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Midway Practical Lab Demonstration > Nitty Gritty > Flashcards

Nitty Gritty Flashcards

1
Q

what to inspect on skin assessment (11)

A
  • colour
  • general pigmentation
  • areas of colour change
  • bruising
  • lumps
  • swelling
  • masses
  • tattoos
  • piercings
  • birthmarks
  • scars
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2
Q

what to palpate on skin assessment (7)

A
  • temperature
  • texture
  • thickness
  • tenderness
  • moisture
  • swelling
  • masses
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3
Q

definition of mobility and turgor

A
  • mobility is the ease of rising of skin

- turgor is the prompt return of skin when its released

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4
Q

6 characteristics of a lesion

A
  • colour
  • location and distribution
  • elevation
  • exudate
  • shape and pattern
  • size
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5
Q

ABCDE’s of dangerous lesion

A
  • asymmetry: should be symmetrical
  • borders: even border
  • colour: same colour throughout
  • diameter: less than 6mm
  • evolution: shouldn’t be changing
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6
Q

what to inspect on nail assessment (5)

A
  • shape
  • contour
  • condition
  • colour
  • markings
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7
Q

what to palpate on nail assessment

A
  • consistency
  • thickness
  • adhered to nail bed
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8
Q

things that could cause changes to nail bed angle

A
  • congenital, chronic, and cyanotic heart disease
  • emphysema
  • chronic bronchitis
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9
Q

things that could cause issues with capillary refill

A
  • cardiovascular dysfunction
  • respiratory dysfunction
  • cold temperatures
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10
Q

10 lymph node chains

A
  • preauricular
  • post auricular
  • occipital
  • submental
  • submandibular
  • tonsillar
  • superficial cervical
  • deep cervical
  • posterior clavicular
  • supraclavicular
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11
Q

technique for assessing lymph nodes

A
  • gentle circular motion
  • tips of fingers
  • bilaterally
  • submental tilt chin forwards
  • deep cervical chain tip head to side being assessed
  • supraclavicular chain hunch shoulder forward
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12
Q

what to note is palpate lymph nodes (7)

A
  • location
  • size
  • shape
  • delimitation
  • mobility
  • consistency
  • tenderness
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13
Q

lymph node in healthy individual

A
  • movable
  • discrete
  • soft
  • nontender
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14
Q

why a lymph node may be enlarged

A
  • infections
  • allergies
  • neoplasm
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15
Q

confrontation test angles

A

60cm, 2ft away

  • 50 superiorly
  • 60 nasally
  • 70 inferiorly
  • 90 temporally
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16
Q

what to note for pupillary response

A
  • size in mm
  • shape
  • symmetry
    all before and during
  • speed of reaction
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17
Q

accommodation test

A
  • have them look far away and then at your finger

- inspect pupils size change

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18
Q

convergence test

A
  • follow finger as it gets closer to bridge of nose
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19
Q

corneal light reflex expected findings

A
  • light should be on same spot of cornea
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20
Q

cover-uncover test expected findings

A
  • look for movement of uncovered eye when care removed
  • should be steady fixed gaze
  • look for movement of covered eye when card removed
  • should be steady fixed gaze
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21
Q

diagnostics position test expected findings

A
  • parallel tracking

- no nystagmus or lid lag

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22
Q

what to inspect and palpate when assessing ears (9)

A
  • size
  • shape
  • position
  • skin colour and condition
  • temperature
  • texture
  • tenderness
  • lumps
  • nodules
23
Q

what to look for in canal and meatus (5)

A
  • cerumen (amount, colour, odour)
  • lesions
  • foreign bodies
  • bleeding
  • discharge
24
Q

what to look for on tympanic membrane (8)

A
  • colour
  • condition
  • cone of light (5 Rt, 7 Lt)
  • bulging
  • retraction
  • lesions
  • scaring
  • fluid
25
Q

whispered voice test

A
  • twice in each ear

- number letter number

26
Q

what to inspect in lips, gums, teeth, and buccal mucosa (8)

A
  • colour
  • condition
  • moisture (saliva)
  • swelling
  • lesions
  • bleeding
  • masses
  • ulcerations
27
Q

what to inspect of surface of tongue (6)

A
  • colour
  • condition
  • lesions
  • masses
  • ulderations
  • nodules
28
Q

inspecting tongue function

A
  • no wasting or tremors
  • position with protrusion should be midline
  • move out and side to side
  • light tight dynamite
29
Q

what to inspect in throat and posterior pharyngeal wall (6)

A
  • colour
  • condition
  • lesions
  • exudate
  • tonsils
  • halitosis
30
Q

what to inspect for uvula

A
  • colour
  • condition
  • position (midline)
  • movement with phonation (“aaa”)
31
Q

what to inspect on abdominal assessment (5)

A
  • contour
  • symmetry
  • umbilicus
  • skin colour and condition
  • pulsations and movements
32
Q

expected findings of bowel sounds

A
  • diaphragm
  • character
  • frequency
  • high pitched, gurgling, cascading sounds
  • normal, hyperactive, hypoactive
33
Q

how to prepare patient for abdominal assessment

A
  • pillow under head and knees
  • arms at side of across chest
  • relax abdominal muscles
  • draping
34
Q

inspection of voluntary guarding and involuntary rigidity

A
  • voluntary guarding may be hunched over and grasping stomach and purposefully tensing muscles
  • involuntary rigidity may be swollen or distended
35
Q

predominant tone over abdomen and where it may change

A
  • tympany
  • dullness heard over a distended bladder, adipose tissue, fluid, or a mass
  • hyper resonance heard with gaseous distension
36
Q

liver span expected findings

A
  • 5th ICS to costal margin

- 6-12cm

37
Q

spleen expected findings

A
  • 9th-11th ICS
  • dullness
  • less than 7cm
38
Q

costovertebral tenderness expected findings

A
  • thud no pain or tenderness
39
Q

difference between light and deep palpation

A
  • light goes 1cm deep and palpate superficial surface

- deep goes 5-8cm deep and palpating organs

40
Q

proper technique for abdominal palpation

A
  • 1cm deep
  • 4 fingers
  • fingers parallel
  • lift between areas
41
Q

what to palpate during abdominal assessment (6)

A
  • texture
  • temperature
  • moisture
  • rigidity
  • pulsations
  • tenderness
42
Q

voluntary guarding vs involuntary rigidity

A
  • voluntary guarding is cold, tense, or ticklish and will relax with exhale
  • involuntary rigidity is constant muscle hardness, sometimes only on one side, may be sign of peritonitis
43
Q

how to deal with anxious or ticklish patient (6)

A
  • bend patients knees
  • keep hand parallel to abdomen
  • coach patient to breath slowly
  • use low and soothing voice
  • coach patient to use emotive imagery
  • interlace fingers with theirs, or use stethoscope
44
Q

inspect demeanour and respiratory effort for thorax assessment

A
  • relaxed posture
  • support own weight
  • relaxed, automatic, effortless, regular, even, no noise, no lags, no use of accessory muscles
  • 10-20/min
45
Q

3 signs of respiratory distress

A
  • tripod position
  • central cyanosis
  • pursed lips
46
Q

inspect shape and configuration of posterior thorax

A
  • spinous process straight and mid line
  • scapulae symmetrical in each hemithorax
  • ribs downward slope of 45 degrees
  • AP to transverse diameter 2:1
  • sternocleidomastoid and trapezius developed
47
Q

inspect shape and configuration of anterior thorax

A
  • sternum straight and midline
  • ribs sloping downward
  • interspaces symmetrical
  • no use of accessory muscles
  • costal angle within 90 degrees
48
Q

what to palpate for posterior thorax (8)

A
  • temperature
  • texture
  • turgot
  • tenderness
  • lumps
  • bumps
  • masses
  • crepitus
49
Q

tactile fremitus of thorax

A
  • apices to bases (6th, 8th, 10th)
  • equal bilaterally
  • more pronounced between scapula dampened in peripheral lung fields
  • more pronounced in 1st or 2nd ICS dampened in peripheral lung field
50
Q

technique for percussing thorax

A
  • apices to bases
  • in ICS
  • avoid bone
51
Q

predominant percussion tone over thorax

A
  • resonance over lung field
  • dull over liver, heart, breast tissue
  • flat over bone
  • tympani over abdomen
  • dull in lungs may mean consolidation
52
Q

bronchial breath sounds

A
  • harsh
  • loud
  • inspiration shorter
  • pause between
  • over trachea
53
Q

bonchovesicular breath sounds

A
  • moderate sound
  • inspiration and expiration equal
  • between scapula and 1st/2nd ICS anteriorly
54
Q

vesicular

A
  • low
  • soft
  • inspiration longer
  • over peripheral lung fields

Midway Practical Lab Demonstration (2 decks)

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