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Health Assessment > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

fluid buildup in the ears can cause _______ issues

A

balance

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2
Q

inability to communicate or understand communication

A

ahpasia

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3
Q

trouble or difficulty communicating or understanding communication

A

dysphasia

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4
Q

inability to swallow

A

aphagia

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5
Q

difficulty or trouble swallowing

A

dysphagia

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6
Q

5 steps to the neuro exam

A

mental status
cranial nerves
motor and cerebellar
sensory
reflexes

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7
Q

the _____ _____ function shows us intellect, communication, and emotional behavior

A

cerebral cortex

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8
Q

if you suspect any abnormalities in consciousness, use the ______ _____ scale and monitor the patient ever hour

A

Glasgow coma

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9
Q

3 areas that Glasgow Coma Scale looks at

A

Eye response
Verbal response
Motor response

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10
Q

sometimes a _____ _____ rub can illicit a pain response to make eyes open

A

deep sternal

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11
Q

best score on Glasgow coma scale

A

15

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12
Q

if the glasgow score is less than __, then the patient is comatosed

A

8

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13
Q

worst score on the Glasgow coma scale

A

3

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14
Q

abnormal posture when the arms are stuck brought to the core

A

decorticate

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15
Q

abnormal posture when the arms are stuck extended by their side

A

decerebrate

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16
Q

if the patient has trouble remembering three simple things you show them, then perform a ____ ____ _____ examination

A

mini mental state

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17
Q

in the mini mental state exam, you ask the patient to name __ simple objects

A

3

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18
Q

CN I

A

olfactory

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19
Q

CN II

A

optic

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20
Q

CN III

A

oculomotor

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21
Q

CN IV

A

trochlear

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22
Q

CN V

A

trigeminal

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23
Q

CN VI

A

abducens

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24
Q

CN VII

A

facial

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25
Q

CN VIII

A

vestibular/acoustic

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26
Q

CN IX

A

Glossopharyngeal

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27
Q

CN X

A

Vagus

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28
Q

CN XI

A

spinal accessory

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29
Q

CN XII

A

hypoglossal

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30
Q

olfactory nerve tests for ____ function

A

sensory

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31
Q

CN that tests smell

A

oflactory

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32
Q

optic nerve tests for _____ function

A

sensory

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33
Q

optic nerve tests for visual _____ and _____

A

acuity and fields

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34
Q

3 CN that test for the motor function of the eyes

A

oculomotor, trochlear, and abducens

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35
Q

3 things the oculomotor, trochlear, and abducens CN test for

A

eyelid elevation
cardinal fields of gaze
pupil reaction

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36
Q

to test cardinal fields of gaze, make an __ with your finger and have the pt. follow with their eyes

A

H

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37
Q

CN that test for both sensory and motor function

A

Trigeminal
Facial
Glossopharyngeal

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38
Q

the trigeminal nerve tests for _____ and _____ muscle strength by having the patient bite down

A

temporal and masseter

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39
Q

2 tests that test the sensory function of the trigeminal nerve

A

sharp and dull on face
corneal reflex

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40
Q

the facial nerve tests for ______ _____ or ______

A

facial drooping or asymmetry

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41
Q

CN that tests for hearing

A

vestibular

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42
Q

the vestibular CN also tests for ______ problems

A

equilibrium

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43
Q

jerky motion of the eyes caused by fluid in the ears

A

nystagmus

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44
Q

the glossopharyngeal and vagus nerve test for the movement of the _____ _______ and ______ and also sees if the ______ is midline by having the patient say AH

A

soft palate and pharynx, uvula

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45
Q

glossopharyngeal and vagus nerve test the ______ reflex

A

gag

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46
Q

glossopharyngeal and vagus nerve check to see if the voice is hoarse or nasally by having the patient say which 5 letter sounds?

A

k, q, ch, b, d

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47
Q

glossopharyngeal and vagus nerve check to see if the patient has any problems ______

A

swallowing

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48
Q

spinal accessory CN checks for atrophy or asymmetry in the ______ muscles

A

trapezius

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49
Q

2 ways to test trapezius muscle use for spinal accessory CN

A

shrug shoulders and turn head against resistance

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50
Q

the hypoglossal CN tests for ________ of words

A

articulation

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51
Q

3 tests to test articulation of words with hypoglossal CN

A

say la la la la
protrude tongue
move tongue side to side

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52
Q

4 tests done to test gait for cerebellar function

A

heel to toe walking
walk on heels
walk on tiptoes
hop

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53
Q

test done where the patient stands with feet together and eyes closed to see if they can keep balance

A

romberg test

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54
Q

wide-based, staggered, unsteady gait

A

cerebellar ataxia

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55
Q

2 things that cause cerebellar ataxia

A

cerebellar disease and intoxication

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56
Q

shuffling gait with stooped posture and flexed hips and knees

A

parkinsonian gait

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57
Q

gait with flexed arm close to body and one leg/foot is dragging behind

A

spastic hemiparesis

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58
Q

a ________ can cause spastic hemiparesis

A

stroke

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59
Q

for the sensory exam, you test the _____, _____, and ______

A

legs, arms, and abdomen

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60
Q

all sensory tests are done with eyes _____

A

closed

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61
Q

6 sensory tests

A

light touch
superficial pain test (sharp dull)
vibration sense
motion and position
stereogenesis
graphesthesis

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62
Q

test where you put the patients finger up or down and they have to tell you what you are doing

A

motion and position test

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63
Q

test where you put an easily identifiable object in the patients hand and have them identify it

A

stereogenesis

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64
Q

test where patient closes their eyes and you draw something in their hand and they have to tell you what you drew

A

graphesthesia

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65
Q

deep reflexes in the upper extremities

A

biceps, triceps, and brachioradialis

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66
Q

deep reflexes in the lower extremities

A

knees and achillies

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67
Q

grade ___ reflexes are present, but diminished

A

1

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68
Q

grade __ reflexes are normal

A

2

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69
Q

grade __ reflexes are mildly increased

A

3

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70
Q

grade ___ reflexes are marked hyperactive

A

4

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71
Q

5 things that can cause hypoactive reflexes

A

hypothyroidism
hypocalcemia
hypermagnesemia
sedation
increased intracranial pressure

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72
Q

3 things that can cause hyperactive reflexes

A

hyperthyroidism
hypercalcemia
hypomagnesium

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73
Q

______ reflex is when you run something along the bottom of the foot

A

plantar

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74
Q

normal plantar reflex in adults

A

toes curl up

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75
Q

abnormal plantar reflex in adults

A

Babinski’s

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76
Q

meningeal irritation is caused by ______ of the meningeal lining

A

infection

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77
Q

_______ _____ is when the neck is stiff and patients have trouble bending chin to chest

A

nuchal rigidity

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78
Q

_______ sign is when there is pain when trying to extend a flexed knee

A

Kernig’s

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79
Q

_______ sign is when the knees and hips flex when you bring your chin to you chest

A

Brudziniki’s

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80
Q

changes in temperature control, mood, and sleep result from changes in _________

A

neurotransmitters

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81
Q

total brain weight _____ with age

A

decreases

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82
Q

memory _____ as you age and learning time ______

A

decreases, increases

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83
Q

CVA can occur when cerebral blood vessels become occluded by a ____ or ______

A

thrombus or embolus

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84
Q

CVA can happen when an intracranial hemorrhage occurs leading to ______ of the brain tissue

A

ischemia

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85
Q

organs in the right upper quadrant

A

liver and gallbladder

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86
Q

organs in left upper quadrant

A

spleen and pancreas

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87
Q

organs in right lower quadrant

A

appendix
colon
ureter
ovary
spermatic cord

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88
Q

organs in left lower quadrant

A

colon
ureter
ovary
spermatic cord

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89
Q

the kidneys are in the _________ area

A

retroperitoneal

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90
Q

kidney that is lower than the other

A

right

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91
Q

coffee ground emesis indicates _______

A

blood

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92
Q

bright red blood in feces indicates an _______ ______

A

external hemrrhoid

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93
Q

tarry black stool indicates a _______ ______ ______

A

upper GI bleed

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94
Q

fatty stool indicates problems with the __________

A

gallbladder

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95
Q

hepatitis risk factors

A

blood transfusion
tattoos
IV drugs
piercings

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96
Q

when assessing the abdomen, position the light across the abdomen at a _____ angle

A

right

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97
Q

position for abdominal exam

A

supine with knees bent

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98
Q

abdomen concaving inwards

A

scaphoid

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99
Q

how to test for abdomen musculature

A

patient lift head and shoulders off the bed

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100
Q

how to test for abdomen bulges

A

patient hold breath and lift head and shoulder off bed

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101
Q

color that indicates bleeding under the skin

A

purple

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102
Q

pale and taught abdomen indicates _______

A

acsities

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103
Q

ability to see food or poop moving through the GI tract

A

visible perstalsis

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104
Q

it is normal to see slight _______ ______ above the belly button

A

aortic pulsations

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105
Q

6 F’s of distention

A

fat
fluid (ascites)
flatus (gas)
feces (constipation)
fetus
fibroids

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106
Q

ascites is usually seen in ____ _____ disease

A

advanced liver

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107
Q

use the _______ of the stethoscope to listen to bowel sounds and the _______ to listen to vascular sounds

A

diaphragm, bell

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108
Q

less than ___ sounds is hypoactive bowel sounds

A

5

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109
Q

greater than ___ sounds is hyperactive bowel sounds

A

35

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110
Q

borborygmi

A

growling of the stomach

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111
Q

3 reasons for hyperactive bowel sounds

A

gastroenteritis
diarrhea
laxative use

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112
Q

2 reasons for hypoactive bowel sounds

A

paritonitis and paralytic ileus

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113
Q

you must listen to bowel sounds for at least ___ minute

A

1

114
Q

for you to document no bowel sounds, you must listen for ___ minutes

A

5

115
Q

bruits may be normal in the _______ area of the abdomen

A

epigastric

116
Q

bruit over the aorta in the abdomen may indicate an ________ or _______

A

aneurysm or stenosis

117
Q

abnormal sound heard over the umbilicus

A

venous hum

118
Q

venous hum may be caused by _______ ______ ________ because of liver cirrhosis

A

obstructed portal circulation

119
Q

sound caused by visceral layers of the peritoneum rubbing over the liver or spleen

A

friction rub

120
Q

percuss the ______ ______ quadrant under the rib cage to find the liver

A

upper right

121
Q

when you percuss the liver, you should hear _______

A

dullness

122
Q

liver span

A

6-12 cm

123
Q

for the spleen, percuss the last ______ ______ at the ________ _____ line while the patient takes a deep breath

A

left interspace, anterior axillary

124
Q

when you percuss the spleen, you should hear ________

A

tympany

125
Q

if you hear dullness when percussing the spleen, it means it is _______

A

enlarged

126
Q

mono can cause an enlarged _______

A

spleen

127
Q

percuss the _______ _____ quadrant at the _____ ______ anterior rib cage and ________ _____ region

A

left upper, left lower, left epigastric

128
Q

to percuss the kidney for pain, place your hand at the __________ ______ and strike it with the _____ surface of your other hand

A

costovertebral angle, ulnar

129
Q

pyelonephritis

A

infection of the kidney

130
Q

2 cases in which you will not do deep palpation

A

aortic aneurysm and splenomegaly

131
Q

light palpation is ___ cm

A

1

132
Q

light palpation determines _____ and _______ of skin

A

tenderness and temperature

133
Q

tensing of rectus muscles during palpation that indicates pain

A

abdominal muscle guarding

134
Q

abdominal muscle guarding can indicate inflammation of the _______

A

peritoneum

135
Q

deep palpation is __ cm

A

5

136
Q

deep palpation is used to assess for _____

A

masses

137
Q

2 methods used to palpate the liver

A

bimanual and hook method

138
Q

when you stand behind patient and reach under the ribs to feel for the liver

A

hook method

139
Q

it is abnormal if you can palpate the liver below the _______ _____ and if there are ______ ______ and _____

A

costal margin, irregular borders and nodules

140
Q

lower border of liver should descend ______ to ____ inches (_____ to ___ cm)

A

0.75 to 1.25 inches
2 to 3 cm

141
Q

the spleen is felt in the _______ _____ quadrant

A

left upper

142
Q

4 causes of an enlarged spleen

A

CHF
cancer
cirrhosis
mononucleosis

143
Q

the kidneys and the spleen are usually not ______

A

palpable

144
Q

3 reasons the kidneys may be palpable

A

hydronephrosis
tumors
polycystic kidney disease

145
Q

the aortic pulsation should be no larger than __ cm

A

4

146
Q

nodular or asymmetric bladder could mean there is a _____

A

tumor

147
Q

if you can palpate a recently emptied bladder it could mean _______ _____

A

urinary retention

148
Q

if there is urine in the bladder, you will hear ______ upon percussion

A

dullness

149
Q

special test for ascites where you press down and watch for movement across stomach

A

fluid wave test

150
Q

percussion test done to assess ascites

A

shifting dullness

151
Q

test done to assess for abdominal inflammation

A

rebound tednerness

152
Q

if there is inflammation, when performing the rebound tenderness test, the patient will feel pain when pressure is ______

A

released

153
Q

in the rebound tenderness test, apply pressure at a _____ degree angle

A

90

154
Q

2 tests done for appendicitis

A

psoas sign and obturator muscle test

155
Q

in the psoas sign, the patient is ______ and does a ______ _____ raise against resistance

A

supine, straight leg

156
Q

in the obturator muscle test, the patient is supine and flexes the leg at the ____ and ____ and does _____ and _____ rotation

A

knee and hip, external and internal

157
Q

cholecystitis

A

inflammation of the gall bladder

158
Q

test for cholecystitis

A

murphy’s sign

159
Q

in the murphys sign, you will use the _____ method and have them take a deep breath at the same time

A

hook

160
Q

measure abdominal girth while patient is ______

A

standing

161
Q

4 causes of liver disease

A

hepatitis
cirrhosis
tylenol overdose
antibiotics

162
Q

excessive alcohol consumption can cause ______ of the liver

A

cirrhosis

163
Q

abdominal pain with stomach ulcers may improve after ______ and be worse at _____

A

eating, night

164
Q

a patient with a stomach ulcer may have ______ aka black poop

A

melana

165
Q

5 causes of peptic ulcer disease

A

stress
H-pylori bacteria
NSAIDs
smoking
alcohol

166
Q

meds for peptic ulcer disease

A

proton pump inhibitors
H2 blockers

167
Q

when you age, you _____ lining becomes less elastic

A

mucousal

168
Q

outpouching of intestinal wall caused by age

A

diverticula

169
Q

2 infections that increases your risk of cervical cancer

A

human papillomavirus infection
HIV infection

170
Q

females between ages ___ and ___ are most at risk for cervical cancer

A

50 and 55

171
Q

a diet low in ____ and _____ increased risks for cervical cancer

A

fruits and vegtables

172
Q

using oral contraceptives for more than _____ years increases risk for cervical cancer

A

5

173
Q

3 races more likely to get cervical cancer

A

african america
hispanic
native american

174
Q

you can only used _____ based lubricant for genital exams

A

water

175
Q

position of patient during female genital exam

A

lithotomy

176
Q

observe the mons pubis for _______ and _______

A

hair and infestation

177
Q

swelling and pain or the labia can result from ______

A

gonorrhea

178
Q

drainage from the urethra can be caused by ______ or _______

A

gonorrhea or chlamydia

179
Q

small, painful, red ulcers on the labia are caused by ______ _____

A

herpes simplex

180
Q

silvery white papules that develop into red moist ulcers are caused by ________ ______

A

syphilitic chancre

181
Q

fleshy lesions on the labia are genital warts caused by _____

A

HPV

182
Q

when the bladder bulges into the anterior wall of the vagina

A

cystocele

183
Q

when the rectum bulges into the posterior wall of the vagina

A

rectocele

184
Q

when the uterus protrudes into the vagina

A

uterine prolapse

185
Q

mucopurulent yellow discharge is seen in ________ and ______

A

gonorrhea and chlamydia

186
Q

yellow-green, frothy, foul-smelling discharge is seen in _______

A

trichomonas

187
Q

thick, white, cheesy discharge is seen in ______

A

candidiasis

188
Q

think, grey, fishy smelling discharge is seen in ________ ______

A

bacterial vaginosis

189
Q

beta blockers can cause ______ ______ in men

A

erectile dysfunction

190
Q

the shaft should be _____, ______, and not _____

A

soft, flaccid, tender

191
Q

silvery white papule that turns into red ulcers on the penis

A

syphillitic chancre

192
Q

clusters of pimple like clear vesicles that erupt and become ulcers on the penis

A

herpes progentitalis

193
Q

fleshy papules on the penis

A

genital warts

194
Q

hardened nodule or ulcer on the glands indicates _____

A

cancer

195
Q

foreskin that cannot be retracted from the glands

A

phimosis

196
Q

urethral meatus is on the bottom side of the glans

A

hypospadias

197
Q

urethral meatus is on the upper side of the glands

A

epispadias

198
Q

cryptorchidism

A

undecsended testicles

199
Q

collection of fluid in the scrotal sac

A

hydrocele

200
Q

loop of bowel in the scrotal sac

A

scrotal hernia

201
Q

infection of scrotum

A

epididymitis

202
Q

when blood supply is cut off from scrotum - emergency

A

torsion of spermatic cord

203
Q

self testicular exam is perform once a _____ after a warm shower

A

month

204
Q

ask the patient to bear down and observe for _____ around the anus

A

bulging

205
Q

_______ external hemrroids contain blood and are painful

A

thrombosed

206
Q

cavity of pus at anal opening

A

perineal abscess

207
Q

split of anal tissue of the anal canal

A

anal fissure

208
Q

a normal prostate has 2 _____ ____ and is divided by a _____

A

lateral lobes, sulcus

209
Q

swollen tender prostate

A

prostatitis

210
Q

enlarged, smooth, firm prostate with no sulcus

A

benign prostatic hypertrophy

211
Q

hard are of prostate or hard fixed nodules

A

cancer

212
Q

3 risk factors for HIV/AIDS

A

anal
IV drug use with shared needles
multiple sexual partners

213
Q

3rd most common cancer in men and women

A

colorectal cancer

214
Q

people over the age ____ are at risk for colorectal cancer

A

40

215
Q

diets of only animal sources put you at risk for ______ cancer

A

colorectal

216
Q

people from _____ ____ ____ decent have a greater risk of getting colorectal cancer

A

eastern european jewish

217
Q

2nd leading cause of cancer death in men

A

prostate cancer

218
Q

men over the age of _____ have a greater risk of prostate cancer

A

50

219
Q

______ ____ have a greater risk for prostate cancer

A

african americans

220
Q

women over the age of ___ are more at risk for breast cancer

A

50

221
Q

___% of breast cancer cases are women

A

99

222
Q

breast cancer death rates are higher in ______ _______ than white people

A

african american

223
Q

up to ___% of breast cancer cases are thought to have a genetic link

A

20

224
Q

menarche before age ___ puts you at risk for breast cancer

A

12

225
Q

pregnancy after _____ or nulliparous (no pregnancy) puts you at higher risk for breast cancer

A

30

226
Q

menopause after age ___ puts you at higher risk for breast cancer

A

55

227
Q

2 different types of medications that can increase your risk for breast cancer

A

oral contraceptives
hormone replacement therapy

228
Q

if you have average risk for breast cancer, then you should have the choice to start getting MMG between ages ___ and ___

A

40 and 44

229
Q

women of average risk for breast cancer between the ages ____ and ____ should get a MMG annually

A

45 and 54

230
Q

women over the age of ____ that are average risk for breast cancer should get a MMG every 2 years

A

55

231
Q

for women of average risk, screening should try to continue annually as long as they are in good health and expected to live ____ years or longer

A

10

232
Q

women who are a high risk for breast cancer should get a MMG and a ____ every year

A

MRI

233
Q

women who are high risk for breast cancer have a lifetime risk of ___ to ___ percent or greater based on measuring tool

A

20 to 25

234
Q

you are high risk for breast cancer if you have the ______ or ______ gene mutation OR you have a first degree relative with the gene mutation

A

BRCA1 or BRCA2

235
Q

if you have had radiation therapy to chest between the ages ____ and ____ then you are at high risk for breast cancer

A

10 and 30

236
Q

the american cancer society reccomends against MRI screening for people with a lifetime risk lower than ____%

A

15

237
Q

for women of high risk for breast cancer, MMG and MRI screening should start at age ___ and continue annually

A

30

238
Q

2 things that can worsen fibrocystic diseases

A

chocolate and caffeine

239
Q

common cause of bump on armpit

A

folliculitis

240
Q

enlargement of one or both breasts in men

A

gynecomastia

241
Q

the upper outer quadrant of the brast contains the _____ ____ _____

A

tail of spence

242
Q

most common area of the breast for tumors

A

upper outer quadrant

243
Q

when documenting the abnormal finding of a breast, you note what quadrant and how many cm away from the _______ it is

A

nipple

244
Q

it is normal for the breast on the ______ side to be bigger

A

dominant

245
Q

asymmetrical deviation of the nipple can be a sign of ______

A

cancer

246
Q

pigmentation of the nipple is enhanced during _______

A

pregnancy

247
Q

it is normal to have ________ nipples

A

supernumeray

248
Q

thickening of the skin and edema that have enlarged pores

A

Peau d’ orange

249
Q

infection caused by breast feeding

A

mastitis

250
Q

nipple inversion is a ______ finding

A

normal

251
Q

if the nipple inversion becomes broader and deeper it may indicate a _______

A

tumor

252
Q

disease where there is consistent eczematous dermatitis of the areola and nipple region that is usually unilateral

A

Paget’s Disease

253
Q

pagets disease is caused by a ______ ______

A

malignant neoplasm

254
Q

pagets disease is most common in _____ _______ women

A

post menopausal

255
Q

4 positions to assess retracting or dimpling of breast tissue

A

arms over head
hands on hips
hand pressed together
leaning forward

256
Q

axillary lymph nodes should be less that ___ cm, nonpainful, and mobile

A

1

257
Q

nodes that are fixed, firm, irregular, and larger than 1 cm may be caused by ________ to _______ _______

A

metastasis or primary lymphoma

258
Q

enlarged, painful, tender axillary nodes that are matted together can be a ______ ______ or ______

A

systemic infection or cancer

259
Q

if the _________ ducts are inflamed it can cause tenderness

A

lactiferous

260
Q

erythema with swelling of the breast with pitting edema can be ________

A

mastitis

261
Q

mastitis is caused by ________ ______

A

staph aureus

262
Q

it is best to perform BSE ___ days after menses or anytime you are not menstrating

A

8

263
Q

if you are post-menopausal, perform BSE on the the ____ day every month

A

same

264
Q

non-cancerous breast conditions account for ___% of clinical breast problems

A

90

265
Q

atrophic changes to female breasts occur from age ___ and on

A

40

266
Q

as glanduar breast tissue atrophies, it is replaced with ______ and ______ tissue

A

fat and connective

267
Q

any disease that is breast related problem not related to cancer

A

benign breast disease

268
Q

______ changes are multiple benign masses caused by ductal enlargement and formation of fluid-filled sacs

A

fibrocystic

269
Q

fibrocystic cysts often fluctuate in size in tenderness with ______ _____

A

menstrual cycle

270
Q

common benign breast tumor in young women

A

fibroadenoma

271
Q

fibroadenomas are made of ______ and ____ tissue

A

glandular and fibrous

272
Q

fibroadenomas are usually _______ and nontender

A

unilateral

273
Q

inflammatory condition of the breast that is usally caused by a bacterial infection

A

mastitis

274
Q

mastitis usually occurs in ______ women

A

lactating

275
Q

in non-lactating women, mastitis can occur as a result of ______

A

trauma

276
Q

term for inappropriate lactation

A

galactorrhea

277
Q

galactorrhea can be caused by a ______ tumor

A

pituitary

278
Q

galactorrhea can be caused by ______ failure

A

renal

279
Q

gynecomastia can occur in newborns because of _________ hormones

A

maternal

280
Q

gynecomastia can be caused by ______ or _______ tumors

A

adrenal or testicular

281
Q

gynecomastia can be caused by ______ or ______ disease

A

renal or liver

Health Assessment (4 decks)

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