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NURS 3320 Exam 3

UTA NURS 3320 Assessment Exam 3

Flexion bending a limb at a joint
Extension straightening a limb at a joint
Abduction moving a limb away from the midline of the body
Adduction moving a limb toward the midline of the body
Pronation turning the forearm so that the palm is down
Supination turning the forearm so that the palm is up
Circumduction moving the arm in a circle around the shoulder
Inversion moving the sole of the foot inward at the ankle
Eversion moving the sole of the foot outward at the ankle
Rotation moving the head around a central axis
Protraction moving a body part forward and parallel to the ground
Retraction moving a body part backward and parallel to the ground
Elevation raising a body part
Depression lowering a body part
No of Bones in body 206
Joints Union of 2 or more bones, allows mobility
Synovial joints Freely movable
Nonsynovial joints Bones are united by fibrous tissue or cartilage and are immovable (e.g., sutures in skull) or slightly movable (e.g., vertebrae)
Ligaments Hold bone to bone, strengthen joint, prevent movement in undesirable directions
Cartilage Cushions bones; gives smooth surface to facilitate movement
Bursae Small sacs filled w/ viscous synovial fluid; minimize friction
Tendon Strong fibrous cord that attaches skeletal muscle to bone
Kyphosis Enhanced thoracic curve; common in aging people
Lordosis Pronounced lumbar curve; common in obese people
Scoliosis Lateral curvature of thoracic and lumbar segments of the spine, usually with some rotation of involved vertebral bodies.
Functional Scoliosis flexible; it is apparent with standing and disappears with forward bending. It may be compensatory for other abnormalities such as leg length discrepancy.
Structural Scoliosis fixed; the curvature shows both on standing and on bending forward.
Herniated Nucleus Pulposus The nucleus pulposus (at the center of the intervertebral disk) ruptures into the spinal canal and puts pressure on the local spinal nerve root.
Osteoarthritis Noninflammatory, localized, progressive disorder involving deterioration of articular cartilages and subchondral bone and formation of new bone (osteophytes) at joint surfaces.
Rheumatoid Arthritis Chronic, systemic inflammatory disease of joints and surrounding connective tissue. symmetric and bilateral and is characterized by heat, redness, swelling, and painful motion of the affected joints.
Dislocation Complete loss of contact between two bones in a joint
Subluxation two bones in a joint stay in contact but their alignment is off
Contracture Shortening of a muscle leading to limited ROM of joint
Ankylosis Stiffness or fixation of a joint
Crepitation Audible & palpable crunching or grating that accompanies movement. Roughened articular surfaces in joints.
Subcutaneous nodules Raised, firm, and nontender. Overlying skin moves freely.
Right Hemisphere Visual spatial skills; expressing emotion; concentration & attention; sense of direction
Left Hemisphere Language; speech; reading & writing; math; verbal communication
Frontal lobe contains primary motor cortex; personality, behavior, emotions, and intellectual function; Precentral gyrus (voluntary movement); Broca's area (speech)
Precentral gyrus in the frontal lobe; initiates voluntary movement.
Broca's area in the frontal lobe; mediates motor speech. When injured in the dominant hemisphere, expressive aphasia results.
Parietal lobe contains primary sensory cortex; position sense, touch, shape, & texture of objects
Postcentral gyrus in the Parietal lobe; the primary center for sensation.
Temporal lobe behind the ear; the primary auditory cortex; Wernicke's area (language comprehension); interprets auditory, visual & somatic input; hearing, taste, and smell.
The occipital lobe the primary visual cortex; receives visual information.
Wernicke's area in the temporal lobe; associated with language comprehension. When damaged in the person's dominant hemisphere, receptive aphasia results. The person hears sound, but it has no meaning, like hearing a foreign language.
Basal ganglia create smooth, coordinated voluntary movement by balancing the production of acetylcholine & dopamine (neurotransmitters) – Automatic movements like arm swing alternate with legs when walk
Thalamus Relay station for the nervous system; Sensory pathways of the spinal cord and brainstem form synapses
Hypothalamus (Homeostasis); Temperature, HR, BP, sleep center; ANS responses; Storage & secretion of pituitary gland hormones
Cerbellum motor coordination of voluntary movements, equilibrium & muscle tone; hemisphere controls ipsilateral side of body
Ipsilateral same side
Brainstem Midbrain, pons, medulla
Midbrain relay info r/t muscle movement to brain
Pons Relays senosry info; regulates respiration
Medulla involuntary functions (e.g., breathing)
Spinothalamic tract transmits sensations of pain, temperature & crude or light touch
Posterior (Dorsal) columns conduct sensations of position (proprioception), vibration, and finely localized touch (stereognosis)
Proprioception Position; knowing where body parts are in space and relation to each other
Stereognosis finely localized touch; identifying familiar objects by touch
Graphesthesia ability to "read" a number by having it traced on the skin
Pyramidal decussation crossing of motor fibers; occurs in Medulla
upper Motor Neurons completely in CNS; convey impulses from motor areas of cortex tolower motor neurons in the spinal cord
Lower Motor Neurons mostly in PNS; provide final direct contact with mucsles; cranial nerves & spinal nerves
Dermatone skiin area supplied mainly from one spinal cord segment through a particular spinal nerve
CN I Olfactory - Smell
CN II Optic = Vision
CN III Oculomotor - Extraocular Movement, opening eyelids; pupil constriction, lens shape
CN IV Trochlear - Down & inward eye movement
CN V Trigeminal - mastication muscles; sensation of face & scalp, cornea, mucous membranes of mouth and nose
CN VI Abducens - Lateral eye movement
CN VII Facial - facial muscles, close eye, labial speech, close mouth; taste (sweet, salty, sour, bitter) on anterior two thirds of tongue; saliva and tear secretion
CN VIII Acoustic - Hearing & equilibrium
CN IX Glossopharyngeal - pharynx movement (phonation & swallowing); taste on posterior 1/3 of tongue, pharynx (gag reflex); parotid gland, carotid reflex
CN X Vagus - Pharynx & larynx movement (talking & swallowing); sensation from carotid body, carotid sinus, pharynx, viscera; carotid reflex
CN XI Spinal Accessory - Trapezius & sternomastoid muscle movement
CN XII Hypoglossal - tongue movement
Sympathetic Nervous System Autonomic Nervous System; fight or flight
Parasympathetic Nervous System Autonomic Nervous System; feed & breed
Decorticate posturing abnormal flexion d/t lesion of cerebral cortex
Palmar drift test assesses upper extremity weakness; hold up both arms with palms up and eyes closed, weak arm with "drift" downward
Clonus set of short jerking muscular contractions
Flaccidity Decreased muscle tone or hypotonia; muscle feels limp, soft, and flabby; muscle is weak and easily fatigued; limb feels like a rag doll
Spasticity Increased tone or hypertonia; increased resistance to passive lengthening; then may suddenly give way (clasp-knife phenomenon) like a pocket knife sprung open
Rigidity Constant state of resistance (lead-pipe rigidity); resists passive movement in any direction; dystonia
Cogwheel rigidity Type of rigidity in which the increased tone is released by degrees during passive range of motion so it feels like small, regular jerks
Spastic Hemiparesis Arm is immobile against the body, with flexion of the shoulder, elbow, wrist, and fingers and adduction of shoulder, does not swing freely. The leg is stiff and extended and circumducts with each step (drags toe in a semicircle).
Cerebellar Ataxia Staggering, wide-based gait; difficulty with turns; uncoordinated movement with positive Romberg sign. Possible Causes: Alcohol or barbiturate effect on cerebellum; cerebellar tumor; multiple sclerosis
Parkinsonian (Festinating) Posture stooped; trunk pitched forward; elbows, hips, & knees flexed. Steps short and shuffling. Hesitation to begin walking, difficult to stop suddenly. Holds body rigid. Walks and turns body as one fixed unit. Difficulty with any change in direction.
Paralysis Decreased or loss of motor power due to problem with motor nerve or muscle fibers.
hemiplegia spastic or flaccid paralysis of one side (right or left) of body and extremities
paraplegia symmetric paralysis of both lower extremities.
quadriplegia paralysis in all four extremities.
Paresis weakness of muscles rather than paralysis.
Fasiciculation Rapid, continuous twitching of resting muscle or part of muscle, without movement of limb, that can be seen by clinicians or felt by patients.
Tic Involuntary, compulsive, repetitive twitching of a muscle group (e.g., wink, grimace, head movement, shoulder shrug); due to a neurologic cause (e.g., tardive dyskinesias, Tourette syndrome) or a psychogenic cause (habit tic).
Myoclonus Rapid, sudden jerk or a short series of jerks at fairly regular intervals. A hiccup is a myoclonus of diaphragm. Single myoclonic arm or leg jerk is normal when the person is falling asleep; myoclonic jerks are severe with grand mal seizures.
Tremor Involuntary contraction of opposing muscle groups. Results in rhythmic, back-and-forth movement of one or more joints.
Rest Tremor occurs when muscles are quiet and supported against gravity (hand in the lap). Coarse and slow (3 to 6 per second); partly or completely disappears with voluntary movement (e.g., “pill rolling” tremor of parkinsonism, with thumb and opposing fingers).
Intention Tremor Rate varies; worse with voluntary movement as in reaching toward a visually guided target. Occurs with cerebellar disease and multiple sclerosis.
Chorea Sudden rapid, jerky, purposeless movements of limbs, trunk or face; Huntington’s disease
Athetosis Slow twisting movement like a snake or worm; occurs with cerebral palsy
Moro Reflex Startle Reflex; looks as if hugging a tree
Babinski reflex Fanning of toes when lateral edge is stroked
Placing reflex flexing of hip and knee, followed by extension at the hip, to place foot on table
Hyporeflexia absence of a reflex; caused by lower motor neuron problem (e.g., spinal cord injury)
Hyperreflexia exaggerated reflex; caused by upper motor neuron lesions (e.g., brain attack)
Reflex Grade 4+ very brisk, hyperactive with clonus, indicative of disease
Reflex Grade 3+ Brisker than average, may indicate disease, probably normal
Reflex Grade 2+ Average, normal
Reflex Grade 1+ Diminished, low normal, or occurs only with reinforcement
Reflex Grade 0 No response
Sodium per day <2300mg/day
Calories from Saturated Fats <10% of total calories
Cholesterol per day <300mg/day
% of Ideal Body Weight Current wt./ideal wt.
mild malnutrition 80-90% of Ideal Body Weight
moderate malnutrition 70-80% of Ideal Body Weight
severe malnutrition <70% of Ideal Body Weight
% of Usual Body Weight Current wt./usual wt.
% weight change (recent) (usual wt.-current wt)/usual
Clinically significant weight change >5% weight change over month, >10% over 6 mos
Waist-Hip Ratio waist circ/hip circ
Normal Waist-Hip Ratio <0.8 women or <1 men
Android Obesity upper body obesity; waist-to-hip ratio > normals
BMI Calculation Wt (lb)/Height (in)2 x 703
Underweight BMI <18.5; <5th percentile
Normal Weight BMI 18.5-24.9; 5th-85th percentile
Overweight BMI 25-29.9; 85th -95th percentile
Obesity BMI 30-39.9; >95th percentile
Extreme Obesity BMI > or equal to 40
Normal Glucose <100 mg/dL
Normal Hgb Males 14-18
Normal Hgb Females 12-16
Low H&H Anemia (deficiency in B12, Iron, or Folate)
Elevated H&H dehydration (polycythemia)
Ideal cholesterol level <200
Normal transferrin 170-250 mg/dL
Normal Triglycerides <150 mg/dL
Normal Albumin 3.5-5
Low Albumin fluid status, blood loss, decreased liver function, trauma & surgery
Normal Prealbumin 15-36
Low Prealbumin surgery, trauma, burns, & infection OR other sources of nutritional depletion
High Prealbumin renal disease
Normal C-reactive protein not detectable
Detectable C-reactive protein atherosclerosis, rheumatoid arthritis, TB
Kwashiorkor protein malnutrition (large belly)
Marasmus protein-calorie malnutrition (skeletal)
Pellagra Vitamin B3 (niacin) deficiency (scaly sores in areas exposed to sun, mucosal changes, & mental symptoms)
Rickets Vitamin D & Calcium deficiency; children (cartilage cell growth/inhibition, enlargement of ephiseal growth plates); Adults (osteomalacia)
Magenta tongue riboflavin deficiency
Pale tongue iron deficiency
Beefy red toung vitamin B-complex deficiency
Scurvy (scorbutic gums) vitamin c deficiency; Gums are swollen, ulcerated, and bleeding
Metabolic syndrome fasting glucose > 110, BP >130/85, Waist Circ > 40/35, low HDL, elevated triglycerides
Osteoporosis Decrease in skeletal bone mass occurring when rate of bone resorption is greater than that of bone formation. (Jarvis 2012, p. 608)
Ankylosing Spondylitis A form of RA; Chronic, progressive inflammation of spine, sacroiliac, and larger joints of the extremities, leading to bony ankylosis and deformity. (Jarvis 2012, p. 608)
Joint Effusion Swelling from excess fluid in joint capsule
Tear of Rotator Cuff Characteristic “hunched” position and limited abduction of arm. (Jarvis 2012, p. 609)
Frozen Shoulder Fibrous tissues form in the joint capsule, causing stiffness, progressive limitation of motion, and pain. (Jarvis 2012, p. 609)
Olecranon bursitis Large, soft knob, or “goose egg,” and redness from inflammation of olecranon bursa. (Jarvis 2012, p. 611)
Gouty arthritis Joint effusion or synovial thickening, seen first as bulge or fullness in grooves on either side of olecranon process. (Jarvis 2012, p. 611)
Subcutaneous nodules Raised, firm, nontender nodules that occur with rheumatoid arthritis. (Jarvis 2012, p. 611)
Epicondylitis Tennis Elbow; Chronic disabling pain at lateral epicondyle of humerus, radiates down extensor surface of forearm. (Jarvis 2012, p. 611)
Ganglion Cyst Round, cystic, nontender nodule overlying a tendon sheath or joint capsule, usually on dorsum of wrist. (Jarvis 2012, p. 613)
Carpal Tunnel Syndrome Atrophy occurs from interference with motor function from compression of the median nerve inside the carpal tunnel. (Jarvis 2012, p. 613)
Ankylosis Wrist in extreme flexion, due to severe rheumatoid arthritis. (Jarvis 2012, p. 613)
Swan-Neck Deformity Caused by RA; Resembles Swan's Neck; flexion contracture of metacarpophalangeal joint, then hyperextension of the proximal interphalangeal joint, and flexion of the distal interphalangeal joint. (Jarvis 2012, p. 613)
Boutonniere deformity Caused by RA; knuckle looks as if it is being pushed through a buttonhole. It is a relatively common deformity and includes flexion of proximal interphalangeal joint with compensatory hyperextension of distal interphalangeal joint. (Jarvis 2012, p. 613)
Ulnar Deviation or Drift Caused by RA; Fingers drift to the ulnar side because of stretching of the articular capsule and muscle imbalance. (Jarvis 2012, p. 613)
Hallux Valgus Caused by RA; lateral or outward deviation of the great toe with medial prominence of the head of the first metatarsal. (Jarvis 2012, p. 616)
Polydactyly Extra digits are a congenital deformity, usually occurring at the fifth finger or the thumb. (Jarvis 2012, p. 613)
Syndactyly Webbed fingers are a congenital deformity, usually requiring surgical separation. (Jarvis 2012, p. 613)
Synovitis Loss of normal hollows on either side of the patella, which are replaced by mild distention. Occurs with synovial thickening or effusion (excess fluid). (Jarvis 2012, p. 615)
Swelling of Menisci Localized soft swelling from cyst in lateral meniscus shows at the midpoint of the anterolateral joint line. (Jarvis 2012, p. 615)
Osgood-schlatter disease Painful swelling of the tibial tubercle just below the knee, probably from repeated stress on the patellar tendon. (Jarvis 2012, p. 615)
Chondromalacia patella inflammation of underside of the patella
Tenosynovitis Inflammation of a tendon sheath; produces a superficial linear swelling and a localized tenderness along the route of the sheath. (Jarvis 2012, p. 616)
Gout metabolic disorder of disturbed purine metabolism, associated with elevated serum uric acid. (Jarvis 2012, p. 616)
Callus Hypertrophy of the epithelium develops because of prolonged pressure, commonly on the plantar surface of the first metatarsal head in the hallux valgus deformity or over the bony prominences of the joints in hammertoes. Not painful.
Plantar Wart Vascular papillomatous growth is probably due to a virus and occurs on the sole of the foot, commonly at the ball. The condition is extremely painful. (Jarvis 2012, pp. 616-617)
Hammertoes includes hyperextension of the metatarsophalangeal joint and flexion of the proximal interphalangeal joint. (Jarvis 2012, p. 616)
Muscle strength grade 5 Full ROM against gravity, full resistance; 100% normal, Normal
Muscle strength grade 4 Full ROM against gravity, some resistance; 75% normal, Good
Muscle strength grade 3 Full ROM with gravity; 50% normal, Fair
Muscle strength grade 2 Full ROM with gravity eliminated (passive motion); 25% normal, Poor
Muscle strength grade 1 Slight contraction, 10% normal, Trace
Muscle strength grade 0 No contraction; 0% normal, Zero
Phalen Test Tests for carpal tunnel; hold both hands back to back while flexing the wrists 90 degrees
Positive Tinel Sign percussion of the median nerve produces burning and tingling along its distribution; occurs in carpal tunnel syndrome
Dorsiflexion Flexion of the ankle (tibiotalar joint)
Planta flexion Extension of the ankle (tibiotalar joint)
Ortolani maneuver Checks infant's hips for congenital dislocation; flex the knees, adduct the legs until your thumbs touch, then gently lift and abduct, moving the knees apart and down.
Allis test Checks infant's hips for congenital dislocation by comparing leg lengths
Genu valgum knees together (Knock knees)
Genu varum knees apart (bowlegged)
Trendelenburg sign screen progressive subluxation of the hip
Location of Liver RUQ; Left lobe LUQ
Location of Gallbladder RUQ
Location of Duodenum RUQ
Location of Pancreas Head RUQ; Body LUQ
Location of Right kidney RUQ
Location of Stomach LUQ
Location of Spleen LUQ
Location of Left kidney LUQ
Location of Cecum RLQ
Location of Appendix RLQ
Location of Ovary & tube RLQ/LLQ
Location of ureter RLQ/LLQ
Location of spermatic cord RLQ/LLQ
Location of Sigmoid colon LLQ
Location of Ascending colon RUQ/RLQ
Location of transverse colon RUQ/LUQ
Location of Descending colon LUQ/LLQ
Location of Aorta Midline
Location of Uterus (if enlarged) Midline
Location of Bladder (if distended) Midline
Where tympany is heard should predominate because air in the intestines rises to the surface when the person is supine.
Where Dullness is heard occurs over a distended bladder, adipose tissue, fluid, or a mass
Normally palpable structures lower edge of liver, right kidney (lower pole), pulsatile aorta, rectus muscles (lateral borders), ascending colon, cecum, sigmoid colon, uterus (gravid), full bladder
Scaphoid abdomen caves in
Protuberant abdomen abdominal distention
Hyperactive bowel sounds Loud, gurgling sounds, “borborygmi,” signal increased motility. They occur with early mechanical bowel obstruction (high-pitched), gastroenteritis, brisk diarrhea, laxative use, and subsiding paralytic ileus. (Jarvis 2012, p. 563)
Hypoactive Bowel Sounds Diminished or absent bowel sounds signal decreased motility as a result of inflammation as seen with peritonitis; from paralytic ileus as following abdominal surgery; or from late bowel obstruction. Occurs also with pneumonia. (Jarvis 2012, p. 563)
Black Stools may be tarry due to occult blood (melena) from GI bleeding or non-tarry from iron meds
Gray stools occur with hepatitis
Red blood in stools occurs with GI bleeding or localized bleeding around anus
Costovertebral Angle (CVA) Tenderness indirect fist percussion causes sharp pain with inflammation of the kidney or paranephric area
Normal stool frequency 3 or more BM per week
Normal bowel sounds high-pitched, gurgling, cascading sounds, occurring irregularly anywhere from 5 to 30 times per minute. (Jarvis 2012, p. 554)
Borborygmus "stomach growling"
Peritoneal Friction Rub rough, grating sound, like two pieces of leather rubbed together, indicates peritoneal inflammation (Jarvis 2012, p. 563)
Socialization the process of being raised within a culture and acquiring the characteristics of that group.
Acculturation the process of adapting to and acquiring another culture
Assimilation the process by which a person develops a new cultural identity and becomes like the members of the dominant culture
Biculturalism dual pattern of identification and often of divided loyalty
Atrophic Vaginitis opportunistic infection related to chronic estrogen deficiency; Postmenopausal vaginal itching, dryness, burning sensation, dyspareunia, mucoid discharge (may be flecked with blood)
Candidiasis (Moniliasis) Intense pruitus, thick whitish discharge; Vulva and vagina are erythematous and edematous. Discharge is usually thick, white, curdy, “like cottage cheese.”
Trichomoniasis Pruritus, urinary frequency, terminal dysuria, itching; Vulva may be erythematous. Vagina diffusely red, granular, occasionally with red, raised papules and petechiae (“strawberry” appearance). Frothy, yellow-green, foul-smelling discharge.
Bacterial Vaginosis Profuse discharge, “constant wetness” with “foul, fishy, rotten” odor; Thin, creamy, gray-white, malodorous discharge. No inflammation on vaginal wall or cervix.
Chlamydia Minimal or no symptoms. May have urinary frequency, dysuria, or vaginal discharge, postcoital bleeding; May have yellow or green mucopurulent discharge, friable cervix, cervical motion tenderness (Jarvis 2012, p. 758)
Gonorrhea Variable: vaginal discharge, dysuria, abnormal uterine bleeding, abscess in Bartholin's or Skene's glands; the majority of cases are asymptomatic.; May have purulent vaginal discharge. Diagnose by positive culture of organism.
Myomas Often no symptoms. When symptoms do occur, include vague discomfort, bloating, heaviness, pelvic pressure, dyspareunia, urinary frequency, backache, or hypermenorrhea if myoma disturbs endometrium (Jarvis 2012, p. 758)
Carcinoma of the Endometrium Abnormal and intermenstrual bleeding before menopause; postmenopausal bleeding or mucosanguineous discharge. Pain and weight loss occur late in the disease. (Jarvis 2012, p. 758)
Endometriosis Cyclic or chronic pelvic pain, occurring as dysmenorrhea, or dyspareunia, low backache. Also may have irregular uterine bleeding or hypermenorrhea or may be asymptomatic. (Jarvis 2012, p. 758)
Menorrhagia heavy menses
Dysmenorrhea painful menses
Gravida number of pregnancies
Para number of births
Phimosis unable to retract foreskin
Paraphimosis unable to return foreskin
Hypospadias urethral meatus in ventral (under side) location
Epispadias urethral meatus in dorsal (upper side) location
Priapism prolonged painful erection without stimulation
Peyronie Disease Hard, nontender, subcutaneous plaques palpated on dorsal or lateral surface of penis; associated with painful bending of the penis during erection
Cryptorchidism absent testis
Testicular Torsion sudden twisting of spermatic cord
Epididymitis acute infection of epididymis
Varicocele dilated, tortuous varicose veins in the spermatic cord
Spermatocele retention of cyst in epidymis
Hydrocele Cystic. Circumscribed collection of serous fluid in tunica vaginalis, surrounding testis. May occur following epididymitis, trauma, hernia, tumor of testis, or spontaneously in the newborn
Orchitis acute inflammation of testis
Prostatitis inflammation of prostate
Benign Prostatic Hypertophy (BPH) Urinary frequency, urgency, hesitancy, straining to urinate, weak stream, intermittent stream, sensation of incomplete emptying, nocturia.
Prostatic Carcinoma Frequency, nocturia, hematuria, weak stream, hesitancy, pain or burning on urination; continuous pain in lower back, pelvis, thighs.
Enuresis involuntary passage of urine after an age at which continence is expected
Created by: camellia