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24 Physical & Health Assessment > Physical Examination (Exam I) > Flashcards

Physical Examination (Exam I) Flashcards

1
Q

How deep would one palpate with light palpation technique?
Deep palpation technique?

A
  • 1-2 cm
  • 4-5 cm
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2
Q

What would be expected with tympanic, drum-like percussion?

A
  • Air-containg space (puffed out cheek, gastric air bubble, etc.)
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3
Q

What would be expected with resonant, hollow sounding percussion?

A
  • Normal lungs
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4
Q

What would be an expected finding with assessed hyper-resonant, booming percussive sounds?

A
  • Emphysematous lungs
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5
Q

What would be an expected finding with assessed dull, thud-like percussive sounds?

A
  • Softer organs (ex. Liver)
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6
Q

What would be an expected finding with assessed flat percussive sounds?

A
  • Denser organs (ex. muscle)
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7
Q

What temperature does one need to be to go to PACU?

A

96°

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8
Q

Approximately what should the axillary temp be in comparison to a core temperature?

A
  • 1° lower
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9
Q

What is Anthropometry?

A
  • Scientific study of the measurements and proportions of the human body (height, weight, etc.)
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10
Q

What is Mediate or Indirect Percussion?
How is it performed and what is its purpose?

A
  • Plexor (striking finger) & pleximeter (finger being struck).
  • Evaluation of abdomen and thorax
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11
Q

What is Immediate percussion? What is it utilized for?

A
  • Striking of surface directly with fingers of the hand.
  • Adult sinus or infant thorax evaluation.
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12
Q

What is Fist percussion? What is it utilized for?

A
  • Flat hand on area to be evaluated being struck with a fist.
  • Used to evaluate the back & kidney for tenderness.
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13
Q

What are the three forms of percussion?

A
  • Mediate/Indirect percussion
  • Immediate percussion
  • Fist percussion
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14
Q

When is circumoral cyanosis primarily seen?
How might circumoral cyanosis present on patients with darker skin tones?

A
  • In infants primarily above the upper lip.
  • gray or white rather than blue
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15
Q

What are situations that can cause jaundice?

A
  • Acute liver inflammation
  • Inflammation/obstruction of the bile duct
  • Cholestasis
  • Hemolytic anemia
  • Gilbert’s syndrome
  • Crigler-Najjar syndrome
  • Dubin-Johnson syndrome
  • Pseudojaundice
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16
Q

What causes pseudojaundice? How harmful is it?

A
  • Harmless condition caused by excess carrots, pumpkins or melon consumption (↑ β-carotene)
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17
Q

What is Gilbert’s syndrome?

A
  • Inherited condition where enzymes CAN’T PROCESS THE EXCRETION OF BILE.
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18
Q

What is Crigler-Najjar’s syndrome?

A
  • Inherited condition that impairs the SPECIFIC ENZYME RESPONSIBLE FOR PROCESSING BILIRUBIN .
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19
Q

What is Dubin-Johnson syndrome?

A
  • Inherited chronic jaundice where conjugated bilirubin can’t be secreted from the hepatic cells.
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20
Q

What type of cells does vitiligo attack?

A
  • Melanocytes
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21
Q

What is the sign name of periorbital ecchymosis? What does it indicate?

A
  • raccoon eyes ( can be accompanied by Battle’s Sign - ecchymosis behind the ears): indicates basilar skull fracture.
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22
Q

What are petechiae indicative of?

A
  • Thrombocytopenia
  • Leukemia
  • Infectious disease
  • Medications
  • Prolonged straining
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23
Q

What is koilonychia? What is it often indicative of?

A
  • Spoon-nails where nails become flat or convex. (opposite of clubbing)
  • Iron-deficiency anemia.
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24
Q

What is nail clubbing? What is it often indicative of?

A
  • Increased concavity of nails
  • Heart/lung diseases, also potential osteoarthropathies.
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25
Q

What is paronychia?

A
  • Inflammation of skin around the nail.
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26
Q

What are Beau’s lines? What are they indicative of?

A
  • Horizontal striations that develop on the nail.
  • Lots of things. Nail trauma, kidney failure, mumps, thyroid disorders, syphilis, etc.
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27
Q

What is hirsutism? What is a common cause?

A
  • Excessive hair growth often caused by PCOS.
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28
Q

What is the name of notable difference in pupillary size between both eyes called?

A
  • Anisocoria
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29
Q

What is ectropion?

A
  • Eversion of eyelid/outward turning of the lower eyelid
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30
Q

What is entropion?

A
  • Inversion of eyelid / inward turning of the lower eyelid
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31
Q

What is Ptosis?

A
  • Abnormal drooping of eyelid
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32
Q

What is Arcus Senilis?

A
  • Deposition of phospholipids/cholesterol in the peripheral cornea of older patients. (benign usually)
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33
Q

What occurs with the eyes during stage 2 of anesthesia?

A
  • Roving eyeball (nystagmus?)
  • Partial pupillary dilation
  • Loss of eyelash reflex
  • No loss of eyelid reflex
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34
Q

What is ocular accomodation?

A
  • Ability of eye to focus in on objects far away and close.
35
Q

What is most often the most important anesthetic consideration regarding the ears?

A
  • Padding during surgery to prevent injury
36
Q

Differentiate Weber’s & Rinne’s tests.

A
  • Weber: tuning fork held on the head (assesses left vs right ear hearing)
  • Rinne: tuning fork held to each ear.
37
Q

What are cherry-colored lips most often indicative of?

A
  • Carbon monoxide poisoning
38
Q

Differentiate pallor & cyanosis presentations as well as what usually causes each.

A
  • Pallor = pale (usually anemia)
  • Cyanosis = blue (hypoxia or hypoperfusion)
39
Q

What would be indicated by the presence of “spongy” gums?

A
  • Bleeding due to Vit-C deficiency (scurvy?)
40
Q

What is Leukoplakia? What causes it?

A
  • Thick white patches on the gums from smoking and/or alcohol
41
Q

Where is the apical pulse located?

A
  • 5th Intercostal space, left of sternum, medial to left mid-clavicular line.
42
Q

How much assistance should a patient receive when a Mallampati assessment is being done?

A
  • None
43
Q

Chest pain in sync with respiratory movement could be indicative of what?

A
  • Musculoskeletal abnormality or infection
44
Q

What can cause radial pulses to become unsymmetric?

A
  • Clavicular fracture or aortic dissection
45
Q

How can Mg⁺⁺ evaluations be done in OB patients?

A
  • Knee extension/flexion
46
Q

What capability is lost with peroneal nerve injury?

A
  • Dorsiflexion
47
Q

What anesthetic consideration should one have for a patient with significant lordosis?

A
  • ↑ abdominal pressure could = worse GERD.
  • Difficult spinal/epidural
48
Q

What anesthetic consideration should one have for a patient with significant kyphosis?

A
  • Airway, ventilation, and positioning issues
49
Q

Patient judgement is relevant to obtaining _______ ________ whilst ________ is pertinent to the patient’s understanding of whats going on.

A
  • informed consent; insight
50
Q

What test evaluates proprioception?
How is this test performed?

A
  • Romberg Test
  • Standing with eyes closing and palms down; loss of balance is a + test
51
Q

What is a VAN exam?
What does being VAN positive indicate?

A
  • Palms up, checking for downward drift.
  • VAN (+) = ↑ risk for LVO (large vessel occlusion)
52
Q

What is another name for plantar reflex?

A

Babinski reflex

53
Q

When would a gluteal reflex be performed?

A
  • Trauma patients in assessing pelvic injury
54
Q

How does one calculate BMI in imperial measurement?

A

(703 x lbs) / inches²

55
Q

What endocrine disorder makes it difficult to manage fluid status?

A
  • Pituitary tumors (think neurohypophysis ADH)
56
Q

What is G6PD deficiency?

A
  • Lack of enzyme that results in RBCs breaking down faster than they are made. (can cause hemolytic anemia).
57
Q

What are seizure meds effects on anesthesia?

A
  • Seizure meds make anesthetics work less effectively.
58
Q

Which court case determined how informed consent should be obtained?

A
  • Salgo vs Leland Stanford Univ.
59
Q

What MET capacity would indicate a patient is good to go for surgery from a cardiovascular fitness standpoint?

A
  • MET of 5 or greater.
60
Q

What class of meds commonly given in anesthesia are teratogenic?

A
  • Benzodiazepines
61
Q

What component of “ester” medications are people allergic to?

A
  • PABA (Para-aminobenzoic acid)
62
Q

Which cardiac hypertension meds need to be discontinued prior to surgery? Why?

A
  • ACEi & ARBs - can lead to severe hypotension.
63
Q

What needs to be checked pre-op with psych patients? Why?

A
  • EKG for prolonged QT interval. Many psych meds prolong QT interval.
64
Q

Which meds cannot be given to a patient taking an MAOI?

A
  • Meperidine & ephedrine
65
Q

P2Y12’s inhibitors and aspirin need to be discontinued ______ days prior to surgery.

When is the exception?

A
  • 7 days
  • Exception: patient needs to complete 6 months of dual therapy before discontinuation of anything.
66
Q

Which herb tends to cause an allergic reaction peri-operatively?

A
  • Echinacea
67
Q

Which surgery times put one at a greater risk for PONV?

A
  • prolong surgeries
68
Q

How is a pack-year calculated?

A

20 cigs per pack. 1ppd x 365

69
Q

Bedridden, wheelchair-bound patients should not receive what drug?

A

Succinylcholine

70
Q

What symptoms/signs point to Horner syndrome?
What most often causes it?

A
  • One sided miosis, ptosis, & anhidrosis
  • Interscalene blocks
71
Q

Pill-rolling tremors are associated with what disorder?

A
  • Parkinson’s
72
Q

What sign is it when one experiences RUQ pain along with cholecystitis?

A
  • Murphy’s sign
73
Q

What vision change accompanies glaucoma?

A
  • Tunnel vision
74
Q

What is the name for chest-clutching that occurs during MI?

A
  • Levine’s sign
75
Q

What nerve runs along the breast that we should be aware of?

A
  • Long thoracic nerve
76
Q

Where is the apical pulse?

A
  • 5th ICS, left of sternum, mid-clavicular line
77
Q

What is the importance of blood in the urine when doing a c-section?

A

Possible severed ureter

78
Q

Who is most at-risk for urinary retention post-operatively?

A
  • BPH patients (old men)
79
Q

What drug treats preeclampsia?
How can you check for overdose with this drug?

A
  • Magnesium
  • hypermagnesemia will cause patellar reflexes to disappear.
80
Q

Chipmunk face is associated with what disorder?

A
  • Bulimia
81
Q

Leoning face is associated with what disease?

A

Leprosy

82
Q

Spider angioma is associated with what liver disorder?

A
  • Cirrhosis
83
Q

Pyloric stenosis is associated with what shape mass?

A
  • Olive

24 Physical & Health Assessment (33 decks)

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