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Exam 3 Flashcards

1
Q

how many pairs of ribs are there

A

12

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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

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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

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4
Q

does residual volume increase in the aging adult

A

yes

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5
Q

what is the most common chronic disease in children

A

asthma

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6
Q

objective data of the lungs includes

A

inspection
palpation
percussion
auscultation

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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”

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8
Q

what is a sound that is not pathologic

A

atelectic crackles

short popping, crackles, few breaths disappear

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9
Q

what is the normal outcome of Tactile (vocal) Fremitus when auscultation

A

soft, muffled, indistinct

hear sound, not distinguish what is said

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10
Q

what do diseases cause in tactile fremitus

A

increase intensity and enhance transmission of sounds

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11
Q

Bronchophony

A

auscultate posterior chest
99 should be muffled and soft
if loud (consider lung consolidation)

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12
Q

Egophony

A

evaluates intensity of voice
say “eee”
if “aaa” is heard, consider lung consolidation

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13
Q

Whispered Pectoriloquy

A 
performed when (+) bronchophony is auscultated 
whisper (1, 2, 3)
should be faint/muffled
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14
Q

what are normal differences of infants lungs/thoracic cavity

A

rounded thorax

equal anterioposterior to transverse chest diameter

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15
Q

by what age does the thorax reach adult ratio

A

6

1:2

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16
Q

are crackles in the lungs of a newborn common

A

yes

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17
Q

what are normal RR for infants

A

30-40

may spike to 60

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18
Q

when may RR be different in infants

A

extremes in temperature
feeding
sleeping

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19
Q

are brief period of apnea in infants normal? if so, for how long?

A

yes

10-15 seconds

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20
Q

when breathing, what may happen to the HR

A

it may speed up

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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
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22
Q

what is the ratio of a barrel chest

A

1:1

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23
Q

whats the ratio of normal chest

A

1:2

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24
Q

what are pulmonary embolisms typically caused by

A

DVT

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25
Q

what are s/s of pulmonary embolism

A 
chest pain (worse on inspiration)
dyspnea
apprehension (impending doom)
anxiety
restless
diaphoresis
hypotension
crackles
wheezes
Partial Pressure <80 mm
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26
Q

what is crepitus

A

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)

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27
Q

where is the apex of the heart

A

bottom

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28
Q

where is the base of the heart

A

top of the heart

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29
Q

what are the great vessels

A

arteries and veins that are connected to the heart

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30
Q

what are the two continious loops of blood vessels

A

Pulmonary Circulation

Systemic Circulation

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31
Q

what are the two AV valves

A

tricuspid (right)

Bicuspid/Mitral (left)

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32
Q

when are the two AV vales closed

A

during systole (emptying) to prevent regurg of blood back into aorta

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33
Q

what are the semilunar valves

A

Pulmonic (right)

Aortic (left)

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34
Q

what is the blood flow of the heart

A 
right atrium
right ventricle
pulmonary artery
lungs
pulmonary vein
left atrium
left ventricle
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35
Q

when does S3 occur

A

when ventricles are resistant to filling during early rapid filling phase (Protodiastole)

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36
Q

when does S4 occur

A

at the end of diastole, at presystole, ventricle resistant to filling

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37
Q

what is S4 a sign of

A

HF

MI

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38
Q

when is S3 normal

A

it is okay in children, pregnancy, and conditioned athletes

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39
Q

what are murmurs caused by

A

the backflow of blood

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40
Q

what is heard if a murmur is present

A

blowing/swooshing

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41
Q

what are the conditions that result in murmurs

A

increased velocity of blood
decreased viscosity of blood
structural defects in valves

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42
Q

what is the node that initiates the electric impulse

A

Sinoatrial Node (SA Node)

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43
Q

what is the equation for cardiac output

A

Heart Rate X Stroke Volume

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44
Q

how much does blood volume increase in pregnancy

A

30-40%

arterial BP decreases

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45
Q

what are the electrocardiogram differences in older adults

A

prolonged PR interval
prolonged QT interval
QRS is the same

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46
Q

what is the most common underlying cause of death globally

A

CVD

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47
Q

what are the risk factors of CVD

A 
HTN
Smoking
Increased Serum Cholesterol
Physical Activity
Diet
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48
Q

what is Paroxysmal Nocturnal Dyspnea

A

SOB at night, feeling of smothering when sleeping

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49
Q

signs of heart issues in infants can include

A

diaphoresis when eating
SOB when eating
fall asleep then wake up soon and still be hungry
cyanosis

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50
Q

what is a bruit

A

something you hear

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51
Q

what can a bruit be a sign of in the carotid

A

atherosclerosis

build up of plaque

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52
Q

what does the jugular venous pressure give information on

A

the hearts efficiency to pump

information about the right side of the heart

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53
Q

if there is JVD, what is it a sign of

A

right sided heart failure

54
Q

what should you observe the precordium

A

possible pulsations

masses

55
Q

what is at the second right interspace

A

aortic valve

56
Q

second left interspace

A

pulmonic valve

57
Q

3rd lower sternal border

A

tricupsid valve

58
Q

5th interspace at midclavicular line

A

mitral valve (apical pulse)

59
Q

what should be noted about murmurs

A 
timing
loudness
pitch
pattern
quality
location
radiation
posture
change in position
60
Q

what is the HR after birth

A

100-180

61
Q

what should infant HR stabilize to

A

120-140

62
Q

does an immediate newborn with a murmur mean it has a heart issue

A

no

typically disppear in 2-3 days

63
Q

does an absence of a murmur in a newborn mean it is healthy

A

not necessarily

64
Q

is a venous hum harmful

A

no

65
Q

what is a common murmur in children

A

Innocent (functional) Murmur

66
Q

what are the characteristics of the innocent murmur

A

soft, relatively short
medium pitch, vibratory
best heard at left lower sternal/midsternal
no radiation

67
Q

what piece of education if important for parents with a child with an innocent murmur

A

that it is just “a noise” and it has no significance

68
Q

how much can a pregnant womens HR increase

A

10-15 bpm

69
Q

what is different about a pregnant womans heart

A

decrease in BP

apical pulse in different location

70
Q

after age 35, if S3 is heard, what can it be a sign of

A

can be the earliest sign of HF (ventricular gallop)

71
Q

what causes a pericardial friction rub

A

inflammation in the pericardial sac as it rubs against the pericardium

72
Q

what does a pericardial friction rub sound like

A

high pitched and scratchy
sandpaper
have patient sit up and hold their breath

73
Q

what are the subjective findings of mitral regurgitation

A

fatigue
palpitations
orthopnea

74
Q

what are the objective findings of mitral regurgitation

A

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
Q

what arteries are accessable for examination

A

temporal/carotid
arms
legs

76
Q

what does peripheral arterial disease affect

A

noncoronary vessels and arteries affecting the limbs

77
Q

why are veins called capacitance vessels

A

their ability to stretch

78
Q

what doe veins carry

A

deoxygenated blood and wastes

79
Q

what are the functions of the lymphatics

A

conserve fluid/plasma proteins that leak from capillaries
immune system, defend against diseases
absorb lipids from intestinal tract

80
Q

what organs are involved in the immune response

A

spleen
tonsils
thymus

81
Q

how is the spleen involved in the immune response

A

produce antibodies
filter microorganisms out of the blood
destroy old RBC’s
store RBC’s

82
Q

why do hemorrhoids, edema, and varicose veins occur in pregnant women

A

as uterus gets larger, it obstructs the drainage

83
Q

what are the signs/symptoms of intermittent claudication (IC)

A

burning and cramping when walking when you sit down it goes away

84
Q

what increases the risk of DVT in older adults

A

progressive enlargement of calf veins

increased imoblitiy

85
Q

what race is more at risk for PAD

A

african americans

86
Q

what are the risk factors for developing PAD

A 
smoking
diabetes
HTN
obesity
increased cholesterol levels
87
Q

what should a normal angle of the nail be

A

160

88
Q

pitting edema scale

A 
\+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
Q

if their is an expected arterial deficit, what should you do

A

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
Q

what is a doppler used to detect

A

weak pulses

magnifies pulsatile sounds from heart/blood vessels

91
Q

what does an increased Wells Score indicate

A

increased risk/probability of DVT

92
Q

more than what indicates a high probablity for DVT

A

3 or higher

93
Q

what should health promotion and education be with veins/arteries/etc

A

FOCUS ON FOOT CARE

94
Q

what is the Raynaud Phenomenon

A

vessels being too cold, constrict and there is no blood flow

95
Q

what are the s/s of Raynaud Phenomenon

A

extreme pain

abrupt color change in digits (loss of color)

96
Q

what can cause Raynaud Phenomenon

A

too cold
stress
smoking

97
Q

what is lymphedema

A

lymph nodes cause edema

98
Q

what causes chronic venous stasis ulcer

A

valves in veins aren’t good at bringing blood back to heart

99
Q

what is the main symptom/sign of chronic venous stasis

A

staining/discoloration to the lower extremeties (brown)

because of the breakdown of RBC’s

100
Q

arterial disease cause what symptoms

A

symptoms of oxygen deficit
cool pale skin
smoking
diabetes

101
Q

what kind of disease is intermittent claudication

A

arterial disease

102
Q

what symptoms do venous diseases cause

A

symptoms of metabolic waste build up

103
Q

what are internal organs called

A

viscera

104
Q

what are the midline organs

A

aorta
uterus if enlarge
bladder if distended

105
Q

what organs are in the Right Upper Quadrant (RUQ)

A 
liver
gallbladder
duodenum
head of pancreas
right kidney/adrenal gland
hepatic flexure of colon
part of ascending/transverse colon
106
Q

what organs are in the Left Upper Quadrant (LUQ)

A 
stomach
spleen
left lobe of liver
body of pancreas
left kidney/adrenal gland
splenic flexure of colon
part of transverse/descending colon
107
Q

what organs are in the Right Lower Quadrant (RLQ)

A 
cecum
appendix
right ovary tube (female)
right ureter
right spermatic cord (male)
108
Q

what organs are in the Left Lower Quadrant (LLQ)

A 
part of descedning colon
sigmoid colon
left ovary tube (female)
left ureter
left spermatic cord
109
Q

what type of anemia is common in the aging adult

A

pernicious anemia
can’t absorb B12
decrease gastric acid is the cause

110
Q

what is celiac disease

A

autoimmune

intolerant to gluten

111
Q

what is a peptic ulcer caused by

A

acids eating away at the stomach in the small intestine

112
Q

what are causes of peptic ulcers

A 
NSAIDS
Alcohol
H. Pylori
radiation
smoking
stomach cancer
113
Q

what is black tarry stool called

A

melana

114
Q

what can green stool indicate

A

bacterial

115
Q

what can pale and clay color stool indicate

A

liver issues

116
Q

what is the order of assessing the abdomen

A

LOOK, LISTEN, FEEL

117
Q

where does auscultation of the abdomen start

A

RLQ

118
Q

what is Borborygmus

A

hyperperistalsis

119
Q

to call bowel sounds absent, what must you do

A

listen to same spot for 5 minutes

120
Q

how do you check for costovertebral angle of tenderness (CVA)

A

place hand over 12th rib and use opposite hand to thump

121
Q

how large must the spleen be to be felt

A

3 times normal size

122
Q

when is the spleen often palpable

A 
Infections
Mono
leukemia
lymphamos
HIV
portal HTN
123
Q

what can occur if the spleen is enlarged

A

it is fribale, it can rupture

124
Q

what tests can be done for ascites

A

fluid wave test

shifting dullness test

125
Q

after what age should the stomach no longer be protruberent when laying supine

A

age 4

126
Q

what are s/s of peptic/duodenal ulcers

A 
dull aching and gnawing pain
does not radiate
relieved by food
may awaken them from sleep
vomiting
127
Q

why may there be diminished bowel sounds

A

abdominal surgery
bowel obstruction
peritonitis (infection)

128
Q

what is the suffix “megaly”

A

irregular enlargement of a body organ

129
Q

what is hepatomegaly

A

enlarged liver

130
Q

how many lobes does the right lung have

A

3 lobes

131
Q

how many lobes does the left lung have

A

2 lobes

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