Clin Med II Systems Review Flashcards
What is the purpose of a systems review?
identify suspicious non-MSK or RED flag S&S that require referral to another healthcare professional
The systems review is NOT a dx of a non-MSK condition
True/False
TRUE
Few RED flag S&S in isolation are _______, we should look for _________
informative; combinations
There is a consensus on which RED flags are most useful
True/False
False; there is NO consensus
Systems are determined from the _____ and ______
hx; observation
What are the constitutional symptoms or general health components requiring a systems review?
Fever, chills, sweats- MOST often associated with systemic illness
Prolonged (≥2 wks.)
- > 102° may require hospitalization
Weight changes, particularly loss of ≥ 5% and if unexplained
Nausea and Vomiting (N&V)
Dizziness and lt. headedness
Fatigue- prolonged (≥ 2 wks.) and limiting
Weakness- limiting
Paresthesia’s/Numbness
Malaise or ill feeling- “I feel like I’m coming down with something”
Mentation or cognitive changes
The kidneys, ureters, bladder, and urethra are located in what system?
Urinary
Which system….??
filters fluid from renal blood flow
removes waste
retain essential substances for fluid and contents balance i.e., electrolytes, acid base balance, etc.
Stimulates RBC production
Blood pressure regulation
Converts Vitamin D to its active form
Urinary System
Which system would be involved if a patient has P! in the trunk, flank, and or pelvic regions?
Urinary
What are the 4 urinary changes involved with the urinary system?
- frequency
- duration
- bleeding
- pus
What are the 3 dysfunctions involved with urinary system S&S?
- flow
- initation
- control
______ means: awake to urinate
Nocturia
Urinary System
What’s a common symptom a patient may notice with their urine?
discoloration
With the urinary system, you learn the most from the patient’s what?
hx
A patient with issues involving the urinary system may experience P! with what follow up tests?
kidney percussion
palpation/ percussion of system organs
This system is responsible for producing sex cells (eggs/sperm), creating sex hormones, and maintaining fertilized eggs for development?
Reproductive
The reproductive system and what other system work together involving hormones?
Endocrine
A patient with reproductive S&S could have P! in what areas of the body?
Pelvis, LB, abdominal regions and or sexual organs
What dysfunctions could be involved with reproductive S&S?
sexual
bowel/bladder (due to proximity)
What are some abnormal S&S involved with the reproductive system?
discharge from sex organs
menstruation
These symptoms are indications of what in women?
Polyuria
Breast Tenderness
Fatigue
N&V
Heartburn
Constipation
Abnormal discharge
Unknown pregnancy symptoms
Which system is involved with the gut, liver, adipose tissue, pancreas, kidney, and muscle?
Metabolic
Which system converts food and liquids into energy, building blocks for proteins, fats, and carbohydrates, and eliminates waste?
Metabolic
Fluid and electrolyte balance is KEY for _________ metabolism
cellular
With the metabolic system:
What electrolyte maintains fluid volume and cell function for messages to and from the CNS?
Sodium
__________ is the MOST frequent electrolyte disorder and contributor to neurological S&S
Hypotranemia (low blood sodium)
With the metabolic system:
What electrolyte maintains fluid volume?
Potassium
With the metabolic system:
What electrolyte is involved with bone health, muscle actions, nerve impulses, circulation, and hormone balance?
Calcium
*involved with the skeleton
With the metabolic system:
What electrolyte plays a CRUCIAL role with metabolism for the growth, maintenance, and repair of ALL tissues?
Phosphorus
The electrolyte phosphorus is majorly located where?
bone and teeth
With the metabolic system:
Which electrolyte works as an acid buffer?
Bicarbonate
What is the MAIN reason for loss of bicarbonate?
Diarrhea
With the metabolic system:
Which electrolyte is mainly involved in neuromuscular functions?
Magnesium
With the metabolic system:
Which electrolyte regulates fluid in and out of cells?
Chloride
The metabolic S&S are really ______
A. typical
B. varied
C. straight-forward
B.
In a systems review, if the S&S don’t match a specific system and seem widespread, it is possibly a ________ condition because altered _______ can affect MULTIPLE systems
metabolic; metabolism
With the metabolic system S&S, overall it is due to what two things?
Fluid and electolyte imbalances
Altered pH
Fluid and electrolyte imbalances is MOST commonly due to conditions involving ______ _____ and _______
fluid loss; dehydration
Name some conditions involving fluid loss and dehydration?
Diabetes
Kidney dysfunction
Alcoholism/dehydration
Malignancy
Medication SE ex. diuretic
Diarrhea
What effects might you see involving the skin with fluid and electrolyte imbalance S&S?
Loss of skin elasticity
Altered temperature
What neuromuscular effects might you see with fluid and electrolyte imbalance S&S?
weakness
fatigue
twitching
cramping
tetany
What CNS involvement might you see with fluid and electrolyte imbalance S&S?
memory impairment
depression
delusions/hallucinations
seizures
What cardiovascular changes might you see with fluid and electrolyte imbalance S&S?
tachycardia
postural hypotension
altered respirations
Fluid and electrolyte imbalance can alter ___
pH
The normal pH ranges from ____ to _______
7.35-7.45
The lungs help to balance the acidic _____ with the neutral _____
CO2; O2
The ______ work with the circulatory system to provide O2 and remove waste products of metabolism
lungs
The kidney’s remove acids and keep _____
bases
Aging can result in decreased respiration, so less _____ _____
gas exchange
Aging can result in ________ where oxygen molecules lose electrons and steal them from other electrolytes and cells
oxidation
What are the 4 acid-base classes?
- Respiratory Acidosis
- Respiratory Alkalosis
- Metabolic Acidosis
- Metabolic Alkalosis
What S&S with altered pH may occur with ALL classes?
confusion and fatigue
Respiratory Acidosis is a _____ _____
lowered pH
Aging, pulmonary conditions, drugs that suppress respiration like opioids/muscle relaxers, and sleep apnea are conditions that are associated with _________
a. hyperventilation leading to a loss of acidic CO2
b. hypoventilation and accumulation of acidic CO2
B.
Respiratory Alkalosis is a _____ _____
higher pH
Pulmonary conditions, anxiety, hypoxemia disorders (ex. anemia) are all associated with?
a. hypoventilation and accumulation of acidic CO2
b. hyperventilation leading to a loss of acidic CO2
B.
What is often the ONLY sign for hyperventilation?
SOB
Metabolic Acidosis is a _____ _______
lowered pH
What is the MOST common acid base abnormality?
Metabolic Acidosis
Acummulation of acidic H+ ions is most commonly due to what condition and why?
diabetes, has a build up of ketone bodies or acids
What is the condition of this description?
Rapid, deep breaths with a fruity smell, from ketone bodies, trying to get rid of of CO2 acids
Metabolic Acidosis
What condition is usually indicated with these S&S?
Frequent urination (polyuria)
dry mouth
extreme thirst (polydipsia)
decreased skin turgor
blurry vision
weakness/fatigue
Diabetes
Metabolic Alkalosis is a _____ ______
higher pH
Accumulation of bicarbonate base may occur with:
_______ by loss of stomach acids
______ disorders or medications that keep too many bases
excessive ______, _______, or ______ medications
diarrhea
vomiting
kidney
antacid, laxative, diuretic
What acid base condition is associated with these S&S?
Headache
Neuromucular excitability (paresthesia’s/numbness)
Twitching and cramping, particular in feet and hands
seizures
Muscle alterations due to associated lowering of Ca2+ (skeletal weakness, cardiac arrhythmias)
Metabolic Alkalosis
Twitching and cramping particuraly in the feet and hands is known as?
Trousseau sign
With metabolic system S&S, resisted or MMT will result in…
wide spread weakness
With metabolic system S&S, neuro tests will result in…
possible wide spread altered sensations
When high speculation of the metabolic system being involved, you should perform an abdominal assessment on which 3 areas?
liver
pancreas
kidney
PT implications involving the metabolic system:
Adequate ______- likely more than just water (electrolytes)
Ensure efficient _______
Increase _______ foods (fruits and veggies)
_______ referral
hydration
respiration
antioxidant
urgent
What condition is most indicated?
Infection
Are lymph nodes with infection tender or non-tender and why?
tender; rapid onset of inflammation
These S&S in older adults may be associated with what condition?
Mentation changes
Subnormal body temp
Bradycardia (low hear rate) or tachycardia (high heart rate)
Tachypnea (excessive respiration rate)
Fatigue
Lethargy- lack of energy
Decreased appetite
Infection
What condition is most indicated?
Immune
Observation with an immune condition could be…
Persistent _______ and possibly ______ edema
_____ changes
swelling
pitting
skin
This system’s function defends the body against harmful substances, pathogens, and cells or non-self‘’s from internal and external threats?
Immune
What condition is most indicated?
Cancer
What condition is most indicated?
Cardiovascular
The cardiovascular system contains…?
the heart and blood vessels
The _________system is in coordination with the respiratory and nervous system
cardiovascular
This system helps circulate oxygenated blood through the arterial system to cells throughout the body?
Cardiovascular
With the cardiovascular system, _______ blood is carried by the venous system to the lungs for ___________
deoxygenated; deoxygenation
With abnormal cardiovascular S&S, you should follow up with ??
auscultations w/ stethoscope
What are abnormal vital signs w/ cardiovascular system?
HR
BP
RR
What condition is most indicated?
Respiratory
Which system involves the nose, mouth, pharynx, larynx, airways, lungs, and diaphragm?
Respiratory
The ________ system is in coordination with cardiovascular, nervous, and immune systems to facilitate gas exchange
respiratory
Which system provides nutrients and oxygen to tissues and removes carbon dioxide and waste from tissues?
Respiratory
Which system if affected could experience hyperresonance with percussions?
respiratory
Vital signs with an effected respiratory system would be an…?
altered RR
If you were to auscultate a patient with respiratory S&S, what would you hear?
decreased breath sounds and pleural rub
What condition is most indicated?
GI
Which system is involved with the mouth, esophagus, stomach, intestines, to colon and rectum?
GI
With the GI system:
_________- deals with the large intestines, colon, and rectum
Excretion
All major categories of immune cells live where? How much %?
in the gut; 70-80%
The GI system is assisted by the _______ system
Hepatic
With the GI system, the abdominal quadrant should be further assessed with ???
Auscultation
Palpation
Percussion
The CNS contains the: _____ and ____ _____
brain; spinal cord
The PNS contains the: ________ and ________ nervous systems
somatic; autonomic
Which system functions are??
Sensory processing
Involuntary and voluntary responses and actions
Maintaining system homeostasis, particularly with endocrine system
MAJOR controlling, regulatory, and communicating bodily system
Nervous
The ________ system meets the nervous system at the hypothalamus- which is called the…?
endocrine; pituitary interface
The __________ is the MAIN integrative center of endocrine and autonomic nervous system functions by hormonal and neural pathways
hypothalamus
Is this UMN or LMN content?
Cranial nerves
Anterior gray column of spinal cord
Cauda equina
Spinal nerves to terminal nerve branches
LMN
Is this UMN or LMN content?
Above anterior horn of spinal cord
Brain and MOST of spinal cord
UMN
LMN or UMN?
Muscle tone is decreased or flaccid
LMN
LMN or UMN?
Muscle tone is Increased or Spastic- velocity dependent resistance to lengthening; co-contractions; synkinesis- UE flexion causes LE flexion
UMN
LMN or UMN?
Bowel and bladder have incontience or leakage
LMN
LMN or UMN?
Bowel and bladder is spastic/retentive
UMN
LMN or UMN?
Dermatomes/Paresthesia’s are often a single segment/area diminished to lt. and/or sharp touch; rarely multi-segmental
LMN
LMN or UMN?
Dermatomes/Paresthesia’s are Multi-segmental and diminished to light/sharp touch plus to vibration, temperature, and/or 2 pt. discrimination into face, extremities, and/or trunk depending on spinal level and severity
UMN
LMN or UMN?
DTR’s are often a single segment of hypoactivity
LMN
LMN or UMN?
DTR’s are often multiple segmental hyperactivity
UMN
LMN or UMN?
Myotomes; possible sexual dysfunction is often a single segment of fatiguing weakness; rarely multi-segmental
LMN
LMN or UMN?
Myotomes; possible sexual dysfunction
Multi-segmental weakness/incoordination/paralysis of face, extremities and/or trunk depending on spinal level and severity
UMN
LMN or UMN is associated with radiculopathy?
LMN
Remember this
Light strokes applied in each abdominal quadrant around the umbilicus:
_____= umbilicus moves in direction of the stroke
______= decreased or lack of umbilical movement
WNL; hypoactive
These S&S are associated with what system or condition?
N&V
Dizziness
Visual or auditory dysfunction
Worst HA ever may be impending stroke
Neurological
With the GI system:
_______ and ________ deal with the stomach and small intestines
digestion; absorption
Polyuria means what?
urinating more than usual
