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226 exam 4
| Question | Answer |
|---|---|
| aura | a simple focal seizure, also known as a partial seizure. |
| automatisms | repetitive, semi-purposeful movements or actions that occur automatically and without conscious control, most often during or after a seizure. |
| resting tremor | affected body part is at rest and supported against gravity. Typically appears when the person is sitting or lying down. Characterized by a rhythmic, pill-rolling motion of the hands, feet, or head. Often seen in Parkinson's |
| action tremor | during voluntary movements. |
| intention tremor | Worsens as the person approaches the target of their movement. |
| paresis | partial or incomplete paralysis, meaning a weakness of voluntary muscles rather than a complete loss of movement |
| total loss of motor function | paralysis, plegia |
| difficulty forming words | dysarthia |
| true language disturbance | aphasia |
| paresthesia | an abnormal sensation characterized by tingling, burning, prickling, or numbness in the skin or other parts of the body |
| tests CN 1 (olfactory) | SENSORY. not routine, close eyes, occlude 1 nostril and present aromatic substance. abnormal-asymmetric sense of smell-neurogenic anosmia |
| testing CN 2 (optic) | SENSORY. tests visual acuity and visual fields of confrontation |
| papillaedema | increased brain pressure, blurring margins of optic nerve |
| testing CN 3,4,6 (oculomotor, trochlear, abducens) | MOTOR. inspect palpebral fissures, check pupil size, regularity, equality, light reaction, assess extraocular movements. abnormal-ptosis, unilateral dilated, nonreactive pupil, strabismus |
| testing CN 5 (trigmenal) | BOTH. motor function-palpate temporal and masseter muscles with clenching. abnormal-asymmetry of movement. sensory- eyes closed, touch wt cotton wisp to forehead, cheeks, chin, say now when touch is felt |
| testing CN 7 (facial) | BOTH. motor-note mobility and symmetry with smile, frown, closed eyes tightly, lift eyebrows, puff cheeks. abnomral-muscle weakness, drooping, asymmetry. |
| testing CN 8 (vestibulocochlear) | SENSORY. test hearing acuity-whisper test |
| testing CN 9 and 10 (glossopharyngeal ad vagus) | BOTH. motor-depress tongue and say ahhh, swallow. uvula is soft and palate rises midline. sensory-touch posterior pharynx wt cotton swab and note sensation |
| testing CN 11 (spinal accessory) | MOTOR. inspect sternomastoid and trapezius muscle size. rotate head and shrug against resistance. abnormal-weakness, atrophy |
| testing CN 12 (hypoglossal) | MOTOR. inspect tongue for tremors, protrude tongue, say light, tight, dynamite. abnormal-atrophy, fasciculations, tongue deviation |
| CN type mnemonic | some say marry money but my brother says big brains matter more |
| upper motor neurons | complex of all descending motor fibers located in CNS that can influence lower motor neurons. ex-disease, stroke, cerebral palsy, MS |
| lower motor neurons | located mostly in PNS from anterior column to muscle, cranial and spinal nerves. ex-bell palsy, spinal cord lesion |
| pyramidal motor pathway | mediates voluntary movement |
| extrapyramidal tracts motor pathway | maintains muscle tone, controls body movements |
| cerebellar system motor pathway | maintains equilibrium, maintains posture, can exert its control back on cortex or lower motor neurons through feedback pathways |
| abnormalities of muscle tone | flaccidity- decr muscle tone, lower motor neuron injury. spascisity-incr tone and resistance to passive lengthening, upper motor neuron injury. rigidity-constant state of resistance, injury to extrapyramidal motor tract |
| abnormal postures | decorticate rigidity-flexion decerebrate rigidity-extension |
| testing cerebellar function | rapid alternating movements, finger nose test, heel to shin test |
| paralysis | decr motor power or loss of motor power |
| tic | involuntary, compulsive, repetitive twitching of muscle group |
| fasciculation | rapid, continuous twitching of resting muscle |
| myoclonus | rapid sudden jerk or short series of jerks at fairly regular intervals |
| chorea | sudden rapid, jerky, purposeless movement at irregular intervals, worse with voluntary actions, disappears with sleep |
| ataxia | unsteady gait |
| relay center | thalamus |
| sensory CNS pathway | sensory receptors-skin, mucous membrane, muscles, tendons, viscera. monitor conscious sensation, internal organ function, body positions and reflexes |
| anterolateral test | sensations of pain and temp, crude touch carried through posterior root synapses to anterolateral tract of spinal cord, travels up to thalamus, synapses to cerebral cortex |
| posterior dorsal columns | sensations of position, vibration, finely localized touch. sensation carried through posterior root up posterior column on same side then synapses in medulla then up to thalamus. pain in right hand is perceived at its specific spot on left cortex map |
| posterior column tract vibration | use low pitch tuning fork, strike and hold on bony surface of fingers/toe, patient tells when vibration starts/stops, compare sides |
| posterior column tract position/proprioception | move finger or great toe up and down and ask person which way it moved |
| stereognosis | place familiar object in hand and have person identify, different object in opposite hand, can manipulate hand. abnormal-asterognosis-the inability to recognize objects by touch alone, often due to damage in the parietal lobe of the brain |
| graphesthesia | cant manipulate hand, trace a single digit in persons hand and person to identify number |
| posterior column tract extinction | simultaneously touch both sides of body at same pint, ask how many points felt |
| deep tendon reflexes must have | intact sensory nerve, functional synapse in cord, intact motor nerve, neuromuscular junction, competent muscle |
| deep tendon reflex grading | 4+-very brisk, hyperactive with clonus 3+-brisker then average 2+-average 1+-diminished, low normal 0-no response |
| UMN | CNS, spastic, hyperreflexia |
| LMN | PNS, flaccid, hyporeflexia |
| stroke | 5th common cause of death, disruption of blood flow that causes brain tissue damage, southeast region more |
| ischemic stroke | occurs when a blood clot blocks an artery in the brain, cutting off blood flow to that area |
| thrombotic stroke | occurs when a blood clot (thrombus) forms in an artery in the brain and blocks blood flow to that area. |
| embolic stroke | occurs when a blood clot (embolus) travels from another part of the body to the brain and blocks a blood vessel, cutting off blood flow to that area. |
| transient ischemic attack | temporary disruption of blood flow |
| urinary irritative symptoms | frequency, urgency, nocturia, dysuria |
| urinary obstructive symptoms | hesitancy, straining, interupptions, force of stream, driibbling, incomplete voiding |
| reasons for obstructive urinary systems in men | distended bladder, benign prostate cancer, stricture |
| cryporthism | undescended testicle |
| when its cold | cremaster muscle raises scrotum |
| when its hot | scrotum descends |
| urethritis | inflammation of urethra |
| hypospadias | urethra is on the lower side |
| epispadias | urethra is on top |
| phimosis | a condition where the foreskin is too tight to be fully retracted over the head of the penis |
| paraphimosis | foreskin in retracted penis |
| priapism | prolonged erection |
| scrotum abnormalities | testicular torsion, epi |
| hernia common in males | inguinal |
| rbc in urine | fewer than 5 |
| wbc in urine | fewer than 5 |
| what shouldn't be in urine | protein, glucose |
| normal specific gravity | 1.003-1.030 |
| tanners sexual maturity rating | stage 2-puberty, age 9-14. african american boys about 1 1/2 years |
| circumcision | elective surgery to remove prepuce. benefits-reduce hiv, uti, decr risk of bv in female partners. risks-pain, bleeding, swelling |
| aging adults men | no definitley end to fertility, sperm decr around 40, decr tone dartos muscle (structure of scrotum), prostate hyperplasia, decline testosterone |
| perform tse | timing-once a month shower-warm water to relax scrotum examine-check for changes and report |
| dyschezia | pain due to local condition or constipation |
| loose or watery stool | hyperactive bowel sounds |
| black or bloody stool | melena-black, tarry |
| hematochezia | passage of fresh blood from anus or in stool |
| clay stool | problem with billirubin. ex-liver disease |
| steatorrhea | pale, yellow, greasy, fat malabsorption |
| gas | flatulence |
| c diff can come from | high dose antibiotics |
| positions for rectal exam | left(natural curve of sigmoid colon) lateral decubitus, lithotomy, standing |
| 12 o clock | symphysis pubis |
| 6 o clock | coccyx |
| hemorrhoids | varicose veins of anus |
| pilonidal cysts | a small, pus-filled cavity that develops in the skin between the buttocks, near the tailbone. |
| anal canal | 3.8 cm long. internal sphincters-controlled by ans. external sphincter-control is voluntary |
| prostate gland | anterior wall of rectum note the elastic bulging prostate. 2.5 x4x1cm, shape-bilobed, heart shaped, elastic rubbery, slightly mobile, nontender |
| function of prostate gland | secretes thin milky alkaline fluid |
| function of seminal vesicles | secretes fluid rich in fructose |
| bulbourethral glands | cowper, secrete clear visicid mucus |
| benign prostatic hypertrophy | irritative and obstructive symptoms, symmetric, nontender, smooth. cannot detect median sulcus |
| prostate cancer | spreads to bone of pelvis, irritative and obstruction symptoms, hematuria, lower back pain, single/hard nodule, asymmetry, fixed |
| prostatis | fever, discharge, perineal/rectal pain or pressure. acute- extremely tender, enlargement. chronic-tender with boggy feel |
| infants | voluntary control of external anal sphincter does not occur until 1.5-2 years, prostate gland doubles during puberty |
| prostate specific antigen | fake positives, 50 years old for average risk, 45 years for african american men |
| fecal immunochemical test | 45 years old for average risk, higher risk as early as 20-25 |
| analgesia | a state of reduced or absent pain sensation. I |
| Afferent | sensory messages sent to the central nervous system (CNS) from sensory receptors |
| Efferent: | motor messages sent from the CNS to muscles & glands; also autonomic messages to internal organs and blood vessels |
| Anterolateral tract: | pathway that contains sensory fibers that transmit pain, temperature, and crude touch located in the posterior gray |
| Dorsal columns | pathway that contains sensory fibers that transmit proprioception, vibrations, and fine touch |
| Proprioception | sense of position of body parts within space and in relation to one another |
| Pyramidal (Corticospinal) trac | pathway that contains motor fibers that transmit from the motor cortex through the anterior horn of spinal cord for voluntary, skilled, purposeful movements such as writing |
| Extrapyramidal tracts: | pathway that contains motor fibers that transmit from outside of the pyramidal tract such as the basal ganglia, brain stem, and spinal cord to maintain muscle tone and gross movements such as walking |
| Upper motor neuron: | motor fibers within the CNS (brain and spinal cord) that influence the lower motor neurons |
| Lower motor neuron: | motor fibers within the peripheral nervous system (PNS) located in the anterior gray column of spinal cord extending to the muscles. Also includes cranial nerves (CN) |
| Dermatome: | overlapping areas of skin that are innervated by a particular spinal nerve |
| Fasciculation: | rapid, continuous twitching of a resting muscle |
| frontal lobe | responsible for personality, behavior, emotions, and intellectual function. |
| parietal lobe | areas responsible for sensation |
| occipital lobe | visual reception |
| temporal lobe | hearing, taste, and smell |
| The hypothalamus controls | body temperature and regulates sleep. |
| The area of the nervous system that is responsible for mediating reflexes is the | spinal cord |
| The cerebellar system coordinates | movement, maintains equilibrium, and helps maintain posture |
| cerebrum | the largest part of the brain, responsible for higher-order cognitive functions such as thought, perception, memory, and movement. |
| The central nervous system is made up of the | brain and spinal cord. The cerebral cortex is the outer layer of nerve cell bodies and the center for a human’s highest functions, governing thought, memory, reasoning, sensation |
| The basal ganglia are large bands of | gray matter that help initiate and coordinate movement and control automatic associated movements of the body |
| The hypothalamus is a major respiratory center with basic vital functions, such as | regulating temperature, heart rate, and blood pressure, as well as sleep and appetite. It also coordinates autonomic nervous system activity and the stress response |
| The brainstem is the | central core of the brain, consisting mostly of nerve fibers. It contains the midbrain, pons, and medulla oblongata |
| The anterolateral tract transmits sensations of | pain, temperature, itch, and crude touch. The posterior columns conduct sensations of position, vibration, and finely localized touch |
| The peripheral nervous system includes all the | nerve fibers outside the brain and spinal cord. This system carries messages from sensory receptors to the central nervous system and from the central nervous system to muscles and glands. |
| Transillumination: | assessment of scrotal swelling to help differentiate a solid or fluid-filled structure |
| An accessory glandular structure for the male genital organs is the | prostate |
| An older man is concerned about his sexual performance. The nurse knows that in the absence of disease, a withdrawal from sexual activity later in life may be attributable to: | side effects of medicine |
| When performing a scrotal assessment, the nurse notices that the scrotal contents show a red glow with transillumination. On the basis of this finding the nurse would | Suspect the presence of serous fluid in the scrotum. |
| When the nurse is performing a genital examination on a male patient, which action is correct | Having the patient shift his weight onto the left (unexamined) leg when palpating for a hernia on the right side |
| Varicocele. | an enlargement of the veins in the scrotum, the pouch containing the testicles |
| direct vs indirect inguinal hernia | direct inguinal hernia shows a bulge from the posterior wall of the inguinal canal, whereas an indirect inguinal hernia passes through the inguinal canal or the groin |
| Para | number of births |
| Herpes simplex 2 | cluster of small, shallow vesicles with surrounding erythema |
| Syphilitic chancre | red, round or oval, superficial ulcer |
| Candidiasis | intense pruritus with thick, whitish, clumpy discharge |
| Trichomoniasis | pruritus with watery, frothy, malodorous discharge |
| Bacterial vaginosis | Profuse discharge, feeling of constant wetness with foul, fishy odor, thin gray-white, discharge |
| Gynecomastia | breast tissue enlargement in males |
| Mastitis: | inflammatory mass of a single breast quadrant that is red, swollen, and tender s/t clogged milk duct or infection |
| The fallopian tubes are | two pliable tubes that extend from the fundus of the uterus to the brim of the pelvis |
| Montgomery glands secrete a | protective lipid material during lactation |
| tail of spence | a small extension of breast tissue that extends into the armpit, site of most breast tumors |
| vestibular glands | provide lubrication for the vulva and vagina through the secretion of mucus |
| skene's glands | help lubricate your vagina during sex and protect it from certain infections. |
| at birth, external genitalia are | engorged bc of maternal estrogen |
| greatest change in pregnant women | uterus change in ph becoming acidic, increase in glycoggen incr risk for candidiasis infection |
| cystocele | a condition where the bladder protrudes into the vagina |
| uterine prolapse | occurs when the uterus descends from its normal position in the pelvis into or through the vagina |
| vulvovaginal inflammation | condition characterized by inflammation of the vulva (external female genitalia) and vagina |
| human papillovamirus | hpv-cervical cancer and genital warts |
| signs of bartholin's gland abscess | local pain, red, shiny, hot palpable mass, 4 and 8 o clokc |
| types of breast tissue | glandular, fatty, fibrous |
| glandular tissue lobes | primary producers of milk in the mammary glands. contains 15-20 lobes radiating from nipple |
| lactiferous duct | transport milk from the mammary glands to the nipple |
| lactiferous sinus | small, milk-filled sacs located at the base of the nipple in the female breast |
| coopers ligaments | fibrous bands extending vertically from surface to attach on chest wall muscle |
| central axillary node | filter lymph from the breast, upper limb, and trunk, and play a key role in the immune response |
| what medication may cause gynecomastia | aldactone |
| fibroadenoma | a noncancerous (benign) breast lump that feels like a smooth, firm, rubbery mass that moves easily under the skin |
| breast acronym | breast mass, retraction, edema, axillary mass, scaly nipple, tender breast |
| dimpling | a change in breast skin that appears as a sunken, puckered, or uneven area, often described as looking like an orange peel |
| mammary duct ectasia | a benign breast condition that causes inflammation and dilation of the milk ducts in the breast. |
| intraductal papilloma | a benign (non-cancerous) growth that occurs in the milk ducts of the breast |
| carcinoma | a type of cancer that originates in epithelial cells, which line the surfaces of organs, glands, and body cavities. |
| paget disease | a chronic bone disorder that causes abnormal bone growth and deformation |
| breast cancer morbidity, mortality, and prognosis | BRCA1 and BRACA2 mutation have a genetic predisposition toward breast and ovarian cancer |
| male breast cancer | painless, firm mass, retro aerolar lump, discharge, retraction |
Created by:
cwehner125