Medical Assisting Techniques 2
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| Abrasion | a wound in which the outer layers of skin are damaged; a scrape
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| abscess | a collection of pus in a cavity surrounded by inflamed tissue
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| absorbable suture | suture material that is gradually digested and absorbed by the body
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| approximation | the process of bringing two parts together through the use of sutures or other means
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| bandage | a strip of woven material used to wrap or covor a part of the body
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| biopsy | surgical removal and examination of tissue from a living body
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| capillary action | the action that causes liquid to rise along a wick, tube or a gauze dressing
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| colposcope | lighted instrument with a binocular magnifying lens used to examine the vagina and cervix
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| colposcopy | visual examination of the vagina and cervix using a colposcope
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| contaminate | as it relates to strile technique,to cause a sterile object or surface to become unsterile
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| contusion | an injury to the tissues under the skin that causes blood vessels to rupture, allowing blood to seep into the tissues; a bruise
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| cryosurgery | therapeutic use of freezing temperatures to destroy abnormal tissues
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| exudate | a drainage produced by the body's tissue
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| fibroblast | an immature cell from which connective tissue can develop
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| forceps | instrument for grasping, holing tissue or an item and squeezing
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| furuncle | a localized staphylococcal infection that originates deep within the hair follicle; a boil
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| hemostasis | the arrest of bleeding by natrual or artificial means
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| incision | a clean cut caused by a cutting instrument
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| infection | the condition in which the body, or part of it, is invaded by a pathogen
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| infiltration | the process by which a substance passes into and is deposited within the substance of a cell, tissue or organ
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| inflammation | a protective responce on the body to trauma and entrance of foreign matter
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| purpose of inflammation | to destroy invading microorganisms and remove damaged tissue debris from the area so that proper healing can occur
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| laceration | a wound in which the tissues are torn apart, leaving ragged and irregular edges
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| ligate | to tie off and close a structure such as a severed blood vessel
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| local anesthetic | a drug that produces a loss of feeling and an inability to perceive pain in only a specific part of the body
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| Mayo tray | a broad, flat metal tray placed on a stand and used to hold sterile instruments and supplies when it has been covered with a sterile towel
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| needle biopsy | type of biopsy in which tissue from deep within the body is obtained by insertion of a biopsy needle through the skin
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| nonabsorbable suture | suture material that is not absorbed by the body and either remains permanently in the body tissue and becomes encapsulated by fibrous tissue or is removed
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| postoperative | after a surgical operation
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| preoperative | before a surgical operation
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| puncture | a wound made by a sharp-pointed object piercing the skin
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| scalpel | small, straight surgical knife consisting of a handle and thin, sharp blade; used to divide tissues
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| scissors | a cutting instrument that have ring handles and straight or curved blades
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| Sebaceous cyst | a thin, closed sac or capsule that contains fatty secretions from a sebaceous gland
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| serum | clear, straw-colored part of the blood that remains after solid elements have been seporated out of it
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| sterile | free of all living microorganism and bacterial spores
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| surgery | branch of medicine that deals with operative and manual procedures for correction of deformities and defects, repair of injuries, and diagnosis and treatment of certain diseases
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| surgical asepsis | practices that keep objects and areas sterile or free of microorganisms and spores
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| sutures | material used to approximate tissues with surgical stitches
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| swaged neddle | a needle with suturing material permanently attached to its end
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| wound | a break in the continuity of an external or internal surface caused by physical means
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| MOS | surgical procedure that is restricted to minor office surgery; management of minor conditions that don't require the use of general anesthesia
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| what are types of MOS performed in medical office? | insertion of sutures, sebaceous cyst removal, I&D of infections, mole removal, needle biopsy, cervical biopsy, ingrown toenail removal
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| I&D | incision an drainage of infections to allow for proper healing and helps prevent spreading of infection through the body
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| when is surgical asepsis used? | caring for open wound, when skin surface id penetrated, administration of an injection, when body cavity is entered that is normally sterile
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| fronting | to always face sterile field
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| operating scissors | straight delicate blades with sharp cutting edges; used to cut through tissue
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| suture scissors | hook on tip for getting under suture, blunt end to prevent puncturing of tissues; used to remove sutures
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| bandage scissors | inserted beneath a dressing or bandage to cut it for removal; flat blunt prow protects from punctioning patients skin
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| thumb forceps | serrated tips; used to pick up tissue or hold tissue between adjacent surfaces
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| tissue forceps | have teeth used to grasp tissue and prevent slipping; "rat-toothed" forceps
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| splinter forceps | sharp points used to remove foreign objects from the tissues
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| dressing forceps | blunt ends with coarse-striations for grasping; Adson forcep; used for application and removal of dressings or to hold/ grasp sterile gauze or sutures during MOS
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| hemostatic forceps | serrated tips, ratchets, ring handles and box locks; straight or curved blades; used to clamp off blood vessels and establish hemostasis; Kelly forceps
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| mosquito hemostatic forceps | small, fine tips; smaller then standard Kelly forcep; used to hold delicate tissue or to clamp off smaller blood vessels
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| needle holder | serrated tips designed to hold curved needle securely without damaging it,stubby nose, ring handles, ratchets and box locks; "driver"
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| retractors | used to hold tissue aside to improve exposure of operative area; can be smooth or have teeth
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| probe | used to determine depth of injury
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| medical asepsis | procedures used to reduce the number of microorganisms and prevent their spread; example is handwashing
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| what are guidelines when caring for instruments? | handle carefully, don't pile in heap, keep sharp instruments seporate, keep ratchets in open position when not in use, rinse blood or secretions off ASAP, only use for intended purpose, use proper technique for sanitization and sterilization
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| types of closed wound | fractures, sprains, strains, contusions
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| types of open wounds | incision, laceration, puncture, abrasion
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| signs of inflammation | redness, swelling, pain, warmth
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| serous exudate | contains serum; clear and watery
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| sanguineous exudate | contains RBC's; red- dark red
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| serosanguineous exudate | clear and blood-tinged drainage
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| purulent exudate | contains pus; white in color with possible tinges of pink, green or yellow
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| suppuration | process of pus formation
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| pus | consists of leukocytes, dead tissue debris, dead and living bacteria
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| function of sterile dressing | protect wound from contamination and trauma, absorb drainage, restrict motion
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| types of nonabsorbable sutures | silk, nylon, polyester, stainless steel, surgical skin staples
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| types of absorbable sutures | surgical gut, synthetic materials
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| Aught | size range below 0
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| how long are sutures in face or neck left in? | 3 to 5 days
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| how long are sutures in chest, arms. legs hands or feet left in? | 7 to 14 days
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| two advantages to surgical staples | fastest method of closing long skin incisions, reduced trauma to tissue
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| advantages of adhesive skin closures | sutures and local anesthetic are not needed, easily applied and removed, lower incidence of wound infection compared to sutures, less scarring than sutures
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| purpose of preparing skin before MOS | to reduce abundance of microorganisms found on skin that can cause wound contamination and possible infection
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| purpose of a fenestrated drape | to provide a sterile area around the operative site in order to decrease contamination of the patients wound
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| time local anesthetic to take effect | 5 to 15 minutes
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| time local anesthetic typically lasts | 1 to 3 hours
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| functions of an ECG | evaluate symptoms(chest apin, SOB, dizziness, palpitations), detect dysrythmias, diagnose damage from MI, determine presence of hypertrophy of heart or electrolyte disturbances, detect heart defects, assess effect of medications or presurgery cardic risk
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| amplitude | refers to amount, extent, size, abundance or fullness
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| artifact | additional electrical activity picked up by the elecrocardiograph that interferes with the normal appearance of the ECG cycles
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| atherosclerosis | buildup of fibrous plaques of fatty deposits and cholesterol on the inner walls of an artery that causes narrowing, obstruction, and hardening of the artery
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| baseline | the flat horizontal line that seporates the various waves of the ECG cycle
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| cardiac cycle | one complete heartbeat
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| dysrhythmia | an irregular heart rate or rhythm
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| ECG cycle | the graphic representation of a heartbeat
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| ECG | electrocardiogram; the graphic representation of the electrical activity of the heart
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| electrocardiograph | instrument used to record the electrical activty of the heart
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| electrode | a conductor of electricity, which is used to promote contact between the body and the electrocardiograph
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| electrolyte | a chemical substance that promotes conduction of an electrical current
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| flow rate | the number of liters of oxygen per minute that come out of an oxygen delivery system
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| hypoxemia | a decrease in the oxygen saturation of the blood
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| hypoxia | a reduction in the oxygen supply to the tissues of the body
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| interval | length of a wave ot the length of a wave with a segment
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| ischemia | deficiency of blood in a body part
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| normal sinus rhythm | refers to an ECG that is within normal limits
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| oxygen therapy | administration of supplemental oxygen at concentrations greater than room air to treat or prevent hypoxemia
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| peak flow rate | the maximum volume of air that can be exhaled when the patient blows into a peak flow meter as forcefully and rapidly as possible
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| segment | the portion of the ECG between two waves
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| spirometer | an instrument for measuring air taken into and expelled from the lungs
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| spirometry | measurement of an individual's breathing capacity by means of a spirometer
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| wheezing | a continuous, high-pitched whistling musical sound heard particularly during exhalation ans sometimes during inhalation
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| P wave | represents atrial depolarization; electrical activity associated with the contraction of the atria
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| QRS complex | represents ventricular depolarization; electrical activity associated with the contraction of the ventricles
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| T wave | represents ventricular repolarization; electrical recpvery of the ventricles
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| placement of V1 electrode | 4th intercostal space at right margin of sternum
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| placement of V2 electrode | 4th intercostal space at left margin of sternum
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| placement of V3 electrode | midway between positions 2 and 4
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| placement of V4 electrode | 5th intercostal space at junction of left midclavicular line
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| placement of V5 electrode | at horizontal level of position 4 at left anterior axillary line
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| placement of V6 electrode | at horizontal level of position 4 at left midaxillary line
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| what do precordial leads measure | use V1-V6 to record heart's voltage from front to back of the heart
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| Lead I | bipolar lead that records current between right arm and left arm
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| Lead II | bipolar lead that records current between right arm and left leg
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| Lead III | bipolar lead that records current between left arm and left leg
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| which lead is used as a ground? | Right leg
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| aVR | augmented voltage-right; records current between right arm and central point between left arm and left leg
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| aVL | augmented voltage-left; records current between left arm and central point between right arm and left leg
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| aVF | augmented voltage- left leg or foot; records current between left foot and central point between right arm and left arm
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| describe ECG paper | divided into two sets of squares, contains a thermo-sensitive coating and is pressure-sensitive
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| describe electrolyte | a gel that is combined with adhesive to aid the facilitation of the transmission of the heart's electrical impulses
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| what are electrides made of? | thin metalic substance that is a good conductor of electricity
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| normal paper speed of ECG | 25mm/sec
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| what does sensitivity refer to in ECG? | the number of boxes on the ECG paper in relation to the speed of recording
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| why would ECG speed or sensitivity need to change? | if person's numbers were off the charts or with tachycardia to obtain a clearer image
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| what are 3 types of ECG machines | multi-channel, teletransmission, interpretive electrocardiograph, EMR Connectivity
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| what are 4 types of artifacts | muscle, wandering baseline, 60-cycle interference,interrupted baseline
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| muscle artifact | caused by involuntary or voluntary muscle movement resulting in a fuzzy, irregular baseline
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| wandering baseline artifact | caused by loose electrodes, dried-out electrolyte on electrode, lubrication of electrode sites or excessive movement of chest during respiration resulting in a poor transmission of electrical impulse
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| 60-cycle interference artifact | caused by electrical interference from crossed lead wires or other electrical equipment in the room, wiring in walls, improper grounding of ECG machine resulting in consistent small straight spiked lines on paper so baseline becomes thick & unreadable
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| interrupted baseline artifact | caused by lead wire detachment or damaged to patient cable rusulting in a break in the baseline
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| What lead is used to run a rhythm strip | Lead II
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| describe a Holter Monitor | Portable monitoring system that records electrical activity of the heart continuously for 24 hours or more
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| atrial premature contraction | extra beat; most harmless of cardiac dysrthythmias
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| proxysmal atrial tachycardia | periodic rapid heart rate
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| arterial flutter | "butterflies"
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| atrial fibrillation | quivers, atria don't contract well
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| premature ventricular contraction | leads to ventricular fibrillation, very rapid contraction of ventricles
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| ventricular fibrillation | fatal due to ventricles not pumping properly
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| amplifier | device located in the machine that amplifies the electrical impulses
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| galvanometer | changes amplified voltages into mechanical motion
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| tachycardia | irregularly fast heart rate (greater than 100 beats/min)
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| bradycardia | irregularly slow heart rate (less than 60 beats/min)
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| purpose of first aid | To save a life, Reduce pain and suffering, Prevent further injury, Reduce the incidence of permanent disability, Increase the opportunity for early recovery
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| purpose of EMS system | to provide emergency care after injury or sudden illness in order to increase the victims chances of survival and further complication
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| describe asthema | wheezing, coughing, dyspnea
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| describe emphysema | damged alveoli and lose elasticity
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| hyperventilation | "overbreathing", respirations are rapid and deep
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| symptoms of a heart attack | chest pain, shortness of breath, profuse perspiration, nausea, fainting
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| symptoms of a stroke | sudden lateral weakness or numbness of face, arm or leg; difficulty speaking; dimmed vision; dizziness;confusion; severe headache; loss of consciousness
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| Cardiogenic Shock | When heart has been injured or damaged (MI, dysrhythmias, severe congestive heart failure, acute valvular damage, pulmonary embolism)
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| Neurogenic Shock | Nervous system is unable to control the diameter of blood vessels (blood vessels dilate= blood pressure drops)
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| Anaphylatic Shock | Serious life-threatening reaction of body to an allergen (drugs, insect venoms, foods, allergen extracts used in hyposensitization injections)
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| Psychogenic Shock | Unpleasant physical or emotional stimuli (pain, fright, sight of blood) leading to dilation of blood vessels
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| Hypovolemic Shock | Loss of blood or other body fluids
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| discribe capillary bleeding | slow oozing, bright red
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| describe venous bleeding | slow and stedy flow, dark red
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| discribe arterial bleeding | spurts/sprays, bright red
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| impacted fracture | the broken ends of the bones are forcefully jammed together
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| greenstick fracxutre | the bone remains intact on one side, but broken on the other
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| transverse fracture | the break occurs perpendicular to the long axis of the bone
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| oblique fracture | the break occurs diagnally across the bone; generally result of twisting force
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| comminuted fracture | the bone is splintered or shattered into three or more fragments; usually from extreme traumatic direct force
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| spiral fracture | the bone is broken into a spiral or S-shape; caused by a twisting force
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| discribe 1st degree burn | superficial;
Involves epidermis
Appears red, warm and dry to touch
Usually painful
Heals in 2-5 days
Doesn’t cause scarring
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| discribe 2nd degree burn | Partial Thickness;
Involves epidermis and dermis
Appears red, mottled and blistered
Usually very painful
Heals in 3-4 weeks
May result in some scarring
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| discribe 3rd degree burn | Full Thickness; Completely destroys epidermis and dermis; Extends into underlying tissues (fat, muscle, bone, nerves); Appears charred black, brown and cherry red; May experience intense pain or no pain if nerves damaged; Typically reults in dense scars
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| partial seizure | abnormal electrical activity is localized into very specific areas of the brain
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| Generalized seizure | abnormal electrical activity spreads throughout the brain
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| Insulin Shock | administration of too much insulin, skipping meals, unexpected or unusual exercise
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| Diabetic Coma | illness and infection, overeating, forgetting to administer insulin injection, administering insufficient insulin
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| symptoms of a seizure | Abnormal behavior
Glassy stare
Aimless wandering
Lip smacking or chewing
Fidgeting with clothing
Loss of consciousness
Rigid muscular contractions
Violent body jerks
Headache
Disoriented
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| symptoms of heat exposure | Painful muscle spasms
Hot, sweaty skin
Weakness
Rapid pulse
Headache
Nausea
Diarrhea
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| treatment for heat exposure | Remove patient to a cool environment
Rest
Replace fluids
Loosen clothing
Call EMS if not
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| symptoms of cold exposure | Loss of feeling in affected area
Cold and waxy skin
White, yellow or blue discoloration of skin
Shivering
Drowsiness
Apathy
Glassy stare
Decreased level of consciousness
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| treatment for cold exposure | Rewarm affected body part
Loosely wrap in warm clothing
Place frozen area next to another body part
Don’t massage or rub area
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| treatment for diabetic coma | needs insulin,
mmediatly transport to emergency facility
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| treatment for insulin shock | needs sugar immediatly,
immediatly transport to emergency facility
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| symotoms of diabetic coma | Polyuria
Excessive thirst and hunger
Vomiting and abnormal pain
Dry warm skin
Rapid and deep sighing respirations
Fruity odor to breath
Rapid weak pulse
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| sympotoms of insulin shock | Normal or rapid respiration
Pale, cold and clammy skin
Sweating
Dizziness and headache
Full rapid pulse
Normal or high blood pressure
Extreme hunger
Aggressive or unusual behavior
Fainting, seizure or coma
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| symptoms of injected poisons | Altered state of awareness
Evidence of stings, bites or puncture marks on skin
Mottled skin
Localized pain or itching
Burning, swelling, or blistering at site
Difficulty breathing
Abnormal pulse rate
Nausea and vomiting
Anaphylactic shock
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| treatment for injected poisons | Seek medical care or call EMS
Scrape stinger and attached venom sac off
Wash wound
Apply cold pack (except for snake bites)
Control bleeding if present
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| symptoms of absorbed poisons | Irritation, burning, itching
Burning of skin and eyes
Headache
Abnormal pulse and/or respiration
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| treatment for absorbed poisons | Remove patient from source
Call poison control or EMS
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| symptoms for inhaled poisons | Severe headache
Nausea & vomiting
Coughing or wheezing
Shortness of breath
Chest pain or tightness
Facial Burns
Cyanosis
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| symptoms of ingested poisons | Strange odors, burns or stains near mouth
Nausea, vomiting, abdominal pain, diarrhea
Difficulty breathing
Profuse perspiration
Excessive salivation
Dilated or constricted pupils
convulsions
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| treatment for inhaled poisons | If safe to approach remove individual from source
Call poison control or EMS
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| treatment for ingested poisons | Acquire information about poison ( type, when, how much)
Call poison control or EMS
If vomit: collect sample
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| treatment for seizures | Protect patient from harm
Remove hazards from area
Don’t restrain patient
Loosen clothing
Roll on side in vomiting occurs
Call EMS
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| burn | an injury to the tissues caused by exposure to thermal, chemical, electrical or radioactive agents
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| crash cart | a specially equipped cart for holding and transporting medications, equiptment and supplies needed for lifesaving procedures in an emergency
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| dislocation | an injury in which one end of a bone making up a joint is seporated or displaced from its normal anatomic position
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| EMS | emergency medical services; a network of community resources, equiptment and personnel that provides care to victims of injury or sudden illness
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| first aid | immediate care administered before complete medical care can be provided to the individual who is injured or suddenly becomes ill
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| fracture | any break in a bone
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| hypothermia | a life-threatening condition in which the temperature of the entire body falls to a dangerously low level
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| poison | any substance that causes illiness, injury, or death if it enters the body
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| pressure point | a site on the body where an artery lies close to the surface of the skin and can be compressed against an underlying bone to control bleeding
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| seizure | a sudden episode of involuntary muscular contractions and relaxations, often accompanied by changes in sensation, behavior and level of consciousness
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| shock | the failure of the cardiovascular system to deliver enough blood to all of the vital organs of the body
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| splint | any device that immobilizes a body part
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| sprain | trauma to a joint that causes tearing of ligaments
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| strain | a stretching or tearing of muscles or tendons caused by trauma
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| most frequently used “routes” of parenteral medications | subcutaneous, intramuscular, intradermal
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| what route for parenteral medication offers the most rapid rate of absorption | intramuscular
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| advantages associated with parenteral medications | Absorbed more rapid and completely than oral
May be only way drug can be given
Required with certain conditions (unconscious patient, gastric disturbance)
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| disadvantages associated with parenteral medications | pain
possible infection
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| 3 types of syringes | Hypodermic: calibrated in mL
Insulin: calibrated in units
Tuberculin: calibrations divided into tenths and hundredths of a mL
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| what are the 7 rights of drug administration | Right drug
Right dose
Right time
Right patient
Right route
Right technique
Right documentation
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| what angle is used for subutaneous injection | 45
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| what angle is used for intramuscular injection | 90
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| what angle is used for interdermal injection | 15 or paralle to skin
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| what needle gauge range is used for subcutaneous injections | 23 to 25
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| what needle gauge range is used for intramuscular injections | 18 to 22
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| what needle gauge range is used for intradermal injections | 25 to 27
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| what length needle is used for subcutaneous injections | 5/8" to 1/2"
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| what length needle is used for intramuscular injections | 1" to 3"
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| what length needle is used for intradermal injections | 3/8" to 5/8"
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| common sites for subcutaneous injections | Upper lateral part of arm, anterior thigh, upper back, abdomen
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| common sites for intramuscular injections | Deltoid, gluteus maximus
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| common sites for intradermal injections | Anterior forearm, middle of back, upper arm
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| purpose of “aspirating” when administering parenteral medications | To make sure not in vessel
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| why use z-tracking | • Seals off needle track, prevents medication from reaching SC layer or skin surface
- Used when medications can irritate or discolor skin/ SC tissue
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| allergen | a substance that is capable of causing an allergic reaction
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| gauge | the diameter of the lumen of a needle used to administer medication
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| induration | an abnormally raised, hardened area of skin with clearlt defined margins
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| parenteral | administration of medication by injection
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| vial | a closed glass container with a rubber stopper that holds medication
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| wheal | a tense, pale, raised area of the skin
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| ampule | a small sealed glass container that holds a single dose of medication
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| purpose of applying heat | relieves pain, congestion, muscle spasms and inflammation
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| types of heat applications | heating pad, hot soak, hot compress, chemical hot pack
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| purpose of applying cold | prevents edema if applied immediately, limits accumulation of fluid, controls bleeding, temporarily relieves pain, reduces inflammation
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| types of cold applications | ice bag, cold compress, chemical cold pack
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| ambulation | walking or moving from one place to another
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| types of crutches | axillary crutch, forearm crutch
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| crutch palsy | muscular weakness in the forearm, wrist and hand from injury to radial nerve when crutches are not proper height
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| what angle should elbow be if handgrip of crutches are at proper height | 20%-30% angle
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| four-point gait | both feet and crutches on ground
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| two-point gait | 1 foot and 1 crutch move together
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| three-point gait | one foot and both crutches on ground
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| swing gait | swing-to ot swing-through
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| types of canes | standard (least amount of support)
tripod and quad canes (bulkier and more difficult to move)
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| what side of body does cane go on | opposite side as need support
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| who benifits from use of walker | patients who need more help with balance and walking than can be provided by crutches or cane
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| examples of contrast medium studies | barium swallow, barium enema, cholecystogram, intravenous pyelogram
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| computed tomography | CT; combination of x-rays and computers to create cross sectional images of the body
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| sonography | unltrasound; uses high frequency sound waves to create cross sectional still or real time images of the body
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| magnetic resonance imaging | MRI; uses a combination of high intensity magnetic fields, radio waves and computers to create cross sectional images of the body (some use contrast media)
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| nuclear medicine | small amounts of radionuclides are injucted into the body and are designed to concentrate in specific areas of the body (thyroid, brain, lungs, liver, spleen are most common)
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| mammography | specialized x-ray of the breast, used as a screening tool for breast cancer
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|
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