Exam 2 Memorization Flashcards
Coordination of movement tied with skeletal System
Cerebellum
Glasgow Coma Scale
3-15 and tests for level of consciousness
Divisions of Glasgow
Eye movement, motor-response, verbal response
Four Coma Scale
Tests four different categories which all range from 1-4. Tests for unconcienceness
Cerebral Cortex
Location in the brain where people are able to understand language or express thoughts
Aphasia:
w/o speech caused by injury to cerebral cortex
Sensory Aphasia
inability to understand written/spoken language
Motor Aphasia:
inability to express, write, or speak appropriately
Cranial Nerve 1
Olfactory, sensory, smell
Cranial Nerve 2
Oculomotor, sensory, visual information to brain
Cranial Nerve 3
oculomotor, motor, extra ocular movement, pupil size
Cranial Nerve 4
Trochlear: motor: up-down eye movement
Cranial Nerve 5
Trigeminal: Motor & Sensory: Jaw movement & facial feeling
Cranial Nerve 6
Abducens: Motor: lateral eye movement
Cranial Nerve 7
Facial: Sensory & motor: taste on the front of the tongue: controls facial expression (frown)
Cranial Nerve 8
Auditory Nerve: Sensory: Hearing
Cranial Nerve 9
Glossopharyngeal: Sensory + motor: gag-reflex + taste on the back of the throat
Cranial Nerve 10
Vegus: Sensory + Motor: Swallowing + movement of the vocal cords
Cranial Nerve 11
Spinal Accessory: Motor: Movement of head and shoulders
Cranial Nerve 12:
Hypoglossal: motor: positioning of tongue
Radiculpathy
pain traveling along the nerve line
Stenosis:
Narrowing of the nerve pathway
Dermopaths
Areas of skin applied by nerve fibers from a single spinal route. Different dermatomes tell us where there is breakdown in the nerve pathway
Sensory Receptors
Transmit info to spinal chord to the brain for interpretation
Motor Nerves
Interrelated to the muscular skeletal system
Portion of brain responsible for motor response
Cerebellum
DTR
Deep Tendon Reflexes
Muscle Spindle
units in every muscle which controls muscle tone and lengths and changes in muscle
Hypermagnesium
Disappearance of DTR. Magnesium Sulfate drip is used for mothers with HTN
Romberg Test
Tests motor nerves through testing balance
ADL
Activities of Daily Living
Active ROM
How much can they do on their own
Passive ROM
How much they can do with assistance (prevents contractures)
Contractures
permanent shortening of muscles that occurs when the muscle remains inactive for a long time
Kyphosis:
Exaggeration of the posterior thoracic spine curvature which can be due to osteoporosis. Affects other body systems like breathing because there is more weight on your diagram
Osteoporosis
Deterioration of bone mass. Bones get thin and stiff and they shorten
Dexascan:
determines bone density. Ultrasound of heel, x-ray of spine or hip to determine loss of bone mass
Bone mineral Density Test
Women get this at 40-60 y/o. Test taken at heel where there is dense bone
Causes for Osteoporosis:
Little/no exercise. Women. Estrogen. Blonde/red-hair. 80% females. Low calcium intake (less than 500mg a day). Long term usage of steroids. Metabolic disorders. Increases risk for fractures
Lordosis
Aka: swayback. Increased lumbar curvature. Often in young children. Causes: neuromuscular from hip problems or posture. TX: lumbar/posture management + exercises
Scoliosis
Lateral curvature of the spine. Begin screen for this at age 11-14 or at completion of growth spurts. Treatment with rods if over 40 degrees.
Palpation
Feel joints, muscles (spasms), bones, warmth, tenderness, edema, resistance to pressure
Crepitus
Popping of the joint
Flexion
Decreasing angle
Extension
Increasing angle
Hyperextension
Overly extending an extremity
pronation
palms down
supination
palms up
abduction
towards the body
adduction
Toward the body
internal rotation
Rotation towards the center of the body
external rotation
rotation away from the body
Eversion
Rotate the ankle away from the body
Inversion
Rotation of the ankle medially
Dorsiflexion
Toes pointed toward the sky
Plantar flexion
Toes pointed downward
Hypertonicity
increase in tightness that leads to spasticity
Hypotonicity
Flaccidity of the muscle
Atrophy
Loss of muscle tone
test for muscle strength
test their muscular resistance
Prone
Lying on the stomach
Supine
Laying on the back
side-lying
laying on one side
Sims
Laying on the left side
Fowlers
sitting at 80-90 degrees
Semi-Fowlers
sitting 30-45 degrees
Dorsal Recumbent
Supine with your knees up
Lithotomy
Feet up and knees up
Knee Chest:
Downward dog
Trendelenburg Position
Head below feet. Used for hypotensive pts to increase BP
Bell Palsy:
Half the face is paralyzed
Canes
Fall at the creases of the hands when arms are limp. Goes on strong side
Walking with cane
cane-weakleg-strongleg
SCD
Inflates and delates to compress leg to avoid blood clotting
Incentive Spirometry
Lung exercise where you breath into a tube. Breath IN. For asthma
Parasteasia
Numbness/tingling
Reverse Trendelenburg
Helps with breathing for supine only pts
NSADS
Could bring about stomach ulcers
dysphaGIa
difficulty swallowing
Steroids
Prednisone may cause GI bleeding
Enuresis
Bedwetting
Flatulence
Farting. When this begins after a surgery, you may begin to feed your pt. again
nocturia
peeing a lot at night
Anuria
no urine
Polyuria
excessive urine
stress incontinence
when stress is placed on the bladder, you pee
Hematuria
Blood in the urine
Pyuria
pus in the urine
Normal Output
1000-2000 mL per 24/h
30 mL/hour
Notify physician
peristalsis
stomach pushing stool
Abdominal Aortic Aneurism
Weakened blood vessel walls that build blood like a balloon. Visible pulsation in stomach
Diaphragm
use for bowel
Bell
Use for abdominal aorta for a brewy which is a forceful sound of blood running.
Borborigamy
hunger sounds
Rebound Tenderness
pain when you do a deep palpation and then take your hands off right away.
Hemacult
tests for blood in the stool. Test will appear blue when hemacult depressor is added.
Order of Abdominal assessment
Inspect, Auscultate, Palpate
Vertical and horizontal planes of abdomen
Vertical: diploid process and symphysis pubis
Horizontal: across umbilicus
RUQ
Liver, Gallbladder, Duodenum, Head of Pancreas, Right adrenal glad, right kidney, portions of ascending and transverse colon
LUQ
Left Lobe of liver, stomach, spleen, body of pancreas, left adrenal and kidney, portions of transverse and descending colon
RLQ
Cecum, appendix, portions of right kidney, right ovary and Fallopian tube, section of ascending colon, right ureter
LLQ
portion of left kidney, portion of descending colon, signed colon, left ovary and Fallopian tube, left ureter
Anti-Biotics
Replace them with probiotics
Natural Laxatives
Hot water, prune juice, bran
Black stool
iron or upper GI bleed
Red stool
Lower GI bleed or hemorrhoids
White/Clay stool
lack of bile or fats. Seen in sorosis, hepatitis, and liver problems
Morphine
Slows down bowel function
Constipation
Straining while pooping and lack of bowl for over three days
Diarrhea
Increase in # of stools r/t liquid. Malabsorption, digestion, or body cannot digest electrolytes
Incontinence
Inability to control bowels
Distension
Too much gas in the stomach that can lead to the expansion of the stomach and blood vessels which can cause breathing problems
Fecal impaction
Large stool stuck in GI tract but liquid can get around it
Sorosis
Bleeding of the liver
Oliguria
Diminished urine output (under 400mL a day)
Retention
Inability to empty your entire bladder (DM, Prostate)
Dysuria
Painful urination
Pyuria
Pus in the urine
Kwashiorkor
Babies who wane form breasts without proper nutrition or protein intake
Marasmus
Syndrom deficiency in protein or calories
Cachexia
Malnutrition/wasting most often r/t cancer
Visible Peristalsis
Beating of aneurysm
Hypoactive Bowel
Less than 1 sound every 35 seconds. R/t surgery, NPO, inflammation, fluid imbalance
Hyperactive Bowel
more than 34 seconds, diarrhea or obstruction
Borborygmi
Stomach growling due to hunger, bleeding, or anxiety
Fluid Output
5x a day WA
Large Intestine
Primary organ for bowel elimination; also absorbs about 1000mL of water every day.
Small Intestine
Breaks down nutrients through enzymes (proteins/carbohydrates)
3 Parts of Small Intestine
Duodenum, Jejunum, Ileum
When is voluntary bowel function gained
22-36mo
Decrease in Muscle Tone in adults
Leads to constipation or diarrhea
Foods that cause constipation
Cheese, lean meat, eggs, past
Foods that are considered laxatives
Fruits, veggies, bran, alcohol, coffee, chocolate
Foods that increase flatulence
beans, onions, cabbage, cauliflower
Antibiotics Affects on the Bowel
Green/grey diarrhea
Endoscopy
Direct visualization of GI. Requires a NPO diet
Esophogogastroduadenoscopy (EGD)
Looks at the lining of the stomach, esophagus, and stomach
Colonoscopy
Camera through the large intestine via rectum
Sigmoidoscopy
Goes only to sigmoid to detect diverticulitis
Wireless Capsule Endoscopy
Swallowing a camera that takes pictures as it passes through the small GI to check disruption in stomach linings
Indirect visualization
Non-invasive procedure to see what is going on in the GI
KUB
Indirect Visualization: abdominal xray
VGI
Small bowel series: contrast ingested and then an X-ray reveals how the contrast moves through the system. Non-invasive
Barium Enema
Contrast that is ingested to reveal how the liquid moves through the lower GI
Abdominal Ultrasound
Looks at the soft tissue organs in the abdomen
MRI
Most thorough (you can see the blood cells). Radiation is a risk and this is also very expensive
Abdominal CT scan
Radiation is involved in this procedure and it shows the body in planes
Constipation
Dry, hard stool or persistency in difficult passage of stool or incomplete passage of stool
Antacids
White discoloration or speckling in stool
Iron Salts
Cause black stool
Hemoccult
Uses a solution of guaiac to test for presence of blood
High risk for constipation
Pts:
- on bedrest taking constipating medicines
- reduced fluids or bulk in their diet
- depressed
- central nervous system disease or local lesions that cause pain while defecating
Oil Retention Enemas
Lubricates the stool and intestinal mucosa, easing defection
Carminative Enemas
Helps expel flatus from the rectum
Medicated Enemas
Provide medicines that are absorbed through the rectal mucosa
Anthelmintic Enemas
Destroys parasites
NG Tubes
Drain the stomach of fluid or unwanted stomach contents, give the stomach a break after surgery, and monitor gastrointestinal bleeding
Colostomy
Located anywhere along the length of the Large Intestine. The further along in the GI tract, the more solid the stool will be, reusable or disposable, stomadhersive is cut and placed around the stoma to protect the skin from urine or stool
Ileostomy
Empties from the end of the small intestine. Water is not absorbed so stool is liquid. Cannot be irrigated and pouch must be worn 24/7. Essentially cuts off the entire Large Intestine and can lead to dehydration because 1000mL are no longer being absorbed by the Large Intestine
Nasmosis
Rejoining a tract after a colostomy
Stoma
The portion of the intestine that comes out of the body after a colostomy
urterostomy
Permanent fistula or drainage of a ureter through the abdominal wall
ileoloop/ileoconduit
ureter drains into a portion of the ileum which forms a “bladder” with an artificial opening into the abdominal wall. A straight catheter can still be placed for drainage of this “bladder”
New Stoma Assessment
q2h= first 24 hours post op
q4h= 28-72 hours post op
q4-8h=routinely
Healthy stoma
Highly vascular, beefy red, and smooth
Colostomy Care
Use clean technique, keep pt free of odors if possible and only allow the appliance to get 1/3 full. Measure I&O
Enterostomal Therapist & Wound Ostomoy Continence Nurse
Specialize in ostomies
Large volume enema
500-1000-2000mL given 500-700mL at a time
Small Dose Enemas
4-6 oz
BP and enemas
BP goes down due to loss of volume so be careful with orthostatic pts. Also, take BP before you give them an enema
Dolhoff Tube
Typically used for feeding/medication
Peg/GTube
tube that goes into the stomach with balloon. This is used for longer term patients
Enteral Nutrition
Eating through the gut (GI tract or GI tube)
Parenteral Nutrition
Eating without the gut (through blood)
GRE
Gastric Residual Volume: is pt absorbing nutrition? How much is in the stomach? Aspirate until there is nothing and if there is less than 200mL notify the physician. Put back what you pulled out
Administering meds through feeding tube
30mL water, med, 30 mL water
Bladder
Smooth muscle tissue (detrusor muscle) sac innervated by the ANS. Sphincter guards opening between urinary bladder and urethra
Micturition
Voiding/emptying a bladder
200mL/800mL
When we feel the urge to pee/how much liquid our bladder can hold
diuretics
Prevent reabsorption of water and certain electrolytes in tubules
Cholinergic
Stimulation contraction of detrusor muscle producing urination
Analgesics
suppress CNA and diminish effectiveness of neural reflex
Polyuria
Excessive Urine
Dysuria
Painful urine
Enuresis
Bedwtting
Anuria
Less than 50mL of urine in a day
pH of urine
4.6-8 (average 5-6)
WBC in urine
indicates a UTI
Specific Gravity
Measures the concentration of solutes in the urine. WNL: 1.01-1.025. Dehydration has a higher specific gravity
24 Hour Urine Collection
Discard first void and keep on ice
BUN
Measures Urea nitrogen in the blood. Liver metabolism. WNL: 10-20mg/dl
Creatinine
More sensitive that BUN. Breakdown of skeletal muscle tissue. WNL: F: 0.5-1 M: 0.6-1.3
BUS
Bladder ultrasound.How much pee is left in the bladder? Used for post void residual
KUB
xray for kidneys, ureters, and bladder
Urodynamic Studies
Series of tests used to evaluate how everything is working
Cystoscopy
Procedure which allows visualization of the bladder lining
IVP:
Intravenous Pyelogram: IV contrast is xrayed to evaluate the kidneys
CAUTI
Catheter associated UTI
Straight Cath
16-18 French is the normal size. Does not stay in. Sterile procedure
Retention/Foley Cath
Stays in for about three days. 16-18 French. Hook to stationary part of the bed
Coude Foley Cath
Used for men with enlarged prostates
Suprapubic Cath
Cath inserted directly into the bladder from the abdomen just about the symphysis pubis. Decreased infection rate