System Return 1 Flashcards
1
Q
Introduction:
A
Hello my name is ___
I am an SRNA and I will be performing a head to toe assessment on you today.
2
Q
Lymph Nodes:
A
- Occipital, pre and post auricular
- ) Tonsillar, Submandibular and submental
- Superficial cervical, posterior cervical and supraclavicular
3
Q
Lymph Node Order:
A
- Pre-auricular
- Post auricular
- Tonsillar
- Submandibular
- Submental (right below chin)
- Anterior Cervical (medial side of sternocleidomastoid)
- Posterior Cervical (behind sternocleidosmastoid)
- Supraclavicular (above clavicle)
- Infraclavicular (below clavicle)
- Occipital (behind neck)
4
Q
Eyes Full Order:
A
- Lids, lashes, conjunctiva, sclera, cornea, iris pupils
- pupil reactivity
- EOMS’s
- Fundoscopic exam and red reflex
- Visual acuity
5
Q
- Lids, lashes, conjunctiva, sclera, cornea, iris pupils
A
- inspect eyebrows, lids, lashes for symmetry
- inspect sclera. It is white and moist.
- Conjuctiva pink w/o any redness.
- Shine light in eye to note any foreign objects
- Look for shape and symmetry of pupils.
6
Q
- pupil reactivity
A
- Next, I’m going to assess your pupils. I am checking to make sure they are equally round and reactive to direct light.
- To make sure the pupils react to consensual light, shine light in R eye and observe for pupil constriction in left eye. Repeat on other eye.
- test accommodation: Place finger in front of patients face and have them look at your finger and then far off.
7
Q
- EOMS’s
A
- Testing 6 cardinal views of gaze.
- have pt follow finger. Go Up, Down, Across, and diagonal on each side.
- Next, tell pt to follow your finger as you bring it into their nose. Looking to ensure that the eyes will converge and follow your finger.
8
Q
- Fundoscopic exam and red reflex
A
- Grab ophthalmoscope.
- Have pt look straight at something on wall.
- Use your R eye when looking at their R eye and vice versa.
- Come in at an angle.
- Note red reflex from about 12 inches away and once you see it follow it all the way in until you are very close to pt.
- You can see optic disk is a creamy yellow to pink color and is round with distinct margins.
9
Q
- Visual acuity
A
- Snellen Eye chart.
- Place pt 20 ft away from chart.
- ask pt to cover one eye and read smallest line possible. repeat on other eye.
- A larger second number (20/40) correlates with worse vision.
10
Q
Ears Full Order:
A
- External Symmetry and placement in relation to the eyes
- Otoscopic exam ear canal, wax, TM, color, light reflex and landmarks.
- hearing
- weber and rinne tests CN VIII
11
Q
- External symmetry and placement in relation to the eyes:
A
Inspect placement of ears.
Look at external canals for d/c or drainage.
12
Q
- Otoscopic exam:
A
- with otoscope; pull ear up and back.
- Locate TM - shoudl be a pearly white color. Also observe bony landmarks looking for light reflex.
** if TM is red/bulging it can indicate infection.
13
Q
- Hearing:
A
Whisper test:
- Put slight pressure on ear to occlude it (the side you are standing on)
- whisper common two syllable phrase.
- repeat on other side.
14
Q
- Weber Test:
A
Tests ability to hear sound bilaterally
- Strike tuning fork and place it on top of head and ask which ear they feel or hear it in.
- Should be both.
15
Q
- Rinne Test:
A
- Strike tuning fork and palce it on back of ear on the bone.
- Ask when they can no longer hear it and when they can’t move it beside their ear and they should still be able to hear it.
- Air conduction should be greater than bone conduction.
16
Q
Neck Full Order:
A
- Neck symmetry and placement of the trachea
- Thyroid gland
- Carotid Artery bruits
17
Q
- Neck symmetry and placement of trachea:
A
- Neck Symmetrical
- Trachea Midline
- Palpate trachea and move it side to side
18
Q
- Thyroid Gland:
A
- Best to stand behind pt for this.
- Place hands just below the cricoid cartilage
- Have pt swallow and you will be able to feel thyroid isthmus move up.
19
Q
- Carotid Artery Bruits
A
- List with both bell and diaphragm.
20
Q
Heat and Face Full Order:
A
- Distribution and texture of hair
- Scalp tenderness, lesions and masses
- Size, shape of cranium, temporal arteries
- Facial symmetry and expression VII
- Masseter and Temporal muscles -CN V
21
Q
- Distribution and texture of hair
A
- inspect hair and head
22
Q
- Scalp tenderness, lesions and masses
A
- Feel on scalp
- Feeling for any lumps, bumps, depressions
- Note color, lesions, or masses.
23
Q
- Size, shape of cranium, temporal arteries
A
- Feel temporal Pulse
24
Q
- Facial symmetry and expression VII
A
- inspect face for symmetry
- Have pt smile to note symmetrical smile
- This is testing CNVII (Facial)
25
Q
- Masseter and Temporal muscles -CN V
A
- Have pt clench jaw
2. This is testing CN V (Trigeminal)
26
Q
Nose and Sinuses Full Order:
A
- External structure, deviation in shape, size, color, and discharge
- Frontal and maxillary sinuses
27
Q
- External structure, deviation in shape, size, color, and discharge
A
- Inspect nose for deviation and any discharge.
- Note color, shape, and size
- Tilt head backwards and shine light into nose.
- Mucosa should be pink
- Also not any deviation of the septum.
28
Q
- Frontal and maxillary sinuses
A
- Palpate sinuses for tenderness - should not be tender
- Frontal sinus: b/w eyes
- maxillary: below eyes
29
Q
Mouth Full Order:
A
- Appearance, discharge pair, lips, teeth and gums, tongue mucosa and salivary ducts.
- Movement of tongue and uvula - CN XII
- Palate, tonsils and throat
- Gag Reflex - CN IX, X
30
Q
- Appearance, discharge pair, lips, teeth and gums, tongue mucosa and salivary ducts.
A
- Inspect mouth, note any sores or cracking.
2. Have pt smile to assess teeth
31
Q
- Movement of tongue and uvula - CN XII
A
- Ask pt to stick out tongue
- move tongue side to side.
- This is testing CN XII (hypoglossal )
32
Q
- Palate, tonsils and throat
A
- have pt open mouth
- Shine light in and ask pt to stick out tongue.
- Note tonsils, uvula, condition; should be midline
33
Q
- Gag Reflex - CN IX, X
A
Testing CN IX (glossopharyngeal ) and X (Vagus)
*Don’t actually do it but you are assessing these CN’s.
