unit 3 learning objectives Flashcards
Distinguish between normal and abnormal data during assessment of the head, neck, and related lymphatic system.
Symmetry
* Nasolabial folds
* Normocephalic
* Facial expression (flat affect?)
* Midline
* Jugular Vein Distention (JVD)
* Teeth/Gums/Tongue
* Palate
Should not feel lymph nodes at all
Identify anatomical landmarks used to assess head/neck lymph nodes and the thyroid gland.
go from cheeks, down jawline, down the neck area and onto shoulder
thyroid gland is like where Adams apple is
Discuss assessment techniques of the head/neck that reflect variations across the lifespan.
Palpation
* TMJ
* ROM
* Lymph nodes
* Pulses
inspect Cartoid arteries
JVD
Distinguish between normal and abnormal data during assessment of the eye and ear
Any hx of vision difficulties?
* Strabismus
* Diplopia
* Discharge
* Injury
* Use of glasses or contacts
* Wear sunglasses?
* Occupation (welding
Check for ay abnormalities that you can see in front
Symmetrical
* Drainage
* Lumps/lesions/eczema
* Tenderness
* Otoscope: Pinna up and back on and adult; Pull pinna down on an
infant or younger than 3 year
Become familiar with the equipment used during an assessment of the eyes and ears.
ophthalmoscope- eye
otoscope-ear
snellen chat-eye
Tuning fork
Discuss assessment techniques of the eye/ear that reflect variations across the lifespan.
Confrontation Test
* Ophthalmoscope
* Snellen Eye chart
* Pen light inspection
* PERRLA
* Red reflex
* EOMs (6 cardinal positions of gaze)
Discuss assessment techniques of the ear that reflect variations across the lifespan.
Inspect for
Symmetry
* Drainage
* Lumps/lesions/eczema
* Tenderness
Use Otoscope: Pinna up and back on and adult; Pull pinna down on an
infant or younger than 3 year
hearing test from feet away
Define range of motion (ROM).
the extent or limit to which a part of the body can be moved around a joint or a fixed poin
Distinguish between normal and abnormal data during assessment of musculoskeletal system
Deformity
* Swelling
* Redness
* Atrophy
* Observe Gait
- Heel/toe walk
- Spine defects
-Kyphosis/ Lordosis/ Scoliosis
Relate type of joint motion to each of the body joints.
Flexion-flex arm
Extension- extend arm
Abduction-arm away from body
Adduction-arm towards body
Pronation-palm down
supinatoin-palm up
Circumduction-shoulder in circle
inversion-ankle inward
eversion-ankle outward
rotation-move head
protraction-move jaw out
retraction-move jaw in
elevation-elevate shoulder
depression-depress shoulder
Describe the range of motion capabilities for each type of joint.
Shoulders-circle shoulders,raise down up/down and side/side
Elbows-Assess ROM- should be able to flex and extend, pronate/supinate
Hand/wrist-Assess ROM by checking hyperextension, flexion, abduction
and opposition
Hip-flexion,internal and
external rotation, abduction and hyperextension.
Knee-Check ROM Flexion, extension- rising from chair
ankle/foot-plantar flexion,
dorsiflexion, eversion, inversio
Discuss modifications of assessment techniques of a musculoskeletal assessment across the lifespan
Grade muscle strength 0-5
palpate joints for noises,swelling,heat,pain
ROM on shoulders, elbow,hand/wrist,hip,knee, ankle
Discuss assessment techniques of a neurological assessment that reflect variations across the lifespan.
Inspection
* LOC
* Lethargic
* Stuporous
* Comatose
* Ax0x4 (person, place, time,
situation)
* Skull fracture
cranial nerves
reflexes
Identify and discuss the cranial nerves.
what cranial nerves do
1
2
5
l-olfactory-smell.
-sniff test
ll-optic-vision–
-snellen test
v-Trigeminal-muscle of mastication, face/scalp , mucous membranes of mouth and nose–
palpate muscles by having pt clench teeth
Identify and discuss the cranial nerves.
what cranial nerves do
3
4
6
lll-oculomotor-EOM movement,pupil constriction, up and down eye
lv-Trochlear-Down and upward movement of eye
vl-Abducens-later movement of eye
lll
lv. Pupil size. PERRLA. EOM
vl
Identify and discuss the cranial nerves.
what cranial nerves do
7
8
9
10
vll-Facial- face muscles, close eyes, close mouth, taste saliva tears–
- :):( close eyes. puff cheeks, lift eyebrows, show teeth
vlll–Acoustic–hearing/equilibrium
- whisper test
lx glossopharyngeal-phonation,swallowing,gag reflex
x-Vagus-talking and swallowing,
Depress tongue-ahh
Identify and discuss the cranial nerves.
what cranial nerves do
11-12
xl-spinal-moves traps and sternoclad muscles
neck strength
xll-hypoglossal-tongue
- stick out tongue
Discuss techniques and tools used to assess cognition and level of consciousness.
GLASGOW COMA SCALE* Score of 15 equals fully alert and oriented
- Eye opening
- Motor response
- Verbal response
Infant reflexes all of them
Babinski
* Palmar grasp
* Rooting
* Moro-startle
* Tonic neck
Adult reflexes
Deep tendon reflexes
* Biceps
* Triceps
* Patellar
* Achilles
DO BILATERAL
Cranial nerves and how to test them
l-sniff test
ll-snellen test
lll
lv. Pupil size. PERRLA. EOM
vl
v-palpate muscles by having pt clench teeth
vll- :):( close eyes. puff cheeks, lift eyebrows, show teeth
vlll- whisper test
lx Depress tongue
x
xl neck strength
xll- stick out tongue
grade muscle strength
0=No movement
1=Trace movement
2=Full ROM (passive)
3=Full ROM (active), not against resistance
4=Full ROM (active), against resistance but weak
5=Full ROM (active), against resistance
canes
Hold the cane on the strong side of the body
Position the tip about 6 inches to the side and 6 inches in front of the near foot
The elbow should be slightly flexed
Move the cane forward while body weight is on both legs
Move the affected leg—weight borne by cane and stronger leg
Move the unaffected leg forward
As strength improves, move cane and weak leg forward together
crutches
The body weight should be on the arms, not the axillae
Maintain an erect posture
Keep crutch tips dry
Wear low-heeled rubber soled shoes (or shoe)
Four-point gait—most stable—need weight bearing on both legs
o Move right crutch ahead 4-6 inches
o Move left foot forward
o Move the left crutch forward
o Move the right foot forward
Three point gait—total body weight is borne on unaffected leg
o Move both crutches and the weaker leg forward—usually held above ground
o Move the stronger leg forward
Two point alternate gait—faster than four point and requires partial weight bearing on both legs
o Move the left crutch and right foot forward together
o Move the right crutch and left foot ahead together
GOING UP STAIRS—“Up with the good”
Transfer body weight to the crutches and move the unaffected leg onto the step
Transfer body weight to the unaffected leg on the step and move the crutches and affected leg up to the step.
GOING DOWN STAIRS—“Down with the bad”
Transfer body weight to the unaffected leg and move the crutches and affected leg down onto the next step.
Transfer body weight to the crutches and move the unaffected leg down to the step.
walkers
When maximum support is needed
o Move the walker ahead about 6 inches while body weight is borne by both legs
o Move the right foot up to the walker—weight on left leg and arms
o Move the left foot up to the right foot—weight on right leg and both arms
When one leg is weaker than the other
o Move the walker and the weak leg ahead together about 6 inches while weight is borne on the stronger
leg
o Move the stronger leg ahead while weight is borne by the affected leg and both arms
NIH stroke scale
Repeat series of numbers and have them repeat them back
Assess sensation to touch- dull v sharp
