Health Assessment Final Flashcards
Cotton wool spots are caused by
vascular disease from HTN and Diabetes Mellitus
Papilledema is caused by
increased intracranial pressure
optic nerve head cupping is caused by
glaucoma increased intraocular pressure
glaucoma can cause intense ocular pain, blurred vision, halos around lights a red eye, and dilated pupil
can even cause stomach pain, N/V
Dot hemorrhages and cotton wool spots can be caused by
hemorrhage at disc margin
diabetic retinopathy
undiagnosed glaucoma
Hypertensive retinopathy look like what in the eye
hemorrhage dot, blot, cotton wool spots if severe papilledema
interruption of red reflex with opacities may indicate
cataract, retinoblastoma, or other serious intraocular pathology
at _ years of age vision test such as _ can begin
4, HOTV or LEA
macular degeneration in elderly is seen as what in the eye
this is the leading cause of legal blindness in people older than
drusen bodies
55 in US
white reflex on photos could indicate (Also called cat eye reflex)
retinoblastoma in children
mutation in RB1 (embryonic malignant tumor arising from the retina).
pregnant patients can experience nasal stuffiness, decreased sense of smell, and impaired hearing from
elevated estrogen
can also have hoarseness, vocal changes, persistent cough
smell begins to deteriorate at
taste at what age
60
50
otitis externa signs and symptoms
What type of hearing loss occurs?
itching in ear canal, typically with swimming
Pain intense with movement on pinna and chewing
Watery and purulent and thick mixed with pus and epithelial cells FOUL smelling
Conductive hearing loss exudate and swelling of canal
Canal is red edematous, tympanic membrane obscured
otitis media with effusion
Sticking or cracking sound on yawning or swallowing
discomfort feeling of fullness
no discharge
conductive as middle ear fills with fluid
tympanic membrane retracted or bulging yellowish air fluid level and bubbles
acute otitis media
abrupt onset of fever, feeling of blockage, anorexia, irritability
Deep- seated earache, that interferes with sleep pulling at the ear
discharge only if tympanic membrane ruptures foul smelling
conductive loss of middle ear fills with pus
Tympanic membrane distinct erythema, thickened clouding bulging air fluid level or bubbles
Rinne postive=
air-conduction longer then bone conduction 2:1 (Good)
infants chest is generally round AP diameter is
equal to lateral and circumference is roughly equal to that of head until 2 years old
PDA and foramen ovale
usually close at birth in minutes however if not large PDA can cause murmur on auscultation and left ventricular overload/heart failure.
Biot or ataaxic respiration
associated with severe and persistent increased intracranial pressure, resp compromise drug poisoning, brain damage at level of medulla and indicates poor prognosis.
DULLNESS to percussion and DECREASED tactile fremitus means
pleural effusion
decreased or absent fremitus can also mean
obstruction, air, empysema, pleural thickening, bronchial obstruction.
anterior mediastinal mass signs
leaning foward, stridor may compress trachea
resonance on percussion means
hyperresonance
dullness /flatness
healthy lung tissue
empysema, asthma, pneumo
pleural effusion, pneumonia, atlectasis, asthma
Vesicular lung sounds
Bronchovesicular
Bronchial
heard over healthy lung tissue over most lung low pitch
Heard over main bronchus medium pitch
heard over trachea high pitch
hyperresonnace is common in
also bronchial and bronchovestibular sounds are common in this age group
children
s1 sound is
lub and when systole contraction occurs
sound is from mitral and tricuspid valves closing
s2 sound is
dub and is diastole is when arotic and pulmonic close
s3 is during
s4
diastole and is sometimes there when the heart is filling
is when the atria contract to make sure all blood is ejected
sounds of heart sounds are best heard where
in the area away from the anatomic site because sound is transmitted in the direction of blood flow.
closure of the ductus arteriosus occurs when
the heart lies more _ in children and infants the location is where?
adult heart position occurs at what age
24-48 hours
horizontally, fourth left intercostal space
7
blood volume for prego increases by
returns to prepregnancy volume by
cardiac output increases by 30-40%
40-50%
3-4 weeks
Chest pain in a _ or _ is seldom due to a cardiac problem
child or adolescent
feeling for a thrill in second inter-coastal spaces can detect
aortic and pulmonic stenosis, atrial septal defect or pulm htn
a loud _ always suggest pathology and needs additional eval
Kentucky goes with which heart sound
Tennessee
s4
s3
s4
pregnancy more audible
_ is abnormal
_ ejection murmurs may be heard over pulmonic , but _ murmurs is not normal
S1 S2 and S3
s4
systolic , diastolic should not be louder than grade II
Markle sign is seen with
peritoneal irritation (positive heel jar test)
Tests for appendicitis are
Aaron sign (pain in heart stomach when pushing on mcburney point)
Blumberg (rebound tenderness)
Mcburney sign (pain in right lower quadrant)
Rovsing (Pain in right lower quadrant when left lower quadrant palpated)
Peritoneal irritation tests
Ballance (Dullness on percussion on left and right flank changes with position)
Blumberg (Rebound tenderness)
Markle (heel jar) heel to floor causes abdominal pain
Rovsing (Pain in right lower quad when pushing on left lower)
Murphy results from
cholecystitis
cessation of inspiration when palpating gallbladder
Cullen sign
seen with
Ecchymosis around umbilicus
Hemoperitoneum, pancreatitis, ectopic pregnancy
Gray turner
flank bruising
Hemoperitoneum, pancreatitis
Dance sign is seen with
intussusception
Absence of bowel signs right lower quadrant
Kehr sign
seen with
abdominal pain radiating to left shoulder
spleen rupture, renal calculi, ectopic pregnancy
iloopsoas muscle test is done to look for
appendicitis , push down on leg when patient lifts if pain means
positive psoas sign
Obturator muscle test is done to look for
ruptures appendix or pelvic abscess
lift leg to 90 degree grab by ankle and turn medially and laterally if pain R hypogastric region obturator muscle irritated
spider nevi in newborn
liver disease
superficial veins normal on abdomen in
distended veins across abdomen
thin infant
abnormal
peristaltic waves in infant can mean
pyloric stenosis or intestinal obstruction
Hepatitis b coinfection is
Hep E is self limited and occurs from
hep D
contaminated water fecal or food
cirrhosis is mostly caused by
hep C and alcohol in US
example of a hinge joint is the
ball and socket joint
elbow, knee
shoulder, hip
ligaments are stronger than bone in _ and _ until _
infants children , adolescents (more prone to fractures)
bone growth is completed by which age
20
Osteoarthritis risk factors
obesity female family history hypermobility syndromes aging >40 injury high level sports peripheral neuropathy occupation with overuse of joints
osteoporosis risk factors
Nulliparous
ammenorhea,
menopause
inadequate vitamin D, calcium excessive carbonated drinks
sedentary lifestyle, lack of aerobic or weight bearing exercise
race white, asian, native american
passive range of motion often exceeds active by
if joint increase or limitation in ROM use
5 degrees
goniometer to measure angle
muscle strength grading
0-5
0 no movement
1 trace movement
2 Full ROM not against gravity
3 Full ROM against gravity not resistance
4 Full ROM against gravity and some resistance, but weak
5 Full ROM against gravity and resistance
RA signs
deviation of fingers to ulnar side
boutonniere disease
swan neck
osteoarthritis seen as
these nodules are called
hard nontender nodules 2-3 mm in distal interphalangeal joints
Heberden nodes
Bouchard nodes
subcurtaneous nodule on ulnar side may indicate
RA or gout tophi
olecranon bursitis results in
swelling, tenderness of bursa
crepitus, locking or popping in TMJ can mean
TMJ dysfunction
kyphosis is common in
Lordosis in
Gibbus
elderly
prego or obese
collapsed verterbrae from osteoporosis (sharp , angular deformity)
gouty arthritis suspected when
inflamed big toe
Thickened achiles tendon
tendonitis
HEAT, swelling, tenderness, redness, signs of inflamed joint caused by
RA, gout, septic joint, fracture, tendonitis
genu valgum
genu varum
knock knees
bow legs (common in children till 18 months)
carpal tunnels tests (medial nerve integrity)
Katz test hand diagram thumb abduction (weakness when push on thumb) tinel sign (tap on wrist) phalen test (1 min hold if numbness or paresthesia)
Allis sign is for _ to detect
infants , hip dislocation or shortened femur
Barlow/Ortalani used to detect
hip dislocation or subluxation (clunk or sensation)
