Exam 1 Flashcards
Describe the technique/response to test for alertness (level of consciousness/arousal).
Speak to patient in normal tone of voice Response: opens eyes, looks at you, responds fully and appropriately
Describe the technique/response to test for lethargy (level of consciousness/arousal).
Speak to the patient in a loud voice Response: appears drowsy but opens eyes, looks at you, responds, falls asleep
Describe the technique/response to test for obtundation (level of consciousness/arousal).
Shake the patient gently as if awakening a sleeper Response: opens eyes, looks at you, responds slowly, is confused, alertness is decreased
Describe the technique/response to test for stupor (level of consciousness/arousal).
Apply a painful stimulus Response: arouses from sleep only after painful stimulus; verbal responses are slow/absent, minimal awareness of self/environment
Describe the technique/response to test for coma (level of consciousness/arousal).
Apply repeated painful stimuli Response: remains unarousable with eyes closed
What are the 12 major aspects of general appearance?
- General state of health 2. Level of comfort 3. Respiratory effort 4. Development stage 5. Height/weight 6. Posture, motor activity, gait 7. Deformities or distinguishing characteristics 8. Characteristic facies 9. Dress, grooming, personal hygiene 10. Odors 11. Level of awareness/consciousnes 12. Skin color/hair distribution
What are some descriptors of general state of health?
Frail, chronically ill, robust, vigorous
What are some indicators of level of comfort?
Wincing/grimacing, crying, doubled over in pain, clutching chest, hand around neck, resting comfortably in bed
What is an important physical cue for emphysema?
Tripod position/leaning forward
What are some indicators of abnormal respiration?
Gasping for breath, labored breathing, coughing, unable to speak in sentences, use of accessory muscles of respiration (SCM, trapezius, scalenus), audible wheezing/stridor
What is the Dahl sign?
Clinical sign in which areas of darkened and thickened skin are seen on the lower thighs and elbows
What are two potential causes of unusual shortness?
- Turner syndrome 2. Achondroplasia
What are two potential causes of unusual tallness?
- Marfan syndrome 2. Gigantism/acromegaly
What are some physical signs of Turner’s syndrome?
Short stature, webbed neck, increased carrying angle, swelling of feet
What are some physical signs of Marfan syndrome?
Tall, thin, disproportionate, chest deformity, thumbs stick out past the side of the hand when making a fist, can wrap hand around wrist and cross finger and thumb
What are the BMI ranges of underweight, overweight, obese, and morbidly obese?
Underweight: less than 18 Overweight: 25-29 Obese: 30-39 Morbidly obese: 40+
What is a weight-related sign of Cushing’s?
Buffalo hump, central obesity with thin limbs
What are some aspects to look for in posture/motor activity?
- Kyphosis 2. Scoliosis 3. Need arms to get out of a chair 4. Ambulation aids 5. Anxious/fidgeting 6. Sitting up (left sided heart failure) 7. Leaning forward sitting up (COPD)
What is a noticeable gait in Parkinson disease?
Shuffling
What is hemiplegic gait?
Circumduction of the paralyzed limb with the ball of the great toe touching the ground as it sweeps around; upper limb is flexed and internally rotated
What does stamping gait occur in?
Tabes dorsalis (proprioception loss)
What is scissor gait and when does it occur?
One leg crosses in front of the other as the patient walks; spastic paraplegia (cerebral palsy)
What are some possible deformities or distinguishing characteristics?
- Amputees 2. Scars 3. Piercings/tattoos
What is moon face associated with?
Cushing’s
What is prognathism associated with?
Acromegaly
What is a stare associated with?
Thyrotoxicosis
What are myxedema, loss of lateral 1/3 of eyebrows, puffy face, dry/dough skin, and brittle hair associated with?
Severe hypothyroidism
What are masked faced, hunched posture, resting tremor, no arm swing with walking, and minimal blinking associated with?
Parkinson
What is a butterfly rash associated with?
Lupus
What are some physical signs of Down syndrome?
Epicanthal folds, increased space between 2 digits of feet, shorter 5th finger, crease across palm, small ears
What might untied shoes indicate?
Edema