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Medical Emergencies > QUIZ 1 > Flashcards

QUIZ 1 Flashcards

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USMLE® Step 1 flashcards
1
Q

AMLS patient assessment pathway

A
  • advanced medical life support
  • initial observations- scene size up, CC, primary assessment
  • first impression- life threats, sick or not sick, differential diagnosis
  • detailed assessment- history, secondary assessment, diagnostics
  • refine differential diagnosis- life threats, critical, nonemergent
  • ongoing management- reassess
    1. scene size up
    1. primary assessment
    1. history taking
    1. secondary assessment
    1. reassessment
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2
Q

OPQRST

A
  • onset- when did it start
  • provocation- does anything you do make it better or worse
  • quality- what does it feel like (tight, pressure)
  • region/radiation/referral- does (pain) it go anywhere else
  • severity- pain on a scale of 1-10
  • time- how long has this been occurring
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3
Q

SAMPLER

A
  • signs and symptoms
  • allergies
  • medications
  • pertinent past history
  • last oral intake
  • events that led to injury or illness
  • risk factors- histories of disease
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4
Q

two components of secondary assessment

A
  • obtaining vital signs

- performing a head to toe survey

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5
Q

AVPU

A
  • alert
  • verbal stimuli
  • painful stimuli
  • unresponsive
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6
Q

pupils

A
  • pinpoint pupils- overdoes
  • fixed and dilated pupils- head trauma
  • ones normal and the other is dilated- brain bleed
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7
Q

glasgow coma scale

A
    1. eye opening- spontaneous (4), to verbal command (3), to pain (2), no response (1)
    1. verbal response- oriented and converses (5), disoriented conversation (4), speaking but nonsensical (3), moans or makes unintelligible sounds (2), no response (1)
    1. motor response- follows commands (6), localized pain (5), withdraws to pain (4) decorticate flexion (3), decerebrate extension (2), no response (1)
  • higher GCS (15)- no neurologic disability
  • 13-14- mild dysfunction
  • 9-12- moderate to severe dysfunction
  • 8 or less- severe dysfunction (lowest possible is 3)
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8
Q

wheezing

A
  • bronchoconstriction
  • lungs are constricted
  • lower airway constriction
  • high pitch whistling
  • vibrate
  • bronchi are swollen and constricted
  • COPD
  • asthma
  • foreign body lodged
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9
Q

rales

A
  • fluid that develops in the lung alveoli
  • the sound of hair rolling between your fingers
  • lower airway obstruction
  • pneumonia
  • congestive heart failure
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10
Q

stridor

A
  • high pitch lung sound
  • happens in the throat
  • constriction of the upper airway
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11
Q

aortic aneurysm

A
  • may be seen pulsating in the upper midline
  • do not palpate an obvious pulsatile mass -> could burst
  • dilates -> aneurysm
  • wall of aorta burst or starts to expand
  • bursts -> dissection (once it starts penetrating the wall
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12
Q

bony crepitus

A
  • you can feel the shattered bones under the skin

- usually for broken ribs

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13
Q

capnography

A

-measure the CO2 you are breathing out

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14
Q

pharynx

A
    1. nasopharynx- air passage with pharyngeal tonsil
    1. oropharynx- common rout for food and air
    1. laryngopharynx - extends to the larynx
  • differing types of epithelial tissue here
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15
Q

larynx

A
  • keeps food and drink out of airway
  • marks where the upper airway ends and the lower airway begins
  • extrinsic muscles connect larynx and elevate it during swallowing
  • intrinsic muscles control vocal cords
  • epiglottis
  • cartilage
  • hypoid bone
  • ligaments
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16
Q

innervation for respiration

A
  • phrenic nerve (C3,C4,C5) is innervated when CO2 increase and pH decreases
  • detected by chemoreceptors in the CSF
  • diaphragm contracts -> inhalation
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17
Q

cell death without oxygen

A
  • 0-1 min -> cardiac irritability
  • 0-4 min -> brain damage not likely
  • 4-6 min -> brain damage possible
  • 6-10 min -> brain damage very likely
  • more than 10 minutes -> irreversible brain damage
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18
Q

COPD

A
  • chronic obstructive pulmonary disease
  • emphysema and chronic bronchitis
  • trouble releasing CO2
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19
Q

tidal volume

A
  • amount inhaled or exhaled in one breath under resting conditions
  • giving too much tidal volume can cause pneumothorax
  • 500ml is average
  • 5-6cc per kilo = tidal volume
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20
Q

agonal respirations

A

-patient may appear to be breathing (gasping) after the heart has stopped

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21
Q

cheyne stoke respirations

A

increased and decreased rate and depth with

  • normal and then drops
  • regular pattern
  • seen in stroke and head injury patients
  • spinal injury
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22
Q

Biot’s respiration

A
  • breathing normally and then dropping or raising
  • irregular pattern
  • may follow serious head injury
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23
Q

kussmals respirations

A
  • deep and fast gasping respirations
  • lacking any apneic periods
  • associated with metabolic/toxic disorders (diabetes mellitus)
24
Q

dyspnea durations

A
  • chronic- usually related cardiac disease, asthma, COPD, or neuromuscular disease
  • acute- asthma exacerbation, infection, pulmonary embolus, acute cardiac dysfunction, inhalation toxic substance, allergen, foreign body
  • sudden- pulmonary embolism, spontaneous, pneumothorax
  • slow- pneumonia, CHF, malignancy
25
Q

tachypnea

A
  • increased respiratory rate
  • fever
  • hypoperfusion
  • metabolic acidosis triggers increase
26
Q

bradypnea

A
  • slower than normal respiratory rate
  • drugs
  • hypoperfusion
  • CNS problem
27
Q

physical exam

A
  1. neurologic- assess mental status

2. neck exam- look for JVD when pt is sitting upright

28
Q

tracheal deviation

A

-late sign of tension pneumothorax

29
Q

OPA adjuncts

A
  • oropharyngeal airways

- unresponsive patients without gag reflex

30
Q

NPA adjuncts

A
  • nasopharyngeal airways
  • intact gag reflex
  • people who cant tolerate OPA
  • do not do on suspected head injury patients
31
Q

nonrebreathing masks

A
  • moderate respiratory distress patients
  • 10-15 L/min
  • delivers oxygen at 60-95%
  • preferred way to give oxygen in prehospital setting
32
Q

nasal cannulas

A
  • 24-44% oxygen delivered
  • 1-6 L/min
  • used for chronic illnesses
  • mild respiratory distress
  • calms patients with minimal oxygen levels
33
Q

assisted ventilation

A
  • CPAP
  • assisted ventilation (BVM)
  • used for patients in respiratory arrest and cannot breath on their own
34
Q

bag mask device

A
  • most common method used to ventilate patients in EMS and during initial respiratory failure in ER
  • 10-15 L/min
  • severe respiratory distress
  • 75-100%
35
Q

CPAP

A
  • continuous positive airway pressure
  • noninvasive ventilatory support for respiratory distress
  • automatic BVM
  • opens collapsed alveoli
  • use with caution for people with low BP -> can cause pneumothorax
  • increases intrathoracic pressure -> aspiration
  • patient needs to be breathing with the machine
36
Q

Nerve 1

A
  • olfactory

- sense of smell

37
Q

Nerve 2

A
  • optic

- sense of sight

38
Q

Nerve 3

A
  • oculomotor
  • size, symmetry, and shape of pupils
  • eye movement
39
Q

Nerve 4

A
  • trochlear

- downward gaze

40
Q

Nerve 5

A
  • trigeminal
  • cheek
  • jaw motion
  • chewing
  • facial sensation
41
Q

Nerve 6

A
  • abducens

- lateral eye movement

42
Q

Nerve 7

A
  • facial
  • strength of facial muscles
  • taste
  • saliva secretion
43
Q

Nerve 8

A
  • acoustic
  • sense of hearing
  • balance
44
Q

Nerve 9

A
  • glossopharyngeal
  • tongue and pharynx sensation
  • taste
  • muscles of swallowing
45
Q

Nerve 10

A
  • vagus
  • sensation of throat and trachea
  • taste
  • muscles for voice production
  • heart rate
46
Q

Nerve 11

A
  • spinal accessory
  • shoulder movement
  • ability to turn head
47
Q

Nerve 12

A
  • hypoglossal
  • speech articulation
  • tongue movement
48
Q

rhonci

A
  • low pitched crackles
  • caused by secretion in the larger airways
  • can be a sign of chronic obstructive pulmonary disease or an infectious process such as bronchitis and pneumonia
49
Q

apneustic

A
  • long, gasping inspiration follow by very short expiration
  • breath is not fully expelled
  • chest is hyperinflated
  • brain lesion
  • causes hypoxemia
50
Q

vesicular lung sounds

A

-auscultated over the anterior and posterior part of the chest

51
Q

bronchovesicular lung sound

A

-auscultated over main bronchi

52
Q

bronchial sounds

A
  • heard over the trachea

- near the manubrium of the sternum

53
Q

adventitious lung sounds

A
  • heard over the normal sound of breathing
  • rales, rhonchi, wheezing
  • lower airway disease
54
Q

decorticate posturing

A
  • arm at chest and angled in
  • fists are clenched
  • dysfunction of the cerebral cortex
  • 3 on the glasgow scale
55
Q

decerebrate posturing

A
  • significant brain injury
  • rigidity
  • arms and legs are extended
  • toes point downward
  • head and neck are arched
  • 2 on the glasgow

Medical Emergencies (16 decks)

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