FINAL EXAM

meaning of expected finding

normal finding

meaning of concerning finding

abnormal finding

define • Stereognosis

ability to identify an object in hand without seeing it

what is a direct pupillary response

looking directly into eye with the light

what is a consensual response

pupils are consenting with eachother

what is accommodation

pupils dilate in the distance with item moving toward the eye

tip for questions about what patient to prioritize

which situation will result in death the quickest

is a positive Romburg test normal

no

what does it mean to be alert and oriented

conscious/talking and A&O x3

name of cranial nerve I

olfactory

function of cranial nerve I

smell

name of cranial nerve II

optic

function of cranial nerve II

vision

name of cranial nerve III

oculomotor

function of cranial nerve III

eye movement

name of cranial nerve IV

trochlear

function of cranial nerve IV

eye movement

name of cranial nerve V

trigmeninal

function of cranial nerve V

facial movement

name of cranial nerve VI

abducens

function of cranial nerve VI

eye movement

name of cranial nerve VII

facial

function of cranial nerve VII

facial movement

name of cranial nerve VIII

auditory

function of cranial nerve VIII

hearing

name of cranial nerve IX

glossopharyngeal

function of cranial nerve IX

tongue and uvula movement

name of cranial nerve X

vagus

function of cranial nerve X

tongue and uvula movement

name of cranial nerve XI

accessory

function of cranial nerve XI

head and shoulders

name of cranial nerve XII

hypoglossal

function of cranial nerve XII

tongue movement

which cranial nerves are considered sensory

I, II, VIII

which cranial nerves are considered motor

III, IV, VI, XI, XII

which cranial nerves are sensory and motor

V, VII, IX, X

types of hollow organs

stomach
small intestine
colon
bladder
gallbladder

types of solid organs

liver
kidneys
pancreas
spleen
uterus
ovaries

define melena

blood in the stool

define dysphagia

difficulty swallowing

order for abdominal assessment

inspection, auscultation, palpation

what do we check for during inspection of abdomen

color, contour, lesions, general appearance

location of bruit noises

carotid and aortic arteries

depth of deep palpation

1.5-2 inches

where is acute abdominal pain felt

in the problem area

define Peritoneal Irritation

discomfort in the peritoneam

what does a bruit indicate

occlusion

sound of a bruit

whooshing sound

what is crepitus

crunching sound in the joints

arterial vs venous: function

A: carry oxygenated blood to organs/tissues
V: deliver deoxygenated blood to the heart

arterial vs venous: blood flow

A: away from heart
V: to heart

arterial vs venous: struture

A: thick. elastic walls to withstand high pressure
V: one way valves, thinner walls, large diameter

arterial vs venous: pain

A: sharp, stabbing
V: aching, dull

arterial vs venous: pain aggravation

A: exercise and elevation
V: standing or sitting for long periods of time

arterial vs venous: pain relief

A: dangling legs, stop exercise
V: elevate legs or walk

arterial vs venous: color

A: pale
V: rust color

arterial vs venous: edema

A: none
V: yes

arterial vs venous: wounds

A: ulcers on toes/feet. pale coloring with well defined edges. no bleeding, deep
V: bleeding, uneven edges, not deep

arterial vs venous: skin appearance

A: cool, shiny, no hair
V: thick, brown discoloration

arterial vs venous: pulses

A: weak/absent
V: normal unless there is edema

what is the PMI

where heart sounds are most clear
aka the apical pulse

AV valves

tricuspid and mitral

semi-lunar valves

aortic and pulmonic

what is happening during systole

ventricles have contracted which open up the semilunar valves and blood moves into the aorta

what is S1

The ventricles now filled with blood have increased pressure and force closed the AV valves

what is S2

pressure is falling and SL valves close

what is happening during diastole

ventricles relax and AV valves open to fill ventricles with blood

path of blood flow into the heart

R Atrium
Tricuspid valve
R ventricle
Pulmonic valve
Pulmonary artery
Lungs
Pulmonary vein
L Atrium
Mitral valve
L ventricle
Aortic valve
Aorta

how should the patient be sitting during a cardiac exam

sit supine

auscultatory areas of the heart

aortic
pulmonic
erbs point
tricuspid
mitral

types of people we will hear S3 best in

pregnant and obese people

normal heart sound

lub dub sound

what does S3 indicate

ventricular failure

when is S4 heard

long standing hypertension and MI

what is a murmur

an abnormal condition with turbulent blood flow and collision of currents

sound of a murmur

gentle swooshing or blowing

objective vs subjective

objective: what we can see and measure
subjective: symptoms, what patient is reporting to us

indications of dehydration

dry skin, sticky mucous membranes, tenting of skin

parts of the skin assessment

temp
turgor
texture
color
lesions
edema
moisture

assessing temp vs texture

temp: use back of hands
texture: use palms of hands

types of lesions

macules (freckles)
papules
cyst
vesicles
pustule
nodule

what are pressure ulcers

localized injuries to the skin/tissue at bony prominences

stage 1 pressure ulcer

redness
non-blanching skin
skin is still intact

stage II pressure ulcer

skin is broken
abrasion/blister
shallow crater

stage III pressure ulcer

full thickness
subQ tissue
extends to fascia
deep crater

stage IV pressure ulcer

full thickness lost
extensive destruction
tissue necrosis

purpose of the Braden scale

assess patient's risk of developing pressure ulcers

categories of the braden scale

sensory perception
moisture
activity
mobility
nutrition
friction and shear

Braden scale rating of someone who is at a high risk

9 or less

Braden scale rating of someone who is at no risk

19-23

normal cap refill

less than 2 seconds

appearance of scoliosis

curved spine when bending forward

what is kyphosis

humpback

what is lordosis

spine curves forward
seen with pregnancy and protruberant abdomens

abduction vs adduction

abduction: move limb away from body
adduction: move limb towards body

muscle strength testing

5: full ROM, full resistance
4: full ROM, moderate resistance
3: possible movement, no resistance
2: possible movement, not against gravity
1: feel muscle contraction, no movement
0: no muscle contraction

normal grip strength

equal bilaterally

tests used on the posterior column

position
vibration
stereognosis
graphestesia

tests used on the spinothalamic tract

temp
pain
light touch

mental status exam

dress/grooming/hygeine
facial expression
level of consciousness
orientation x3
short term memory
long term memory
speech
intellectual performance
judgement
abstract reasoning