Exam 3 Flashcards
1
Q
how many pairs of ribs are there
A
12
2
Q
what are the 4 major functions of the respiratory system
A
supply oxygen to the body for energy
remove carbon dioxide (waste)
maintain acid-base balance (homeostasis) of arterial blood
maintain heat exchange
3
Q
what can environmental tobacco smoke (ETS) cause in a baby
A
sudden infant death syndrome
negative behavioral/cognitive functioning
increased rates of adolescent smoking
4
Q
does residual volume increase in the aging adult
A
yes
5
Q
what is the most common chronic disease in children
A
asthma
6
Q
objective data of the lungs includes
A
inspection
palpation
percussion
auscultation
7
Q
what is Tactile (vocal) Fremitus
A
use hands to assess for palpable variations
hands over skin
have them say “99” or “blue moon”
8
Q
what is a sound that is not pathologic
A
atelectic crackles
short popping, crackles, few breaths disappear
9
Q
what is the normal outcome of Tactile (vocal) Fremitus when auscultation
A
soft, muffled, indistinct
hear sound, not distinguish what is said
10
Q
what do diseases cause in tactile fremitus
A
increase intensity and enhance transmission of sounds
11
Q
Bronchophony
A
auscultate posterior chest
99 should be muffled and soft
if loud (consider lung consolidation)
12
Q
Egophony
A
evaluates intensity of voice
say “eee”
if “aaa” is heard, consider lung consolidation
13
Q
Whispered Pectoriloquy
A
performed when (+) bronchophony is auscultated whisper (1, 2, 3) should be faint/muffled
14
Q
what are normal differences of infants lungs/thoracic cavity
A
rounded thorax
equal anterioposterior to transverse chest diameter
15
Q
by what age does the thorax reach adult ratio
A
6
1:2
16
Q
are crackles in the lungs of a newborn common
A
yes
17
Q
what are normal RR for infants
A
30-40
may spike to 60
18
Q
when may RR be different in infants
A
extremes in temperature
feeding
sleeping
19
Q
are brief period of apnea in infants normal? if so, for how long?
A
yes
10-15 seconds
20
Q
when breathing, what may happen to the HR
A
it may speed up
21
Q
what are normal findings in the aging adult related to respiratory system
A
increase in AP diameter Kyphosis (hunchback) outward curvature of thoracic spine chest expansion may decrease but still symmetric tend to tire easily when auscultating
22
Q
what is the ratio of a barrel chest
A
1:1
23
Q
whats the ratio of normal chest
A
1:2
24
Q
what are pulmonary embolisms typically caused by
A
DVT
25
what are s/s of pulmonary embolism
```
chest pain (worse on inspiration)
dyspnea
apprehension (impending doom)
anxiety
restless
diaphoresis
hypotension
crackles
wheezes
Partial Pressure <80 mm
```
26
what is crepitus
it is noticed palpating surface of ones skin
can sound like bubble wrap
can be sign of an open thoracic injury (punctured lung leaking air)
27
where is the apex of the heart
bottom
28
where is the base of the heart
top of the heart
29
what are the great vessels
arteries and veins that are connected to the heart
30
what are the two continious loops of blood vessels
Pulmonary Circulation
| Systemic Circulation
31
what are the two AV valves
tricuspid (right)
| Bicuspid/Mitral (left)
32
when are the two AV vales closed
during systole (emptying) to prevent regurg of blood back into aorta
33
what are the semilunar valves
Pulmonic (right)
| Aortic (left)
34
what is the blood flow of the heart
```
right atrium
right ventricle
pulmonary artery
lungs
pulmonary vein
left atrium
left ventricle
```
35
when does S3 occur
when ventricles are resistant to filling during early rapid filling phase (Protodiastole)
36
when does S4 occur
at the end of diastole, at presystole, ventricle resistant to filling
37
what is S4 a sign of
HF
| MI
38
when is S3 normal
it is okay in children, pregnancy, and conditioned athletes
39
what are murmurs caused by
the backflow of blood
40
what is heard if a murmur is present
blowing/swooshing
41
what are the conditions that result in murmurs
increased velocity of blood
decreased viscosity of blood
structural defects in valves
42
what is the node that initiates the electric impulse
Sinoatrial Node (SA Node)
43
what is the equation for cardiac output
Heart Rate X Stroke Volume
44
how much does blood volume increase in pregnancy
30-40%
| arterial BP decreases
45
what are the electrocardiogram differences in older adults
prolonged PR interval
prolonged QT interval
QRS is the same
46
what is the most common underlying cause of death globally
CVD
47
what are the risk factors of CVD
```
HTN
Smoking
Increased Serum Cholesterol
Physical Activity
Diet
```
48
what is Paroxysmal Nocturnal Dyspnea
SOB at night, feeling of smothering when sleeping
49
signs of heart issues in infants can include
diaphoresis when eating
SOB when eating
fall asleep then wake up soon and still be hungry
cyanosis
50
what is a bruit
something you hear
51
what can a bruit be a sign of in the carotid
atherosclerosis
| build up of plaque
52
what does the jugular venous pressure give information on
the hearts efficiency to pump
| information about the right side of the heart
53
if there is JVD, what is it a sign of
right sided heart failure
54
what should you observe the precordium
possible pulsations
| masses
55
what is at the second right interspace
aortic valve
56
second left interspace
pulmonic valve
57
3rd lower sternal border
tricupsid valve
58
5th interspace at midclavicular line
mitral valve (apical pulse)
59
what should be noted about murmurs
```
timing
loudness
pitch
pattern
quality
location
radiation
posture
change in position
```
60
what is the HR after birth
100-180
61
what should infant HR stabilize to
120-140
62
does an immediate newborn with a murmur mean it has a heart issue
no
| typically disppear in 2-3 days
63
does an absence of a murmur in a newborn mean it is healthy
not necessarily
64
is a venous hum harmful
no
65
what is a common murmur in children
Innocent (functional) Murmur
66
what are the characteristics of the innocent murmur
soft, relatively short
medium pitch, vibratory
best heard at left lower sternal/midsternal
no radiation
67
what piece of education if important for parents with a child with an innocent murmur
that it is just "a noise" and it has no significance
68
how much can a pregnant womens HR increase
10-15 bpm
69
what is different about a pregnant womans heart
decrease in BP
| apical pulse in different location
70
after age 35, if S3 is heard, what can it be a sign of
can be the earliest sign of HF (ventricular gallop)
71
what causes a pericardial friction rub
inflammation in the pericardial sac as it rubs against the pericardium
72
what does a pericardial friction rub sound like
high pitched and scratchy
sandpaper
have patient sit up and hold their breath
73
what are the subjective findings of mitral regurgitation
fatigue
palpitations
orthopnea
74
what are the objective findings of mitral regurgitation
thrill in systole at apex of the heart (sounds like cat purring)
displaced apical pulse (down and to the left)
S1 diminished
S3 often heard
75
what arteries are accessable for examination
temporal/carotid
arms
legs
76
what does peripheral arterial disease affect
noncoronary vessels and arteries affecting the limbs
77
why are veins called capacitance vessels
their ability to stretch
78
what doe veins carry
deoxygenated blood and wastes
79
what are the functions of the lymphatics
conserve fluid/plasma proteins that leak from capillaries
immune system, defend against diseases
absorb lipids from intestinal tract
80
what organs are involved in the immune response
spleen
tonsils
thymus
81
how is the spleen involved in the immune response
produce antibodies
filter microorganisms out of the blood
destroy old RBC's
store RBC's
82
why do hemorrhoids, edema, and varicose veins occur in pregnant women
as uterus gets larger, it obstructs the drainage
83
what are the signs/symptoms of intermittent claudication (IC)
burning and cramping when walking when you sit down it goes away
84
what increases the risk of DVT in older adults
progressive enlargement of calf veins
| increased imoblitiy
85
what race is more at risk for PAD
african americans
86
what are the risk factors for developing PAD
```
smoking
diabetes
HTN
obesity
increased cholesterol levels
```
87
what should a normal angle of the nail be
160
88
pitting edema scale
```
+1 = mild, slight indentation
+2 = moderate, indentation disappears rapidly
+3 = deep, indentation remains, legs look swollen
+4 = very deep, lasts long, leg grossly swollen
```
89
if their is an expected arterial deficit, what should you do
raise legs off table, wag feet for 30 seconds to drain venous blood
sit with legs over side of table
compare feet color/time it takes color to return to feet (less than or equal to 10 seconds)
90
what is a doppler used to detect
weak pulses
| magnifies pulsatile sounds from heart/blood vessels
91
what does an increased Wells Score indicate
increased risk/probability of DVT
92
more than what indicates a high probablity for DVT
3 or higher
93
what should health promotion and education be with veins/arteries/etc
FOCUS ON FOOT CARE
94
what is the Raynaud Phenomenon
vessels being too cold, constrict and there is no blood flow
95
what are the s/s of Raynaud Phenomenon
extreme pain
| abrupt color change in digits (loss of color)
96
what can cause Raynaud Phenomenon
too cold
stress
smoking
97
what is lymphedema
lymph nodes cause edema
98
what causes chronic venous stasis ulcer
valves in veins aren't good at bringing blood back to heart
99
what is the main symptom/sign of chronic venous stasis
staining/discoloration to the lower extremeties (brown)
| because of the breakdown of RBC's
100
arterial disease cause what symptoms
symptoms of oxygen deficit
cool pale skin
smoking
diabetes
101
what kind of disease is intermittent claudication
arterial disease
102
what symptoms do venous diseases cause
symptoms of metabolic waste build up
103
what are internal organs called
viscera
104
what are the midline organs
aorta
uterus if enlarge
bladder if distended
105
what organs are in the Right Upper Quadrant (RUQ)
```
liver
gallbladder
duodenum
head of pancreas
right kidney/adrenal gland
hepatic flexure of colon
part of ascending/transverse colon
```
106
what organs are in the Left Upper Quadrant (LUQ)
```
stomach
spleen
left lobe of liver
body of pancreas
left kidney/adrenal gland
splenic flexure of colon
part of transverse/descending colon
```
107
what organs are in the Right Lower Quadrant (RLQ)
```
cecum
appendix
right ovary tube (female)
right ureter
right spermatic cord (male)
```
108
what organs are in the Left Lower Quadrant (LLQ)
```
part of descedning colon
sigmoid colon
left ovary tube (female)
left ureter
left spermatic cord
```
109
what type of anemia is common in the aging adult
pernicious anemia
can't absorb B12
decrease gastric acid is the cause
110
what is celiac disease
autoimmune
| intolerant to gluten
111
what is a peptic ulcer caused by
acids eating away at the stomach in the small intestine
112
what are causes of peptic ulcers
```
NSAIDS
Alcohol
H. Pylori
radiation
smoking
stomach cancer
```
113
what is black tarry stool called
melana
114
what can green stool indicate
bacterial
115
what can pale and clay color stool indicate
liver issues
116
what is the order of assessing the abdomen
LOOK, LISTEN, FEEL
117
where does auscultation of the abdomen start
RLQ
118
what is Borborygmus
hyperperistalsis
119
to call bowel sounds absent, what must you do
listen to same spot for 5 minutes
120
how do you check for costovertebral angle of tenderness (CVA)
place hand over 12th rib and use opposite hand to thump
121
how large must the spleen be to be felt
3 times normal size
122
when is the spleen often palpable
```
Infections
Mono
leukemia
lymphamos
HIV
portal HTN
```
123
what can occur if the spleen is enlarged
it is fribale, it can rupture
124
what tests can be done for ascites
fluid wave test
| shifting dullness test
125
after what age should the stomach no longer be protruberent when laying supine
age 4
126
what are s/s of peptic/duodenal ulcers
```
dull aching and gnawing pain
does not radiate
relieved by food
may awaken them from sleep
vomiting
```
127
why may there be diminished bowel sounds
abdominal surgery
bowel obstruction
peritonitis (infection)
128
what is the suffix "megaly"
irregular enlargement of a body organ
129
what is hepatomegaly
enlarged liver
130
how many lobes does the right lung have
3 lobes
131
how many lobes does the left lung have
2 lobes
