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Physical assessment > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

How many bones are in the cranium?

A

8

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2
Q

How many bones are in the face?

A

14

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3
Q

Sternocleidomastoid muscle

A

Rotates and flexes the head

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4
Q

Trapezius muscle

A

Extends the head and moves the shoulders

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5
Q

What are the cranial nerves?

A

I olfactory; smell
II optic; vision
III oculomotor; eye movement
IV trochlear; eye movement
V trigmenal; face
VI abducens; eye movement
VIII Auditory (vestibulocochlear); hearing/balance
XI spinal accessory; motor head and neck
XII hypoglossal; motor- lower throat tongue mobility + strength

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6
Q

Blood vessels located in the neck?

A
  • internal jugular veins and carotid arteries. Located parallel and anterior to the sternocleidomastoid muscles
    *DO NOT compress both sides at the same time it can cause patient to pass out
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7
Q

Hypothyroidism presentations?

A

-High sensitivity to cold
-Constipation
-depression
-Fatigue
-Increase in weight
-Bradycardia

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8
Q

Hyperthyroidism presentations?

A

-Weight loss
-Tachycardia
-Anxiety
-Nervousness
-Enlarged palpable thyroid soft blowing/swishing sound when asculated (bruit)
-Exophthalmos: bulging of the eyes (with Graves’ disease only)

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9
Q

Symptoms of Meningitis

A

Nausea, vomiting, *neck stiffness

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10
Q

Lymph nodes of the head and neck

A

-Preauricular
-Postauricular
-Occipital
-Tonsillar
-Submandibular
-Submental
-Superficial cervical
-Posterior cervical
-Deep cervical
-Supraclavicular
*if healthy should be less than 1cm

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11
Q

What to note when palpating the lymph nodes?

A

-Size + shape
-Delimitation (position or boundary)
-Mobility
-Consistency
-Tenderness + location

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12
Q

Tender and enlarged lymph nodes suggest?

A

Acute infections

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13
Q

Lymphadenopathy

A

Swollen lymph nodes

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14
Q

Goiter

A

Enlarged thyroid gland
(can be caused by iodine deficiency)

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15
Q

Asymmetry of earlobes occurs with?

A

Parotid glad enlargement

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16
Q

Types of headaches and their characteristics

A
  • Sinus headache: deep, constant, throbbing pain. Occurs with or after a cold. My occur in one area of along eyebrow ridge and below cheek
  • Cluster headache: stabbing pain. May be accompanied by ingesting alcohol. Localized in the eye region
  • Tension Headache: dull, tight, diffuse. May occur with stress, anxiety, or depression. Located in the frontal, temporal, or occipital region
  • Migraine Headache: nausea, vomiting, sensitivity to light and noise. Located around eyes, cheeks, or forehead; may affect only one side of the face
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17
Q

Acromegaly

A

Enlargement of the facial features, hands, and feet

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18
Q

Cushing’s syndrome

A

Moon shaped face w reddened cheeks and increased facial skin

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19
Q

Bell’s palsy

A

twitching, weakness, paralysis, drooping eyelids or corner of mouth

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20
Q

Abbreviations for eye and ears

A

OS= left eye
OD= right eye
OU= both eyes
AS= left ear
AD= right ear
AU= both ears

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21
Q

Mnemonic for assessing pupils

A

PERRLA
Pupils
Equal
Round
Reactive
Light
Accommodation

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22
Q

What are the eye directions?

A
  • Esotropia: eye turns inward
  • Exotropia: eye turns out
  • Hypertropia: eye turns up
  • Hypotropia: eye turns down
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23
Q

Abnormalities of the eye

A
  • Papilledema: swelling of optic disk
  • Muscular degeneration (black hole is seen) *use amsler test
  • Glaucoma: test with puff of air *tonometry test. Normal pressure 10-21 < risk for glaucoma
  • Cataracts: 1st common source of blindness *cloudiness of the eye
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24
Q

What are the vision tests and how they are performed?

A
  • Snellen chart: tests distant visual acuity; lines of different letters stacked one above the other
  • E chart: tests distant visual acuity for clients who cannot read or has a verbal handicap
  • Jaegar test: near vision test; done by holding pocket screener or newspaper 14 inches away
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25
Q

What time should be longer when assessing the ears?

A

Air conduction > Bone conduction

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26
Q

Conductive hearing loss

A

Something blocks or impairs the passage of vibrations from getting to the inner ear

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27
Q

Sensorineural or perceptive hearing loss

A

Damage is located in inner ear

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28
Q

Tinnitus

A

Ringing in the ears *could be a symptom of ototoxic medications
-ototoxic medication can cause hearing loss

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29
Q

Inappropriate use of ototoxic drugs during pregnancy is a risk for?

A

Baby having hearing loss

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30
Q

Risk factors for otitis media?

A

Babies fed from a bottle, especially lying down

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31
Q

Risk reduction to preserve hearing?

A

If you have a newborn, avoid feeding from bottle while laying on back

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32
Q

Ear tests and how to conduct them?

A
  • Whisper test: have client place finger on tragus of ear and whisper a a two syllable word 1-2 feet behind the client
  • Webber test: place tuning fork on center of head or forehead
  • Rinne test: place tuning fork on mastoid process and then anterior ear
  • Romberg test: tests equilibrium; place arms around patient to ensure they dont fall
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33
Q

Where should the cone of light be seen in right and left ear?

A

Right ear seen at 5 o’clock
Left ear seen at 7 o’clock

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34
Q

When assessing ears with an otoscope

A
  • pull ear up and back for adults and older children
  • Pull ear down and back for infants and children under 3 years
35
Q

Presbycusis

A

Hearing loss common after 50 years of age

36
Q

Otalgia

A

Earache

37
Q

Vertigo

A

Spinning motion

38
Q

BPPV

A

Benign paroxysmal positional vertigo *can test with Epley Maneuver

39
Q

Otitis externa

A

Swimmers ear. PAIN when pinna and tragus are moved

40
Q

Darwin tubercle

A

Small painless nodule on the helix

41
Q

Acute otitis media

A

Tympanic membrane is red, bulging w no light reflex

42
Q

Serous otitis media

A

fluid collects in the middle ear causing an obstruction of the auditory tube

43
Q

Ostosclerosis

A

Abnormal spongy bone formation found around the stapes

44
Q

Most common site for tongue cancer

A

Side of tongue

45
Q

Most common site for oral cancer

A

Under the tongue

46
Q

Epistaxis

A

Nose bleed
*kiesselbachs area= common site for nose bleeding

47
Q

Rhinorhea

A

Runny nose

48
Q

Most common oral cancer

A

Squamous cell carcinoma on the lip

49
Q

Disphagea

A

Difficulty swallowing

50
Q

Bruxism

A

Grinding of the teeth

51
Q

Distinctive mouth odors

A
  • Fruity breath
  • Ammonia smelling: kidney disease
  • Stool smelling breath: intestine blockage
  • Sulfur smelling: liver disease
52
Q

Giving meds buccal route

A

In the cheek

53
Q

Sublingual meds

A

Under the tongue

54
Q

Blue-black line in gums

A

Led poisoning

55
Q

How to grade tonsils?

A

1+ normal
2+ midway between tonsillar pillars and uvula
3+ touching uvula
4+ touching each other

56
Q

Thrush

A

White fungal infection on the tongue
*can be caused by not washing mouth out when using inhaler

57
Q

Carbon monoxide poisoning

A

Lips are reddish

58
Q

Frenulum

A

Connects tongue to floor of mouth

59
Q

What are the names of the sinuses that can be assessed and the ones you cannot assesses

A

Can assess: Frontal and maxillary sinuses
Cannot assess: sphenoidal and the ethmoidal

60
Q

Signs of vitamin B12 deficiency?

A

Smooth, red, shiny tongue, without papillae

61
Q

Torus palatinus

A

Hard mass found in midline of palate of mouth

62
Q

Aging of the head, face, and Neck

A
  • Decrease in pulsation of temporal artery
  • Facial wrinkles
  • Neck pain with arthritis
  • kyphosis
  • palpable thyroid feels more nodular
63
Q

Aging of the eyes

A

-Presbyopia
-Yellowish bulbar conjunctiva
- Arcus senilis
- Entropy and ectropian

64
Q

When using an opthalmascope

A

Right hand with right eye
Left hand with left eye

65
Q

Accommodation

A

Assessing by looking at pupillary response near (constrict) and far (dilate)

66
Q

Aging of the ears

A

-Presbycusis
-Elongated ear lobes
- harder cerumen (ear wax)
- Cilia more rigid
- eardrum appears cloudy

67
Q

Aging of mouth, throat, nose, and sinuses

A
  • receding gums
  • tooth surfaces worn down
  • decreased smell and taste
  • oral mucosa is dry
  • varicose veins in ventral surface of tongue
68
Q

Location of Supersternal notch, angle of Louis, and xyphoid process?

A
  • Supersternal notch: between clavicles
  • Angle of Luis: on the manubrium
    -Xyphoid process: bottom point of the manubrium
69
Q

What notch should your lungs be at during inhalation and exhalation

A
  • inhalation: 7th or 8th
  • exhalation: 5th or 6th
70
Q

Fremitus

A

Vibrations of air in the bronchial tubes
*have patient repeat ninety-nine

71
Q

Difference between left and right lung

A

Right: 3 sections
Left: 2 sections

72
Q

COPD

A

Barrel lungs
Clubbed finger nails
Tripod position (orthopenic position)
*do not increase O2 will make patient worse

73
Q

Crepitus

A

Crackling sensation; feels like rice crispies

74
Q

Normal breath sounds

A
  • Bronchial: high pitch, short during inspiration long during expiration; trachea and thorax
  • Bronchovesicular: moderate pitch, same during inspiration and exhalation; over major bronchi, between scapulae, around upper sternum
  • Vesicular: low pitch, long in inspiration short in exhalation; peripheral lung fields
75
Q

Aging in thorax and lungs

A
  • Dyspnea
  • chest pain
  • ability to cough effectively
  • kyphosis
  • decrease in thoracic expansion
  • sternum and ribs may be more prominent
76
Q

How many pairs of ribs are there?

A

12

77
Q

Tachypnea

A

Respirations over 20

78
Q

Bradypnea

A

Respirations less than 12

79
Q

Where are you more likely to find breast cancer?

A

Upper outer quadrant

80
Q

What is it called when males have a greater amount of breast tissue?

A

Gynecomastia

81
Q

Most common cancer among women

A

Breast cancer
*5-10% breast cancer are hereditary from the BRCA gene

82
Q

Adventious breath sounds

A
  • Crackle: crumbly hair by ear sound; COPD, pneumonia
  • Wheeze: Hight pitched , musical sounds; asthma
  • Stridor: high pitched whistle or squeak; obstruction or narrowing of upper airway
83
Q

Hyperplasia

A

Enlarged red gums; may cover some of exposed teeth

84
Q

Normocephaly

A

“Normal” head size

Physical assessment (3 decks)

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