Systems Flashcards
CNS
CN1
name and tests
Olfactory
ask about smell and taste being affected
CNS
CN2
name and tests
Optic
visual field test =
nasual: P. covers eye across and follows my finger
Temporal: Hand over same side
peripheral vision decreased can be from glaucoma
Light test:
Both pupils should constrict. if they dont = loss of consensual pupillary light reflex. f only one eye constricts could be Horners syndrome
CNS
CN3
name and tests
Oculomotor
H test: follow my pen
looking down tests for the CN4 trochlear
looking up lat tests for CN6 abducens
CNS
CN5
name and test
Trigeminal - sensory and motor
Sharp/soft test - sensory
Motor test - V3 mastication test. holding face as P chews
CNS
CN7
name and test
Facial - sensory and motor
Facial expressions:
smile
puffed cheeks - i apply pressure
eyes closed - i try open them
surprised face
CNS
CN8
name and test
Vestibular - hearing and balance
webers test - tuning fork.
bone conduction on forehead and is sound the same in both ears
Rinnes test - bone conduction on mastoid process. Air conduction - hearing the sound on each ear
CNS
CN9/10
name and test
glossopharyngeal and vagus
listen to voice - hoarse/whispered
swallowing test - water
uvala deviation - “awww”
gag reflex - ask
CNS
CN11
name and test
Accessory (motor)
restrict scm and trapezius
CNS
CN12
name and test
hypoglossal - motor
tongue test:
out
protrusion - tongue to cheek and i push
GIS
Observe
Nails: clubbing, can be signs of:
IBS, liver disease
Gastrointestinal tumours
Triple A (AAA)
Cystic and pulmonary fibrosis
Arms: out and hands up. Look for flapping. can be signs of:
liver failure
cardiac/rental failure
Eyes: pull down lids
look for yellowing = pallor and jaudice
Mouth:
Ulcers and pear drop smell = T1/2D
Tongue can show signs for iron, b12 and folate deficiencies if very smooth.
GIS
Considerations for abdominal pain
Site
nature of pain
speed of onset
progression
associated features
GIS
Palpation
Neck:
stand behind P as they sit and palpate neck for lymph nodes, enlargement can indicate stomach flu
Abdom:
P supine. applying pressure around tummy, asking P for any pain or discomfort. slowing go deeper.
Percussion - liver, spleen (dull), kidney, bladder, aorta
Auscultation - bowel sounds
GIS
conditions
Pancreatitis - inflamed pancreas
UTI - infection
Crohn’s disease - inflamed gut
Appendicitis - inflamed appendix
diverticular disease - bulges in intestine = inflamed
GIS
what can i be feeling around stomach
guarding - reflex contraction of muscles from pain / inflammation
rebound tenderness - pain caused by sudden withdrawal of pressure. can suggest inflamed visuc. ruptures eg in appendicitis
rigidity - spasm of muscles
sunken abdomen, profound weight loss
GIS
palpation location and possible mass causes
top right = liver, gall bladder, kidney
middle top = transverse colon, stomach, pancreas, AAA
top left = spleen, colon, stomach
low left = inflammatory bowel, colon cancer, loaded colon, ovary
middle bottom = bladder, uterus
bottom right = appendix, inflammatory bowel mass, ovary
CVS
observe
Breathing: breathlessness, anxiety
Hands: redness, swollen, colour (anaemia), tar stains (smoker)
Eyes: arcus (ring around eye = high cholesterol), anaemia (pale), jaudice (yellow, kidney issues).
Face: mular flash (purple/red rash on cheeks, can be low cardia output)
CVS
Pulse
Rate - 60/90 per min
Rhythm - regular, irregular
Feeling for collapsing radial pulse:
elevated arm, holding radial pulse and feeling for throbbing
Areas:
radial = wrist
femoral = groin
popliteal = knee
ankle
carotid = neck
CVS
BP
120/80 healthy
increases with age
put on cuff
hold radial pulse
inflate
slowly let go
note the number when i cant feel pulse
listen on brachial artery
inflate
slowly set go
note when i can hear pulse (SYSTOLIC )
slowly keep getting go
note when i cant hear pulse (DIASTOLIC), will also flicker
Low = dehydration, internal bleeds, medication (antidepressants), diabetes, infections, pregnancy
High = coronary heart disease, diabetes, kidney diseases, hyper/hypothyroidism, stress. medication = the pill, steroids, antidepressants. overweight, high alcohol
CVS
BP
120/80 healthy
increases with age
put on cuff
hold radial pulse
inflate
slowly let go
note the number when i cant feel pulse
listen on brachial artery
inflate
slowly set go
note when i can hear pulse (SYSTOLIC )
slowly keep getting go
note when i cant hear pulse (DIASTOLIC), will also flicker
Low = dehydration, internal bleeds, medication (antidepressants/betablockers), diabetes, infections, pregnancy
High = diabetes, kidney diseases, hyper/hypothyroidism, stress. medication = the pill, steroids, antidepressants. overweight, high alcohol
Auscultation of chest
name valves
MY TITS ARE PERFECT
Mitral - Left - mid clavicular line
Tricuspid - left sternum
Aortic - Left below manubrium, 3rn intercostal space
Pulmonary - Right, below manubrium, 3rn intercostal space
Listening for murmurs - change in blood flow. graded 1-6
listen for first pulse - closure of mitral and tricuspid valve
and second pulse should be softer and higher pitched - closure of aortic and pulmonary valve
CVS
conditions
Dyspnoea - breathlessness
Aneurysm - bulge in artery
Palpitations
Syncope - fainting (vasovagal attacks, blood pooling)
Hypertension
angina - decreased blood to heat muscles
PNS
movement and tone
ask patient to straight out arms and look for involuntary movement / tremors. caused by lesions of the basal ganglia
tone - flex and extend joints rapidly. assess tone. ankle would be leg rolling = look for spasticity (being from upper motor neurones / rigidity
PNS
muscle power
i restrict a movement and compare each side
recrease can be from muscle wasting from inactivity
PNS
reflexes location
tsp where the tendon is
Biceps jerk C5 C6 - lat cubital fossa
Triceps jerk C6 C7 - just above elbow
Supinator jerk C5 C6 - radial puzzle tat
Knee jerk L3 L4 - Just below knee
Ankle jerk L5 S1 - med achilles
