Boards Exam Deck #3 Flashcards
Innervation of deltoid
axillary N
Typical CPM cycle
2 cycles per minute
pleural effusion
- accumulation of fluid in the pleural space
- lung sounds are usually created
- a pleural friction rub may be heard if pleural surfaces are inflamed
Typical breath sounds found with pulmonary fibrosis
-decreased breath sounds with auscultation
Pulmonary fibrosis
- type of restrictive lung disease characterized by changes in the alveoli & lung architecture from an inflammatory process
- inflammatory changes cause scarring & fibrotic lesions in the lungs which result in decreased lung compliance, lung volumes, diffusing capacity, increased pulmonary arterial pressure, & work of breathing
Asymmetrical tonic neck reflex (ATNR)
- head turned to one side is stimulation
- response is fencing posture
- normal age response is from birth to 6 months
Moro reflex
- stimulated when an infant’s head is suddenly dropped into extension for a few inches
- response is that the arms abduct with fingers open, then cross the trunk into adduction; often followed immediately by crying
integration of Moro reflex
28 weeks gestation to 5 months
Landau reflex
-equilibrium response that occurs when a child responds to prone suspension by aligning their head & extremities in line with the plane of the body
integration of Landau reflex
-around 3 months to 2 years
Symmetrical tonic neck reflex
- stimulated by the head moving into flexion or extension
- when head is in flexion, the arms are flexed & legs extended
- when head is in extension, the arms are extended & legs are flexed
integration of tonic neck reflex
6-8 months
Hill-Sachs Fracture
- aka hill-sachs lesion
- impaction fracture of the anterior medial humeral head
- typically associated with a posterior glenohumeral dislocation
typical presentation of a posterior glenohumeral dislocation
- holding arm medially rotated & adducted
- may exhibit flattening of anterior shoulder & a prominent coracoid process
Angiotensin
- hormone released for regulation in blood pressure
- release of this hormone causes vasoconstriction, which results in an increase in BP
Erythropoietin
- hormone involved in production of red blood cells
- under hypoxic conditions, the kidneys will secrete this hormone to increase production of RBCs
Prostaglandins
- group of hormones that help protect the lining of the stomach by inhibiting gastric acid secretion & increasing the production of mucous in the stomach lining
- NSAIDS inhibit production of these protective prostaglandins, which results in the stomach becoming more susceptible to damage from the gastric acids
Gastrin
-hormone hat stimulates secretion of gastric acid in the stomach
ejection fraction
- measure of left ventricular contractility
- stroke volume / left ventricular end-diastolic volume
- normal EF = 55-70%
definition of Cushing’s syndrome
-excess of free circulating cortisol from the adrenal cortex
Positive Inotropic Agents side effects
cardiac arrhythmias, GI distress, dizziness, blurred vision
action of positive inotropic agents
increases the force & velocity of myocardial contraction, slows the HR, decreases conduction velocity through AV node, and decreases the degree of activation of sympathetic nervous system
What does hearing stridor indicate with auscultation?
-upper airway obstruction
bronchophony
- increased vocal resonance with greater clarity & loudness of spoken words
- ex: “99”
egophony
-a form of bronchophony in which the spoken long “E” sound changes to a long, nasal-sounding “A”
whispered pectoriloquy
-recognition of whispered words, “1,2,3”
ST segment depression
-sign of subendocardial ischemia but also can be due to digitalis toxicity or hypokalemia
ST segment elevation
- earliest sign of acute transmural infarction
- can also indicate a benign early depolarization pattern in a normal heart
Percussion sound heard almost exclusively with a large pneumothorax?
tympany
Normal infant heart rate
100 - 130 beats/minute
Normal child heart rate
80 - 100 beats/minute
Obstructive ventilatory impairment FEV1/FVC is equal to what?
Restrictive ventilatory impairment
- characterized by reduced lung volumes (total lung capacity, FVC, FEV1) and relatively normal expiratory flow rates
- inferred from spirometry when FVC is reduced & FEV1 / FVC is normal or > 80%
Rate pressure product
- index of myocardial oxygen consumption & coronary blood flow
- provides an easy to measure physiologic correlate to onset of angina or development of ECG abnormalities in patients with heart disease
- signs & sx of myocardial ischemia generally occur at a reproducible RPP value
- RPP = HR x SBP
Newborn respiratory rate
33-45 breaths/minute
1 year old respiratory rate
25-35 breaths/minute
10 year old respiratory rate
15-20 breaths/minute
Adult respiratory rate
12-20 breaths/minute
Normal respiratory rhythm
- inspiration is half as long as expiration
- 1:2 ratio
Respiratory rhythm of COPD
- longer expiration phase
- 1:3 or 1:4 ratio
apnea
absence of spontaneous breathing
biot’s breathing pattern
- irregular breathing
- breaths vary in depth & rate with periods of apnea
- often associated with increased intracranial pressure or damage to the medulla
bradypnea
-slower than normal respiratory rate
-
Cheyne-Stokes (periodic)
- decreasing rate & depth of breathing with periods of apnea
- can occur due to central nervous system damage
eupnea
normal rate & depth of breathing
hyperpnea
increased rate & depth of breathing
hypopnea
decreased rate & depth of breathing
Kussmaul’s
- deep & fast breathing
- often associated with metabolic acidosis
paradoxical breathing pattern
- chest wall moves in with inhalation & out with exhalation
- due to chest trauma or paralysis of diaphragm
tachypnea
- faster than normal respiratory rate
- > 20 breaths/minute in adults
