vitals week 1 Flashcards
appropriate cuff size: width of cuff is _____% of upper arm circumference.
if the cuff is too big the the reading will be ______
if the cuff is too small the the reading will be ______
40%
reading will be too low
reading will be too high
a normal pulse rate is between _____ and ____
indications if pulse is:
a) < 50bpm
b) > 90bpm
c) Pulse missing on one side
d) Arrhythmia
between 50-90 BPM
a) Bradycardia: hypothyroidism, well trained athlete
b) Tachycardia: hyperthyroidism, caffeine, nervousness, exercise, hypertension
c) Stenosis, blocked artery, TOS or intermittent claudication
d) Decrease = hypervolemia, heart failure, aortic stenosis, atherosclerosis
- Increase = fever, exercise, hypothyroidism, anemia, aortic regurgitation, Arteriosclerosis
a NORMAL respiratory rate is between ____ and ____ RPM
positive findings if:
a) < 50rpm
b) > 90rpm
c) Hyperpnea (hyperventilation)
d) Orthopnea
e) Paroxysmal Nocturnal Dyspnea
-12- 20 RPM
a) Bradypnea: old age, well trained athlete, diabetic coma, increased intracranial pressure
b) Tachypnea: hyperthermia, anxiety, restrictive lung disease (COPD), elevated diaphragm, pleurisy
c) Rapid deep breathing caused by exercise, anxiety, metabolic acidosis, brainstem damage
d) Shortness of breath
e) Shortness of breath after a period of sleep
A normal tempreature is between ____ and _____
positive findings of:
a) < 96.4°F
b) > 99.1°F
c) > 106 °F
Normal Rate: 96.4-99.1° F
a) Hypothermia: cold drink, old age, slow metabolism, nutritional deficiency, hypothyroidism, hypoglycemia
b) Pyrexia (fever): emotion, infection, exercise, hot drink, trauma, acute immune disorder, hyperthyroidism
c) Hyperpyrexia
a normal blood pressure reading can be seen as ____ Over ______
positive findings:
a) 120-139mmHg (systolic) or 80-89mmHg (diastolic)
b) 140-159mmHg (systolic) or 90-99mmHg (diastolic)
c) >=160mmHg (systolic) or >=100mmHg (diastolic)
d) 80-89mmHg
e)
Normal Rate: 120/80mmHg
a) Pre-hypertension
b) Stage 1 Hypertension: stress, obesity, high blood viscosity, type II diabetes mellitus, high cholesterol, atherosclerosis
c) Stage 2 Hypertension
d) Pre-hypotension
e) Hypotension: hypothyroidism, thin/small person
the Confrontation test checks what nerve?
if the patient cannot see your fingers or indicates blind spots in vision possible indications include:
(CN2 - Optic)
-Scotoma (blind spot), diminished peripheral vision, glaucoma, macular degeneration, MS, CN2 lesion, retinal disorder
the Cardinal Fields of Gaze makes us of which 3 nerves?
positive findings of this test include:
a) Nystagmus (eye has trouble following the pen; staggering, shaking)
b) Strabissmus (eye doesn’t follow)
(CN3 - Oculomotor, CN4 - Trochlear, CN6 - Abducens)
a) Eye not following laterally – CN6: Abducens (lateral rectus muscle)
b) Eye doesn’t go down and IN (clinical test) – CN4: Trochlear (superior oblique muscle)
- All other directions – CN3: Oculomotor (med, sup. Inf. Rectus, inf. Oblique muscles)
- Lesion to eye muscle
the Accomodation test makes use of which nerve and is testing which distinct muscle?
- if eyes do not converge there most likely is a _________.
(CN3 - Oculomotor - Medial Rectus muscle)
-Lesion to CN3 - Oculomotor
Pupillary Light Reflex Test:
Scenario:
if there’s Lack of constriction in L eye, what could it be? and what test would you do to narrow it down?
- if there’s convergence rules out___a___–> __a____=Lack of constriction in R eye, light in L constricts L but not R
- if there’s a R oculomotor lesion Light in L eye, both constrict; Light in R eye, no constriction in ___b___ eye.
- Damage to EDW nucleus motor, symptom of ___c___ ___c____ disease
-it could be EDW or CN III. To decide, perform accommodation
a- CN 3; EDW
b- either
c- teritary Syphillis
the Levator Palpebrae Superioris test checks what nerve?
some positive findings include:
a) Any grade (1-5) less than 5, pain (ask)
b) Right side is stronger
c) Left side is stronger
(CN 3 - Oculomotor)
a) CN3 – Oculomotor lesion
b) Left sided CN3 – Oculomotor lesion
c) Right sided CN3 – Oculomotor lesion
The Corneal Reflex tests which nerves? and what specific muscle?
Scenario:
Cotton in R eye, both eyes blink; cotton in L eye, no eyes blink
a) wheres the Lesion?
Cotton in R eye, L doesn’t blink
b) wheres the Lesion?
c) One or both eyes fail to blink…
(CN 5 – Ophthalmic Divison of Trigeminal: Sensory, CN 7 – Facial: Motor to Orbicularis Oculi)
a) L CN V1
b) L CN7 Facial
c) Afferent or sensory loss to CN5 (trigeminal)
- Or Efferent or motor loss to CN7 (facial) to Orbicularis Oculi Muscle
how do you perform the Light test with the Ophthalmoscope?
Instruction: Patient focuses straight ahead at distant object, relax
Dr: Use same eye to inspect, focus lens on hand then 18” (2ft away) with hand on shoulder, find red reflex and move directly towards it, focus past pupil, look lateral to medial to inspect fovea, arteries, retinal integrity
Possible positive findings of Light test?
a) c
b) AV nicking/hemorrhaging
c) Papilledema
d) Increased cup to disc ratio (>1:2)
e) Macular Degeneration
f) Cotton wool patches
a) Cataracts
b) Retinopathy
c) Increased intracranial pressure
d) Glaucoma
e) Old age
f) Diabetes, hypertension
how do you perform an examination of the ear with the otoscope?
OtoscopeDr: pull pina up and back and put specula in to observecone of light and ear drum
some possible findings of the otoscope test are:
what are the indications of these findings?
a) Absence of cone of light
b) Redness in canal (w/ purulent effusion)
c) Bony exostoses around perimeter
d) Perforated tympanic membrane
e) Amber Fluid behind eardrum
f) Largee chalky white patch
a) Intracranial pressure
b) Otitis Media: acute (no pain), externa (pain)
c) Swimmer’s Ear (common in children)
d) Trauma caused by sharp object put into ear
e) Serous effusion
f) tympanosclerosis
