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NUR 204 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

What is the function of the cerebral cortex?

A

Center of functions for governing thought, memory, reasoning, sensation, and voluntary movement

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2
Q

What are the lobes of the cerebral cortex?

A

-Frontal lobe
-Parietal lobe
-Occipital lobe
-Temporal lobe

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3
Q

What is the function of the frontal lobe?

A

-Personality
-Behavior
-Emotions
-Intellectual function
***Contains Broca’s area that mediates motor speech

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4
Q

What is the function of the parietal lobe?

A

Sensation

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5
Q

What is the function of the occipital lobe?

A

Visual receptor center

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6
Q

What is the function of the temporal lobe?

A

-Auditory reception center
-Taste
-Smell
***Contains Wernicke’s area that is associated with language comprehension

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7
Q

What are the components of the CNS?

A

-Basal ganglia
-Thalamus
-Hypothalamus
-Cerebellum
-Brainstem
-Spine

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8
Q

What does the brainstem contain?

A

Central core of the brain
-Contains: midbrain, pons, and medulla

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9
Q

What is the function of the hypothalamus?

A

Main respiratory center with basic function control and coordination

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10
Q

What is the function of the cerebellum?

A

Concerned with motor coordination and muscle tone of voluntary movements

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11
Q

How many cranial nerves are there?

A

12

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12
Q

Where do CN I & II extend from?

A

Cerebrum

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13
Q

Where do CN III & XII extend from?

A

Midbrain and brainstem

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14
Q

Where does the vagus nerve travel to?

A

-Heart
-Respiratory muscles
-Stomach
-Gallbladder

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15
Q

What may cause dizziness and loss of sensation in aging adults?

A

Progressive decrease in cerebral blood flow and oxygen consumption

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16
Q

What is cranial nerve I’s function?

A

Olfactory nerve
-Sense of smell

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16
Q

What sequence do you use when collecting objective data for neuro?

A

-Mental status
-Cranial nerves (II, III, IV, VI, VII, VIII)
-Motor system
-Sensory system
-Reflexes

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17
Q

How do you assess CN I function?

A

-Have pt close eyes
-Occlude one nostril
-Present aromatic substances (familiar smells)
-Have them identify smell

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18
Q

What is CN II?

A

Optic nerve
-Acuity and visual fields

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19
Q

What are CN III, IV, and VI?

A

-Oculomotor
-Trochlear
-Abducen nerves (eye movements)

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20
Q

Wat is CN V?

A

Trigeminal nerve
-Motor and Sensory function (assess jaw and cotton balls)

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21
Q

What are coordination and skilled movement tests?

A

-RAMs (flipping hands on knees)
-Finger-to-finger test
-Finger-to-nose test
-Heel-to-shin test

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22
Q

What are cerebellar function tests?

A

-Gait (ambulate 10-20 ft and turn around)
-Tandem walking (heel-to-toe)
-Romberg sign (closing eyes while standing – have them perform slight knee bend, etc)

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23
Q

How do you assess the anterolateral (spinothalamic) tract?

A

-Pain
-Light touch
-Poke vs wisp of cotton ball

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24
Q

How do you assess the posterior (dorsal) column tract?

A

-Vibration (tuning fork)
-Position (have pt close their eyes and move there fingers and toes up or down)
-Tactile discrimination (fine touch)
-Two-point discrimination test

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25
Q

What is stereognosis?

A

Pts ability to identify object in hand with eyes closes based on form, size, and weight

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26
Q

What is graphesthesia?

A

Pts ability to read a number by having it traced in skin

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27
Q

What is extinction?

A

Simultaneously touch both sides of body at same point – have pt distinguish how many times they are being touched

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28
Q

What is the deep tendon reflex scale?

A

0-4
0= no response
1= diminished, low normal, or occurs with reinforcement
2= average, normal
3= brisker than average, may indicate disease
4= very brisk, hyperactive with clonus, indicative of disease

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29
Q

What does the deep tendon reflex test do?

A

Measures of stretch reflexes reveals intactness of reflex arc at specific spinal levels

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30
Q

What is the normal response of the biceps reflex (C5 to C6)?

A

Contraction of biceps muscle and flexion of forearm

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31
Q

What is the normal response to the triceps reflex (C7 to C8)?

A

Extension of forearms

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32
Q

What is the normal response to the Brachioradialis reflex (C5 to C6)?

A

Flexion and supination of forearm

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33
Q

What is the normal response to the quadriceps reflex (L2 to L4 – knee jerk)?

A

Extension of lower leg

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34
Q

What is the normal response to the achilles reflex (L5 to S2 – ankle jerk)?

A

Foot plantar flexes against your hand
(foot is originally held in dorsiflexion position during testing)

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35
Q

What unit of measurement is PERRLA in?

A

Milimeters

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36
Q

What does the neuro recheck consist of?

A

-Change in LOC
-Motor function
-PERRLA

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37
Q

What are the different muscle movement abnormalities?

A

-Paralysis
-Fasciculations (rapid continuous twitching of resting muscles)
-Tic (involuntary movements)

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38
Q

What are the major neck muscles?

A

Sternomastoid & trapezius

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38
Q

What is the function of the sternomastoid?

A

Enables head rotation and flexion

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39
Q

What is the function of the 2 trapezius muscles?

A

Move shoulders and extend/turn head

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40
Q

What is the purpose of the lymph system?

A

Detects and eliminates foreign substances from the body

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41
Q

What is the purpose of lymphatic drainage?

A

Helps to prevent potentially harmful substances from entering the circulation

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42
Q

What are the topics that you would ask about for a health history assessment for HEENT?

A

-Headaches
-Head injury
-Dizziness
-Neck pain
-Lumps or swelling
-Hx of head or neck surgery

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43
Q

What are the 3 types of headaches?

A

-Tension
-Migraine
-Cluster

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43
Q

What is a tension headache?

A

Headache of the musculoskeletal origin; mild to moderate pain

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44
Q

What is a migraine/

A

Headache of genetically transmitted vascular and trigeminal nerve origin; aura as well as other symptoms
***2-3x more common in women

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45
Q

What is a cluster headache?

A

Headache is intermittent, excruciating and unilateral (rare)

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46
Q

What is Graves disease?

A

**Hyperthyroidism
-An autoimmune disease with increased production of thyroid hormones

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47
Q

What are physical clinical manifestations of Graves disease?

A

**Physical presentation on neck and face
-Goiter
-Eyelid retraction
-Exophthalmos

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48
Q

What is Myxedema?

A

***Hypothyroidism
-A deficiency of thyroid hormone

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49
Q

What are the physical clinical manifestations of Myxedema?

A

**Presentation on face and neck
-Puffy edematous face
-Periorbital edema (eye swelling)
-Coarse facial features
-Coarse hair and eyebrows

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50
Q

What are the most common causes of decreased visual functioning in older adults?

A

-Cataract formation
-Glaucoma
-Age-related macular degeneration
-Diabetic retinopathy

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50
Q

True or False:
As we age, our pupil size decreases

A

True

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51
Q

What is cataract formation?

A

-Lens opacity
-Results from a clumping of proteins in the lens

52
Q

What is glaucoma?

A

-Increased intraocular pressure
**Chronic open-angle glaucoma is the most common

53
Q

What is age-related macular degeneration (AMD)?

A

-Breakdown of cells in macula of retina
-Loss of central vision

54
Q

What is the leading cause of blindness in adults ages 25-74 yrs old?

A

Diabetic retinopathy

55
Q

What is typically used to test central visual acuity?

A

Snellen alphabet chart
-Person stands 20 ft from chart
-Person can leave glasses or contacts in as long as they are not reading glasses

56
Q

How do you test confrontation?

A

Peripheral vision
-Pt covers one eye with a card
-Provider covers the eye across from pts covered eye with card about 2 feet away

57
Q

What does PERRLA stand for?

A

Pupils equal, round, react to light, and accommodation

58
Q

What is esotropia?

A

Inward turning of eye

59
Q

What is exotropia?

A

Outward turning of eye

60
Q

What are some eyelid abnormalities?

A

-Periorbital edema
-Exophthalmos (protruding eyes)
-Enophthalmos (sunken eyes)
-Ptosis

61
Q

What can cause periorbital edema?

A

-Infection
-Crying
-Trauma
-CHF
-CKD

62
Q

What can cause exophthalmos?

A

Thyrotoxicosis

63
Q

What can cause enophthalmos?

A

-Dehydration
-Chronic wasting

64
Q

What can cause ptosis (drooping upper lid)?

A

-CN III damage
-Sympathetic nerve damage
-Congenital

65
Q

What are the structures of the external ear?

A

-Auricle (aka pinna)
-Auditory canal
-Outer 1/3 of the canal is cartilage

66
Q

What separates the external and middle ear?

A

Tympanic membrane (aka eardrum)

67
Q

What are the 3 functions of the middle ear?

A

1) Conducts sound vibrations from outer ear to central hearing apparatus in inner ear
2) Protects inner ear by reducing amplitude of loud sounds
3) Eustachian tube allows equalization of air pressure on each side of TM so that it does not rupture

68
Q

What is the structure of the middle ear?

A

***Tiny air-filled cavity inside temporal bone
-Contains tiny ear bones or auditory ossicles:
1) Malleus
2) Incus
3) Stapes

69
Q

True or False:
The inner ear is not accessible for direct examination, but its functions can be assessed

A

True

70
Q

What does the inner ear contain?

A

Bony labyrinth – holds sensory organs for equilibrium and hearing

71
Q

What things can happen related to hearing as we age?

A

Osteosclerosis & presbycusis

72
Q

What is otosclerosis?

A

Gradual hardening that causes footplate of stapes to become fixed in oval window

73
Q

What is the common cause of conductive hearing loss in young adults between ages of 20 and 40

A

Otosclerosis

74
Q

What is presbycusis?

A

Type of hearing loss that can occur with aging, even in people living in quiet environment

75
Q

When is presbycusis accentuated?

A

When unfavorable background noise is present

76
Q

What questions do you ask regarding tinnitus?

A

-Ever felt ringing, crackling, or buzzing in your eyes? When did this occur?
-Does it seem louder at night?
-Are you taking any medications?

77
Q

When does screening for a hearing deficit begin?

A

During the health history

78
Q

What is the whispered voice test?

A

-Stand at arms length (2ft) behind the person
-Test one ear at a time while masking the other & place one finger on tragus while rapidly pushing it in and out of auditory meatus
-Shield lips so person cannot compensate for hearing loss by lip reading
-With your head 30 to 60 cm (1 to 2 ft) from person’s ear, exhale fully and whisper slowly 3 random number/letter combinations

79
Q

What is the passing score for the whispered test?

A

Correct repetition of 4 out of 6 possible numbers/letters

80
Q

What are the 2 tuning fork tests?

A

-Weber test
-Rinne test

81
Q

What do tuning fork tests measure?

A

Measure hearing air conduction or by bone conduction in which sound vibrates through cranial bones to the inner ear

82
Q

What is the scale for the Weber test?

A

1) Normal = sound is heard equally in both ears
2) Abnormal = sounds lateralizes to one ear
3) Conductive loss = sounds lateralizes to poorer ear
4) Sensoineural loss = sound lateralizes to better ear

83
Q

What is the scale for the Rinne test?

A

Normal = AC greater than BC, noted as positive finding
Abnormal related to:
-Conductive loss – AC = BC or BC> AC
-Sensorineural loss = normal ratio intact but reduced, the person hears poorly both ways

84
Q

What are abnormal findings of the external ear?

A

-Sebaceous cyst
-Tophi
-Chondrodermatitis
-Keloid
-Battle sign
-Carcinoma

85
Q

What is the first segment of the respiratory system?

A

Nose

86
Q

True or False
Sinus openings are narrow and easily occluded & may cause inflammation or sinusitis

A

True

87
Q

Where are olfactory receptors and hair cells found?

A

Liet at the root of the nasal cavity & upper third of septum

88
Q

What 2 pairs of sinuses are accessible to examine?

A

-Frontal sinuses
-Maxillary sinuses

89
Q

Where are frontal sinuses located?

A

In frontal bone above and medial to orbits

90
Q

Where are maxillary sinuses located?

A

Maxilla (cheekbone) along side walls of nasal cavity

91
Q

What is the first segment of the digestive system and an airway for the respiratory system?

A

Mouth

92
Q

Why is the tongue arranged in a crosswise pattern?

A

So it can change shape and position

93
Q

How many permanent teeth do adults have?

A

32 (16 in each arch)

94
Q

What 2 main structures make up the throat (pharynx)?

A

Oropharynx & Nasopharynx

95
Q

What structure is inside the oropharynx?

A

Tonsils

96
Q

Where does the breast lie anatomically?

A

Anterior to pectoralis major and serratus anterior muscles

97
Q

What surrounds the nipples?

A

Areola

98
Q

What are Montgomery’s Glands?

A

Sebaceous glands that secrete protective lipid material during lactation

99
Q

What kind of tissues is the breast composed of?

A

-Glandular tissue
-Fibrous tissue
-Adipose tissue

100
Q

What quadrant on the breast is the most common site for breast tumors?

A

Upper outer quadrant

101
Q

What 4 groups of axillary nodes are present in the breast lymphatic drainage system?

A

-Central axillary nodes
-Pectoral (anterior)
-Subscapular (posterior)
-Lateral

102
Q

What is the flow of drainage from the central axillary nodes?

A

Drainage flows up to infraclavicular and supraclavicular nodes

103
Q

What can cause breast glandular tissue to atrophy in women after menopause?

A

Decreased ovarian secretion of estrogen and progesterone

104
Q

What ages should women be getting an annual mamography?

A

45-54

105
Q

When does mammography screening begin?

A

40-44

106
Q

True or False:
After age 55, women can either continue annual mammograms or biennially

A

True

107
Q

How do you palpate a woman’s breast?

A

Have her lay supine & uncover one breast at a time

108
Q

True or False:
It is common to have slight asymmetry of breasts

A

True

109
Q

How do you inspect & palpate the axillae region?

A

Examine while they are sitting, use ROM exercises to increases surface area

***Node typically not palpable, but you may feel a small, soft, nontender node in the central group

110
Q

What is the typical pattern recommended to palpate breasts?

A

Vertical stripe pattern – recommended to detect fro breast masses

111
Q

What are 2 other common patterns used to palpate breasts?

A

1) From the nipple palpating out to periphery as if following spokes on a wheel
-Palpating in concentric circles out to the periphery

112
Q

True or False:
In nulliparous (woman who hasn’t given birth) women, normal breast tissue feels firm, smooth, and elastic

A

True

113
Q

True or False:
After a woman is pregnant, the breast tissue feels softer and looser

A

True

114
Q

Why is premenstrual engorgement of the breasts normal?

A

Increasing progesterone

115
Q

How do you normally palpate the nipple?

A

With your thumb and forefinger – gently depress nipple tissue into well behind areola (tissue should move inward easily)

116
Q

How do you palpate the nipple if the woman reports spontaneous nipple discharge?

A

Press areola inward with index finger

117
Q

True or False:
If a woman mentions a breast lump that was self-discovered, the nurse should examine the unaffected breast first to gain baseline

A

True

118
Q

What characteristics do you look at for breast lumps or masses?

A

-Location
-Size
-Shape
-Consistency
-Movable
-Distinctness
-Nipple (displaced or retracted?)
-Note skin over lump
-Tenderness
-Lymphadenopathy

119
Q

What are the ABCDE’s of lumps/masses in the breast?

A

-Asymmetry
-Border
-Color
-Diameter
-Evolution

120
Q

What produces sweat?

A

Eccrine

121
Q

What do apocrine produce?

A

Milky secretion and open into hair follicles

122
Q

True or False:
Skin produces Vitamin D

A

True

123
Q

How do you palpate the skin for temp?

A

With back of hand

124
Q

What is the normal degree/contour of a nail?

A

160 degrees

125
Q

What are the different shapes and configurations of skin lesions?

A

-Annular or circular
-Confluent
-Discrete
-Grouped
-Gyrate
-Target or iris
-Linear
-Polycyclic
-Zosteriform

126
Q

What are the types of primary skin lesions?

A

-Macules
-Papules
-Patches
-Plaques
-Nodules
-Wheals
-Tumors
-Urticaria
-Vesicles
-Cysts
-Bullas
-Pustules

127
Q

What are types of secondary skin lesions?

A

-Debris on skin surfaces
-Fissures
-Erosions
-Ulcers
-excoriations
-Scars
-Atrophic scars
-Keloids

128
Q

What are the malignant types of skin lesions?

A

-Basal cell carcinoma (most common)
-Squamous cell carcinoma (grows rapidly)
-Malignant melanoma (worst)

128
Q

What ages are considered young-old?

A

65 to 74

129
Q

What ages are considered middle-old?

A

75 to 84

130
Q

What age is considered old-old?

A

85+

131
Q
A
131
Q
A

NUR 204 (2 decks)

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