B vaccine? |
|
Definition
1. All adults in high-risk settings 2. In primary care or specialty settings 3. Adults in occupations involving exposure to blood or other potentially infectious body fluids 4. All pregnant women at first prenatal visit |
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|
Term
What are risk factors for Hep C? |
|
Definition
-Repeated percutaneous exposure -IV drug users -Transfusion with clotting factors before 1987 -Hemodialysis -Sex partners using IV drugs -Blood transfusion or organ transplant before 1992 -Occupational exposure -Multiple or infected sex partner |
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|
Term
Risk factors for colorectal cancer |
|
Definition
-Past colorectal cancer or adenomatous polyp -History of inflammatory bowel disease -Family history of colorectal cancer or adenomatous polyp |
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|
Term
Screening for colorectal cancer |
|
Definition
-Fecal occult blood test annually -Flexible sigmoidoscopy every 5 years -Colonoscopy every 10 years |
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|
Term
Prevention of urinary incontinence |
|
Definition
-Pelvic muscle training -Pelvic muscle exercises -Biofeedback -Incontinence is not normal |
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|
Term
Peptic Ulcer and Dyspepsia process |
|
Definition
Peptic ulcer refers to a demonstrable ulcer, usually in the duodenum or stomach. Dyspepsia causes similar symptoms but no ulceration. Infection by H. Pylori is often present. |
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|
Term
Peptic Ulcer and Dyspepsia (Location, quality, timing, aggravating factors, relieving factors, and associated symptoms and setting) |
|
Definition
L: Epigastric, may radiate to back Q: Variable: gnawing, burning, pressing or hunger-like T: Intermittent. Duodenal ulcer more likely to cause pain that 1) wakes at night, 2) occurs intermittently over a few weeks, then disappears for months, then recurs. AF: Variable RF: Food and antacids may bring relief AS&S: N&V, Belching, bloating; Heartburn, weight loss. Dyspepsia is more common in the young (20-29), and gastric ulcer in those over 50, and duodenal ulcer in those 30-60. |
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|
Term
The processes of acute and chronic pancreatitis |
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Definition
Acute: An acute inflammation of the pancreas Chronic: Fibrosis of the pancreas secondary to recurrent inflammation |
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|
Term
Acute pancreatitis (Location, quality, timing, aggravating factors, relieving factors, and associated symptoms and setting) |
|
Definition
L: Epigastric, may radiate to the back or other parts of the abdomen; may be poorly localized Q: Usually steady T: Acute onset, persistent pain AF: Lying supine RF: Leaning foward with trunk flexed AS&S: N&V, abdominal distention, fever. Often a history of previous attacks and alcohol abuse or gallstones. |
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|
Term
Chronic pancreatitis (Location, quality, timing, aggravating factors, relieving factors, and associated symptoms and setting) |
|
Definition
L: Epigastric, radiating through to the back Q: Steady, deep T: Chronic or recurrent course AF: Alcohol, heavy or fatty meals RF: Possibly leaning forward with trunk flexed; often intractable AS&S: Symptoms of decreased pancreatic function may appear: diarrhea with fatty stools (steatorrhea) and diabetes mellitus |
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|
Term
Acute cholecystitis process |
|
Definition
Inflammation of the gallbladder, usually from obstruction of the cystic duct by a gallstone |
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|
Term
Acute cholecystitis (Location, quality, timing, aggravating factors, relieving factors, and associated symptoms and setting) |
|
Definition
L: RUQ or upper abd; may radiate to the right scapular area Q: Steady, aching T: Gradual onset AF: Jarring, deep breathing AS&S: Anorexia, N&V, fever |
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|
Term
Acute diverticulitis process |
|
Definition
Acute inflammation of a colonic diverticulum, a sac-like mucosal outpouching through the colonic muscle |
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|
Term
Acute diverticulitis (Location, quality, timing, aggravating factors, relieving factors, and associated symptoms and setting) |
|
Definition
L: LLQ Q: May be cramping at first, but becomes steady T: Often gradual onset AS&S: Fever, constipation. There may be initial brief diarrhea. |
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Term
|
Definition
Acute inflammation of the appendix with distention or obstruction |
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|
Term
Acute appendicitis (Location, quality, timing, aggravating factors, relieving factors, and associated symptoms and setting) |
|
Definition
L: Poorly localized periumbilical pain, followed by RLQ pain Q: Mild but increasing, possibly cramping; becomes steady and more severe T: Lasts roughly 4-6 hours; then when it moves to RLQ it depends on intervention AF: Movement or cough RF: If it subsides temporarily, suspect perforation of the appendix AS&S: Anorexia, nausea, possibly vomiting, which typically follows onset of pain, low fever |
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|
Term
Acute Mechanical Intestinal Obstruction process |
|
Definition
Obstruction of the bowel lumen, most commonly caused by 1) adhesions or hernias (small bowel) or 2) cancer or diverticulitis (colon) |
|
|
Term
Acute Mechanical Intestinal Obstruction (Location, quality, timing, aggravating factors, relieving factors, and associated symptoms and setting) |
|
Definition
L: Small bowel: periumbilical or upper abdominal; Colon: lower abdominal or generalized Q: Cramping T: Paroxysmal AS&S: Small bowel: Vomiting of bile and mucus or fecal material. Obstipation develops; Colon: Obstipation early. Vomiting later ir at all. Prior symptoms of underlying cause. |
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|
Term
What are some problems that cause constipation? |
|
Definition
1. Lifestyle Activities and Habits 2. Irritable Bowel Syndrome 3. Mechanical Obstruction 4. Painful Anal Lesions 5. Drugs 6. Depression 7. Neurologic Disorders 8. Metabolic Conditions |
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|
Term
Acute diarrhea (2 processes) |
|
Definition
1. Secretory Infection: Infection by viruses, preformed bacterial toxins, cryptosporidium 2. Inflammatory Infection: Colonization or invasion of intestinal mucosa |
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|
Term
Acute Diarrhea: Secretory Infection (Characteristics of Stool, Timing, Associated Symptoms, Setting/Persons at Risk) |
|
Definition
CoS: Watery, without blood, pus, or mucus T: Duration of a few days, possibly longer. Lactase deficiency may lead to a longer course. AS: N&V, periumbilical cramping pain. Temperature normal or slightly elevated. S/PaR: Often travel, a common food source, or an epidemic |
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|
Term
Acute Diarrhea: Inflammatory Infection (Characteristics of Stool, Timing, Associated Symptoms, Setting/Persons at Risk) |
|
Definition
CoS: Loose to watery, often with blood, pus, or mucus T: An acute illness of varying duration AS: Lower abdominal cramping pain and often rectal urgency, tenesmus; fever S/PaR: Travel, contaminated food or water. Men and women who have had frequent anal intercourse |
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|
Term
What are the 6 components for a neurological physical examination? |
|
Definition
1. Mental Status: Cerebral Cortex 2. Cranial Nerves: Brainstem 3. Cerebellum and Motor system: Cerebellum, cerebral cortex, corticospinal and extrapyramidal tracts 4. Sensory system: Cerebral cortex, spinal cord/spinothalamic tract and posterior columns 5. Reflexes |
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|
Term
What are the two major divisions to the nervous system? |
|
Definition
1. Central Nervous system: brain and spinal cord 2. Peripheral Nervous system: 12 pairs cranial nerves and 31 pairs of spinal nerves |
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|
Term
What are the central components of the CNS? |
|
Definition
1. Brain and brainstem 2. Cerebellum 3. Spinal cord |
|
|
Term
|
Definition
Bundle of fibers outside the CNS |
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|
Term
2 types of peripheral nerve fibers are: |
|
Definition
1. Efferent: motor messages from the CNS out to muscles, organs, and glands 2. Afferent: sensory messages to the CNS from sensory receptors |
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|
Term
What are the 2 main functions of the peripheral nervous system? |
|
Definition
1. Somatic: skeletal muscles (voluntary movement) 2. Autonomic: smooth muscles (involuntary movement) |
|
|
Term
List the 12 cranial nerves. |
|
Definition
CNI-Olfactory CNII-Optic CNIII-Oculomotor CNIV-Trochlear CNV-Trigeminal CNVI-Abducens CNVII-Facial CNVIII-Acoustic CNIX-Glossopharyngeal CNX-Vagus CNXI-Spinal-Accessory CNXII-Hypoglossal |
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|
Term
|
Definition
Autonomic nervous system reacts causing bradycardia AND allows vasodilation in the extremity vessels - decrease blood - decrease O2 - on floor |
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|
Term
What are the symptoms of expressive dysphagia? |
|
Definition
-Can understand what others are saying -Words are slow and laborious, but meaningful -Often gets frustrated |
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|
Term
What are the symptoms of receptive dysphagia? |
|
Definition
-Little or no comprehension of words -Spoken words are fluent and nonsensical -No idea the words and language are wrong |
|
|
Term
|
Definition
A neurological scale that aims to give a reliable, objective way of recording the conscious state of a person. The score ranges between 3 (deeply unconscious) and 15 |
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|
Term
What part of the nervous system does each vital sign correlate to? |
|
Definition
HR = Vagus Respiratory = Medulla, pons BP=Medulla Temp = Hypothalamus |
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|
Term
How do you test each of the cranial nerves? |
|
Definition
1. Olfactory: smell 2. Optic: snellen 3, 4, and 6. Oculomotor, Trochlear, Abducens: PERRLA, EOM 5. Trigeminal: clench teeth, light touch on face 7. Facial: Smile, frown, puff cheeks out 8. Acoustic: Whisper test, Rinne, Weber 9, 10. Say "Ahh," Gag reflex, taste 11. Spinal accessory - turn head and shrug shoulders against resistance 12. Hypoglossal - stick out tongue, speaking |
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|
Term
What would an abnormal finding during rapid rhythmic alternating movements be indicative of? |
|
Definition
Possible cerebral disease . . . or drunk. Either one. |
|
|
Term
What would an inability to walk straight be indicative of? |
|
Definition
Cerebral Disease (MS) . . . or he's drunk. |
|
|
Term
|
Definition
Stand upright, place feet together, then close eyes for 20 sec Positive test menas loss of balance - cerebellar disorder (MS, drunk) altered proprioreception |
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|
Term
|
Definition
Pt holds a "pizza box" at chest level - with supinated palms, close eyes and holds for 20 sec. |
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|
Term
What would abnormal muscle tones indicate? |
|
Definition
-Flaccid: polio, Guillan-Barre -Spastic: cerebral palsy, spinal cord injury -Rigid: tetanus -Cogwheel rigidity: parkinonism |
|
|
Term
|
Definition
Familiar item in hand. If unable to ID, it means sensory cortex lesion |
|
|
Term
|
Definition
"Write" number in palm and ID. If unable to ID, it indicates sensory cortex lesion |
|
|
Term
|
Definition
1. Involuntary 2. Helps maintain muscle tone 3. Permits quick response to bad stimuli |
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|
Term
5 components needed for DTR response (IMPORTANT TO KNOW HINT HINT!) |
|
Definition
1. Intact sensory nerve (afferent) 2. A functional synapse in the cord 3. An intact motor nerve fiber (efferent) 4. Neuromuscular joint 5. A competent muscle |
|
|
Term
Charting deep tendon reflexes |
|
Definition
Rated from 0 (no response) and 4+ (very brisk - clonus present) |
|
|
Term
If reflexes are hyperactice, what should you do? |
|
Definition
|
|
Term
If assessing a comatose patient for deterioration, what should you do? |
|
Definition
Check for Babinski response |
|
|
Term
Order of the deterioration of LOC |
|
Definition
1. A&O alters 2. Lose ability obey simple commands 3. Then responses deteriorate from purposeless responses to pain 4. Then absence of response to pain 5. Then loss of corneal and gag reflexes |
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|
Term
What would cause sudden pupillary dilation and nonreactive pupil? |
|
Definition
Pressure on the brainstem |
|
|
Term
|
Definition
Involuntary extension of the upper extremities as a response to external stimuli |
|
|
Term
|
Definition
Arms are flexed toward chest, fists are clenched, legs are extended, feet turned inward. A person decorticating in response to pain gets a 3 on the Glasgow Coma Scale |
|
|
Term
|
Definition
Positive if hips and knees flex as you flex pt.'s neck, is meningeal sign |
|
|
Term
|
Definition
Flex pt.'s leg at hip and knee, then try to straighten (neck adn back pain & resistance occurs). Positive Kernig's bilateral suggests meningeal irritation |
|
|
Term
|
Definition
Sudden neurologic deficit caused by ischemia or hemorrhage |
|
|
Term
Transient Ischemic Attack (TIA) |
|
Definition
Focal neurologic deficit lasting <1hr without underlying structural defects, highest risk of stroke within next 30 days |
|
|
Term
|
Definition
-Sudden numbness or weakness of the face, arm, or lef -Sudden confusion or trouble speaking or understanding -Sudden trouble walking, dizziness, or loss of balance -Sudden trouble with vision in one or both eyes -Sudden severe headache |
|
|
Term
|
Definition
Loss of voice that accompanies disease affecting the larynx or its nerve supply |
|
|
Term
|
Definition
Refers to less severe impairment in the volume, quality, or pitch of the voice. For example, a person may be hoarse or only able to speak in a whisper. |
|
|
Term
|
Definition
Refers to a defect in the muscular control of the speech apparatus. Words may be nasal, slurred, or indistinct, but central symbolic aspect of language remains intact. |
|
|
Term
|
Definition
Refers to a disorders in producing or understanding language. It is often caused by lesions in the dominant cerebral hemisphere, usually the left. |
|
|
Term
|
Definition
Start with focal manifestations. Divided into simple partial seizures, which do not impair consciousness, and complex partial seizures, which do. |
|
|
Term
|
Definition
Begin with bilateral body movements, impairment of consciousness, or both. They suggest widespread, bilateral cortical disturbance that may be either hereditary or acquired. |
|
|
Term
|
Definition
May mimic seizures but are due to a conversion reaction (a psychological disorder) |
|
|
Term
Aortic stenosis and hypertrophic cardiomyopathy |
|
Definition
Vascular resistance falls with exercise, but cardiac output cannot rise |
|
|
Term
|
Definition
Abnormal slowness of movement |
|
|
Term
|
Definition
Refers to a lack of coordination of movement typified by the undershoot or overshoot of intended position with the hand |
|
|
Term
What is often the first sense lost in peripheral neuropathy? |
|
Definition
|
|
Term
|
Definition
Responsible for hearing, taste, and smell |
|
|
Term
|
Definition
|
|
Term
|
Definition
Numbness, tingling, burning, crawling |
|
|
Term
|
Definition
Dysphasia: Partial or complete impairment of the ability to communicate resulting from a brain injury Dysphagia: difficulty swallowing |
|
|
Term
|
Definition
Eye twitching because you're tired |
|
|
Term
Acute care neuro assessment (Glasgow coma) |
|
Definition
-LOC -Motor function -Pupillary response -Vital sets -Add score for each thing, gives you an objective level of deterioration -If you want neuro checks q15, this is what you would do |
|
|
Term
|
Definition
L1 or below: paraplegic T6 and below: paraplegic C6 and above: tetraplegia C4 and above: tetraplegia, ventilator |
|
|
Term
|
Definition
Difficult to arouse (loud noise, vigorous shaking or pain), sleeps most of the time, speech affected |
|
|
Term
|
Definition
Not fully alert, drifts off when not stimulated |
|
|
Term
|
Definition
Need persistent, loud noise or pain for arousal, may respond to stimuli with a groan |
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|