Health Assement Exam 2

Front 1

What are Physical examination techniques?

Back 1

Inspection, palpation, auscultation and percussion

Front 2

When does the inspection start?

Back 2

Begins when you first meet the patient and continues throughout the health history and physical exam

Front 3

What can palpation help acess?

Back 3

Assess: texture, temperature, moisture, organ location and size as well as any swelling, vibration or pulsation, rigidity or spasticity, crepitation, presence of lumps or masses, and presence of tenderness or pain.

Front 4

What are some palpation techniques?

Back 4

Fingertips
Grasping action of fingers and thumb
Base of fingers
Dorsa of hands and fingers

Front 5

Is an otoscope used to exam eyes?

Back 5

No, an opthalmuscope is used for eyes, an otoscope is used for eyes.

Front 6

Can an infant be held aggainst parents chest for some techniuqes?

Back 6

May also be held against parents chest for some steps

Front 7

When is baby aware of surroundings?

Back 7

By 9-12 mos. infant is acutely aware of surroundings, so parents must be in few view.

Front 8

What are some things to remember when examining an infant?

Back 8

Should be 1-2 hours after feeding
Warm environment
Leave on diaper
Warm hands and stethoscope
Use a soft, crooning voice

Front 9

What should you know whe introducing yourself to a toddler and parent?

Back 9

Greet the child and parent by name. It is essential to focus first on the parents; this allows the child to adjust to you.

Front 10

What are some things to know when examining an adolecent?

Back 10

Adolescent:
Position on table alone
Preparation: Do not talk down to them or too advanced to them either
Ripe for learning as positive attitudes are long lasting Promote health teaching!!
Apprise them of the wide variety of growth at that age
Sequence: head to toe

Front 11

What are some things to know when examining an older adult/aging adult?

Back 11

Aging Adult:
Position on exam table; a frail adult may need to be supine
Arrange the sequence to allow as few position changes as possible
Allow for rest periods
Go at a slow pace
Sequence : Head to toe
Remember: aging years contain more stress; loss, illness, financial loss etc.

Front 12

General survey: what are the four major areas that we get are objective information from during the general survey?

Back 12

Phys. apperance, body structure, mobility, and behavior.

Front 13

General survey: What do we gather from there phys. apperance?

Back 13

Looks his age, sexual development, skin color(pigmentation, lessions, tone), facial features, LOC

Front 14

General survey: What do we obtain from Body structure?

Back 14

Appropriate height, nutrition, symmetry of body parts.

Front 15

General survey: What info do we obtain about mobility?

Back 15

Gait(walk), ROM

Front 16

General survey: What info do we obtain from the clients behavior?

Back 16

Facial expression, mood, hygiene, speech.

Front 17

What are the normal values for vital signs?

Back 17

Temp- 106-96
HR- 100-60 bpm
Resperations- 16-20
Bp- 100-119/6-79

Front 18

Techniques: What are the four types of assessment techniques?

Back 18

Inspection, percussion, palpation, and auscultation.

Front 19

Techniques: What senses do we use when inspecting?

Back 19

Smell, hearing, and vision.

Front 20

Techniques: When does the inspection begin?

Back 20

when we meet the patient

Front 21

Techniques: What do we take in to account when we are inspecting someone/ something?

Back 21

Color, size, location, texture, odor, symmetry, and sound

Front 22

Techniques:What are the two major types of palpation?

Back 22

Light and Deep(size & shape)

Front 23

Techniques:What are the degrees of palpation?

Back 23

Finger tips, grasping with fingers and thumb, base of fingertips, grasping with hand.

Front 24

Techniques:What is being accessed during palpation?

Back 24

Temp, moist, texture, size,/swelling, organ location, masses, lumps, lessions, tendernous, vibration, pulsation, regidity, spacity, and crepitation.

Front 25

Techniques: what does percussion acess?

Back 25

organ borders and density

Front 26

Techniques: what is taken into consideration when percussing?

Back 26

Amplitude, pitch, quality, and durration

Front 27

How old is it when a bay is aware of his surroundings and how long after feeding should the exam be done?

Back 27

By 9-12 mos. infant is acutely aware of surroundings, so parents must be in few view.
Should be 1-2 hours after feeding

Front 28

PE: What do we do when an infant is asleep?

Back 28

Sequence: Seize the moment when infant is asleep to listen to heart, lungs and abdomen

Front 29

PE: When examining a preschooler what do we examine first?

Back 29

Examine thorax, abdomen extremities and genitals first and the head, eyes, ears last.

Front 30

What age group is most private?

Back 30

School age: Remember that they have a sense of modesty and privacy

Front 31

PE: for the aging adult what steps should what sequence should we do our exam in?

Back 31

Arrange the sequence to allow as few position changes as possible

Front 32

PE: what does color change in the skin give us clues of?

Back 32

Pallor- Whitening due to loss of Hgb.
Ashen gray - anemia, shock, arterial insufficiency
Erythema - Intense redness: seen with fever, local inflammation or emotional reaction, carbon monoxide poisoning, venous statis
Cyanosis- bluish color : hypoxemia, heart failure, shock, CHD
Jaundice- yellowing: elevated bilirubin; hepatitis, cirrhosis, sickle cell disease

Front 33

What is one reason someone could have very bad turgor?

Back 33

Because of dehydration

Front 34

Describe senile lentigines?

Back 34

Senile Lentigines: aka liver spots- small , flat and brown macules; not malignant.

Front 35

What are reasons for pallor, cyanosis, erythema, jaundice, and brown tan?

Back 35

Pallor =Decreased Hgb
Cyanosis = Poor oxygenation
Erythema = increased RBC’s with inflammation
Jaundice = Liver disease, hemolytic disease, severe burns, infection
Brown Tan = Addison's: Cortical Deficiency stimulates increased Melanin.

Front 36

Skin hair and nails: What are diabetics more at risk for with there skin?

Back 36

These include bacterial infections, fungal infections, and itching

Front 37

Where are the Preauricular nodes found?

Back 37

Preauricular: front of ear

Front 38

Where are the Posterior auricular nodes found?

Back 38

superficial to the mastoid process

Front 39

Where the occipital nodes found?

Back 39

Base of skull

Front 40

Where are the submental nodes found?

Back 40

Midline, behind the tip of the mandible

Front 41

Where are the Jugulodigastric nodes found?

Back 41

under the angle of the mandible

Front 42

PE: how often should we measure the head an chest of an infant, and when do the fontenels close?

Back 42

Developmental Consideration Infants and Children: fontanels aka “soft spots” during first year, anterior closes in 9 mos.-2 years and posterior closes in 1-2 mos.
Head size > at birth than chest (Please measure me with each visit until the terrible 2’s !!!!!!!!!!)

Front 43

How do we test the motor and sensory function of Craniel nerve 5?

Back 43

We take a cutip and press the hard and sharp sides to the persons face and see if they can distinguish between the two for sensory, for motor we press there TMJ and feel then tension in their jaw muscles as they flex.

Front 44

How do we test cranial nerve VII?

Back 44

We have them go through a bunch of facial expressions including puffing there cheeks as we press them.

Front 45

How do we test craniel nerves IX an X (9and10)?

Back 45

We have the patient say cah, cah, cah and we have them open there mouth and say ahhh as we watch there soft upper palet raise.

Front 46

What is pruritis?

Back 46

itching

Front 47

What is vertigo?

Back 47

feels like its Spinning

Front 48

What is Xerosis?

Back 48

Xerosis refers to abnormally dry skin or membranes

Front 49

What is tinnitus

Back 49

ringing, roaring, clicking or hissing sound in your ears

Front 50

What is Nystagmus?

Back 50

Nystagmus is a vision condition in which the eyes make repetitive, uncontrolled movements, often resulting in reduced vision

Front 51

What is Epistaxis?

Back 51

Bleeding from the nose; Epistaxis

Front 52

what is syncope

Back 52

fainting

Front 53

What is ecchymosis

Back 53

Bruises

Front 54

what is erythema

Back 54

erythema toxinoma, is that rash that appears on newborns it is idopathic. It looks like little red dots all over a persons body.

Front 55

what is diplopia

Back 55

double visoun

Front 56

What is dysphagia

Back 56

If you have a swallowing disorder, you may have difficulty swallowing and may also have pain while swallowing.

Front 57

What is hematoma

Back 57

A bruise is a mark on your skin caused by blood trapped under the surface

Front 58

presbycusis

Back 58

Hearing disorders make it hard, but not impossible, to hear.

Front 59

lacrimation

Back 59

crying

Front 60

How do we test craniel nerves 3 4 and 6. (III,IV,VI)

Back 60

Check if both eyes are symetrical, shine a light in each eye to see if they constrict, and concencual reaction. test there perhipfreal vision as well.

Front 61

For craniel nerves I and II how do we test them?

Back 61

First we test there smelling with familer substances, then we check the borders of there periphrel vision by wiggling our fingers into the line of sight.

Front 62

Can you feel an infants lymphnodes?

Back 62

Infants lyph nodes are not palpable

Front 63

What is one way of testing CN IX and X?

Back 63

by depressing the tongue to see the pharyngeal wall you may elicit a gag reflex which tests cranial nerve IX glossopharyngeal and CN X vagus.

Front 64

How do we test babies for there eye sight?

Back 64

Developmental Considerations: Neonates should blink with bright lights and pupils should constrict in response to light
By 2-4 weeks infant should fixate on an object
By 1 month they may be able to track an object
At 3-4 months fixate and reach for objects
Fixate in all directions at 6-10 mos
You may use picture charts at age 2 ½ years

Front 65

What is important to ask about the mothers vagina when discussing infants eyes?

Back 65

Did she have any vaginal infections.

Front 66

What happens to the elderlies eyes and they get older?

Back 66

The Aged: Central acuity decreases at 70
Peripheral vision is diminished
Brow hair may diminish, loss of elasticity
Eyes may be sunken
Tears decrease

Front 67

What is cerumen

Back 67

cerumen is an ear wax build up

Front 68

What does CN III do?

Back 68

eye movement and eyelid movment

Front 69

What does CN IV do?

Back 69

innervates superior oblique
turns eye downward and laterally

Front 70

What does CN V do?

Back 70

chewing
face & mouth touch & pain

Front 71

What does CN VII do?

Back 71

controls most facial expressions
secretion of tears & saliva
taste

Front 72

What does CN VIII do?

Back 72

hearing
equillibrium sensation

Front 73

What does CN IX do?

Back 73

taste
senses carotid blood pressure

Front 74

What does CN X do?

Back 74

senses aortic blood pressure
slows heart rate
stimulates digestive organs
taste

Front 75

What does CN XI?

Back 75

controls trapezius & sternocleidomastoid
controls swallowing movements

Front 76

What does CN XII?

Back 76

controls tongue movements

Front 77

What are some skin marks/ lesions that often appear on the elderly?

Back 77

 Senile Lentigines (liver spots) - small , flat and brown macules; not malignant.
 Keratosis: Raised lesions, thick, crusty, scaly and warty.
 Seborrheic keratosis: dark, greasy and “stuck on”
 Moisture: dry
 Texture; acrochordons or skin tags
 Sebaceous hyperplasia- raised yellow papules on forehead, nose, cheeks
 Thickness: SQ fat diminishes and thin skin is evident over dorsa of hands, feet, legs.

Front 78

What should I know about fontenells?

Back 78

soft spots on head, allow for stretchability
** Anterior close: 18 months, Posterior close: 2 months **
Sunken = bad, Bulging=bad b/c of increased ICP

Front 79

How do we rate tonsels?

Back 79

+1= Visible
+2=Halfway between tonsillar pillars and uvula
+3=Touching uvula
+4=Touching each other

Front 80

What is the The pupillary light reflex

Back 80

(CN II) is the normal constriction of the pupils when bright light shines on the retina. -- When one eye is exposed to a bright light a direct light reflex occurs as well as a consensual reflex.

Front 81

What is accommodation?

Back 81

Adaptation of the eye for near vision. Convergence of the eyeballs and pupillary constriction occur.

Front 82

What is the Corneal Light Reflex (Hirschberg Test):

Back 82

Focus a light 12” in front of pt. The reflection should be in exactly the same spot on each cornea

Front 83

What does the cover uncover test do?

Back 83

A normal response is a steady fixed gaze Use an opaque card and cover one eye slowly

Front 84

What does Diagnostic Positions Test do?

Back 84

Leading the eyes through 6 cardinal positions of gaze will elicit any muscle weakness during movement. Hold a finger 12” from person and move it in 6 different positions

Front 85

What is normal for a babies eye development?

Back 85

By 2-4 weeks infant should fixate on an object
At 3-4 months fixate and reach for objects
By 1 month they may be able to track an object
Fixate in all directions at 6-10 mos

Front 86

what does the Rinne Test do?

Back 86

 Rinne Test: Compares air conduction and bone conduction. Place over mastoid and ask when sound goes away. Quickly invert the fork so that the vibrating end is near the ear canal; the pt should still hear the sound.

Front 87

What is the Corneal Light Reflex (Hirschberg Test):

Back 87

Focus a light 12” in front of pt. The reflection should be in exactly the same spot on each cornea

Front 88

What does the cover uncover test do?

Back 88

A normal response is a steady fixed gaze Use an opaque card and cover one eye slowly

Front 89

What does Diagnostic Positions Test do?

Back 89

Leading the eyes through 6 cardinal positions of gaze will elicit any muscle weakness during movement. Hold a finger 12” from person and move it in 6 different positions

Front 90

What is normal for a babies eye development?

Back 90

o At 3-4 months fixate and reach for objects
o By 2-4 weeks infant should fixate on an object
o By 1 month they may be able to track an object
o Fixate in all directions at 6-10 mos

Front 91

what does the Rinne Test do?

Back 91

 Rinne Test: Compares air conduction and bone conduction. Place over mastoid and ask when sound goes away. Quickly invert the fork so that the vibrating end is near the ear canal; the pt should still hear the sound.