Test 4 Flashcards
1
Q
What anatomical line cuts the chest in half?
A
Midsternal line
2
Q
What is the equal distance from the midsternal as it is to the shoulder on the other side?
A
Midclavicular line (MCL)
3
Q
Gives access to organs that are not accessible on the front or back?
A
Axillary lines
4
Q
What axillary line runs right down the middle of the armpit?
A
Midaxillary
5
Q
What axillary line is where the chest and the axilla meet?
A
Anterior axillary
6
Q
What axillary line is where the back and axilla meet?
A
Posterior axillary
7
Q
Where does the vertical abdominal line run through?
A
The umbilical (separates left from right)
8
Q
Where does the horizontal abdominal line run through
A
Halfway between the pubic and upper portion of the abdomen (separates upper from lower)
9
Q
The sternal notch, manubrium, Angle of Louis, Xyphoid process, ribs, ICS, and lower border of anterior ribs all lie within what part of the body?
A
Anterior thorax
10
Q
The C7 process, borders of the scapula, and lower border of posterior ribs all lie within what part of the body?
A
Posterior thorax
11
Q
The anterior superior iliac spine, pubic bone, and interior border of ribs all lie within what part of the body?
A
Abdomen
12
Q
What cervical process creates the bulge in the back of the neck?
A
C7
13
Q
What rib is usually a genetic trait?
A
13th rib
14
Q
What is the joint of the manubrium and sternum called?
A
Angle of Louis
15
Q
Which rib do you use to find the Angle of Louis?
A
2nd rib
16
Q
Which rib is at the edge of the clavicle?
A
1st rib
17
Q
The first 5 ribs attach at the ________ or ________ in the front.
A
Sternum or Manubrium
18
Q
The first 5 ribs attach at the _____ _____ in the back.
A
Thoracic cage
19
Q
Which ribs can attach to one another (floating cage)?
A
Ribs 6-10
20
Q
Which ribs are considered floating ribs?
A
11 and 12
21
Q
What is Transverse: Anterioposterior ratio for someone with a healthy chest?
A
2:1, twice as wide as you are deep
22
Q
What are abnormal visual findings in an abdominal assessment?
A
Pulsations at midline or waves of motion
Can be an aortic aneurysm
23
Q
What hormone influences breast development?
A
Estrogen
24
Q
What should be documented on the appearance of skin on the chest and abdomen?
A
- Color
- Temperature
- Texture
25
What is the difference between female and male breasts?
Males breasts have less adipose tissue
26
During a health history for thorax and abdomen assessment, what should be assessed?
Occupational Hazards or Recent Travel
27
What are two examples of occupational hazards that can affect the thorax/abdomen?
Trauma or chemical exposures
28
What occupational hazard can affect the respiratory system?
Inhaled dusts or gases (Coal miner's lung)
29
Hepatoxic chemicals can harm what part of the body?
Liver (abdominal)
30
Why is recent travel important to ask about during an assessment?
Exposure to parasites, disease, ect
31
True or False: Extra flatulence can be indicative of a problem
True
32
What is the difference between history and subjective information?
History is past; subjective is present
33
What does PQRSTU stand for?
```
P: Palliative/Provocative
Q: Quality
R: Radiate
S: Severity
T: Time
U: Understanding
```
34
How long a person can do an activity for.
Stamina
35
Shortness of breath when lying down
Orthopnea
36
Burning feeling in the abdomen
Pyrosis
37
Which lung is wider and shorter?
The right lung
38
________ makes right lung more vulnerable to aspiration pneumonia
Asymmetry
39
_______ makes left lung more vulnerable to pneumonia from pulmonary edema
Circulation
40
Duodenum of small intestine, gallbladder, liver, head of pancreas, right kidney, right adrenal gland, hepatic flexure of colon, and part of ascending and transverse colon are all part of which quadrant?
RUQ
41
Left lobe of liver, stomach, spleen, body of pancreas, left kidney, left adrenal, splenic flexure of colon, and part of the transverse and descending color are all part of which quadrant?
LUQ
42
Cecum, appendix, part of ascending colon, right ovary and tube, right ureter, and right spermatic cord are all part of which quadrant?
RLQ
43
Part of descending color, sigmoid colon, left ovary and tube, left ureter, and left spermatic cord are all part of which quadrant?
LLQ
44
Aorta, Uterus and Bladder are located where?
Midline
45
Where is the ileocecal valve located?
RLQ
46
Where is the sigmoid located?
LLQ
47
Where is the splenic fissure located?
LUQ
48
Where is the hepatic fissure located?
RUQ
49
A condition where the anterior wall (the front) of the abdomen has become sunken and hollow in appearance, or rather, has become convex rather than concave.
Scaphoid
50
A bulging abdomen
Protuberant
51
When are waves in the abdomen normal?
Babies ONLY
52
Which valve in the large intestine is the noisest?
Ileocecal
53
What is the expected noises per minute for the bowel sounds?
5-13
54
What is the proper order of abdominal assessment?
1. Inspect
2. Auscultate
3. Palpate
55
What can cause absent bowel sounds?
Paralytic ileus, bowel obstruction
56
What causes bowel sounds?
Movement of gas
57
What can cause hypoactive bowel sounds?
Constipation, obstruction, or certain medications
58
What can cause hyperactive bowel sounds?
Diarrhea, laxative use, gastroenteritis, early intestinal obstruction
59
What is the name of loud, gurgling bowel sounds audible without a stethoscope?
Barborygmus
60
How deep should you palpate the abdomen?
About 1/2 inch
61
How many fingers should be used for palpation of the abdomen?
The whole hand should be used
62
How long should an abdominal assessment take?
1-2 minutes (if normal findings)
63
Where do you palpate for the bladder?
Above the suprapubic bone
64
Which sound is louder at the base of the heart?
S2
65
What sound is louder at the apex of the heart?
S1
66
Where are the semilunar valves located?
at the base of the heart
67
Where at the AV valves located?
Apex of the heart
68
Where is the majority of the heart located?
On the left side
69
Where can you find the aortic valve?
2ICS RSB
70
Which heart sound is only heard on the right side?
Aortic Valve
71
Where can you find the pulmonic valve?
2ICS LSB
72
Where can Erb's point be auscultated?
3ICS LSB
73
Where can the Tricuspid valve be ausculated?
4ICS LSB
74
Where can the mitral valve be auscultated?
5ICS MCL
75
Where can both heart sounds be equally heard?
Erb's point (3ICS LSB)
76
What sound is the systole of the heart?
Lubdub
77
What sound does the diastole of the heart give off?
No sound, the pause between heartbeats
78
What is the pattern of the sounds called?
Rhythm
79
Beats per minutes is called _____
rate
80
Coincides with radial or carotid pulse
S1
81
What sound represents the Lub?
S1
82
What sound represents the Dub?
S2
83
Coincides with the peripheral pulses
S1 (AV) valves closing-- tricupid and mitral
84
Coincides with the base of the heart, with the semilunar valves closing
S2 ---aortic and pulmonic
85
How long should you listen for a heartbeat?
30 seconds if regular, 60 seconds if irregular
86
What should never be used as a landmark for a cardiac assessment?
The breasts
87
What order should the cardiac assessment be done in?
```
Aortic
Pulmonic
Erb's
Tricuspid
Mitral
```
88
What are the extra heart sounds called?
S3 and S4
89
When is S3 heard?
After S2
| Ken-S1, Tuck-S2, Y-S3
90
When is S4 heard?
A sharp sound before S1
| S4-Ten, Nes-S1, See-S2
91
True or False: S3 and S4 are emergency sounds
False. Can be pathological; mainly a physiological condition
92
A vascular sound caused by turbulent blood floor
Murmur
93
Where can a murmur be heard?
Over the site of constriction
94
What condition can cause a murmur?
Pregnancy
95
True or False: Murmurs are only limited to heart valves
False; can be in artery, thyroid, or fistula created for dialysis
96
What causes a murmur in the heart?
A constriction or regurgitation in the valve
97
Where can the Apex of the heart be auscultated?
4th or 5th ICS
98
Where is the apical impulse/point of maximal impulse?
5ICS MCL
99
Which valve do you auscultate to determine the apical pulse?
Mitral valve
100
The difference between the apical pulse and radial pulse
Apical radial deficit
101
When is a apical radial deficit typically present?
in Cardiac arrhythmias (ie: atrial fibrillation)
102
What measures the electrical conduction of the heart?
EKGs
103
The _ waves should be measured to find the regularity of the rhythm on an EKG
R
104
Space between __ waves should be exact the same
R
105
The 12 lead measures what?
12 views of the heart
106
A wireless transmission of EKG
Telemetry
107
How long should a Holter Monitor be placed?
24 hours
108
The ultrasound of a heart is called
An echocardiogram
109
Percentage of blood ejected from the LV into circulation
Ejection fraction
110
How many mL of blood can the LV hold?
100 mL
111
What does the ejection fraction tell us?
How much blood is getting pumped out into the body's circulation
112
What is the normal ejection fraction?
40-60% (60% is ideal)
113
What is the main cause of low ejection fraction?
Heart failure
114
What are some symptoms of low ejection fraction?
- pale
- fatigued
- high capillary refill
- cool extremities
- physical activity is harder
115
How is a cardiac catheter placed?
Through a large peripheral artery (usually femoral or radial)
116
What is injected to illuminate the arteries of the heart?
Dye
117
True or False: Cardiac Catherization is an invasive procedure
True
118
What does a cardiac catherization do?
Take pictures of blood vessels (angiogram); helps check patency of coronary arteries---circulation
119
What kind of test is a dobutamine stress test?
chemical
120
Where is a stress test performed?
On a treadmill
121
What two stress tests uses an EKG?
Exercise stress test and dobutamine stress test
122
What does the stress test do?
Measures the rhythm and function of the heart when stressed
123
Enzymes released with damage to the heart muscle
Creatinine Kinase-MB
124
Proteins released with ischemia to the heart muscle
Troponin
125
What are the normal levels of troponin?
0-0.4
126
Which blood test is done at time-repeated intervals: 3-4 hours post injury to 12, 24, and 36 hours?
Creatinine Kinase-MB
127
Which blood test may be measurable up to 7 days after injury to the heart?
Troponin
128
What is used to measure the severity of the heart failure?
NT pro-BNP (Brain natriuretic peptide)
129
What is secreted by the LV in response to damage to flexibility?
NT pro-BNP (Brain natriuretic peptide)
130
What is the normal values of NT pro-BNP (Brain natriuretic peptide)?
Norms depend on age, heart condition
131
What is the optimal level of LDLs in the blood?
Less than 129
132
What is the optimal levels of total cholesterol?
Less than 200
133
What is the optimal levels of HDL?
Above 40; no upper limit
134
What makes HDL and LDL?
Triglycerides
135
_______ are good for structure in cell membranes and are a precursor for creating hormones
Cholesterol
136
What should triglycerides optimal levels be?
Less than 150
137
The valve between the the RV and the pulmonary artery
Pulmonic valve
138
The valve between the LV and aorta
Aortic Valve
139
The valve between the RA and RV
Tricuspid Valve
140
The valve between the LA and LV
Mitral valve
141
The apical impulse can be displaced laterally and lower due to what?
An enlarged ventricle
142
What is the tightening of the aortic valve from scarring called?
Aortic Stenosis
143
A leaflet of the valve that does not close all the way
Mitral valve prolapse
144
Where can the upper lobes of the lung be accessible during an assessment?
Easiest on from the anterior chest; posterior: above the scapulae
145
Where can the lower lobes of the lung be accessible during an assessment?
Anterior: lower lateral edge of anterior rib cage
Posterior: Easily accessible on posterior thorax
146
What are the three types of normal lung sounds?
1. Bronchial (Bronchiotracheal)
2. Bronchovesicular
3. Vesicular
147
For a bronchiole breath sound, what is the normal rate of inspiration to expiration?
I < E
148
For a bronchovesicular breath sound, what is the normal rate of inspiration to expiration?
I = E
149
For a vesicular breath sound, what is the normal rate of inspiration to expiration?
I > E
150
What are four adventitious lung sounds?
1. Crackles
2. Rhonchi
3. Wheezes
4. Stridor
151
What adventitious lung sound is audible without a stethoscope?
Stridor
152
What is a partial obstruction of the trachea or mainstem?
Stridor
153
What is the feeling of being unable to breathe called?
Shortness of breath
154
What part of the lung structure can vesicular sounds be heard?
Alveoli
155
What part of the lung structure can bronchiole sounds be heard?
Traches
156
What part of the lung structure can bronchovesicular sounds be heard?
Bronchioles
157
What are occasionally called rales?
Crackles
158
Where can crackles be heard?
Vesicular spaces
159
What causes crackles?
Caused by alveoli expanding after collapse from mucus
160
What condition is associated with crackles
Atelectasis
161
What causes atelectasis?
- General anesthesia
- Infection (pneumonia)
- Sleep (lack of deep breathing)
162
What lung sounds are characterized by high pitched sounds?
Wheezes "Wee"
163
What lung sounds are characterized by low pitch sounds?
Rhonchi
164
What should you have a patient do if an adventitious sound is heard initially?
Cough
165
What lung sound sounds more watery (bubbling through something thick)?
Rhonchi
166
A scope passed through the mouth, trachea to the bronchioles to look at tissue in the bronchioles and lung
Bronchoscopy
167
What is done to a patient's airways before a bronchoscopy?
They are numbed
168
What does a bronchoscopy do?
Biopsies and direct visualizations of obstructions
169
Shows soft tissues, organs, hard tissues in multiple positions of the body?
CT scan
170
What is the most common diagnostic testing for a lung condition?
Chest Xray
171
What lung sound is comparable to rubbing hair back and forth by your ear?
Crackles
172
On an xray, why do bones show up more white?
They are more dense
173
How many alveoli in each lung?
300 million
174
Plural effusion
Fluid in the interpleural space
175
What breathing tool is not good for a patient with a bronchiole problem?
Incentive Spirometer
