301 Final Flashcards
how many bones are in the head?
22 bones
bones of the cranium
frontal, parietal, occipital, and temporal
bones in the head stay where they are supposed to be because of
sutures
sutures
join the bones of the head together include the coronal, sagittal, and lambdoidal
coronal suture
ear to ear
lambdoidal suture
along the occipital
sagittal suture
front to back
corners of the eye
lateral and medial canthus
sclera
white part of the eye. helps to maintain the size and shape of the eye
cornea
clear covering. allows light rays to enter, responsible for blink reflex, and highly sensitive to touch
iris
eye color and regulates the amount of light that enters the pupil
ciliary body
produces aqueous humor and contains the muscle that controls the shape of the lens
pupil
open and closes to permit light to enter the eye
lens
sits behind the pupil, retracts and focuses light on to the retina
choroids
cover the recessed portion of the eye and are a network of blood vessels to the eye
vitreous humor
clear gel in the posterior segment of eye. maintains intraocular pressure
rods
work in dim light and peripheral vision receptors
cones
bright light and provide sight to color
retina
innermost layer of the eye. covering of the back of the eye. extension of the optic nerve. receives and transmits visual stimuli to the brain
optic disc
where the optic nerve comes into the eye
macula
responsible for central vision. on retina with greatest concentration of cones
anterior chamber
space between the cornea in the front
posterior chamber
starts behind the iris and goes to the lens and filled with aqueous humor that helps nourish the cornea
superior rectus
cranial nerve 3 - elevates the eye upward and adducts and rotates the eye medially
inferior rectus
rotates eye downward and adducts and rotates the eye medially - cranial nerve 3
lateral rectus
moves eye laterally - cranial nerve 6
medial rectus
moves. eye medially - cranial nerve 3
superior oblique
turns the eye downward and abducts and rotates the eye medially - cranial nerve 4
inferior oblique
turns eye upward and abducts and turns the eye laterally - cranial nerve 3
explain the visual pathway
light rays enter the cornea and are refracted on the central fovea which is inverted, reversed, and focused on the retina. It then goes to the brain where the image returns to its original form
cerumen
earwax
middle ear contain
the tympanic membrane, bone Eustachian tube
bones of the ear
maleus, incus, and stapes
what does the inner ear do to sounds?
conducts sound vibrations from external ear to inner ear
eustachian rube helps with
equalizing pressure
explain the sound pathway
sounds hit the tympanic membrane, tympanic membrane vibrate, ossicles vibrate, vibrations travel via fluid of the cochlea, hair cells of organ of corti, cranial nerve 8 (acoustic), sent to temporal lobe of the brain
ossicles
bones of the ear
nose does what
humidifies, filters, and warms air. identifies odor, gives resonance to laryngeal sounds
dosum
anterior slope of the nose which ends inferiorly at the tip and laterally at the ala
nasal bone attaches
superiorly at the bridge of the frontal bone and laterally to the lacrimal and maxillary bone
turbinates
inferior, middle, and superior
what do turbinates do?
provide large surface area of nasal mucosa for heat and water exchange as air passes through
most anatomically significant area involved in chronic sinusitis
middle turbinate
bone that forms and separates the roof of the nose from the brain
ethmoid bone
where is mucous that empties into the nasal cavity produced
sinuses
sinuses
frontal, ethmoid, and maxillary
outlet for sinuses
middle meatus
nasolacrimal duct drains
inferior meatus
how does air and mucus pass into the nasopharynx
through the choana (opening) of the nose
linea frenulum
also called the median fold, connects the base of the tongue to the floor of the mouth
vallate papillae
tastebuds that are on the anterior 2/3 of the tongue and identify. sweet, sour, salty, and bitter
what makes saliva
salivary glands
opens into the mouth in the buccal mucosa just opposite the second molar
paratoid duct
where is the submental gland
just beneath the body of the mandible
where is the sublingual salivary gland
within the floor of the mouth under the tongue with openings along the submandibular duct
what can decrease salivary flow
emotional response, aging, damage to the glands, certain medications, and certain disorders
xeroxima
dry mouth
blood supply of the neck is through
the carotid artery
muscle that arises from the sternum and medial clavicle and extends behind the ear
sternocleidomastoid
muscle that arises from the occipital bones and vertebra and fans out to the clavicle and scapula
trapezius
what creates the Adams apple
thyroid cartilage
thyroid crosses the
trachea
parathyroid plasma a role in
serum calcium and phosphate levels
lymphatic drainage from the nose leads to
preauricular and submandibular lymph nodes
-itis
inflammation
-post
after, behind
extra
outside
-graphy
process of recording
opthalm
eye
-opia
vision condition
photo-
light
gloss-
tongue
naso/rhin
nose
oro-
mouth
ot-
ear
ringing or buzzing in the ears
tinnitus
vertigo indicates
dysfunction of the bony labyrinth in the inner ear
malodorous discharge=
bacterial infection. its thick/green discharge from the nose
could smelling unilateral discharge fro nose
foreign body in nose or chronic sinusitis
profuse watery discharge from nose
allergies
bloody discharge from nose
neoplasm, trauma
name for normal face
normocephalic
ptosis
dropping of the eyelids
exophthalmos
protrusion of the eyeball anteriorly
chalazion
cyst in/around the eye
pterygium
abnormal thickening of the conjunctiva from the limbus over the cornea
blepharitis
inflammation of the eyelash follicles
conjunctivitis
allergic/bacterial
hordeolum
stye of the eye
chart used to test eye sight
snellen chart
20/40 eye sight means
that the person can read at 20 feet what a normal person reads at 40 feet
what is considered legally blind
20/200
what do you use to test near vision
jaeger card
a result of 14/20 means
the person can read at 14 inches what a normal sighted person can read at 20 inches
strabismus light reflex
eyes not aligned with each other. Shine a penlight at their eye and note where the light reflects on the cornea of each eye
esotropia light reflex
one eye turns inwards
exotropia light reflex
one eye turns outwards
hypotonia light reflex
one eye turns downwards
hypertropia light reflex
one eye turns upwards
what are you looking for in the cover/uncover test in the eyes
strabismus, cross eyed, or eye weakness
cover test in the eyes tests what
presence and amount of ocular deviation. inspecting for any movement in the uncovered eye
aniscoria
one pupil is bigger than the other
nystagmus
An involuntary eye movement which may cause the eye to rapidly move from side to side, up and down, or in a circle, and may slightly blur vision
what does accommodation of the eyes test
shifting gaze from far to near
what do you look for during accommodation of the eyes
pupils constrict when focusing on a close object and converge (turn inward)
pupils ____ when focusing on a distant object
dilate
PERRLA
pupils equal, round, and react to light and accommodation
coloboma
irregularly shaped iris
anisocoria
unequal pupils
miosis
pinpoint pupils
mydriasis
fixed and dilated pupils. happens when people have a concussion
why would you not be able to elicit a red light reflex
cancer or detached retina
otoscope inspection on adults vs children
adults pull pinna upward and outward and in children pull pinna downward and out
cone of light reflex
5 o’clock right ear and 7 o’clock left ear
rinne test
test if hearing is equal in both ears and for conductive and sensorineural hearing loss. start with pitch fork on the bone and end with pitch fork next to ear
Bone conduction will be greater or less than Air Conduction with conductive hearing loss?
greater, air conduction should be 2:1 with bone conduction
conductive hearing
air conduction
sensorineural hearing
bone conduction
weber’s test
strike tuning fork and place on the top of the patients head. helps with unilateral hearing loss
in webers test if the sounds is lateralized to impaired ear
it is conductive hearing loss
in webers test if the sound is lateralized to good ear
it is sensorineural
halitosis
bad breath
gingivitis is highest among what group of people
hispanics
cleft lip and palates are highest among what group of people
native Americans and asian Americans
if a lymph node is palpable you want to note which characteristics
location, size, consistency, and mobility
if palpable the thyroid should feel like
smooth, rubbery, contender, symmetrical, and barely palpable beneath the sternocleidomastoid
presbyopia
diminished ability to focus on near objects. normal process of aging. usually starts to happen over 40
AMD
age related macular degeneration
age related macular degeneration
destroys sharp, central vision
risk factors of age related macular degeneration
age (over 60), smoking, obesity, being caucasian, family history, and being a woman
presbycusis
a common form of sensorineural hearing loss which results from gradual degeneration of nerves
cerumen becomes ______ as you age
thicker, you do not produce more
otosclerosis
as you age bones start to remodel so the bones in your ears have less vibration and you can’t hear as well
what happens with a patients nose and mouth over 60
there is a decrease in olfactory sensory fibers, production of saliva, and number of taste buds
common general assessment findings with inflammation
redness, swelling, warmth, drainage, fever, and enlarged lymph nodes
lymph nodes can be swollen from
infection, autoimmune disease, and cancer
rhinitis
inflammation of the nasal mucosa can be either allergic or nonallergic
objective findings of rhinitis
excessive clear watery nasal drainage, pale blue boggy mucosa, redness or inflammation
sinusitis
infection of one or more of the paranasal sinuses
objective findings of sinusitis
redness and inflammation of nasal mucosa with thick purulent drainage
tonsillitis
inflammation in lymphoid tissue of oropharynx
objective findings of tonsillitis
redness of pharyngeal walls, exudate, fever, rash, and in severe cases airway obstruction
diplopia
double vision
glaucoma
group of eye conditions that lead to damage to the optic nerve. often times there is damage to the optic nerve due to increased pressure in the eye (intraocular pressure-IOP)
what can you do for glaucoma
give beta blocker in form of eye drop
cataracts
opacity or clouding of the eye’s lens
risk factors for cataracts
age, exposure to ultraviolet B light, DM, smoking, alcohol, diet low in antioxidant vitamins, HTN, eye injuries, steroid use, female gender, gout, abdominal obesity, and beta blocker use
conductive hearing loss
occurs when sound wave transmission through the external or middle ear is disrupted.
sensorineural hearing loss
occurs from a problem somewhere beyond the middle ear. often from dysfunction in the cochlea, organ of corti, auditory nerve or auditory cortex
common assessment findings with alteration in nutrition
swallowing impairment, ill fitting dentures, mouth sores, weight changes, dry, brittle, fine nails/hair, fatigue, weakness
hypothyroidism manifestations
fatigue, anorexia, cold intolerances, dry skin, brittle/coarse hair, menstrual irregularities, weight gain,
emergency manifestations with hypothyroidism
called myxedema coma - hypothermia w/o shivering, hypoventilation, hypotension, hypoglycemia, lactic acidosis, coma, death
hypothyroidism labs
primary - high TSH with low T4
secondary - low TSH and T4
hyperthyroidism manifestations
fatigue, anxiety, palpitations, tachycardia, enlarged thyroid, exophthalmos, fine/limp hair, diaphoresis, muscle weakness
labs for hyperthyroidism
low TSH, and high T4
emergency manifestations of hyperthyroidism
called thyrotoxic coma (thyroid storm) - tachycardia, diarrhea, anxiety, fear, weakness, psychosis, coma, death
candidiasis
yeast infection of the buccal mucosa and tongue (thrush)
candidiasis manifestations
white/cheesy mucus on tongue or buccal mucosa
constipation can lead to what with the bladder
bladder retention
three phases of the menstrual cycle
follicular, ovulation, and luteal
onset of menses correlates with _____ release
estrogen release by the hypothalamic-pituitary-ovarian axis
follicular stage
also called the proliferative phase - the wall begins to thicken. begins at the end of menstruation and lasts until ovulation
which hormone targets the ovaries and triggers the maturation process of follicules
follicle-stimulating hormone (FSH)
ovulation stage
release of LH (luteinizing hormone) matures the egg and fully developed follicle releases its secondary oocyte
secondary oocyte matures into an
ootid and then becomes a mature ovum
luteal phase
also called the secretory phase. progesterone and estrogen are secreted by the corpus luteum
most fertile window
5 days before ovulation until 1-2 days after ovulation and corresponds with rise in body temperature
anteverted uterus
most common - tipped towards the bladder - anterior end slightly concave
retroverted uterus
tipped backwards towards the spine and anterior end convex
ante flexion uterus
the fundus is pointing forward relative to the cervix
retroflexion uterus
the fundus is pointing backwards relative to the cervix
fundus
is the broad curved upper area in which the fallopian tubes connect to the uterus. top part of the uterus
when is estrogen usually at zero for woman
around the age of 74
mammograms begin at the age of
40 or 50 and should be done every 2 years and stopped at the age of 74
paps are recommended to start when
upon the initiation of sexual activity and occur annually until 3 consecutive normal paps and then every 3 years
most great cancer is found
up the tail of sense and outer quadrant
basic signs of breast cancer
lump, skin dimpling, change in skin color or texture, change in nipple appearance, clear or bloody fluid leakage out of nipple, swelling of lymph nodes, pain/itchiness of the breast, swelling of one breast
mastitis
infection of the breast tissue. happens in people who are breastfeeding or from rough sex
HPV strain 16 and 18 correlate with
cervical cancer
HPV strain 6 and 11 correlate with
genital warts
most common STD in the US
HPV
vaccines ofr HPV
Gardasil and cervarix
condylomata acuminata
anogenital warts, are manifestations of anogenital human papillomavirus (HPV) infection
discharge from gonorrhea
yellow, ph of less than 4.5 and painful
discharge from chlamydia
clear/white, ph of less than 4.5
trichomonas
parasite that causes trichomoniasis - discharge yellow, green, and frothy. ph is greater than 4.5
PID
pelvic inflammatory disease
pelvic inflammatory disease
chandelier sign and can cause infertility
bacterial vaginosis
an imbalance of normal vaginal bacteria - discharge grey/white, fishy odor, ph greater than 4.5
candida vaginitis
not an STD - yeast infection
risk factors for ovarian cancer
history or HPV, smoking, immunosuppression, poor dietary choices, long term oral contraception, multiple full term pregnancies, multiple sex partners
uterine fibroids
Noncancerous growths in the uterus that can develop during a woman’s childbearing years
cystocele
weakening of the anterior vaginal wall and the bladder prolapses into vagina
rectocele
building of the posterior vaginal wall and there is a rectal prolapse into vagina
uterine prolapse
uterus prolapses into the vagina
risk of uterine prolapse
several births and advanced age
genital warts from HPV may not______ in males
they may not show up for weeks to months after sexual contact with a person who is HPV positive
is there a test for men to see if they have HPV?
no
testicular exams are recommended every
5 years
hydrocele
collection of serous fluid in the scrotum outside the testes
spermatocele
sperm filled cystic mass located on the epididymis
varicocele
abnormal dilation of vein in the spermatic cord, veins will be palpable and could lead to infertility
epididymitis
infection of the epididymis - scrotum will be enlarged, reddened, and swollen. extremely painful
testicular torsion
twisting of the spermatic cord- scrotum will be swollen and reddened. extremely painful. usually in young men. affected side is generally higher
BPH
benign prostatic hyperplasia
benign prostatic hyperplasia
an enlargement of the prostate gland that usually affects older men
benign prostatic hyperplasia symptoms
difficulty/pain urinating, urge to urinate soon after urinating, decrease strength of urine stream
shift assessment focuses on
the patients immediate needs and potential complications related to their diagnosis
goal of patient care at admission
to discharge home
skin tears need to be documented separate from
pressure wounds as they are a result of acute, traumatic injury
skin tears is seen most on
the very old or someone on chronic steroid therapy
OLDCARTS
onset, location, duration, characteristics, aggravating and alleviating, related symptoms, treatment, and severity
ABCDEF
asymmetric, border, color, diameter, elevation, and feel
test for risk of pressure ulcers
BRADEN scale- based off sensory perception, moisture, activity, mobility, nutrition, and friction and shear
macule
solely a color change ex: freckles, measles
papule
something you can feel. ex: mole, lichen planus, wart
plaque
papule that merge together, ex: psoriasis or lichen planus
patch
macule that are larger than 1 cm
wheal
superficial, raised, transient, slightly irregular due to edema. Ex: mosquito bite, allergic reaction, TB testing
urticaria
Hives. very pruritic (itchy)
vesicle
elevated cavity containing free fluid. Ex: varicella, herpes zoster
bulla
usually single chambered/superficial in epidermis. Thin wall and ruptures easily. Ex: blister, burns, contact dermatitis
pastule
turbid fluid (pus) in the cavity. elevated and circumscribed. Ex: impetigo and acne
cyst
encapsulated fluid filled cavity in dermis or subcutaneous layer. Ex: sebaceous cyst
fissure
linear crack with abrupt edges. extends into dermis, dry Ex: athletes foot, cheilosis
cheilosis
painful inflammation and cracking of the corners of the mouth
erosion
scooped out but shallow depression. moist but not bleeding
lichenification
prolonged intense scratching eventually thickens the skin and produces tightly packed sets of papules. Ex: psoriasis
purpura
small blood vessels join together or leak blood under the skin
petechiae
when purpura spots are very small
spooning
concave curves in nails. from iron deficiency
jagged nails
shape in nails from chronic anxiety
paronychia
infection of the nail folds
stage 1 pressure ulcer
purple/maroon discolored area/blood filled blister. the skin remains intact, nonblanchable redness
stage 2 pressure ulcer
partial thickness loss of dermis, looks like an open blister, no slough
stage 3 pressure ulcer
full thickness tissue loss, fat may be visible but not bone or tendon, can include undermining or tunneling
stage 4 pressure ulcer
full thickness loss with exposed bone, tendon, or muscle. slough or eschar can be present. high risk of osteomyelitis
unstageable pressure ulcer
full thickness tissue loss in which the base of the ulcer is covered in eschar, slough, or both. eschar has to be surgically removed unless on heal
first degree burn
superficial
second degree burn
superficial partial thickness
third degree burn
deep partial thickness
fourth degree burn
full thickness
5th and 6th degree burns
lethal and found during autopsy
normal body temp
96.8-99
diffusion
movement of oxygen and carbon dioxide between the alveoli and red blood cells
perfusion
the distribution of red blood cells to and from the capillaries
upper respiratory tract
nose, mouth, sinuses, pharynx, larynx, and upper trachea
lower respiratory tract
lower trachea, bronchi, and lungs
cystic fibrosis
mucus producing cells always secreting
vesicular breath sounds
soft, low pitched, found over fine airways and near sites of air exchange
bronchovesicular breath sounds
found over major bronchi that have fewer alveoli
rhonchi
low pitched continuous sounds. similar to wheezes. imply obstruction of the larger airways
expected findings of bronchophony
sounds should be muffled, is sounds are clear can indicate consolidation
physical exam findings with COPD
hyperresonance, decreased chest exclusion, decreased fremitus, dyspnea, pallor, pursed lip breathing
physical exam findings with asthma
tachypnea, tachycardia, retractions, wheezing, hyper expansion of the thorax
physical exam findings of pneumonia
SOB, fever, decreased breath sounds, increased pulse, cough, phlegm, pain in chest, decreased SaO2
atelectasis
consolidation and closing of small airways. will have decreased breath sounds in the bases
pleural effusion
fluid in pleural space
pneumothorax
air in pleural space - can cause tracheal deviation to good side
hemothorax
blood in the pleural space
shock
decrease perfusion systemically
SA node
body’s natural pacemaker
electrical condition of the heart
SA node, AV node, bundle of his, purkinje fibers
what is going on during systole
mitral and tricuspid valves are closing
what is going on during diastole
pulmonic and aortic valves are closing
exception to direction of arteries and veins
pulmonary vein and artery
pulse pressure
the pressure difference between the systolic and diastolic pressure. normal is 30-40
S3
extra heart sound that occurs just after s2 can be normal in children. also called kentucky
S4
extra heart sound occurs just before S1. normal in children. also called Tennessee
NSTEMI
someone who we don’t see changes in EKG but think the are having MI. vessel is semi blocked bu still has some blood flow
STEMI
see changes in EKG. means vessel is completely blocked
intermittent claudication
pain that is relieved with rest
arterial ulcer characteristics
tips of toes, heel, very painful, deep, circular shape, minimal edema
venous ulcer characteristics
medial malleolus or anterior tibial, less painful than arterial, superficial depth, irregular border, granulated tissue, edema moderate to severe
thrombophlebitis
inflammation of vein that may or may not be accompanied by a clot
paresthesia
numbness or tingling
assessing pitting edema and grade
apply pressure on shin.
0+ - no pitting edema
1+ - mild (2mm)
2+ - deeper pit (4mm) disappears in 10-15 sec
3+ - deep pit (6mm) last more than a minute
4+ - severe (8mm)- can last more than 2 minutes
valve stenosis
valve opening is narrowed. tissue is stiffer. heard during diastole when valve is opening. forward flow of blood impaired
valve regurgitation
incomplete valve back flow of the blood. heard when valve is trying to close.
pericarditis
inflammation of the pericardial sac. chest pain that is worse with inspiration and lying flat and relieved by sitting up.
if you can’t pump right
back up into systemic
if you can’t pump left
back up into lungs
What objective findings would you predict to find with pulmonary edema
SOB, 3 word dyspnea, increased work of breathing, tachypnea, cyanosis or pallor, crackles heard upon auscultation, increased tactile fremitus, Bronchophony potentially present, dull percussion
What objective findings would you predict to find with left sided failure
Potentially anxious, pale, cyanotic. Dyspnea, tachypnea, left ventricular heave/palpable thrill, tachycardia, displaced apical pulse, S3 heart sound, Systolic murmur, Crackles (pulmonary edema)
what objective finings would you predict to find with mitral valve regurgitation
Many people asymptomatic. Weakness, fatigue, Dyspnea on exertion, palpitations, systolic murmur, possible s3 heart sound. Could be acute- signs of pulmonary edema, thready pulse, cool, Clammy extremities
what objective finings would you predict to find with right sided heart failure
Fatigue, JVD, dependent peripheral edema, dusky hyperpigmentation of LE skin, S3 heart sounds, systolic murmur, weight gain, enlarged liver, Right ventricle heave, tachycardia
people with burns are at risk for
hypovolemic shock
what lab do we look at to assess nutrition
total protein= prealbumin, albumin, and globulin
normal albumin
3.5-5 gdL
prealbumin normal levels
15-36 mg/dL
normal levels of blood glucose
70-105 mg/dL
what do alcohol and street drugs do to your nutrition
decrease nutritional absorption
how do you calculate BMI with inches and pounds
((weight in pounds/(height in inches x height inches)) X 703
esophagus ph
6-8
stomach ph
2-4
liver functions
bile production, secretion to emulsify fat, transfer bilirubin, metabolism of proteins, carbohydrates, and fats, storage of glucose in form of glycogen, production of clotting factors and fibrinogen for coagulation, synthesis of plasma proteins, detoxification of substances, and storage of minerals and vitamins
plasma proteins
albumin and globulin
gallbladder
stores bile produced by liver and ducts drain bile into duodenum
endocrine secretions of the pancreas
insulin, glucagon, somatostatin, and gastrin
exocrine secretions of the pancreas
bicarbonate, pancreatic enzymes
kidneys
erythropoietin secretion for erythrocyte production, regulation of fluid and electrolyte balance, RAAS, production of active vitamin D
Right upper quadrant ABD
liver, gallbladder, pylorus, duodenum, head of pancreas, right kidney, right adrenal gland, hepatic flexure of colon, portions of ascending and transverse colon
left upper quadrant ABD
stomach, spleen, left lobe of liver, body of pancreas, left kidney, left adrenal gland, splenic flexure of colon, and portions of transverse and descending colon
left lower quadrant ABD
portion of descending colon, sigmoid colon, left ureter, left ovary, left spermatic cord, bladder if distended, and uterus if enlarged
right lower quadrant ABD
cecum, appendix, right ovary, right ureter, right spermatic cord, bladder if distended, and uterus if enlarged
what could black stool indicate
bleeding internally due to ulcer or cancer
what could light color or white stool indicate
it could mean a bile duct obstruction
what could red stool mean
symptom of cancer
what can brown urine indicate
increased bilirubin
cola urine
rhabdomyolysis from muscle breakdown
entero
intestine
colo
large intestine
procto
anus/rectum
cysto or vesical
bladder
uro
relating to urine
findings with GERD
heartburn, regurgitation, dysphagia, often aggravated by lying down relived by sitting up antacids, eating, and mid epigastric pain with palpation
peptic ulcer disease risk factors
H. Pylori, NSAIDS, ASA, corticosteroids
peptic ulcer disease findings
burning pain in the LUQ/epigastric anywhere from 1-4 hours after eating
hepatitis A
usually food-borne
hepatitis B
uncommon secondary due to immunization
hepatitis C
common. often undiagnosed, sometimes it doesn’t effect liver enzymes profoundly, leading cause of cirrhosis and liver transplant
risk factors for gallstones
female, fat, flatulent, forty
gallstones clinical finding
RUQ colicky pain that can radiate to right shoulder, indigestion, mild jaundice, nausea after eating high fat foods
clinical findings of pancreatitis
sudden onset, LUQ can radiate to back, chronic, pain is deep, piercing, and heavy, weight loss, steatorrhea, tender abdomen, ascites, jaundice, hypotension, internal bleeding, shock, patient in fetal position
nephrolithiasis
kidney stones
clinical findings of kidney stones
fever, hematuria, severe pain at costovertebral angle
radiculopathy
referred pain. pain that is causing/radiating somewhere else
vagus knees
knocked knees and usually obese
varus knees
bowed and usually skinny
what is the screening for osteoporosis?
the Dexa scan
lordosis
A curving inward of the lower back
dysphasia
also called aphasia - difficulty speaking or understanding due to neurological changes
dysarthria
slurring
dysphagia
difficulty swallowing
dementia that occurs in younger people
Korsakoff’s dementia and pick’s disease
risk factors for dementia
age, brain/head injury, fewer years of education, female, genetics, alcohol
visceral pain
originates from the abdominal organs. is crampy or gnawing
somatic pain
originates from the skin, muscle, bones, and joints. aching or throbbing
cutaneous pain
originates from the dermis, epidermis, and subcutaneous tissue. described as sharp
referred pain
called radiculopathy. originates from a specific site but pain is at another site
protective structures of the central nervous system
meninges
layers of the meninges
dura matter - outer layer, arachnoid - middle layer, Pia matter - inner meningeal layer that contains blood vessels
frontal lobe
primary motor cortex responsible for functions related to voluntary motor activity. controls intellectual function, awareness of self, personality, and autonomic responses related to emotion
broca’s area
in the left frontal lobe. formulation of words
parietal lobe
contains sensory cortex contains position sense, touch, shape, and texture objects
temporal lobe
contains primary auditory cortex, wernickes area
wernickes area
responsible for comprehension of speech, speech production, and interpreting sounds
parkinsons causes
tremors at rest
FAST
face- facial droop
arm - hemiparesis
speech - dysarthria/aphasia
timing - 3 hr window for t-PA
hemiparesis
Muscle weakness or partial paralysis on one side of the body that can affect the arms, legs, and facial muscles.
dementia vs delirium
delirium - Serious disturbance in mental abilities that results in confused thinking and reduced awareness of surroundings.
dementia - A group of thinking and social symptoms that interferes with daily functioning.
ligament
bone to bone
tendon
muscle to bone
Sepsis signs and symptoms
high HR, fever, shivering, fever, confusion, shortness of breath, pain, clammy, sweaty
wheezes
hissing or resonant sounds
emphysema will have what type of resonance
hyper resonance
percussion of fluids such as pneumonia or a mass
sounds will be dull
increased tactile remits would indicate
consolidation
percussion of ABD will be _______ over hollow organs
tympanic
MMT
manual muscle testing
ataxia
Impaired balance or coordination, can be due to damage to brain, nerves, or muscles.
apraxia
Inability to perform a movement or task when asked despite having the desire and physical capability to carry it out
Obtunded
Louder, more vigorous stimuli will awaken patient, but patient promptly returns to “sleep
stuporous
will withdraw from painful stimuli
semicomatose
responds to painful stimuli with abnormal flexion or extension
comatose
does not respond to any stimuli
Glasgow coma scale
3 is the worst and 15 is best
expressive aphasia
can comprehend but cannot speak (Broca)
global aphasia
cannot understand or express
receptive aphasia
cannot associate words and meaning but still able to speak (wernickes)
