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health assessments and diagnostics > COMPREHENSIVE > Flashcards

COMPREHENSIVE Flashcards

1
Q

what are we looking for when palpating the nose?

A

tenderness, access patency

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2
Q

mixed hearing loss

A

combination of conductive and sensorineural types in same ear

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3
Q

Sensorineural hearing loss signifies pathology of cranial nerve ___

A

8

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4
Q

gradual nerve degeneration resulting in hearing loss

A

presbycusis

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5
Q

conductive hearing loss

A

involves mechanical dysfunction of external or middle ear

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6
Q

What can cause conductive hearing loss?

A

cerumen, foreign bodies, perforated TM, pus, serum, otosclerosis (decrease in mobility of ossicles)

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7
Q

Rinne test expected finding

A

AC greater than BC

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8
Q

Weber test

A

patient can hear tuning fork on both sides of head

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9
Q

What do we inspect the tympanic membrane for?

A

landmarks, color, contour, translucence

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10
Q

What can cause the red reflex to be absent?

A

cataracts

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11
Q

adaptation of eye for near vision

A

accommodation

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12
Q

Although the lens cannot be observed directly, the following
components of accommodation
can be observed

A

convergence, puillary constriction

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13
Q

fixation

A

a reflex direction of eye toward an object attracting person’s attention

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14
Q

When we fixate on an image, it is fixed in the center of the visual field, the ______

A

fovea centralis

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15
Q

pupillary light reflex

A

ormal constriction of
pupils when bright light shines on retina
 Subcortical reflex arc, person has no
conscious control over it

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16
Q

why do our pupils have a consensual response?

A

Because the optic nerve carries the
sensory afferent message in and
then synapses with both sides of the brain

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17
Q

how to perform Corneal light reflex (AKA hirschberg test)

A

Assess parallel alignment of eye
axes by shining a light toward
person’s eyes
 Direct person to stare straight
ahead as you hold the light about
30 cm (12 inches) away
 Note reflection of light on
corneas; should be in exactly
same spot on each eye

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18
Q

What do we inspect ocular structures for?

A

corneal light reflex, sclera (color, surface characteristics), iris for shape and color, pupils for PERRLA

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19
Q

what do we inspect for on the conjunctiva?

A

color, moisture, drainage, lesions

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20
Q

Normal Jaeger card result

A

14/14

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21
Q

How to use a jaeger card

A

hold card in good light about 35 cm (14 in) from eye. his
distance equals print size on 20-
foot chart
 Test each eye separately, with
glasses on

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22
Q

What is the most commonly used and accurate measure of visual acuity?

A

snellen chart

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23
Q

How to use snellen chart

A

place in a well-lit spot at eye level. position person 20 feet away. hand them an opaque card to shield one eye at a time. they can wear normal glasses but not readers.

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24
Q

what is the most common type of endocrine malignancy?

A

thyroid cancer

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25
Q

Thyroid cancer clinical findings?

A

frequently does not cause symptoms. first idscovered as a small nodule on thyroid

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26
Q

candidiasis (thrush)

A

oral infection caused by candida albicans in those chronically
debilitated or
immunosuppressed, or as a
result of antibiotic therapy.

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27
Q

Epistaxis

A

bleeding from nose

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28
Q

inflammation of middle ear space, resulting in accumulation of serous fluid in middle ear

A

otitis media with effusion

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29
Q

Common symptoms of OME

A

clogged sensation in ears, problems with hearing and balance

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30
Q

early stage of acute otitis media

A

tympanic
membrane (TM) appears inflamed,
red, and may be bulging and
immobile.

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31
Q

later stages of otitis media

A

may reveal
discoloration (white or yellow
drainage) and opacification to the
TM

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32
Q

Purulent drainage from the ear
canal with a sudden relief of pain
suggests

A

perforation

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33
Q

foreign body in the ear is mostly seen in

A

children

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34
Q

Cataract

A

opacity of crystalline
lens from denaturation of lens
protein caused by aging and may
be congenital or caused by
trauma

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35
Q

clinical findings with cataracts

A

cloudy or blurred vision, poor night vision, absent red reflex, cloudy lens observed on inspection

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36
Q

corneal abrasion clinical findings

A

intense pain, foreign body sensastion, reports photophobia, tearing and redness observed

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37
Q

inflammation of conjuncgtiva caused by local infection of bacteria or virus, or by allergic reaction, systemic infection or chemical irritation

A

conjunctivitis

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38
Q

a patient comes in with red eyes that are oozing sticky goo especially in the mornings. what might be going on?

A

conjunctivitis “pink eye”

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39
Q

common name for hordeolum

A

sty

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40
Q

Why do we get stys?

A

they are caused by an acute staph infection of the eye.

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41
Q

Chalazion

A

nodule of meibomian gland in the eyelid. may be tender if infected.

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42
Q

What age group most commonly gets tension headaches?

A

20 to 40 years old

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43
Q

What type of headache is usually bilateral, with gradual onset, and may be accompanied by contraction of the neck muscles as well as the muscles of mastication?

A

tension headaches

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44
Q

Which is the most painful of primary headaches?

A

cluster headache

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45
Q

cluster headache clinical findings

A

intense epidsodes of excruciating unilateral pain. lasts 30 mins to 1 hour and may repeat daily, sometimes for years.

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46
Q

Age group who most commonly gets cluster headaches?

A

adolescence to middle age

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47
Q

True or false? recurrent headaches are a symptom of primary headache disorder

A

true

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48
Q

Starts with aura from vasospasm
of intracranial arteries; throbbing
unilateral distribution of pain

A

migraine

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49
Q

second most
common headache syndrome in the
United States

A

migraine

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50
Q

Most common medical complaint.

A

headache

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51
Q

describe dry cerumen

A

gray, flaky, and frequently forms thin
mass in ear canal

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52
Q

describe wet cerumen

A

honey brown to dark brown and
moist

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53
Q

take caution to avoid mistaking flaky, dry cerumen for

A

eczematous lesions

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54
Q

True or false? salivation starts at one week and the baby will immediately know how to swallow saliva.

A

false. 3 months, takes a few months before swallowing and they will drool for a while

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55
Q

When do teeth begin developing?

A

in utero

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56
Q

When do decidous teeth emerge?

A

between 6 months and 24 months. all 20 should emerge by age 2.5

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57
Q

how many decidous teeth do we have?

A

20

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58
Q

Deciduous teeth are lost beginning at age 6 through 12 and are replaced with permanent teeth. Which permanent teeth emerge first?

A

central incisors

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59
Q

When does the nose start and stop growing?

A

starts at 12 or 13, stops at 16 in females and 18 in males

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60
Q

tiny oval clumps of lymphatic tissue, usually located in groups along blood vessels

A

lymph nodes

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61
Q

True or false? lymph nodes are found in chains or clusters

A

true

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62
Q

Name all of the lymph nodes of the HEENT

A

preauricular, parotid, facial, submandibular, submental, sublingual, anterior superficial cervical, posterior auricular, occipital, sternomastoid, retropharyngeal (tonsilar), posterior superficial cervical chain

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63
Q

What is the largest endocrine gland?

A

thyroid

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64
Q

where is the thryoid accessible for examination?

A

either side of the trachea

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65
Q

Where is the larynx?

A

below the pharynx, above the trachea

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66
Q

structures within the neck include

A

cervical spine, sternocleidiomastoid muscle, hyoid bone, larynx, trachea, esophagus, thyroid glands, lymph nodes, carotid arteries, jugular veins

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67
Q

components of oropharynx

A

uvula, tonsils, posterior pharyngeal wall, epiglottis

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68
Q

Cartilagenous structure protecting laryngeal opening

A

epiglottis

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69
Q

Three turbinates lining the lateral walls of the nasal cavity

A

inferior meatus, middle meatus, superior meatus

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70
Q

drains nasolacrimal duct

A

inferior meatus

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71
Q

drains frontal, maxillary, and ethmoid sinuses

A

middle meatus

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72
Q

drains posterior ethmoid sinus

A

superior meatus

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73
Q

face comprises _____ bones

A

14

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74
Q

cranial nerves innervating the face

A

V (trigeminal), V11 (facial)

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75
Q

palpebral fissure

A

opening between eyelids

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76
Q

2 thin transparent mucous membranes between eyelids and eyeball

A

conjunctivae

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77
Q

meibomian gland

A

secretes
substance to lubricate lids,
slows evaporation of tears,
provides airtight seal when
lids closed

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78
Q

Lacrimal glands

A

form tears
that combine with
sebaceous secretions to
maintain constant film over
cornea

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79
Q

3 layers of eyeball

A

sclera (outer)
uvea (middle)
retina (inner)

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80
Q

tough, fibrous, outer layer/ white of eye

A

sclera

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81
Q

cornea

A

covers iris and pupil. is transparent, avascular, and richly innervated with sensory nerves

82
Q

Cornea allows light transmission through lens to ________

A

retina

83
Q

tears provide cornea with oxygen and protect the surface from ____

A

drying

84
Q

explain the mechanism of the corneal reflex

A

CN5 will carry afferent sensation to brain, and CN7 carries efferent message that stimulates blink

85
Q

What does the uvea consist of?

A

choroid layer (posteriorly), iris (anteriorly), pupil (central opening of iris, allows light transmission to retina), ciliary body, anteriorly

86
Q

Transparent layer of eye with photoreceptor cells, rods and cones, unevenly distributed over its surface

A

retina (inner)

87
Q

occurs when rods and cones respond to various stimuli

A

vision

88
Q

lenses constantly adjust to stimuli at different distances by ______

A

accommodation

89
Q

CN2

A

optic nerve

90
Q

CN3

A

oculomotor nerve

91
Q

How many exrinsic eye muscles do we have and what are they?

A
  1. 4 rectus, 2 oblique
92
Q

conjugate movement

A

when two eyes move, their axes always remain parallel

93
Q

Why are parallel axes important?

A

the brain has a binocular, single-image, visual system.

94
Q

3 cranial nerves repsonsible for eye movement

A

6 (abducens), 4 (trochelar), 3 (oculomotor)

95
Q

3 main functions of auricle

A

collection, location, protection

96
Q

opens briefly during yawning , swallowing, or sneezing to equalize pressure of middle ear to the atmosphere

A

eustachian

97
Q

function of middle ear

A

amplification of sound

98
Q

3 middle ear ossicles

A

malleus, incus, stapes

99
Q

3 main inner ear structures

A

cochlea, vestibule, semicircular canals

100
Q

where are the inner ear receptors for balance found?

A

vestibule, semicircular canals

101
Q

pathway of hearing

A

middle ear ossicles- oval window- through cochlea- vibration - organ of corti- auditory portion of cn 8, brain stem

102
Q

Where are the maxillary sinuses?

A

on either side of cheekbones

103
Q

Where is the sphenoid sinus?

A

deep in skull, behind ethmoid

104
Q

where is the ethmoid sinus?

A

near supeiror portion of nasal cavity

105
Q

Where is frontal sinus?

A

frontal bone above nasal cavities

106
Q

Can the red reflex still be considered present if it is yellow or orange?

A

yes. think about what was seen on digital cameras

107
Q

what can we do to rule out inflammation before inserting the otoscope?

A

tug test on outside of ear. (pull down on kids up on adults)

108
Q

What should the tympanic membrane look like?

A

pearly grey, shiny, translucent, with no bulging or retraction. 2) Consistency - smooth.

109
Q

how does blood leave the brain?

A

venous sinuses that dump into the jugular

110
Q

CN1

A

olfactory

111
Q

CN2

A

optic

112
Q

CN3

A

oculomotor

113
Q

CN4

A

trochlear (superior oblique)

114
Q

CN5

A

trigeminal (innervates face)

115
Q

CN6 (abducens)

A

controls lateral rectus

116
Q

CN7

A

facial movement, expression

117
Q

CN8

A

vestibulocochlear

118
Q

CN9

A

glossopharyngeal (sensory, motor, parasympathetic)

119
Q

CN10

A

vagus nerve

120
Q

CN11

A

accessory nerve (sternocleidomastoid)

121
Q

CN12

A

hypoglossal (tongue efferent nerve)

122
Q

neuro problem based history

A

headaches, diziness, seizures, LOC, movement changes, sensation changes, dysphasia, aphasia— head trauma, drug use– genetic conditions– vertigo–loss of ADL skills – disorientation

123
Q

3 types of memory

A

immediate recall, recent memory, remote memory

124
Q

Guillain-Barre syndrome

A

widespread demyelination of nerves of PNS. believed to be caused by cell-mediated autoimmune response to viral infection.

125
Q

Guillain barre prognosis

A

80-90% of patients make basically a full recovery but they die if the respiratory depression develops rapidly. (paralysis of thorax)

126
Q

in someone with an active case of guillan barre syndrome, deep tendon reflexes will be

A

absent

127
Q

warning sign of guillain barre

A

respiratory or gastrointestinal infection weeks before onset

128
Q

True or false? guillain barre has both an ascending and descending variation

A

true

129
Q

acute unilateral paralysis of facial nerve

A

bell’s palsy

130
Q

bell’s palsy prognosis

A

80% of patients recover fully in weeks.months

131
Q

Bell’s palsy clinical findngs

A

history of pain behind ear or face few hours and days before paralysis. eye on affected side does not close. forehead does not wrinkle.

132
Q

3 stages of Alzheimer’s and how long they last

A

early stage : 2-4 years. patient’s memory begins to fail.

second stage 2-12 years
patient loses ADL skills, language skills, becomes disoriented, confused

final stage : patient requires total care and cannot communicate

133
Q

incurable, degenerative neurologic disorder beginning with decline in memory

A

alzheimer’s

134
Q

What is a CVA

A

cerebrovascular accident

135
Q

neurodegenerative disease that develops slowly due to degeneration of the substantia negra. second most prevalent to alzheimer’s

A

parkinson’s

136
Q

craniocerebral injury clinical findings

A

LOC can be for a few minutes to several week.s depends on severity of trauma and areas to the brain. may have residual deficits in memory, congnition and motor sensory abilities

137
Q

Encephalitis

A

inflammation of brain tissue and meninges

138
Q

encephalitis clinical findings

A

headache, lethargy, irritability, nasuea, fever, nuchal rigidity, vomiting, decreased LOC< motor weakness, tremors, seizures, positive babinski sign

139
Q

nuchal rigidity

A

inability to extend or turn neck

140
Q

hyperesthesisa

A

more than normal sensation

141
Q

Fine motor tests- upper extremities

A

finger to nose, alternating supination and pronation of hands on knees, finger to nose and nurse’s finger, finger to finger, finger to thumb

142
Q

fine motor tests - lower extremities

A

heel down opposite shin, toe/ball of foot to nurse’s finger

143
Q

Gross and Motor Balance Tests

A

walking gait, romberg test, standing on one foot with eyes closed (5 sec), heel-to-toe walking

144
Q

What are proprioceptors and where are they?

A

muscles, tendons, joints, inner ear, give information about position and movement of the body

145
Q

Test CN11

A

have patient shrug shoulders and turn head to side against hands

146
Q

Test CN12

A

have patient perform controlled movement with tongue including pushing it against a gloved finger

147
Q

Test CN3

A

IGNORECARD

148
Q

Test CN 7,9

A

test tongue for taste. not done unless problem is reported

149
Q

Test Cn 9, 10

A

inspect for gag reflex

150
Q

how to use Glascow coma scale

A

goes from 1-15. 7 or less = comatose client

151
Q

The glascow coma scale tests 3 major areas

A

eye response, verbal response, motor response

152
Q

The glascow coma scale was originally developed to __________ and is also used to _______

A

predict recovery from a head injury, also used to assess LOC

153
Q

orientation to person, time and place

A

oriented x3

154
Q

Glascow motor response scores

A

1- no response
2- extends abnormally
3-flexes abnormally
4- flexes and withdraws
5- to localized pain
6- to verbal command

155
Q

Glascow verbal response scores

A

1- no response
2- makes incomprehensible sounds
3- uses inappropriate words
4- disoriented, converses
5- oriented, converses

156
Q

Glascow eye opening scores

A

1- no response
2-to pain
3- to verbal command
4- spontaneous

157
Q

sympathetic vs parasympathetic nervous system

A

parasympathetic : stop it
sympathetic : run now you’re in danger

158
Q

Scoliosis

A

s- shaped deformity of vertebrae. usually lateral curvature. can cause unequal leg strength

159
Q

occurs when fibrocartilage surrounding an intervertebral disk ruptures and nucleus pulposus is displaced and compresses adjacent spinal nerves

A

herniated disk/slipped disk/ herniated nucelus pulposus

160
Q

hereditary disorder with increase in
serum uric acid due to increased production, or
decreased excretion of uric acid and urate salts

A

gout

161
Q

gout is thought to be caused by

A

ack of an enzyme
needed to completely metabolize purines for
renal excretion

162
Q

bursitis clinical findings

A

pain, limited motion, edema, point tenderness, erythema of affected joint

163
Q

degenerative change in articular cartilage

A

osteoarthritis

164
Q

osteoarthritis clinical findings

A

joint edema and ache, heberden’s nodes in distal interphalangeal joints, bouchard’s nodes in peripheral interphalangeal joints.

165
Q

RA rheumatoid arthritis

A

chronic, autoimmune inflammatory disease of connective tissue.

166
Q

RA clinical findings

A

joint involvement bilateral. pain, edema, stiffness, low-grade fever and fatigue, ulnar deviation, swan-neck deformity, boutonniere deformity

167
Q

loss of bone density and decreased bone strength

A

osteoporosis

168
Q

osteoporosis s/s

A

loss of height, spontaneous fracture from brittle bones, develop kyphosis

169
Q

True or false? because there is often no “normal” for the musculoskeletal system, normality is established best by comparing sides.

A

true!

170
Q

acetablulum and femur form

A

hip joint

171
Q

movements permitted by ball and socket joint

A

flexion, extension, hyperextension, abduction, adduction, internal and external rotation, circumduction

172
Q

how many cranial bones?

A

6

173
Q

Where does the neck have the most mobility?

A

C4-5, C5-6

174
Q

long bones act as _____ and have a flat surface for ________ with grooves at end for tendon or nerve

A

levers, attachment of muscles

175
Q

2 major divisions of human skeleton

A

axial, appendicular

176
Q

articulation where two or more bones come together

A

joint

177
Q

Joint Classes

A

hinge, pivot, condyloid, ball-and-socket, gliding

178
Q

ligament vs tendon

A

ligaments attach bones, tendons attach muscles to bones

179
Q

semi-smooth, gel-like supporting tissue. strong and able to support weight

A

cartilage

180
Q

small sacs in connective tissues that act to reduce friction when muscles or tendons rub against other muscles, tendons, or bones

A

bursae

181
Q

point of articulation between femur, tibia, patella

A

hinge joint

182
Q

What kind of joint is the ankle?

A

hinge

183
Q

excessive inward curvature of the spine

A

lordosis

184
Q

kyphosis

A

exaggerated, forward rounding of the upper back

185
Q

True or false? the esophagus lies outside the abdominal cavity.

A

true

186
Q

2 layers of peritoneum (abdominal lining)

A

parietal, visceral

187
Q

fluid filled space that reduces friction between organs and membranes, between parietal and visceral layers

A

peritoneal cavity

188
Q

strong membrane covering entire ventral surface of abdomen. lies superficial to rectus abdominus.

A

external oblique aponeurosis

189
Q

linea alba

A

tendinous band protecting midline of rectus abdominis muscles from xiphoid process to symphysis pubis

190
Q

What forms the inferior and superior borders of the abdomen?

A

inferior : superior aperture of lesser pelvis

superior : diaphragm

191
Q

Alimentary tract extends from mouth to anus. how many feet/ meters is this?

A

27 feet, 8.2 meters

192
Q

Which aspect of the nervous system controls peristalsis?

A

autonomic

193
Q

How long is the esophagus? What is its typical pH?

A

10 inches, 6-8

194
Q

Where is the stomach?

A

directly below the diaphragm in the LUQ

195
Q

pepsin

A

breaks down proteins to peptones and amino acids

196
Q

small intestine segments

A

duodenum, jejunum, ileocecal valve (between ileum and large intestine),

197
Q

length of small intestine segments

A

duodenum (1 foot/30cm)
jejunum (8 ft)
ileum

198
Q

large intestine segments

A

cecum, appendix, colon, rectum, anal canal

199
Q

Besides skin, what is the largest organ?

A

liver

200
Q

Where is the liver?

A

under right diaphragm, from 5th intercostal space to below costal margin

health assessments and diagnostics (12 decks)

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