Exam 2 Flashcards
Jugular venous pressure
The point of highest oscillation of the jugular veins
Reflection of the pressure in the right atrium
Patient at 45 deg, head turned away, located internal jugular vein near SCM
Use ruler on sternal angle and card at highest point of oscillation to determine height. >4cm abnormal
Heart palpation areas
Aortic valve: 2nd interspace R
Pulmonic valve: 2nd interspace L
4-6 interspace L: tricuspid valve
left interspace 5th, midclavicular line mitral valve
Heart sounds and valve closures
s1 closure of mitral valve
s2 closure of bicuspid valve
systole is between s1 and s2
diastole is between s2 and s1
Allens test
for vascular patency
block radial and ulnar arterires
get pt to pump hand
release arteries one at a time and time how long it takes to refill
Tactile fremitus
feeling the vibration of speech
place hand on posterior rib cage and get patient to say 99 over and over again, palpate whether you can feel the vibration of the patient talking
Auscultation of the GIT
5-30 bowel sounds, can be transmitted to RLQ
friction rubs
Percussion sounds
resonane: lungs
tympany: GIT, hollow spaces
dull: mass
McBurneys point
for appendicites
Murpheys sign
for gall bladder
push in midclavicular line under liver
FAI
causd by overactivity of epiphyseal growth plate during periods of rapid growth
CAM lesion- affects femoral head- most common
PINCER lesion- affects acetabulum
Osteochondritis dessicans
cracks forming in the articular cartilage of the knees snf femoral condyle, necrosis
Types of Primary HA
migraine with/without aura
Tension type
Trigeminal autonomic cephalgias
Other; e.g. exercise, sex
Migraine features
4-72 hours
unilateral, pulsating
aggravated by exercise
nausea, photophobia, phonophobia
Migraine with aura
unilateral, reversible, visual and sensory symtpms,
develop graduually and last for minutes
Tension type headache features
bilateral, pressing in quality, minutes to days, does not worsen with PA, no nausea, photo/phonophobia may be present
