Chapter 14-19: HEENT, Respiratory, and Cardiovascular Systems – Nursing Notes

Vocabulary flashcards to review key terms from the HEENT, respiratory, and cardiovascular notes.

OPQRSTU

A headache assessment mnemonic: Onset, Provocation, Quality, Region/Radiation, Severity, Timing, and Understanding/associated factors.

Headache

Pain in the head; used to help differentiate etiologies when combined with OPQRSTU.

Meningitis (headache context)

Headache accompanied by severe fever and nuchal rigidity suggesting meningitis.

Normocephalic

Normal head shape and proportions upon inspection.

Hydrocephaly

Enlarged head due to excess CSF.

Plagiocephaly

Flattened skull shape from external pressures.

Craniostenosis

Premature fusion of cranial sutures affecting skull growth.

Lymphatics

Part of the immune system; vessels carry clear fluid from tissues to circulation.

Lymph Nodes

Filters lymph and engulfs pathogens; drain into the deep cervical chain.

Lymphadenopathy

Enlargement of lymph nodes.

Lymphadenopathy assessment

Look for swelling; palpate for movable, small, soft, non-tender nodes; hard/immobile nodes can suggest malignancy.

Thyroid Gland

Endocrine gland in the neck; assess for goiter, nodules; auscultate for bruit if enlarged.

Goiter

Enlargement of the thyroid gland.

Thyroid Nodules

Discrete lumps within the thyroid; may indicate nodular disease.

Bruit (thyroid)

Pulsing sound over enlarged thyroid indicating increased blood flow.

Hypothyroidism signs

Cold intolerance, weight gain, cool/dry skin, decreased vital signs, constipation, myxedema.

Hyperthyroidism signs

Heat intolerance, weight loss, warm skin, increased vital signs, diarrhea, exophthalmos.

Thyroid palpation (posterior approach)

Posterior approach is preferred; normal thyroid is often nonpalpable.

CN VII (Facial Nerve)

Cranial nerve responsible for facial movement; assessed for symmetry.

CN V (Trigeminal Nerve) sensation

Sensation testing with a cotton wisp in HEENT exam.

Temporomandibular Joint (TMJ)

Jaw joint; assess movement, tenderness, locking, crepitus.

Sensation testing (cotton wisp)

CN V sensory test in facial examination.

Frontal & Maxillary Sinuses

Sinuses assessed for tenderness, drainage, and motion limitations.

Eyelids (ptosis)

Drooping of the upper eyelid.

Conjunctiva

Mucous membrane that lines the eyelids and eyeball.

Sclera

The white part of the eye; color reflects health status.

Visual Acuity (Snellen)

Vision test using the Snellen chart to measure clarity.

Hyperopia/Myopia

Hyperopia: farsightedness; Myopia: nearsightedness.

Confrontation Test

Peripheral vision test (CN II) to detect field defects.

EOMs (six cardinal gazes)

Assessment of eye movements in six directions to test extraocular muscles.

Diagnostic Positions Test

Assesses ocular alignment by tracking light and movement.

Corneal Light Reflex

Shine light to observe reflections for symmetry of eyes.

Anisocoria

Pupils of unequal size.

Pupillary response

Pupils equal, round, reactive to light; accommodation reflex assessed.

Ophthalmoscopic Exam

Examination of the fundus; look for red reflex, optic disc, retinal vessels.

Optic Disc

Nasal retina area; optic nerve head with distinct margins.

Retinal Vessels

Arteries and veins visible in the retina during exam.

Cataract

Opacity of the lens causing blurred vision and abnormal red reflex.

AMD (Age-Related Macular Degeneration)

Macular degeneration leading to loss of central vision.

Diabetic Retinopathy

Diabetes-related retinal disease; leading cause of blindness; floaters, vision loss.

Retinal Detachment

Separation of retina with sudden shadow or vision loss.

Strabismus

Abnormal eye alignment due to extraocular muscle weakness.

Glaucoma

Increased intraocular pressure that damages the optic nerve.

External Ear

Auricle inspection; check tenderness, skin, discharge, cerumen.

Tympanic Membrane

Eardrum; normal: pearly gray, translucent; cone of light; mobile.

Otitis Media

Middle ear infection; red, bulging tympanic membrane with otalgia.

Otitis Externa (Swimmer’s Ear)

Outer ear infection; otalgia, redness/swelling externally.

Presbycusis

Age-related sensorineural hearing loss.

Cerumen Impaction

Earwax buildup causing hearing loss.

Nose & Olfactory (CN I)

Assessment of nasal area and smell (olfactory function).

Allergic Rhinitis

Allergic nasal symptoms; turbinates pale or violet.

Acute Rhinitis

Common cold symptoms; clear, watery discharge may become purulent.

Epistaxis

Nosebleed.

Mouth/Lips

Inspect lips, teeth, gums, tongue, and mucosa for lesions.

Aphthous Ulcer

Canker sore; round/oval ulcer with yellow center and red halo.

Oral Candidiasis (Thrush)

Candida infection with nonadherent creamy plaques.

Leukoplakia

Precancerous white patches on oral mucosa; often linked to smoking/alcohol.

Tonsillitis

Inflamed tonsils; fever, malaise, exudate; may need Strep test.

Peritonsillar Abscess

Severe tonsillar infection with fever, severe throat pain, trismus.

Arcus Senilis

Grey-white arc around cornea seen with aging.

Scleral/blue changes in older adults

Scleral pigment changes; bluish tint or brown macules related to aging.

Nose – Allergic vs Acute Rhinitis features

Allergic: pale/dark turbinates; Acute: clear/watery discharge.

Thoracic Landmarks

Sternal angle (Angle of Louis) marks tracheal bifurcation; 2nd ICS; vertebra prominens (C7).

Intercostal Spaces (ICS) naming

ICS named for the rib above them.

Right vs Left Lung Lobes

Right lung: 3 lobes; Left lung: 2 lobes.

Pleura & Pleural Space

Visceral and parietal pleura with a potential space containing fluid.

Alveoli

Air sacs where gas exchange occurs.

Pericardium/Myocardium/Endocardium

Pericardium=(outer), Myocardium=(muscular wall), Endocardium=(inner lining of chambers).

Heart Valves (flow)

Right AV valve = tricuspid; Left AV valve = mitral; Pulmonic (right) and Aortic (left) semilunar valves.

Blood Flow Through Heart

SVC/IVC → RA → tricuspid → RV → pulmonic valve → PA → lungs → LA → mitral → LV → aorta.

Systole vs Diastole

Systole: ventricular contraction (S1); Diastole: ventricular relaxation (S2).

PMI (apical impulse)

Normal pulsation at 4th-5th ICS, left midclavicular line; thrill absent.

S3 & S4

Low-pitched sounds; S3 (early diastole) suggests HF; S4 (late diastole) suggests stiff ventricle; best with bell at apex.

Murmurs (innocent vs pathologic)

Blowing sounds from turbulent flow; innocent murmurs have no pathology; pathologic murmurs indicate disease.

Carotid Bruit

Audible murmur over carotid suggesting carotid artery disease.

JVD

Jugular venous distension; sign of elevated central venous pressure.

Apical Impulse (PMI) location

Typically at 4th-5th ICS, left MCL; should be normal without thrill.

S3/S4 positioning for auscultation

Best heard with bell at apex; left lateral position improves detection.

Murmur Auscultation considerations

Use diaphragm for high-pitched sounds; bell for low-pitched murmurs; position changes may reveal murmurs.

Peripheral Pulses

Palpate carotids; also femoral, popliteal, posterior tibial, and dorsalis pedis.

ABIs

Ankle-brachial index; <0.90 indicates PAD.

Claudication

Leg pain due to intermittent arterial insufficiency.

DVT signs (Homan’s sign)

Calf pain with dorsiflexion indicating possible DVT.

Heart Failure types

HFrEF (systolic dysfunction) vs HFpEF (diastolic dysfunction).

Hypertension

Silent killer; untreated HTN risks include MI, HF, stroke, kidney disease.

Myocardial Infarction (MI)

Ischemia with tissue death; heavy chest pain, radiating pain, diaphoresis; ST changes.

Pericarditis

Inflammation of pericardium; friction rub; sharp chest pain worsened by breathing.

Murmurs – etiologies

Stenosis causes murmurs when valve opens; regurgitation murmurs when valve closes.

Atherosclerosis/ PAD risk factors

Smoking, high cholesterol, HTN, diabetes, age; arterial insufficiency in legs.

DVT vs Venous insufficiency

DVT: clot risk with pain, redness, swelling; venous insufficiency: edema, stasis changes.

Lymphedema

Chronic swelling from lymphatic system dysregulation; non-pitting in some cases.

Pulmonary Conditions (ARDS, TB, Pneumonia)

ARDS: rapid respiratory failure from pulmonary edema; TB: contagious bacterial infection; pneumonia: alveolar consolidation.

RSV and Croup (pediatrics)

RSV causes bronchiolitis/pneumonia; croup causes swelling of airway with barking cough and stridor.