Chapter 9 - General Survey... Flashcards
Endogenous obesity is caused by…
excess adrenocorticotropin production by the pituitary gland
Physical appearance includes statements that compare appearance with…
stated age
What are the four main point of the general survey?
physical appearance
body structure
mobility
behavior
General Survey: Physical Appearance
Age Sex Level of consciousness Skin color Facial Features Signs of distress
General Survey: Body Structure
Stature Nutrition Symmetry Posture Position Body Build/Contour Any physical deformities
General Survey: Mobility
Gait
ROM
Any involuntary movmt?
General Survey: Behavior
Facial expression Mood/Affect Speech Manor of thought delivery Dress Personal hygiene
A healthy BMI is …
How to calculate manually?
19 - 25
Or, you can calculate with the following formula:
BMI=Weight (inpounds)/
Height (ininches)2 ×703
Or
BMI=Weight (inkilograms) / Height (inmeters)2
Stroke Volume –> Pulse
The amount of blood pumped into the aorta of the heart in a given beat (about 70mL in the adult)
Pulse = 50-90 beats/min
systolic pressure
is the maximum pressure felt on the artery during left ventricular contraction, or systole.
diastolic pressure
is the elastic recoil, or resting, pressure that the blood exerts constantly between each contraction.
pulse pressure
is the difference between the systolic and diastolic pressures and reflects the stroke volume
mean arterial pressure (MAP)
is the pressure forcing blood into the tissues, averaged over the cardiac cycle
not an arithmetic average of systolic and diastolic pressures because diastole lasts longer
Rather, it is a value closer to diastolic pressure plus 1/3 the pulse pressure
Blood Pressure & Race
frican American adult’s BP is often higher than that of a white person of the same age. The incidence of hypertension is twice as high in African Americans as in whites.
Diurnal rhythm
A daily cycle of a peak and a trough occurs: the BP climbs to a high in late afternoon or early evening and then declines to an early morning low.
Cardiac output
If the heart pumps more blood into the container (i.e., the blood vessels), the pressure on the container walls increases
Gigantism
Excessive secretion of growth hormone by the anterior pituitary resulting in overgrowth of entire body.
during childhood, before closure of bone epiphyses in puberty, it causes increased height (here 2.09 m, or 6 ft 9 in) and weight and delayed sexual development
Acromegaly (Hyperpituitarism)
Excessive secretion of growth hormone in adulthood, after normal completion of body growth, causes overgrowth of bone in the face, head, hands, and feet but no change in height.
Internal organs also enlarge (e.g., cardiomegaly), and metabolic disorders (e.g., diabetes mellitus) may be present
Marfan’s Syndrome
inherited connective tissue disorder, characterized by tall, thin stature (greater than 95th percentile), arachnodactyly (long, thin fingers), hyperextensible joints, arm span greater than height, pubis-to-sole measurement exceeding crown-to-pubis measurement, sternal deformity, high-arched narrow palate, and pes planus.
Endogenous Obesity—Cushing Syndrome
Either administration of adrenocorticotropin (ACTH) or excessive production of ACTH by the pituitary will stimulate the adrenal cortex to secrete excess cortisol.
characterized by weight gain and edema with central trunk and cervical obesity (buffalo hump) and round, plethoric face (moon face).
Excessive catabolism causes muscle wasting; weakness; thin arms and legs; reduced height; and thin, fragile skin with purple abdominal striae, bruising, and acne.
Hypotension
<95/60
increased pulse, dizziness, diaphoresis, confusion, and blurred vision. (Jarvis 156)
Jarvis, Carolyn. Physical Examination and Health Assessment, 6th Edition. Saunders, 2012. VitalBook file.
Hypertension
> 120/80
Ratio of pulse rate to respiratory rate should be approximately
4:1
Bradycardia
(slow <60)
