Medical Aspects Flashcards
Name types of diseases associated wit he electrical conduction issues
Wolff-parkinson-whiteMarfans syndrome -tall, thin, large people. Body grows too fast for the heart to keep up
What is a pulmonary embolus?
Blood clot in arms or usually the legs that breaks free and travels to the heart or lungs. Suddenly causes no oxygen in bloodstream.Clot has potential to block off blood from both lungs-impossible to recover fromIf at risk use blood thinnersVena cava umbrellaThose at risk-surgery, prolonged immobilizations,
Define signs symptoms and causes of cardiac arrest. Who is at risk?
-Immediate loss of consciousness-unable to awake-NOT A HEART ATTACK (could be v. Fib)Risks- males over 40- females over 45-smokers-diabeticsSyncope-known heart disease
Focal neurological deficits
Not one thing is specifically wrong
What can cause a concussion
Whiplash, coup contacoup, direct blow to anywhere on the body,
Explain the nature of symptoms seen with a concussion
Rapid onset but short lived neurological impairment that resolve spontaneouslySymptoms reflect functional problems, can not see concussion with a MRIMay or may not involve LOC
What tests do you use to assess a concussion?
ABC’s, LOC (Glasgow coma scale), rule out c-spine, neuro exam, SCAT 3, SAC, Maddocks questionnaire
How to perform neuro sideline exam
Mental status use SCATcranial nervesSensory/motor function ReflexesSymmetry/asymmetryRombergs testNystagmus ( involuntary eye movement)
C5 reflex
Biceps
C6 reflex
Brachioradialis
C7 reflex
Triceps
L3/L4
Patellar
L5
Medial hamstring
S1
Achilles
Types of Post concussion sequela
Second impact syndromePost concussion syndromePost concussion convulsions - seizure (not serious)Neuropsychological deficits
Second impact injury
- 2nd concussion before first has resolvedUsually minor in natureWill cause cerebral edema, sudden on set, fatal
Let’s talk about epidural hematoma
Between skull and dura materTempo parietal region+- LOCheadacheVomit, seizure, abnormal pupilsEmergency head CTcushings triad -hypertension, bradycardia, slow respiration
Now let’s talk about subdural hematoma
Below dura and and above arachnoid spaceCollection of blood -acute -subacute: 3-7 days -chronic: 2-3 weeks post injurySurgical emergencyHigh mortality rate
What are seizures
Electrical neuronal brain dysfunctionUsually udiopathic, hereditaryHigher chance of happening after first seizureLie the patient on right side (to prevent aspiration)
What is post-seizure state known as, what should you do?
Post ictalmust protect the airway, unbutton loose clothing,lie them on the right side
How to RTP for a seizure
-differs by each case-consider safety of others-frequency, how well will it be controlled-activity being considered (i.e. swimming is a no go)-readiness, physically fit enough
What is meningitis? who is most at risk?
It is a bacterial, viral, or fungal disease -viral disease is more common -bacterial will lead to brain damage (i.e. neisseria)infants, and age 15-24 are at risk-EMERGENCY!
what to look for with Meningitis
Kernig’s sign, petechia rash.final diagnosis: CSF by lumbar puncture
Symptoms of Meningitis
fever, severe persistant headache, stiff painful neck, photophobia, vomiting, confusion, seizures, muscle aches (myalgia)
Encaphalitis. what is it?
Inflammation, infection of brain tissue.causes changes in mental status, convulsions, aphasia (loss of ability to speak, understand words), stupor, hallucinations
List causes of headaches. classify as serious or non serious.
Serious-intracranial bleeding-hypertension-meningitis/encaphalitis-tumor-systemic infectionNon Serious-vascular (migraines)-tension-post-concussive-benign exertional-altidude
Organs involved with breathing. name em
oral pharynxvocal chordstracheabronchi (L and R)bronchiolesalveoli (exchange of oxygen)
What is exercise induced asthma (bronchospasm)
EIBhappens 3-5 min after exercise, stops about an hour after exerciseSymptoms include:-coughing, tight chest, shortness of breath, decreased endurance. seems like person is ‘out of shape’
what causes EIB?
most likely related to inhalation of large volumes of cool, dry air during exercise-happens to cross country skiers, and swimmers, even runners.
What clues you in to whether or not it is Asthma or EIB
asthma shows signs of wheezing, coughing, shortness of breath, worse at night, exposure to allergens (chronic asthma).if night times symptoms occur more than 2 times a month it is probably asthmaShortness of breath at night is asthma
how to Test for asthma
SpirometryFVC, FEV1, baseline and post exercise,
FVC. what is it
max amount of air, measured in liters, that can be forcibly and rapidly exhaled
FEV1. what is it?
the volume of air expelled in the 1st second of forced expiration
baseline and post exercise. how do you do it?
raise HR to 85% of max.repeat test every 10-15 min for 30 min
Diagnosing form FEV1 test….
decrease of FEV of 15% or more considered diagnostic of EIB
Treatment of EIB containing no drugs
treat the refractory periodperform at 50% of max intensity for 15 min as a warmup before intense practice
Treatment of EIB with drugs
Albuterol, 2 puffs 5-15 min before exerciseSeverant, Foradil, 30-60 min prior to activity may last up to 12 hoursMast Cell Sabilizers: CromoylnLeukotriene Receptor Antagoist: Singulair
Treatment for Chronic Asthma
Inhaled Corticosteroids (Flovent, qvar, advair)
How to use an inhaler?
always use spaceexhale completelypush buttontilt head backhold breath for 5 sec
What is Vocal Chord Dysfunction?
Affects trachea rings, Vocal chords should do this: -Abduct (open) - experation/aspiration -Adduct during phonation, swalloingWith VCD they don’t adduct correctly-psychogenic in nature
Who does VCD affect? What does it sound like?
women 20-40, history of psychiatric disorderoften confused with asthma, stars in early exercise, ends with cessation of exercise
Difference between symptoms of asthma and VCD
high pitched sound -asthma: on exhale -VCD: on inhaleasthma: tight throatVCD: tight chestVCD: poor response to albuterol
Treating VCD
speech therapy, relaxation techniques, treat psychiatric illness, GERD, or other underlying issues
What are seasonal allergies known as?
allergic rhinitis
What is Exercise Induced anaphylaxis (EIA)?
triggers mast cell release of histamine and other mediators,
what are symptoms of EIA
itching, hives, welts, swelling of limbs, upper airway obstruction
TReatment of anaphylaxis
exercise, intramuscular epinphrine (Epipen)
Urticaria?
type of skin rash: blotchy, red, raised, mounds, widespread
Cholinergic Urticaria?
hives after exercise, wheezing, anti-histamines, triggered by weather change, not serious
Orbital floor fractures affect what part of the eye
the floor, which is the weakest
Abrasions of the eye.
very painful, treat with bandage, 24 hrs to regenerate cornea tissue
Hyphema (eye)
poor blood supply
Sublated intraocular lens
zonules hold lens in, when they break, lens falls
Commotio REtnae
Retnal whitening, doesn’t affect vison
Cotton wood Spot (eye)
fluffy looking, tissue lacking blood/oxygen
Subretnal hemmorhage
heals in about a month, may or may not affect vision
retnole
hole in retna,no symptoms
55% of brains pathways deal with the eyes/vision. true or false?
true.
How is Stomach/GI pain generally described?
colicky pain, constant, burning, stabbing
Location of organs. (quadrants)
RUQ - gall bladder liverLUQ - spleenRLQ - appendix (McBurney’s pt)
Appendicitis and symptoms
Inflammation of the appendixSymptoms: Annorexia, low grade fever
Esophagitis (worsened and relieved how?)
Worsened by lying downRelieved by antacids
UTI
Dysuria of urinary frequency
Medical History what to look for (when treating GI disorders)
use of Nsaid (gastritis, ulcers)Abdominal surgeryMenstrual history
How to perform a physical exam for GI issues
Inspect (paleness, listen look for movement)Auscultation palpate
GERD. what is it?
gastroesophageal reflux diseaseretrograde movement of gastric acid and pepsin which irritates the esophageal epithelium
GERD symptoms?
heartburn, burping, retrosternal burning, worsened by eating, exercise, laying down-may also see: sore throat, dyspnea, cough, wheezing, laryngitis
Treatment of GERD
small portions, avoid spicy/acidic foods, no alcohol or coffee, lose weight, stop smoking, laying down right after eating
Medications for GERD
OTC antacidsOTC beta #2 blockersPPI’s if persistent
main 5 drugs tested for?
Marijuana, amphetamines, opiates, cocaine, phencyclidine
Pain relievers equal to Marijuana?
yes
How long can 5+ alcoholic drinks affect the brain/body
3 days
How long does it take one beer to metabolize?
hour
What does alcohol do to the body
dehydrate, decrease minerals and vitamins, slows healing, increases recovery time, directly results in accidents
name some anabolic steroids
testosterone, bolderone, androstenedione, etc
what drugs are highly prescribed for pain and highly addictive?
Oxycotin, Loratab
Read the Pain power point
Understand what chronic pain isSymptoms of chronic painLow Back painBiopsychosocial modelTreatment of chronic pain
