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Assessment final > assessment_exam_2_20200730034734 > Flashcards

assessment_exam_2_20200730034734 Flashcards

1
Q

CC to look out for

A

RashHivesDry skinAcneHair lossIngrown nails

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2
Q

HPI to look out for

A

OLDCARTSEnvironmental exposuresTravelImmunizations

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3
Q

Past/present medical hx to look out for

A

SkinSkin cancerAcnePrev. lesions/proceduresSystemic disorders

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4
Q

Family Hx to look out for

A

Skin cancerAtopy (genetic tendency to develop allergic diseases)Balding

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5
Q

Social Hx to look out for

A

TobaccoAlcoholDrug useSun exposureTanning boothsCosmeticsSkin care

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6
Q

Examination of the skin is performed by

A

Inspection and palpation

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7
Q

Skin inspection requirements

A

Adequate lighting (tangential for contour)Room temperatureOnly expose the skin that needs to be exposedFull body sweep

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8
Q

Skin inspection points to look out for while performing inspection on the entire skin surface

A

PallorScars, bruises, lesionsEdemaMoistureHydration

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9
Q

8 Steps of skin lesion description

A

LocationDistributionPrimary or secondaryShape/arrangementBorders/marginsAssociated changesPigmentationSize

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10
Q

Palpation of skin for

A

Moisture (should be minimal sweat/oil)Temp. (use dorsal surface of hands/fingersTexture (smooth, soft, even)Turgor (3 seconds or less for tenting)

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11
Q

Where do you check for tenting in the elderly?

A

Over the sternum

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12
Q

Normal tenting time

A

3 seconds or less

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13
Q

Inspect hair for

A

ColorDistributionQuantity (look for Hirsutism/alopecia)

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14
Q

Palpate hair for

A

Texture

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15
Q

Inspect nails for

A

ColorShapeContour (clubbing)

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16
Q

Palpate nails for

A

TextureThicknessCapillary refill

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17
Q

Risk assessment consists of

A

Sun exposureTanning boothsUse of sunscreen

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18
Q

ABCDE of melanoma

A

AsymmetryBorders are irregularColor variations (black, blue, red)Diameter over 6mmElevation/evolution

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19
Q

A of melanoma

A

Asymmetry

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20
Q

B of melanoma

A

Borders are irregular

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21
Q

C of melanoma

A

Color variations (black, blue, red)

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22
Q

D of melanoma

A

Diameter over 6mm

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23
Q

E of melanoma

A

ElevationEvolution (growth)

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24
Q

Present/past medical Hx to look out for

A

Eye disordersEar infectionsSinus infectionsThroat infectionsAllergiesThyroid diseaseCancer

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25
Q

Past surgical Hx to look out for

A

Head and neck procedures/medicationCataract correctionLasik eye correctionEar tubesTonsillectomyWisdom teeth removal

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26
Q

Family hx to look out for

A

Thyroid, atopic triad

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27
Q

General signs to look out for

A

FeverChills weight changes

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28
Q

Integumentary signs to look out for

A

Rashes

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29
Q

Face signs to look out for

A

Tenderness/swelling

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30
Q

Eyes signs to look out for

A

painrednessdrainageitching

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31
Q

Ear signs to look out for

A

tinnitusear paindrainage

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32
Q

Nose signs to look out for

A

congestionrhinorrheasneezingepistaxis

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33
Q

Throat signs to look out for

A

Paindysphagiahoarseness

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34
Q

Neck signs to look out for

A

lymphadenopathy

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35
Q

Gordon health patterns to reference

A

SleepSexuality (infections)Nutrition/metabolic

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36
Q

Head exam:

A

Aligned?Normocephalic

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37
Q

Face exam

A

ScarsLesionsSymmetryMuscle weakness

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38
Q

Tell-tale signs on initial exam

A

Allergic shinersNasal crease in allergiesNoisy nasal breathing

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39
Q

Patient voice points to listen to

A

Breathy voiceNasalyStridor?

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40
Q

External eye points of interest

A

Eyebrow thinning/symmetryEyelashes (even distribution and direction of curl, infestations)Able to close eyelids fully/lesions

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41
Q

Eye abnormalities

A

PtosisEntropionHordeolum (sty)

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42
Q

PERRLA for eye assessment

A

PupilsEqualRound (should be perfectly round)Reactive (should react to:Light: dilation/contractionAccommodation(Looking far away pupils dilate, looking close pupils constrict)

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43
Q

Red light reflex

A

Detect cataract and retinoblastomaReddish-orange reflection of light from fundus

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44
Q

How to hold opthalamascope

A

Hold right hand, use your right eye and examine the patient’s right eyeVice versa for left

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45
Q

Cataracts

A

Clouding of lensLeading cause of blindness worldwideRisk factors: AgeUV B lightDiabetesCigarettesHTNSteroid useObesityBeta blockersFemale

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46
Q

Further eye testing

A

Peripheral vision6 cardinal fields (slowly) (three descending vertical on left side, three descending vertical on right side)

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47
Q

Ear external exam

A

AlignmentDeformitiesNodulesUlcersLesions

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48
Q

Otoscopy use

A

External auditory canal for erythema, stenosis, debris/discharge

49
Q

Examine tympanic membrane for

A

Normal: shiny, translucent, visible light reflex (R 5o clock vs. L 7 o clock)White= scarringRedness, bulging, dull, retraction= infectionPerforations and tubes

50
Q

Whisper test

A

6 words on each side, should hear at least 3/6

51
Q

What size otoscope?

A

Biggest that will fit

52
Q

Rinne test for ears

A

determine conductive or sensorineural hearing lossPlace tuning fork on mastoid behind earPatient will tell you when sound disappearsThen put tuning fork to earIf air conduction>bone conduction they should hear it

53
Q

Weber test for hearing

A

Tuning fork on top/center of headNormal=equal on both sidesCheck if sound is lateralized

54
Q

ear abnormalities

A

Otitis externa (swimmers ear)=crusty, inflammed, nasty afOtitis media (ear infection)=red and opaqueTympanostomy tubesScarring= opaque white

55
Q

Which ear has cone of light at 7 O clock

A

Left ear

56
Q

Which ear has cone of light at 5 o clock

A

Right ear

57
Q

Nose external exam

A

Deformities, symmetry, size/nare patencyPress on maxillary and frontal sinus

58
Q

Nasal speculum to find

A

Septum (deviation)RhinorrheaMassesPolyps (peeled grapes)Prominent vessels (snorting drugs)Allergies (pale/blue, puffy)

59
Q

Abnormal nose findings

A

SinusitisEpistaxisDeviated septumsPolyps

60
Q

Grading tonsils

A

1 and 2 normal1+: fills <25% oropharynx between tonsil pillars2+: 25-50%3+: 50-75%4+: >75% (almost or fully touching each other)

61
Q

Posterior pharyngeal wall look for

A

ErythemaDrainagePurulenceExudatesCobblestone appearance (allergies)

62
Q

Black harry tonge

A

Smokers, pepto bismol, antibiotics

63
Q

Leukoplakia in mouth

A

Permanent white marks in mouthCan turn to oral cancer

64
Q

Head lymph nodes should be

A

Less than 1cm or invisibleSoft Doesnt move

65
Q

Meniere’s disease

A

Inner ear disease that causes dizzy spells (verigo) and hearing loss. Can affect one or both ears.

66
Q

atopic triad

A

Eczema, allergies, asthma

67
Q

Delayed gagging is common in

A

Elderly

68
Q

ectropion vs entropion

A

Ectropion: eyelid turns outwardsEntropion: eyelid inwards

69
Q

Allergic shiners

A

Allergy symptom Looks like you got punched in the eye

70
Q

Neurological assessment components

A

Mental status examLOCCranial nerve assessmentReflex testingSensory sys. assesmentMotor system assessment

71
Q

Musculoskeletal assessment components

A

Inspection of skeleton and extremities for alignment and symmetryMuscles for symmetry and size: should be bilaterally equalPalpation of bones/joints for pain, temp, edemaROM head to toeMuscle strength 0-5 scale

72
Q

Muscle strength grading scale

A

0: 0% normal strength, complete paralysis1: 10% strength, no movement, muscle contraction is palpable/visible2: 25% strength, full movement against gravity w/support3: 50% strength, normal movement against gravity4: 75% normal strength, full movement against gravity and min. resistance5: 100% normal, full movement against gravity and full resistance

73
Q

Present/past Hx to look for

A

Trauma, disease, congenital anomalies, migraines, strokes, surgeries, fractures/sprains/strainsMental health hxMedications

74
Q

Family Hx to look out for

A

Migraines, seizures, stroke, brain tumors, MS, arthritis

75
Q

Elderly life span changes

A

Decreased sens. to outside stimuliFallsMay not realize temp is too hot/coldvision worsensPupils smallerDecreased hearing

76
Q

Mental status exam

A

A&O x 4Languagememoryattention span and calculation

77
Q

Glasgow coma scale

A

Eye openingVerbal responseMotor responseDeclared coma from 3-8 points

78
Q

If all cranial nerves are normal chart

A

“II-XII grossly intact”

79
Q

CN IIOptic sensory nerve assessment

A

Snellen Leave glasses/contacts onLeft eye then right eyePeripheral visionOpthalmoscope for red light reflex

80
Q

CN III Oculomotor nerve assessment

A

PERRLAEqualRoundReact to lightAccommodate to near/far vision

81
Q

CN III (oculomotor), IV (trochlear), VI (Abducens) motor nerve asessment

A

Examined together, control of eyelid elevation, eye movement, and pupil constrictionFinger of penlight follow with just eyes6 fieldsAbnormal reaction: nystagmus

82
Q

CN III eye movements

A

CNIII: Up and outUp and inCross eyesDown and out

83
Q

CN IV trochlear eye movements

A

Superior Oblique (down and in)

84
Q

CN VI abducens eye movement

A

Lateral rectus (middle out)

85
Q

CN V Trigeminal assessment

A

Corneal sensation (often deferred)Palpate jaw/temples while patient clenches teethCotton ball: swipe across different areas of face bilaterally

86
Q

CN VII Facial (motor and sensory) assessment

A

Symmetry and mobility of face:-smile-frown-close eyes-lift eyebrows-puff cheeksAsymmetrical in trauma, bells balsy, CVA, tumorAbility to taste (often deferred)

87
Q

CN VIII assessment (sensory) vestibulocochlear

A

Ability to hear spoken wordEyes closedWhisper 6 words bilaterally or rub fingers near earsSlowly move hand away while continuing to rub fingers Repeat bilaterallyAbnormal finding caused by: Occlusion, drug toxicity, tumor

88
Q

CN IX glossopharyngealand CN X vagus motor and sensory

A

Ability to swallowAssess voice for hoarsenessTaste (often deferred)

89
Q

Abnormal IX and X ( motor)

A

Motor deficits can indicate brain stem tumor or neck injury

90
Q

CN XI spinal accessory assessment

A

Hands on patients cheek and see if they resist head turnHands on shoulders, gently push down shoulders while they shrug

91
Q

CN XII hypoglossal assessment

A

Motor Assess tongue controlHave them stick it out straight, back and forth, up and down

92
Q

Reflex grades

A

4+ hyperactive3+ brisker than normal2+ normal1+ diminished0 absent

93
Q

Sensory neurological tests

A

Sharp and dull-show patient difference between sharp and dull-close their eyes-touch arms/legs randomly-Have them identify area and sensation

94
Q

Cortical sensory function

A

Discriminatory sensory functionBoth with eyes closedSterognosis (guess object in hand)Graphesthesis (number written on hand)

95
Q

Fine motor coordination test of upper extremities

A

Finger to finger test (eyes open and to examiners finger)Finger to nose test (eyes closed)

96
Q

Fine motor coordination test of lower extremities

A

Patient moves heel of one foot up and down shin of other foot

97
Q

Fine motor tests for general coordination

A

Rapid alternating movementsPatient pats knees with both hands alternating supination and pronationorpatient touches thumb to each finger on same hand

98
Q

Romberg test

A

Tests for balance Stand with feet together, arms at side and close eyesLook for swaying or lack of balance for 30 secondsNormal to have slight sway

99
Q

Opposition

A

Thumb to palm

100
Q

Reposition

A

Thumb back to normal position

101
Q

Circumduction

A

Move in circular fashion (ex. moving back and forth from hand supination to pronation)

102
Q

Inversion

A

Turn inwards

103
Q

Eversion

A

Turn outwards

104
Q

Retraction

A

move backwards

105
Q

Protraction

A

move forwards

106
Q

Lordosis

A

Accentuated lumbar curvecommon in pregnancies

107
Q

Left/right lateral bending

A

Moving head to the respective shoulder

108
Q

Plantar flexion

A

Pointing toes down

109
Q

Kyphosis

A

Hunchback

110
Q

1+

A

2mm or lessslight pittingdisappears rapidly

111
Q

2+

A

2-4mmSomewhat deeper pitDisappears in 10-15 seconds

112
Q

3+

A

4-6mmPit noticeably deep1 min or longerExtremity looks swollen

113
Q

4+

A

6-8mmVery deep2-5 minutesExtremity grossly distorted

114
Q

plantar (babinski) reflex

A

Poke heeltoes should curl in

115
Q

Biceps reflex

A

Antecubital area (inside of elbow)

116
Q

Brachioradialis reflex

A

Radial process Palm supinated, hit like 3 inches up on radius

117
Q

Triceps reflex

A

Back of arm right above elbow

118
Q

Patellar reflex

A

Right below kneecap

119
Q

Achilles reflex

A

Right on achilles tendon at heelShould cause foot to point down

Assessment final (5 decks)

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