PD Exam 1 Refined Deck Flashcards
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Extracorporal signs in general assessment of a patient
- Clothing (might suggest poverty)
- Reading materials or other things with them (might say something about their character, whats on their mind)
- Familial support (either present through people or gifts or not)
Regularly irregular pulse
Mobitz 1 AV block
Irregularly irregular pulse
Atrial fib or premature ventricular contraction
Occasionally irregular pulse
Normal premature contraction
Weak pulse indications
Shock, MI, aortic aneurysm
Bounding pulse indications
Anxiety, fever, pregnancy, hyperthyroidism, anemia
pulsus altercans
Alternating strong and weak pulse indicative of LV failure, often due to CAD, aortic stenosis, hypertension
Pulsus bisferians
Biphasic pulse, indicative of aortic valve problem, often due to aortic stenosis or regurgitation
Dicrotic pulse
2 distinguishable pulses, indicative of low cardiac output
Pulsus parvus et tardus
Weak and late pulse, indicative of aortic valve stenosis
Pulsus paradoxus
Pulse weakening upon inhalation, indicative of cardiac tamponade or pericardial disease
Blood pressure measuring technique
1) Ensure skin exposure
2) Palpate radial pulse and trace to brachial pulse
3) Place cuff on arm properly
4) Palpate radial pulse while inflating, keeping note of value when pulse stops
5) Reinflate cuff with stethoscope in cubital fossa to 20 mmHg above previous inflation
6) Listen till sounds complete
7) repeat on other arm
Auscultory gap
A period when listening to blood pressure in which korkoff sounds stop for a period before returning, indicative of stiff vessels
Korotkoff sounds
A series of 4 phases of sounds heard when listening at the cubital fossa during a blood pressure measurement, beginning marks systolic pressure, and ending marks diastolic pressure
Tachypnea
Rapid shallow breathing, indicative of anxiety or restrictive lung disease
Hyperpnea
Rapid deep breathing, indicative of infarct or exercise
Hypopnea
Shallow, infrequent breathing, indicative of smoking or certain medications
Bradypnea
slow breathing, indicative of coma or respiratory depression
Apnea
Lack of breathing, indicative of seizure, head trauma, choking
Kussmaul
Fast, slow, and normal breathing alternating, indicative of metabolic acidosis
Cheyne stokes respiration
Periods of breathing followed by periods of apnea, indicative of brain injuries or tumors
Respiration is regulated at the…
Pons and medulla of the hindbrain
Ataxic or Biot’s breathing
Unpredictable and irregular breathing due to brain damage or respiratory depression
Describe the different temps and variation among them
Oral (baseline)
Axillary (1 degree lower than oral)
Tympanic (1.4 degrees higher than oral)
Rectal (1 degree higher than oral and most accurate)
Herpiform vs zosteriform
Randomly spread vs following a dermatomal distribution
Koebner distribution
Spread of lesions along an area of trauma
Distribution in skin lesions
Generalized vs localized, exposed vs nonexposed areas, sun exposed or not, bilateral or unilateral, acral vs truncal, extensor surfaces vs flexor surfaces, upper or lower extremity, mucus membrane involvement
Patterns in skin lesions
Isolated, scattered, groups, circular (annular - complete, arciform - incomplete ring, polycyclic - multiple rings), linear, angular, reticulated
Hepatic necrotic nail appearance
Half and half coloration of nail
Anemia appearance of nail
White color
Hypoxia appearance of nail
Clubbing
Anxiety appearance of nail
Bitten
Nephrotic syndrome appearance of nail
White and pink bands
Hypothyroidism appearance of nail
brittleness
Useful precision
Concept that the problem at hand should dictate the level of precision in information from the patient
ROS system list
General Endocrine HEENT Lung/pulmonary Breast Cardiovascular Abdominal/GI Genitourinary Psych Neurological Musculoskeletal
Pneumonic for obtaining history
Onset Paliating/provoking factors Quality Radiating Severity Timeline
Social history pneumonic
Family and food Lifestyle Abuses Marrital status and sex Employment Support system
6 S’s of abuse and accident
Substances Smoking Security of guns, toxins Seatbelt Smoke detectors Sexual contact
Cranial nerve IV movement
Superior oblique, moves eyes inferiorally and convergently
Cranial nerve VI movement
Lateral rectus, allows movements laterally away from the nose (activated once on each side)
Ipsalateral monocular vision loss
Lesion at the optic nerve resulting in one eye completely blind
Bitemporal hemianopia
Lesion at the optic chiasm resulting in temporal blindness in each eye, remember light is coming from the temporal side to the nasal side
Ipsalateral nasal hemianopia
Lesion at the uncrossed optic nerve fibers resulting in nasal blindness in one eye, remember that light is coming from the nasal side to the temporal side
Contralateral homonymous hemianopia
Lesion at the optic tract resulting in temporal and nasal blindness in each eye, remember light is coming from nasal side to tempoal side on one eye and tempral side to nasal side on the other
Contralateral homonymous hemianopia with macular sparing
Lesion at the optic nerve posteriorally resulting in temporal and nasal blindness in each eye only in periphery, remember light is coming from the nasal side to temporal side on one eye and temporal side to nasal side on the other
Vertical eye defects are usually caused by…
…vascular problems
Ipsalateral central scotoma
Lesion in eye at a fixed point resulting in blind spot
Hyperopia
Farsightedness, difficulty focusing on a near object
Myopia
Nearsightedness, inability to focus on distant objects
Corneal light reflex
Tests the assemetry from normal ocular alignment, indicates a lazy eye
PERRLA
Pupils equal, round, react to light, accomodation
Nystagmus
Abnormal movement of eye in the vertical, horizontal, or torsional direction
Visual fields assessment
Have patient cover one eye, hold up different fingers in each quadrant of visual field
Optic disc
Entry point into the retina for ganglion cells forming the optic nerve and small vessels entering the posterior eye, lacks any rods or cones and forms the blind spot of the eye, 3-4mm toward the nasal side of the fovea, has an optic cup central depression within
Fovea
Small pit of closely packed cones in the eye at the center of the macula, forming central vision
A large cup to disc ratio (close to 1) indicates…
…Glaucoma or other pathology
Tonometry
Testing of intraocular pressure, either via numbing the eye (contact) or via air puff method
Fluorescein eye exam
Applied via drops to most medial area of eye, use cobalt blue light to examine eyes with lights dimmed where abrasions will appear yellow
Anisocoria
Unequal pupil size distribution
Weber tuning fork exam
Place tuning fork on top of patient’s head and ask if they hear it equally in both ears or if one is louder, conductive hearing loss sound is heard in impaired ear, sensorineural hearing loss, sound is heard in good ear
Rinne tuning fork exam
Place sound through bone until they lose it, then move to ear, if they can still hear than normal hearing or sensorineural hearing loss, if conductive hearing loss bone is as long or longer than airr
Frontal sinus development period
Do not appear until age 7-8 so no such thing as frontal sinusitis in these children
