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Professional Development > Part 5 > Flashcards

Part 5 Flashcards

1
Q

Cisterna chyli

A

Dilated lymph vessel usually located on the right of the first or second lumbar vertebra marking the beginning of the thoracic duct

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2
Q

Thoracic duct

A

Receives overwhelming majority of lymphatic drainage from the entire left side and bottom right side of body, travels up the left side of the abdomen and thorax to empty where the left internal jugular and left subclavian vein meet

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3
Q

Right lymphatic duct

A

Responsible for minimal lymphatic drainage from the body, just the right upper extremity and right side of the head, travels to empty into the junction where the right internal jugular and right subclavian vein meet

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4
Q

Horizontal inguinal lymph nodes

A

Travel along th einguinal canal and drain the lower abdomen and buttocks, external genitalia (minus testes or ovaries) scrotum, anal, and lower vagina

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5
Q

Vertical inguinal lymph nodes

A

Travel along the line of the great saphenous vein and drain portions of the leg corresponding

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6
Q

Infraclavicular nodes

A

Any palpation is abnormal and can be indicative of breast cancer or malignant lymphoma

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7
Q

Virchow’s node and what does it represent

A

Left supraclavicular node if palpated indicative of stomach, intestinal, breast, lung, or lymphoma cancers

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8
Q

Milroy’s disease

A

Lymphatic system congenital defect where valves do not work resulting in lymphedema (hard, non pitting, thickened skin)

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9
Q

Cullen’s sign

A

Bruising around the umbilicus indicative of acute pancreatitis or intra-abdominal bleeding

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10
Q

Grey turner’s sign

A

Bruising around the flanks, a sign of retroperitoneal hemorrhage or pancreatic necrosis in severe pancreatitis

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11
Q

Caput medusa

A

Distension and engorging of periumbilical veins seen with late stage hepatic cirrhosis

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12
Q

Rovsing’s sign

A

Press deeply in LLQ, pain in RLQ with pressure in LLQ is positive for appendicitis

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13
Q

Psoas sign

A

Test for appendicitis involving either having pt lay on left side and passively extending the right hip past normal orientation to see if pain is elicited, or by pressing on knee and having pt against resistance flex the right hip

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14
Q
A
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15
Q

Murphy’s sign

A

Ask patient to exhale, place hand below costal margin on right side of midclavicular line, have patient inspire, if sharp pain then positive test for acute cholecystitis

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16
Q

Inspeection of the breast

A

Make sure you check for 4 views (hands at sides, hands on hips, hands overhead and leaning forward)

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17
Q

Cervical motion test/chandellier test

A

A test for PID during the bimanual exam involving physical manipulation of the cervix, positive if patient experiences acute pain from manipulation

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18
Q
A
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19
Q

MSE Judgement exam

A

“What would you do if you saw a fire while in a grocery store”

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20
Q

MSE Insight exam

A

What brings you here today

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21
Q

MSE abstract thinking exam

A

What does the proverb Rome wasn’t built in a day mean to you?

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22
Q

MSE orientation exam

A

Tell me your name, where you are, what is the date

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23
Q

MSE attention exam

A

Serial 7’s, spell world backward

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24
Q

MSE recent memory and remote memory exam

A

Recent news, name last 4 presidents

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25
Q

MSE new learning ability exam

A

Give 3 words and have them repeat after 5 minutes

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26
Q

MSE info and vocab exam

A

Name an object

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27
Q

MSE constructional ability exam

A

Draw a clock

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28
Q

Cranial nerves sensory, motor, or both

A 
Some (I)
Say (II)
Money (III)
Matters (IV)
Some (V 1)
Say (V 2)
Brains (V 3)
My (VI
Brother (VII)
Says (VIII)
Big (IX)
Boobs (X)
Matter (XI)
Most (XII)
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29
Q

CN I function and test

A

Olfaction, do sniff test, inspect nasal cavity, test each side with smell test

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30
Q

CN II function and test

A

Vision, visual fields by confrontuation, manipulate to view conjunctiva, snellen chart and color vision test, fundoscopic exam

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31
Q

CN III, function and test

A

Motor movement of eye and extraocular muscles except superior oblique and lateral rectus, , pupil size test, accommodation, direct and indirect response to light, nystagmus, lid lag,

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32
Q

CN IV and VI test function and tests

A

eye’s ability to move down and inward torsionally and eye’s ability to move to the lateral side

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33
Q

Strabismus vs ambylopia

A

Cross eyed due to paralysis or weakness of EOMs vs lazy eye which is visual acuity of cranial nerve ii that results in failure of acuity and favoring of the other eye that cannot be fixed wit hglasses

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34
Q

Adie’s (tonic) pupil

A

Absence of light response in dilated pupil (cannot constrict), can be seen in diabetic neuropathy or alcoholism

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35
Q

Argyll Robertson pupil

A

Absence of pupillary dilation in dark, pathognomonic of neurosyphilis

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36
Q

CN V function and test

A

Facial sensation and motor function of the jaw, sharp dull test, corneal reflex,

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37
Q

corneal reflex

A

involuntary blinking of both eyelids (direct and consensual) in responnse to stimulus, begins with CN V for sensory afferent fibers and then hits the pons of the brain before triggering efferent fibers of CN VII to initiate the blink

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38
Q

CN VII function and test

A

Muscle of facial expression and taste on anterior 2/3 of tongue, facial motion test, taste test

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39
Q

Branches of facial nerve motor function (remember the pneumonic two zebras bit my clavicles)

A 
Temporal
Zygomatic
Buccal
Mandibular
Cervial
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40
Q

CN VIII function and test

A

Hearing and balance, finger rub test, rinne and weber

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41
Q

CN IX function and test

A

Muscles of the throat, posterior 1/3 of tongue taste sensation
Swallow test, gag reflex, taste sensation test

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42
Q

CN X function and test

A

Esophagus contraction, ear sensation, pericardium, bronchi, stomach, uvula, say ahhh,

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43
Q

CN XI function and test

A

Trapezius and SCM function, test with resistance

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44
Q

CN XII function and test

A

Motor tongue innervation, look for deviation, cheek test

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45
Q

Hyperactive DTR’s and spacticity are a sign of

A

Upper motor lesion

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46
Q

Hypoactive DTR’s and flaccidity are a sign of

A

Lower motor lesion

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47
Q

Recall corticospinal, spinothalamic, and posterior column tracts

A

Corticospinal - voluntary movement and muscle tone
spinothalamic - pain, temp, crude touch
posterior column - position, vibration, refinded touch

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48
Q

Stereognosis test

A

Hold hands out and close eyes, give object and have them know it

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49
Q

Graphesthesia test

A

Draw a number on a patient’s hand and have them tell you what it is

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50
Q

Vibratory sensation test

A

Place tuning fork distally and tell patient when senesation stops

51
Q

Light touch test

A

Cotton ball when is touch felt, compare side to side

52
Q

2 point discrimination test

A

Have patient determine difference between 1 point or 2 on finger pads

53
Q

Point localization test

A

Touch skin with patient’s eyes closed, have them point to where they were touched

54
Q

Normal strength test would be graded a ___/5

A

5/5

55
Q

Babinski sign

A

A reflex test on infants after the sole of the foot has been firmly stroked causing fanning of the toes and movement upward being positive, normal in infants but a sign of disease in adults

56
Q

Rapid alterrnating movements test

A

Cerebellar test where they tap hands alternatively

57
Q

Romberg test

A

Have patient close eyes, slight push and watch for maintanance of balance

58
Q

Pronator drift test (2 parts)

A

1) Place hands out and supine while eyes are closed, if unable to hold patient will start to slowly pronate hand indicative of contralateral stroke
2) push down on arms and see if they return to normal position, if not or overshoot then positive indactive of contralateral storke

59
Q

How are DTR’s graded?

A

0-4 with 2 being normal

60
Q

Location of the different DTR tests

A 
Ankle
Knee
Brachioradialis
Biceps
Triceps
Abdominal
61
Q

Brudzinski’s sign

A

Flexion of hips and knees in response to passive neck flexion by examiner positive for meningitis

62
Q

Kernig’s sign

A

Pain bilaterally behind knee when flexed knee is extended, positive for meningitis

63
Q

Direct hernia

A

Above the inguinal ligament, rarely in the scrotum, hernia bulges anteriorally and pushes side of finger forward

64
Q

Indirect hernia

A

Above inguinal ligament, often into the scrotum, touches the fingertip

65
Q

What 2 serotypes of HPV are high risk?

A

16 and 18

66
Q

Poorly controlled afib can progress to what?

A

Afib with RVR that can cause myocardial ischemia >110 bpm

67
Q

Medial plantar artery is derived from what artery?

A

Posterior tibial

68
Q

Lateral plantar artery is derived from what artery?

A

Posterior tibial

69
Q

Posterior tibial artery is derived from what artery? What branches from it? What is it’s path?

A

Popliteal artery, fibular artery, travels deep before wrapping around the medial malleolus and then dividing into medial and lateral plantar arteries

70
Q

Fibular artery is derived from what, and what does it supply?

A

Posterior tibial artery, lateral chamber of the leg

71
Q

Anterior tibial artery derived from what? And what is it’s course?

A

Popliteal artery, travels anteriorally through hole at top of interosseous membrane and then inferiorally to the anterior chamber of the leg

72
Q

Dorsal pedal artery derived from?

A

Anterior tibial artery

73
Q

Popliteal artery is derived from what? What is it’s course?

A

Derived from femoral artery, name change at adductor hiatus at the medial posterior thigh just above the knee before entering the popliteal fossa where the genicular arteries branch from

74
Q

How many genicular arteries are there?

A

5, superior lateral, superior medial, middle, inferior lateral, inferior medial

75
Q

Femoral artery is derived from what? What is it’s course?

A

External iliac artery, travels on the anterior side of the thigh with profunda femoral artery branch going deep from it, continues inferior and medial penetrating adductor hiatus

76
Q

Profunda femoral artery is derived from what and what is its course?

A

Femoral artery, travels deep into the thigh and has 2 circumflex branches off of it as well as 3 perforating arteries

77
Q

Medial circumflex branch of profunda femoral artery path

A

1st branch off profunda femoris that travels around anatomic neck of the femur

78
Q

Lateral circumflex branch of profunda femoral artery path

A

2nd branch of profunda femoris that travels around surgical neck of femrur

79
Q

Perforating arteries are derived from what and how do they travel?

A

profunda femoris artery, travel posteriorally on the medial side of the thigh penetrating adductor magnus to supply hamstring muscles posteriorally

80
Q

Descending limb of lateral circumflex branch of profunda femoris artery

A

Travels inferiorally to supply vastus lateralis on the lateral side of the thigh and is clinically relevant for administration of injectable medications

81
Q

Obturator artery is derived from what? and what is it’s course?

A

Internal iliac artery, travels inferiorally through obturator foramen to supply muscles ther

82
Q

Sural nerve is derived from what? what is it’s path?

A

Derived from tibial nerve, travels superficially and provides innervation to posterior calf

83
Q

medial plantar nerve is derived from what?

A

(Posterior) tibial nerve

84
Q

Any reference to tibial nerve below the knee is reference to ____ tibial nerve because ____ tibial nerve is also called ____

A

posterior, anterior deep fibular

85
Q

Lateral planter nerve is derived from what?

A

(posterior) tibial nerve

86
Q

Tibial division of sciatic nerve derivation and course

A

Derived from: L4-S3
Travels inferiorally around the pyraformis in close tandem with the common fibular division of sciatic nerve until splitting above the popliteal fossa, in which the tibial division enters the deep posterior chamber of the leg

87
Q

Musculocutaneous/superficial fibular nerve derivation and course

A

Common fibular nerve, Travels inferior lateral into the lateral chamber of the leg where it innervates both muscles and cutaneous area

88
Q

Anterior tibial/deep fibular nerve derivation and course

A

Derived from common fibular nerve, travels inferior and enters the anterior chamber of the leg

89
Q

Common fibular division of sciatic nerve derivation and course

A

Derived from: L4-S3
Travels inferiorally around the pyraformis in close tandem with the tibial division of sciatic nerve until splitting above the popliteal fossa, in which the common fibular division wraps laterally around the knee to the anterior side before dividing into the superficial and deep fibular nerves

90
Q

Great saphenous vein course

A

Travels superiorally from the medial malleolus up the medial part of the knee, then the medial thigh before draining into the femoral vein in the femoral triangle

91
Q

Small saphenous vein course

A

Travels from lateral maleolus posteriorally upward the posterior side of the leg before draining into the popliteal vein at the level of the popliteal fossa

92
Q

How is sickle cell evolutionarily advantageous?

A

Protection against malaria (plasmodium falciparum) the altered shape of the cells gives natural resistance to malaria’s reshaping of protein on the surface of RBCs to adhere to capillaries and organs

93
Q

Pathogen definition

A

Any microorganism capable of causing disease

94
Q

Opportunistic infections definition

A

Microorganisms that may or may not cause disease generally colonize but do not infect a host unless introduced to an area not normally found or immunosuppression

95
Q

Normal human flora 3 major functions

A
  • Prevent colonization by pathogens for competing for attachment
  • Excrete vitamins in excess of their own needs for absorption by the host
  • kill pathogen pathogens through released factors
96
Q

Community acquired vs hospital acquired criteria

A

Hospital acquired must be 48 hours after hospitalization OR within 30 days after discharge

97
Q

Virulence definition

A

Capacity to cause disease

98
Q

Vector definition

A

Agent that carries pathogen from one organism to another

99
Q

TORCHS Test components

A

Test to check for different diseases of the newborn in cases of failure to thrive,
Toxoplasmosis
Other (varicella or zika)
Rubella
Cytomegalovirus
HIV
Syphilsi

100
Q

Most common trace element deficiency in the world

A

Iron

101
Q

Community onset healthcare associated MRSA definition

A

MRSA that occurs outside the hospital within 12 months of exposrure to healthcare

102
Q

Obligate anaerobe definition

A

Requires anaerobic environment to thrive, die in o2 rich environments

103
Q

Facultative anaerobe definition

A

Capable of making ATP by aerobic respiration if O2 is available, but also capable of making ATP via fermentation if O2 is not present

104
Q

a hemolysis

A

Incomplete destruction of erythrocytes, resulting in green coloration

105
Q

B hemolysis

A

Complete destruction of erythrocytes results in clear distinct zone around colonies

106
Q

gamma hemolysis

A

no hemolysis on blood agar, no visible effect on agar

107
Q

Viridan’s streptococci causes these 2 things

A

…-dental caries, bacterial endocarditis

108
Q

Enterococci

A

Formerly known as group D streptococci, are part of normal fecal flora, but can colonize oral mucosa membranes and skin, particularly in a hospital setting. Very resistant to environment, fairly common cause of nosocomial infections

109
Q

VRE

A

Vancomycin resistant enterococci

110
Q

Complications of untreated gonorrhea in females

A

PID or sterility

111
Q

Most common bacterial agent cause of UTI

A

E. coli

112
Q

Bacteroides genus definition

A

Genus composed of obligate anaerobic gram neg rods that do not form spores, primarily inhabit the GI tract, may account for 99% of fecal flora, often seen in a mixed flora infection with other bacteria

113
Q

Chlamydia is uniquely a ____

A

obligate intracellular bacteria

114
Q

Universal/Standard precautions definition

A

Infection control practices used to prevent transmission of infectious agents transmitted via blood, body secretions, non-intact skin, or mucus membranes not only to healthcare providers but also patients and hospital/clinic guests through assumption that all fluids listed are infectious with all blood borne pathogens, implemented standard in all patient care interactions

115
Q

What bodily fluids do standard precautions ignore?

A

-Feces, nasal secretions, vomit, saliva, sweat, tears, and urine (unless containing frank blood)

116
Q

3 types of standard precautions

A

Primary - Immunizations, PPE, work practices
Secondary - Post exposure prophylaxis (PEP)
Expanded - Techniques specific to highly contagious diseases to limit exposure such as negative pressure rooms or isolation

117
Q

3 Common modes of exposure

A

1) Percutaneous injury - penetration of skin by needle or other sharp object formerly in contact with blood/body fluid/etc
2) Mucus membrane exposure - Contact of mucus membrane (eyes, nose, mouth) with fluid, tissues, or specimen
3) Non-intact skin exposure - Contact with fluid, tissues, or specimen

118
Q

What bodily fluids to standard precautions typically include?

A

-Semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid, and amniotic fluid, blood

119
Q

Most common healthcare worker exposure type

A

percutaneous injury

120
Q

Transmission based precautions

A

Secondary tier of techniques to be used in conjunction with standard precautions in regards to patients with specific infectious agents such as airborne, droplet, or contact

121
Q

N-95 respirator

A

Very efficient respiratory protective devices that block 95% of .3 micron or greater particles

122
Q

Seroconversion

A

Time period in which a specific antibody develops and becomes detectable in blood, transition from seronegative to seropositive, indicative of exposure

123
Q

Disease with highest seroconversion rate post needle stick injury (NSI)

A

Hepatitis B (up to 30%)

124
Q

3 Steps to handle blood spill

A

1) Clean area with absorptive towels
2) clean area with soap and water
3) Disinfect area with 1:10 solution of bleach

Professional Development (20 decks)

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