Assessment Flashcards
Amplitude is
the intensity (soft or loud) of sound
Duration is
the length of time the note lingers
Pitch is
the number of vibrations per second (high or low)
Quality is
or timbre
the subjective difference due to a sound’s distinctive overtones
Deep palpation is used to identify
abdominal contents
Light palpation is used to evaluate
surface characteristics
Percussion with a reflex hammer is used to elicit
deep tendon reflexes
Percussion is used to determine
the density (air, fluid, or solid) of a structure by a characteristic note
The base of the fingers or ulnar surface of the hand is best for
vibration
What isused for detecting fine tactile discrimination such as skin texture, swelling, pulsation, and presence of lumps
The fingertips
The otoscope is used to visualize the
ear canal and tympanic membrane
The pharynx is best examined with a…
A flashlight or penlight and tongue depressor
A funduscopic examination is an examination of the…
internal structures of the eye
An otoscope may also be used with a short, broad speculum to view the…
nasal turbinates and nares
Use physical touch (if it is not a cultural contraindication) to offset the disadvantages of…
diminishing vision and hearing.
To perform percussion, the examiner strikes the stationary finger at the…
distal interphalangeal joint (just behind the nail bed)
When should the examiner use hand washing instead of an alcohol-based hand rub?
A. if the pt has Mycobacterium tuberculosis
B. if the pt has Clostridium difficile
C. if the pt has hepatitis B virus
D. if the pt is HIV positive
The examiner should use the mechanical action of soap-and-water hand washing when hands are visibly soiled and when patients are infected with spore-forming organisms (e.g., Clostridium difficile or Bacillus anthracis)
The stethoscope’s diaphragm is used for what type of sounds…
high-pitched sounds
Ex: breath, bowel, and normal heart sounds.
The stethoscope’s bell is used for what type of sounds…
soft, low-pitched sounds
Ex: extra heart sounds or murmurs
Resonant
Over Normal Lung Tissue
Low-pitched, clear, hallow sound
Hyperresonant
Normal Over Child’s Lung.
Abnormal over adults lung = too much air is present (emphysema)
amplitude: Louder
pitch: Lower
quality: Booming
duration: Longer
Tympany
Air-Filled Stomach / Intestine
amplitude: Loud
pitch: High
quality: Drumlike
duration: Sustained Longest
Dull
Dense Organ (live/spleen)
amplitude: Soft
pitch: High
quality: Muffled Thud
duration: Short
Flat
No air is present, over thigh muscle, bone, tumor
amplitude: Very Soft
pitch: High
quality: No Sound
duration: Very Short
The general survey consists of four distinct areas…they are
Physical appearance
Body structure
Mobility
Behavior
What should the width and length be on a blood pressure cuff?
Width: 40% of the arm circumference
Lenth: 80% of the arm circumference
What rate should the cuff be deflated at while taking a blood pressure?
Rate of 2 mm Hg per heart beat
A cuff that is too narrow or too wide yields what kind of reading?
Narrow: falsely high pressure
Wide: falsely low pressure
Does the Doppler technique more easily identify systolic or diastolic pressure?
systolic blood pressure
Endogenous obesity is caused by
administration/excessive production of adrenocorticorticotropin ACTH by the pituitary
Acromegaly is caused by
an excessive secretion of growth hormone in adulthood
Bradycardia
HR less than 50 bpm in an adult
Tachycardia
HR greater than 90 bpm in an adult
A full, bounding pulse (3+) reflects…
increased stroke volume, as with anxiety and exercise
The ratio of the pulse rate to respiratory rate commonly is
4 to 1
5 Factors Blood pressure level is determined by…
Cardiac output Peripheral vascular resistance Blood volume Blood viscosity Vessel wall elasticity
Tympanic Membrane Thermometer
- Accurately measure of core body temperature
- Senses the infrared emissions of the tympanic membrane
- Temperature is displayed in 2 to 3 seconds
- Used with unconscious patients or those in the emergency department, recovery areas, and labor and delivery units
Neuropathic pain implies an abnormal
processing of the pain message
On a 2000 calorie, a person should consume…
2 cups of fruit 2½ cups of vegetables per day 20-35% fat 60% complex carbs less than 300 mg of cholesterol
Serum albumin
Common measurement of visceral protein status.
Low serum albumin levels occur w/ protein-calorie malnutrition, altered hydration status, and decreased liver function.
A serum albumin level of 2.8 to 3.5 g/dl represents moderate visceral protein depletion, and less than 2.8 g/dl denotes severe depletion
Obese persons with more fat in the upper body, especially the abdomen, have…
android obesity
A waist to hip ratio of 1.0 or greater in men or 0.8 or greater in women is indicative of android obesity
Cephalhematoma
Subperiosteal hemorrhage resulting from birth trauma
Craniosynostosis
Asymmetry caused by a severe deformity caused by premature closure of the sutures resulted in a long, narrow head.
Caput Succedaneum
edematous swelling and ecchymosis of the presenting part of the head caused by birth trauma
Paget disease (osteitis deformans)
Localized bone disease of unknown etiology that softens, thickens, and deforms bone
Facial characteristics of fetal alcohol syndrome include…
Narrow palpebral fissures
Epicanthal folds
Midfacial hypoplasia
Facial characteristics of Down syndrome include…
Upslanting eyes with inner epicanthal folds Flat nasal bridge Small broad flat nose Protruding thick tongue Ear dysplasia
Facial characteristics of chronic allergies include…
Exhausted face
Blue shadows below the eyes
Double or single crease on the lower eyelids
Central facial pallor
Open mouth breathing (malocclusion of the teeth and malformed jaw)
Transverse line on the nose
Facial characteristics of congenital hypothyroidism include …
Low hairline Hirsute forehead Swollen eyelids Narrow palpebral fissures Widely spaced eyes Depressed nasal bridge Puffy face Thick tongue protruding through an open mouth Dull expression
Congenital hypothyroidism
Thyroid deficiency - occurs at an early age
(low hairline, hirsute forehead, swollen eyelids, narrow palpebral fissures, widely spaced eyes, depressed nasal bridge, puffy face, thick tongue protruding through an open mouth, and a dull expression.)
The trachea is normally midline; the trachea will deviated to the unaffected side (left) with a …
right pneumothorax
A clinical manifestation common in an individual with chronic obstructive pulmonary disease (COPD) is A. periodic breathing patterns B. pursed-lip breathing C. unequal chest expansion D. hyperventilation
pursed-lip breathing
An individual with COPD may purse the lips in a whistling position. By exhaling slowly and against a narrow opening, the pressure in the bronchial tree remains positive, and fewer airways collapse
The thoracic cage is defined by the …
sternum, ribs, vertebrae, and diaphragm
The major muscle responsible for inspiration is the
Diaphragm & Intercostal muscles.
Intercostal muscles lift the sternum and elevate the ribs, making them more horizontal; this increases the anteroposterior diameter
The gradual loss of intraalveolar septa and a decreased number of alveoli in the lungs of the elderly cause
decreased surface area for gas exchange
The function of the trachea and bronchi is to…
transport gases between the environment and the lung parenchyma
Stridor is a high-pitched, inspiratory crowing sound commonly associated with
upper airway obstruction
Which of the following correctly expresses the relationship to the lobes of the lungs and their anatomic position? A. Upper lobes—lateral chest B. Upper lobes—posterior chest C. Lower lobes—posterior chest D. Lower lobes—anterior chest
Lower lobes - posterior chest
The posterior chest is almost all lower lobe
An increase in the transverse diameter of the chest cage in a pregnant female is due to a(n)
increase in estrogen
Base of the fingers or ulnar surface detects…
Vibration
When inspecting the ear canal, the examiner chooses what type of speculum for the otoscope?
The Largest that will fit
Normal Gait is how wide?
Shoulder-width
Pulses 3 point scale 3+ 2+ 1+ 0
3+ Full, Bounding
2+ Normal
1+ Weak, Thready
0 Absent
Pulse rate to Respiratory rate ratio is…
4:1
During BP, a cuff size that is too narrow yields what kind of reading?
Falsely High BP
The Wong-Baker Scale
Faces Pain Scale
Simple Descriptor Scale
List words that describe different levels of pain. no pain mild pain moderate pain severe pain
3 types of Normal Breath sounds
Bronchial
Bronchovesicular
Vesicular
Bronchial is heard over
Trachea & Larynx
Bronchovesicular
Major bronchi, between scapulae, upper sternum, 1st & 2nd intercostal spaces
Vesicular
Peripheral Lungs - Rustling sound
Apgar Scoring Scale
Newborns 1st respiratory assessment.
Scored at 1 min & 5 min after birth
Unequal chest expansion occurs with…
Atelectasis
Lobar pneumonia
Pleural Effusion (fluid in lungs)
Thoracic Trauma
Pallor
Absence of red-pink tones from the oxygenated hemoglobin in blood
Tension Headache
All over
non-throbbing
dull, aching pain
stress, anxiety, depression brings it on
Migraine Headaches
Pain often behind the eyes (usually just on 1 side)
Throbbing/pulsating
Hormones, certain foods, changes in sleep can bring it on
Cluster Headaches
Always 1 sided
continuous/burning/piercing pain
Need to move/pace to feel better
Blood Vessel that runs diagonally across the sternomastoid muscle
External Jugular Vein
Cephalhematoma is associated with
Subperiosteal Hemorrhage
What size are normal cervical lymph nodes?
smaller then 1 cm
Manubriosternal angle is
The articulation of the manubrium & the body of the sternum
How many lobes does the L lung have?
2 lobes
narrower then the R lung
Absence of diaphragmatic excursion occurs with…
pleural effusion or atelectasis of the lower lobes
