Lecture 1 - Vital Signs and HEENT

Question 1

Irregularly irregular heart rhythm is indicative of?

Answer 1

Atrial fibrillation

Question 2

Regularly irregular heart rhythm is indicative of?

Answer 2

Bigeminy or trigeminy

Question 3

Lack of symmetry between right and left extremities suggests: ______?

Answer 3

impaired circulation

Question 4

If femoral pulsation is absent, __________ must be suspected.

Answer 4

coarctation of the aorta

Question 5

Arteries that can be auscultated:

Answer 5

1. temporal 2. carotids 3. subclavian 4. abdominal aorta 5. renal 6. iliac 7. femoral

Question 6

Two variations from a normal arterial pulse are:

Answer 6

1. pulsus alternans 2. pulsus bisferiens

Question 7

What is the clinical term for an alternation of a pulse of small amplitude with a pulse of large amplitude.

Answer 7

Pulsus alternans (alternating pulse)

Question 8

What is the primary cause of pulsus alternans?

Answer 8

heart failure

Question 9

What are the two causes of pulsus bisferiens?

Answer 9

Leaking aortic valve Hypertrophic obstructive cardiomyopathy

Question 10

What is the clinical term for a double impulse best felt at the carotid?

Answer 10

Pulsus bisferiens

Question 11

The image below is an example of?

Answer 11

Pulsus alternans

Question 12

The image below is an example of?

Answer 12

Pulsus Bisferiens

Question 13

Too small of a blood pressure cuff will lead to:

Answer 13

Artificially elevated blood pressure reading

Question 14

The brachial artery being positioned too low will lead to:

Answer 14

Artificially elevated blood pressure reading

Question 15

What type of sounds are first listened for when taking a blood pressure reading?

Answer 15

Korokoff sounds

Question 16

The _____ pressure is the mmHG at the level where you hear two consecutive beats.

Answer 16

systolic

Question 17

The _____ pressure is the mmHG at the level where the sounds become muffled and disappear.

Answer 17

diastolic

Question 18

A difference of more than 10-15 mmHg between arms suggests:

Answer 18

arterial obstruction on the side with lower pressure

Question 19

The ________ pressure is the more reliable indicator of true systolic pressure.

Answer 19

higher

Question 20

An _____________ is the silent interval that may be present between the systolic and diastolic pressures.

Answer 20

auscultatory gap

Question 21

An unrecognized auscultatory gap may lead to:

Answer 21

serious underestimation of the systolic pressure

Question 22

An increase in pulse of greater than 20 beats per minute, OR a decrease in systolic of more than 20 mmHg is called:

Answer 22

Orthostatic hypertension (postural hyptertension)

Question 23

A difference in systolic pressure of >10 mmHg during inspiration and expiration is called:

Answer 23

Pulsus Paradoxus

Question 24

________ is rapid, shallow breathing.

Answer 24

Tachypnea

Question 25

What is kussmaul breathing?

Answer 25

Deep breathing due to meatbolic acidosis

Question 26

______ is periods of no breathing

Answer 26

apnea

Question 27

__________ breathing is defined as periods of deep-breathing with periods of no breathing.

Answer 27

Cheyne-Stokes Breathing

Question 28

What are causes of Cheyne-Stokes breathing?

Answer 28

heart failure; brain damage (typically in both hemispheres)

Question 29

What causes obstructive breathing?

Answer 29

Forms of COPD - especially asthma

Question 30

Which temperature locations are typically higher, middle, and lowest?

Answer 30

Rectal, oral, axillary

Question 31

Pupillary inequality of <.5 mm, also called ________ is visible in 20% of normal people

Answer 31

anisocoria

Question 32

The iris is examined for what two features?

Answer 32

1. Color
2. Presence of arcus senilus

Question 33

What occurs during lidlag?

Answer 33

As eyes look down, white surrounds the iris

Question 34

What occurs during nystagmus?

Answer 34

Fine, rhythmic oscillation of the eyes;

a few beats on extreme lateral gaze are within normal limits

Question 35

What is presbyopia?

Answer 35

Impaired near vision