Clin Med II Systems Review Flashcards by Siva Pye

What is the purpose of a systems review?

identify suspicious non-MSK or RED flag S&S that require referral to another healthcare professional

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The systems review is NOT a dx of a non-MSK condition

True/False

TRUE

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Few RED flag S&S in isolation are _______, we should look for _________

informative; combinations

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There is a consensus on which RED flags are most useful

True/False

False; there is NO consensus

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Systems are determined from the _____ and ______

hx; observation

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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

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The kidneys, ureters, bladder, and urethra are located in what system?

Urinary

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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

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Which system would be involved if a patient has P! in the trunk, flank, and or pelvic regions?

Urinary

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What are the 4 urinary changes involved with the urinary system?

frequency
duration
bleeding
pus

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What are the 3 dysfunctions involved with urinary system S&S?

flow
initation
control

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______ means: awake to urinate

Nocturia

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Urinary System

What’s a common symptom a patient may notice with their urine?

discoloration

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With the urinary system, you learn the most from the patient’s what?

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A patient with issues involving the urinary system may experience P! with what follow up tests?

kidney percussion

palpation/ percussion of system organs

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This system is responsible for producing sex cells (eggs/sperm), creating sex hormones, and maintaining fertilized eggs for development?

Reproductive

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The reproductive system and what other system work together involving hormones?

Endocrine

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A patient with reproductive S&S could have P! in what areas of the body?

Pelvis, LB, abdominal regions and or sexual organs

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What dysfunctions could be involved with reproductive S&S?

sexual
bowel/bladder (due to proximity)

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What are some abnormal S&S involved with the reproductive system?

discharge from sex organs

menstruation

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These symptoms are indications of what in women?

Polyuria
Breast Tenderness
Fatigue
N&V
Heartburn
Constipation
Abnormal discharge

Unknown pregnancy symptoms

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Which system is involved with the gut, liver, adipose tissue, pancreas, kidney, and muscle?

Metabolic

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Which system converts food and liquids into energy, building blocks for proteins, fats, and carbohydrates, and eliminates waste?

Metabolic

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Fluid and electrolyte balance is KEY for _________ metabolism

cellular

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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

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 ___

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?

1. Respiratory Acidosis 2. Respiratory Alkalosis 3. Metabolic Acidosis 4. 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

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

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?

Which system is involved with the mouth, esophagus, stomach, intestines, to colon and rectum?

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