Test 2 Flashcards
Test for visual acuity and sharpness of vision 20/20 means you can see 20 feet away covering one eye.
Snellen Test
Test where one hits the tuning fork and place it on the mastoid process. when the patient can no longer hear vibrations then move it in front of the ear
Hearing-rinne test
What is a bruit and how do you assess for it ??
It is a blowing or swishing SOUND during systole- heard over the carotid area while auscultating.
It indicates blow flow turbulence.
What is PERRLA and what does it stand for ??
Pupils, equal, round, reactive to light, and accommodation.
It’s what you check the eyes for
How to auscultate over a bruit?
Lightly apply BELL of stethoscope to auscultate over carotid artery at 3 levels.
- Angle of jaw
- mid-cervical area
- Base of neck
How to auscultate lungs ?
Have patient breath normal with mouth open
Auscultate lungs bilaterally, alternate and compare sides.
Use the diaphragm of the stethoscope, first listen with a quiet respiration, deep breaths
Note the intensity, quality, and pitch of breaths
How to auscultate abdomen?
Inspect abdomen
Auscultate from Lower Right Quadrant clockwise to upper right, upper left, lower left.
Palpate sites/any pain?
Ask when was your last BM?
how to do Assessment of moles?
Assess ABCDE
Asymmetry, border, color, diameter, envolving or changing appearance
skin lesion type- Confluence, brought on by patient or environmental factors external causes such as scratch, trauma, infections, wound healing, crust, scale, scar, excoriation, ulcer
Secondary skin lesion
Pustules, macule, papule, nodule, tumor, plaque, vesicle, bullae,
(elevated superficial lesion greater than 1cm in diameter, formed by a confluence of papules or developed from previously “normal” skin)
Primary skin lesion
Lymph nodes and sites
Cervical neck <1cm
Axillary armpits
Supraclavicular collar bone
Mediastinal upper body behind sternum/between lung sac
Mesentery-Lower body/abdomen
Inguinal- groin
Femoral- inner/upper thigh
What is normal finding when palpating lymph nodes ?
Non tender, non-palpable , soft ,smooth, moveable , bean shaped in subq tissue
1 cm in size , 0.5-2.0 depending on location
Normal breath sounds in :
anterior if lungs ?
Posterior of lungs?
Anterior: bronchial- high pitched
Posterior: bronchovesicular and vesicular - low pitched lungs
Lung sounds and what they might mean?
- continuous low pitched sounds (like wheezes/whistling) with gurgling, snoring
Sounds like snoring in a stronger an expiration
Heard in the chest wall where bronco occurs. Air is blocked or flow is rough
Rhonchi-
Could mean asthma, chronic obstructive pulmonary disease, foreign body
Lung sounds and what they might mean?
High/fine or low/course popping , clicking, bubbling, when air opens closed air spaces (opening of small airways),
Crackles
Could mean inflammation, infection of small bronchi, bronchioles, and alveoli.
May indicate pulmonary edema or fluid in the alveoli due to heart failure, pneumonia, pulmonary Edema, TB, or bronchitis
Lung sounds and what they might mean?
High pitched whistles
Wheezing
Airways are narrowing or keeping air from flowing through
Lung sounds and what they might mean?
High pitched, wheeze like sounds heard when breathing due to blockage of airflow in windpipe , trachea , or back of throat
Stridor
May indicate croup
Lung sounds and what they might mean?
Low pitched, non musical , many repeated sounds
Rub
May indicate inflammation of lungs and lung tremors
Lung sounds and what they might mean?
Short breaths,
can be due to Partial loss all of ventilation tissue, hyper inflated lung tissue, abnormality that reduces transmission, absence of functioning structures
Diminished lung sounds
Results from valve damage or _________distention
If valve leak occurs, veins become incompetent and blood falls back under gravity as calf muscles relax, increasing _______pressure
Venous
Venous
Venous insufficiency
Pallor with legs elevated , dusky redness of toes , feet, and calves, dry shiny skin, pulses, delayed cap refill, cool to cold skin, loss of hair over toes, dorsum (top of foot) , thickened nails, pain, intermittent (stoping for some time and then going) claudication (impairment in walking) to sharp, unrelenting(hard), constant.
Arterial insufficiency
Bdvvc
Limb assessment
Different stages of edema ?
How long it lasts? mm?? Severity of pitting? 0+ 1+ 2+ 3+ 4+
0 + none
1+mild pitting 2mm and disappears rapidly
2+ moderate 4mm, 10-15 second pitting
3+ moderately severe, 6mm and lasts more than 1 min
4+ severe pitting edema, 8mm and lasts more than 2 minutes
What causes heart sounds?
Opening and closing of the valves to blood flow throughout the heart
