Final (All Subjects) Flashcards
Why is temperature taken?
take to reflect homeostasis of the body
What is the normal temperature range?
97.6-99.0 degrees F
What are the routes at which temperature can be taken?
- Oral
- Rectal (high +1)
- Axillary (lower -1)
- Tympanic (high +1)
What are some causes for temperature variation?
- Diurnal variation
- Recent hot or cold ingestion
- Cigarette smoking in mouth
- Cerumen in ear
What is the normal range for radial pulse in adults?
60-100 bpm
What heart rate is considered to be tachycardia?
> 100 bpm
When is respiratory rate counted?
While palpating pulse
What is the normal respiratory rate for adults?
12-20 breaths/min
What does bradypnea mean?
slow respirations
What does tachypnea mean?
fast respirations
What does hyperpnea mean?
deep respirations
What does apnea mean?
no respirations
What is blood pressure?
BP is the pressure required to move oxygenated blood through the heart. The pressure depends on the energy needed for the heart to pump, the elasticity of its arterial walls, and the volume and viscosity of the blood.
What is the formula for blood pressure?
BP= Cardiac output (CO) X Peripheral Resistance (PR)
What is the formula for cardiac output (CO)?
CO= Stroke volume + Heart rate
What does systolic mean?
Maximum pressure at the end of the stroke output (emptying) of the left ventricle
What does diastolic mean?
Minimum pressure at the end of left ventricular filling (resting) of the heart
What nonpharmacologic factors decrease blood pressure?
-Dehydration
What is orthostatic hypotension?
significantly lowered blood pressure upon standing, associated with dizziness/fainting
What nonpharmacologic factors increase blood pressure?
- Lack of sleep
- Pain
- Stress
- Smoking
- Licorice
What are you looking for in Brudzinski’s sign?
- Stiff neck, indication of meningitis
- Flexion of neck –> flexion of knees
What are you looking for in Kernig’s sign?
high and knee flexed, pain upon straightening the knee
What are some common ear symptoms?
- Hearing loss
- Vertigo
- Tinnitus
- Pain (otalgia)
- Itching
- Discharge (otorrhea)
What are some common ear disorders?
- Hearing loss
- Otitis media
- Otitis externa
- Eustachian tube dysfunction
What is air conduction hearing?
uses the bones of the middle ear to amplify sound waves
What is bone conduction hearing?
uses sound waves traveling on the surface of the bones of the skull to transmit sound to the cochlea without using the ear canal
What does conductive ALWAYS mean?
air conduction
What is sensorineural loss?
When cochlea or CN VIII is damaged. Occurs when sound waves are not processed correctly
What is conductive hearing loss?
occurs when sound waves do not reach the inner ear
What are the tests for CN VIII?
- Whisper test
- Rub test
What does the Rinne Test test for?
Bone and air conduction
What medications can have an adverse effect on hearing?
- Aminoglycoside antibiotics
- Vacomycin
- Loop diuretics
- Aspirin (at high doses)
- Anti-convulsants
What is landmark for a healthy tympanic membrane?
Maleus and cone of light
What is the most common cause of epistaxis?
nose picking
What is the cornea?
protects iris and pupil
What is the iris?
muscles that control amount of light entering eye
What is the pupil?
allows light into the eye
What is the lens?
changes shape to focus
What is conjunctiva?
(sclera) lines the surface of the eyeball and inner part of the lids
What is the retina?
thin film that lines the inner globe and is composed of billions of nerve endings that respond to light and color
What is the optic nerve?
CN II- transmits visual info to the brain
What causes nystagmus?
phenytoin
What is a sign of icterus?
Jaundice/yellowing of the eye (sign of liver dysfunction)
What is the typical size of the pupils?
3-5 mm
What is mydriasis?
dilation of the eye
What is miosis?
constriction of the eye
What is an observation of the eyes that can indicate anemia?
inside the eyelid, color
What is an observation of the eyes that can indicate allergies?
watery eyes, redness
What is an observation of the eyes that can indicate hyperthyroidism?
bulging eyes
What is an observation of the eyes that can indicate hypothyroidism?
short eyebrows
What cranial nerve is tested for with visual acuity?
CN II
What chart is used to test for far vision?
Snellen chart
What chart is used to test for near vision?
Rosenbaum chart
What is hyperopia?
far-sighted (impaired near vision)
What is presbyopia?
far-sighted as lens get more rigid with age
What cranial nerves do pupillary reactions to light test?
CN II, III
What cranial nerve does pupillary reaction to accommodation test?
CN III
Which cranial nerves control eye movement?
CN III, IV, and VI
What does point of care device mean?
tests designed to be used at or near the site where the patient is located, that do not require permanent dedicated space, and are performed outside the physical facilities of clinical laboratories.
What are some examples of point of care devices?
- Blood glucose
- Cholesterol
- A1c
- INR
What are CLIA-waivers?
Clinical Laboratory Improvement Amendments of 1988 (CLIA) law “specified laboratory requirements be based on the complexity of the tests and established provisions for categorizing a test as waived”
What is the main objective of the CLIA-waivers?
to ensure quality laboratory testing
What is OSHA?
Occupational Safety and Health Administration- regulates workplace safety; including protecting employees from exposure to blood borne pathogens/hazards
When sticking someone else, one must always wear _________
GLOVES
What can mucoid sputum (translucent, white, or gray in color) indicate?
viral infections
What can purulent sputum (yellowish or greenish) indicate?
bacterial infection
What can rust-color, pink sputum indicate?
pneumonia, tuberculosis
What can hemoptysis sputum indicate?
pulmonary emboli, TB, cystic fibrosis, ADR (warfarin)
What can tenacious (sticky) sputum indicate?
cystic fibrosis, COPD
What does barrel chest indicate?
accompanies aging, COPD
What are some possible causes of tactile fremitus?
Mass, fluid, COPD, fibrosis, pneumonia (increased fremitus)
What does a resonant percussion sound indicate?
percussion note over healthy lung
What does a dull percussion sound indicate?
note over consolidated lung or liquid in pleural cavity (pneumonia, TB)
What does a flat percussion sound indicate?
similar to dull
What does a hyper-resonant percussion sound indicate?
note over hyper-aerated lung or air in the pleural cavity (asthma, emphysema)
What does a tympanic percussion sound indicate?
note over air-filled structure (pneumothorax)
What do short, sounds of alveoli “popping open” indicate?
- Crackles or rales
- fluid, edema, pneumonia
What do high pitched whistling sounds indicate?
- Wheezes
- Asthma, COPD
What do harsher, coarser, low-pitched, “snoring” sounds indicate?
- Rhonchi
- Bronchitis
What does the conversion of “EE” to “AY” sound indicate?
- Egophony
- Fluid or mass (pneumonia)
What disease should a peak flow meter be used to help detect and monitor?
asthma
What is peak expiratory flow?
fastest speed (L/min) which air is forced out from lungs after taking a deep breath
What does a volumetric exerciser measure?
inspired air
What contracts during systole and what valves open?
- Ventricles contract
- Aortic and pulmonary valves open
What relaxes during diastole and what valves open?
- Ventricles relax
- Tricuspid and mitral valves open
What sound does S1 make and what does it mean?
- Lub
- Begins systole and tricuspid valve closure
What sound does S2 make and what does it mean?
- Dub
- Begins diastole and pulmonary valve closure
What sound does S3 make?
- Ventricular gallop
- SLOSH-ing sound
- abnormal after age ~40
What sound does S4 make?
- Atrial gallop
- a-STIFF-wall sound
- incidence increases with age
Where is S1 the loudest?
at apex of the heart (mitral area)
Where is S2 the loudest?
at the base of the heart (aortic and pulmonary area)
Which part of a stethoscope is best for detecting high-pitched sounds like S1, S2, and systolic murmers?
diaphragm
Which part of a stethoscope is best used for detecting low-pitched sounds like S3 and bruits?
bell
What can cause a murmur?
blow flowing “backwards” or in any other way that results in turbulence
What is a carotid endarectomy?
when you insert something to clean up build up in the arteries
What is the normal pulse grade?
2
List the major organs in the epigastric region
- stomach
- pancreas
- liver
List the organs in the RUQ
- gallbladder
- duodenum
- liver
- right kidney
List the organs in the LUQ
- stomach
- spleen
- left kidney
- pancreas
- liver
List the organs in the RLQ
- cecum
- appendix
- right ovary
- right ureter
List the organs in the LLQ
- descending colon
- sigmoid color
- left ovary
List the organs in the suprapubic region
- bladder
- uterus
What does pain/discomfort in the RLQ indicate?
appendicitis
What does pain/discomfort in the epigastric region indicate?
- stomach ulcer
- hepatitis
What does pain/discomfort in the RUQ or LUQ indicate?
pyelonephritis
What color stool/urine does taking iron produce?
black stool
What color stool/urine does taking pyridium produce?
orange urine
What color stool/urine does taking rifampin produce?
red
What color stool/urine does taking pepto bismol produce?
black
What is borborygmi and how often should you hear the gurgles?
- bowel sounds
- Hear every 5-10 seconds
- If none heard in 2 min = absent
What is the normal percussion sound for all four quadrants?
tympany (drum-like)
What does a positive Lloyd’s sign indicate?
UTI because if painful, underlying kidney is inflamed
What does a positive Murphy’s sign indicate?
Inflammation of the liver or gallbladder
What is a ligament?
collagen connecting bone to bone
What is a tendon?
collagen connecting muscle to bone
What is cartilage?
collagen overlying bony surfaces
What is bursae?
pouches of fluid that cushion movement of tendons and muscles over bone/other joint structures
What would indicate RA upon inspection of the hand?
ulnar deviation of phalanges
What would indicate osteoarthritis upon inspection of the hand?
- Heberden’s nodes
- Bouchard’s nodes
What does flexion mean?
decrease in angle between the surfaces of the joining bones
What does extension mean?
increase in angle
What does abduction mean?
movement away from the midline of the body
What does adduction mean?
movement toward the midline
What indicated carpal tunnel syndrome?
- thumb abduction
- Tinel’s sign (tapping on media nerve)
- Phalen’s sign
What is the normal for grading muscle strength?
5
What is the normal reflex grading for deep tendon reflexes?
2
Name the 5 areas tested for deep tendon reflexes
- biceps
- triceps
- brachioradialis
- patellar
- achilles
Name the two types of pain
- nociceptive pain
- neuropathic pain
What are the two types of nociceptive pain?
- somatic pain
- visceral pain
What are examples of somatic pain?
- injury to tissues
- nociceptor stimulation in injured tissue
- throbbing, burning, tenderness
What are examples of visceral pain?
- injury to organs
- stretching, injury or inflammation of organs
- deep, cramping, pressure, dull
What are examples of neuropathic pain?
- idiopathic or injury to nerves
- malfunctioning of peripheral or central nerves
- postherpetic neuralgia, diabetic neuropathy, phantom pain
- tingling, burning, itching, electrical shock
What does PQRST stand for?
- P- provokes and palliates
- Q- quality
- R- region and radiation
- S- severity
- T- time
What is medication abuse?
using medication to alter state of consciuosness
What is medication misuse?
- using more medication or taking more often than prescribed
- altering route of delivery
- getting drugs from other sources
What is medication diversion?
- redirection of medication to someone else for illicit use
- may involve selling or trading medication
What is the function frontal lobe?
executive function (thought, mathematics, complex reasoning?
What is the function parietal lobe?
initiation of movement, sense of body, language comprehension (speech and written)
What is the function cerebellum?
balance and coordination
What is the function occipital lobe?
vision
What is the function temporal lobe?
hearing, spatial relationships
How many cranial nerves are there?
12
-both sensory and motor function
How many pairs of spinal nerves are there?
31 pairs
-both sensory and motor function
What does each spinal nerve contain and what is its function?
- anterior root (motor function)
- posterior root (sensory function)
CN I
Olfactory- sensory
CN II
optic- sensory (retina)
CN III
oculomotor- motor
CN IV
trochlear- motor
CN V
trigeminal- motor
CN VI
abducens- motor
CN VII
facial- motor
CN VIII
acoustic/vestibulocochelar- sensory
CN IX
glossopharyngeal- motor
CN X
vagus- motor
CN XI
spinal accessory- motor
CN XII
hypoglossal- motor
What diseases affect gait and balance?
Parkinson’s, vertigo
What is illusion?
false perception of a real external stimulus; the mistaking of something for what it is not
What is labile affect?
unstable; extreme at certain points
What is loose associations?
patient’s responses do not relate to the interviewer’s questions – or one paragraph, sentence or phrase is not logically connected to those occurring before or after
What is neologism?
new word or phrase of the patient’s own making or an existing word used in a new meaning
What is obsession?
recurrent and persistent idea, thought, or impulse to carry out an act—a desire that cannot be voluntarily suppressed
What is perseveration?
constant repetition of a meaningless word or phrase
What is phobia?
any objectively unfounded morbid dread or fear that arouses a state of panic
What is tangential?
person tends to digress readily from one topic to another (does not get to the point)
What is blunted affect?
shallowness and a severe reduction in the expression of feeling
What is circumstantial?
delayed in reaching the point because of unnecessary detail, although components of the discussion have a meaningful connection
What is compulsion?
repetitive behaviors or mental acts that a person feels driven to perform as an unconscious mechanism to avoid ideas/desires
What is delusion?
false belief or wrong judgment held with conviction despite evidence to the contrary
What is echolalia?
involuntary parrot-like repetition of a word or sentence just spoken
What is flat affect?
absence of or reduction in the outward emotional reaction
What is flight of ideas?
streams of unrelated words and ideas occur to the patient at a rate that is impossible to vocalize despite a marked increase in the individual’s overall output of words
What is hallucination?
apparent, often strong subjective perception of an object or event where no stimulus is present
