Exam 3 Flashcards
Primary survey
Airway
Breathing
Circulation
Disability
Exposure
Priority assessment
Pain
Pulse
Pallor
Parethesia
Paralysis
Osteomalacia, causes, S/S, influences
“Soft bone”- impaired bone metabolism and reduced mineralization
Causes: vitamin C deficiency, rickets (children), renal disease/failure
S/S: bone pain, pigeon breast, boeing legs
Influences: hypocalcemia, hypophosphatemia, high parathyroid hormone
Major depressive disorder
2+ weeks of sadness and apathy
Post-partum depression
80% of women in first two weeks after delivery
Seasonal affective disorder
Associated with winter
Decreased melatonin
Generalized anxiety
Persistent, “global”
Social anxiety disorder
Fear of social interactions
Obsessive-compulsive disorder
Recurrent behaviors that demand to be performed
Panic disorder
Induced by stress
Schiophrenia
Abnormal thinking patterns that result in impaired social function and self care
High dopamine and psychosis
Positive (psychosis) symptoms of schisophrenia
Hallucinations
Delusions
Disorganized speech
Paranoia
negative symptoms of schizophrenia
Alogia (lack of conversation)
Avolition (lack of motivation)
Anhedonia (lack of pleasure)
Social withdrawal
Attention deficit hyperactivity disorder
Inattention and hyperactivity
Low dopamine and norepinephrine
Risk factors for ADHD
Genetics
TBI
Toxins
Signs/symptoms of ADHD
Hyperactivity
Inattention
Impulsiveness
+/- self esteem issues
+/- social skill issues
Transient Ischemic attack
Temporary occlusion, symptoms resolve
No Permanent damage
Warning sign of bigger stroke
Cerebrovascular accident (CVA/Stroke)
Death of brain cells
Ischemic CVA
Blockage of artery
Caused by thrombus or embolism
Treatment of Ischemic stroke
Fibrinolytics
Hemorrhagic stroke
Causes, S/S
Rupture of blood vessel
Causes: hypertension, aneurysm, trauma,
Spontaneous
Sudden headache/vomiting/ LOC
Epidural hematoma
Atrial bleed b/n skull and dura mater
Fast and severe
Subdural hematoma
Venous bleed b/n dura and arachnoid mater
Slower
Intracerebral hemmorhage
Bleed within brain tissue
Ruptured aneurysm from hypertension or trauma
Subarachnoid hemorrhage
Bleed in the subarachnoid space
Berry aneurysm, trauma
Concussion and S/S
Caused by impact or whiplash (Coup-countercoup)
S/S
CSF drainage from ear/nose
Blurred vision
Weakness/lethargy
Impaird coordination and motor function
Headaches, personality changes
Increased Intracranial pressure (ICP)
Suffocated brain tissue from lack of nutrients
Accumulation of fluid or swelling tissue
Cushings triad
Increased systolic BP
Decreased pulse
Decreased respirations
S/S of ICP
Neuro: headache, drowsiness, confusion, seizures, AMS, double vision, N/V
Late signs: Fixed/dilated pupils Pressure on CNIII), loss of consciousness, Cushings triade
Uncal herniation:
Part of temporal lobe goes through tentorial notch
concern in increased ICP
Hydrocephalus and S/S
“Water head”
Excessive Cerebral spinal fluid due to blockage of the draining system (most common) or overproduction of CSF
S/S:
Infant: increased head circumference, LOC changes, irritability
Adult: headache, vomiting, ataxia, urinary incontinence, lethargy, coma, instability
Needs shunt
High risk areas for Spinal cord injuries
Cervical and lumbar
Flexion Spinal cord injury
Chin downward
Motor vehicle accident
Hyperextension spinal cord injury
Head backward
Hitting chin on fall
Compression spinal cord injury
Vertical pressure
Diving into a pool
Subluxation spinal cord injury
Slipped disk
Falling off a horse
Spinal shock and duration
Loss of deep tendon reflexes (DTRs)
Loss of motor sensor below injury
Lasts days to months (transient)
Neurogenic shock
Loss of sympathetic activity
Low BP (hypotension)
Low HR (bradycardia)
Poikilothermia (no temp. Regulation)
Can last up to 6 weeks
Management for neurogenic shock
Airway
Fluids
Atropine for bradycardia
Vasopressors for bp
Autonomic dysreflexia
Sympathetic overdrive from irritant
Sci at T6 or higher
S/S of autonomic dysreflexia
Forhead sweating, facial flushing, confusion, anxiety, headache, severe hypertension, bradycardia
Bell’s palsy
Unilateral paralysis of facial nerve (CNVII)
Cause: unknown(maybe herpes or lyme disease)
Facial weakness: inability to wrinkle brow, drooping eyelid, asymmetrical smile, dropping corner of mouth
Seizures
Sudden disorganized discharge of electrical activity
Status epilepticus
Seizure > 5 minutes or 2 seizures within 5 minutesf
Encephalitis, causes S/S
Inflammation of brain tissue
Commonly caused by viral infection
Non-specific symptoms: fever, headaches, photophobia
Meningitis
Inflammation of meningeal tissue and/or brain tissue
S/S: confusion, fever, neck stiffness, severe headache, photophobia
Spina Bifida and cause
Improper closing of spinal column during development
Cause: folate deficiency
Occulta (hidden) spina bifida
Minimal, no symptoms
Meningocele spina bifida
Neurological symptoms below level affected, cauda equina (no nerve protrusion)
Myelomeningocele
Significant neurological symptoms below level affected, limb paralysis
Nerve protrusion
Osteomyelitis, S/S
Bacterial infection in the bone
Risk with open fractures
Signs/symptoms: constant bone pain, fever, night sweats, chills, tenderness/warm to touch, not seen initially on x-ray
Can lead to sepsis and ulcerations
Fat embolism and S/S
Yellow bone marrow entering blood stream, occluding vessels
S/S: Confusion (brain), Petechia (Skin), Shortness of breath (heart)
Compartment syndrome and S/S
Pressure compromises neurovascular function of tissue from edema.
Ischemic damage from compressed arteries
S/S 6 P’s: Pain, parethesia (loss of sensation), pallor, paralysis, distal pulselessness, poikilothermia
Sprains and S/S
Overstretching of ligament from quick twist of pull, found around joints
S/S: redness/bruising, swelling, instability, reduced function and painful movement
Strains
Large muscle groups, back, calf, hamstring
Rotator cuff injury symptoms
Pain with abduction
Popping/clicking
Muscle weakness
Anterior cruciate ligament (ACL) tear
Non-contact “plant and twist”
Increases risk for osteoarthritis
Kyphosis
Exaggerated forward rounding of upper back
Lordosis
Inward curvature of lower back
Scoliosis
Sideways curvature
Osteoporosis, risks and S/S
Bone demineralization
Risks: alcohol, smoking, caucasian or asian, prolonged steroid use (autoimmune treatments), low calcium, menopause/low estrogen, hyperthyroidism, sendentary
S/S: pain in bone, kypohosis, heightloss
Osteoarthritis and risk factors
Wear and tear, bone on bone rubbing
Age
Female
Genetics
History of injury
Obesity
Repetitive joint use
Rhambdomylosis and s/s
Breakdown of muscle from overuse or injury
S/S: mylagia (muscle pain), tenderness w/ palpitation, hyperkalemia, increased creatine kinase, myoglobinemia, dark brown urin, weakness, confusion
Acne
Inflammation of skin
Pilosebaceous unit
Increased gland activity, blockage of follicles, bacteria in follicle
Urticaria
Rash with alergies
Itchy
IgE-mediated: histamine release
Wheal and flare
Measles and S/S
Respiratory virus
Affects skin: maculopapular rash (descending red spots)
S/S: high fever, cough, conjunctivitis, coryza, koplik spots, encephalitis
Herpes simplex, HSV 1 and 2
Initial is sever,
Painful vesicular rash, tingling/numbness
Infect others in dormancy
C section in pregnancy
HSV 1 above the belt
HSV 2 bellow the belt
Skin infections: bacteria type
Staphylococcus or streptococcus bacteria
Impetigo
Superficial, honeycomb crust, contagious
Cellulitis
Deep infection involving the hypodermis/subcutaneous tissue
Drainage is contagious
Fungal infection
Warm moist areas
Superficial: tinea, candida
Deep: may occur in immunocompromised
Atopic dermatitis (eczema)
Chronic inflammation
Redness
Flexor surfaces
Dry ithy
Linked to asthma and allergies
Infection with skin breakage
Basal carcinoma
Common, rarely metastisize
Squamous cell carcinoma
May metastisize
Melanoma
Most dangerous, metastisize, Monitor ABCDE
ABCDE for skin cancer
Asymmetry, border, color, diameter, evolution (Growth)
Pressure ulcers
Ischemic injury leading to skin breakdown, decubitus ulcers
Extrinsic factors for pressure ulcers
Skin pressure, shearing, friction, moisture
Intrinsic factors for pressure ulcers
Immobilization, cognitive (forget to move), chronic illness (diabetes), poor nutrition, steriod use (break down proteins), Aging
Venous stasis
Dysfunctional valves in veins
Accumulation of fluid and waste products, edema, tissue damage
Burn complications
Infection/sepsis
Hypovolemic shock
Respiratory dysfunction
Increased metabolic demand
Hypothermia
