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Health Assessment > Test 3 > Flashcards

Test 3 Flashcards

1
Q

Anterior neck triangle

A

Trachea, sternomastoid muscle, and bottom of mandible

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2
Q

Posterior neck triangle

A

Sternomastoid muscle,

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3
Q

Lymph node locations

A
  1. Preauricular
  2. Posterior auricular
  3. Occipital
  4. Submental
  5. Submandibular
  6. Cervical chain
  7. Supraclavicular
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4
Q

Preauricular

A

In front of ear

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5
Q

Posterior auricular

A

Behind ear

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6
Q

Occipital

A

Base of skull in back

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7
Q

Submental

A

Lower chin

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8
Q

Submandibular

A

Lower jaw

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9
Q

Cervical chain

A

anterior/posterior, deep; behind/in front and behind sternocleidomastoid muscle

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10
Q

Supraclavicular

A

Abnormal if you feel it; on top of clavicle; possible cancer if felt

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11
Q

What is normal with lymph nodes?

A

Not feeling them

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12
Q

What could it mean if you do feel them or if they are enlarged or tender

A

Infection

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13
Q

XWhat to ask about in head, ears, eyes, nose, throat:

A
  1. How bad is the headache
  2. Head injury
  3. Dizziness
  4. Neck pain or limitation of motion
  5. Lumps or swelling
  6. History of head or neck surgery
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14
Q

XWhat to inspect on skull:

A
  1. Size
  2. Shape
  3. Temporal area
  4. Facial structure (drooping)
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15
Q

What to inspect on neck

A
  1. Range of motion

2. Lymph nodes

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16
Q

What to palpate on trachea and thyroid

A
  1. Trachea is midline

2. Thyroid gland

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17
Q

What could it mean if trachea is deviated

A

Collapsed lung

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18
Q

Ways to palpate thyroid

A
  1. Anterior approach

2. Posterior approach

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19
Q

What do you do if you feel an enlarged thyroid

A

Auscultate, bruits is abnormal

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20
Q

Iris

A

Colored part of eye

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21
Q

Sclera

A

White part of eye

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22
Q

Limbus

A

Dark ring between cornea and sclera

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23
Q

Palpebral fissue

A

Slit where eyes come together

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24
Q

Lacrimal apparatus

A

Tear duct

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25
Q

XWhat to ask with eye exam

A
  1. Vision difficulty
  2. Pain
  3. Strabismus
  4. Diplopia
  5. Watering, discharge
  6. History of ocular problems
  7. History/been tested for glaucoma
  8. Glasses or contacts
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26
Q

Strabismus

A

Cross eyes

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27
Q

Diplopia

A

Double vision

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28
Q

Additional history for aging adult

A
  1. Visual difficulty
  2. Glaucoma test
  3. Cataracts
  4. Eye dryness
  5. Decreased activities
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29
Q

XWhat to look for in eye exam

A
  1. Eyebrows
  2. Eyelids and lashes
  3. Eyeballs
  4. Conjuctiva and sclera
  5. Eversion of the upper lid
  6. Lacrimal apparatus
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30
Q

Conjuctiva

A

Pink membrane under eyelid

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31
Q

Blepharitis

A

Inflammation of eyelids

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32
Q

Ptosis

A

Drooping of eyelid

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33
Q

XWhat to inspect in eyeballs

A
  1. Cornea and lens
  2. Iris and pupil (PERRLA)
  3. Size and shape
  4. Pupillary light reflex: Shine light into pupils and it should restrict
  5. Consensual reflex
  6. Accommodations
  7. Converge
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34
Q

Consensual reflex

A

Both eyes should constrict when light is on one

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35
Q

How to test accommodations

A

Have them look off in distance and then look at your finger

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36
Q

How to test convergence

A

Pull fingers in middle and their eyeballs should meet in midline

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37
Q

PERRLA

A

Pupils Equal Round Reactive to Light Accommadations

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38
Q

Hirshberg test

A

Light shown in front of person should reflect in the exact same spot in both eyes

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39
Q

Corneal light reflex

A

Corneal light reflex sign of visual acuity problems

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40
Q

Red reflex test

A

Use abdomoscope to look into eyes and see if it turns red

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41
Q

Postitive red reflex test means

A

Blown retina or tumor (retinoblastoma)

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42
Q

6 Cardinal fields of vision

A

“follow my finger” Looking for fluid eye movement

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43
Q

Nystagmus

A

“Dancing eyes”

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44
Q

Cover test

A

Tell pt to look at something in distance and cover eye; both eyes should still be looking in the same direction when you move the card

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45
Q

Snellen eye chart

A

Pt stands 20 ft from chart; have them cover the eye to test the individually and then test both together; they read the line they can read most comfortably and get all of them correct until they can’t

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46
Q

What to note with Snellen chart

A

How far they went down; use numbers off to the side; notate X(what pt saw at 20 ft)/X (what normal person would see)

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47
Q

Jaeger chart

A

Smaller Snellen chart that is held in hand while each eye is covered; older adults may have trouble with this

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48
Q

Confrontation test

A

Tests peripheral vision; Cover opposite eye from pt (mirrored) and check peripheral vision against yours

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49
Q

Asian cultural difference

A

Narrowed palpebral fissures

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50
Q

African american cultural risk

A

Glaucoma is higher risk

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51
Q

White cultural risk

A

Increased macular degeneration: loss of central vision, big black spot

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52
Q

Presbyopia

A

Older adults; Nearsightedness

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53
Q

Arcus senillus

A

Older adults; white line around iris; normal variation

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54
Q

Cataracts

A

Older adults; Lossing contrast; blurred vision

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55
Q

Glaucoma

A

Older adults; increased intraoccular pressure

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56
Q

Ear range from external auditory canal

A

3.5-

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57
Q

Tympanic membrane

A

Eardrum; gray color

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58
Q

Where does light reflex in right ear

A

5 o’clock

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59
Q

Where does light reflex in left ear

A

7 o’clock

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60
Q

What is different about kids and adults in the eustachian tube

A

Kids have a horizontal eustachian tube and adults have sloped

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61
Q

XWhat to ask about with ears

A
  1. Earaches
  2. Trauma
  3. Infections
  4. Discharge
  5. Hearing loss
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62
Q

Tinnitus

A

Ringing of ears

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63
Q

Vertigo

A

Dizziness

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64
Q

XWhat to inspect with ears

A
  1. Size and shape
  2. Skin condition
  3. Tenderness
  4. External auditory meatus
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65
Q

Voice test

A

Stand 1-2 feet from ear and close opposite ear and whisper a 2 syllable word

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66
Q

How to inspect ear in kids

A

Pull down and back

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67
Q

How to inspect ear in adults

A

Back and up

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68
Q

Septum

A

Should be midline; middle of nostril

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69
Q

Turbinates

A

Membranes in nose; there are three; usually can only see 2

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70
Q

Paranasal sinuses

A
  1. Frontal (eyebrows)
  2. Maxillary (cheeks)
  3. Ethmoid
  4. Sphenoid
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71
Q

When do sinuses develop

A

Around age 4, young kids can’t have a sinus infection

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72
Q

Gingivitis

A

From smokeless tobacco: gumline inflammation

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73
Q

Halitosis

A

Smelly breath

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74
Q

Signs of oral cancer

A
  1. Painless sore that does not heal
  2. Smooth leathery white patch
  3. Restricted movement
  4. Difficulty chewing
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75
Q

XQuestions to ask with mouth

A
  1. Lesions
  2. Pain
  3. Epistaxis
  4. Difficulty breathing
  5. Drainage
  6. Change in ability to smell or taste
  7. Dysphagia
76
Q

Epitaxis

A

Nose bleed

77
Q

How to examine nose

A

Have them push up tip of nose and use otoscope light and slightly insert

78
Q

What to palpate with sinuses

A

Palpate frontal and maxillary sinuses; looking for sinus infection

79
Q

Transillumination

A

Shining light in sinuses to look for active sinus infection (not science based anymore)

80
Q

XWhat to inspect in mouth

A
  1. Lips
  2. Teeth and gums
  3. Tongue
  4. Buccal mucosa
  5. Palate and uvula
81
Q

Buccal mucosa

A

Membrane around jaw

82
Q

Tori/Torus

A

Bony protrusions in mouth; normal

83
Q

What to inspect in throat

A
  1. Tonsils (Grade them)

2. Posterior pharyngeal wall (back of throat)

84
Q

Normal tonsil grading

A

1+

85
Q

4+ tonsil grading

A

Touching

86
Q

Mental status

A

Emotional and cognitive functioning; inferred through behaviors

87
Q

XMental status is inferred through

A
  1. Consciousness
  2. Language
  3. Mood and affect
  4. Orientation
  5. Attention
  6. Memory
  7. Thought process
  8. Perceptions
88
Q

3 domains of orientation

A
  1. Person
  2. Place
  3. Time
89
Q

Parts of memory

A
  1. Recent

2. Remote

90
Q

Components of mental status exam

A

A: Appearance
B: Behavior
C: Cognition
T: Thought processes

91
Q

XObjective data of mental status exam appearance wise

A
  1. Posture
  2. Body movements
  3. Dress
  4. Grooming and hygiene
  5. LOC: Level of consciousness
92
Q

Levels of consciousness

A
  1. Alert
  2. Lethargic: Drifts off to sleep
  3. Obtunded: Sleeps most of time
  4. Stuporous: Difficult to arouse
  5. Comatose
93
Q

XObjective data of mental status behavior wise

A
  1. Facial expression
  2. Speech
  3. Mood and affect (does facial expression match mood)
94
Q

XObjective data of mental status cognitive function wise

A
  1. Orientation
  2. Attention span
  3. Recent memory
  4. Remote memory
  5. New learning: Four unrelated words test
  6. Judgment
95
Q

How to test recent memory

A

Ask what they ate this morning or last night

96
Q

How to test remote memory

A

When is your anniversary, who was president in…

97
Q

XObjective data of mental status thought processes and perceptions wise

A
  1. Thought processes
  2. Thought content
  3. Perceptions
  4. Screen for suicidal thoughts
98
Q

XWhat does a mini mental state exam check

A
  1. Orientation
  2. Registration: Repeating words test
  3. Attention and calculation: Count backward from 100 for 3 cycles
  4. Recall: Recalling words
  5. Language: Ask to define common abstract statement
99
Q

XHealth history questions with mental state

A
  1. Headache
  2. Head injury
  3. Seizures
  4. Lack of coordination
  5. Numbness or tingling
  6. Dysphagia/Aphasia
  7. Environmental/occupational history
100
Q

Leading modifiable risk factors for stroke

A
  1. High BP
  2. High cholesterol
  3. Cigarette smoking
  4. Diabetes
  5. Poor diet and physical inactivity
  6. Overweight and obesity
101
Q

Signs of stroke

A

F: Face drooping
A: Arm weakness
S: Speech difficulty
T: Time to call 911

102
Q

BPP Vertigo (BPPV)

A

Benign paroxysmal positional vertigo

103
Q

Cranial nerves

A 
I. Olfactory
II. Optic
III. Oculomotor
IV. Trochlear
V. Trigeminal
VI. Abducens
VII. Facial
VIII. Acoustic
IX. Glossopharyngeal
X. Vagus
XI. Spinal accessory
XII. Hypoglossal
104
Q

How to test olfactory cranial nerves

A

Have pt smell familiar scent

105
Q

How to test optic visual acuity cranial nerve

A

Have them read snellen chart or your badge

106
Q

How to test oculomotor/trochlear/abducens cranial nerve

A 
Palpate fissures (touch eyelids) 
Test pupils (direct and consentual)
Extra ocular muscles (doing big H)
107
Q

How to test trigeminal cranial nerve

A 
Jaw strength (clench teeth)
Sensation (rub q-tip on face) 
Corneal reflex (touch q-tip on eye)
108
Q

How to test VII. cranial nerve

A

Have them smile, frown, close eyes, and puff cheeks

109
Q

How to test VIII. cranial nerve

A

Acoustic test hearing acuity (Whisper test)

110
Q

How to test IX/X cranial nerve

A

Have them say AH and watch uvula

Gag reflex

111
Q

How to test XII cranial nerve

A

Stick out tongue

112
Q

How to test XI cranial nerve

A

Have them shrug shoulders with resistance, and turn face with resistance

113
Q

How to test cerebellar/motor function (balance and coordination)

A
  1. Gait
  2. Tandem walking (heel/toe)
  3. Rapid alternating movements (RAM) (use finger to nose test opp. sides)
  4. Finger to finger test
  5. Finger to nose test
  6. Heel to shin test
  7. Romberg test
114
Q

Romberg test

A

Have the patient stand with their heels together and eyes closed. They should be able to maintain their balance

115
Q

XHow to inspect/palpate motor system (muscle)

A
  1. Size
  2. Strength
  3. Tone
  4. Involuntary movements
116
Q

XWhat to check in sensory tests (check upper and lower extremities)

A
  1. Pain
  2. Temperature (hot/cold)
  3. Light touch
  4. Vibration (tuning fork)
  5. Position (do fingers up and down)
  6. Stereognosis
  7. Graphesthesia
  8. 2 point discrimination
117
Q

Stereognosis

A

Advanced practice; putting familiar object in their hand

118
Q

Graphesthesia

A

Draw a letter or number in their hand

119
Q

2 point discrimination

A

Use 2 cotton tips and see if they can tell if you are using 1 or 2

120
Q

Deep tendon reflexes

A
  1. Biceps
  2. Triceps
  3. Quadriceps
  4. Achilles
121
Q

Grading reflexes

A

0-4+

2+ is normal

122
Q

What do you do if you cannot elicit a response

A

Have pt perform an isometric exercise in another area (grab arms for legs)

123
Q

Superficial reflexes

A
  1. Abdominal
  2. Cremasteric: Only in males, testes
  3. Plantar: Toes curl/fan out
124
Q

Babinski

A

Infants toes fan out, after 3 months, toes curl

125
Q

Brudzinski’s neck sign

A

In infant, if you lift their head, legs should pull in until about 4 months

126
Q

Frontal release signs (infant)

A
  1. Snout reflex: Put finger under nose, infant lips curl up until 3/4 months
  2. Sucking reflex
  3. Grasp reflex
127
Q

What to check in neurologic check

A
  1. Level of consciousness (PPT)
  2. Motor function
  3. Pupillary response
  4. Vital signs
  5. Glasgow Coma Scale (GCS)
128
Q

Glasgow Coma Scale

A
  1. Eye opening response (1-4)
  2. Motor response (1-6)
  3. Verbal response (1-5)
129
Q

Bad GCS score

A

Less than 8

130
Q

Good GCS score

A

15 (highest)

131
Q

Decorticate (abnormal flexion)

A

Hands curled up to chest

132
Q

Decerebrate (abnormal extension)

A

Hands to sides, fists curled out

133
Q

Types of gaits

A
  1. Parkinson’s (festination)
  2. Scissors gait
  3. Steppage gait
  4. Cerebellar ataxia
134
Q

Healthy people 2020 Reducing traumatic brain injury goals

A
  1. Seat belts
  2. Not riding in back of pickup trucks
  3. Not drinking and driving
  4. Wear helmets
135
Q

Optimal nutritional status

A

Taking in enough calories and nutrients

136
Q

Undernutrition

A

Does not get enough nutrients; at risk for vitamin deficiency, illness, infections, delayed wound healing, longer hospital stays,

137
Q

What are people who are undernutrition at risk for

A
  1. Vitamin deficiency
  2. Illness
  3. Infections
  4. Delayed wound healing
  5. Longer hospital stays
138
Q

Who is at risk for undernutrition

A
  1. Poverty
  2. Elderly
  3. Already sick
  4. Pregnant
  5. Children/infants
139
Q

Overnutrition

A

Getting too many calories/nutrients

140
Q

What are people who have overnutrition at risk for

A
  1. Obesity
141
Q

How many adults/children are overweight in USA

A

2/3 of adults and 1/3 of children

142
Q

What to ask in nutrition exam

A
  1. Diet
  2. Height and weight
  3. Food allergies
  4. Medications/supplements
  5. Recent surgery, trauma, burns, infections
  6. Self care behaviors/diet fads/exercise
  7. Alcohol/drug use
  8. Family history
143
Q

Nutrition screening/assessment tools

A
  1. Admission nutrition screening tool
  2. Food frequency questionnaire
  3. 24-Hour diet recall
  4. Food diaries
  5. Direct observation
144
Q

Body typles

A
  1. Ectomorph (tall thin)
  2. Mesomorph (athletic)
  3. Endomorph (round, soft)
145
Q

Anthropometric measures

A
  1. Height/weight
  2. BMI
  3. Waist to hip ratio
  4. Skinfold/tricep thickness
  5. Arm span
146
Q

What do you usually don’t get from adult pt

A

Height

147
Q

Underweight BMI

A

18.5

148
Q

Normal BMI

A

18.6-24.9

149
Q

Overweight BMI

A

25-29.9

150
Q

Obese BMI

A

30-39.9

151
Q

Morbidly Obese BMI

A

> 40

152
Q

What waist to hip ratio indicates increases risk for obesity related disease and early mortality

A

> .9 in men

>.8 in women

153
Q

Gynoid obesity

A

Pear shape, heavier in hipe

154
Q

Android obesity

A

Apple shape; Round all over

155
Q

How to measure skinfold/tricep thickness

A

Have pt flex arm and use skin caliber on back of arm; measure it 3 times and take average

156
Q

Normal skinfold/tricep thickness

A

Men 13.5

Women 16.5

157
Q

How to measure arm span or total arm length

A

Measure distance from middle finger to middle finger with arms out, should be equal to height

158
Q

When do you use arm span

A

If you can’t get height, if they are really tall, or in sports medicine

159
Q

Orthadox jews nutrition

A

Kosher

160
Q

Buddhist nutrition

A

Vegetarian

161
Q

Muslim nutrition

A

No pork

162
Q

Seventh day adventist nutrition

A

Vegetarian, no alcohol or caffeine

163
Q

Parts of musculoskeletal system

A
  1. Joint
  2. Bone
  3. Tendon
  4. Ligaments
164
Q

Questions to ask with musculoskeletal ( joints )

A
  1. Pain
  2. Stiffness
  3. Swelling
  4. Heat
  5. Redness
165
Q

Questions to ask with musculoskeletal (muscles)

A
  1. Pain (Cramps)

2. Weakness

166
Q

Questions to ask with musculoskeletal (bones)

A
  1. Pain
  2. Deformity
  3. Trauma
167
Q

What to inspect in joints

A
  1. Swelling
  2. Masses
  3. Deformity
  4. Equal bilaterally
168
Q

What to palpate in joints

A
  1. Temperature
  2. Tenderness
  3. Swelling
169
Q

rheumatoid arthritis

A

Affects all joints

170
Q

Bulge sign

A

Push on inside of knee and it should slide over, when you go to other side there will be a fluid line

171
Q

Weight bearing statuses

A
  1. Full weight bearing
  2. Weight bearing as tolerated (WBAT)
  3. Partial weight bearing
  4. Touch
  5. Non-weight bearing
172
Q

Phalens test

A

Tests for carpal tunnel; have pt hold their hands with the wrist flexed at 90 degrees, should be no pain

173
Q

Tinel’s sign

A

Tests for carpal tunnel; direct percussion on the median nerve; no pain or tingling

174
Q

Chvosteks sign

A

Tell pt to relax face then stand in front of them and tap the facial nerve either anterior to earlobe and below zygomatic arch or between zygomatic arch and corner of mouth. Positive response is twitching or spasm, usually due to low calcium (hypocalcemia)

175
Q

Troussea sign

A

Put BP cuff on arm and pump it up greater than systolic and leave in place for 3 minutes; positive sign is a spasm in arm/hand; indicates low calcium (hypocalcemia)

176
Q

Temporomandibular join (TMJ)

A

Feel jaw joint and have them open and close jaw and move side to side; light crackling is ok, pain or crepitus is positive sign

177
Q

Scoliosis

A

Lateral curvature of the spine; scapula may be uneven

178
Q

Gangion cyst

A

Fluid filled cyst, usually on back of hand

179
Q

Gouty arthitis

A

Buildup of crystals in joints, painful, usually effects great toe

180
Q

Pes planus

A

Flat feet

181
Q

Kyphosis

A

Forward bend of spine, in older adults

182
Q

What is normal in ROM for aging adults

A

Should not decrease unless they have an underlying disease

183
Q

What does functional assessment include

A
  1. ADL’s
  2. Can they dress/bathe/toilet/feed
  3. Can they use phone
  4. Can they drive
  5. Can they write a check
184
Q

Osteroporosis

A

Decrease of calcium causing breaking down of bones

185
Q

Who is more at risk for osteoporosis

A

Caucasions

186
Q

What things prevent osteoporosis

A
  1. Add milk, fish, greens, soy
  2. Less caffeine
  3. Increase exercise
  4. Stop smoking, drink less alcohol
  5. Medical screening
  6. Supplements
187
Q

How to document strength

A

5/5

Health Assessment (3 decks)

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