Final 2 Flashcards
Location of heart sounds.
A – arotic P – pulmonic E – erb’s point (murmors) T – tricuspid valve M – mitral valve
S1
heard at apex, mitral and tricuspid closing (AV valves close)
S2
heard at base, arotic and pulmonic value closing (semilunar valves close)
How do you assess the PMI,
5th ICS MCL
- If you have increased peripheral vascular resistance you would most likely have what changes in blood pressure?
So if increase then increase blood pressure
What does JVD tell you?
Pt at 45 degrees <3cm = normal
Tell you if there is right sided heart failure
How is Pitting Edema documented and scored?
1 + mild, disappears rapidly, no distortion
2+ moderate – disappears in 10 -15 seconds, no distortion
3+ deep – last > minute, looks swollen
4+ frank/severe – lasts 2-3 minutes, grossly distorted
How would you describe a grade IV murmur?
Measured: 1-6; 4 - loud
gh-pitched sounds are heard best using the
Diaphragm
low pitched sounds are heard best using the
Bell
Describe the normal curvature of the nail, and what would be classified as Clubbing?
> 180 degrees (people with COPD)
S3
congestive heart failure (sloshing in) (early diastole, rapid ventricular filling)
S4
atria has to contract against noncompliant ventricle (a stiff wall) (late diastole, non-compliant ventricle)
When using the GCS what does this assess?
level of consciousness – degree of wakefulness or arousability (eye opening, best motor response, best verbal response)
What does CN III, IV, and VI test?
Oculomotor, trohclear, abducens (motor function of the eye, exam together to assess extraocular movements, 6 cardinal fields of gaze, papillary response to light, accommodation, convergence
How do you assess for facial symmetry?
Identifies correct taste on anterior two thirds of tongue
Assessing Deep Tendon Reflexes.
Reinforcement techniques - clinch teeth when testing arm reflexes, Interlock & tense hands (pull apart)
Do not overly test reflex
Grading scale: 4+ hyperactive, very brisk, clonus; 3+ more brisk than normal, but not indicative of disease; 2+ normal; 1+ decreased, less than normal; 0 absent
locations of deep tendon reflexes
Biceps - Elbow flexes
Triceps- Elbow extends
Brachioradialis- Foreman flexes and supinates
Patellar- Knee extends
Achilles- Plantar flexion of foot
Ankle clonus - No rapid oscillations (clonus) with brisk dorsi-flexion of foot
What is the best method for testing strength?
Pulling and pushing against resistance
5/5 normal
What could cause atrophy in only one extremity?
stroke
How do you assess the Thyroid?
Have pt swallow, can be tested anteriorly or posteriorly (have thumbs on)
What does a normal T.M. look like?
Gray and pearly
If its clear then – fluid
If its red then – infection
What is the proper technique for using the otoscope in children and in adults.
Children – pull down and back
Adult – pull up and back
How do you perform the Weber Test and the Rhinne Test?
Weber equally heard bilaterally, Rhinne air conduction is louder than bone
