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Health Assmt. week 2
| Question | Answer |
|---|---|
| What quadrant is the duodenum in? | RUQ |
| what is the abdominal viscera? | the underlying organs |
| what is visceral pain? | pain radiating from an organ. |
| Name the structures found in the RUQ? | Liver gallbladder pylorus duodenum head of pancreas right adrenal gland portion of right kidney hapatic flexure of colon portion of ascending & trans. colon |
| 3 major systems of the abdomen? | genito-urinary gastrointestinal system hepatic system |
| Name the structures in the LUQ | left lobe of liver spleen stomach body of pancreas left adrenal gland portion of left kidney splenic flexure of colon portion of trans. & descending colon |
| Name the structures in the RLQ | lower portion of right kidney cecum and appendix portion of ascending colon urinary bladder (if full) right ovary and salpinx uterus if enlarged right spermatic cord right ureter |
| Name the structures in the LLQ | lower pole of left kidney sigmoid colon portion of descending colon urinary bladder if full left ovary & salpinx uterus if enlarges left spermatic cord left ureter |
| what is AAA? | abdominal aorta aneurism (5X more common in men) |
| classic symptom of AAA | searing back pain |
| structures found at the midline of the abdomen | abdominal aorta uterus (enlarged) bladder (distended) |
| Things to ask about in an abdominal assessment? | APPETITE: changes, anorexia, dyshphagia, intolerances, GERD ABD PAIN: N&V, BM freq., color, consistency, ETOH/smoking |
| What to look for in an abdominal inspection? | Contour Umbilicus Skin Abd. pulsations (aorta) |
| What is the order of IPPA for the abdomen? Why? | Inspect Auscultate Percuss Palpate |
| What is GERD? | Gastroesophogeal Reflux Disease |
| what could rapid weight change signify? | Thyroid problems |
| What is Dysphagia? | difficulty swallowing |
| what are signs of Hypothyroidism | sluggish constipated weight gain |
| Signs of Hyperthyroidism | diarrhea loss of weight (^metabolism) lots of energy |
| How would you test for dysphagia on a pt. that cannot talk? | see if they have a gag reflex: positive reflex means neg. dysphagia |
| what is hematamesis? | blood in vomit |
| what is hemoccult test for? | to check for microscopic blood in stool |
| what is melana? | microscopic blood in stool |
| How would you describe contour? | Flat, rounded, distended, or protuberant |
| What are some things that could cause distention? | The 9 F's: fluid, feces, fetus, flatus, full bladder, false pregnancy, fat, fibroid, fatal tumor |
| what is a hernia? | abnormal obtrusion of bowel through a weakened abdominal muscle |
| what is ascites? | accumulation of serous fluid (thin, straw-colored fluid--like in a blister (common with cirrhosis of liver and colon cancer). |
| Sanguinous | fluid that is bloody and thick |
| where should you start auscultation of the abdomen? | ileoceccal valve of the RLQ |
| How long should you auscultate before noting "absense of sound" | 5 minutes |
| what is paralytic ileus | complete absence of peristalsis that can occur after abd. or bowel surgery, or if there is an obstruction |
| what is borborygmi? | stomach growling from hunger |
| why do we auscultate after inspecting? | because poking around can change the sounds and/or you could cause more pain |
| How do we palpate the abdomen? | Light (at first), then deeper to look for organ enlargement. |
| what are some signs of abdominal palpation? | CVA tenderness-- kidney infection Rebound tenderness--inflamed appendix Murphy's sign-- gall bladder disease Fluid wave-- ascites |
| another name for rebound tenderness | Blumberg's sign |
| What is Blumberg's sign looking for? | pain in the RLQ that signals inflamed appendix. |
| How to check for rebound tenderness? | press on LLQ and release quickly. If pain is felt in RLQ, then appendix problem. |
| what is the costovertebral angle and what is pain there associated with? | posterior where the 12th rib and the vertebral column come together. Flank pain associated with renal disease. |
| What is Murphy's sign? | It's a way to test for gall bladder disease: find liver border, push in and release. |
| what is cholecystitis? | Gallbladder disease |
| When do we not palpate an abdomen? | On a pt. with appendicitis or a pt. who has had an organ transplant. |
| why do we not give pain meds to a pt. complaining of abd pain before doing an exam? | because then we wouldn't know where the pain is coming from when we palpate. |
| what are the expected sounds over the abdomen? | tympanic, due to air |
| where would you hear dull sounds? | Over an organ, because it's solid. |
| what are bowel sounds? | sounds of peristalsis |
| Olfactory nerve is associated with what? | smell |
| Optic nerve is associated with what? | vision |
| extraocular movement, pupillary constriction, upper eyelid elevation, and lens shape change are associated with which nerve? | Oculomotor |
| downward and inward eye movement is associated with which nerve? | Trochlear |
| chewing, corneal reflex, face, and scalp sensations are associated with which nerve? | Trigeminal |
| The Abducens nerve is associated with what? | lateral eye movement |
| The Facial nerve is associated with what? | expressions in forehead, eye, and mouth; taste. |
| The Acoustic nerve is associated with what? | hearing and balance |
| Which nerve is associated with swallowing, salivating, and taste? | Glossopharyngeal |
| Which nerve is associated with swallowing, gag reflex, talking, sensations of the throat, larynx, and abdominal viscera are all associated with which nerve? | Vagus |
| Tongue movement is associated with which nerve? | Hypoglossal |
| CN I | Olfactory |
| CN XII | Hypoglossal |
| CN III | Oculomotor |
| What number is the Trochlear nerve? | CN IV |
| CN IX | Glossopharyngeal |
| CN XI | Accessory |
| What number is the Abducens nerve? | CN VI |
| What number is the Vagus nerve? | CN X |
| CN V | Trigeminal nerve |
| What number is the Facial nerve? | VII |
| CN VIII | Acoustic |
| What number is the Optic Nerve? | CN II |
| Another name for Broca's aphasia | expressive aphasia |
| Another name for Wernicke's aphasia | receptive aphasia |
| what is global aphasia? | most common and severe form of aphasia: expressive and receptive speech are both impaired |
| what are the levels of consciousness? | alert, confuse, lethargic, obtunded, stupor, coma |
| what are the major components of a mental status examination? | Appearance Behavior Cognition Thought processes |
| How to assess cognitive function? | Ask about time, place, person. Attention span recent/remote memory |
| How to assess thought processes? | logical, coherent, congruent train of thought; look for suicidal/homocidal ideation; look for paranoid responses |
| Glascow coma scale measures what three criteria? | eye opening, motor response, verbal response |
| The mini mental status exam looks at what? | cognitive function |
| What is the most crucial factor when performing neurological checks? | change is LOC (level of consciousness): this is the earliest and most sensitive index of declining neuro. status |
| what range of scores on the mini mental status exam would indicate mild impairment? | 18-23 |
| what range of scores on the mini mental status test would indicate normal mental status? | 24-30 |
| what range of scores on the mini mental status exam would indicate severe cognitive impairment? | 0-7 |
| what is the maximum score on the mini mental status exam? | 30 |
| what is the maximum score on the Glascow Coma Scale? | 15 |
| On the Glascow Coma Scale, what range of scores would indicate come? | 0-7 |
| what is the lowest possible score on the Glascow Coma Scale? | 3 |
| What is PERRLA? | Pupils are equal, round, and reactive to light and accommodation. |
| Define Anisocoria | pupils of different size |
| what type of tumor can cause visual changes, like decreased peripheral vision? | Pituitary tumor |
| Another name for double vision? | diopia |
| What is the medical term for "droop" | ptosis |
| Define hemiparesis | one-sided weakness |
| Define hemiplegia | paralysis on one side of the body |
| What is FAST (for stroke assessment)? | Facial droop, Arms, Speech, Time (to call 911) |
| what happens if pts. brain herniates? | the patient dies |
| what color is CSF? | clear, no color |
| what are some things you never do with a brain tumor pt? | lay them down, blow their nose, drink through a straw |
| what are two types of abnormal posturing? | extension (decerebrate rigidity) and |
| field sobriety tests are all used to check if the __________ is intact. | cerebellum |
| what is ataxia? | inability to walk straight. |
| how should eyes move in response to cold caloric injection in ear? | toward the ear |
| what are doll's eyes? | reflex in which eyes should move with turning of the head |
| Which nerve are we assessing when checking the tongue for midline and resistance. | hypoglossal (XII) |
| which nerve are we assessing when checking hearing? | Acoustic (VIII) |
| which nerve are we assessing when have pt. smile, frown, and raise eyebrows? | Facial (VII) |
| which nerve are we assessing when testing visual acuity and visual field, or when we use an opthalmoscope? | Optic (II) |
| When we ask the pt. to clench their teeth, what nerve are we assessing? | Trigeminal (V) |
| when we look for ptosis or check pupils for rxn to light and accommodation, what nerve are we assessing? | Oculomotor (III) |
| when we assess the 6 cardinal positions of gaze, what nerve are we assessing? | Trochlear (IV) Abducens (VI) |
| what nerve are we assessing when looking for gag reflex, have pt. say kuh, kuh, kuh, la, la, la, and mi, mi, mi? | Glossopharyngeal (IX) Vagus (X) |
| what nerve are we assessing when we have pt. shrug their shoulders against resistance or have them turn their head against resistance? | Accessory (XI) |
| Name two examples of how to check for cerebellar function. | Gait and Romberg |
| what to look for during head inspection? | Size, shape (normocephalic), symmetry, involuntary movements |
| subjective data in head assessment | Headaches (PQRSTU), trauma/injury, dizziness/vertigo, neck pain, surgery? |
| what are two things commonly associated with migraines? | aura and photophobia |
| Define nucchal rigidity. | inability to flex the head forward due to rigidity of the neck muscles; symptom of meningitis |
| Objective data for the head includes what? | trachea at midline? normal ROM of head and neck? Lymph nodes palpable? |
| Name the lymph nodes of the head and neck | Preauricular, postauricular, occipital, submental, submandibular, cervical |
| how should lymph nodes feel? | movable, soft, discrete, not tender. |
| How to access lymph nodes? | Location, size/shape, consistency, discrete or clumped, tenderness? |
| what is lymphedema? | chronic swelling of lymph node that is common is breast cancer pts. |
| what is the term used to describe lymph nodes enlarged over 1cm | lymphadenopathy |
| what are the symptoms of an acute lymph node infection? | bilateral enlargement, warm, tender, freely movable, discrete. |
| what are the symptoms of cancer in the lymph nodes? | unilateral, hard, non-tender, fixed |
| what are the symptoms of an chronic lymph node infection? | bilateral enlargement, warm, tender, freely movable, clumped together. |
| pupil size is determined by what? | The ANS (autonomic nervous system) |
| stimulation of which branch of the ANS dilates the pupil? | sympathetic |
| the parasympathetic branch determines the extent to which the pupil ________ ? | constricts |
| OS, OD, OU | abbreviations for left eye, right eye, both eyes |
| what is myopia? | near-sightedness |
| medical term for far-sightedness | hyperopia |
| changes in vision related to age | presbyopia |
| normal size range of an adult pupil | 3-5mm |
| Name 4 disorders of the external eye | conjunctivitis, corneal abrasion, subconjunctival hemorrhage, cataracts |
| what are the two different pupillary light reflexes? | direct light reflex and consensual light reflex |
| objective info for ear assessment? | earaches, infections, discharge, hearing loss, environmental noise exposure, tinnitus, vertigo, self-care behaviors |
| what is the tragus? | the part you occlude to block hearing from that ear. |
| what is the pinna? | outer ear (aka auricle) |
| Define ototoxic. | medications that can cause permanent hearing loss |
| Functions of the nose | inspiration, smell, warm the air, filter the air |
| Things to ask in an subjective nose assessment? | discharge, colds, sinus pain or pressure, trauma, change in smell, nosebleeds, patency of nares, deviated septum |
| medical term for nosebleeds | epistaxis |
| objective data for mouth and throat assessment? | oral care, sore throat, hoarseness dysphagia, change in taste, ETOH/smoking |
| Describe tonsil assessment scale | 1+ visible; 2+ midway to uvula; 3+ tough uvula; 4+ touch each other |
| SBE stands for what? | self breast exam |
| STE stand for what? | self testicular exam |
| when is the best time for SBE? | once/month after menstrual period |
| what are two patterns of SBE? | spokes on wheel and concentric circles |
| where is most common sight for malignancy of the breast? | upper outside quadrant (axillary area) |
| If a breast mass is felt, what should you note? | mobility, shape, size, consistency |
| who should perform TSE? | Males > 13 yo. |
| who is at greatest risk for testicular cancer? | undescended testicles, age 20-49, white males |
| what to ask about when assessing GU tract? | frequency, urgency, dysuria, nocturia, hematuria, and polyuria |
| what is dysuria? | burning upon urination |
| needing to urinate at night | nocturia |
| what is hematuria? | blood in urine |
| large volume of urine | polyuria |
| gynelogical questions | gravida (how many pregnancies), para (how many live births), LMP (first day of), discharge |
| what is gravida | how many pregnancies |
| what is para? | how many live births |
| what is LMP? | first day of last menstrual period |
| VTP | voluntary termination of pregnacy |
| explain G6P5AB1VTP0 | 6 pregnancies, 5 live births, 1 spontaneous abortion, 0 voluntary abortion |
| musculoskeletal system parts | bones, joints, tendons, muscles |
| funtions of the musculoskeletal system | support, movement, protection of vital organs, produce RBSs, store Calcium and phosphorus |
| movements of musculoskeletal system | extension, flexion, hyperextension, abduction, adduction, pronation, supination, circumduction, internal/external rotation |
| what is osteoporosis | bone loss > bone growth |
| classic sign of hip fracture | external rotation of foot and shortening of leg. |
| subjective data of the musculoskeletal system | pain, stiffness, limitation of movement, swelling/heat/redness, cramps, weakness, history of injury, usual activity level |
| objective data of musculoskeletal system | inspect joints for color, swelling, deformity; palpate joints for heat, tenderness, swelling; check ROM (active/passive); muscle strength. |
| where do you begin ROM? | head |
| what is benefit of daily ROM for bed pts.? | To avoid contracture/muscle coiling. Healed only through surgery. |
| what is a CVA? | cerebrovascular accident (brain attack) |
| what disability is common after stroke? | hemiplegia |
| what is a stroke? | blood supply to the brain is interruped by blockage (clot) or hemorrhage (vessel burst). |
| what is critical time frame with stroke? | 20 minutes from ER to CT scan to determine whether it's a clot or a hemorrhage. |
| what is TIA | transient ischemic attack; warning sign of impending stroke |
Created by:
whitenlm
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