ccdb Flashcards
measuring BP? oscillometric vs. auscultatory
The oscillometric method, employed by most clinical-grade automated BP devices, analyzes pulse waves collected from the cuff during constricted blood flow. In this case, the cuff is the sensor. The auscultatory and oscillometric methods are two very different approaches to determining the same vital sign
five Korotkoff sounds of BP
TAP, SOFT swish,< CRISP< BLOW, SILENCE
1 Phase I—The first appearance of faint, repetitive, clear tapping sounds which gradually increase in intensity for at least two consecutive beats is the systolic blood pressure. 2 Phase II—A brief period may follow during which the sounds soften and acquire a swishing quality. 3 Phase III—The return of sharper sounds, which become crisper to regain, or even exceed, the intensity of phase I sounds. 4 Phase IV—The distinct abrupt muffling of sounds, which become soft and blowing in quality. 5 Phase V—The point at which all sounds finally disappear completely is the diastolic pressure.
The second and third Korotkoff sounds have no known clinical significance.
In some patients, sounds may disappear altogether for a short time between Phase II and III which is referred to as auscultatory gap.
Auscultatory - cuff need to be right size.
The auscultatory method uses a stethoscope and a sphygmomanometer.
This comprises an inflatable cuff placed around the upper arm at roughly the same vertical height as the heart, attached to a mercury or aneroid manometer.
The mercury manometer, (often need for clinical trials) considered the gold standard, measures the height of a column of mercury, giving an absolute result without need for calibration and, consequently, not subject to the errors and drift of calibration which affect other methods.
Four vital signs?
BP (120/80), temp (sustained 38, or 38.5), respiration (16-20), Pulse 60 - 100
Posterior-Anterior (PA) projection
The standard chest radiograph is acquired with the patient standing up, and with the X-ray beam passing through the patient from Posterior to Anterior (PA). The chest X-ray image produced is viewed as if looking at the patient from the front, face-to-face
AP or PA better for x ray? - upright PA
The AP shows magnification of the heart and widening of the mediastinum. Whenever possible the patient should be imaged in an upright PA position. AP views are less useful and should be reserved for very ill patients who cannot stand erect
OLD CARTS
Onset Location/radiation Duration Character Aggravating factors Relieving factors Timing Severity
Symptom vs. Sign?
What patient feels vs What is observed by Dr. (observed and quatified)
dyspepsia, dysphagia, emesis
indigestion
swallowing difficulty
vomit
hematemesis
vomiting blood
hepatomegaly
abnormal enlargement of the liver.
hematochezia
pooping red blood
Gastrointestinal (GI) bleeding is usually categorized as either melena or hematochezia. Melena refers to black stools, while hematochezia refers to fresh, red blood in your stool. … Hematochezia usually comes from the colon, while melena usually comes from a higher point in your GI tract
melena
pooping blood that is black
Ileus
lack of movement somewhere in the intestines that leads to a buildup and potential blockage of food material. An ileus can lead to an intestinal obstruction. This means no food material, gas, or liquids can get through. It can occur as a side effect after surgery.
icterus
jaundice
organomegaly
abnormal enlargement of an organ
peritonitis
inflammation of the peritoneum, typically caused by bacterial infection either via the blood or after rupture of an abdominal organ.
proctodynia
A condition of episodic rectal pain, caused by spasm of the levator ani muscle. Also known as levator ani syndrome or as levator syndrome.
rebound effect
or rebound phenomenon, is the emergence or re-emergence of symptoms that were either absent or controlled while taking a medication, but appear when that same medication is discontinued, or reduced in dosage.
Angina:
a pain in the chest following EXERCISE or eating, which is caused by an inadequate supply of blood to the heart muscles because of narrowing of the arteries. It is commonly treated with nitrates or calcium channel blocker drugs.
Apnea: the stopping of breathing
Bradycardia:
Bradypnea:
a slow rate of heart contraction, shown by a slow pulse rate of less than 70 beats per minute
unusually slow breathing
Cardiomegaly:
an enlarged heart
Cyanosis:
a condition characterized by a blue colour of the peripheral skin and mucous membranes, a symptom of lack of oxygen in the blood, e.g. in heart or lung disease
Dependent edema:
the accumulation of excess fluid in a fluid comparment
