NURS 264 Exam 4 Flashcards
Right Upper Quadrant (RUQ) What is located in this quadrant?
Right Upper Quadrant (RUQ)
➢ Liver
➢ Gallbladder
➢ Duodenum
➢ Head of pancreas
➢ Right kidney and adrenal
gland
➢ Hepatic flexure of colon
➢ Part of ascending and
transverse colon
Left Upper Quadrant (LUQ) What organs are in this quadrant?
Left Upper Quadrant (LUQ)
➢ Stomach
➢ Spleen
➢ Left lobe of liver
➢ Body of pancreas
➢ Left kidney and adrenal gland
➢ Splenic flexure of colon
➢ Part of transverse and descending colon
Anatomic Locations of Upper Quadrants
Right lower quadrant (RLQ) What organs are in this quadrant?
Right lower quadrant (RLQ)
➢ Cecum
➢ Appendix
➢ Right ovary and tube
➢ Right ureter
➢ Right spermatic cord
Left lower quadrant (LLQ) (What organs are in this quadrant?
Left lower quadrant (LLQ)
➢ Part of descending colon
➢ Sigmoid colon
➢ Left ovary and tube
➢ Left ureter
➢ Left spermatic cord
Developmental changes in pregnant women in terms of abdominal cavity.
Nausea and vomiting, or “morning sickness”
➢ Cause unknown; may be due to hormone changes, such as production of human chorionic gonadotropin (hCG)
➢ “Acid indigestion” or heartburn (pyrosis) caused by esophageal reflux
What is Celiac disease?
Celiac disease
➢ Autoimmune disorder
➢ Intolerant of gluten ; protein found in wheat, rye, barley & some oats.
➢ Diarrhea, abdominal pain & distention; anemia, neuropathy, osteoporosis, abnormal liver functions, skin lesions
What is dysphagia?
Difficulty swallowing
What order should inspection of the abdomen be done on older adults?
- Inspection
- Auscultation
- Palpation
- Percussion
What are the 4 types of abdomen contour?
- Flat
- Rounded (belly)
- Scaphoid (sunken belly)
- Protuberant (beer belly)
What order should the 4 abdominal quadrants be assessed in?
- RLQ
- RUQ
- LUQ
- LLQ
Borbogymus (What is it?)
Borborygmus is the sound of hyper peristalsis (stomach growling
Where should be assessed to assess the kidneys?
To assess kidney, place one hand over 12th rib at costovertebral angle on back
➢ Thump that hand with ulnar edge of your other fist
Hooking technique (What is it?)
Hooking technique
➢ Alternative method used to palpate liver
Is the spleen normally palpable?
No, only if distention has occurred
What tests can be performed for appendicitis?
Other special tests for Appendicitis:
➢ McBurney’s Point Tenderness
➢ Iliopsoas Muscle Test
Are the kidneys and liver easier to palpate in older adults?
- Yes, they stick out more
What is succession splash?
- Marked peristalsis +projectile vomiting in newborn = pyloric
stenosis
What should be assessed in each of the 4 stages of an abdomen examination?
Inspection
➢ Contour, symmetry, umbilicus, skin, pulsation or movement, hair distribution & demeanor
Auscultation
➢ Bowel sounds; note any vascular sounds
Percussion
➢ All four quadrants and borders of liver & spleen
Palpation
➢ Light and deep palpation in all four quadrants, & palpate for liver and spleen
What are the 3 sutures of the skull
➢ Coronal
➢ Sagittal
➢ Lambdoid
What are the 3 pairs of glands in the mouth?
Parotid glands are in cheeks over mandible, anterior to and
below ear; the largest of salivary glands, they are not
normally palpable
➢ Submandibular glands beneath mandible at angle of jaw
- Third pair, sublingual glands, lies in floor of mouth
What does the thyroid release?
Thyroxine (T4) and triiodothyronine (T3), which are
hormones that stimulate rate of cellular metabolism
What is special about fetal development in respect to the skull?
Head size is greater than chest circumference at birth and reaches 90% of final size at 6 years old.
What happens during pregnancy to the thyroid?
Thyroid gland enlarges slightly during pregnancy
as a result of hyperplasia of tissue and increased
vascularity
What are the 3 types of headaches?
➢ Tension-type headaches (TTH) most common
➢ Migraine – 2nd most common
➢ Episodic and Chronic
If a lymph node is palpable what should you do?
If any nodes are palpable, note location, size,
shape, delimitation (discrete or matted together),
mobility, consistency, and tenderness
What reflex do infants do and when does it stop?
Shows tonic neck reflex when supine and head
turned to one side (extension of same arm and
leg, flexion of opposite arm and leg); reflex
disappears at 3 to 4 months
Is a tremor ever normal in older adults?
In some aging adults, a mild rhythmic tremor of head may be normal
➢ Isolated head tremors are benign and include head nodding and tongue protrusion
Hydrocephalus (What is it?)
Hydrocephalus
➢ Obstruction of drainage of cerebrospinal fluid results in excessive accumulation, increasing intracranial pressure, and enlargement of the head
Plagiocephaly (What is it?)
Plagiocephaly
➢ Positional or deformational due to sleeping position
Craniosynostosis (What is it?)
Craniosynostosis
➢ Premature closing of one or more cranial sutures that leads to
head malformation
Fetal alcohol spectrum disorders (FASD) (What is it?)
Fetal alcohol spectrum disorders (FASD)
➢ Narrow palpebral fissures, epicanthal folds, thin upper lip, and midfacial hypoplasia
Pilar cyst (Wen) (What it it?
Pilar cyst (Wen)
➢ Benign growth that presents as smooth, fluctuant swelling on scalp
Graves Disease (What is it and what does it look like?
Physical presentation
neck and face
➢ Goiter
➢ Eyelid retraction
➢ Exophthalmos
Hypothyroidism (What it it and what does it look like?
Physical presentation
neck and face
➢ Puffy edematous face
➢ Periorbital edema
➢ Coarse facial features
➢ Coarse hair and
eyebrows
Cushing syndrome (What does it look like?)
Cushing syndrome
➢ Classic “moonlike” face, red cheeks, and hirsutism
Where are olfactory receptors located?
Olfactory receptors, hair cells, lie at roof of nasal cavity
and upper third of septum
➢ These receptors for smell merge into olfactory nerve, cranial
nerve I, which transmits to temporal lobe of brain
How many teeth do adults have?
Adults have 32 permanent teeth; 16 in each arch
➢ Each tooth has three parts: crown, neck, and root
How many teeth do children have?
Children have 20 deciduous, or temporary, teeth that erupt between 6 months and 24 months of age
They all should appear by age 2.5
Torus palatinus (What is it?)
Torus palatinus - bony ridge running in middle of hard palate
20% to 35% of the US population, more common in females
Leukoedema (What is it?)
Leukoedema - benign lesion (bluish-white) on buccal mucosa
More common in blacks.
What are the 4 grades of tonsils
- 1+ Visible
- 2+ Halfway between tonsillar pillars and uvula
- 3+ Touching uvula
- 4+ Touching each other
What happens to pregnant peoples gums?
Gum hypertrophy
➢ Surface looks smooth and stippling disappears.
➢ May occur normally at puberty or during pregnancy
(pregnancy gingivitis)
What is epistaxis?
a nosebleed
What is Carcinoma?
a type of cancer on the lips
What is epulis?
Enlargement of the gums
What is Atrophic Glossitis?
The tongue being glossy and smooth
What is Migratory glossitis?
Geographic tongue
What is oral Kalosi’s sarcoma?
A type of cancer of the mouth that causes lesions
What Defines a tension headache?
- it is the most common type
- Feels like a band on the head
- lasts 30 minutes to 7 days
- Dull aching pain
- Treated with NSAIDS or cold packs
- It is of muscular origin
What defines a Migrane?
- more common in men than women
- Vascular or nerve origin
- usually one sided
- throbbing pulsating feeling
- Lie down, use NSAIDS, Sleep
What are the 4 stages of Migranes?
- Prodrome (hours-days before) change in mood and sensitivities
- Aura (5-60 mins) visual changes, vertigo, tingling
- Migrane attack (4-72 hours)
- Postdrome (24-48 hours) Fatigue and irritability
What defines a Cluster headache?
- More common in men than women
- Unilateral and intermitent
- Always one sided
- Sharp burning pain
- Can happen multiple times a day in clusters
- Helped with inhaled oxygen or blockers
What do gastric ulcers cause?
Pain on an empty stomach (relieved by eating)
What do duodenal ulcers cause?
Pain 2-3 hours after eating (because food touches it)
What is the difference between acute and allergic rhitinus?
Acute is red and swollen inferior turbinate
Allergic is pale and swollen inferior turbinate
What test assesses gallbladder issues?
Murphys sign
What does vertigo feel like?
Like you are spinning
What is the difference between subjective and objective vertigo?
Subjective vertigo is you spinning around
Objective vertigo is objects spilling
