test 1 Flashcards
which of the following chambers of the heart can you assess by palpation?
right ventricle
what is responsible for the inspiratory splitting of s2?
closure of the aortic, then pulmonic valves
heart murmur heard mostly at the cardiac apex?
mitral murmur
Which stage of HTN would you place someone with a BP of 132/85?
prehypertension
which risk factor is used to determine 10 year risk for developing CAD?
gender
Which condition is considered equivlaent to coronary heart disease when speaking of heart disease risk?
peripheral arterial disease
elevated JVP could indicate..?
constrictive pericarditis
what could cause the apical pulse to feel diffuse and increased?
aortic stenosis, with pressure overload of the left ventricle
Lying on the left side helps you to hear which heart sounds?
S3, S4, and mitral murmurs
When listening for an aortic regurgitation murmur, which position would you place the patient?
upright, but leaning forward
When examining a patient that is over 60 with a heart rate under 60, what could the potential rhythm be?
second degree heart block
where is the PMI usually located?
the left 5th intercostal space, 7 to 9 cm lateral to the sternum
which of the following events occurs at the start of diastole?
closure of the aortic valve
What is the third heart sound (s3) caused by?
a rapid deceleration of blood against the ventricular wall
Where can the splitting of the second heart sound be heard?
best heard of the pulmonic area with the bell of the stethoscope
How do you measure JVP?
the verticle height of the blood column in cm, plus 5 cm
What jugular venous pulsation is a systolic phenomenon?
the “x” descent
How much does cardiovascular risk increase for each increment of 20mm Hg systolic and 10 mm Hg diastolic in blood pressure?
100%
in healthy adults over 20, how often should blood pressure, BMI, waist circumference, and pulse be assessed?
q 2 years
In measuring the JVP which of the following is important?
measure the highest visible pressure, usually at the end of expiration
a bounding carotid pulse could indicate?
aortic insufficiency
how would you determine if a murmur is systolic or diastolic?
palpate the carotid pulse
what correlates with a sustained, high-amplitude PMI?
HTN
when examining patients with emphysema, where should you place the stethoscope to hear optimal heart sounds?
epigastric area
what is associated with a grade 4 murmur?
thrill
which valve lesion typically produces a murmur of equal intensity througout systole
mitral insufficiency
paitent has a strong pulse and then a weak pulse, what could they be displaying?
Severe left heart failure
what is a common or concerning symtpom for the peripheral vascular system?
intermittent claudicaiton
To initial evaluate for risk for peripheral vascular disease, this test should be ordered..
Ankle-brachial index (ABI)
To check for PVD in the arms, you should check which pulses?
radial, brachial
to examine for PVD in legs, which physical things should you look for?
size, symmetry, and skin color
Bounding pulses should be documented as
3+
When performing the allen test, which artery are you checking for flow in?
ulnar
with athlerosclerosis in the lower extremities, you would be concerned for pain in which body area?
calf
in a patient with chronic arterial insufficiency, you would find what skin changes in the lower extremities?
thin, shiny, atrophic skin
which area of the arm drains to the epitrochlear nodes?
ulnar surface of the forearm and hand, little and ring fingers, and ulnar middle finger
An ABI of 0.85 indicates….
mild peripheral arterial disease
asymmetric BPs are seen in which of the following conditions?
congenital narrowing of the aorta
diminished radial pulses may be seen in patients wiht which of the following
arterial emboli
when assessing temp of the skin, which portion of your hand should be used?
backs of fingers
painful ulcerative lesion near the medial mallelous, accompanying hyperpigmenetation, indicates?
venous insufficiency
normal weight loss is recommended to be?
0.5-1lb/week
patient with CHF and fluid overload, what should you feel when palpating a pulse?
small amplitude, weak
patient with gastroenteritis and high fever, what should you feel when palpating a pulse?
large amplitude, forceful
DKA patient is having kussmal’s respirations, and is breathing?
rapid and deep
weight gain of 4lbs in a week probably indicates
fluid weight
this can cause a falsely low BP reading in office if present
ausculatory gap
pain caused by shingles is
neuropathic pain
information the patient gives you is considered
subjective
information the clinician collects from doing a physical assessment is
objective
saying “mm-hmm” “go on”
facilitation
symptom involving eye
scotomas
theatrical nature of behavior
histrionic
patient fills all numbers in on a clock just on right side
hemianopsia
patient had stroke, speaks slow and deliberate, very small word usage, stroke occured in which area of brain?
Broca’s area
patient had stroke, speaks fluently but nothing they say makes sense
Wernkickes area
misinterpretation of real external stimuli
illusion
vertigo that occurs from head changing positions
benign positional vertigo
patient has vertigo associated with tinnitus
meniere’s disease
shuffeling gate, facial expression limitation, slow
parkinsons
protruding eyes, can occur on one side
exopthalmos
another term for sty
hordeolum
triagnular thickening of the bulbar conjunctiva that grows slowly across the outter surface fo the cornea
pterygium
red flag for new onset headaches
age over 50
sudden, painless unilateral vision loss may be caused by
retinal detachement
sudden, painful unilateral loss of vision may be
optic neuritis
Diplopia which is present with ONE eye covered is caused by
an irregulariry of hte cornea or lens
a patient complains of epistaxis, should also consider
hematemeiss
what can be seen in a patient with glaucoma?
increased cup-to-disc ratio
sensitive methods for hearting testing
audiometric testing
the area of the fundus that is the central focal point for incoming images?
Fovea
Pupils contract when light is showin on ONE pupil
concensual reaction
stroke patient, can’t see right side when either eye covered has
right homonymous hemianopsia
Anisocoria is
unequal pupils
Anisocoria is present in
horner’s syndrome
uvula deviates to non-effected side can be cauesd by a lesion on which nerve?
CNX
hard mass midline of palate
torus palatinus
mobile lymph nodes just behind sternocleidomastoid muscles bilaterally are
posterior cervical lymph nodes
