Exam 3 study guide material Flashcards
What do normal bowel sounds sound like
Occur every 5-10 seconds, high pitched
If no bowel sounds are heard after 2 minutes, what could this indicate
illium does not contract normally, diffuse peritoneal irritation or peritonitis
When is borborygmi expected
during hyperperistalsis- expected in early acute intestinal obstruction
When are hyperactive bowel sounds expected
inflammation of intestinal mucosa (infections that cause diarrhea)
When would rushes be heard
When intestines are trying to foce their contents through a tight opening- noted in an obstruction
What is a normal liver span
10cm
What are key abnormal physical exam findings for patients who are in liver failure
-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)
What causes lower extremity edema in liver failure
inability to synthesize albumin
Which fissures do R and L lung have
R: Both horizontal and oblique
L: Oblique
Normal tracheal breath sounds
Loud, harsh over trachea
Normal bronchial sound
loud, harsher, high-pitched like air being pushed through a tube
Normal vesicular sounds
Soft, low-pitched, over most lung fields
Which abnormal lung sounds are typically heard in inspiration
Rales and Stridor
Which abnormal lung sounds are heard during expiration
Wheezing
Which abnormal lung sounds can be heard in inspiration and expiration
- Ronchi, Pleural rub
What is a pleurisy
Infection of pleural cavity
What is atelectasis
decreased or absent sounds, fine crackles.
Because of partial or full collapse of lung, alveoli become deflated or filled with fluid
What is the quantitative measure for barrel chest
Increased AP diamater is barrel chestedness
Where are bruits heard renally
few cm above umbilicus and at the edge of rectus muscles
Where is the PMI located
5th intercostal space, Mid clavicular line
What develops embryonically in the brest
Mamillary line- thickened embryonic tissue, accessory nipple accompanies soemtimes
What os occult blood
blood that is microscopic and found in stool
What are the 4 upper extremity blood supplies
- Subclavian a. (Aortic arch(L) or brachiocephalic trunk(R)–>upper limb)
- Axillary artery
- Brachial artery
- Radial and ulnar artery
What are the 3 lower extremity artieries (and 2 branches off the most distal one)
- External iliac artery, continues as femoral artery
- Femoral artery, becomes popliteal
- Popliteal
a. Anterior tibial
b. Posterior tibial
Where does most lymph node dranage occur
axillary lymph nodes>mammilary lymph nodes>Rotters>supraclavicular
