Systems Review LQ Flashcards
Purpose of systems review?
identify suspicious non-MSK or RED flag S&S that require referral to another healthcare professional
________are the best tools to raise suspicion of pathology
RED flags
What are the constitutional symptoms or general health components requiring system(s) review when present?
Fever, chills, sweats- MOST often associated with systemic illness
Prolonged (≥2 wks.)
> 102° may require hospitalization
Weight changes, particularly loss of ≥ 5% and if unexplained
Nausea and Vomiting (N&V)
Dizziness and lt. headedness
Fatigue- prolonged (≥ 2 wks.) and limiting
Weakness- limiting
Paresthesia/Numbness
Malaise or ill feeling- “I feel like I’m coming down with something”
Mentation or cognitive changes
Kidneys, ureters, bladder, and urethra belong to what system?
Urinary
The function of the Urinary System:
Filter fluid from renal blood flow
Remove waste
Retain essential substances for fluid and contents balance i.e., electrolytes, acid-base balance, etc.
The urinary system stimulates _______ production
BP _________
Converts _______ to its active form
RBC
regulation
vitamin D
Urinary S&S
P! in trunk, flank, and/or pelvic regions
Discoloration
-Urinary changes
Frequency
Urgency
Bleeding
Pus
-Dysfunction
Flow
Initiation
Control
-Nocturia- awake to urinate
Urinary Review
MOST from Hx
Observation of urine is unlikely
P! w/kidney percussion
P! with bladder palpation/percussion during abdominal assessment
Function of the reproductive system
Producing sex cells i.e., eggs/sperm, and creating sex hormones with the Endocrine system
Maintaining fertilized eggs for development
Reproductive S&S
P! in pelvis, LB, abdominal regions and/or sexual organs
Dysfunction
Sexual
Bowel and bladder due to proximity
Abnormal
Discharge from sex organs
Menstruation
Early and possibly UNKNOWN pregnancy indications are ________ S&S
reproductive
What is polyuria?
excessive or an abnormally large production or passage of urine
Breast tenderness
Fatigue
N&V with possible wt. loss
Heartburn
Constipation
Abnormal vaginal discharge
These are ___________ S&S?
reproductive
Reproductive review
MOST from Hx
Observation unlikely
NO other specific assessment
The metabolic system compose of what structures?
gut, liver adipose tissue, pancreas, kidney, and mm
Functions of the metabolic system?
Conversion of foods and liquids into:
Energy for all cellular processes
Building blocks for proteins, fats, and carbohydrates
Eliminate waste
Fluid and electrolyte balance is KEY for cellular metabolism
Metabolic S&S:
Due to imbalance of fluid, electrolytes, and/or pH
If the S&S don’t match to a specific system and seem widespread, it is possibly a metabolic condition because altered metabolism can affect MULTIPLE systems
What are two of the MOST common reasons you get fluid and electrolyte imbalances?
polyuria and/or dehydration
What are things that contribute to polyuria and/or dehydration:
Diabetes (rid excess sugars)
Kidney dysfunction- regulates MOST electrolytes followed by intestines, bone, and parathyroid gland
Malignancy
Alcoholism/liver disease
Medication side affects e.g., diuretic for HTN
Burns
Diarrhea
N&V
What are the 3 common electrolytes?
sodium, potassium , calcium
What are other electrolytes? (4)
Phosphorus, bicarbonate, magnesium, chloride
Fluid and Electrolyte imbalance S&S
Skin
-Loss of skin elasticity
-Temperature
Warm and flushed due to vasodilation from impaired circulation and thermoregulation with metabolic acidosis or Diabetes
Pale and cool due to vasoconstriction with hypovolemia or dehydration
-Neuromuscular irritability
Fatigue
Twitching
Cramping
Tetany
CNS involvement regarding fluid and electrolyte imbalance S&S (4)
Memory impairment
Depression
Delusions/Hallucinations
Seizures
Cardiovascular changes regarding fluid and electrolyte imbalance S&S (3)
Tachycardia
Postural hypotension
Altered respirations
pH is ideally between ____ and ______
Kidney removes ____ and keep _____
Lungs balance the ________
7.35 and 7.45
acids; bases
acidic C02
Four classes of pH imbalance
Respiratory Acidosis
Respiratory Alkalosis
Metabolic Acidosis
Metabolic Alkalosis
T or F: Confusion and fatigue S&S may occur with ALL classes listed below
Respiratory Acidosis
Respiratory Alkalosis
Metabolic Acidosis
Metabolic Alkalosis
True
respiratory acidosis (lowered pH)
Hypoventilation and an accumulation of acidic CO2 may occur with:
-numerous disorders affecting respiration
-drugs that suppress respiration like -opioids/muscle relaxers
-sleep apnea
S&S of Respiratory Acidosis (lowered pH)
Headache
Anxiety
May progress to:
-memory loss/personality changes
-sleep disturbances
-incoordination/tremors
Respiratory Alkalosis (higher pH)
Hyperventilation leading to a loss of acidic CO2 may occur with:
-pulmonary conditions
-anxiety
-anemia with less oxygenation
S&S of Respiratory Alkalosis (higher pH)
Shortness of breath (SOB) is often the ONLY sign
Lightheadedness
Otherwise highly variable
Metabolic Acidosis (lowered pH)
MOST common acid-base abnormality
Accumulation of acidic H+ ions may occur with:
MOST commonly due to diabetes with build-up of ketone bodies or acids
Diarrhea/dehydration leading to greater acid concentration
Kidney diseases that hold onto too many acids
S&S of Metabolic Acidosis (lowered pH)
Long deep breaths with a fruity smell due to ketoacidosis
Think Diabetes cardinal S&S
-frequent urination (polyuria)
–dry mouth
–extreme thirst (polydipsia)
–decreased skin turgor
Blurry vision
Weakness/fatigue
Metabolic Alkalosis (higher pH)
Accumulation of bicarbonate base may occur with:
-vomiting by loss of stomach acids
-kidney disorders or medications that keep too many bases
-excessive antacid, laxative, or diuretic medications
-diarrhea
S&S of metabolic Alkalosis
Headache
Neuromuscular excitability
-paresthesia/Numbness
-twitching and cramping, particularly in feet and hands (Trousseau sign)
-seizures
Muscle alterations due to associated lowering of Ca2+
-skeletal weakness
-cardiac arrhythmias- irregular heart beating
What is the MOST common metabolic condition?
Metabolic Acidosis (lowered pH)
What are the review components for metabolic system?
Hx
Observation
resisted and or mmt -weakness
neuro test- possibly altered sensations
abdominal assessment
standard vitals
palpation
Observation: Metabolic Review (6)
muscle twitching/tetany
altered respiration
memory loss
dry mouth
fruity breath**
Metabolic Review: (+) abdominal assessment P! with palpation and percussion of (3)
liver
kidney
pancreases
Metabolic Review: standard vital signs – what are they?
tachycardia or irregular heartbeat
postural hypotension
altered respiratory rate
Metabolic Review: what should a PT expect to see w/palpation? (2)
loss of skin mobility
extreme skin temperatures
