Final 2 Flashcards

1
Q

Location of heart sounds.

A
A – arotic 
P – pulmonic 
E – erb’s point (murmors)
T – tricuspid valve 
M – mitral valve
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1
Q

S1

A

heard at apex, mitral and tricuspid closing (AV valves close)

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2
Q

S2

A

heard at base, arotic and pulmonic value closing (semilunar valves close)

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2
Q

How do you assess the PMI,

A

5th ICS MCL

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3
Q
  1. If you have increased peripheral vascular resistance you would most likely have what changes in blood pressure?
A

So if increase then increase blood pressure

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3
Q

What does JVD tell you?

A

Pt at 45 degrees <3cm = normal

Tell you if there is right sided heart failure

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4
Q

How is Pitting Edema documented and scored?

A

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

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4
Q

How would you describe a grade IV murmur?

A

Measured: 1-6; 4 - loud

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5
Q

gh-pitched sounds are heard best using the

A

Diaphragm

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5
Q

low pitched sounds are heard best using the

A

Bell

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6
Q

Describe the normal curvature of the nail, and what would be classified as Clubbing?

A

> 180 degrees (people with COPD)

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6
Q

S3

A

congestive heart failure (sloshing in) (early diastole, rapid ventricular filling)

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7
Q

S4

A

atria has to contract against noncompliant ventricle (a stiff wall) (late diastole, non-compliant ventricle)

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7
Q

When using the GCS what does this assess?

A

level of consciousness – degree of wakefulness or arousability (eye opening, best motor response, best verbal response)

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8
Q

What does CN III, IV, and VI test?

A

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

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8
Q

How do you assess for facial symmetry?

A

Identifies correct taste on anterior two thirds of tongue

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9
Q

Assessing Deep Tendon Reflexes.

A

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

9
Q

locations of deep tendon reflexes

A

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

10
Q

What is the best method for testing strength?

A

Pulling and pushing against resistance

5/5 normal

10
Q

What could cause atrophy in only one extremity?

A

stroke

11
Q

How do you assess the Thyroid?

A

Have pt swallow, can be tested anteriorly or posteriorly (have thumbs on)

11
Q

What does a normal T.M. look like?

A

Gray and pearly
If its clear then – fluid
If its red then – infection

12
Q

What is the proper technique for using the otoscope in children and in adults.

A

Children – pull down and back

Adult – pull up and back

12
Q

How do you perform the Weber Test and the Rhinne Test?

A

Weber equally heard bilaterally, Rhinne air conduction is louder than bone

13
Q

How do you assess for accommodation?

A

Have object move in closer and eyes should cross

13
Q

How do you assess the sinus

A

Frontal – above eyebrows; Maxiallary – cheeks; Ethmoid – beside eyes; palpate and percus all

14
Q

what is the purpose of assessing the sinuses?

A

looking for tenderness or fullness on palpation suggests infection

14
Q

What are abnormal assessment finding you may find when assess the lymph nodes?

A

If swollen then strep throat

15
Q

What does CN III, IV, and VI test?

A

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

16
Q

How do you assess for facial symmetry?

A

Identifies correct taste on anterior two thirds of tongue

17
Q

Assessing Deep Tendon Reflexes.

A

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

18
Q

locations of deep tendon reflexes

A

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

19
Q

What is the best method for testing strength?

A

Pulling and pushing against resistance

5/5 normal

20
Q

What could cause atrophy in only one extremity?

A

stroke

21
Q

How do you assess the Thyroid?

A

Have pt swallow, can be tested anteriorly or posteriorly (have thumbs on)

22
Q

What does a normal T.M. look like?

A

Gray and pearly
If its clear then – fluid
If its red then – infection

23
Q

What is the proper technique for using the otoscope in children and in adults.

A

Children – pull down and back

Adult – pull up and back

24
Q

How do you perform the Weber Test and the Rhinne Test?

A

Weber equally heard bilaterally, Rhinne air conduction is louder than bone

25
Q

How do you assess for accommodation?

A

Have object move in closer and eyes should cross

26
Q

How do you assess the sinus

A

Frontal – above eyebrows; Maxiallary – cheeks; Ethmoid – beside eyes; palpate and percus all

27
Q

what is the purpose of assessing the sinuses?

A

looking for tenderness or fullness on palpation suggests infection

28
Q

What are abnormal assessment finding you may find when assess the lymph nodes?

A

If swollen then strep throat