HAN 477 FINAL

What is minute volume?

Respiratory rate multiplied by the tidal volume

How do you palpate the pulse?

Count # of beats in 15 seconds and multiply

times 4 (normal 60-100)

What is bradycardia?

When the resting heart rate is less than 60 bpm

What is tachycardia?

When the resting heart rate is more than 100 bpm

What is used to evaluate the body's ability to restore blood?

Capillary refill

How can you test capillary refill in the body?

1. Place the thumb on

the patient's finger and

compress

2. Remove pressure

3. Adequate perfusion:

color restored within 2

seconds

What is venous bleeding?

steady blood flood

What is arterial bleeding?

spurting flow of blood

What is capillary bleeding?

Slow flow of blood

What does it mean to auscultate?

Examine a patient by listening to sounds from (the heart, lungs, or other organs), typically using a stethoscope

What is the primary means of diagnosing the chief complaint?

Patient history

What does OPQRST stand for?

- Onset

- Provocation

-Quality

- Region/radiation/referral

- Severity

- Time

What is OPQRST used for?

To asses the patient to determine diagnosis

What is layperson terminology?

Using simple language that a non-expert can understand

What is facilitation?

Using techniques that encourage your patient to feel open to giving you any information you need.

What is reflection?

Pausing to consider something significant that you've just been told.

What is clarification?

The technique of asking your patients for more information when some aspect of the history

is vague or unclear to you.

What is confrontation?

Make your patient aware that you perceive something that is not consistent with his or her behavior, the actual scene, or the information the patient is giving you.

What is interpretation?

Inferring the cause of the

patient's distress, then ask the patient if you are right.

What are some special challenges you might face in history taking?

- Limited education or

intelligence

- Language barriers

- Hearing problems

- Visual impairment/ blindness

- Family and friends

What is a secondary assessment?

The process by which quantifiable, objective information is obtained

from a patient about his or her overall state of health

What are the two elements of a secondary assessment?

- Obtaining vital signs

- Performing a head-to-toe survey

What are some assessment techniques to understand the patient's body?

- Inspection (Looking)

- Palpation (Touching)

- Percussion (striking the surface of the body to detect density, rigid abdomen)

- Auscultation (Using stethoscope)

What are the different types of vital signs?

- Pulse rate/rhythm/quality

- Respiratory rate/rhythm/quality

- Blood pressure

- Pulse oximetry

- Temperature

What do you assess for pulse?

Assess rate, presence, location, quality, regularity

What do you assess for respiration?

Assess rate by inspecting the patient's chest

What do you assess for Blood pressure?

Product of cardiac output and

peripheral vascular resistance

• Systolic pressure

• Diastolic pressure

What is the systolic pressure?

Top number of blood pressure

What is diastolic pressure?

Bottom number of blood pressure

What is considered hypertensive?

If the systolic number is above 140

What is the normal blood pressure?

120/80

What is considered hypotensive?

If the systolic number is under 100

What does a pulse oximeter do?

Measures percentage of hemoglobin saturation

What are considered normal oxygen saturation levels?

95%-100%

What are some signs of significant distress?

- Dress

- Hygiene

- Expression

- Overall size

- Posture

- Untoward odors

- Overall state of health

What do you do for any patient with a "head" problem?

Assess and palpate for signs of truame

What 4 areas do you have to assess for mental status of a patient?

- Person (Ask Name)

- Place (Ask where they are)

- Day of week (Ask date/time)

- The event (what happened prior)

What is used to determine level of consciousness?

AVPU

What does AVPU stand for?

Alert

Verbal stimuli

Painful stimuli

Unresponsive

What is the Glasgow Coma Scale?

-A brain injury severity scale that assesses depth

and duration of impaired consciousness and coma.

-Used by clinicians to gauge deterioration or

improvement at the emergent and acute stages of

brain damage or lesions.

-Predicts ultimate functional outcome.

What is the eye opening scale range?

4. Spontaneous

3. Verbal response

2. Pain response

1. No response

What is the verbal response scale?

5. Oriented and converses

4. Disoriented conversations

3. Speaking but nonsensical

2. Moans or makes unintelligible sounds

1. No response

What is the motor response scale?

6. Follows commands

5. Localizes pain

4. Withdraws to pain

3. Decorticate flexion (curled in)

2. Decorticate flexion (flexed out)

1. No response

What is pallor (pale skin) caused by?

Poor red blood cell perfusion to capillary beds

What is vasoconstriction? What is it indicated by?

The narrowing of blood vessels. Pale skin

What is cyanosis (Bluish-purple skin) caused by?

low arterial oxygen saturation

What is mottling (blotchy skin) caused by?

severe hypoperfusion and shock

What is hypoperfusion?

a medical condition where there is an inadequate blood flow to organs and tissues

What is ecchymosis?

localized bruising or blood collection within or under the skin

What does your skin turgor (elasticity) relate to?

Hydration

Why are skin lesions helpful for doctors?

May be the only external evidence of a serious internal injury

What is the cranium?

the skull

What are the 4 regions of the cranium?

Occiput: Posterior

Temporal: Each side

Parietal: between temporal and occiput

Frontal: Forehead

What covers the cranium?

The scalp

What do meninges do?

suspend the brain and spinal cord (dura matter, arachnoid, pia matter)

Where does cerebrospinal fluid go?

Fills between meninges

What should you look for when assessing pupils?

Check for size, shape, and symmetry, and

reaction to light

What do you look for when evaluating the mouth, pharynx, and neck?

Any foreign objects or obstruction

What do you look for when inspecting the mouth/lips?

- Symmetry

- Gums

- Look for cyanosis around the lips

What are the different types of breath sounds?

Normal

- Tracheal

- Bronchial

- Bronchovesicular

- Vesicular

- Adventitious

What are adventitious breath sounds?

wheezing, rales, rhonchi, stridor, pleural friction rubs

What are questions you think of when listening to a chest?

• Are sounds:

- Dry or moist?

- Continuous or intermittent?

- Course or fine?

• Are breath sounds diminished or absent?

- In a portion of one lung or entire chest?

- If localized, assess transmitted voice sounds

What are the 4 different hypertension classifications?

Normal, prehypertension, stage 1 hypertension, and stage 2 hypertension

What is normal systolic/diastolic blood pressure?

Less than 120/ and less than 80

What is prehypertension systolic/diastolic blood pressure?

120-139/ or 80-89

What is the range for stage 1 hypertension systolic/diastolic blood pressure?

140-159/ or 90-99

What is stage 2 hypertension systolic/diastolic blood pressure?

Above 160 / or below 100

What is an aortic aneurysm?

- A bulge or enlargement of the aorta

- May be seen pulsating in the upper midline

What is a hernia?

A condition where an internal organ or tissue pushes through a weak spot in the surrounding muscle or tissue wall, often causing a visible bulge or swelling

What are some common injuries seen in medical emergencies?

- Fractures

- Sprains

- Strains

- Dislocations

- Contusions

- Hematomas

- Open wounds

What is bony crepitus?

A crackling, grinding, or popping sound or sensation that occurs when two bones or other structures rub against each other

How many vertebrae are in the spine?

33

What does the spine protect?

The spinal cord

What are the 5 regions of the spine?

Cervical, thoracic, lumbar, Sacrum, Coccyx

What makes up the central nervous system?

Brain and the spinal cord

What are the three main parts of the brain?

Cerebrum, Cerebellum, and medulla

What are the only nerves that DO NOT get channeled to the brain via the spinal cord?

Cranial nerves

What type of nerves control motion or movement?

Motor nerves

Which nerves send external signals to the brain?

Sensory nerves

What makes up the peripheral nervous system?

The remaining motor and sensory nerves

What is Cranial nerve I?

Olfactory

What is Cranial nerve II?

Optic

What is Cranial nerve III?

Oculomotor

What is Cranial nerve IV?

Trochlear

What is Cranial nerve V?

Trigeminal

What is Cranial nerve VI?

Abducens

What is Cranial nerve VII?

Facial

What is Cranial nerve VIII?

Vestibular (Acoustic) (Auditory)

What is Cranial nerve IX?

Glossopharyngeal

What is Cranial nerve X?

Vagus

What is Cranial nerve XI?

Accessory

What is Cranial nerve XII?

Hypoglossal

What is the function of the olfactory nerve?

Smell

What is the function of the optic nerve?

Vision

What is the function of the oculomotor nerve?

Eye movement and pupil dilation

What is the function of the trochlear nerve?

- Vertical eye movement

- Innervate the superior oblique muscle (Inner corner/ intorsion)

What is the function of the trigeminal nerve?

Chewing and sensation (pain/temp) to face, teeth, and anterior tongue

What is the function of the abducens nerve?

- Lateral eye movement

- Lateral rectus abduction of eye

What is the function of the facial nerve?

Movement of facial muscles, taste, salivary glands

What is the function of the Vestibular (auditory) nerve?

Hearing and balance