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Health Assessment > HA Final > Flashcards

HA Final Flashcards

1
Q

artery is somewhat obstructed, increased risk of stroke (don’t mistake this w/ murmur), swooshing sound

A

bruits

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2
Q

nail abnormality due to chronic hypoxia to distal fingers (pts w/ COPD, emphysema, congestive heart failure)

A

clubbing

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3
Q

nail abnormality d/t chronic renal failure (proximal white, distal brown)

A

half and half nails

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4
Q

nail abnormality d/t slowed or halted nail growth (w/ deep horizontal line) in response to illness, physical trauma, or poisoning

A

Beau’s line

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5
Q

what causes longitudinal ridging nails

A

aging

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6
Q

nail abnormality d/t lesions from psoriasis, crating on nail bed

A

pitted nails

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7
Q

nail abnormality that is spoon-like (indentation) d/t trauma, iron deficiency aka hemochromatosis (may be normal in infants) or anemia .. nail is lifted along edgers, indented near center

A

Koilonychia

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8
Q

nail abnormality where nail plate and nail bed separation d/t trauma, fungal infections, topical irritants, psoriasis, sublingual neoplasms or warts

A

Onycholysis

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9
Q

what causes yellow nails

A

lung disorders or lymphedema

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10
Q

this nail abnormality is normal in dark-skinned pts

A

Dark longitudinal streaks

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11
Q

this nail abnormality is d/t damaged capillaries supplying the nail matrix caused by micro emboli

A

splinter hemorrhages

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12
Q

s/s of hypothyroidism

A

weight gain, fatigue, constipation, cold, large neck goiters, dysthymia (depression), dry skin, brittle nails, low b/p, low HR,
high TSH, low T3/T4

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13
Q

s/s of hyperthyroidism

A

weight loss, heat intolerance, tachy (high HR), high bp, warm aka heat intolerance, oily skin/hair, anxious, energetic, hyper,
low TSH, high T3/T4

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14
Q

method used to test peripheral vision

A

Confrontation

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15
Q

this is used to test near vision

A

jaeger chart

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16
Q

this is used to test color blindness

A

Ishihara chart

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17
Q

this is used to test distance vision, most common eye exam

A

Snellen chart

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18
Q

referred to as lazy eye

A

Amblyopia

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19
Q

term for eye strain

A

Asthenopia

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20
Q

exposure to UV can cause this (foggy/cloudiness/dull), it obstructs light that is going through the eyes

A

cataracts

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21
Q

normal part of aging for eyes

A

decreased depth perception & decreased night vision

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22
Q

this is nearsightedness aka can only see close up

A

Myopia

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22
Q

this is term for far sighted, so pt can only see far, due to aging

A

Presbyopia

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23
Q

2 types of hearing loss

A

conductive- blockage in ear like cerumen, hearing loss can be reversed .. middle/external ear

sensorineural- due to loud noises, hearing loss can’t be reversed, inner ear

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24
Q

Webber vs. Rinne Test

A

Webber: tuning fork goes on the middle of the head.. evaluates unilateral hearing loss.. determines if someones has SNHL or conductive HL

Rinne: tuning fork is placed behind the ear on the MASTOID PROCESS once , evaluates AC & BC (AC should be twice as long as BC)

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25
Q

epistaxis

A

nose bleeds

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26
Q

anosmia

A

loss of smell

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27
Q

3 sinus locations

A

frontal, maxillary, ethmoid

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28
Q

pt w/ allergies might have hx of what?

A

frequent upper respiratory infections

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29
Q

6 Ps of acute arterial occlusion

A
  1. Pain
  2. pallor (pale)
  3. poikilothermia
  4. paresthesia (tingly)
  5. pulselessness
  6. paralysis
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30
Q

coolness of an extremity may indicate this

other s/s include: pain, paresthesia (tingly), pallor (pale)

A

arterial occlusion

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31
Q

difference between DVT vs acute arterial occlusion

A

DVT- clot that forms in vein
erythema (red)

acute arterial occlusion- blockage in peripheral artery impacting flow to limbs
pallor (pale)

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32
Q

this is the result of a DVT, when the DVT breaks free & starts traveling which could lead to a PE (to lung) or MI (to heart) or stroke (to brain)

A

VTE (venous thromboembolism)

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33
Q

This is louder in aortic and pulmonic areas

A

S2

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34
Q

This is louder in mitral and tricuspid areas

A

S1

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35
Q

S1 & S2 are equal at this location

A

Erb’s pt

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36
Q

the amount of pressure in the great vessels, arteries/arterioles, the resistance

A

Afterload

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37
Q

the volume in the right atrium at the end of diastole, an indicator of how much blood will be forward to & ejected from the ventricles. More blood in the RV causes a stronger force of contraction

A

Preload

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38
Q

amount of blood ejected from LV each minute. It can be calculated by multiplying HR x stroke volume (How much blood is ejected with each beat or stroke)

A

cardiac output

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39
Q

3 layers of heart

A

Endocardium: thin; lines interiors of chambers, valves

Myocardium: thick; muscular for pumping

Epicardium: thin; muscle, exterior layer

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40
Q

dark brown leg due to old blood, warm and pink leg

A

venous insufficiency

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41
Q

pale, cold, pulseless leg

A

arterial insufficiency

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42
Q

this is the change in arterial blood flow d/t plaque, resulting in coolness, paleness, lower HR, paresthesia (tingling), hypoesthesia (numb)

A

PVD (peripheral vascular disease)

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43
Q

how does the PVS work (Peripheral vascular system)

A

blood vessels that carry oxygenated blood away from the heart to the periphery and carry deoxygenated blood back to the heart and to the lungs for reoxygenation

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44
Q

diastole vs systole

A

diastole: where the heart chamber is in a state of relaxation and fills with blood that receives from the veins

systole: where the heart chambers are contracting and pumps the blood towards the periphery via the arteries

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45
Q

abdominal vs lung assessment

A

abdominal:
1. inspect
2. auscultate
3. percuss
4. palpate

lung:
1. inspect
2. palpate
3. percuss
4. auscultate

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46
Q

DTR grading

A

*0 no response
*1+ diminished, low normal
*2+ average, normal
*3+ brisker than average
*4+ very brisk, hyperactive with clonus

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47
Q

RA vs OA

A

RA- systemic s/s include fatigue, fever, rash, splenomegaly, subcutaneous rheumatoid nodules, lymphadenopathy. Joints are more symmetrical, often in smaller joints, ulnar deviation, joint pain/tenderness, redness, swelling, joint deformity, worse in the AM and gets better with movement.

OA- not systemic s/s joints are less symmetrical, minimal redness, heat and swelling of joints. worsens throughout day and worsens with movement.

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48
Q

venous vs arterial ulcer

A

Venous ulcer- develops from chronic pooling of blood in extremity. Usually painless. Larger, more shallow.

Arterial ulcer- result from chronic ischemia as a consequence of impaired arterial circulation to an extremity. Usually located distally, such as at the ends of toes or fingers. Painful and usually infected. Smaller, deeper.

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49
Q

branden scale

A

tool used to assess pt’s risk for developing pressure ulcer

higher score (over 18) = less at risk
lower score (under 9) = high risk

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50
Q

sign of Lyme disease

A

bull’s eye rash

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51
Q

main 2 female hormones

A

estrogen and progesterone

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52
Q

this test tests for collateral circulation of radial & ulnar arteries, performed prior to drawing ABGs or insertion of an arterial line

A

Allen test

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53
Q

3 things GCS evaluates …?
what does the score mean?

A
  1. eye response (do their eyes respond to voice, pain, touch, nothing, etc)
  2. motor response (what movement do they make)
  3. verbal response (do they talk/nonverbal)

** 3 = deep coma, 15 = normal

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54
Q

burn classifications (fine to worst)

A
  1. superficial (brisk bleeding, pain, rapid cap refill)
  2. superficial dermal (brisk bleeding, pain, slow cap refill)
  3. dermal (delayed bleeding, no pain, no cap refill)
  4. full thickness (worst one, not painful and no bleeding)
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55
Q

3 layers of skin

A
  1. Epidermis, the top layer (protective barrier)
  2. Dermis, the middle layer (collagen/elastin, produces sweat/oil)
  3. Hypodermis, the bottom or fatty layer (cushions muscles and bones)
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56
Q

what kind of pt would have ascites?

A

pts with cirrhosis secondary to chronic alcoholism

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57
Q

location of appendix pain

A

McBurney’s point , near RLQ umbilical and ileac crest … this would be painful for appendicitis

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58
Q

what are the 2 signs for appendicitis?

A

Psoas sign: place hand right above pt’s right knee and ask them to raise that thigh against your hand, extend the right leg at the hip to stretch the iliopsoas muscle (if painful then positive for appendicitis)

Obturator sign: flex the pt’s right thigh at the hip w/ the knee bent and rotate the leg internally at the hip stretching the internal obturator muscle (if painful then positive for appendicitis)

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59
Q

what does it mean for a positive Murphy’s sign?

A

cholecystitis

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60
Q

pt is having right abdominal pain that radiates to the right scapula .. what could be wrong?

A

cholecystitis

61
Q

vibration, have pt say “99” and feel for vibrations using ulnar surfaces

A

Tactile fremitus /
Bronchophony

62
Q

breath sounds

A

Bronchial BS– over the trachea and larynx, loud, coarse high pitch

Broncho vesicular BS – over major bronchi

Vesicular BS – soft, low-pitched, found at distal airways

63
Q

PNA, fluid in lung, or collapse of lung, consolidation

A

atelectasis

64
Q

feels like Rice Krispies or bubble wrap, can’t see it but CAN feel this air leak

A

crepitis

65
Q

what part of lungs is responsible for gas exchange?

A

Bronchioles and alveoli responsible for gas exchange

66
Q

PNA will congregate where?

A

lower lobes first then go up, more common in right lung!

67
Q

boney ridge that joins the sternum to the manubrium

A

sternal angle AKA Angle of Luis or Manubrio

68
Q

S3 vs S4

A

S3 = ventricular gallop
Kentucky

S4 = Atrial gallop
Tennessee

69
Q

normal BMI

A

19 - 24

underweight = less than 18
obese = over 30
extreme obese = over 40

70
Q

how would you measure fluid volume overload?

A

by obtaining jugular venous pressure (JVP)

71
Q

what is the main trigger for breathing?

A

increased level of CO2 in blood

*(but not COPD pts due to them already having increased CO2 in their blood

72
Q

pneumonia is more likely to be found in which lung?

A

right lung bc it’s larger

73
Q

mitral & tricuspid valve closure, occurs during systole

A

S1

74
Q

sounds like balloons high pitched, scratching, grating. Heard at the left sternal border.

A

pericardial friction rub

75
Q

diastole, the relaxation phase

A

S2

76
Q

Systole, the contraction phase

A

S1

77
Q

what is the carina?

A

where the bronchi bifurcate

78
Q

aortic & pulmonic valve close. this occurs during diastole

A

S2

79
Q

mitral stenosis, quickly after S2, hard to differentiate, sudden bulge of aortic or pulmonic valve

A

snaps

80
Q

heart disease, aortic or pulmonic valve, quickly after S1

A

clicks

81
Q

heart sound heard in pregnant women or athletes, S3 gallop happens before S2, S4 gallop occurs before S1

A

gallops

82
Q

continuous, coarse, low pitched snoring sound, results from secretions moving around, may clear w/ coughing

A

rhonchi

83
Q

musical & high pitched, narrowing or partially obstructed airway, typically occurs w/ inspiration

A

wheezes

84
Q

fluid in airway, velcro sound, chest hair can sound like this too

A

crackles, rales

85
Q

percussion sounds

A

-resonance (loud, low pitched heard over lung tissue)
-tympany (loud, higher pitched sound over air filled spaces)
-dullness (heard over solid spaces)
-flat (higher pitched over dense tissue like pleural effusions & ascites)

86
Q

sympathy vs empathy

A

sympathy = feeling what the pt feels, you’re not being therapeutic bc you’re interpreting the situation as YOU perceive it

empathy = feeing what the pt is feeling from THEIR perspective, keeps the focus on the pt & what they’re feeling

87
Q

Pain in the epigastric area that radiates to the scapula with SOB aka dyspnea , sharp and stabbing pain!

A

this might be a sign of an aortic aneurism (ruptured aorta)

88
Q

skin of elderly

A

dry, no hair, shiny due to poor venous blood flow

89
Q

pitting vs non pitting edema, what’s the scale

A

pitting- leaves fingerprint
non pitting- does not leave mark

pitting scale:
1+ slight pitting, 2mm depression

2+ increased pitting, 4mm depression

3+ deeper pitting, 6mm depression, obvious edema of extremity

4+ severe pitting, 8mm depression, extremity appears very edematous

90
Q

what can lead to odynophagia (painful swallowing) or dysphagia (difficulty swallowing)

A

GERD, Parkinson’s disease, hiatal hernia, stroke pts

91
Q

pinpoint of cervical/spine

A

C7

92
Q

Need to assess respiratory first if this area is injured

A

C4 and above

93
Q

where is the Dorsalis pedis pulse

A

top of foot lateral to extensor longus tendon

94
Q

what can cause enlarged spleen and enlarged liver

A

spleen - EBV

liver- cirrhosis or hepatitis

95
Q

s/s of a PE resulting from a DVT

A

acute dyspnea (SOB), chest pain, tachycardia (high HR), diaphoresis (sweating), anxiety

96
Q

difference between Dysphagia vs Odynophagia

A

Odynophagia - painful swallowing

Dysphagia - difficulty swallowing

97
Q

s/s of venous stasis?

A

swelling/edema in legs, shiny skin, no hair growth, red/brown color due to old blood

pt can also get ulcers due to impaired skin integrity

98
Q

what is a pt at risk for if venous stasis occurs?

A

at risk for impaired skin integrity which can cause ULCERS

**due to lack of O2 rich blood flow to capillaries in tissue (slow death of tissues)

99
Q

how to assess thyroid gland

A
  1. thyroid cartilage (at top)
  2. cricoid cartilage (aka Adam’s apple)
  3. thyroid gland (at bottom)
100
Q

3 types of sweat glands

A

-Eccrine: sweat secretion, assist in thermoregulation

-Apocrine: located in axillae and genital areas, active during puberty- the stench! decreases w/ age

-Sebaceous: secrete sebum (oily substance that hydrates skin), decrease w/ age

101
Q

clear/slightly yellow tinged fluid filled blisters less than 1cm (small!)
aka serous fluid filled vesicles

A

chicken pox

102
Q

type of rash that is clear/blister like appearance

A

vesicular rash

103
Q

refers to a pattern of skin lesions that resemble the distribution of herpes zoster (shingles), distributed along dermatome, specific area of skin that is innervated by a single spinal nerve root
*unilateral on one side of body
*vesicular (blister-like) rash, serous fluid

A

Zosteriform

104
Q

ABCDE of Melanoma detection

A

-Asymmetric

-Borders (irregular)

-Color (coffee, multicolor, blue, green)

-Diameter (more than 6mm aka bigger than pencil erase)

-Evolution (change is bad)

105
Q

high pressure in eye, causes tunnel vision, damage to optic nerve

A

glaucoma

106
Q

involuntary twitching

A

fasciculation

107
Q

involuntary/ voluntary contraction

A

tremor

108
Q

what causes ptosis?

A

stroke, MS

109
Q

intentional vs resting tremors

A

intentional - worse w/ movement, better at resting

resting tremor - Parkinson’s , tremors get better w/ movement.. worse w/ rest

110
Q

this is caused primarily by brain edema, tumors, trauma

symptoms include mobility issues, severe case of this is stiff neck before going unconscious

A

cerebellar herniation

111
Q

this is irregular gait…
what can cause this?

A

-ataxia is irregular gait
-can be caused by vestibular abnormality aka inflamed labyrinth which causes vertigo

112
Q

this is known as “sway back”, the spine is curved inward

A

Lordosis

113
Q

most common site of anterior nosebleeds aka epistaxis

A

Kiesselbach plexus

114
Q

dry mouth

A

xerostomia

115
Q

this test evaluates high pitched hearing loss

A

whisper test

116
Q

this is thought to be an inability to filter internal noise from the external input of sound.. ringing in the ear

A

tinnitus

117
Q

this is the sensation of the room spinning, indicates dysfunction of the bony labyrinth in the inner ear

A

vertigo

118
Q

these may indicate barotrauma from pressure changes or a basilar skull fracture

A

hemotympanum, otorrhea, or TM rupture

119
Q

the term for unequal pupils

A

anisocoria (defect in oculomotor nerve)

120
Q

this condition causes blurred distance and near vision

A

astigmatism

121
Q

this condition is where your eyes make rapid, repetitive, uncontrolled movements

A

nystagmus

122
Q

How many spinal nerves are there? What are the 5 regions?

A

31 spinal nerve pairs

  1. Cervical (C1-8)
  2. Thoracic (T1-12)
  3. Lumbar (L1-5)
  4. Sacral (S1-5)
  5. Coccygel (Co1)
123
Q

What is the name of the fall risk scale?

A

Morse Palmer Scale

124
Q

This is what connects the muscle to the bone

A

tendon

125
Q

what are physical signs of dehydration

A

-dry skin
-cracked/dry lips
-increased HR
-lower B/P

126
Q

what separates the middle and external ear?

A

the tympanic ear drum

127
Q

the test evaluates cortical sensory function and is not usually done. ask the pt to close the eyes and identify a familiar object (coin, key) placed in their palm

A

stereognosis

128
Q

a pt will have control of their legs and walk, but may have loss of bowel and bladder control with this type of injury

A

S4-5 (sacral) injury

129
Q

a pt will have arm movement and sensation, but no leg movement & will be in a wheelchair with this type of injury

A

T5 (thoracic) injury

130
Q

a pt will not be able to cough or breathe on their own with this type of injury

A

C3 (cervical) injury

131
Q

what can cause herniation of the brain which can lead to change in basic vital functions such as breathing, reduced LOC, death

A

increases in CSF

132
Q

what is global aphasia

A

both expressive and receptive aphasia

133
Q

a pt that has damage to their Broca area (frontal lobe) causes what?

A

problems with speaking or finding words aka expressive aphasia

134
Q

a pt w/ a stroke in the brain’s left hemisphere/temporal are more likely to have what?

A

damage to the wernicke area so will have language deficits- difficulty understanding verbal communication aka receptive aphasia

135
Q

broca vs wernicke

A

wernicke- integrates understanding of spoken and written words (language is processed).. temporal lobe/ left hemisphere

broca- regulates verbal expression and writing ability.. the frontal lobe

136
Q

this area regulates verbal expression and writing ability, the frontal lobe

A

broca area

137
Q

this area integrates understanding of spoken and written words, language is processed here in the temporal lobe/left hemisphere

A

wernicke area

138
Q

type of flexion that moves the foot so that the toes move away from the heel

A

plantar flexion

139
Q

type of flexion that is bending the ankle so that toes move toward the heel

A

dorsiflexion

140
Q

these are synovial (diarthrotic) joints known as the gliding joints

A

intervertebral

**Gliding joints are numerous, mostly small, allow very little motion.
Ex: carpal joints of the wrist, the tarsal joints of the ankle, and the facet joints of the spine

141
Q

these are synovial (diarthrotic) joints known as saddle joint

A

thumb

142
Q

these are synovial (diarthrotic) joints known as the condyloid joint

A

wrists

Condyloid joints perform flexion, extension, abduction, and adduction movements.

143
Q

these are synovial (diarthrotic) joints that are known as the pivot joints

***allows bone rotation about another bone

A

atlas & axis

**this is the 1st & 2nd cervical vertebrae directly under the skull… allows for turning of the head from side to side

144
Q

these are synovial (diarthrotic) joints that are known as the ball and socket joints

A

hip and shoulder

145
Q

these are synovial (diarthrotic) joints that are known as the hinge joints & only perform flexion and extension

A

knee and elbow

**extension - increases angle
**flexion- decreases angle between bone or brings bones together

146
Q

what is the area where two bones come together, what is it’s function

A

joint, provides mobility to the skeleton

147
Q

if a patient had a hip replacement, what should they not do when it comes to ROM? & why?

A

they should not test adduction or flexion greater than 90 degrees b/c it could cause dislocation

148
Q

what are signs of meningeal irritation? (spinal cord meninges / intracranial hemorrhage)

A

-Flexion of the knee when the leg is pulled up, pt will also have stiffness in neck (nuchal rigidity) w neck pain (kernig and brudzinski signs)
-photophobia
-headaches
-fever

149
Q

A condition that affects the arteries, causing them to narrow or become blocked.

A

Peripheral arterial disease (PAD)

Health Assessment (4 decks)

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