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OS 600 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What are the CNs that innervate the various muscles of the eye?

A

3, 4, 6 (SO4 LR6 R3)

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2
Q

Which CN causes mydriasis (dilation) and miosis (constriction)?

A

3

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3
Q

How will the eye respond if CN3 is damaged?

A

It will go down and out

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4
Q

If a patient has a left afferent papillary defect and you shine a light into the right eye, how will the eyes respond? how about the left eye?

A

Right eye: both eyes will constrict

Left eye: neither eye will react

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5
Q

What causes an efferent papillary defect to occur?

A

Trauma causing the impulse from brain to eye via CN3 to be damaged

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6
Q

If the patient’s left eye is affected in an efferent papillary defect, how will it react when hit with light? how about if the right (good eye) is hit with light?

A

Both will cause the good eye to constrict and the bad eye to no react

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7
Q

Which parts of the eye measure sharpness and is where the light focuses?

A

Macula and fovea

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8
Q

Pt has hypertension and you notice decreased sharpness w/in the eye around the borders upon ophthalmoscopic exam…what do you expect her to have?

A

Papilledema

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9
Q

If a patient wakes up and they cannot see at all, what pathology can you expect from an ophthalmoscopic standpoint?

A

Hyphema - blood in the anterior chamber of the eye that has pooled b/c the patient was laying down

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10
Q

What is the syndrome called when you lose sympathetics to the eye?

A

Horner’s syndrome

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11
Q

What innervates Mueller’s muscle?

A

Sympathetics

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12
Q

What are the triad of symptoms involved with loss of innervation to Mueller’s muscle?

A

Ptosis of eye, Anhydrosis, Miosis

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13
Q

If a patient is experiencing bitemporal hemianopsia (tunnel vision) what happened?

A

Their optic chiasm was cut

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14
Q

If a patient is experiencing homonymous hemianopsia (cut left, right is blocked out and vice versa), what happened?

A

Their optic tract was cut

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15
Q

If a patient is experiencing ipsilateral eye blindness?

A

Their optic nerve was cut (cut left, lose left and vice versa)

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16
Q

What is it called when a patient has increased intraocular pressure?

A

Glaucoma

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17
Q

What is it called when the lens of the eye is clouded?

A

Cataract

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18
Q

What is it called when an eye can accommodate, but not respond with direct light?

A

Argyll Robertson Pupil - like a hooker - often seen in syphillis

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19
Q

What is it called when a patient’s pupils are not equal in size?

A

Anisocoria

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20
Q

What type of pupils are found in a comatosed or brain dead patient?

A

Dilated fixed pupils

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21
Q

What type of pupils are common in patients with narcotic issues?

A

constricted fixed pupils

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22
Q

If a patient has conductive hearing loss, what will the result of a Rinne test be?

A

BC > AC

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23
Q

If a patient has senseroneurial hearing loss, what will the result of a Rinne test be?

A

AC > BC

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24
Q

What does the Weber test test?

A

Lateralization

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25
Q

What type of hearing loss is present if the Weber test lateralizes to the bad ear?

A

Conductive hearing loss

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26
Q

What type of hearing loss is present if the Weber test lateralizes to the good ear?

A

Senseroneurial hearing loss

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27
Q

Why would a patient sneeze when placing an otoscope into their ear?

A

It can stimulate the vegas nerve

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28
Q

When examining a nasal cavity what does a unilaterally enlarged turbinate indicate?

A

A chronic septal deviation - otherwise, it is acute

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29
Q

If a patient experiences a subcondylar fracture, which direction will the jaw deviate toward?

A

The affected side

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30
Q

What is the order of evaluation for the thorax or heart?

A

Inspection, palpation, percussion, auscultation

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31
Q

Which organs are you concerned about in a patient with funnel chest? Why are you concerned about them?

A

Heart and lungs - they are being compressed due to the compression in the center of the anterior thorax

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32
Q

When the thorax is deviated, what is the condition called?

A

Kyphosis

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33
Q

Does it take longer to expire or inspire air?

A

Expire (about 2x longer)

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34
Q

When a patient is experiencing hyperpnea or hyperventilation, how would you treat the patient?

A

Put them into a rebreather (i.e. a paper bag) so they can restore their CO2 levels

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35
Q

When can Cushing’s triad been seen in a patient?

A

When a patient has intracranial pressure

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36
Q

What are the three things involved with Cushing’s triad?

A

Hypertension, Bradypnea, Bradycardia

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37
Q

When you notice a patient undergoing a period of faster and deeper breathing followed by a period of apnea (no breathing), what is it called?

A

Cheyne-Stokes breathing

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38
Q

What is the most common cause of right side heart failure?

A

Left side heart failure

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39
Q

What are the two things that keep fluid within a blood vessel?

A

Oncotic pressure (pressure that allows fluid to enter a capillary) and Hydrostatic pressure (pressure that pushes fluid out of a capillary)

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40
Q

What does it mean when oncotic pressure > hydrostatic pressure?

A

fluid enters a capillary

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41
Q

When you notice a patient experiencing egophony, bronchophony, and/or whispered pectoriloquy, what disease would they have?

A

Pneumonia - and more specifically, pulmonary consolidation

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42
Q

What is egophony?

A

When ‘ay’ changes to ‘ee’ when using a stethoscope

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43
Q

What is bronchophony?

A

Through a stethoscope: when a patient speaks, and it sounds like an echo

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44
Q

What is Whispered pectoriloquy?

A

When a patient whispers, it sounds loud

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45
Q

if you hit on a patient’s chest that has bronchitis, what kind of sound will you hear?

A

A dull sound

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46
Q

What does it sounds like when you hit on a patient’s chest that has emphysema? why?

A

it would sound like a drum; b/c in emphysema, air gets trapped, causing the interalveoli septi to be destroyed and the sound to be hyperresonant

47
Q

What is a tension pneumothorax?

A

A collapsed lung that occurs due to a puncture - a pressure buildup would occur, causing things within the lungs to be pushed around - causes a decrease of blood flow to the heart

48
Q

Which direction would the trachea deviate if a patient has a pneumothorax?

A

away from the affected lung

49
Q

How do the heart valves react in systole?

A

Aortic & Pulmonic: open

Mitral & Tricuspid: closed

50
Q

How do the heart valves react in diastole?

A

Aortic and Pulmonic: closed

Mitral & Tricuspid: open

51
Q

Systolic or diastolic: Mitral valve prolapse (regurgitation)

A

Systolic

52
Q

Systolic or diastolic: Aortic valve regurgitation

A

Diastolic

53
Q

Systolic or diastolic: Pulmonic valve stenosis

A

Systolic

54
Q

Systolic or diastolic: Tricuspid valve stenosis

A

Diastolic

55
Q

When could you expect to hear a mid-systolic click?

A

During mitral/tricuspid valve regurgitation upon opening of the valve

56
Q

During pulsus alterans, which type of pulse can you expect to see?

A

a weak pulse followed by a strong pulse

57
Q

What is pulsus paradoxis?

A

During inspiration, BP decreases due to decreased interthroacic pressure and therefore, decreased venous return to the heart

58
Q

When is pulsus paradoxis seen in a patient?

A

during cardiac tamponade and COPD

59
Q

Where is the point of max impulse typically located?

A

5th intercostal space, just left of the sternum

60
Q

During CHF, the heart enlarges, what then happens to the point of max impulse?

A

it moves inferior and to the left

61
Q

if you are going to only check one area when checking the heart, where would you check?

A

Erb’s space - heart murmurs are referred here

62
Q

Where is Erb’s space?

A

left 3rd IC space

63
Q

What is S1?

A

“Lub” - the sound from the mitral and tricuspid valves closing

64
Q

What is S2?

A

“Dub” - the sound from the aortic and pulmonic valves closing

65
Q

What is an example of a heart defect where fixed splitting of S2 is evident?

A

Atrial septal defect (ASD)

66
Q

What is a murmur?

A

The sound of turbulent blood flow

67
Q

Which type of murmur exhibits a crescendo-decrescendo shape of intensity?

A

a systolic (book says mid-systolic) murmur

68
Q

What can cause a pansystolic (holosystolic) murmur?

A

Mitral/tricuspid regurgitation or Ventricular septal defect

69
Q

What is clotication a sign of?

A

Peripheral Vascular Disease - which is then indicative of CVD

70
Q

Which sounds are present during systole and diastole?

A

Pericardial friction rub, Patent ductus arteriosus, Venoous hum

71
Q

What is an organic murmur?

A

a pathologic condition

72
Q

what is a functional murmur?

A

there is an alteration in anatomy, but the alteration is not pathological

73
Q

What is an innocent murmur?

A

no alteration in anatomy, and no pathology are present - this murmur is a sound due to high cardiac output through normal anatomy

74
Q

What is the order of evaluation within the abdomen?

A

1) Inspection
2) Auscultation
3) Palpation
4) Percussion

75
Q

What is the term for high pitched bowel sounds that are often indicative of impending bowel obstruction?

A

Bor Borygmus - rebound tenderness - press down and when it hurts when you let go, that indicates peritonitis

76
Q

What is Murphy’s sign? and what does a positive test indicate?

A

palpation of the RUQ causes inspiratory arrest - causes Acute cholecystitis

77
Q

What is Kehr’s sign? and what does the sign indicate?

A

pain in the left shoulder - indicates a splenic fracture

78
Q

Which organs are included in the retroperitoneum?

A
  • Pancreas
  • Duodenum
  • Kidney
  • Ureter
79
Q

What is Gray-Turner sign? and what does it indicate?

A

bruising in the flanks - indicates a retroperitoneal bleed

80
Q

What is Cullen’s sign? and what does it indicate?

A

superficial bruising of umbilicus - indicates pancreatitis

- patient may experience pain burrowing from back to front

81
Q

What is Rousing sign? and what does it indicate?

A

pain occurs in LRQ from pushing on LLQ - indicates appendicitis

82
Q

What is Psoas sign? and what does it indicate?

A

patient lays flat, you raise their leg (or if the patient is standing, then you swing the patient’s leg behind them) - if abdomen pain forms, it is indicative of appendicitis

83
Q

what resembles left side appendicitis?

A

Diverticulitis - patient feels pain in LLQ

84
Q

What is it called when the ab muscles separate into two distinct ridges upon contraction?

A

Diastasis Recti

85
Q

When a patient has shifting dullness, what is that indicative of? What are the diseases associated with this?

A

Indicative of Ascites - Liver disease, congestive heart failure

86
Q

What are the five separate components required by a deep tendon reflex (DTR)

A

1) Intact sensory organs
2) functional synapse in the spinal cord
3) intact motor nerve fiber - efferent
4) functional neuromuscular junction (NMJ)
5) competent muscle fiber

87
Q

What is the Babinski sign? what does it indicate?

A

upon dragging pressure to bottom of an adult patient’s foot, the great toe dorsal flexes, while the other toes fan out (big toe goes up, others go down) - indicates Upper motor neuron damage

88
Q

When testing a unilaterally damaged CNX, you press a tongue depressor and you notice the uvula deviates. which direction does it go?

A

It deviates toward the normal side (away from the affected side)

89
Q

When testing CNXII, you ask the patient to stick their tongue out. When they do, it deviates to the right. What does this indicate?

A

This indicates a right side CNXII problem

90
Q

What does the Glasgow Coma Scale measure?

A

Best Eye opening
Best Motor response
Best Verbal response (graded from 3-15)

91
Q

What is the Brudzinski test? what does this indicate?

A

If the patient is laying flat, you raise their head and the patient will bend their knee by reflex - indicates meningeal irritation

92
Q

What is the Kernig test? what does this indicate?

A

If the patient is laying flat, you bend their knee, and their head will raise as a reflex - indicates meningeal irritation

93
Q

What is the occulocephalic reflex test? what does it test for?

A

(AKA doll’s eye test) turn patient’s head to left and right and the eyes should stay forward…like a doll - if their eyes do not react like this, then their brainstem is not functioning properly

94
Q

What is the occulovestibular reflex? What does it test for?

A

Inject ice water at 30 degree angle into ear - patient’s eyes should move toward irrigated ear, then scan back - if this result occurs, then the patient’s brainstem is functioning properly

95
Q

What is the Chovstek test?

A

Tap the patient’s zygoma with your finger, if they are hypocalcemic, they will spasm on that side of the face

96
Q

What is Trousseau’s test?

A

Pump the BP cuff to ~30mmHg - if the patient goes into a carpopedal spasm, then they are hypocalcemic

97
Q

Which nerve is affected in Carpal Tunnel Syndrome?

A

Median n.

98
Q

What is Tinel’s sign?

A

Hit the base of the palm or funny bone and if the patient feels tingling, they have carpal tunnel

99
Q

What is Phalen’s sign?

A

Press wrists together, then, after a while, if the patient feels numbness, it is indicative of injury to the median n. in the carpal tunnel

100
Q

What is decorticate rigidity? Why does it happen?

A

Toes plantar flex, arms flex and adduct, wrists flex - the cortical region of the brain has been cut

101
Q

What is decerebrate rigidity? Why does it happen?

A

Toes plantar flex, arms extend and pronate, wrists flex - the brain has been completely cut from the rest of the body

102
Q

What is Bell’s Palsy and how does it occur?

A

the patient loses all impulses to 1/2 of the face. it happens due to a Lower motor nerve injury

103
Q

What is one of the first sensations lost by a diabetic patient?

A

Vibration - this should be one of the first things a physician tests for in a diabetic

104
Q

What does a unilateral dilated pupil in a patient indicate is occuring?

A

The patient has a hematoma that is pressing on the occulomotor n. The pressure is on the same side as the eye dilation

105
Q

What is the corneal flex test?

A

use a cotton wisp on the cornea and look for blinking of the eye - it is testing for CN5 & 7

106
Q

what is the jaw jerk reflex test and what does it test?

A

put finger on the genoid and hit it with a rubber hammer - it tests CN5

107
Q

When is a mid-systolic click seen?

A

Mitral/tricuspid regurgitation

108
Q

When is a systolic ejection murmur (mid-systolic ejection murmur) seen?

A

Aortic &pulmonary stenosis

109
Q

When would you notice a crescendo/decrescendo murmur?

A

During systole-specifically aortic stenosis

110
Q

Which murmur is consistent with psychiatric problems?

A

Mitral valve prolapse (regurgitation)

111
Q

How does the trachea react during Atelectasis?

A

Trachea moves toward affected side

112
Q

How does the trachea react in a pneumothorax?

A

Trachea deviates away from the affected side

113
Q

How does the uvula react when CNX is damaged unilaterally?

A

Uvula deviates away from affected side

114
Q

With a subcondylar fracture, which way does the jaw deviate?

A

Jaw deviation toward the affected side

OS 600 (3 decks)

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