Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 204 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What is the definition of the thoracic cage?

A

A bony structure with a conical shape, which is narrower at top

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the anatomy of the thoracic cage?

A

-Surrounded by the sternum
-12 pairs of ribs
-12 thoracic vertebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where do the first seven ribs attach to?

A

Attach to sternum by costal cartilages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where do ribs 8, 9, and 10 attach to?

A

Attach to costal cartilage above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

True or False:
Ribs 11 and 12 are considered to be “floating”

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are costochondral junctions?

A

Points at which ribs join their cartilages
-Not palpable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the anterior thoracic landmarks?

A

-Suprasternal notch
-Sternum
-Sternal angle
-Costal angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where is the suprasternal notch located?

A

A U-shaped depression just above the sternum between the clavicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the sternum considered to be?

A

The breastbone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where is the sternal angle located?

A

“Angle of Louis”
-At articulation of manubrium and sternum, and continuous with the second rib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where is the costal angle located?

A

The right and left costal margins form an angle where they meet at the xiphoid process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the posterior thoracic landmarks?

A

-Vertebra prominens
-Spinous processes
-Inferior border of scapula
-Twelfth rib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where is the vertebra prominens located?

A

Flex your head and feel for most prominent bony spur protruding at the base of the neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where is the spinous processes located?

A

Count down these knobs on vertebrae, which stack together to form spinal column

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where is the inferior border of scapula located?

A

Scapulae are located symmetrically in each hemothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where is the 12th rib located

A

Palpate midwat between spine and a person’s side to identify its free tip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the reference lines for the anterior chest?

A

Midsternal and midclavicular lines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the reference lines of the posterior chest?

A

Vertebral (midspinal) line and scapular line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What 3 lines do you divide the lateral chest by?

A

-Anterior axillary line
-Posterior axillary line
-Midaxillary line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the definition of the mediastinum?

A

Middle section of thoracic cavity containing esophagus, trachea, heart, and great vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which lung has 3 lobes?

A

Right lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which lung is shorter?

A

Right lung because of the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which lung is narrower?

A

The left because the heart bulges to the left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the 4 major functions of the respiratory system?

A

1) Supplying oxygen to the body for energy production
2) Removing CO2 as a waste product of energy reactions
3) Maintaining homeostasis (acid-base balance) of arterial blood
4) Maintaining heat exchange (less important in humans)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the respiratory consequences of aging?

A

-Decreased vital capacity
-Increased residual volume based on structural change
-Cannot take in as much air b/c they lack the ability to
-Capacity to take in air is weaker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What questions do you ask the pt in regards to a cough?

A

-Duration
-Frequency
-Timing
-Presence of cough as an irritating factor
-Productive or non-productive
-Quality of cough
-Precipitating and/or alleviating factors
-Any tx tried
-Associated symptoms
-Impact of cough on ADLs and quality of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What questions do you ask a pt in regards to shortness of breath?

A

-Precipitating factor
-Severity
-Duration
-Impact of change of position and specific timing pattern
-Association with other symptoms
-Any triggering mechanisms related to food, emotion, or environment
-Measures taken when SOB occurs
-Impact of SOB on ADLs
-Progression of SOB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What questions do you ask pts in regards to chest pain with breathing?

A

-Onset
-Timing (constant vs intermittent)
-Pain characteristics in terms of quality or intensity
-Associated symptoms
-Interventions used to decrease pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What do you ask the pt in regards to a hx of respiratory infections?

A

-Any unusually frequent or unusually severe colds
-Any family hx of allergies, TB, or asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What do you ask a pt in regards to a hx of smoking?

A

-Onset
-Duration
-Pattern of smoking
-2nd hand exposure
-Smoking cessation
-Counseling using 5 A’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the 5 A’s?

A

-Ask
-Advise
-Assess
-Assist
-Arrange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What do you ask pts in regards to environmental exposure?

A

-Occupational factors and exposure
-Protection from exposure
-Monitoring and f-up to exposure
-Awareness of symptoms that might signal breathing problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What do you ask pts in regards to pt-centered care?

A

-Screening and f-up testing
-When was the last time you had the following: TB skin test, Chest x-ray, pneumonia or influenza immunization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

When do you use a Lung Function Questionnaire?

A

For aging adults with a hx of COPD, lung cancer, or TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the order for assessment of the respiratory system?

A

-Inspect
-Palpation
-Percussion
-Auscultation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What do you need to inspect for on the thoracic cage?

A

-Shape and configuration of chest wall
-Position the person takes to breath
-Skin color and condition
-Any lesions
-Any changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How do you percuss the lung fields?

A

-Start at apices and percuss band of normally resonant tissue across tops of both shoulders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is resonance?

A

A low-pitched, clear, hollow sound that predominates in healthy lung tissue in adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What creates a characteristic set of noises that are audible through the chest wall?

A

Passage of air through the tracheobronchial tree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are the two phrases you can uses to assess for palpable vibrations of the tactile (vocal) fremitus?

A
  • 99
  • Blue moon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is tactile fremitus?

A

A palpable vibration from the larynx that is transmitted through patent bronchi and lung parenchyma to the chest wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is crepitus?

A

A course, crackling sensation palpable over the skin surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What causes crepitus?

A

Subcutaneous emphysema – when air escapes from the lung and enters the subq tissues (pot-op, open thoracic injury, chest tube air leak)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

How do you assess breath sounds with your stethoscope?

A

-Use the diaphragm
-Listen to one full respiration in each location bilaterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the 3 types of breath sounds normally heard?

A

-Bronchial (tracheal or tubular)
-Bronchovesicular
-Vesicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What are the adventitious sounds (added sounds that are not normally heard)?

A

-Crackles (or rales)
-Wheeze (or rhonchi)
-Atelectactic crackles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What do atelectactic crackles sound like?

A

Short, popping crackles that sound like fine crackles but do not last beyond a few breaths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What do fine crackles (or rales) sound like?

A

Discontinuous popping sounds heard over inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What causes fine crackles (or rales)?

A

-Pneumonia
-CHF
-Interstitial fibrosis
-Bronchitis
-Asthma
-Emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What do coarse crackles sound like?

A

Loud, low-pitched bubbling and gurgling sounds in inspiration and expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What causes coarse crackles?

A

-PE
-Pneumonia
-Pulmonary fibrosis
-Depressed cough reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What does a wheeze (or rhonchi) sound like?

A

Continuous musical sounds heard mainly over expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What causes wheezing?

A

-Diffuse airway obstruction d/t asthma or emphysema
-Bronchitis
-Airway tumor/obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What causes atelectactic crackles?

A

Bedridden persons or recently awoken pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What do you look for in inspection of the anterior chest?

A

-Shape and configuration of chest wall
-Pts facial expressions
-Skin color and condition
-Assess LOC and quality of respirations (effort, symmetry, accessory muscle use)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What do you assess when palpating the anterior chest?

A

-Symmetric chest expansion
-Tactile (vocal) fremitus
-Palpate anterior chest wall
-Not tenderness of lumps
-Skin mobility
-Skin turgor
-Skin temp
-Moisture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

How do you percuss the anterior chest?

A

Begin by percussing apices in supraclavicular areas bilaterally

**Note borders of cardiac dullness normally found on anterior chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Where is dullness evident when palpating for right hemothorax?

A

Upper border of liver dullness is located in 5th intercostal space in the right midclavicular line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

In left hemothorax, where in tympany evident?

A

Over the gastric space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is forced expiratory time?

A

The number of seconds it takes to exhale from total lung capacity to residual volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is a safer, simple, inexpensive, clinical measure of functional status in aging adults?

A

The 6 min walk test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What respiratory changes can be expected with the aging adult?

A

-Increasing AP diameter
-Kyphosis
-Outward curvature of thoracic spine
-Chest expansion may be decreased, but still symmetric
-Tend to tire easily when auscultating when deep mouth breathing is required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What are abnormal findings of the configurations of the thorax?

A

-Barrel chest – equal AP to transverse diameter and ribs are horizontal
-Pectus excavatum
-Pectus carinatum
-Scoliosis
-Kyphosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is pectus excavatum?

A

-Funnel breast
-Sunken sternum and adjacent cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is pectus carinatum?

A

Forward portrusion of the sternum
-Ribs sloping back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is scoliosis?

A

S-shaped curve of the thoracic/lumbar spine with vertebrae rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is kyphosis?

A

Exaggerated posterior curvature of thoracic spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are abnormal findings of tactile fremitus?

A

-Increase/decrease tactile fremitus
-Rhonchial fremitus
-Pleural friction fremitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What are abnormal respiration patterns?

A

-Sigh
-Tachypnea/bradypnea
-Hyperventilation/hypoventilation
-Cheyne-Stokes respiration
-Biot’s respiration
-Chronic obstructive breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What are the discontinuous adventitious lung sounds?

A

-Crackles – fine
-Crackles – course
-Atelectatic crackles
-Pleural friction rub

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What are continuous adventitious sounds?

A

-Wheeze – sibilant
-Wheeze – sonorous rhonchi
-Stridor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is atelectactic?

A

Collapsed shrunken section of alveoli or an entire lung as a result of airway obstruction, compression on the lung, lack of surfactant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is IPPA for atelectactic?

A

I- Cough, slow expansion on affected side, Increased RR and HR
P- Chest expansion decreased on affected side
P- Dull over area
A- Breath sounds decreased vesicular or absent over area, none or fine crackles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is bronchitis?

A

Proliferation of mucus glands in passageways, resulting in excessive mucus secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is IPPA for bronchitis?

A

I- Hacking, rasping cough, productive thick mucus
P- Normal
P- Resonant
A- Crackles over deflated areas, wheezes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is emphysema?

A

-Caused by destruction of pulmonary connective tissue
-Permanent enlargement of air sacs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is IPPA for emphysema?

A

I- Increased AP diameter, barrel cheat, accessory muscle use, tripod position, SOB, tachypnea
P- Decreased chest expansion
P- Hyperresonant
A- Decreased breath sounds, muffled heart sounds d/t overdistention of lungs, wheezes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is asthma?

A

Allergic hypersensitivity to certain inhaled allergens, irritants, microbes, stress or exercise that causes bronchospasm and inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is IPPA for asthma?

A

I- Tachypnea, SOB, audible wheezes, accessory muscle use, labored
P- Tachycardia
P- Resonant
A- Diminished air movement, wheezes expiration and/or inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What organs are located in the RUQ of the abdomen?

A

-Liver
-Gallbladder
-Duodenum
-Head of pancreas
-Right kidney and adrenal gland
-Hepatic flexure of colon
-Part of ascending and transverse colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What organs are located in the RLQ of the abdomen?

A

-Cecum
-Appendix
-Right ovary and tube
-Right ureter
-Right spermatic cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What organs are located in the LUQ of the abdomen?

A

-Stomach
-Spleen
-Left lobe of liver
-Body of pancreas
-Left kidney and adrenal gland
-Splenic flexure of colon
-Part of transverse and descending colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What organs are located in the LLQ of the abdomen?

A

-Part of descending colon
-Sigmoid colon
-Left ovary and tube
-Left ureter
-Left spermatic cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What organs are located in the midline of the abdomen?

A

-Aorta
-Uterus (if enlarged)
-Bladder (if distended)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

True or False:
As you age, your abdominal wall musculature relaxes and increased reporting of constipation

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

True or False:
As we age, salivation decreases, leading to a dry mouth and decreased sense of taste

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

True or False:
As we age, esophageal emptying and gastric acid secretion are delayed

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

True or False:
As we age, the incidence of gallstones increases and drug metabolism is impaired

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What are the common causes of constipation related to aging?

A

-Decreased physical activity
-Inadequate intake of water
-Low-fiber diet
-Side effects of medications
-IBS
-Bowel obstruction
-Hypothyroidism
-Inadequate toilet facilities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What subjective data do you ask for related to appetite?

A

-Any changes in appetite (time period and amount)
-Changes in weight? (loss/gain and time period)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What subjective data do you ask about relating to dysphagia?

A

-Any difficulty swallowing?
-Onset and associated symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What subjective data do you ask for relating to food intolerance?

A

-Type of food reaction that occurs
-Use of Rx or OTC medication (amount and frequency)

92
Q

What subjective data do you ask about relating to pain?

A

-Onset, duration, location, and severity
-Characteristics (quality and pattern) and associated symptoms
-Association with any other clinical symptoms
-Alleviating factors and aggravating factors
-Treatment methods: Rx and OTC

93
Q

What subjective data do you ask about relating to nausea and vomiting?

A

-Onset, frequency, type, and amount
-Associated symptoms and/or triggers
-Recent foods eaten and/or travel habits

94
Q

What subjective data do you ask about relating to bowel habits?

A

-Frequency, color, consistency, diarrhea or constipation
-Any recent changes
-Laxative use? type, amount, and frequency

95
Q

What subjective data do you ask about relating to past abdominal history?

A

-GI disease/pathology
-GI diagnostic procedures
-GI surgeries and clinical response

96
Q

What subjective data do you ask about relating to medications?

A

-Rx and OTC
-Alcohol (type, amount, frequency)
-Smoking history

97
Q

What subjective data do you ask about relating to nutritional assessment?

A

-Dietary history

98
Q

What additional history can you gather from the aging adult relating to abdominal health?

A

-Access to groceries and food preparation
-Shared meals or eat alone
-24 hr dietary recall
-Swallowing or feeding difficulties
-Activities done following mealtimes
-Bowel health (fiber in diet, use of laxative, frequency, constipation)
-Meds (Rx and OTC)

99
Q

What do you do in preparation for examining the abdomen?

A

-Ensure good lighting
-Drape genitalia and breasts
-Encourage abdominal wall relaxation

100
Q

What are some ways that we can encourage abdominal wall relaxation?

A

-Empty bladder
-Keep room warm
-Position supine
-Head on pillow
-Knees bent
-Arms at sides
-Warm stethoscope
-Exam painful areas last
-Distraction techniques

101
Q

What do you assess in the inspection phase for the abdomen?

A

-Contour
-Symmetry
-Umbilicus
-Skin
-Pulsation or movement
-Hair distribution
-Demeanor

102
Q

Where may you typically see pulsation or movement in the abdominal area?

A

May see pulsations from the aorta beneath the skin in the epigastric area

103
Q

How is the umbilicus typically located?

A

Normally it is midline and inverted

104
Q

What are the abnormal bowel sounds?

A

-Hypoactive
-Hyperactive
-Perfectly “silent abdomen”

105
Q

Where do bowel sounds originate from?

A

From movement of air and fluid through the small intestine

106
Q

Where do you palpate for vascular sounds?

A

Use firm pressure and check over:
-Aorta
-Renal arteries
-Iliac
-Femoral arteries

107
Q

True or false:
When placing an NG tube, you use auscultation for the initial placement verification

A

False- you do not use auscultation for initial placement verification

108
Q

How do you initially confirm the placement of an NG tube?

A

With evidenced-based practice
-Confirm by imaging study and assessment (tube length, pH, color)

109
Q

When you percuss the general tympany, liver, and splenic dullness, what are to assessing for?

A

-Relative density of abdominal contents
-Locate organs
-Screen for abnormal fluid or massess

110
Q

What is tympany?

A

A medical condition in which excess gas accumulates in the GI tract and causes abdominal distention

111
Q

How do you assess for general tympany?

A

First, percuss lightly in all 4 quadrants to determine prevailing amount of tympany and dullness in clockwise manner

112
Q

True or false:
Percussing the liver span, splenic dullness, and bladder yield highly variable results

A

True – therefore not typically recommended

113
Q

How do you percuss/assess the kidney?

A

-Place one hand over the 12th rib at the costovertebral angle on the back
-Thump that hand with the ulnar edge of your other fist

**Pt will feel thud but no pain

114
Q

What is the general rule to follow when palpating a pts abdomen?

A

Begin with light palpation and then gradually go deeper

115
Q

How deep is light palpation?

A

1 cm with 4 fingers close together, lift fingers and move clockwise

116
Q

How deep is deep palpation?

A

5-8 cm

**if there is resistance, use the bimanual technique

117
Q

What do you note if you identify a mass?

A

-Location
-Size
-Shape
-Consistency (soft, firm, hard)
-Surface (smooth or nodular)
-Mobility (including movement with respirations)
-Pulsatility
-Tenderness

118
Q

True or false:
As we age, there are increased deposits of subcutaneous fat on the abdomen and hips found during inspection

A

True

119
Q

True or False:
As we age, our abdominal musculature is thinner

A

True

120
Q

True or False:
As we age, organs are more difficult to palpate in the absence of obesity

A

False – organs may be EASIER to palpate d/t thinner, softer abdominal wall

121
Q

Where can the liver be palpated in an older adult if their lungs are distended and their diaphragm is depressed?

A

-Liver can be palpated lower
-Descends 1-2 cm below costal margin with inhalation

122
Q

What does IPPA stand for?

A

Inspect
Palpate
Percuss
Auscultate

123
Q

What does it mean when you palpate and area of the body?

A

You are feeling that specific region of the body with your fingers or hands

124
Q

What does it mean if you are percussing a specific region of the body?

A

You are producing sounds usually by tapping on specific areas of the body

125
Q

What is IPPA for obesity in the abdomen?

A

I- uniformly rounded, umbilicus sunken
P- Normal
P- Tymapny with scattered dullness
A- Normal BS

126
Q

What is IPPA for air or gas in the abdomen?

A

I- Single rounded curve
P- Muscle spasm of abdominal wall possible
P- Tympany over large areas
A- Depends on cause

127
Q

What is IPPA for ascites?

A

I- Single curve, everted umbilicus, bulging flank when supine, taut and glistening skin
P- Taut skin
P- Tympany at top, dull over fluid, fluid wave
A- Normal BS except in ascitic area (diminished)

128
Q

What is IPPA for feces?

A

I- Localized distention
P- Plastic like or ropelike mass
P- Tympany over large areas predominantes, scattered dullness over fecal mass
A- Normal BS

129
Q

What is IPPA for tumor in the abdomen?

A

I- Localized distention
P- Defined borders
P- Dull over mass if reaches skin surface
A- Normal BS

130
Q

What is an umbilical hernia and what does it look like?

A

-Protrusion through omentum or intestine d/t weakness or incomplete closure in the umbilical ring
-Soft, skin covered mass

131
Q

What is an umbilical hernia usually seen with?

A

Abdominal pressure (crying, coughing, straining, vomiting)

132
Q

What is an epigastric hernia?

A

-Small fatty nodule at the epigastrium in midline
-Protrusion of abdominal structures
-Palpable when standing

133
Q

What is an incisional hernia?

A

-Bulge near old operative scar
-Seen with increased abdominal pressure

134
Q

What is a diastasis recti?

A

-Midline longitudinal ridge that is a separation of abdominal rectus muscles
-Seen with intra-abdominal pressure by raising HOB

135
Q

What do hypoactive bowel sounds indicate?

A

Decreased motility d/t
-Inflammation (periotinitis)
-Paralytic ileus post op
-Bowel obstruction

136
Q

What do hyperactive bowel sounds indicate?

A

Increased motility d/t:
-Mechanical bowel obstruction
-Gastroenteritis
-Diarrhea
-Laxative use
-Subsiding paralytic ileus

137
Q

What does the musculoskeletal system consist of?

A

-Muscles
-Bones
-Joints

138
Q

What is the musculoskeletal system needed for?

A

-To stand and stand erect
-Movement
-Encase and protect inner vital organs
-Produce RBCs in the bone marrow
-Reservoir for storage of essential minerals

139
Q

What is flexion?

A

Bending limb at joint

140
Q

What is extension?

A

Straightening limb at joint

141
Q

What is abduction?

A

Moving limb away from midline of the body

142
Q

What is adduction?

A

Moving limb toward midline of the body

143
Q

What is pronation?

A

Turning forearm so that the palm is down

144
Q

What is supination?

A

Turning the forearm so the palm is up

145
Q

What is circumduction?

A

Moving arm in circle around shoulder

146
Q

What is inversion?

A

Moving sole of foot inward at the ankle

147
Q

What is eversion?

A

Moving sole of the foot outward at ankle

148
Q

What is rotation?

A

Moving head around central axis

149
Q

What is protraction?

A

Moving body part forward, parallel to the ground

150
Q

What is retraction?

A

Moving body part backward, parallel to the ground

151
Q

What is elevation?

A

Raising a body part

152
Q

What is depression?

A

Lowering a body part

153
Q

What health hx questions do you ask regarding joints?

A

-Pain
-Location (unilateral or bilateral)
-Characteristics (quality and severity)
-Onset, duration, frequency
-Aggravating or precipitating factors
-Associated clinical presentations
-Limitation of motion, stiffness, or swelling or erythema
-Impact on ADLs

154
Q

What health hx questions do you ask regarding muscles?

A

-Location of pain or cramping
-Pain while walking vs pain relief at rest
-Associated clinical presentation
-Muscle characteristics (weakness and size)
-Onset and duration of symptoms

155
Q

What health hx questions do you ask regarding bones?

A

-Pain (at rest or affected by movement)
-Presence of deformity d/t injury or trauma and effect on ROM
-Hx of accidents or trauma with impact on bones
-Medical and/or surgical tx (any residual deficits)
-Presence of back pain (provide pain characteristics description)
-Presence of neurological or physical deficits

156
Q

Who do we typically recommend DEXA screenings for?

A

Females ages 65+

157
Q

What is the order of examination for the musculoskeletal system?

A

-Inspect
-Palpate
-ROM
-Muscle testing

158
Q

True or False:
Joints are usually tender to palaptation

A

False- they are NOT usually tender to palpation

159
Q

What is the grading scale for muscle testing?

A

0-5

160
Q

What does a score of 5 mean for muscle testing?

A

Full ROM against gravity, full resistance

161
Q

What does a score of 4 mean on muscle testing?

A

Full ROM against gravity, some resistance

162
Q

What does a score of 3 mean on muscle testing?

A

Full ROM with gravity

163
Q

What does a score of 2 mean on muscle testing?

A

Full ROM with gravity eliminated (passive)

164
Q

What does a score of 1 mean on muscle testing?

A

Slight contraction

165
Q

What does a score of 0 mean on muscle testing?

A

No contraction

166
Q

What is a fracture?

A

A break in a bone

167
Q

What is a dislocation?

A

Complete loss of contact between the two bones in a joint

168
Q

What is a sublaxation?

A

Two bones in a joint stay in contact, but their alignment is off

169
Q

What is a contracture?

A

Shortening of a muscle leading to limited ROM of joint

170
Q

What is ankylosis?

A

Stiffness or fixation of a joint

171
Q

What is articular disease?

A

Disease inside the joint capsule produces swelling and tenderness around joint

Ex: Arthritis

172
Q

What is crepitation?

A

An audible and palpable crunching or grating that accompanies movement

173
Q

What is TMJ?

A

Temporomandibular Joint
-Articulation of mandible and temporal bone
-Permits jaw function of speaking and chewing

***Can feel it in depression anterior to tragus of ear

174
Q

What 3 motions does TMJ allow?

A

-Hinge action to open and close jaws
-Gliding action for protrusion and retraction
-Gliding for side-to-side movement of lower jaw

175
Q

How do you inspect and palpate for TMJ?

A

-Pt is in a seated position
-Place tips of your first 2 fingers in front of each ear
-Open mouth maximally
-Measure between upper and lower incisors (3-6 cm or 3 fingers)
-Partially open mouth & protrude lower jaw and move it side to side

175
Q

True or false:
When you stick out your lower jaw, it should protrude with deviation normally

A

False – it should protrude without deviation

176
Q

Where do you palpate the jaw to check for TMJ?

A

-Contracted temporalis and masseter muscles as pt clenches their teeth
-Compare R and L for size, firmness, and strength

177
Q

How many vertebrae are in humans?

A

32-33

178
Q

How many cervical vertebrae are there?

A

7

179
Q

How many thoracic vertebrae are there?

A

12

180
Q

How many lumbar vertebrae are there?

A

5

181
Q

How many sacral vertebrae are there?

A

5

182
Q

How many coccygeal vertebrae are there?

A

3-4

183
Q

What are the surface landmarks of the spine and vertebrae?

A

1) Spinous processes of C7 and T1 prominent at base of neck
2) Inferior angle of scapula normally at level of interspace between T7 and T8
3) Imaginary line connecting highest point on each iliac crest crosses L4

184
Q

Where should you palpate on the cervical spine?

A

-Spinous processes
-Sternomastoid
-Trapezius
-Paravertebral muscles

***Should feel firm with no muscle spasms or tenderness

185
Q

What motions should the patient do to assess the cervical spine?

A

-Touch chin to chest
-Lift chin toward the ceiling
-Tough ear toward corresponding shoulder
-Turn chin toward each shoulder

186
Q

True or False:
For the spine, a person can normally maintain flexion against full resistance

A

True

187
Q

What tests the integrity of cranial nerve XI (spinal nerve)?

A

See if pt can maintain flexion against full resistance

188
Q

What 3 bony articulations do your elbows contain?

A

-Humerus
-Radius
-Ulna of forearm

189
Q

Where do the radius and ulna articulate with each other?

A

At 2 radioulnar joints
-One at elbow
-One at wrist

190
Q

What is the Phalen test?

A

Have pt hold both hands back to back whole flexing wrists at 90 degrees

***Hold for 60 seconds and no pain should occur

191
Q

What is the Tinel Sign Test?

A

Direct percussion of the location of median nerve at the wrist

***Should produce no symptoms

192
Q

Where is the articulation of the hip?

A

Between acetabulum and head of the femur

193
Q

What permits a wide range of motion on many axes for the hip?

A

Ball and socket
-More stability for weight-bearing function
-Muscles enhance stability and bursae facilitate movement

194
Q

What guides examination of the hips?

A

Palpation of bony landmarks?

195
Q

What bony landmarks can you palpate at the hip?

A

-Iliac crest – anterior superior spine to posterior
-Ischial tuberosity
-Greater trochanter of the femur

196
Q

What is the most common dysfunction found in hip disease?

A

Limitation of abduction of hip while supine

197
Q

What 3 bones are the articulation of the knee joint?

A

-Femur
-Tibia
-Patella

198
Q

What is the largest joint in the body?

A

Knee joint

199
Q

What permits flexion and extension of lower leg, and can also supinate?

A

Hinge joint

200
Q

What 2 wedge-shaped cartilages cushion the tibia and femur?

A

Medial and lateral menisci

201
Q

What is a bulge sign and how do you assess it?

A

-Confirms the presence of small amount of fluid
-Firmly stroke up on the medial aspect on knee 2-3 times to displace fluid
-Tap the later aspect
-Watch for a bulge from fluid wave

202
Q

What is ballottement of patella and how do you assess it?

A

-Confirms larger amounts of fluid
-Use left hand to compress supratellar pouch to move fluid into the knee joint
-With right hand, push the patella sharply against the femur

203
Q

What bones does the ankle articulate?

A

-Tibia
-Fibula
-Talus

***Limited dorsiflexion and plantar flexion

204
Q

What is plantar flexion?

A

Point toes towards floor
-45 degreees

205
Q

What s dorsiflexion?

A

Point toes towards nose
-20 degrees

206
Q

How many degrees for eversion of the foot?

A

20

207
Q

How many degrees for inversion of the foot?

A

30

208
Q

What happens to the musculoskeletal system as we age?

A

-Bone remodeling is cyclic process of reabsorption and deposition
-Postural changes and decreased height
-Distribution of subq fat changes leading to different contour
-Absolute loss in muscle mass
-Impact of sedentary lifestyle

209
Q

After what age does resorption occur more rapidly than deposits in the musculoskeletal system?

A

after 40

210
Q

What physiological changes happen with posture and decreased height as we age?

A

-Kyphosis with slight flexion of hips and knees to compensate
-Shortening of the vertebral column

211
Q

True or false:
Loss of subcutaneous fat leaves bony prominences more marked

A

True

212
Q

What health promotion and pt teachings do you provide for the musculoskeletal system?

A

-Diet to protect and maintain healthy bones
-Smoking cessation
-Alcohol intake pattern
-Exercise promotion
-Osteoporosis screening
-Fall prevention risk

213
Q

What are the 2 abnormal inflammatory conditions of the musculoskeletal system?

A

-Rheumatoid arthritis
-Ankylosing Spondylitis

214
Q

What is the definition of rheumatoid arthritis?

A

Chronic inflammatory pain condition that is started by an autoimmune response, inflammatory event, or infection

215
Q

What are the S&S of rheumatoid arthritis?

A

-Weakness
-Anorexia
-Weight loss
-Low grade fever
-Lymphadenopathy

216
Q

What is the pathophysiology behind rheumatoid arthritis?

A

-Inflammation causes fibrosis
-Cartilage and bone destruction
-Limited motion and deformities

217
Q

What is the definition of ankylosing spondylitis?

A

Chronic inflamed vertebrae that in extreme form leads to bony fusions of vertebral joints

218
Q

What are the S&S of ankylosing spondylitis?

A

-Inflammatory back pain (dull, deep ache in lower back/butt)
-Morning stiffness

219
Q

What areas does ankylosing spondylitis affect?

A

-Spine
-Pelvis
-Thoracic cage

220
Q

What is the pathophysiology of ankylosing spondylitis?

A

-Spams of muscles pull spine forward
-Obliterating lumbar and cervical curves
-Thoracic curve is exaggerated
-Flexion of deformed hips and knees d/t spinal flexion

221
Q

What are the 2 degenerative conditions of the musculoskeletal system?

A

-Osteoarthritis
-Osteoporosis

222
Q

What is the definition of osteoarthritis?

A

Non-inflammatory, localized, progressive disorder involving deterioration of articular cartilages, subchondral bone remodeling, synovial inflammation, and formation of new bone at joint surface

223
Q

What does osteoarthritis cause?

A

-Stiffness
-Swelling
-Pain with motion
-Limited ROM in hands, knees, hips, lumbar and cervical spine

224
Q

What is the pathophysiology of osetoarthritis?

A

-Inflammation causes fibrosis
-Cartilage and bone destruction
-Limited motion and deformities occur

225
Q

What is the definition of osteoporosis?

A

Decrease in skeletal bone mass leading to low bone mineral density and impaired bone density

226
Q

Who is at the highest risk of developing osteoporosis?

A

-Those smaller in height and weight
-Younger at menopause
-Lack of physical activity
-Lack of estrogen

227
Q
A

NUR 204 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions