Exam 3 study guide material

Question 1

What do normal bowel sounds sound like

Answer 1

Occur every 5-10 seconds, high pitched

Question 2

If no bowel sounds are heard after 2 minutes, what could this indicate

Answer 2

illium does not contract normally, diffuse peritoneal irritation or peritonitis

Question 3

When is borborygmi expected

Answer 3

during hyperperistalsis- expected in early acute intestinal obstruction

Question 4

When are hyperactive bowel sounds expected

Answer 4

inflammation of intestinal mucosa (infections that cause diarrhea)

Question 5

When would rushes be heard

Answer 5

When intestines are trying to foce their contents through a tight opening- noted in an obstruction

Question 6

What is a normal liver span

Answer 6

10cm

Question 7

What are key abnormal physical exam findings for patients who are in liver failure

Answer 7

-Jaundice/icterus- yellowing of skin and eyes because of bilirubin buildup
-Ascites- fluid buildup in abdomen
- Gynecomastia- increased estrogen levels systemically causes enlarged breasts
-Spider angiomata- increased estrogen levels
- Varices with portal vein hypertension
-Coffee ground emesis (ground like vomit)
- Bilirubinuria (bilirubin in urine)

Question 8

What causes lower extremity edema in liver failure

Answer 8

inability to synthesize albumin

Question 9

Which fissures do R and L lung have

Answer 9

R: Both horizontal and oblique
L: Oblique

Question 10

Normal tracheal breath sounds

Answer 10

Loud, harsh over trachea

Question 11

Normal bronchial sound

Answer 11

loud, harsher, high-pitched like air being pushed through a tube

Question 12

Normal vesicular sounds

Answer 12

Soft, low-pitched, over most lung fields

Question 13

Which abnormal lung sounds are typically heard in inspiration

Answer 13

Rales and Stridor

Question 14

Which abnormal lung sounds are heard during expiration

Answer 14

Wheezing

Question 15

Which abnormal lung sounds can be heard in inspiration and expiration

Answer 15

• Ronchi, Pleural rub

Question 16

What is a pleurisy

Answer 16

Infection of pleural cavity

Question 17

What is atelectasis

Answer 17

decreased or absent sounds, fine crackles.
Because of partial or full collapse of lung, alveoli become deflated or filled with fluid

Question 18

What is the quantitative measure for barrel chest

Answer 18

Increased AP diamater is barrel chestedness

Question 19

Where are bruits heard renally

Answer 19

few cm above umbilicus and at the edge of rectus muscles

Question 20

Where is the PMI located

Answer 20

5th intercostal space, Mid clavicular line

Question 21

What develops embryonically in the brest

Answer 21

Mamillary line- thickened embryonic tissue, accessory nipple accompanies soemtimes

Question 22

What os occult blood

Answer 22

blood that is microscopic and found in stool

Question 23

What are the 4 upper extremity blood supplies

Answer 23

1. Subclavian a. (Aortic arch(L) or brachiocephalic trunk(R)–>upper limb)
2. Axillary artery
3. Brachial artery
4. Radial and ulnar artery

Question 24

What are the 3 lower extremity artieries (and 2 branches off the most distal one)

Answer 24

1. External iliac artery, continues as femoral artery
2. Femoral artery, becomes popliteal
3. Popliteal
   a. Anterior tibial
   b. Posterior tibial

Question 25

Where does most lymph node dranage occur

Answer 25

axillary lymph nodes>mammilary lymph nodes>Rotters>supraclavicular