301 Final Flashcards

1
Q

how many bones are in the head?

A

22 bones

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2
Q

bones of the cranium

A

frontal, parietal, occipital, and temporal

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3
Q

bones in the head stay where they are supposed to be because of

A

sutures

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4
Q

sutures

A

join the bones of the head together include the coronal, sagittal, and lambdoidal

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5
Q

coronal suture

A

ear to ear

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6
Q

lambdoidal suture

A

along the occipital

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7
Q

sagittal suture

A

front to back

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8
Q

corners of the eye

A

lateral and medial canthus

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9
Q

sclera

A

white part of the eye. helps to maintain the size and shape of the eye

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10
Q

cornea

A

clear covering. allows light rays to enter, responsible for blink reflex, and highly sensitive to touch

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11
Q

iris

A

eye color and regulates the amount of light that enters the pupil

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12
Q

ciliary body

A

produces aqueous humor and contains the muscle that controls the shape of the lens

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13
Q

pupil

A

open and closes to permit light to enter the eye

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14
Q

lens

A

sits behind the pupil, retracts and focuses light on to the retina

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15
Q

choroids

A

cover the recessed portion of the eye and are a network of blood vessels to the eye

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16
Q

vitreous humor

A

clear gel in the posterior segment of eye. maintains intraocular pressure

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17
Q

rods

A

work in dim light and peripheral vision receptors

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18
Q

cones

A

bright light and provide sight to color

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19
Q

retina

A

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

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20
Q

optic disc

A

where the optic nerve comes into the eye

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21
Q

macula

A

responsible for central vision. on retina with greatest concentration of cones

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22
Q

anterior chamber

A

space between the cornea in the front

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23
Q

posterior chamber

A

starts behind the iris and goes to the lens and filled with aqueous humor that helps nourish the cornea

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24
Q

superior rectus

A

cranial nerve 3 - elevates the eye upward and adducts and rotates the eye medially

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25
Q

inferior rectus

A

rotates eye downward and adducts and rotates the eye medially - cranial nerve 3

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26
Q

lateral rectus

A

moves eye laterally - cranial nerve 6

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27
Q

medial rectus

A

moves. eye medially - cranial nerve 3

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28
Q

superior oblique

A

turns the eye downward and abducts and rotates the eye medially - cranial nerve 4

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29
Q

inferior oblique

A

turns eye upward and abducts and turns the eye laterally - cranial nerve 3

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30
Q

explain the visual pathway

A

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

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31
Q

cerumen

A

earwax

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32
Q

middle ear contain

A

the tympanic membrane, bone Eustachian tube

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33
Q

bones of the ear

A

maleus, incus, and stapes

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34
Q

what does the inner ear do to sounds?

A

conducts sound vibrations from external ear to inner ear

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35
Q

eustachian rube helps with

A

equalizing pressure

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36
Q

explain the sound pathway

A

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

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37
Q

ossicles

A

bones of the ear

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38
Q

nose does what

A

humidifies, filters, and warms air. identifies odor, gives resonance to laryngeal sounds

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39
Q

dosum

A

anterior slope of the nose which ends inferiorly at the tip and laterally at the ala

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40
Q

nasal bone attaches

A

superiorly at the bridge of the frontal bone and laterally to the lacrimal and maxillary bone

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41
Q

turbinates

A

inferior, middle, and superior

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42
Q

what do turbinates do?

A

provide large surface area of nasal mucosa for heat and water exchange as air passes through

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43
Q

most anatomically significant area involved in chronic sinusitis

A

middle turbinate

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44
Q

bone that forms and separates the roof of the nose from the brain

A

ethmoid bone

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45
Q

where is mucous that empties into the nasal cavity produced

A

sinuses

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46
Q

sinuses

A

frontal, ethmoid, and maxillary

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47
Q

outlet for sinuses

A

middle meatus

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48
Q

nasolacrimal duct drains

A

inferior meatus

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49
Q

how does air and mucus pass into the nasopharynx

A

through the choana (opening) of the nose

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50
Q

linea frenulum

A

also called the median fold, connects the base of the tongue to the floor of the mouth

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51
Q

vallate papillae

A

tastebuds that are on the anterior 2/3 of the tongue and identify. sweet, sour, salty, and bitter

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52
Q

what makes saliva

A

salivary glands

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53
Q

opens into the mouth in the buccal mucosa just opposite the second molar

A

paratoid duct

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54
Q

where is the submental gland

A

just beneath the body of the mandible

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55
Q

where is the sublingual salivary gland

A

within the floor of the mouth under the tongue with openings along the submandibular duct

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56
Q

what can decrease salivary flow

A

emotional response, aging, damage to the glands, certain medications, and certain disorders

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57
Q

xeroxima

A

dry mouth

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58
Q

blood supply of the neck is through

A

the carotid artery

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59
Q

muscle that arises from the sternum and medial clavicle and extends behind the ear

A

sternocleidomastoid

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60
Q

muscle that arises from the occipital bones and vertebra and fans out to the clavicle and scapula

A

trapezius

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61
Q

what creates the Adams apple

A

thyroid cartilage

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62
Q

thyroid crosses the

A

trachea

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63
Q

parathyroid plasma a role in

A

serum calcium and phosphate levels

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64
Q

lymphatic drainage from the nose leads to

A

preauricular and submandibular lymph nodes

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65
Q

-itis

A

inflammation

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66
Q

-post

A

after, behind

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67
Q

extra

A

outside

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68
Q

-graphy

A

process of recording

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69
Q

opthalm

A

eye

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70
Q

-opia

A

vision condition

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71
Q

photo-

A

light

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72
Q

gloss-

A

tongue

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73
Q

naso/rhin

A

nose

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74
Q

oro-

A

mouth

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75
Q

ot-

A

ear

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76
Q

ringing or buzzing in the ears

A

tinnitus

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77
Q

vertigo indicates

A

dysfunction of the bony labyrinth in the inner ear

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78
Q

malodorous discharge=

A

bacterial infection. its thick/green discharge from the nose

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79
Q

could smelling unilateral discharge fro nose

A

foreign body in nose or chronic sinusitis

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80
Q

profuse watery discharge from nose

A

allergies

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81
Q

bloody discharge from nose

A

neoplasm, trauma

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82
Q

name for normal face

A

normocephalic

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83
Q

ptosis

A

dropping of the eyelids

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84
Q

exophthalmos

A

protrusion of the eyeball anteriorly

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85
Q

chalazion

A

cyst in/around the eye

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86
Q

pterygium

A

abnormal thickening of the conjunctiva from the limbus over the cornea

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87
Q

blepharitis

A

inflammation of the eyelash follicles

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88
Q

conjunctivitis

A

allergic/bacterial

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89
Q

hordeolum

A

stye of the eye

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90
Q

chart used to test eye sight

A

snellen chart

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91
Q

20/40 eye sight means

A

that the person can read at 20 feet what a normal person reads at 40 feet

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92
Q

what is considered legally blind

A

20/200

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93
Q

what do you use to test near vision

A

jaeger card

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94
Q

a result of 14/20 means

A

the person can read at 14 inches what a normal sighted person can read at 20 inches

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95
Q

strabismus light reflex

A

eyes not aligned with each other. Shine a penlight at their eye and note where the light reflects on the cornea of each eye

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96
Q

esotropia light reflex

A

one eye turns inwards

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97
Q

exotropia light reflex

A

one eye turns outwards

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98
Q

hypotonia light reflex

A

one eye turns downwards

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99
Q

hypertropia light reflex

A

one eye turns upwards

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100
Q

what are you looking for in the cover/uncover test in the eyes

A

strabismus, cross eyed, or eye weakness

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101
Q

cover test in the eyes tests what

A

presence and amount of ocular deviation. inspecting for any movement in the uncovered eye

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102
Q

aniscoria

A

one pupil is bigger than the other

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103
Q

nystagmus

A

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

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104
Q

what does accommodation of the eyes test

A

shifting gaze from far to near

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105
Q

what do you look for during accommodation of the eyes

A

pupils constrict when focusing on a close object and converge (turn inward)

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106
Q

pupils ____ when focusing on a distant object

A

dilate

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107
Q

PERRLA

A

pupils equal, round, and react to light and accommodation

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108
Q

coloboma

A

irregularly shaped iris

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109
Q

anisocoria

A

unequal pupils

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110
Q

miosis

A

pinpoint pupils

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111
Q

mydriasis

A

fixed and dilated pupils. happens when people have a concussion

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112
Q

why would you not be able to elicit a red light reflex

A

cancer or detached retina

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113
Q

otoscope inspection on adults vs children

A

adults pull pinna upward and outward and in children pull pinna downward and out

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114
Q

cone of light reflex

A

5 o’clock right ear and 7 o’clock left ear

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115
Q

rinne test

A

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

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116
Q

Bone conduction will be greater or less than Air Conduction with conductive hearing loss?

A

greater, air conduction should be 2:1 with bone conduction

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117
Q

conductive hearing

A

air conduction

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118
Q

sensorineural hearing

A

bone conduction

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119
Q

weber’s test

A

strike tuning fork and place on the top of the patients head. helps with unilateral hearing loss

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120
Q

in webers test if the sounds is lateralized to impaired ear

A

it is conductive hearing loss

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121
Q

in webers test if the sound is lateralized to good ear

A

it is sensorineural

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122
Q

halitosis

A

bad breath

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123
Q

gingivitis is highest among what group of people

A

hispanics

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124
Q

cleft lip and palates are highest among what group of people

A

native Americans and asian Americans

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125
Q

if a lymph node is palpable you want to note which characteristics

A

location, size, consistency, and mobility

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126
Q

if palpable the thyroid should feel like

A

smooth, rubbery, contender, symmetrical, and barely palpable beneath the sternocleidomastoid

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127
Q

presbyopia

A

diminished ability to focus on near objects. normal process of aging. usually starts to happen over 40

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128
Q

AMD

A

age related macular degeneration

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129
Q

age related macular degeneration

A

destroys sharp, central vision

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130
Q

risk factors of age related macular degeneration

A

age (over 60), smoking, obesity, being caucasian, family history, and being a woman

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131
Q

presbycusis

A

a common form of sensorineural hearing loss which results from gradual degeneration of nerves

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132
Q

cerumen becomes ______ as you age

A

thicker, you do not produce more

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133
Q

otosclerosis

A

as you age bones start to remodel so the bones in your ears have less vibration and you can’t hear as well

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134
Q

what happens with a patients nose and mouth over 60

A

there is a decrease in olfactory sensory fibers, production of saliva, and number of taste buds

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135
Q

common general assessment findings with inflammation

A

redness, swelling, warmth, drainage, fever, and enlarged lymph nodes

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136
Q

lymph nodes can be swollen from

A

infection, autoimmune disease, and cancer

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137
Q

rhinitis

A

inflammation of the nasal mucosa can be either allergic or nonallergic

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138
Q

objective findings of rhinitis

A

excessive clear watery nasal drainage, pale blue boggy mucosa, redness or inflammation

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139
Q

sinusitis

A

infection of one or more of the paranasal sinuses

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140
Q

objective findings of sinusitis

A

redness and inflammation of nasal mucosa with thick purulent drainage

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141
Q

tonsillitis

A

inflammation in lymphoid tissue of oropharynx

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142
Q

objective findings of tonsillitis

A

redness of pharyngeal walls, exudate, fever, rash, and in severe cases airway obstruction

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143
Q

diplopia

A

double vision

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144
Q

glaucoma

A

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)

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145
Q

what can you do for glaucoma

A

give beta blocker in form of eye drop

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146
Q

cataracts

A

opacity or clouding of the eye’s lens

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147
Q

risk factors for cataracts

A

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

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148
Q

conductive hearing loss

A

occurs when sound wave transmission through the external or middle ear is disrupted.

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149
Q

sensorineural hearing loss

A

occurs from a problem somewhere beyond the middle ear. often from dysfunction in the cochlea, organ of corti, auditory nerve or auditory cortex

150
Q

common assessment findings with alteration in nutrition

A

swallowing impairment, ill fitting dentures, mouth sores, weight changes, dry, brittle, fine nails/hair, fatigue, weakness

151
Q

hypothyroidism manifestations

A

fatigue, anorexia, cold intolerances, dry skin, brittle/coarse hair, menstrual irregularities, weight gain,

152
Q

emergency manifestations with hypothyroidism

A

called myxedema coma - hypothermia w/o shivering, hypoventilation, hypotension, hypoglycemia, lactic acidosis, coma, death

153
Q

hypothyroidism labs

A

primary - high TSH with low T4

secondary - low TSH and T4

154
Q

hyperthyroidism manifestations

A

fatigue, anxiety, palpitations, tachycardia, enlarged thyroid, exophthalmos, fine/limp hair, diaphoresis, muscle weakness

155
Q

labs for hyperthyroidism

A

low TSH, and high T4

156
Q

emergency manifestations of hyperthyroidism

A

called thyrotoxic coma (thyroid storm) - tachycardia, diarrhea, anxiety, fear, weakness, psychosis, coma, death

157
Q

candidiasis

A

yeast infection of the buccal mucosa and tongue (thrush)

158
Q

candidiasis manifestations

A

white/cheesy mucus on tongue or buccal mucosa

159
Q

constipation can lead to what with the bladder

A

bladder retention

160
Q

three phases of the menstrual cycle

A

follicular, ovulation, and luteal

161
Q

onset of menses correlates with _____ release

A

estrogen release by the hypothalamic-pituitary-ovarian axis

162
Q

follicular stage

A

also called the proliferative phase - the wall begins to thicken. begins at the end of menstruation and lasts until ovulation

163
Q

which hormone targets the ovaries and triggers the maturation process of follicules

A

follicle-stimulating hormone (FSH)

164
Q

ovulation stage

A

release of LH (luteinizing hormone) matures the egg and fully developed follicle releases its secondary oocyte

165
Q

secondary oocyte matures into an

A

ootid and then becomes a mature ovum

166
Q

luteal phase

A

also called the secretory phase. progesterone and estrogen are secreted by the corpus luteum

167
Q

most fertile window

A

5 days before ovulation until 1-2 days after ovulation and corresponds with rise in body temperature

168
Q

anteverted uterus

A

most common - tipped towards the bladder - anterior end slightly concave

169
Q

retroverted uterus

A

tipped backwards towards the spine and anterior end convex

170
Q

ante flexion uterus

A

the fundus is pointing forward relative to the cervix

171
Q

retroflexion uterus

A

the fundus is pointing backwards relative to the cervix

172
Q

fundus

A

is the broad curved upper area in which the fallopian tubes connect to the uterus. top part of the uterus

173
Q

when is estrogen usually at zero for woman

A

around the age of 74

174
Q

mammograms begin at the age of

A

40 or 50 and should be done every 2 years and stopped at the age of 74

175
Q

paps are recommended to start when

A

upon the initiation of sexual activity and occur annually until 3 consecutive normal paps and then every 3 years

176
Q

most great cancer is found

A

up the tail of sense and outer quadrant

177
Q

basic signs of breast cancer

A

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

178
Q

mastitis

A

infection of the breast tissue. happens in people who are breastfeeding or from rough sex

179
Q

HPV strain 16 and 18 correlate with

A

cervical cancer

180
Q

HPV strain 6 and 11 correlate with

A

genital warts

181
Q

most common STD in the US

A

HPV

182
Q

vaccines ofr HPV

A

Gardasil and cervarix

183
Q

condylomata acuminata

A

anogenital warts, are manifestations of anogenital human papillomavirus (HPV) infection

184
Q

discharge from gonorrhea

A

yellow, ph of less than 4.5 and painful

185
Q

discharge from chlamydia

A

clear/white, ph of less than 4.5

186
Q

trichomonas

A

parasite that causes trichomoniasis - discharge yellow, green, and frothy. ph is greater than 4.5

187
Q

PID

A

pelvic inflammatory disease

188
Q

pelvic inflammatory disease

A

chandelier sign and can cause infertility

189
Q

bacterial vaginosis

A

an imbalance of normal vaginal bacteria - discharge grey/white, fishy odor, ph greater than 4.5

190
Q

candida vaginitis

A

not an STD - yeast infection

191
Q

risk factors for ovarian cancer

A

history or HPV, smoking, immunosuppression, poor dietary choices, long term oral contraception, multiple full term pregnancies, multiple sex partners

192
Q

uterine fibroids

A

Noncancerous growths in the uterus that can develop during a woman’s childbearing years

193
Q

cystocele

A

weakening of the anterior vaginal wall and the bladder prolapses into vagina

194
Q

rectocele

A

building of the posterior vaginal wall and there is a rectal prolapse into vagina

195
Q

uterine prolapse

A

uterus prolapses into the vagina

196
Q

risk of uterine prolapse

A

several births and advanced age

197
Q

genital warts from HPV may not______ in males

A

they may not show up for weeks to months after sexual contact with a person who is HPV positive

198
Q

is there a test for men to see if they have HPV?

A

no

199
Q

testicular exams are recommended every

A

5 years

200
Q

hydrocele

A

collection of serous fluid in the scrotum outside the testes

201
Q

spermatocele

A

sperm filled cystic mass located on the epididymis

202
Q

varicocele

A

abnormal dilation of vein in the spermatic cord, veins will be palpable and could lead to infertility

203
Q

epididymitis

A

infection of the epididymis - scrotum will be enlarged, reddened, and swollen. extremely painful

204
Q

testicular torsion

A

twisting of the spermatic cord- scrotum will be swollen and reddened. extremely painful. usually in young men. affected side is generally higher

205
Q

BPH

A

benign prostatic hyperplasia

206
Q

benign prostatic hyperplasia

A

an enlargement of the prostate gland that usually affects older men

207
Q

benign prostatic hyperplasia symptoms

A

difficulty/pain urinating, urge to urinate soon after urinating, decrease strength of urine stream

208
Q

shift assessment focuses on

A

the patients immediate needs and potential complications related to their diagnosis

209
Q

goal of patient care at admission

A

to discharge home

210
Q

skin tears need to be documented separate from

A

pressure wounds as they are a result of acute, traumatic injury

211
Q

skin tears is seen most on

A

the very old or someone on chronic steroid therapy

212
Q

OLDCARTS

A

onset, location, duration, characteristics, aggravating and alleviating, related symptoms, treatment, and severity

213
Q

ABCDEF

A

asymmetric, border, color, diameter, elevation, and feel

214
Q

test for risk of pressure ulcers

A

BRADEN scale- based off sensory perception, moisture, activity, mobility, nutrition, and friction and shear

215
Q

macule

A

solely a color change ex: freckles, measles

216
Q

papule

A

something you can feel. ex: mole, lichen planus, wart

217
Q

plaque

A

papule that merge together, ex: psoriasis or lichen planus

218
Q

patch

A

macule that are larger than 1 cm

219
Q

wheal

A

superficial, raised, transient, slightly irregular due to edema. Ex: mosquito bite, allergic reaction, TB testing

220
Q

urticaria

A

Hives. very pruritic (itchy)

221
Q

vesicle

A

elevated cavity containing free fluid. Ex: varicella, herpes zoster

222
Q

bulla

A

usually single chambered/superficial in epidermis. Thin wall and ruptures easily. Ex: blister, burns, contact dermatitis

223
Q

pastule

A

turbid fluid (pus) in the cavity. elevated and circumscribed. Ex: impetigo and acne

224
Q

cyst

A

encapsulated fluid filled cavity in dermis or subcutaneous layer. Ex: sebaceous cyst

225
Q

fissure

A

linear crack with abrupt edges. extends into dermis, dry Ex: athletes foot, cheilosis

226
Q

cheilosis

A

painful inflammation and cracking of the corners of the mouth

227
Q

erosion

A

scooped out but shallow depression. moist but not bleeding

228
Q

lichenification

A

prolonged intense scratching eventually thickens the skin and produces tightly packed sets of papules. Ex: psoriasis

229
Q

purpura

A

small blood vessels join together or leak blood under the skin

230
Q

petechiae

A

when purpura spots are very small

231
Q

spooning

A

concave curves in nails. from iron deficiency

232
Q

jagged nails

A

shape in nails from chronic anxiety

233
Q

paronychia

A

infection of the nail folds

234
Q

stage 1 pressure ulcer

A

purple/maroon discolored area/blood filled blister. the skin remains intact, nonblanchable redness

235
Q

stage 2 pressure ulcer

A

partial thickness loss of dermis, looks like an open blister, no slough

236
Q

stage 3 pressure ulcer

A

full thickness tissue loss, fat may be visible but not bone or tendon, can include undermining or tunneling

237
Q

stage 4 pressure ulcer

A

full thickness loss with exposed bone, tendon, or muscle. slough or eschar can be present. high risk of osteomyelitis

238
Q

unstageable pressure ulcer

A

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

239
Q

first degree burn

A

superficial

240
Q

second degree burn

A

superficial partial thickness

241
Q

third degree burn

A

deep partial thickness

242
Q

fourth degree burn

A

full thickness

243
Q

5th and 6th degree burns

A

lethal and found during autopsy

244
Q

normal body temp

A

96.8-99

245
Q

diffusion

A

movement of oxygen and carbon dioxide between the alveoli and red blood cells

246
Q

perfusion

A

the distribution of red blood cells to and from the capillaries

247
Q

upper respiratory tract

A

nose, mouth, sinuses, pharynx, larynx, and upper trachea

248
Q

lower respiratory tract

A

lower trachea, bronchi, and lungs

249
Q

cystic fibrosis

A

mucus producing cells always secreting

250
Q

vesicular breath sounds

A

soft, low pitched, found over fine airways and near sites of air exchange

251
Q

bronchovesicular breath sounds

A

found over major bronchi that have fewer alveoli

252
Q

rhonchi

A

low pitched continuous sounds. similar to wheezes. imply obstruction of the larger airways

253
Q

expected findings of bronchophony

A

sounds should be muffled, is sounds are clear can indicate consolidation

254
Q

physical exam findings with COPD

A

hyperresonance, decreased chest exclusion, decreased fremitus, dyspnea, pallor, pursed lip breathing

255
Q

physical exam findings with asthma

A

tachypnea, tachycardia, retractions, wheezing, hyper expansion of the thorax

256
Q

physical exam findings of pneumonia

A

SOB, fever, decreased breath sounds, increased pulse, cough, phlegm, pain in chest, decreased SaO2

257
Q

atelectasis

A

consolidation and closing of small airways. will have decreased breath sounds in the bases

258
Q

pleural effusion

A

fluid in pleural space

259
Q

pneumothorax

A

air in pleural space - can cause tracheal deviation to good side

260
Q

hemothorax

A

blood in the pleural space

261
Q

shock

A

decrease perfusion systemically

262
Q

SA node

A

body’s natural pacemaker

263
Q

electrical condition of the heart

A

SA node, AV node, bundle of his, purkinje fibers

264
Q

what is going on during systole

A

mitral and tricuspid valves are closing

265
Q

what is going on during diastole

A

pulmonic and aortic valves are closing

266
Q

exception to direction of arteries and veins

A

pulmonary vein and artery

267
Q

pulse pressure

A

the pressure difference between the systolic and diastolic pressure. normal is 30-40

268
Q

S3

A

extra heart sound that occurs just after s2 can be normal in children. also called kentucky

269
Q

S4

A

extra heart sound occurs just before S1. normal in children. also called Tennessee

270
Q

NSTEMI

A

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

271
Q

STEMI

A

see changes in EKG. means vessel is completely blocked

272
Q

intermittent claudication

A

pain that is relieved with rest

273
Q

arterial ulcer characteristics

A

tips of toes, heel, very painful, deep, circular shape, minimal edema

274
Q

venous ulcer characteristics

A

medial malleolus or anterior tibial, less painful than arterial, superficial depth, irregular border, granulated tissue, edema moderate to severe

275
Q

thrombophlebitis

A

inflammation of vein that may or may not be accompanied by a clot

276
Q

paresthesia

A

numbness or tingling

277
Q

assessing pitting edema and grade

A

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

278
Q

valve stenosis

A

valve opening is narrowed. tissue is stiffer. heard during diastole when valve is opening. forward flow of blood impaired

279
Q

valve regurgitation

A

incomplete valve back flow of the blood. heard when valve is trying to close.

280
Q

pericarditis

A

inflammation of the pericardial sac. chest pain that is worse with inspiration and lying flat and relieved by sitting up.

281
Q

if you can’t pump right

A

back up into systemic

282
Q

if you can’t pump left

A

back up into lungs

283
Q

What objective findings would you predict to find with pulmonary edema

A

SOB, 3 word dyspnea, increased work of breathing, tachypnea, cyanosis or pallor, crackles heard upon auscultation, increased tactile fremitus, Bronchophony potentially present, dull percussion

284
Q

What objective findings would you predict to find with left sided failure

A

Potentially anxious, pale, cyanotic. Dyspnea, tachypnea, left ventricular heave/palpable thrill, tachycardia, displaced apical pulse, S3 heart sound, Systolic murmur, Crackles (pulmonary edema)

285
Q

what objective finings would you predict to find with mitral valve regurgitation

A

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

286
Q

what objective finings would you predict to find with right sided heart failure

A

Fatigue, JVD, dependent peripheral edema, dusky hyperpigmentation of LE skin, S3 heart sounds, systolic murmur, weight gain, enlarged liver, Right ventricle heave, tachycardia

287
Q

people with burns are at risk for

A

hypovolemic shock

288
Q

what lab do we look at to assess nutrition

A

total protein= prealbumin, albumin, and globulin

289
Q

normal albumin

A

3.5-5 gdL

290
Q

prealbumin normal levels

A

15-36 mg/dL

291
Q

normal levels of blood glucose

A

70-105 mg/dL

292
Q

what do alcohol and street drugs do to your nutrition

A

decrease nutritional absorption

293
Q

how do you calculate BMI with inches and pounds

A

((weight in pounds/(height in inches x height inches)) X 703

294
Q

esophagus ph

A

6-8

295
Q

stomach ph

A

2-4

296
Q

liver functions

A

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

297
Q

plasma proteins

A

albumin and globulin

298
Q

gallbladder

A

stores bile produced by liver and ducts drain bile into duodenum

299
Q

endocrine secretions of the pancreas

A

insulin, glucagon, somatostatin, and gastrin

300
Q

exocrine secretions of the pancreas

A

bicarbonate, pancreatic enzymes

301
Q

kidneys

A

erythropoietin secretion for erythrocyte production, regulation of fluid and electrolyte balance, RAAS, production of active vitamin D

302
Q

Right upper quadrant ABD

A

liver, gallbladder, pylorus, duodenum, head of pancreas, right kidney, right adrenal gland, hepatic flexure of colon, portions of ascending and transverse colon

303
Q

left upper quadrant ABD

A

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

304
Q

left lower quadrant ABD

A

portion of descending colon, sigmoid colon, left ureter, left ovary, left spermatic cord, bladder if distended, and uterus if enlarged

305
Q

right lower quadrant ABD

A

cecum, appendix, right ovary, right ureter, right spermatic cord, bladder if distended, and uterus if enlarged

306
Q

what could black stool indicate

A

bleeding internally due to ulcer or cancer

307
Q

what could light color or white stool indicate

A

it could mean a bile duct obstruction

308
Q

what could red stool mean

A

symptom of cancer

309
Q

what can brown urine indicate

A

increased bilirubin

310
Q

cola urine

A

rhabdomyolysis from muscle breakdown

311
Q

entero

A

intestine

312
Q

colo

A

large intestine

313
Q

procto

A

anus/rectum

314
Q

cysto or vesical

A

bladder

315
Q

uro

A

relating to urine

316
Q

findings with GERD

A

heartburn, regurgitation, dysphagia, often aggravated by lying down relived by sitting up antacids, eating, and mid epigastric pain with palpation

317
Q

peptic ulcer disease risk factors

A

H. Pylori, NSAIDS, ASA, corticosteroids

318
Q

peptic ulcer disease findings

A

burning pain in the LUQ/epigastric anywhere from 1-4 hours after eating

319
Q

hepatitis A

A

usually food-borne

320
Q

hepatitis B

A

uncommon secondary due to immunization

321
Q

hepatitis C

A

common. often undiagnosed, sometimes it doesn’t effect liver enzymes profoundly, leading cause of cirrhosis and liver transplant

322
Q

risk factors for gallstones

A

female, fat, flatulent, forty

323
Q

gallstones clinical finding

A

RUQ colicky pain that can radiate to right shoulder, indigestion, mild jaundice, nausea after eating high fat foods

324
Q

clinical findings of pancreatitis

A

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

325
Q

nephrolithiasis

A

kidney stones

326
Q

clinical findings of kidney stones

A

fever, hematuria, severe pain at costovertebral angle

327
Q

radiculopathy

A

referred pain. pain that is causing/radiating somewhere else

328
Q

vagus knees

A

knocked knees and usually obese

329
Q

varus knees

A

bowed and usually skinny

330
Q

what is the screening for osteoporosis?

A

the Dexa scan

331
Q

lordosis

A

A curving inward of the lower back

332
Q

dysphasia

A

also called aphasia - difficulty speaking or understanding due to neurological changes

333
Q

dysarthria

A

slurring

334
Q

dysphagia

A

difficulty swallowing

335
Q

dementia that occurs in younger people

A

Korsakoff’s dementia and pick’s disease

336
Q

risk factors for dementia

A

age, brain/head injury, fewer years of education, female, genetics, alcohol

337
Q

visceral pain

A

originates from the abdominal organs. is crampy or gnawing

338
Q

somatic pain

A

originates from the skin, muscle, bones, and joints. aching or throbbing

339
Q

cutaneous pain

A

originates from the dermis, epidermis, and subcutaneous tissue. described as sharp

340
Q

referred pain

A

called radiculopathy. originates from a specific site but pain is at another site

341
Q

protective structures of the central nervous system

A

meninges

342
Q

layers of the meninges

A

dura matter - outer layer, arachnoid - middle layer, Pia matter - inner meningeal layer that contains blood vessels

343
Q

frontal lobe

A

primary motor cortex responsible for functions related to voluntary motor activity. controls intellectual function, awareness of self, personality, and autonomic responses related to emotion

344
Q

broca’s area

A

in the left frontal lobe. formulation of words

345
Q

parietal lobe

A

contains sensory cortex contains position sense, touch, shape, and texture objects

346
Q

temporal lobe

A

contains primary auditory cortex, wernickes area

347
Q

wernickes area

A

responsible for comprehension of speech, speech production, and interpreting sounds

348
Q

parkinsons causes

A

tremors at rest

349
Q

FAST

A

face- facial droop
arm - hemiparesis
speech - dysarthria/aphasia
timing - 3 hr window for t-PA

350
Q

hemiparesis

A

Muscle weakness or partial paralysis on one side of the body that can affect the arms, legs, and facial muscles.

351
Q

dementia vs delirium

A

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.

352
Q

ligament

A

bone to bone

353
Q

tendon

A

muscle to bone

354
Q

Sepsis signs and symptoms

A

high HR, fever, shivering, fever, confusion, shortness of breath, pain, clammy, sweaty

355
Q

wheezes

A

hissing or resonant sounds

356
Q

emphysema will have what type of resonance

A

hyper resonance

357
Q

percussion of fluids such as pneumonia or a mass

A

sounds will be dull

358
Q

increased tactile remits would indicate

A

consolidation

359
Q

percussion of ABD will be _______ over hollow organs

A

tympanic

360
Q

MMT

A

manual muscle testing

361
Q

ataxia

A

Impaired balance or coordination, can be due to damage to brain, nerves, or muscles.

362
Q

apraxia

A

Inability to perform a movement or task when asked despite having the desire and physical capability to carry it out

363
Q

Obtunded

A

Louder, more vigorous stimuli will awaken patient, but patient promptly returns to “sleep

364
Q

stuporous

A

will withdraw from painful stimuli

365
Q

semicomatose

A

responds to painful stimuli with abnormal flexion or extension

366
Q

comatose

A

does not respond to any stimuli

367
Q

Glasgow coma scale

A

3 is the worst and 15 is best

368
Q

expressive aphasia

A

can comprehend but cannot speak (Broca)

369
Q

global aphasia

A

cannot understand or express

370
Q

receptive aphasia

A

cannot associate words and meaning but still able to speak (wernickes)