Quiz 2 Adv Assessment Flashcards
Characterisitics of Chronic Bronchitis
Recurrent cough & Increased sputum production
Exertional dyspnea
Digital clubbing
Dusky color to cyanotic (Blue Bloater)
Characterisitics of Emphysema
Increased CO2 retention (PINK) Purse Lip Breathing (PUFFER) Orthopneic Barrel Chest Thin Appearance Hyperresonance on Chest Percussion
Normal chest percussion sound
Resonance
Where are VESICULAR breath sounds heard?
Lower Lobes
Where are BRONCHIAL breath sounds heard?
Upper Lobes
What exam findings are noted with CONSOLIDATION?
Dullness to percussion
Increased tactile fremitus (have pt say 99)
Bronchial or tubular breath sounds, often with late inspiratory crackles that do not clear w/ cough
EGOPHONY: “eee” sounds like ah
What exam findings are noted with PLEURAL INFLAMMATION?
Sharp, localized pain, worse w/ deep breath, movement, cough
Audible pleural friction rub (sounds like stepping in fresh snow)– heard on inspiration & expiration
What physical exam findings are noted w/ AIR TRAPPING?
Hyperresonance Decreased tactile fremitus Wheeze (exp. first, insp. later) Low diaphragms Increased AP diameter
Normal percussion sound for thorax
Normal percussion sound for abdomen
Abnormal percussion sounds for thorax and indications
Abnormal percussion for abdomen and indications
What is EGOPHONY and indications
What is BRONCHPHONY and indications
Difference between ACUTE cough?
< 3 weeks Indicates: acute resp infection Exacerbation of COPD Asthma Pneumonia PE
Difference between CHRONIC cough?
> 8 weeks Indicates: Asthma GERD Pertussis, atypical pneumonia ACE inhibitors (begins 1-2 weeks p starting med) Chronic bronchitis Bronchiectasis Lung Ca
What medications can cause a chronic cough?
Angiotensin-Converting Enzyme Inhibitors (ACEI)
What microorganisms are associated with community acquired pneumonia (CAP)?
Strep pneumoniae
H. influenzae
Mycoplasma
Chlamydophila pneumonia
What is the CURB 65 criteria?
Confusion of new-onset
Blood Urea nitrogen
Respiratory rate > 30
Age 65 or older
What is the Centor criteria?
absence of Cough Exudative tonsils Anterior cervical adenopathy Hx of fever Age
Score > 2 screen for Strep
What does asymmetrical chest expansion indicate?
Pneumothorax
Maculopapular rashes that are oval w/ Herald patch (Christmas tree) occurs mainly on the trunk
Pityriasis rosea
Ringworm of the scalp
Tinea Capitis
Ringworm of the body
Tinea Corporis
Jock itch: Ringworm of the groin
Tinea cruris
Athlete’s foot
Tinea pedis
Tinea of the hands
Tinea manuum
Pityriasis versicolor (caused by yeast)
Tinea versicolor
Onchymycosis: Toenail fungus
Tinea Unguium
Movement away from body
Abduction (Varus)
Movement toward the body
Adduction (VALGUS)
Test that indicates De Quervain’s tenosynovitis from inflammation of the tendon at the base of the thumb. Pain w/ ulnar deviation
Finkelstein’s test
Full wrist flexion for 60 sec (backward praying hands) + if tingling of median nerve
indicates CTS
Phalen’s test
Tap anterior wrist briskly. + if “pins & needles” sensation used to diagnosis carpal tunnel
Tinel’s test
Painful condition that affects the ball of your foot most commonly between the 3rd & 4th toes may feel as if you are standing on a pebble
Morton’s neuroma
Rotator cuff muscles
Supraspinatus (abduction) Infraspinatus (external rotation) Teres minor (external rotation) Subscapularis (internal rotation)
Apley scratch test
Hawkins shoulder test
What test is used to indicate rotator cuff tear? Tenderness is greater at the supraspinatus insertion
Empty can test
Test that indicates knee instability/ torn ligaments that prevent the femur from sliding posteriorly on the tibia and hyperextension of the knee & limits medial rotation of the femur when the foot is on the ground and the leg is flexed
Anterior drawer test (ACL)
The test that indicates knee instability/torn ligament of the ligament that prevents the femur from sliding anteriorly on the tibia particularly when the kee is flexed
Posterior drawer test (PCL)
Test conducted at 30-degree flexion suggests ACL damage
Lachman test
“Click” on manipulation of knee w/ rotation of ankle indicates injury to a medial meniscus tear. Passive flexion, varus stress & external rotation of the LLE
McMurray test (Medial/ lateral meniscus)
Apley’s grinding test
Skin and nail appearance in hypothyroidism
Hand at or above the level of shoulder begins to be painful in lateral shoulder area
Reach up into pantry/ closet = PAINFUL
Impingement syndrome
Lateral deltoid pain, weakness, loss of strength in external rotation or abduction usually disturbs sleep
Rotator cuff tear
Anterior shoulder pain, joint stiffness, measurable loss of movement in external rotation and abduction common in diabetes
Adhesive capsulitis (Frozen shoulder)
In a ring ( Bull’s eye lesion-Lyme disease) - central clearing
Annular
Blisters > 1 cm w/ fluid (burn)
Bulla
Lesion occurring in a group w/o pattern (herpes)
Clustered
Multiple lesions blending together (psoriasis vulgarsis)
Confluent or Coalescent
Raised, encapsulated fluid-filled lesion
Cyst
Skin thickening usually found over pruritic or friction areas
Lichenification
Lesion distributed in streaks (poison ivy)
Linear
Flat non-palpable are of discoloration < 1 cm (freckle)
Macule
Solid lesion > 0.5 - 2 cm (> 2 cm tumor)
Nodule
Solid elevation < 0.5 cm (mole)
Smooth papule dome-shaped w/ central w/ white plug (molluscum contagiosum)
Papule
Flat, non-palpable area of skin discoloration larger that a macule (vitiligo)
Patch
< 1 cm (thrombocytopenia)
Petechiae
Elevated, variable shape > 1 cm (psoriasis)
Plaque
Flat, red-purple discoloration that does not blanch w/ pressure
Purpura
Vesicle like lesion w/ purulent content (impetigo)
Pustule
Netlike cluster
Reticular
Raised superficial lesions that flake w/ ease (dandruff)
Scale
generalized over body w/o specific pattern (rubella/ roseola)
Scattered
Clear filled (herpes)
Vesicle
Circumscribed area of skin edema (urticaria)
Wheal
Maculopapular butterfly rash (malar rash)
thick scaly red rash on sun-exposed areas (discoid rash)
Autoimmune
photosensitivity
Systemic Lupus erythematosus (SLE)
Order of examination for ABDOMEN
Inspect
Auscultate
Percuss
Palpate
Order of examination for Chest
Inspect
Palpate
Percuss
Auscultate
Flat lung sounds on percussion indicate
Pleural effusion
Dull lungs sounds indicate
Pneumonia
Resonant lung sounds
Healthy lung
Hyperresonant lung sound
Emphysema, pneumothorax
