Test 2 Flashcards
what is the head structure?
- Cranial bones
- Sutures
- Facial bones
- Facial muscles
- Salivary glands
what is the neck structure?
- Neck
muscles - Anterior and
posterior triangles - Thyroid gland
what is Lymphatics?
is part of the immune system. It keeps body fluid levels in balance and defends the body against infections.
what are Lymphatics locations?
- Preauricular (Infront of ear)
- Posterior auricular (behind ear- mastoid)
- Occipital (occipital bone)
- Submental (under the mandible)
- Submandibular
- Tonsillar
- Superficial cervical
- Deep cervical
- Posterior cervical
- Supraclavicular
Subjective Data: Health History?
- Headache
- Head injury
- Dizziness
- Neck pain or limitation of motion
- Lumps or swelling
- History of head or neck surgery
objective data of Lymphatics (head)?
- inspect the head, skull and face.
- normocephalic: normal shape and size.
- temporal area: temporal artery, Temporomandibular joint
objective data of neck?
1) inspect and palpate Lymph nodes.
2) Trachea
3) Thyroid gland: use anterior, posterior approach. also Auscultate for bruit.
assessment of the eye:
- Snellen eye chart
- Near vision
- confrontation test
inspect the eye for: Corneal light reflex (Hirschberg test)
What type of breath sounds are often described as discontinuous, high-pitched, and popping?
Crackles (Rales)
continuous, low-pitched sounds that are best heard when you’re breathing out (also called “expiration”). also has bubbling/snoring sound
Rhonchi
high-pitched, harsh, crowing sound that is typically heard during inspiration.
Stridor
- Loud and high-pitched.
- Expiration is longer than inspiration.
- Harsh and tubular quality.
Bronchial Breath Sounds
- Over the major bronchi (tracheal bifurcation).
- Moderate pitch.
- Inspiration ≈ Expiration.
- Heard between scapulae and near upper sternum.
Bronchovesicular
Vesicular breaths
- Low intensity.
- Inspiration is longer than expiration.
- Soft, rustling quality
what assessments is used to assess emotional and cognitive functioning of patient?
Mental Status Examination
what is a detailed mental assessment include?
Appearance of patient:
* Posture
* Body movements
* Dress
* Grooming and hygiene
Behaviours of patient:
* Level of consciousness
* Facial expression
* Speech
* Mood and Affect
Cognitive Functions of pt:
- attention, old and new memory, new learning (4 unrelated word test)
what is Montreal Cognitive Assessment (MoCA)?
for assessing cognitive performance in mild, moderate, and severe cognitive impairement, for people: aged 55–85 years
what is mini cog test?
The Mini Cog is a simple screening test for cognitive impairment. It combines a** brief memory test** and a simply scored clock-drawing test and allows rapid screening for short term memory defects, learning and different cognitive abilities that are impaired in dementia patients
Mini Mental State Examination
(MMSE)?
performed on pt who may be confused, such as after a head injury or during a sudden episode of illness such as an infection. also to determine if pt has dementia.
- Impacted by level of education. (writing)
example of Assessment and Activities of Daily Living (ADLs)?
-Nutritional patterns
* Sleep/rest changes
* Activity/mobility
- relationships
- spirituality
…
the sources of pain?
- Nociceptive: Caused by tissue injury; well localized
- Described as “aching” or “throbbing”
- Somatic pain: occurs in tissues such as the muscles, skin, or joints.
- visceral pain: internal organs.
- neuropathic: pain within the nerve, affects the nerves that carry sensations to your brain.
- Referred pain: Originates in one location but is felt in another site. ex when you have an injury in one area of your body but feel pain somewhere else the reason because it Innervated by same spinal nerve.
what are the types of pain
- Acute pain: short term, Follows a predictable trajectory like when getting a cut on skin.
- Persistent (chronic) pain: long standing pain that persists beyond the usual recovery period.
talk about some pain assessments tool?
- Graduated scale (0–10)
- Faces Pain Scale
- Visual analogue scale
types of nonverbal pain?
*Acute: Guarding, grimacing, vocalizations (moaning), agitation.
*Persistent: Person adapts over time to chronic pain
5 A’s for Integrating Knowledge of Substance Use in Health Assessment
- Acquire knowledge; replace erroneous assumptions
- Anticipate harm that may be caused by your practices,
reactions, judgements - Avoid social judgement about substance use, such as seeing a
person as “bad,” deviant, or morally weak - Analyze the impact of policies at levels of organization and
society - Approach ALL patients respectfully.
extra ocular muscle function
- corneal light reflex
- tells about muscle weakness
- light points to the side that is weaker
use of ophthalmoscope
Contains set of lenses - unit of strength is diopter
Positive diopters (black) focus on near objects
Negative diopters (red) focus on objects farther away
the types of hearing loss?
conductive: happens when sounds cannot get through the outer and middle ear. It may be hard to hear soft sounds. Louder sounds may be muffled.
sensorineural: occurs when the inner ear or the actual hearing nerve itself becomes damaged.
mixed: both
auditory system levels
- Peripheral: Amplitude (loudness) and Frequency (pitch)
- Brain stem
- Cerebral cortex
Testing hearing acuity?
- conversational speech
- whispered voice test
- tuning fork tests (weber: midhead, rinne: on mastoid)
characteristic location of tympanic membrane?
the tympanic membrane should be pearly-grey in color, translucent, shiny, and mobile on insufflation. it is located at the lateral end of the external acoustic meatus. integrity: intact
define nutritional status?
the degree of balance between nutrient intake and nutrient requirements
what is Optimal nutritional status?
Consumption of nutrients in amounts that support daily growth and any increased metabolic demands
Undernutrition?
Depletion of nutritional reserves or inadequate intake to meet daily requirements
Overnutrition?
Consumption of nutrients in excess of requirements
what is Measures Percent usual body weight formula?
- Measures Percent usual body weight: Current weight/Usual weight X100
the results could indicate: 85-95% = mild malnutrition
75-84% = moderate malnutrition
<75% = severe malnutrition
Recent Weight Change formula?
usual weight – current weight/ usual weight X100
- 5% over 1 month; 7.5% over 3 months; 10% over 6
months
what is screening tool TWEAK used for?
The TWEAK alcohol screening test is a short, five-question test that was originally designed to screen pregnant women for harmful drinking habits.
tool CIWA used for?
- The Clinical Institute Withdrawal Assessment for Alcohol–Revised.
- is the most common method of treating alcohol withdrawal.
tool COWS used for?
The Clinical Opiate Withdrawal Scale is to reproducibly rate common signs and symptoms of opiate withdrawal and monitor these symptoms over time.
what is the apex and the base of the heart?
Heart shape: upside down triangle
Apex at the bottom and base at the top.
name the heart walls from outside to inside?
- pericardium: This is the outermost layer its a fluid-filled sac, also known as the fibrous layer of the serous pericardium. It is a thin layer that covers the surface of the heart. (not part of heart just coverings)
- epicardium: It covers the outer surface of the heart and contributes to the serous pericardial layers.
- myocardium: more like cardiac m, responsible for the pumping action of the heart. It forms the rings in the heart valves.
- endocardium: The innermost layer, which is a thin, smooth membrane lining the inner chambers of the heart. It also covers the heart valves, which means this layer forms the valves in heart.
name the heart valves and where they are found
- tricuspid (right atrioventricular) valve : located between the right atrium and the right ventricle.
- mitral (bicuspid) valve: located between the left atrium and the left ventricle.
- pulmonary valve (semilunar) : located between the right ventricle and the pulmonary artery.
- aortic semilunar valve : located between the left ventricle and the aorta.
what is diastolic and systolic cycles?
Diastole: cardiac cycle when everything is relaxed, that’s when we hear S1 or LUB, which is loudest at the apex of the heart
Systole: Ventricular contraction, DUB sound heard when closing of semilunar valve, top (base) of heart.
what is S3 and S4?
- they are ventricular filing and its abnormal as it may indicate heart failure during diastolic period
- S3: “Ken-tuc-ky” Heard early in diastole, associated with rapid ventricular filling.
- S4: “Ten-nes-see” Heard late in diastole, associated with atrial contraction and stiff ventricles.
the areas in the heart to auscultate?
- aortic area: 2nd right intercostal space.
- pulmonic area: 2nd left intercostal.
- ERB’s point: left 3rd intercostal space.
- tricuspid area: 4th left intercostal space.
- mitral area- apex: 5th left intercostal space (midclavicular).
Mnemonic: All People Enjoy Time Magazine
where do you auscultate for bruit?
in the carotid arteries
objective data for the precordium?
inspect the anterior chest, palpate the apical impulse and across
when looking at arms of pt what do we look for?
Skin
Clubbing
Profile Sign
Capillary refill
Symmetry
how do we grade pulses?
Grading Scale
0 absent
1+ weak
2+ normal
3+ increased/full/bounding
Palpate the Epitrochlear Lymph Node
what is modified allen test used for
- is performed to assess the arterial blood flow to the hand. How do you perform the Allen’s test? The examiner should palpate and apply pressure to the radial and ulnar arteries at the wrist, using three fingers on each artery.
The pectinate muscle is formed by what?
the longitudinal muscle fibers
