Term
| 1-7th ribs; 8-10th ribs; 11-12th ribs |
|
Definition
| Attach to sternum; attach to costal cartilage above them; floating ribs- no anterior attachment |
|
|
Term
| Left lung has how many lobes? |
|
Definition
|
|
Term
| Right lung has how many lobes? |
|
Definition
|
|
Term
| Which lung has a horizontal fissure? |
|
Definition
|
|
Term
| What is another name for the sternal angle? |
|
Definition
|
|
Term
| The right lung's horizontal fissure travels from where to where? |
|
Definition
| Medial: 4th rib --> 5th rib mid-axillary |
|
|
Term
| The left lung's oblique fissure travels from where to where? |
|
Definition
| 5th anterior axillary -> 6th rib MCL |
|
|
Term
| The posterior oblique fissure in both lungs begins at which vertebral level? |
|
Definition
|
|
Term
| Breathing at rest is stimulated by what? |
|
Definition
|
|
Term
| The trachea may be displaced by what? |
|
Definition
| Effusion, (away from) pneumothorax, atelectasis |
|
|
Term
| What is the normal rate and depth for breathing? |
|
Definition
| 10-20 breaths per minute, 500-800 ml |
|
|
Term
| What is the difference b/t hyperventilation and hypoventilation? |
|
Definition
| 1) Fast and deep 2) Slower and less deep |
|
|
Term
| What is periodic respiration? |
|
Definition
| Irregular patterns of alternating rapid and slow with prds of apnia. |
|
|
Term
| What factors are you inspecting in thoracic configuration and chest wall movement? |
|
Definition
| AP:transverse diameter, spinal curvature, deformities, unilateral movement, accessory muscle use. |
|
|
Term
| What are you palpating for in the pulmonary exam? |
|
Definition
| Tracheal position or deviation, thoracic expansion, tactile fremitus, tenderness/crepitation. |
|
|
Term
| Regarding thoracic expansion, what could delay or dimunition mean? |
|
Definition
| Fibrotic disease, effusion, lobar pneumonia, pleural pain, upper lobe bronchial obstruction. |
|
|
Term
| Consolidation has what effect on tactile fremitus? |
|
Definition
|
|
Term
| Pleural fluid has what effect on tactile fremitus? |
|
Definition
|
|
Term
| What could abnormal dullness mean during the pulmonary exam? |
|
Definition
| Lobar pneumonia, pleural effusion, blood, pus, fibrous tissue, tumor. |
|
|
Term
| What could hyperresonance mean during the pulmonary exam? |
|
Definition
| Hyperinflated lung, emphysema, pneumothorax, bulla. |
|
|
Term
| What is normal diaphragmatic excursion? |
|
Definition
|
|
Term
| When auscultating the lungs, you listen with what part of the stethescope? |
|
Definition
|
|
Term
| If you hear something during the lung exam, how would you describe it? |
|
Definition
| Pitch, intensity, and duration. *The presence of a silent gap. |
|
|
Term
| What are crackles and rales caused by? |
|
Definition
| Fluid in the alveolar and interstitial spaces. *Discontinuous |
|
|
Term
| Wheezes are caused by what? |
|
Definition
| Bronchoconstriction. *Continuous |
|
|
Term
| Rhonchi are caused by what? |
|
Definition
| Described as gurgling. Secretions collecting in larger airways. *continuous. |
|
|
Term
|
Definition
| Inspiratory wheeze caused by mechanical airway obstruction. |
|
|
Term
| What does a friction rub sound like? |
|
Definition
|
|
Term
| What tests are included in transmitted voice sounds? |
|
Definition
| Bronchophony, egophony (abnormal indicates consolidation), whispered pectoriloquy. |
|
|
Term
| How would you describe any pulmonary abnormalities? |
|
Definition
| Location: vertically and circumferentially |
|
|
Term
| What is the percussion sound over the scapula? |
|
Definition
|
|
Term
| What are some of the accessory breathing muscles? |
|
Definition
| Intercostals, SCMs, scalenes |
|
|
Term
| An abnormally high level of diaphragmatic excursion could indicate what... |
|
Definition
| Pleural effusion, atelectasis, diaphragmatic paralysis. |
|
|
Term
| What are the abnormals for the transmitted voice sounds: bronchophony, egophony, and whispered pectoriloquy? |
|
Definition
| 1) Louder clearer voice sounds 2) E->A 3) Louder clearer whispers |
|
|
Term
| What kind of sound will you get when fluid or solid tissue replaces air-containing lung? |
|
Definition
| Dullness replaces resonance. |
|
|
Term
| A lung affected by COPD will have what characteristics? |
|
Definition
| Hyperresonance. It will also displace the liver downward and lowers the level of diaphragmatic dullness posteriorly. |
|
|
Term
| What will indicate early left-sided heart failure in a pulmonary exam? |
|
Definition
| Late inspiratory crackles in dependent portions of the lungs; resonant, otherwise normal lung sounds; possibly wheezing. |
|
|
Term
| What conditions will illicit a dull percussion note? |
|
Definition
| Consolidation, atelectasis, pleural effusion. |
|
|
Term
| Which way will the trachea be displaced in atelectasis? |
|
Definition
| Toward the involved side. |
|
|
Term
| Which way will the trachea be displaced in a pleural effusion? |
|
Definition
| Towards the opposite side of the effusion. |
|
|
Term
| What effect will consolidation have on breath sounds, tactile fremitus, and transmitted voice sounds? |
|
Definition
| Bronchial over involved area; increased; increased. |
|
|
Term
| What effect will atelectasis have on breath sounds, tactile fremitus, and transmitted voice sounds? |
|
Definition
|
|
Term
| What can cause hyperresonance? |
|
Definition
| Pneumothorax, COPD, and asthma |
|
|
Term
| Which direction is the trachea displaced with a pneumothorax? |
|
Definition
| Opposite side if much air. |
|
|
Term
| How do you calculate BMI in pounds? |
|
Definition
| (weight in lbs x 700/height in inches)/height in inches |
|
|
Term
| How do you calculate BMI in meters? |
|
Definition
| weight in kilograms/height in meters^2 |
|
|
Term
| What factors are you looking for in a pulse? |
|
Definition
| Rate, rhythm, amplitude, contour |
|
|
Term
| What is an abnormal orthostatic bp change? |
|
Definition
| >3-5 minutes after standing up: >20/10 increase sustained and pulse not quickly returning to normal. |
|
|
Term
| How do you describe a lesion? |
|
Definition
| Type, color, shape, arrangement, distribution. |
|
|
Term
|
Definition
| Flat lesion that differs in color compared to surrounding skin <1cm. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Elevated superficial lesion 1cm or larger. |
|
|
Term
|
Definition
| Elevated superficial lesion <1cm |
|
|
Term
| What is Cheyne-Stokes breathing? |
|
Definition
| Periods of deep breathing alternates with periods of apnia. |
|
|
Term
| What is obstructive breathing? |
|
Definition
| Expiration is prolonged. Caused by asthma, chronic bronchitis, COPD. |
|
|
Term
| What is Kussmaul breathing? |
|
Definition
| Deep breathing of any rate that indicates metabolic acidosis. |
|
|
Term
|
Definition
| A raised, pus filled lesion. |
|
|
Term
|
Definition
| A raised fluid filled lesion <1cm. Ex. Herpes simplex and herpes zoster. |
|
|
Term
|
Definition
| A marble-like lesion larger than .5cm, often deeper and firmer than a papule. Ex. dermatofibroma. |
|
|
Term
|
Definition
| Nodule filled with expressible material either liquid or semi-solid. |
|
|
Term
|
Definition
| Irregular, relatively transient, superficial area of localized skin edema. Ex. urticaria. |
|
|
Term
|
Definition
| Filled with serous fluid 1cm or larger. |
|
|
Term
|
Definition
| A minute, slightly raised tunnel in the epidermis caused by scabies. |
|
|
Term
| Smallpox would cause lesions that would be described how? |
|
Definition
|
|
Term
|
Definition
| Loss of epidermis and dermis. |
|
|
Term
| What are three vascular lesions? |
|
Definition
| Cherry angioma, spider angioma, and spider veins. |
|
|
Term
| Which vascular lesion is accompanied by puslatility? |
|
Definition
|
|
Term
| What are two purpuric lesions? |
|
Definition
| Petechia/purpura, ecchymosis |
|
|
Term
| Actinic keratosis may develop into what? |
|
Definition
|
|
Term
| Describe actinic keratosis |
|
Definition
| Superficial, flattened papules covered by a dry scale. |
|
|
Term
| Describe seborrheic keratosis |
|
Definition
| Benign, yellowish to brown raised lesions that feel slightly greasy; look stuck on. |
|
|
Term
| What is the difference b/t squamous cell and basal cell carcinomas? |
|
Definition
| Squamous cell carcinomas usually look red, while basal cell carcinomas usually look pearly. Also, basal cell carcinomas usually have a firm raised border. |
|
|
Term
| What are the ABCDs of melanomas? |
|
Definition
| Assymetry, irregular Borders, variation in Color, and Diameter >6mm. |
|
|
Term
|
Definition
| Enlargement of the free edge of the nail. |
|
|
Term
|
Definition
| Nail plate turns white in cirrhosis, congestive heart failure, and DM. |
|
|
Term
| What indicates primary herpes varicella? |
|
Definition
| Pruritic vesicles and pustules in various stages. |
|
|
Term
|
Definition
| Variola; lesions are all in the same stage |
|
|
Term
| What does coxackie virus cause? |
|
Definition
| Hand, foot, and mouth disease in children. Lesions will be seen on palms of hands, souls of feet and on the mouth. |
|
|
Term
| What indicates rubeola/measles? |
|
Definition
| Red macules/papules that start on the upper portion of head->moves downward over 2-3 days->disappears in this order over 7 days. Kopliks spots on day 2. |
|
|
Term
| Give several examples of fungal infections. |
|
Definition
| Tinea pedis, tinea corpus, tinea cruris, and tinea capitus. "pruritic scaling." |
|
|
Term
|
Definition
| Caused by S. pyogenes. Inflammatory infection with sharply defined borders. |
|
|
Term
| Erythema migrans indicates what disease. |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Alopecia in localized round or oval areas. |
|
|
Term
| What is the motor and sensory components for CN VII? |
|
Definition
| M: facial expressions; S: sense of taste |
|
|
Term
| How do you inspect the interior of the ear? |
|
Definition
| Grasp pinna and gently pull back, up, and out from head; then direct otoscope down and forward. |
|
|
Term
| With the weber test, describe what the results will be with different types of hearing loss. |
|
Definition
| Conductive: lateralizes to bad ear; sensorineural- lateralizes to good ear. |
|
|
Term
| What special tests can you do for the sinus exam? |
|
Definition
| Transillumination and positional changes. |
|
|
Term
| What special tests do you do when doing the oral exam? What CNs are they testing? |
|
Definition
| Say "ah" with mouth open. Tests CN IX and X while looking for symmetrical elevation of soft palate and uvula. Ask patient to stick out tongue. Testing XII. |
|
|
Term
| What can indicate a retracted drum? |
|
Definition
| An unusually prominent short process and a prominent handle that looks more horizontal. |
|
|
Term
| How can you tell the difference b/t viral and allergic rhinitis? |
|
Definition
| Viral- mucosa is red and swollen. Allergic- mucosa is pale and bluish. |
|
|
Term
| What happens in CN X paralysis? |
|
Definition
| The soft palate fails to rise and the uvula deviates away from the affected side. |
|
|
Term
| Diffuse lymphadenopathy raises the suspicion of what disease? |
|
Definition
|
|
Term
| What are some causes for macrocephaly? |
|
Definition
| Acromegaly, rickets, hydrocephaly, Paget's Dz (osteitis deformans), pituitary disturbances. |
|
|
Term
| What is a disease that causes thickening and hypertrophy of long bones, deformity of short bones, and enlargement of skull bones so that the face looks triangular? |
|
Definition
| Paget's dz/osteitis deformans |
|
|
Term
|
Definition
| The cranial vault is small relative to the facial skeleton. It is secondary to hypoplasia of the cerebral cortex. NOT a abnormality of the skull itself. |
|
|
Term
| What are some genetic and environmental causes for microcephaly? |
|
Definition
| G: primary, down's syndrome, trisomy 18. E: intra-uterine infections, drugs taken during pregnancy, prenatal radiation exposure, birth asphyxia. |
|
|
Term
| What are two conditions which involve epicanthal folds? |
|
Definition
|
|
Term
|
Definition
| Caused by excess adrenal hormone production. Moon face, buffalo hump, flushed cheeks, hirsuitism. |
|
|
Term
|
Definition
| also mastoid ecchymosis, is an indication of fracture of the base of the posterior portion of the skull, and may suggest underlying brain trauma |
|
|
Term
|
Definition
| Uric acid deposits on the helix of the ear; occurs in pts with gout. |
|
|
Term
| What will a TM look like with otitis media? |
|
Definition
|
|
Term
| A fluid line may be seen in what kind of ear infection/ |
|
Definition
|
|
Term
| What are common causes of chronic suppurative OM? |
|
Definition
| Pseudomonas, proteus, and coliforms. |
|
|
Term
| What is a condition in the ear that can often be confused with perforation of the TM? |
|
Definition
| Adhesive/atrophic OM. *blocks middle ear space. |
|
|
Term
| Describe keratosis obturans. |
|
Definition
| Stony plug of white keratin; commonly occurs with chronic sinusitis. |
|
|
Term
|
Definition
| Non-cancerous overgrowths that can obscure the TM. Non-tender, produces swelling. |
|
|
Term
|
Definition
| Fungal pathogen. Tiny mycelia. May occur after use of antibiotic ear drops. |
|
|
Term
| What can chalky white deposits on the TM indicate? |
|
Definition
| Tympanosclerosis; hx of chronic ear infections |
|
|
Term
| Tympanosclerosis involving the ossicles can produce what? |
|
Definition
|
|
Term
|
Definition
| Fissuring of angles of mouth. |
|
|
Term
| Describe acute moniliasis. |
|
Definition
| Oral thrush; caused by candida albicans. Common in children after antibiotic use or inhaled steroids. Scrapes off leaving erythematous base. |
|
|
Term
|
Definition
| Enlarged ectopic sebaceous glands in the mucosa of the mouth; asymptomatic; benign. |
|
|
Term
| What is a type of polyp caused by denture irritation? |
|
Definition
|
|
Term
|
Definition
| Inflammation of the tongue with loss of surface texture. Could be caused by niacin or B6 deficits. May have tongue pain or burning. |
|
|
Term
| When does hairy tongue usually present? |
|
Definition
|
|
Term
|
Definition
| Swelling of the parotid and submandibular glands. |
|
|
Term
| What does genuine vertigo present with? |
|
Definition
| Nystagmus and gait instability. |
|
|
Term
| Describe visual acuity notation. |
|
Definition
| The first number indicates the distance from the chart. The second indicates the distance at which a normal eye can read letters that size. |
|
|
Term
| What occurs during the accommodation reflex? |
|
Definition
| 1) Lens rounds up 2) Pupillary constriction 3) Convergence |
|
|
Term
| When do you watch for lid lag? |
|
Definition
| On the downward vertical. |
|
|
Term
| When do you watch for nystagmus? |
|
Definition
|
|
Term
| What are you testing for during the cover/uncover test? |
|
Definition
|
|
Term
| What are you looking for when you're looking at the fundus of the eye? |
|
Definition
| Retina: color, lesions, vessels, optic cup and disk, macula and fovea. |
|
|
Term
| What are the differences b/t the arteries and veins in the eye? |
|
Definition
| Arteries are small, brighter, have a light reflex. AV ratio should be 2:3 or 4:5 |
|
|
Term
| Describe what a healthy cup and disk should look like. |
|
Definition
| Disk margins should be smooth and even; the cup should be no more than half the diameter of the disk. |
|
|
Term
|
Definition
| Decreased far vision (near-sighted); eyeball too long. |
|
|
Term
|
Definition
| Decreased near vision; far-sighted. |
|
|
Term
|
Definition
| Decreased near vision b/c of decreased accommodation. |
|
|
Term
| What can cause blephoptosis? |
|
Definition
| Congenital condition, Bell's palsey, myasthenia gravis, OM nerve damage. |
|
|
Term
| What is horner's syndrome? |
|
Definition
| Sympathetic denervation; moderate ptosis; miosis. |
|
|
Term
| What can cause exophthalmos? |
|
Definition
| Graves disease/hyperthyroidism, inflammation or tumor behind the orbit. |
|
|
Term
|
Definition
| Yellow plaques at the medial borders b/c of a lipid disorder such as hypercholesterolemia. |
|
|
Term
|
Definition
| Painless granuloma of the meibomen gland. |
|
|
Term
|
Definition
| Stye- inflammation of the glands or ducts. |
|
|
Term
|
Definition
| Inflammation of the lacrimal gland. |
|
|
Term
|
Definition
| Winglike fold of membrane which extends from the conjunctiva to the cornea. |
|
|
Term
|
Definition
| Yellow sclera, as in jaundice or liver disease. |
|
|
Term
| What symptoms indicate glaucoma? |
|
Definition
| Erythema/pain, decreased vision, fixed dilated pupil, corneal clouding. |
|
|
Term
| Opiates can cause what eye condition? |
|
Definition
| Miosis (unchallenged smallness) |
|
|
Term
| Sympathetic stimulants, antihistamines, and CO poisoning cause what eye condition? |
|
Definition
| Mydriasis (unchallenged pupillary dilation) |
|
|
Term
| What is the difference b/t proliferative and non-proliferative diabetic retinopathy? |
|
Definition
| Proliferative has more superior vessels at the disk margin. |
|
|
Term
| Describe both types of diabetic retinopathies. |
|
Definition
Non- dilated retinal veins, exudate, hemorrhages.
Pro-hemorrhages, more vessels at superior margin of the disk. |
|
|
Term
| Describe end-stage diabetic retinopathy. |
|
Definition
| Abnormal fibrous tissue, abnormal vessels, hemorrhaging. |
|
|
Term
| Describe hypertensive retinopathy. |
|
Definition
| Will have flam hemorrhage and exudate. |
|
|
Term
|
Definition
| Colloid bodies; may be associated with macular degeneration. White specks. |
|
|
Term
| What happens in advanced retinitis pigmentosa? |
|
Definition
| Attenuated blood vessels and lost pigmentation. |
|
|
Term
| Describe central retinal vein occlusion. |
|
Definition
| Dilated torturous veins with hemorrhaging. |
|
|
Term
| What will happen in optic atrophy? |
|
Definition
| The retina becomes pale white, the arteries become attenuated, the veins are normal. |
|
|
Term
| What condition causes blurred disk margins AND dilated vessels on the disk. |
|
Definition
|
|
Term
|
Definition
| Increased intracranial pressure. |
|
|
Term
| What extra heart sounds do you listen for? |
|
Definition
| S3, S4, OS, Ej, and murmurs. |
|
|
Term
|
Definition
| IJV anatomically continuous w/ RA; therefore an indirect measurement of RA pressure. |
|
|
Term
| What is the contour of an arterial pulse determined by? |
|
Definition
| The structure of the opening through which blood flows. |
|
|
Term
| What are two NONOs when palpating the carotid arteries? |
|
Definition
| Don't palpate them together and never palpate near the thyroid cartilage area. |
|
|
Term
| Which part of your stethescope do you listen for carotid bruits? |
|
Definition
|
|
Term
| Regarding the apical impulse, what is abnormal? |
|
Definition
| A diffuse impulse, or a discrete impulse shifted laterally. |
|
|
Term
| Murmur accompanied by a thrill wil increase grade of murmur to what level? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is an ejection sound made by? |
|
Definition
| During systole, blood rushing out of the heart. |
|
|
Term
|
Definition
| Rapid deceleration of blood entering the ventricle b/c of decreased ventricular compliance. |
|
|
Term
|
Definition
| Atrial contraction in patients with decreased ventricular compliance. Late diastole. |
|
|
Term
| What do you use the diaphragm to listen for in the cardiac exam? |
|
Definition
| S1, S2, regurgitation murmurs, friction rubs, midsystolic clicks, opening snaps, ejection sounds. |
|
|
Term
| What sounds do you listen for with the bell in the cardiac exam? |
|
Definition
|
|
Term
| What are the 8 characteristics of murmurs that you will want to document? |
|
Definition
| Timing, shape, location of max intensity, intensity, radiation, pitch, quality, +/- thrill |
|
|
Term
| What are different types of shapes of murmurs? |
|
Definition
| Crescendo, decrescendo, crescendo-decrescendo, plateau |
|
|
Term
| Describe radiation as it pertains to murmurs. |
|
Definition
| The sound usually radiates in the direction of blood flow. |
|
|
Term
| What are different qualities of murmurs? |
|
Definition
|
|
Term
| What does the vasalva maneuver help do during a cardiac exam? |
|
Definition
| Increases intensity of mitral valve prolapse and hypertrophic cardiomyopathy; decreases intensity of aortic stenosis. |
|
|
Term
| What does squatting and standing help accomplish during a cardiac exam? |
|
Definition
| Increases intensity of aortic stenosis, decreases intensity of outflow obstruction in hypertrophic cardiomyopathy. |
|
|
Term
| What are the arteries you are feeling for in the lower extremities? |
|
Definition
| Femoral artery, popliteal artery, dorsalis pedis a., and posterior tibial a. |
|
|
Term
| What can cause claudication? |
|
Definition
| Arterial spasm, atherosclerosis, arteriosclerosis, and/or occlusion. |
|
|
Term
| What occurs with venous stasis? |
|
Definition
| The skin becomes hyperpigmented and thickens. |
|
|
Term
| What occurs with artery problems in the extremities? |
|
Definition
| Skin becomes pale/blue, thin. |
|
|
Term
| What is the Homan's sign? What is it for? |
|
Definition
| DVT. Flex the patient's knee slightly with one hand and with the other, dorsiflex the foot forcefully. Not absolutely reliable. |
|
|
Term
| What transports then stores milk in the breast? |
|
Definition
| Ducts (12-20)-->lactiferous sinuses |
|
|
Term
| What are the supporting ligaments in the breast? |
|
Definition
|
|
Term
| What are several ways to describe a breast mass consistency. |
|
Definition
| Firm, spongy, cystic, hard, soft. |
|
|
Term
| What are some characteristics of benign breast disease? |
|
Definition
| Fibrocystic- tender, lumpy before period, palpable, moveable. |
|
|
Term
| Electrical vectors approaching an EKG lead cause what kind of deflection? |
|
Definition
| Positive or upward deflection |
|
|
Term
| Electrical vectors moving away from an EKG lead cause what kind of deflection? |
|
Definition
| Negative or downward deflection |
|
|
Term
| The P wave represents what on an EKG recording? |
|
Definition
|
|
Term
| The Q wave represents what on an EKG recording? |
|
Definition
| A downward deflection from septal depolarization. |
|
|
Term
| What does the R wave represent in an EKG recording? |
|
Definition
| Ventricular depolarization |
|
|
Term
| What does the T wave represent on an EKG recording? |
|
Definition
| Ventricular repolarization |
|
|
Term
| What effect does first degree heart block have on the sound of S1? |
|
Definition
|
|
Term
| What effect does aortic stenosis have on the sound of S2? |
|
Definition
|
|
Term
| What does a palpable S2 suggest? |
|
Definition
|
|
Term
| What does a midsystolic murmur usually indicate? |
|
Definition
| Turbulent blood flow across the semilunar valves. |
|
|
Term
| What does a pansystolic murmur indicate? |
|
Definition
| Regurgitant blood flow across the AV valves. |
|
|
Term
| What does a late systolic murmur usually indicate? |
|
Definition
|
|
Term
| Which murmur is usually, but not always, preceded by a systolic click? |
|
Definition
|
|
Term
| What does an early diastolic murmur usually indicate? |
|
Definition
| Regurgitant blood flow across incompetent semilunar valves. |
|
|
Term
| What do middiastolic and presystolic murmurs usually indicate? |
|
Definition
| Turbulent blood flow across the AV valves. |
|
|
Term
| Describe an early ejection sound. |
|
Definition
| Occurs shortly after S1; relatively high in pitch, and have a sharp, clicking quality. Heard better with the diaphragm. |
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Term
| Is mitral valve prolapse crescendo or decrescendo? |
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Definition
| Crescendo during last systole. |
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Term
| Squatting has what affect on mitral valve regurgitation? |
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Definition
|
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Term
| Standing has what effect on mitral valve prolapse? |
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Definition
|
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Term
| An opening snap is heard when in the cardiac cycle? |
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Definition
| Early diastole concurrent with the opening of the mitral valve. |
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Term
| Would S3 be heard before or after an opening snap? |
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Definition
| After- during early diastole |
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Term
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Definition
|
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Term
| When does S4 occur in the cardiac cycle and what does it mean? |
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Definition
| It occurs dust before S1. It is due to increased resistance to ventricular filling following atrial contraction. |
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Term
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Definition
|
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Term
| What is a major difference b/t mitral and tricuspid regurgitation. |
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Definition
| Mitral regurgitation does not become louder on inspiration. Also, the locations of maximal intensity are different. M: apex; T: lower left sternal border. |
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Term
| What occurs with a ventricular septal defect? |
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Definition
| Congenital abnormality in which blood flows from the high-pressure left ventricle to the lower-pressure right ventricle. Causes a harsh pan-sytolic murmur. |
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Term
| What are the most common types of heart murmurs? |
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Definition
| Midsystolic ejection murmurs. |
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Term
| Describe a midsystolic ejection murmur. |
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Definition
| Crescendo-decrescendo. Ends before S2. Probably caused by turbulent blood flow generated by ventricular ejection of blood into the aorta. Can be innocent, physiological, or pathological. |
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Term
| Describe the murmur created by aortic stenosis. |
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Definition
| Crescendo-decrescendo during all of systole. There could be a single S2 on expiration or a paradoxical split. |
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Term
| What is a major difference between aortic stenosis and hypertrophic cardiomyopathy murmurs? |
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Definition
| With hypertrophic cardiomyopathy, the carotid pulse rises quickly. |
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Term
| Describe hypertrophic cardiomyopathy murmurs. |
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Definition
| Crescendo-decrescendo near the 3rd and 4th left interspaces. Increases with the valsalva maneuver. |
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Term
| Describe pulmonic stenosis murmurs. |
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Definition
| Heard over the second and third left interspaces; crescendo-decrescendo; S2 can be widely split; can early ejection sound may be heard; |
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Term
| Describe the murmur created by aortic regurgitation. |
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Definition
| Decrescendo; early diastole; heard best with pt leaning forward and holding breath after exhalation; an ejection sound may be present; pulse pressure increases->pulses are often large and bounding. |
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Term
| Describe the murmur created by mitral stenosis. |
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Definition
| Usually limited to the apex; described as a decrescendo low-pitched rumble; heard better during exhalation; an opening snap often precedes the late-diastolic murmur; |
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Term
| Where on the chest marks the division of the trachea into the left and right bronchi? |
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Definition
|
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Term
| What vertebra marks the division of the trachea into the left and right bronchi? |
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Definition
|
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Term
| What is the main difference between resonance and tympany? |
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Definition
| Both are relatively loud, but tympany has a high pitch while resonance is a low pitch sound. |
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Term
| Describe vesicular breath sounds. |
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Definition
| Inspiratory longer than expiratory; intensity and pitch of expiratory sounds are soft and low and occurs over most of the lungs. |
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Term
| Describe broncho-vesicular breath sounds. |
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Definition
| Inspiratory=expiratory sounds. Intensity and pitch are both intermediate. Heard best in the 1st and second interspaces anteriorly and b/t the scapulae. |
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Term
| Describe bronchial breath sounds. |
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Definition
| Expiratory>inspiratory. Intensity and pitch are loud and relatively high. Heard best over the manubrium. |
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Term
| Describe tracheal breath sounds. |
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Definition
| Inspiratory=expiratory. Intensity and pitch loud and relatively high. Best over trachea. |
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Term
| If bronchovesicular or bronchial breath sounds are heard in unusual locations, what should you suspect? |
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Definition
| That air-filled lungs have been replaced by fluid-filled or solid lung tissue. |
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Term
| What does a respiratory gap suggest? |
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Definition
|
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Term
| What is the main difference b/t wheezes and rhonchi? |
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Definition
| Wheezes are relatively high pitched, while rhonchi are low pitched with a snoring quality. |
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Term
|
Definition
| Abnormalities of the lungs: pneumonia, fibrosis, early congestive heart failure. Abnormalities of the airways: bronchitis, bronchiectasis. |
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Term
|
Definition
| Narrowed airways as in asthma, COPD, or bronchitis. |
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Term
| Clearing of crackles, wheezes, or rhonchi after coughing suggests what? |
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Definition
| Inspissated secretions as in bronchitis or atelectasis. |
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Term
| What is pectus excavitum? |
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Definition
| Funnel chest- depression in the lower portion of the sternum. |
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Term
| What is pectus carinatum? |
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Definition
| Pigeon chest- the sternum is displaced anteriorly, increasing the anteroposterior diameter. The costal cartilages adjacent to the protruding sternum are depressed. |
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Term
|
Definition
| It is caused by trauma; multiple rib fractures may result in paradoxical movements of the thorax. On inspiration, the injured area caves inward. On expiration, it moves outward. |
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Term
|
Definition
| Inflamed and roughened pleural surfaces grate against each other as they are momentarily and repeatedly delayed by increased friction. |
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Term
| What is mediastinal crunch? |
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Definition
| Hamman's sign- series of precordial crackles synchronous with the heart beat, not with respiration. Due to mediastinal emphysema. |
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Term
|
Definition
| Occurs when a plug in a mainstem bronchus obstructs airflow, affected lung tissue collapses in an airless state. Dull percussion note; causes the trachea to be displaced towards the involved side; no adventitious sounds; no breath sounds; tactile fremitus and transmitted voice sounds absent. |
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Term
| What kind of breath sound is produced with lung consolidation? |
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Definition
|
|
Term
| Unilateral headaches usually occur with what general types of headaches? |
|
Definition
| Migraine and cluster headaches |
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Term
| Optic neuritis occurs primarily with what disease? |
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Definition
|
|
Term
| Noisy environments can enhance what kind of hearing loss? |
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Definition
|
|
Term
| What three symptoms indicate Meniere's disease? |
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Definition
| Hearing loss, vertigo, and tinnitis |
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Term
| Describe what a vision of 20/200 means. |
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Definition
| At 20 the patient can read something that a person with normal vision can read at 200 ft. |
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Term
| What causes a crescent shadow? |
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Definition
| When the iris bows abnormally far forward forming a narrow angle with the cornea. |
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Term
|
Definition
| Pupillary inequality of <.5mm |
|
|
Term
| What is ataxic breathing? |
|
Definition
| An abnormal pattern of breathing characterized by complete irregularity of breathing, with irregular pauses and increasing periods of apnea. |
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Term
| Testing the near rxn is helpful in diagnosing what two pupillary impairments? |
|
Definition
| Argyll Robertson and tonic (Adie's) pupils |
|
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Term
|
Definition
| Swelling of the optic disc and anterior bulging of the physiologic cup. |
|
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Term
|
Definition
| Where the TM meets the tip of the malleus. |
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Term
| What and where are Wharton's ducts? |
|
Definition
| Ducts of the submandibular salivary glands; on either side of the lingual frenulum. |
|
|
Term
| What and where are Stenson's ducts? |
|
Definition
| Ducts of the parotid salivary glands; they open onto the buccal mucosa near the upper second molar. |
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Term
|
Definition
| Pupil is large, regular, and usually unilateral. Rxn to light is reduced and slowed or absent. Near rxn is slow but present. |
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|
Term
| What is Argyll Robertson pupil? |
|
Definition
| Small, irregular pupils that accomodate but do not react to light. Seen in CNS syphilis. |
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Term
|
Definition
| A thin grayish white arc or circle not quite to the edge of the cornea. |
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Term
| Increased dilatation of conjunctival blood vessels that is primarily peripheral is common in what condition? |
|
Definition
| Bacterial, viral, allergic, irritation conjunctivitis |
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Term
| Describe corneal injury or infection. |
|
Definition
| Ciliary injection, moderat to severe superficial pain, decreased vision, watery or purulent discharge, unaffected pupil. Can be caused by abrasions or viral and bacterial infections. |
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Term
|
Definition
| Ciliary injection; moderate, aching, deep pain; decreased vision, no discharge, small pupil, slightly clouded cornea, associated with many ocular and systemic disorders. |
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Term
|
Definition
| Ciliary injection; severe, aching, deep pain; decreased vision; no discharge; dilated, fixed pupil; clouded lens; caused by an acute increase in intraocular pressure. |
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Term
| Hemangioma and vitiligo are examples of what kind of skin lesion? |
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Definition
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|
Term
| Cafe-au-lait spots are what kind of example of skin lesions? |
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Definition
|
|
Term
| Psoriasis is an example of what kind of skin lesion? |
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Definition
|
|
Term
| Dermatofibroma is an example of what kind of skin lesion? |
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Definition
|
|
Term
| Herpes simplex and herpes zoster are examples of what kind of skin lesion. |
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Definition
|
|
Term
| Ichthyosis vulgaris is an example of what kind of skin lesion? |
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Definition
|
|
Term
| Neurodermatitis is an example of what kind of skin lesion? |
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Definition
|
|
Term
| Which type of vascular lesion can accompany varicose veins? |
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Definition
|
|
Term
| Which type of vascular lesions are almost never below the waist? |
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Definition
|
|
Term
| What is another word for a bruise? |
|
Definition
|
|
Term
| What are petechia/purpura? |
|
Definition
| Deep red to reddish purple; blood outside the vessel; may suggest a bleeding disorder; if petechiae, emboli to skin. Petechia is 1-3 mm, purpura is larger than 3 mm. |
|
|
Term
|
Definition
| Superficial infection of the proximal and lateral nail folds adjacent to the nail plate. |
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Term
|
Definition
| Painless separation of the whitened opaque nail plate from the pinker translucent nail bed. Causes can include trauma, psoriasis, fungal infection, and nail cosmetics. |
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Term
|
Definition
| White spots that grow slowly out with the nail; commonly caused by trauma. |
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|
Term
| Curving transverse white bands that move distally as the nail grows out; occurs with arsenic poisoning, heart failure, hodgkin's disease, carbon monoxide poisoning, and leprosy. |
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Definition
|
|
Term
|
Definition
| Transverse depressions of the nail plates bilaterally; caused by systemic illness. |
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|
Term
| What effect would intracranial pressure have on respiration? |
|
Definition
|
|
Term
| Prolonged expiration occurs with what kind of breathing? |
|
Definition
| Obstructive; with COPD, asthma, and chronic bronchitis. |
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