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N190 - Physical Assessment > Midterm Review > Flashcards

Midterm Review Flashcards

1
Q

4 basic techniques of assessment

A

inspection
auscultation
percussion
palpation

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2
Q

doppler

A

used to asses pulses when pulses cannot be palpated

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3
Q

stadiometer

A

used to measure height

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4
Q

wood lamp

A

used to assess fungal infections on the skin

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5
Q

goniometer

A

used to measure degree of joint flexion and extension

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6
Q

transilluminator

A

use to detect air, blood, fluid, or mass in body cavity

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7
Q

epidermis

A

top layer of skin

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8
Q

dermis

A

contains nerves, blood, and lymphatic vessels
- embedded with hair follicules, sweat glands, oil glands, and sensory nerves

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9
Q

subcutaneous tissue

A

third layer of skin

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10
Q

stage 1 pressure injury

A

1 layer of skin is affected
- intact, but red and non-blanchable

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11
Q

stage 2 pressure injury

A

2 layers affected (epidermis and dermis)
- bleeding

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12
Q

stage 3 pressure injury

A

3 layers affected (epidermis, dermis, and subcutaneous)
- see subcutaneous tissue
- skin is completely compromised

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13
Q

stage 4 pressure injury

A

can see muscles and bones

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14
Q

grading of skin edema

A

press around bony prominences w/ 3 finger pads
- 0: no edema
- 1+: 2mm
- 2+: 4mm
- 3+: 6mm
- 4+: 8mm

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15
Q

annular vs target lesion

configuration/shape

A

both circular lesions
- annular: only 1 circle
- target: circle with concentric circles inside w/ dot at center (bullseye lesion)

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16
Q

wheal

primary lesion

A

reddened, irregular borders, elevated
- cause by insect bite or hives

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17
Q

macule

primary lesion

A

flat, circumcised border, change in skin color, <1cm
ie/ freckles, petichiae

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18
Q

patch

primary lesion

A

irregular, >1cm
ie/ mangolian spots, port wine stain, vitiligo

type of macule

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19
Q

vesicle vs bulla

primary lesion

A

fluid filled round, oval w/ translucent wall
- vesicle: <0.5cm
*ie/ chicken pox, poison ivy, small burn blister
- bulla: >0.5cm
ie/ large burn blisters

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20
Q

port wine stain

vascular lesion

A

on face that is flat, deep purple/red, irregular shaped
- deepens when person cries or is highly emotional or high temperature
- typically does not fade

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21
Q

spider angioma

vascular lesion

A

flat, bright red dot w/ tiny radiating blood vessels ranging from pinpoint to 2cm

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22
Q

venous lake

vascular lesion

A

on the face, neck, ear, and lips; usually common in ages 50+
- soft, compressible, slightly elevated dark blue to purple
- may be due to sun exposure

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23
Q

senile lentigines (liver spots)

A

usually on hands like hyperpigmented freckles
- common in elderly

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24
Q

cutaneous tags

A

usually on the neck and upper chest
- common in elderly
- may increase in numbers

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25
Q

manifestations of cirrhosis of the liver

A
  • skin variation: yellowish (jaundice) due to not getting rid of billirubin
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26
Q

tinea pedis

A

also known as athletes foot

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27
Q

keloid

secondary lesion

A

elevated, irregular, darkened; excess scar tissue
- the primary lesion: scar

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28
Q

ABCDE criteria

A

used to rule out malignant lesions
- A: asymmetry
- B: border irregularity
- C: color (varied)
- D: diameter >6mm
- E: evolving change

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29
Q

malignant melanoma

A

most serious type of skin cancer b/c it spreads rapidly to lymph and blood vessels
- varied colors, irregular borders, >6mm

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30
Q

kaposi’s sarcoma

malignant lesion

A

painless; blue to purple; resembles keloid; common in HIV patients

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31
Q

black hairy tongue

A

consistent w/ fungal infection of the tongue

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32
Q

leukoplakia

A

whitish thickening of the mouth of HIV positive patients
- cannot be scraped off

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33
Q

risk factors of skin cancer

predisposition

A
  • overexposure to UV light
  • genetic predisposition
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34
Q

order of occurence of herpes zoster

A

1) parasthesia (burning/tingling sensation)
2) redness and swelling
3) development of vesicles/blisters
4) weaping blisters
5) crusted lesions
6) posthepaticneuralgia (pain/burning sensation long after blisters disappear

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35
Q

cause of shingles (herpes zoster)

A

chicken pox virus

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36
Q

lanugo

normal variation

A

fine, downy hair in newborns
- prominent in the upper chest, shoulder, and back

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37
Q

mongolian spots

normal variation

A

harmless purplish/blue spots on the sacral area
- common in dark skin
- disappears at age 3

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38
Q

vernix caseosa

normal variation

A

harmless white, cheese-like mixture of sebum and epidermal cells on skin of newborn
- disappears after several bathings

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39
Q

milia

normal variation

A

pimple like whiteheads on the nose or cheeks of the newborn
- disappears after 2-3 weeks

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40
Q

vitiligo

A

harmless white, patchy depigmented areas over the face, neck, hands, and skinfolds of newborn
- does not disappear

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41
Q

hydrocephalus

A

enlarged head w/ prominent, visible scalp veins
- due to accumulation of cerebral spinal fluid in the head of the baby

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42
Q

craniosynostosis

A

premature closure of the coronal and saggital sutures of the head
- elongated head and altered orbital and face of baby

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43
Q

vellus hair

A

short, fine, pale all over the body except lips, nipples, palms, and soles of feet

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44
Q

terminal hair

A

longer and coarser hair
- on eyebrows, scalp, axillary, leg, pubic, and face/chest of men

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45
Q

stages of hair growth

A
  • anagen: growth phase; 2-6 yrs
  • catagen: transitional phase; 2 weeks
  • telogen: shedding phase; 1-4 months
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46
Q

eccrine gland

sweat gland

A

made of water and salt
- located all over the body

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47
Q

apocrine gland

sweat gland

A

made of water, salt, protein, fatty acids
- in groin and axillary region
- when mixed with bacteria = musty

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48
Q

sebaceous glands

A

predominant in scalp area

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49
Q

palpating lymph nodes

A

gentle, circular motion

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50
Q

assessing for hearing loss

A

important to ask if there is family history of hearing loss

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51
Q

normal tympanic membrane

A

pearly gray

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52
Q

white patches on tympanic membrane

A

indicates previous ear infection

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53
Q

otitis externa

ear infection

A

fever, drainage, redness, itchiness in ear
- as long as tympanic membrane is pearly gray

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54
Q

otitis media

ear infection

A

infection of the middle ear
- affects the ossicles (hammer, anvil, stirrup)

55
Q

otitis interna and S/S

labyrinthitis

ear infection

A

infections of the semicircular canal, vestibule, and cochlea
- S/S: severe vertigo, hearing loss, ringing of ears

56
Q

tenderness of mastoid process

A

indicates infection that can lead to brain infection

57
Q

unable to visualize tympanic membrane

A

1) remove otoscope
2) position auricle (pull up and back)
3) reinsert otoscope

58
Q

classic migraine

type of headache

A

preceded by aura
- floaters/flashing lights can be seen by patient
- cannot tolerate bright light

59
Q

cluster headache

type of headache

A

several headaches over period of days or months
- lasts mins to hrs
- pain usually lasts a few mins/hrs
- onset: sudden

60
Q

tension headache

type of headache

A

headache starts @ cervical area and radiates to top of the head; unilateral or bilateral
- onset: gradual

61
Q

sinus headache

type of headache

A

patient with sinus headache

62
Q

normal rinne test

A

air conduction 2x greater than bone conduction

63
Q

weber test

A

1) activate the time
2) put base of fork at midline of skull
- normal: equal lateralization of vibration to right and left ear

64
Q

ear impacted with cerumen

weber test

A

lateralization will go to the impacted ear

65
Q

romberg test

A

test for balance
- done for 20 secs
- pt stand erect, feet together, hands to sides, with eyes closed
- support pt front and back with both hands
- normal: no swaying; swaying <2in

66
Q

confrontation

A

assessing for peripheral vision

67
Q

how to asses eyes for accomodation

A

move object closer to the eyes and observe for pupil constriction and convergence

68
Q

preferred test for stabismus for children

A

cover/uncover test

69
Q

normal finding for 6 cardinal fields of gaze

A

no nystagmus (jerking of the eyes)

70
Q

normal consensual response

A

on transillumination, the pupil with direct light will constrict faster than other eye

71
Q

snellen test grading

A

example: 20/30
- pt can see at 20 feet what a normal person can see at 30 feet

72
Q

myopia vs hyperopia

A
  • myopia: nearsighted (difficulty w/ far vison)
  • hyperopia: farsighted (difficulty w/ near vision)
73
Q

presbyopia

A

farsightedness for ages 45+
- difficulty w/ near vision

74
Q

dry eyes

A

redness, grainy, burning
- occurs w/ aging
- advise to instill OTC eye drops (follow direction on bottle)

75
Q

macular degeneration

A

central vision loss
- peripheral vison intact

76
Q

ectropion

A

lower eyelids everted
- exposing conjuctiva

77
Q

intropion

A

upper eyelid is inverted
- causing redness and irritation

78
Q

midriasis

A

prolonged dilation of pupils w/o any change to light
- pupils ~ 7mm

79
Q

causes of midriasis

A

migraine headache, marijuana, anticholinergic, adrenaline, cocaine, amphetamine, hallucinogen

80
Q

who usually has blown pupils?

(extensive midriasis)

A

clients with brain injury

81
Q

anisocoria

A

unequal pupil size by 1mm
- both pupils react to light but differ in size
- harmless

82
Q

causes of anisocoria

A

injury/lesions in brain

83
Q

myosis

A

pinpoint pupils; unilateral or bilateral

opposite of midriasis

84
Q

causes of myosis

A

head injury, tobacco use, HTN drug, antipsychotics, galucoma drugs

85
Q

true ribs

A

1-7 ribs

86
Q

false ribs

A

8-10 ribs

87
Q

floating ribs

A

11 & 12 ribs

88
Q

angle of louis

A

articulation between manubrium and body of sternum
- inline w/ second rib

89
Q

skin turgor in elderly

A

pinch bilaterally below clavicle and below wrist

90
Q

inspecting yellowing of skin in dark skin patients

A

inspect lips, oral mucosa, conjuctiva, and palm of hand

91
Q

clubbing of fingers

A

> 160 degrees

92
Q

phalen’s test

A

conducted for 60 secs to asses for carpal tunnel syndrome;
- dorsal aspect of wrist brought together below the breast
- normal: no pain on wrist, forearm, upper arm, neck, and chest

93
Q

tinel’s sign

A

ask pt to put forearms on lap/table and feel for medial nerve
- use 3 fingertips and percuss
- ask if there is any pain

94
Q

indirect percussion

lung techniques

A

used to percuss the lung in the intercostal spaces
- normal: resonant sound

95
Q

auscultation is used to assess for?

lung techniques

A

bronchophony, egophony, and whispered pectoriloquy

96
Q

palpation

lung techniques

A

used to asses for tactile fremitus

97
Q

what causes tactile fremitus?

A

fluid in lungs, fibrosis, tumor, and infection

98
Q

percussion

lung techniques

A

used to asses for diaphragmatic excursion

99
Q

diaphragmatic excursion

A
  • normal: 3-5cm; up to 7-8cm in well-fit/athletes
  • <3-5cm: should be ruled out for pneumonia or pneumothorax (chest xray)
100
Q

transillumation of sinuses

A
  • normal: red glow around
  • no red glow = congestion of sinuses
101
Q

complaint of sinus headache

A

transillumination or direct percussion of sinuses

102
Q

sounds of bronchophony

ausculation techniques of lungs

A
  • normal: muffled sound
  • abnormal: loud and clear
103
Q

hyperresonance

percussion techniques of lungs

A

air is trapped in lungs

104
Q

crackles

ausculation techniques of lungs

A
  • expected in lobar pneumonia
105
Q

rhonchi (sibulant)

wheezing

ausculation techniques of lungs

A

continuous, high-pitched
- expected in asthmatic pt

106
Q

rhonchi (sonorous)

wheezing

ausculation techniques of lungs

A

low-pitched, continuous, snoring, rattling
- common in COPD, pneumonia, chronic bronchitis, and cystic fibrosis

107
Q

whispered petriloguy

ausculation techniques of lungs

A
  • normal: faint, muffled, indistinguishable
108
Q

causes of atelectasis

A

decrease breath sounds on lower lobes of lungs
- causes: prolonged bedrest of postop pts, ineffective coughing, or HYPOventilation

109
Q

normal chest configuration in adults

A

eliptical
- lateral diameter 2:1 with posterior diameter of chest

110
Q

normal chest configuration of infants

A

barrel chest
- common in COPD patietns

111
Q

scoliosis

A

lateral deviation of the spinal process

112
Q

kyphosis

A

exaggerated curve of thoracic vertebrae
- common in elderly and osteoporosis

113
Q

lordosis

A

exaggerated curve of the lumbar vertebra
- common in pregnant women

114
Q

pectus excavatum

(funnel chest)

A

congenital; depression of sternum and adjacent cartilage
- compresses the heart and lungs
- hear cardiac murmurs
- surgery is indicated

115
Q

tachypnea vs hyperventilation

breathing

A

greater than 20 breaths/min
- tachypnea: shallow
- hyperventilation: deep

116
Q

bradypnea vs hypoventilation

breathing

A

less than 12 breaths/min
- bradypnea: regular
- hypoventilation: irregular, shallow

117
Q

cheyne’s stokes vs biot’s ataxia

breathing

A

periods of apnea
- cheyne’s stokes: regular (in elderly, dying pts)
- biot’s ataxia: irregular (due to brain damage)

118
Q

pt w/ rhinitis

A

most important question to ask: Hx of allergies

119
Q

most common area of breast tumor

A

upper, outer quadrant of breast
- close to axillary region

120
Q

SBE

(self breast exam)

A
  • elderly/men: same day and time every month
  • mensturating female: 3-5 days after cycle (hormones are more stable)
121
Q

fibroadenoma

A

well-defined breast tumor w/ no tenderness or discharge
- most common in adolescent girls (15-35 y/o)

122
Q

intraductal papilloma

A

most common cause of benign nipple discharge (bloody or liquidy)
- common in postmenopausal females

123
Q

peau d’orange

A

orang peel appearance on skin of breast
- sign of breast malignancy

124
Q

S/S of hypoxia

A

tachycardia, tachypnea, low O2 sat

125
Q

monitor/action of hypoxia

A
  • monitor: O2 sat, ABG
  • actions: O2 therapy, IS, elevate HOB, breathing exercises
126
Q

S/S and actions of retinal detachment

A
  • S/S: floaters, sudden flashes of light, shadow in vision, diminished vision
  • actions: prepare for Sx (laser sx, laser beam freezing sx)

EMERGENCY; may lose vision withing days of diagnosis

127
Q

10 lymph nodes

A
  • preauricular
  • postauricular
  • occipital
  • submental
  • submandibular
  • retropharyngeal
  • anterior cervical cahin
  • deep cervical chain
  • post cervical chain
  • supraclavicular
128
Q

infected pressure injury

A
  • elevated temp
  • elevated WBC
  • purulent discharge
  • redness
129
Q

S/S of COPD

A
  • barrel chest
  • decreased O2 sat
  • clubbing of fingers (hypoxia)
  • rhonchi (sonorous)
130
Q

tracheal

breath sounds

A
  • harsh, high-pitched
  • over trachea
  • I < E
131
Q

bronchial

breath sounds

A
  • loud, high-pitched
  • next to trachea
  • E > I
132
Q

bronchiovesicular

breath sounds

A
  • medium-pitched
  • next to sternal border; between scapulae
  • I = E
133
Q

Vesicular

breath sounds

A
  • soft, low-pitched
  • over remainder of lungs
  • I > E

N190 - Physical Assessment (4 decks)

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