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Advanced health assessment > AHA Exam 2 > Flashcards

AHA Exam 2 Flashcards

1
Q

Pectus carinatum

A

Sternal Protrusion

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2
Q

Pectus excavatum

A

sternal cavitation

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3
Q

Deep rapid respirations associate with metabolic acidosis

A

Kussmaul respiration

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4
Q

Hyperpnea

A

deep breathing

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5
Q

hypopnea

A

shallow breathing

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6
Q

Feel increased vibration in chest over lung and indicates possible consolidation

A

Tactile fremitus

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7
Q

Hyperresonance of lungs indicates what condition?

A

hyperinflation

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8
Q

Dullness over lungs indicates what?

A

Bone, impaired air exchange, consolidation

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9
Q

Increased resonance of the spoken voice with auscultation

A

Bronchophony

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10
Q

Intelligibility of the whispered voice to auscultation in presence of consolidation

A

Pectoriloquy

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11
Q

“e” sounds like “a” with auscultation in presence of consolidation

A

Egophony

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12
Q

Place backs of hands on the back and have patient say “99” and feel for increased vibration

A

Tactile fremitus

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13
Q

Sounds more loud and clear over one lung may indicate what condition?

A

Pneumonia

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14
Q

Decreased resonance on one side of the lungs could indicate what condition?

A

Bleb

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15
Q

What other exams should be done with respiratory?

A

Cardiovascular, peripheral signs with respiratory; ENT is often indicated

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16
Q

What condition includes prolonged expiration and wheezing?

A

Asthma

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17
Q

What condiiton is collapse of the lung?

A

Atelectasis

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18
Q

What would be a significant finding of atelectasis?

A

Absence of lung sounds or very muted

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19
Q

What would be significant findings of bronchitis?

A

Diminished lung sounds and hacking non productive cough

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20
Q

Significant findings of pneumonia

A

febrile, crackles, rhonchi, diminished breath sounds, egophony, bronchophony, and whisper pectoriloquy, dullness over area of consolidation

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21
Q

What condition may cause displacement of the trachea?

A

pneumothorax

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22
Q

Significant findings of pulmonary embolism

A

pleuritic chest pain with or without dyspnea; possible low grade fever; hypoxia

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23
Q

Findings of emphysema.

A

barrel shaped chest; scattered crackles or wheezes; overinflated lungs are hyperresonant; prolonged expiratory effort.

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24
Q

Findings of COPD

A

rhonchi, inspirational crackles; breath sounds diminished; diminished vocal fremitus; cyanosis; distention of neck veins with right sided heart failure

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25
Q

What part of the cardiac cycle includes ventricular contraction ejecting blood?

A

Systole

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26
Q

What part of the cardiac cycle includes ventricular dilation and contraction of the atria draws blood into ventricles from the atria?

A

Diastole

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27
Q

What is the first heart sound?

A

mitral and tricuspid valves close

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28
Q

What is the second heart sound?

A

aortic and pulmonic valves close

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29
Q

What is the third heart sound?

A

mitral and tricuspid valves open

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30
Q

What is the fourth heart sound?

A

atria contract and empty

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31
Q

What heart sounds are in systole?

A

1,2, and 3

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32
Q

What heart sounds are in diastole?

A

4

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33
Q

Which EKG waves indicate atrial depolarization?

A

P wave

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34
Q

Which EKG waves indicate stimulation of the atria to initial stimulation of the ventricles?

A

PR interval

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35
Q

Which EKG waves indicate spread of a stimulus through the ventricles?

A

QRS complex

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36
Q

Which EKG waves indicate ventricular repolarization?

A

ST segment and T wave

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37
Q

Which EKG wave is sometimes seen and indicates repolarization of Purkinje fibers

A

U wave

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38
Q

Which electrical node is located in the right atrium?

A

SA

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39
Q

Which electrical node is located in the atrial septum?

A

AV

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40
Q

Where is the point of maximum impulse (PMI) located?

A

4th intercostal space

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41
Q

Where is the aortic valve area?

A

2nd intercostal space, right pulmonic border

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42
Q

Where is the pulmonic valve area?

A

2nd intercostal space, left pulmonic border

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43
Q

Where is the second pulmonic area (ERB’s point)

A

3rd intercostal space, left pulmonic border

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44
Q

Where is the tricuspid area?

A

4th intercostal space

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45
Q

Where is the mitral area?

A

5th intercostal space

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46
Q

What is the range of intensity of murmurs?

A

1- barely audible to VI- loud, audible without stethoscope

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47
Q

What grade of murmurs include a thrill?

A

IV and V

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48
Q

Where does the mitral sound radiate to?

A

axilla

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49
Q

Where does the aortic and pulmonic sounds radiate to?

A

carotids

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50
Q

How do you differentiate between a systolic and diastolic murmur?

A

If carotid impulse the same as what you are hearing it is a systolic murmur

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51
Q

What is the most common cause of heart murmur in elderly?

A

aortic stenosis

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52
Q

What is the most common cause of heart murmur?

A

mitral regurgitation

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53
Q

Name the Systolic murmurs

A

MR ASS mitral regurgitation and aortic stenosis=systolic

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54
Q

Name the Diastolic murmurs

A

MS ARD (mitral stenosis and aortic regurgitation)

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55
Q

What characteristics of murmurs are assessed?

A

location, timing and duration, pitch and intensity; pattern; quality; radiation; variation with respiratory phase

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56
Q

What is the range for muscle grading?

A

1-5

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57
Q

Muscle grading: visible or palpable muscle response

A

1

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58
Q

Muscle grading: full or partial ROM but not against gravity

A

2

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59
Q

Muscle grading: full ROM but not against resistance

A

3

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60
Q

Muscle grading: full ROM against some reistance

A

4

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61
Q

Muscle grading: full ROM against full resistance

A

5

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62
Q

Which tests are used to evaluate rotator cuff impingement or tear?

A

Neer test, Hawkins test

63
Q

Test: internally rotate and forward flex arm at the shoulder: presses supraspinatus muscle against anteroinferior acromion

A

Neer test

64
Q

Test: forward flexing shoulder to 90 degrees, flex elbow to 90 degrees and then internally rotate arm to its limit

A

Hawkins test

65
Q

What tests can measure strength of rotator cuff muscles?

A

Supraspinatus (empty can test), subscapularis, infraspinatus and teres minor

66
Q

Test; abduct arms 90 degrees and flex shoulders forward 30 degrees; apply downward pressure on distal humerus when arms are rotated so that thumbs point down or up

A

Supraspinatus (empty can test)

67
Q

Test: arm at side, elbow flexed 90 degrees; rotate forearm medially against resistance

A

subscapularis

68
Q

Test: arm at side, elbow flexed 90 degrees, and rotate arm laterally against resistance

A

infraspinatus and teres minor

69
Q

What tests can be done for impingement syndrome of the rotator cuff?

A

empty can test, neers test, painful arc, hawkins, opposition to internal and external rotation

70
Q

What test can be done for impingement syndrome of the AC joint

A

cross body adduction

71
Q

What test can be done for impingement syndrome of the bicep tendonitis?

A

Speed test

72
Q

What tests can be done to indicate shoulder instability or dislocation?

A

Apprehension test, sulcus sign, and internal rotation greater than internal rotation

73
Q

Test: lay on back and externally rotate arm

A

Apprehension test

74
Q

Test: squaring off of shoulder; divot where ball of humerus is dislocated from AC

A

Sulcus sign

75
Q

What indicates a rare posterior dislocation of the shoulder?

A

Internal rotation of the shoulder is greater than external rotation

76
Q

What tests indicate thoracic outlet syndrome?

A

Wright’s test and Adson’s test

77
Q

Test: fully abduct the arm shoulder while palpating the radial pulse; if pulse decreases, positive for thoracic outlet syndrome

A

Wright’s test

78
Q

Test: abduct arm to 30 degrees and hyperextend with head turned toward affected side. If pulse diminishes, sign is positive for thoracic outlet syndrome

A

Adson’s test

79
Q

How do you test for deQuervain’s tendonitis?

A

Finklestien’s sign

80
Q

Test: make fist with fingers overlying thumb. provide ulnar deviation of the wrist. Pain in first compartment indicates a positive sign

A

Finklestien’s sign

81
Q

Carpal tunnel syndrome association tests

A

Tinel test; Phalen; thumb opposition

82
Q

Test: tap on ulnar nerve of wrist; positive sign is pins and needles

A

Tinel test

83
Q

Test: inverted prayer; positive sign is burning, tingling, or numb sensation over the thumb, index, middle, and ring fingers

A

Phalen test

84
Q

Flexion of fingers

A

90 degrees

85
Q

Hyperextension of fingers

A

30 degrees

86
Q

flexion of wrist

A

90 degrees

87
Q

hyperextension of wrist

A

70 degrees

88
Q

radial rotation of wrist

A

20 degrees

89
Q

ulnar rotation of wrist

A

55 degrees

90
Q

forward flexion of shoulder

A

180 degrees

91
Q

hyperextension of shoulder

A

50 degrees

92
Q

abduction of shoulder

A

180 degrees

93
Q

adduction of shoulder

A

50 degrees

94
Q

internal and external rotation of the shoulder

A

90 degrees

95
Q

Shoulder shrug tests which cranial nerve?

A

XI spinal accessory

96
Q

How do you test the ulnar nerve?

A

OK sign

97
Q

How do you test the medial nerve of the wrist?

A

crossing fingers

98
Q

How do you test the radial nerve?

A

thumbs up

99
Q

Arthritis: ulnar deviation

A

rheumatoid

100
Q

Arthritis: boutonniere deformities

A

rheumatoid

101
Q

Arthritis: Bouchard’s nodes

A

PIP, osteo

102
Q

Arthritis: Herberden’s nodes

A

DIP, osteo

103
Q

Swan neck deformity

A

rheumatoid

104
Q

PIP hyperextension and DIP flexion

A

boutonniere deformity

105
Q

Large knuckles

A

bouchard’s nodes

106
Q

Bony growth on the finger joints nearest the finger tip (DIP) and sometimes on PIP

A

Herberden’s nodes

107
Q

DIP hyperextension and PIP flexion

A

Swan neck

108
Q

Back flexion

A

70-90 degrees

109
Q

Back hyperextension

A

30 degrees

110
Q

Back lateral bending

A

35 degrees

111
Q

rotation of upper trunk

A

30 degrees

112
Q

Tests for nerve rot impingement

A

straight leg raising test, Bragard stretch test; sitting knee extension; femoral stretch test

113
Q

Test for shortened iliopsoas muscle

A

Thomas test

114
Q

Test: examiner lifts the patient’s leg while the knee is straight. Positive sign is sciatic pain when the straight leg is between 30 and 70 degrees. Could indicate herniated disc at about L5

A

Straight leg raising test

115
Q

Test: straight leg lift to 60 degrees, dorsiflex the foot. Positive if pain from hip to knee. Indicates nerve involvement at L4,5, and S1

A

Bragard stretch test

116
Q

Test: patient supine on exame table and holds uninvolved knee to his or her chest, while allowing the involved extremity to lie flat. Holding the knee to the chest flattens ou the lumbar lordosis and stabilizes the pelvis. If the iliopsoas muscle is shortened, or a contracture is present, the lower extremity on the involved sid will be unable to fully extend at the hip

A

Thomas test

117
Q

Test: lay flat and cross ankle over the knee; may indicate contractures in hip

A

Ileopsoas

118
Q

Test: test leg is flexed and the thigh abducted and externally rotated. If pain is elicited on the ipsilateral side anteriorly, it is suggestive of a hip joint disorder on the same side.

A

Patric test

119
Q

Diminished patellar reflex involves which dermatome?

A

L4

120
Q

Which dermatome causes weak dorsiflexion and extension of great toe?

A

L5

121
Q

Which dermatome causes weak plantar flexion and diminshed Achilles reflex?

A

S1

122
Q

Knee flexion

A

130 degrees

123
Q

Knee extension

A

0 degrees

124
Q

knee hyperextension

A

15 degrees

125
Q

Test: checks for effusion; push down on patella and would be able to feel it hit the femoral head and float back up

A

Ballottment

126
Q

Test: milk fluid distally from suprapatellar pouch. Repeat several times; press behind patella lateral margin; swelling reappears in knee joint effusion

A

Bulge sign

127
Q

Test: knee is flexed at 20-30 degree angle with the patient supine. The examiner should place one hand behind the tibia and the other grasping the patient’s thigh; Tibia is pulled forward to assess the amount of anterior motion of the tibia in comparison to the femur

A

Lachman’s test

128
Q

Test: have the patient lie supine and extend the knee; stabilize the femur with one hand and hold the ankle with your other hand. Apply varus or valgus force against the ankle and internal/external rotation. Laxity indicates injury to the lateral collateral ligamen

A

Valgus (adduction) and Varus (abduction) stress test

129
Q

Tests for knee effusions

A

Ballottment; Bulge sign

130
Q

Tests for meniscal tears

A

McMurray or Apley (don’t do this one- can cause cartilage tear)

131
Q

Tests for ligamental injuries

A

Anterior and posterior drawer test; Lachman test; Varus and Valgus stress test

132
Q

Foot dorsiflexion

A

20 degrees

133
Q

plantar flexion

A

45 degrees

134
Q

Foot inversion

A

30 degrees

135
Q

Foot eversion

A

20 degrees

136
Q

Test: crank foot inversion

A

Tallar tilt test

137
Q

What does the tib fib squeeze test for?

A

fracture

138
Q

Test: When calf squeezed, calf should naturally plantar flex

A

Thompson test

139
Q

What does the Thompson test check for?

A

achilles tendon issues

140
Q

Pneumonic for conditions that mimic psych issues

A

Thinc Med

141
Q

What are the conditions that mimic psych issues?

A

Tumors, Hormones; Infections and immune diseases; Nutrition; CNS; Misc (sleep apnea, CHF, anemia); Electrolyte; Drugs

142
Q

Pneumonic for depression symptoms

A

SIGECAPS

143
Q

What are depression symptoms?

A

Sleep disorder; Interest deficient; Guilt; Energy deficient; Concentration deficient; Appetite disorder; Psychomotor; Suicidal

144
Q

What is the pneumonic for bipolar disorder symptoms?

A

DIGFAST

145
Q

What are bipolar disorder symptoms?

A

Distractibility; Insomnia; Grandiosity; Flight of ideas; Activity increase; Speech; Thoughtless risk

146
Q

Autism symptoms are usually seen by what age?

A

3

147
Q

ADHD symptoms are seen by what age?

A

12

148
Q

Does Delirium, Dementia, or mood disorder come on suddenly?

A

Delirium

149
Q

Causes of Delirium

A

Dementia; Electrolyte disorders; Lung, liver, heart, kidney, brain; Infection; Rx drugs; Injury, pain, stress; Unfamiliar environment; Metabolic dementia

150
Q

Pneumonic used for Alcohol abuse

A

CAGE

151
Q

Alcohol abuse symptoms

A

Concern, cut down; Annoyed; Guilt; Eye-opener

152
Q

Left affected stroke symptoms

A

neglect of affected side; impulsive; lack of insight regarding disability

153
Q

Right affected stroke symptoms

A

often have speech/language disorder; tend to need motivation; insight usually intact

154
Q

Lacunar stroke symptom

A

coordination or balance

Advanced health assessment (11 decks)

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