NURS5004 - Exam 3 Flashcards
How do you illicit the rooting reflex?
What age is it present?
Touch the corner of the mouth and the infant will turn their head and open their mouth on the side of sensation; birth to 3-months
How do you illicit the palmar reflex?
What age is it present?
Touch the infants palm with a finger and the infant will grasp the finger; birth to 3-months
How do you illicit the plantar reflex?
What age is it present?
Touch the foot beneath the toes and the infant’s toes should curl downward; birth to 8-months
How do you illicit the moro reflex?
What age is it present?
From a semi-sitting position, drop the head and trunk back 30 degrees, and the infant should abduct and extend arms; birth to 6-months
How do you illicit the placing reflex?
What age is it present?
Hold infant under the arms next to a surface, touch the dorsal aspect of the foot against the surface, and the infant should “step” onto the surface with that foot; 4 days
How do you illicit the stepping reflex?
What age is it present?
Hold infant under the arms with feet on a flat surface and watch for alternating flexion and extension of legs; birth to 8-weeks
How do you illicit the asymmetric tonic neck reflex?
What age is it present?
With the infant laying supine, turn head so that chin is over shoulder, and the same arm should extend outward; 2-6 months
How do you illicit the startle reflex?
What age is it present?
Infant throws back head, arms, and legs in response to a loud sound; birth to 2-months
What is graphesthesia?
Having a patient identify the letter or number you draw in their hand while their eyes or closed
What is stereognosis?
Having a patient identify a common object placed in their hand with their eyes closed (e.g. coin, key, or paperclip)
What is 2-point discrimination?
Asking a patient to tell you whether they feel one or two points of contact with their eyes closed; distance required to distinguish between points varies based on location on the body
How can you test for sharp, soft, and dull sensation?
Sharp end of a broken tongue blade, cotton wisp, rounded end of a tongue blade
How would you test equilibrium? What is the test called?
Have patient stand with feet together, arms at sides, and eyes open. Have the patient close their eyes. Total loss of balance indicated cerebellar ataxia, vestibular dysfunction, or sensory loss. Romberg test.
How do you test for coordination?
Rapid Alternating Movements (palm-up/palm-down & thumb-to-fingers)
Accuracy of Movements (finger-to-nose or heel-to-shin)
What is Tinel’s Sign?
Pain, numbness, or tingling when tapping over the median nerve indicated carpal tunnel syndrome
How do you perform Phalen’s test?
Have patient press the dorsal surfaces of their hands together for 1-minute. Pain, numbness, or tingling indicates carpal tunnel syndrome.
How would you test the ACL/PCL?
Anterior/Posterior drawer test. Have patient place foot flat on the table, sit on the foot, and move the knee backwards and forwards.
How do you perform McMurray’s test?
With the patient laying supine, flex the knee and hip to 90-degrees. Hold the knee with one hand and the heel with the other hand. Point toes and knee inward/outward, extend the legs and then flex the leg. Pain, popping, or clicking is a positive sign of a torn meniscus.
What does a positive Valgus sign suggest?
A torn medial meniscus
What test would you use to evaluate a torn lateral meniscus?
Varus stress test
How do you test infants for hip dislocation?
Barlow-Ortolani maneuver; flex knees and hips to 90-degrees, adduct one thigh (while stabilizing opposite side), and gently apply downward pressure on the femur in an attempt to disengage the femoral head from the acetabulum.
What are the ligaments of the knee?
ACL, PCL, fibular collateral, tibial collateral, patellar, medial patellar, and lateral patellar ligaments.
What is the function of ligaments?
They provide stability
What is the function of the meniscus?
To provide cushion
What are causes of limp and hip pain in children?
Slipped capital femoral epiphysis and Osgood-Schlatter disease
What is Osgood-Schlatter Disease?
A traction apophysitis (inflammation of a bony outgrowth) of the anterior aspect of the tibial tubercle
What test evaluates nerve root inflammation of L4-S1?
Straight leg raise
How do you perform the straight leg raise? What is abnormal?
Have patient lie supine with neck slightly flexed, ask patient to raise leg while keeping the knee extended. Pain below the knee is indicative of nerve root inflammation or herniated nucleus pulposus
What structures should be felt during a bimanual pelvic exam?
Cervix, uterus, adnexa, ovaries, and vaginal wall; ovaries may not be palpable based on size; uterus may not be palpable based on orientation
What does uterine deviation from midline on bimanual pelvic exam suggest?
Pelvic adhesions, pelvic masses, or pregnancy
What should the provider assess about the cervix on a bimanual pelvic exam?
Circumference, size, shape, length, movement (1-2cm is normal), and consistency of tissue
How should a patient be positioned for a breast exam?
Seated first and then supine
What positions can be used to perform a pelvic exam?
Lithotomy, knee-to-chest, diamond, obstetric stirrups, and v-shaped position
What positions can be used to perform a prostate exam?
Standing with hips flexed, lithotomy, knee-to-chest, left lateral with hips and knees flexed
What position would a patient be in for a testicular exam?
Standing while hold penis up
How should a prostate feel on palpation in a young man?
Firm, smooth, and slightly moveable; similar to a pencil eraser
What would expected finding be during a prostate exam of an elderly patient?
Symmetric enlargement of prostate with a smooth, rubbery texture
What does cervical motion tenderness suggest?
A pelvic inflammatory process such as PID or a ruptured tubal pregnancy
What is the most common cause of an inflamed Bartholin Gland?
Gonorrhea
What is the anatomical description of testicular torsion?
Twisting of the testis on the spermatic cord cutting off blood supply
What is orchitis?
Acute inflammation of the testis secondary to infection
What is phimosis? What causes it?
Phimosis is tight ire-tractable foreskin. It is caused by recurrent balanitis or balanoposthitis.
What is Goodell’s sign?
The softening of the cervix that occurs during pregnancy.
What color is the cervix starting in the 2nd trimester?
The cervix has a bluish color. This is called Chadwick’s sign.
What are risk factors for cervical cancer?
HPV, HPV vaccine status, Pap smear history, 3 or more full-term pregnancies, smoking, DES, Chlamydia
What are risk factors for testicular cancer?
Cryptorchidism, history of testicular cancer, family history of testicular cancer, HIV, androgen suppression
What are risk factors for penile cancer?
HPV, uncircumcised, phimosis, age, smoking, HIV, UV exposure
What are expected age-related changes in male genitalia?
Less abundant or gray pubic hair, pendulous scrotal sac and contents, enlargement of prostate, and decreased sphincter tone
What are expected age-related changed to female genitalia?
Gray and sparse pubic hair, smaller and flatter labia, narrower and shorted vagina, smaller uterus, loss of elasticity and tone causing a loss of structural integrity in the vaginal walls, and breast tissue that is flattened, elongated and suspended more loosely from the chest wall.
