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633 Cards in this Set
- Front
- Back
- 3rd side (hint)
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superior |
above
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inferior
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below
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proximal
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towards the point of origin
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distal
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away from the point of origin
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medial
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onwards; towards the midline
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lateral
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outwards; away from the midline
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anterior
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toward the front
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posterior
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toward the back
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dorsal
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pertaining to the back; also upper side of an appendage (top of hand)
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ventral
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pertaining to the front
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palmar
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pertaining to the Palm or sole
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anasarca
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generalized body edema (swelling)
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cachectic
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physical wasting
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lethargic
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drowsy but patient will open eyes to look at interviewer, respond to questions, then falls asleep
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malaise
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generalized body distress, discomfort, or weakness.
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obtunded
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mentally dulled, patient will open eyes and look at you, but response is slow.
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cushingoid
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resembling signs and symptoms of Cushing's disease.
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obese
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excessively overweight
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toxic appearing
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overwhelming infection of the body (sepsis)
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mood
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a conscious state of mind or predominant emotion
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affect
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the emotional tone a person expresses
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fowlers
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an inclined position obtained by raising the head of the bed about 60 to 90 cm
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positional term
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prone
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lying face down
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positional term
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supine
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lying on the back
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positional term
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trendelenburg
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a position in which the patient is placed head down on a table inclined at about 45 degrees from the flour with the knees uppermost and the legs hanging over the end of the table.
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positional term
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iris
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muscle/colored portion |
eyes
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sclera
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white of the eye
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conjunctiva
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paper thin covering to the exposed portion of the white part of the eye
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cornea
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transparent part of the coat of the eyeball that covers the iris and pupil
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retina
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innermost, light sensitive layer of the eye, containing rods, cones, neurons and blood vessels
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ptosis
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drooping of the eyelid
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visual acuities |
a measure of the resolving power of the eyes, particularly with their ability to distinguish letters and numbers at a distance |
Ex. L eye 20/20; R eye 30/40
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corneal uptake
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abrasions or injury usually determined by staining and examining the eye to note increase uptake of the dye (slit lamp). fluorescein test (solution or strips) |
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corneal reflux |
the closing of the eyelid when the cornea is lightly touched
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hyphema
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hemorrhage in the anterior chamber of the eye
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fundoscopic exam
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examination of the inside of the eye (fundus) with the use of an ophthalmoscope
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fundus
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Inner portion of the eye, contains the optic nerve disc, the veins and the arteries that supply the eye
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scleral icterus
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yellowing of the sclera
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symptoms of jaundice
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stye
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infection/abscess in the follicle of an eyelash
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photophobia
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intolerance to light
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fluorescein exam |
staining of the eye
(+) uptake indicates corneal abrasion |
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what does the physician look for in the tympanic membrane (TM)
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bulging, dullness, redness (erythematosus, injection) perforation, deformities.
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otoscope exam
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cone of light
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normal vs. abnormal light reflex. abnormal may be indicative of an ear infection.
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otoscope exam
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cerumen
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ear wax
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otitis media
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middle ear infection commonly seen in children (LOM, ROM, or BOM). the TM is often bulging and erythematosus with otitis media
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otitis externa
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infection or inflammation of the external auditory canal.
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swimmer's ear
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tragus
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small projection in front of ear canal; pain on movement of tragus is a common finding of otitis externa
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otoscope exam
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tinnitus
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the sensation of a ringing, roaring, or buzzing sound in the ears or head often associated with many forms of hearing impairment and noise exposure.
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Tuning fork test
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procedure in which a vibration source is placed in front of the opening to the ear to test air conduction of sound waves
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nares
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the nostrils
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nasal speculum
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tool used to examine the nares
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septum
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the cartilage and skin that separates the two nares
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deviated septum
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leaning of the septum to one side or the other of the nose; may create blockage of a nare
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epistaxis
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nosebleed
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anterior epistaxis
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most common type of nosebleed
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posterior epistaxis |
less common type of nosebleed, most often regarded as a surgical emergency
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Rhinitis
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inflammation of the nasal lining which can be caused by infection, allergies, foreign body, abnormal nerve input, or other inflammatory agents |
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Rhinorrhea
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discharge from the nose, runny nose
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Turbinate
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Structure inside the nose that humidifies and filters air.
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Buccal mucuosa
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mucous membrane lining the inner cheek
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Dentition intact
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refers to normal arrangement of teeth in the dental arch
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Malocclusion
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the inability to properly close the mouth due to the abnormal contact of the teeth of the upper jaw with the teeth of the lower jaw
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avulsion of tooth
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broken or missing tooth
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Gingiva
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the gum tissues of the mouth
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Caries
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cavities
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Palate
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the roof of the mouth
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hard palate
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front portion, bony
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Soft palate
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muscular, behind the hard palate, lacks bone
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Uvula
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Small structure hanging from the soft palate into the throat; helps close the mouth from the nose during speech
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uvular edema
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swelling of uvula, emergency cases: likely severe allergic reaction
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exam findings for the pharynx
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redness (erythema), exudates (discharge/pus), white patches (thrush), ulcers, lesions
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tonsil
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lymphoid tissue located in the back of the mouth may appear as enlarged (hypertrophic), erythematosus, with exudates if infected
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airway
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the throat and the nose are parts of the upper airway
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patent
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no obstructions, open
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stridor airway
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harsh sound heard on inhalation associated with inflammation or narrowing of the larynx or trachea
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common finding in pediatric cases of croup
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drooling
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patient is unable to swallow saliva, May indicate airway obstruction
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larynx
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voice box
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laryngitis
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a hoarse voice or the complete loss of the voice because of irritation to the vocal cords
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Aphonia
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complete loss of voice due to disease of voice producing structures
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Esophagus
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swallowing tube made of muscle that connects the throat with the stomach
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Croup
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inflammation of the upper respiratory tract characterized by the "barkinf" cough
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Laryngotracheobronchitis
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epiglottitis
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bacterial infection with inflammation of the epiglottis that can result in a life threatening airway obstruction
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salivary glands
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found in and around the mouth and throat. the major salivary are the parotid, submandibular, and sublingual glands.
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apical
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pulse heard by auscultation of the heart by stethoscope
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carotid
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pulse in the neck
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radial
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palpated at the lateral aspect of the wrist
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femoral
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pulse in the inguinal area
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brachial
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palpated in the upper arm near the bicep
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common pulse detected in infants
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popliteal
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palpated behind the knee
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posterior tibial
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palpated on the anterior ankle by the medial malleolus
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dorsalis pedis
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palpated on top of the foot
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tachycardia
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greater than 100bpm in adults
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bradycardia
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less than 60bpm in adults
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normal range of bpm in adults
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600-100bpm
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regular rhythm
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evenly spaced beats, May vary slightly with inspiration
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regularly irregular rhythm
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regular pattern overall with "skipped" beats, (PVC's, PAC's)
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Irregularly irregular rhythm
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chaotic, no real pattern, very difficult to measure rate accurately (atrial fibrillation)
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murmur
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abnormal heart sound, May indicate valve abnormality, graded on scale of 1-6
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abnormal heart sounds
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systolic murmurs
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aortic stenosis, mitral regurgitation, mitral valve prolapse
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abnormal heart sounds
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diastolic murmurs
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aortic regurgitation, mitral stenosis
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continuous murmurs
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cervical venous, patent ductus arteriosus
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abnormal heart sounds
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innocnent murmurs
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heard in children, athletes, and in young adults. Ex: 2/6 systolic ejection murmur
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abnormal heart sounds
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gallop
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abnormal heart sound, a 'third' sound heard in addition to the normal 'lub-dub', common in elderly and CHF patients, May indicate serious heart disease
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abnormal heart sound
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click
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May be caused by prosthetic valve
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abnormal heart sounds
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snaps
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another abnormal valve sound
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abnormal heart sound
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bruit
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turbulent blood flow through vessels, caused by partial obstruction
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Thrill
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Palpated sensation associated with murmurs 4/6, 5/6, 6/6
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abnormal heart sounds
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Aneurysm
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Local widening of an artery caused by weakness in the arterial wall or breakdown of the wall
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angina
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chest pain caused by decreased blood flow to the heart muscle
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Arrhythmia
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abnormal heart rhythm
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atria
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the upper two chambers of the heart
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atrial fibrillation
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an irregular heart rhythm originating in the atria of the heart
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atrial flutter
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extremely fast heart rhythm originating in the atria of the heart
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cardioversion (electric)
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brief discharges of electricity passing azcross the chest to stop cardiac arrhythmia (may also be done chemically)
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congestive heart failure
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inability of the heart to pump its required amount of blood
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hypercholesterolemia
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excessive cholesteral in the blood, a common cardiac risk factor
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hyperlipidemia
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excessive quantity of fat (cholesterol and triglycerides) in the blood
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hypertension
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high blood pressure
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hypotension
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low blood pressure
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hyponatremia
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low blood sodium level
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ischemia
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decreased tissue perfusion
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perfusion
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the normal oxygenation of the organs and tissues of the body
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infarct
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area of dead tissue due to a decrease of tissue perfusion
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myocardial infarction
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heart attack
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jugular venous distention
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caused by back-up of fluid in jugular vein, common finding in CHF or severe chest trauma
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mediastinum
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the mass of tissues and organs separating the sternum in front and the vertebral column behind, containing the heart and its large vessels, trachea, esophagus, thymus, lymph nodes, and other structures and tissues
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pulseless electrical activity
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refers to any heart rhythm observed on the electrocardiogram that should be producing a pulse, but it's not.
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PEA
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ventricular tachycardia
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tachycardia originating in the ventricles that may lead to ventricular fibrillation
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ventrir fibrillation
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a condition in which there is uncoordinated contraction of the cardiac muscle of the ventricles in the heart, making them quiver rather than contact properly
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Asystole
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a state of no cardiac electrical activity, hence no contractions of the myocardium and no cardiac output or blood flow.
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a condition required for a medical practitioner to certify death
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paroxysmal dysrhythmia
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a cardiac rhythm disturbance which occurs briefly and transiently.
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Supraventricular tachycardia
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any tachycardic rhythm originating above the ventricular tissue
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Paroxysmal supraventricular tachycardia
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a rapid rhythm of the heart which involves an accessory pathway
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tachypnea
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rapid breathing, greater than 24 breaths per minute in an adult
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patterns of breathing
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bradypnea
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slow breathing, less than 12 breaths per minute in an adult
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patterns of breathing
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apnea
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cessation of breathing
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patterns of breathing
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Kussmaul
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rapid breathing pattern usually associated with acidosis, DKA
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Cheyne-Stokes
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commonly seen in coma patients; associated with neurological damage
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patterns of breathing
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sternotomy
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a type of surgical procedure in which a vertical inline incision is made along the sternum, after which the sternum itself is divided, or "cracked".
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this procedure provides access to the heart and lungs for surgical procedures.
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central line (central venous catheter)
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used to give chemotherapy, antibiotics, fluids or to draw blood. Can be left in for weeks or months
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implantable port (portacath)
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the port will show as a small bump under the skin but nothing will be visible outside of the body. Can be used to give chemotherapy, antibiotics, fluids, out to draw blood. Can be left in for weeks, months, or even years.
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retractions
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use of accessory muscles to help move air on and out of the lungs during a period of respiratory distress.
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pediatrics signs of respiratory distress
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nasal flaring, grunting, retractions, tachypnea
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what is normally associated with COPD?
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barrel chest
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pectus excavatum
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tunnel chest, usually seen at birth
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pectus carinatum
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pigeon chest
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palpation
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to feel
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flail chest
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indicates unstable chest wall due to injury
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rales (crackles)
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lung sound indicative of fluid in the lungs
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Rhonchi
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abnormal sound caused fluid in large airways; common in bronchitis
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wheeze
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a high pitched whistling sound caused by air moving through narrowed breathing airways (asthma/COPD/obstruction)
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rubs
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sound indicating friction
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upper airway sounds
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I.e. stridor
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categories of breath sounds
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coarse, fine, diffuse, scattered
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4 types
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locations of auscultation
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bilateral, unilateral, bibasilar, all fields, R greater than L, individual fields where sound is heard
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decreased air entry
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term that means less air is heard in the lungs than normal
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how many lobes are in the left lung? what are they?
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2. left upper lobe and left lower lobe
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how many lobes are in the right lung? what are they?
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3. right upper lobe, right middle lobe, and right lower lobe
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alveoli
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thin walled chambers within the lungs where oxygenation and carbon dioxide exchange takes place
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bronchi
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airways of the lungs
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bronchioles
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the final generation of the airways before the alveoli are reached
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diaphragm
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muscular structure that separates the thoracic area from abdominal contents
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epiglottis
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a small flap-like valve of cartilage that closes over the voice box (larynx) during swallowing so that food goes down the esophagus and not into the lungs
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asphyxia
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extreme decrease in the amount of oxygen in the body with increase of carbon dioxide which leads to loss of consciousness or death
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asthma
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spasm and narrowing of bronchi, leading to bronchial airway obstruction
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atelectasis
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collapse of alveoli
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bronchiolitis
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inflammation of the bronchioles particularly seen in children age 2 and under that may cause respiratory distress, tachypnea, and wheezing
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chronic obstructive pulmonary disease (COPD)
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emphysema and chronic bronchitis - lung diseases that are progressive and characterized by difficulty breathing and chronic cough
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congestive heart failure (CHF)
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condition in which the heart fails to adequately pump blood, results in fluid back-up in blood vessels and lungs; primary presenting symptom is dyspnea
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dyspnea
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shortness of breath
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effusion
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fluid in a cavity
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hemotpysis
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coughing up blood
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infiltrate
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a shadow seen on a chest x-ray most likely indicating fluid consolidation in the lung
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pneumonia
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inflammation of the lungs usually due to infection or consolidation caused by cellular exudate in the alveoli
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pneumothorax
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air or gas in the pleural cavity due to perforation through the chest wall or the pleura (traumatic vs. spontaneous), 'collapsed lung'
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presenting complaints: cough dyspnea, unilateral chest/back pain
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pulmonary embolus
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a clot that had traveled to the lungs and obstructed the flow of blood, therefore preventing gas exchange
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presenting complaints: dyspnea, chest pain, pleuritic component, tachycardia
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how many quadrants are in the GI system? what are they?
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4. right upper quadrant, right lower quadrant, left upper quadrant, and left lower quadrant
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how many areas are in the GI system? what are they?
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5. umbilical, periumbilical, flanks, suprapubic, and epigastric
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what organs are found in the RUQ of the GI system?
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gallbladder and liver
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what organs are found in the RLQ of the GI system?
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appendix, small intestine, large intestine, ovary in females
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what organs are found in the LUQ of the GI system?
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spleen and pancreas
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what organs are found in the LLQ of the GI system?
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small intestine, large intestine, ovary in females
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what organ(s) is/are found in the flanks of the GI system?
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kidneys
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what organ(s) is/are found in the epigastic area of the GI system?
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stomach
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what organ(s) is/are found in the suprapubic area of the GI system?
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urinary bladder
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Distention |
abdomen appears inflated |
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Gravid |
Pregnant |
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Pulsatile masses |
May indicate Abdominal aortic aneurysm |
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Ascites |
Globular abdomen due to fluid |
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How many categories of bowel sounds are there? What are they? |
4. Hyperactive, hypoactive, normal, absent |
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Vascular sounds; Bruit |
Turbulent blood flow |
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What indicates that the liver span is in the right midclavicular line (MCL)? |
Delineates upward and downward liver area through dullness |
Percussion |
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What happens when percussion is at the lowest intercostal space of the left anterior axillary line (LAAL)? |
Delineates spleen dullness (sign of enlargement) |
percussion |
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What is a light palpation |
Detects muscular resistance and abdominal tenderness |
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What is deep palpation |
Delineates abdominal organs or other pathological masses |
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What is a soft palpation |
Abdomen is normal |
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What is a rigid palpation |
may indicate internal bleeding, or enlargement of organs |
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Organomegaly |
enlargement of organs; i.e. hepatomegaly (liver), splenomegaly (spleen) |
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Rebound Tenderness |
upon deep palpation, pain increases after palpation is released (may indicate peritoneal irritation) |
Test for abdominal tenderness |
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peritoneum |
membrane that covers the abdominal cavity |
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Guarding |
a defense method by the body to prevent movement of an injured part, especially spasm ofo abdominal muscles when an examiner attempts to palpate inflamed areas or organs in the abdomen |
Test for abdominal tenderness |
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Psoas Sign |
Hand on patient's right knee, patient is asked to flex right hip against resistance. |
Test for abdominal tenderness |
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What is a positive sign for Psoas sign? What does it suggest? |
Positive if motion increases abdominal pain. Suggests appendicitis |
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Obturator sign |
Right leg of patient is raised when knee flexed, leg is then rotated internally at the hip |
Test for abdominal tenderness |
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What is a positive result of Obturator sign? What does it suggest? |
It is positive if motion increases abdominal pain. Suggests appendicitis |
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Rovsing's Sign |
Tenderness felt in RLQ when palpation is performed on the left. Suggests appendicitis |
Test for abdominal tenderness |
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Murphy's sign |
Painful splinting of respiration during deep inspiration and RUQ palpation. Suggests Cholecystitis |
Test for abdominal tenderness |
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Gallbladder |
A small pear-shaped organ located beneath the liver on the right side of the abdomen. |
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What is the gallbladder's primary function? |
To store and concentrate bile, and secrete bile into the small intestine to help digest food |
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Cholecystitis |
Inflammation of the gallbladder |
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Cholecystectomy |
Surgical removal of the gallbladder |
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Cholelithiasis |
gallstone; pieces of solid material that develop in the gallbladder when substances in the bile, primary cholesterol, and bile pigments form hard, crystal-like particles |
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Crohn's disease |
A chronic inflammatory bowel disease that involves all layers of the intestinal wall |
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Diverticulitis |
an inflammation or infection of small sacs or outpouching (diverticula) of the inner lining of the intestine, which protrude through the intestinal wall |
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Diverticulosis |
Abnormal condition of small pouches or sacs in the wall of the intestine |
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Emesis |
vomiting |
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Gastritis |
An inflammation of the lining of the stomach from any cause, including infection or alcohol |
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Gastroenteritis |
Inflammation of the gastrointestinal tract, manifested by vomiting and diarrhea |
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Gastroesophageal reflux disease (GERD) |
A condition in which acid-containing contents of the stomach travel back up into the esophagus, causing a burning sensation (heartburn) |
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Hematochezia |
Bright red blood per rectum (BRBPR), indicates bleeding in lower GI tract |
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Irritable bowel syndrome (IBS) |
Signs and symptoms are cramping, abdominal bloating, constipation, and diarrhea |
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Melena |
Black, tarry stool indicative of bleeding from the upper GI tract |
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Hemorrhoids |
Swollen blood vessels that line the anal opening, caused by excess pressure from the straining during a bowel movement, persistent diarrhea or pregnancy |
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Hiatal Hernia |
Abnormal bulge or protrusion of a portion of the stomach through a hole in the diaphragm where the esophagus and the stomach join |
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Incontinence (bowel) |
loss of bowel control |
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Inguinal hernia |
Abnormal bulge or protrusion that can be seen and felt in the groin area (area between the abdomen and thigh) |
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Liver |
One of the most complex and largest organs in the body, which performs more than 5,000 life-sustaining functions |
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Hepatitis |
Inflammation of the liver |
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Cirrhosis |
A slowly progressing disease in which healthy liver tissue is replaced with scar tissue, eventually preventing the liver from functioning properly |
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Jaundice |
A condition in which the skin and eyes turn yellow because of increased levels of bilirubin in the blood |
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Mesentery |
Membranous tissue which carries blood vessels and lymph glands, and attaches various organs to the abdominal wall |
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Where is the pancreas located |
Behind the stomach, next to the duodenum, the first part of the small intestine |
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What are the two basic functions of the pancreas |
Produces enzymes that help digest food, and hormones (such as insulin) that regulate how the body stores and uses food |
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Pancreatitis |
A disease in which the pancreas becomes inflamed |
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Peptic Ulcer Disease (PUD) |
A disorder in which sores or ulcers form on the tissue lining the stomach or the first part of the small intestine (duodenum) |
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Where is the rectal exam documented |
Generally documented in the GI section following the abdominal exam |
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What things are monitored in a rectal exam? |
Hemoccult, occult, melena, gross blood |
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Guiac test |
Test for fecal occult blood found in stool |
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what are the main structures of the renal and GU system? |
The kidneys, flanks, ureter, and urinary bladder |
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What is the function of the kidneys |
Maintains levels of some chemicals and electrolytes in the body by filtering the blood and excreting waste products as urine |
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Flanks |
Often considered part of the abdomen, located in the posterior portion of the body below the ribs and above the pelvis |
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Ureter |
Tube that pased urine from the kidney to the urinary bladder |
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Urinary bladder (suprapubic region) |
Stores urine until it is excreted from the body |
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what are signs of kidney stones? |
Commonly complain of flank pain, radiating to the groin with nausea. (+) flank tenderness and (+) costovertebral angle tenderness (CVAT) |
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Anuria |
No urine output |
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Benign Prostatic Hyperplasia (BPH) |
Condition in which the prostate becomes enlarged as part of the aging process |
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Diuretic |
Drug that increases the amount of water in the urine, removing excess water from the body; used in treating high blood pressure and fluid retention |
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Dysuria |
Painful urination |
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Hematuria |
Blood in urine |
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Hyperkalemia |
High potassium level in the blood |
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Incontinence (urine) |
Loss of bladder/urine control |
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Kidney stones/renal colic |
Hard mass composed of substances from the urine that form in the kidneys |
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Nephrectomy |
Surgical removal of a kidney |
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Nocturia |
Excessive urination at night |
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Polyuria |
excessive urination |
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Cystitis |
Inflammation of the urinary bladder |
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Pyelonephritis |
Inflammation of the kidney usually due to infection that has ascended from the urinary bladder. Symptoms include: fever, flank pain, urinary symptoms |
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Urinary Tract Infection (UTI) |
Infection of the bladder and/or urethra most often caused by E. coli. Symptoms may include dysuria, frequency, urgency, suprapubic discomfort, fever |
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Urosepsis |
Systemic infection caused by infected urine |
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Femoral pulse |
Pulse in the inguinal area |
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Hernia |
The protrusion of an anatomical structure through the wall that normally contains it |
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Reducible hernia |
Protruded structure is able to be returned to its normal location in the abdominal cavity |
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Incarcerated hernia |
protruded structure is entrapped in the hernia sac and cannot be easily returned to its normal location; requires surgical intervention |
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Coronary artery bypass grafting (CABG) |
an artery is taken from the patient's inguinal area to serve as a shunt that permits blood to travel around an obstruction in the coronary artery; surgical scars or ecchymosis in the inguinal area may result |
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Typical location for Cardiac Catheterization |
Right femoral artery |
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Hematospermia |
Blood in semen |
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Hydrocele |
Fluid filled mass in the scrotum |
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Hypospadias |
Congenital displacement of the urinary opening on the inferior surface of the penis |
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Prostate |
A muscular, walnut-sized gland that surrounds part of the urethra. It secretes seminal fluid, a milky substance that combines with sperm to form semen |
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Testicular torsion |
Twisting of the spermatic cord. Requires emergency surgery to repair blood flow to the testicle |
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Epididymitis |
Condition in which there is inflammation of the epididymis |
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Orchitis |
Inflammation of one or both testicles |
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Varicocele |
Varicose veins of the spermatic cord |
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What is examined during a vaginal exam |
Cervix, CMT, vaginal walls, uterus, and adnexal structures |
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What is an os |
The opening of the cervix that dilates during the first stage of labor |
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Cervical motion tenderness (CMT) |
May be indicative of pelvic inflammatory disease (PID) |
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what are adnexal structures |
ovaries and the fallopian tubes |
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abortion |
involuntary or voluntary termination of a fetus prior to viability (miscarriage included) |
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Amniotic sac |
fluid sac where fetus develops |
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Bartholin's glands |
glands on either side of the vagina which secrete fluid to help lubricate the vagina |
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What happens when Bartholin's glands has a back up of fluids |
Becomes infected and a Bartholin's cyst will form requiring incision and drainage (I&D) |
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Beta Human Chorionic Gonadotropin (BHCG) |
Serum test for pregnancy. |
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What is the qualitative and quantitative test of the BHCG |
The qualitative test is a urine test The quantitative test is a blood test |
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Dilation and Curretage (D&C) |
Scraping to remove contents of uterus in a failed pregnancy |
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Dysmenorrhea |
Painful menses |
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Dyspareunia |
Painful intercourse |
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Ectopic pregnancy |
Fertilized ovum that is developing outside the uterus |
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Fallopian tube |
Passageway that allows for eggs to travel from ovaries to the uterus |
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Fundus |
Top portion of the uterus |
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Gravida/Para |
Shorthand for a woman's obstetrical history |
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Gravida |
total number of pregnancies |
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Para |
Amount of Viable children |
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G6P2M3A1 |
6 total pregnancies 2 live children 3 miscarriages 1 abortion |
Gravida/Para/Miscarriages/Abortion |
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Menopause |
Permanent cessation of menstruation |
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Pelvic Inflammatory Disease (PID) |
Commonly causes lower abdominal or pelvic pain -Infection of the uterus, fallopian tubes, and adjacent pelvic structures most commonly caused by an untreated sexually transmitted disease |
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Bacterial Vaginosis (BV) |
Most common cause of vaginal infection |
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GC - Gonorrhea |
STD |
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Chlamydia |
STD |
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Trichomonas |
STD |
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Vulvovaginal candidiasis |
Vaginal fungal infection |
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Bruit |
Turbulent blood flow through vessels, caused by partial obstruction |
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What is looked for when examining the neck |
Symmetry; pulsations; carotid pulse |
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Jugular Venous Distention (JVD) |
Causedy by back-up of fluid in jugular vein, common finding in CHF or severe chest trauma |
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Stoma |
Opening from an organ to the outside |
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Exam findings of the lymph nodes |
palpable, hard, immobile, fixed, free mobile |
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Lymphadenopathy |
Swelling of lymph nodes
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Lymphadenopathy is associated with what |
Infection |
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Trachea |
Windpipe, tube passing from larynx to bronchi |
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Thyroid |
Endocrine gland in the neck |
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Goiter |
Enlarged thyroid |
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Tenderness of the neck is either |
Midline (along the vertebrae) vs. paraspinal |
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Torticollis |
Stiffneck |
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Signs of torticollis |
-Tenderness of right or left lateral neck -Pain aggravated by movement to ipsi (same) or contra (opposite) - lateral side |
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Stiffness and rigidity on the neck are terms that may be symptoms of what? |
Meningitis |
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Meningeal Sign (Brudzinski's) |
Patient supine, trunk immobilized, upon passive flexion of the neck or chin to chest |
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Positive result of Brudzinski's neck sign |
Involuntary arm, hip, and knee flexion occurs upon movement of the neck to chest |
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How many cervical vertebrae are on the neck |
7, referred as C-spine |
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How many thoracic vertebrae are there |
12 vertebrae of the thorax, ribs are attached and referred as T-spine |
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How many lumbar vertebrae are there |
5 vertebrae of the lower back, referred as L-spine |
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What does the LS-spine commonly refer to |
the area including the lumbar and sacral portions of the spine |
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Kyphosis |
Posterior curvature of spine, result of disease or congenital problem |
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Scoliosis |
Congenital lateral curve of the spine |
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Sacral and coccygeal |
inferior to the L-spine, fused vertebrae, part of sacrum and coccyx |
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During a back exam what is a positive result of costovertebral angle tenderness? What does it suggest
|
Firmly tapping over the kidneys; positive if it produces pain. Suggests renal infection/disease
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Sciatica |
Lower back pain radiating along the sciatic nerve to thigh/leg |
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Herniated disc |
Protruding disc of cartilage; named by what 2 vertebrae it's between |
L4-L5 disc |
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Straight leg raise (SLR) |
Test for sciatica or herniated disc in the lumbar spine. -Patient lies on back, raise one leg from behind the heel until patient complains of pain, then dorsiflexes the food. Patient should be able to raise the leg 90 degrees of hip without pain. |
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Saddle anesthesia |
loss of sensation restricted to the area of the buttocks and perineum. |
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What is Saddle anesthesia usually associated with |
Cauda equina syndrome |
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Muscle tone |
decreased (flaccid), increased (rigid/spastic) |
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Muscle strength |
Movement against resistance, scale 0-5, compare sides to each other |
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What are signs that the back pain is infection-related |
Persistent fever > 100.4 History of IV abuse Severe pain Lumbar spine surgery within the last year Recent bacterial infection Immunocompromised state |
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What are signs that the back pain is related to Cauda Equina Syndrome |
Urinary incontinence or retention Saddle anesthesia Decreased anal sphincter tone or fecal incontinence Bilateral lower extremity weakness or numbness Progressive neurological deficits |
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what are signs that back pain is related to cancer |
History of cancer Unexplained weight loss < 17 y/o or >50 y/o Persistent pain > 4-6 weeks Failure to improve with therapy Pain at rest or night pain |
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Range of motion (ROM) |
range a joint can be moved |
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Full range of motion (FROM) |
normal, patient able to move extremities without limitations |
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Active range of motion (AROM) |
patient moves extremity without assistance |
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Passive range of motion (PROM) |
physician manually moves the extremity |
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Tenderness |
Pain on palpation |
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Fracture |
Break of bone or cartilage |
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Dislocation |
Displacement of a bone from its joint |
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Contusion |
Bruise of the affected area with no break in the skin |
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Sprain |
Stress or tearing injury to a ligament |
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Strain |
Tearing injury to muscle |
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Arthralgia |
Joint pain |
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Atrophy |
wasting, a decrease in size of an organ or tissue |
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Capillary refill |
A test of the circulation that is performed by putting pressure on a fingernail quickly and then releasing the pressure. |
Tests circulation of an extremity |
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What is expected from the capillary refill test |
After losing color the nail normally regains its pink color within 2 seconds |
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Crepitus |
Crackling sound/grating sensation that indicates bone rubbing directly on bone |
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Distal pulses |
Indication of circulation in an extremity; radial, dorsalis pedis |
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Clubbing |
A deformity of the fingers and finer nails that is associated with a number of diseases, mostly the heart and lungs |
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Cyanosis |
A bluish discoloration of the skin or mucous membranes due to deficient oxygenation of the blood |
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Edema |
Swelling, 1+, 2+, 3+, pitting edema |
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Pitting edema |
characterized by the skin maintaining a depression when pressed firmly. |
Highest grade of swelling |
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Malaise |
Generalized feeling of discomfort, illness, or lack of well-being |
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Meningeal sign (Kernig) |
Patient supine, hip and knee flex to 90 deg., while holding hip immobilized knee is extended |
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Positive Kernig sign |
Resistance to knee extension or pain in the hamstrings |
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Myalgia |
Muscle pain |
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Deep Vein Thrombosis (DVT) |
Clot in the extremity that can cause pulmonary embolism |
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Pallor |
Deficiency of color especially of the face; paleness |
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Jaundice |
Yellow discoloration caused by increased bilirubin |
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Skin moisture is examined for |
Dry vs. diaphoretic |
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Diaphoretic |
Excessively sweating |
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Turgor |
Pressure within a cell which gives rise to cell rigidity (skin elasticity) |
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Tenting |
Indicates poor turgor, common finding related to dehydration |
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Arrangement of lesions |
Linear, clustered, annular, arciform, or dermatomal |
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annular |
circular |
an arrangement of lesions |
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Arciform |
arc |
An arrangement of lesions |
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Dermatomal |
Follows along the sensory nerve root as in herpes zoster or shingles |
an arrangement of lesions |
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Macule |
A patch of skin that is altered in color but usually not elevated. i.e. freckle, petechiae |
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Maculopapular |
A rash that exhibits characteristics of a macule and a papule |
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Papule
|
A patch of skin that is altered in color and usually elevated
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Nodule |
A small mass of rounded or irregular shape |
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Wheal |
Hive; urticaria |
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Hive |
urticaria |
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Pustule |
Filled with pus i.e. blister or pimple |
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Vesicle |
A small abnormal elevation of the outer layer of skin enclosing a watery liquid |
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Petechiae |
Looks like small, red, dots and are caused by localized hemorrhage (broken capillaries). |
mascular rashes |
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Petechiae can be a symptom of... |
Leukemia, idopathic thrombocytopenia (ITP), or meningococcemia, as well as other conditions |
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Abrasion |
Superficial scratching of the skin surface |
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Avulsion |
Tearing away, i.e. flap of skin, piece of bone |
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Contusion |
Bruise or injury to an area without a tear in the skin |
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Laceration |
irrregular tear of the skin |
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Puncture |
Injury caused by sharp, narrow object cutting the skin |
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Cellulitis |
an acute, spreading, painful infection of skin, soft tissue, and muscle; often associated with abscess |
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Suppuration |
formation of pus |
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Fluctuance |
Feeling of fluid collected under the area being palpated |
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Induration |
abnormal hard spot under the skin |
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Lymphangitis |
Inflammation of lymphatic vessel |
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Lymphadentitis |
Inflammation of lymph nodes |
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Ecchymosis |
The appearance of a bruise, a purplish patch caused by hemorrhaging under skin or mucous membranes |
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Cranial Nerves (CNs) |
Tested throughout entire physical exam |
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If CNs is normal it is written as |
CNs intact |
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Normally pupils are... |
Pupils are equal, round, and reactive to light (PERRL) |
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Facial drooping |
right or left side, common in stroke (CVA) |
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What is examined for in the CNs during a physical exam |
Pupils, facial drooping, and strucutres of the mouth |
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Structures of the mouth |
Uvula or tongue, normally midline, deviation indicates possible stroke or brain injury |
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Motor functions are tested by looking at/for... |
Pupils, hemiparesis, range of motion |
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Hemiparesis |
Paralysis of one side of the body, common finding in stroke (CVA) |
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What is the scale for grip strength |
0-5 |
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What is normal grip strength |
5/5 bilaterally |
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Sensory functions are examined by |
Light tough, pain, position sense, vibration, discrimination, stereognosis |
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Light touch |
soft cotton ball applied to various sections of the body to test feeling |
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Pain |
pinprick or sharp object applied to various sections of the body to test for "sharp" or "dull" sensations |
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Position sense
|
Starting at toe, patient is asked to identify direction in which examiner moves toe, up or down
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Vibration |
Tuning fork |
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Discrimination |
Usually measured as two point discrimination in which the patient must identify the tip of a caliber/paper clip as one or two points |
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For the discrimination test what should the patient recognize |
Should be able to recognize two-point separation of 2-4 mm on the lips and finer pads, 8-15mm on the palms and 3-4 cm on the shins. |
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Stereognosis |
Ability to identify an object by touch |
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Coordination and Gait are examined by |
Rapid alternating movements, point-to-point movements, Romberg test, ataxia, gait |
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Point-to-point movements |
Patient touches examiner's index finger and their nose alternately several times, while examiner moves finger. |
Can be done "Finger-to-nose" and "Heel-to-Shin" |
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Romberg Test |
Positive when patient is unable to maintain balance while standing with eyes closed and feet together |
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Ataxia |
Defective muscular coordination |
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Gait |
Pattern of walking; patient is asked to perform the follow: Walk across the room, turn and come back Walk Heel-to-toe in a straight line Walk on their toes in a straight line walk on their heels in a straight line Hop in place on each foot Do a shallow knee bend Rise from a sitting position |
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Babinski reflex |
Normally the great toe flexes when the lateral aspect of the sole of the foot is stroked |
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Positive Babinski reflex result |
The great toe extends instead of flexes and the outer toes spread out. |
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What age range is it normal to have a positive Babinski's reflex result
|
< 6 months of age
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Petit Mal |
Temporary disturbance of brain function caused by abnormal electrical activity in the brain and characterized by abrupt, short-term lack of conscious activity or other abnormal change in behavior |
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How long do Petit mal cases usually last |
Last only a few seconds |
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Are there any side effects of petit mal? If not, what happens afterwards? |
Usually no side effects. Full recover occurs rapidly and no lingering confusion |
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How do petit mal seizures usually manifest |
Usually manifest themselves as staring episodes during which the child's activity or speech ceases |
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Grand Mal (Tonic-Clonic seizure) |
Characterized by loss of consciousness, bowel or bladder incontinence, and convulsions |
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Febrile |
Brought on by a fever in infants or children |
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Tonic |
Stiffening |
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Clonic |
Shaking/jerking movements |
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Aphasia |
Impairment in ability to communicate through speech, writing, or sign due to brain dysfunction |
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Dysphasia |
Difficulty with speech |
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Dysphagia |
Difficulty swallowing |
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Coma |
State of unconsciousness |
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|
|
Cerebrospinal fluid (CSF) |
A clear, colorless, bodily fluid, that occupies the subarachnoid space and the ventricular system around and inside the brain and spinal cord. Removed during a lumbar puncture |
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Paresthesia |
Subjective sensation experienced as numbness, tingling, or "pins and needles" |
|
|
|
Decerebrate posturing |
Pathological posturing associated with increased intracranial pressure in response to painful stimuli the extremities become stiff and extended, the head is retracted. |
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Decorticate posturing |
Pathological posturing associated with increased intracranial pressure in response to painful stimuli the patient's back and lower extremities are rigid with the arms flexed to the chest with fists clenched |
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|
Delirium Tremens (DTs) |
Visual and auditory hallucinations associated with alcohol abuse (withdrawal) |
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|
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Dysarthria |
Defect in the muscular control of speech, words may be slurred, nasal or indistinct |
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Syncope |
Loss of consciousness (LOC), to pass out, to faint |
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Ingestion |
To take into the body by the mouth |
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|
|
Is there such thing as accidental ingestion. If yes, how? |
Yes. Usually in the form of a medication overdose but could also include caustic agents and/or other chemicals. |
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|
Mood and affect |
Involves tone and intensity and a structured set of beliefs about general expectations of a future experience of pleasure or pain, or of positive or negative affect in the future |
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|
Moods |
Hypothetical constructs depicting an individual's emotional state |
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Inappropirate affect |
inconsistent with the accompanying idea, thought, or speech |
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Blunted affect |
Severe lack of affect |
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Flat affect |
absence of any affective signs of emotion |
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|
|
Labile affect |
rapid and abrupt changes in affect |
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|
Suicidal ideation |
Thoughts of wanting to harm or kill self |
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|
|
Suicidal gesture |
Suicidal act that attracts attention without seriously injuring the subject for example suerficial cutting of the wrist |
More serious than a suicidal threat |
|
|
Homicidal ideation |
Thoughts of wanting to harm or kill others |
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|
|
Hallucinations |
Perception in the absence of a stimulus which has the qualities of a real perception |
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|
|
Auditory Hallucinations |
Hearing things that are not present |
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|
Visual hallucinations |
seeing things that are not present |
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|
Olfactory hallucinations |
Smelling thingst that are not present |
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|
|
Anxiety disorder |
Characterized by persistent, excessive, and unrealistic worry about everyday things. |
|
|
|
Bipolar disorder (manic-depressive illness) |
A brain disorder that causes unusual shifts in a person's mood, energy, and ability to function. |
A spectrum of moods |
|
|
Manic episode |
Diagnosed if an elevated mood occurs with three or more primary symptoms most of the day, nearly every day, for at least one week. Irritable mood requires 4 additional symptoms |
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|
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Signs and symptoms of a manic episode |
Increased energy, activity, and restlessness excessively high, overly good, euphoric mood Extreme irritability Racing thoughts and talking very fast Distractibility Little sleep needed Unrealistic beliefs in one's abilities and powers Poor judgment Spending sprees A lasting period of behavior that is different from usual Increased sexual drive Drug abuse Provocative, intrusive, or aggressive behavior Denial that anything is wrong |
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Delusions of Grandeur |
A delusion that you are much greater and more powerful/influential than you really are |
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Schizophrenia |
Mental disorder characterized by a breakdown of thought processes and by a deficit of typical emotional responses. Hard to tell real from no real, think clearly, have normal emotional responses, and act normally in social situations. |
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Common symptoms of Schizophrenia |
Auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social or occupational dysfunction |
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Apgar scoring system |
Assessment of the neonate for immediate adaptation to extrauterine life. |
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How is scoring done for the apgar scoring system |
Scoring is done at 1min and at 5 min after birth. Rating is done in 5 categories: heart rate, respiratory, muscle tone, irritability, and color |
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Colic |
Periods of unexplained irritability and intense crying in infants, associated with abdominal pain |
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Diaper dermatitis/candidiasis |
Diaper rush |
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Fontanelle |
The soft spots of the skull in between the bones in a new born |
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What is a sign that the infant does not have enough fluid in his/her body |
A noticeably sunken fontanelle |
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FUO |
Flu of unknown origin |
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Neonate |
Through the first 28 days of life |
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Nursemaid's Elbow (Radial Head Subluxation) |
a condition where the radial head is pulled partially out of its socket |
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Postneonatal |
29th day of life to the first year |
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Full-term |
Gestation 37-42 weeks |
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Pre Term |
< 73 weeks gestation |
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Post Term |
>42 weeks gestation |
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Scarlet Fever |
Streptococcal infection characterized by fever, pharyngitis and rash |
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Tinea Corporis |
Ringworm of the body, superficial fungal infection |
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Tinea Pedis |
Ringworm of the food, athlete's foot |
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Varicella |
Chicken pox |
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Hyperglycemia |
High blood sugar |
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Hypoglycemia |
Low blood sugar |
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Diabetes Mellitus (DM) |
A life-long disease marked by high levels of sugar in the blood |
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Diabetes type 1 |
Usually diagnosed in childhood. The body makes little or no insulin, and daily injections of insulin are needed |
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Diabetes type 2 |
Most common type of diabetes and usually occurs in adulthood. The pancreas does not make enough insulin to keep blood sugar levels normal |
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Diabetic Ketoacidosis (DKA) |
Insufficient insulin levels in the body result in high blood sugar and the buildup of substances called ketones in the blood (ketoacidosis). |
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What happens when DKA is untreated |
Can lead to coma or death |
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What are common symptoms of DM |
Polydipsia, polyuria, polyphagia |
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Polydipsia |
Excessive thirst |
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Polyuria |
Excessive urination |
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Polyphagia |
Excessive hunger |
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Blood type and cross match (TXM) |
Determines patient blood type and matches to potential blood transfusion compatibility. |
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How is TXM ordered |
Often ordered by the number of units of blood needed |
Ex: Crossmatch x 2 units |
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Complete blood count (CBC) |
Provides information about the hematological system and other organ systems |
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Complete blood count (CBC) |
Provides information about the hematological system and other organ systems |
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What are the 4 most important components of the CBC? |
White blood count (WBC), Differential count, Hemoglobin (Hgb), and Hematocrit (HCT) |
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Total WBC |
White blood cells (leukocytes) fight infection and react against foreign bodies |
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When does WBC indicate there is infection, inflammation, or tissue death |
WBC > 10,000 |
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When does WBC indicate bone marrow failure, overwhelming infections, dietary deficiencies, or autoimmune disease |
WBC <4,000 |
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Differential count |
Measures each type of leukocytes |
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What are the different types of leukocytes |
Neutrophils (polys or segs), Bands (stabs), lymphocytes, monocytes, eosinophils, basophils |
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Enuresis |
The involuntary passage of urine, usually at night in a child over 5 years of age
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Neutrophils (Polys or Segs) |
Mature leukocytes that are the first line to kill bacterial organisms via digestion (phagcytosis) |
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When is there an increase in neutrophils, in the body |
Increased in acute bacterial infection and trauma |
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Bands (stabs) |
Immature forms of neutrophils, seen when neutrophil production is significantly stimulated |
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What does it mean to have a "shift to the left" |
When nuetrophil production is significantly stimulated; signifies an acute bacterial infection |
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Lymphocytes |
Fight chronic bacterial infections and acute viral infections |
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What type of lymphocytes are there |
T cells and B cells |
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What is the function of T cells |
Cellular type immune reactions; killer cells |
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What is the function of B cells |
Antibody production |
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Monocytes |
Phagocytic cells responsible for removing debris and microorganisms from the blood |
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Eosinophils |
Associated with allergic reactions |
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Basophils |
Mast cells, seen in allergic reactions |
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What is the function of hemoglobin (Hgb) in the blood |
Serves as a vehicle for the transport of oxygen and carbon dioxide |
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Why is testing for hemoglobin important |
It is a rapid indirect measurement of the RBC count. Can be repeated serially in patients with ongoing bleeding and plays an integral role of the evaluation of the anemic patient |
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What is the most common reason for low hemoglobin (Hgb) |
Most commonly due to bleeding |
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Hematocrit (HCT) |
Measure of the percentage of the total blood volume that is made up of the RBCs. |
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How many times hemoglobin is the hematocrit |
3 Times hemoglobin |
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Platelet (thrombocyte) count |
Essential for blood clotting. It is an actual number of platelets per cubic milliliter of blood |
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Prothrombin Time (PT) |
Evaluates the blood clotting mechanism of the body, and monitors patients on Coumadin anticoagulant therapy |
Coagulation factors |
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Partial Thromboplastin Time (PTT) |
Evaluates the blood clotting mechanism of the body, and monitors patients on Heparin anticoagulant therapy |
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International Normalized Rato (INR) |
International measurement associated with PT used in the evaluation of bleeding times. |
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How are Anticoagulant (Coumadin) doses based |
Anticoagulants will be dosed based on PT and INR values |
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What is the function of magnesium (Mg2) |
Most organ functions, including neuromuscular and cardiac |
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What occurs when you have low levels of magnesium |
Low levels can cause cardiac arrhythmias |
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What happens when you have high levels of magnesium |
High levels can effect cardiac conduction and respiratory depression |
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What is the function of sodium (Na) |
Monitor fluid and electrolyte balance |
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What is the function of chloride (Cl) |
reflects body acid base status and hydration. Usually follows sodium |
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What is the function of potassium (K+) |
Important electrolyte in cardiac function |
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What can be evaluated from Carbon dioxide (CO2) in the body |
pH of blood can be evaluated |
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What components make up the basic metabolic panel (BMP) |
Sodium, Chloride, Potassium, Carbon dioxide, Blood, urea, nitrogen (BUN), Creatine, and glucose |
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What components make up the comprehensive metabolic pattern |
Sodium, Chloride, Potassium, Carbon dioxide, Blood, urea, nitrogen (BUN), Creatine, Glucose, and Calcium |
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What are the liver function tests |
Albumin, Alkaline Phosphatase, AST, ALT, Bilirubin total, Protein total |
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Erythrocyte sedimentation rate (ESR) |
Nonspecific test used to detect illness associated with acute and chronic infection, inflammation, and tissue injury |
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C-Reactive Protein (CRP) |
A protein found in the blood, the levels of which rise in response to inflammation (an acute-phase protein) |
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What can be detected by using angiography |
X-ray imaging of blood vessels. Can detect blockage by clots, cholesterol plaques, tumors or aneurysms |
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How does an angiography work |
A contrast substance is injected into blood vessels and x-ray images are taken of the vessels |
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Cardiac catheterization is an introduction of what |
Introduction of a catheter into the heart allowing for visualization of the heart chambers, arteries and great vessels |
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How is a cardiac catheterization used |
Used in the evaluation of chest pain, it locates the site of obstruction in coronary blood flow. |
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what is commonly included for cardiac panel/cardiac work-up/ccu labs |
CBC, electrolytes, troponin, PT/INR, CXR, EKG |
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Doppler ultrasound |
Technique that focuses sound waves on blood vessels and measures blood flow as echoes bounce of red blood cells |
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Troponin |
Protein complex consisting of three types (T, I, C) |
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Where are isoenzymes found |
CPK is found predominantly in the heart muscle, skeletal muscle, and brain |
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What are Isoenzymes |
CPK-MM, CPK-MB, CPK-BB |
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When do serum CPK levels elevate |
Serum CPK levels are elevated whenthere is injury to the heart muscle or nerve cells |
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How is myocardial injury specifically tested |
Electrophoresis is performed to detect three CPK isoenzymes which are CPK-BB (CPK1), CPK-MB (CPK2), and CPK-MM (CPK3) |
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Which isoenzyme helps detect the degree of infarction and the timing of onset of the injury. |
CPK-MB (CPK2) |
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D-Dimer |
Blood test used to determine the probability of a blood clot in a vein |
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When is a D-Dimer ordered |
Typically ordered in situations where a deep vein thrombosis (DVT) or a pulmonary embolus (PE) is suspected |
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Echocardiogram (ECHO) |
Used in the evaluation of heart wall motion, the detection of valvular disease, evaluation of the heart during stress testing, and to identify and quantify fluid around the heart |
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Stress Test and Nuclear Stress Test |
A non-invasive study that provides information regarding a patient's cardiac function when stressed (exercise/chemical) |
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Holter monitor |
Portable device for continuously monitoring various activity of the heart for at least 24 hours usually for an outpatient study |
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What is represented by the electrocardiogram (EKG, ECG) |
It is the graphic representation of the electrical impulses that the heart generates during the cardiac cycle |
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What is evaluated by the EKG |
It evaluates arrhythmias, conduction defects, myocardial injury and damage, enlargement of a chamber and diseases of the heart |
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What are common EKG rhythms |
Normal sinus rhythm (NSR) Sinus tachycardia ( ST) >100bpm Sinus bradycardia (SB) < 60bpm Atrial fibrillation (AF) Atrial flutter Paced rhythm |
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On an EKG what is the P representative of |
atrial depolarization (electrical activation) |
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On an EKG what is the QRS representative of |
ventricular depolarization |
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On an EKG what is the T representative of |
ventricular repolarization (recover phase) |
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What are common EKG findings |
No acute ST-T changes (NASTTdelta's) Non-specific ST-T changes or NSSTTdelta's No acute ischemic change or NAIdelta 1st, 2nd, 3rd degree heart block or complete heart block left ventricular hypertrophy (LVH) Ectopy: out of turn beat |
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What is PVC |
premature ventricular contraction |
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PAC |
Premature atrial contraction |
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What is a Barium enema (BE) |
Series of x-rays that visualize the colon |
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What does a Barium (BE) detect |
Can detect the presence and location of polyps, tumors, and diverticula |
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What is the therapeutic use of barium enema (BE) |
Therapeutically it can reduce a nonstrangulated ileocolonic intussusception in children |
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Hemoccult test |
Examination of a small sample of stool for otherwise inapparent occult (hidden) traces of blood |
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When are stool cultures indicated in the patient |
Indicated in the patient with unrelenting diarrhea, fever, and abdominal bloating |
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What is the purpose of X-ray abdomen obstructive series (2 view) |
X-ray to rule out obstruction/constipation |
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What is albumin and what organ synthesizes it |
It is the major protein present within the blood and synthesized by the liver |
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What practical use does albumin have for lab settings |
It is easy to measure so, it represents a reliable and inexpensive laboratory test for physicians to assess the degree of liver damage present in a patient |
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What is alkaline phosphatase (Alk Phos) |
It is an enzyme, which is associated with the biliary tract |
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What is considered when alkaline phosphatase is elevated |
biliary tract damage and inflammation is considered |
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Aspartate aminotransferase (AST)/Serum glutamic oxaloacetic transaminase (SGOT) |
Evaluates suspected coronary occlusive heart disease or hepatocellular disease and also reflects damage to the hepatic cell |
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Why is the ratio between AST and ALT useful |
It is useful to physicians in assessing the etiology of liver enzyme abnormalities |
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Alanine aminotransferase (ALT)/ Serum glutamic pyruvic transaminase (SGPT) |
ALT is an enzyme produced within the cells of the liver and is the most sensitive marker for liver cell damage |
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What can result in elevation of ALT |
Any form of hepatic cell damage |
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How does the normal range of ALT vary |
It varies according to a number of factors, including age and gender |
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Bilirubin (T. Bili and C. Bili) |
A major breakdown product of hemoglobin |
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What is bilirubin used to measure |
It is a valuable measurement that helps in the differentiation of liver damage or gallbladder disease |
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What is reflected when direct bilirubin is low and total bilirubin is high |
It reflects liver cell damage or bile duct damage within the liver |
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What is measured using the lyme titer |
It measures a patient's antibody, IgM and/or IgG, in response to exposure to the Lyme bacteria |
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What is a lyme titer used for |
Used in the diagnosis of Lyme disease |
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What is used to detect heterophile antibodies |
Mononucleosis spot (Mono Spot) |
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What are heterophile antibodies |
Antibodies that non-specifically react against different proteins and are useful in the diagnosis of infectious mononucleosis |
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Rapid strept |
quick test to determine the presence of a strep throat infection |
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Throat culture |
takes 24-48 hours, more accurate than a rapid strep test which may give a false negative |
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What is amylase used for |
Enzyme used to diagnose pancreatic damage such as acute or chronic pancreatitis and other pancreatic diseases |
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How does amylase pinpoint the diagnosis of pancreatic attacks |
The near-immediate rise of amylase at the beginning of a pancreatic attack, and its fall after about 2 days helps to pinpoint this diagnosis |
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When is a test ordered on patients with acute abdominal pain |
If acute pancreatitis, amylase levels are very, often 5-10 times normal levels |
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How is lipase used |
Lipase is an enzyme used to diagnose pancreatic damage such as acute or chronic pancreatitis and other pancreatic diseases |
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How is lipase used to indicate acute pancreatitis |
Rapid and sharp rise of lipase in the blood within hours after the beginning of an attack, and the decline after about 4 days, usually indicates acute pancreatits |
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When using lipase, when is a test ordered on patients with acute abdominal pain |
In acute pancreatitis lipase levels are very high, often 2-5 times the normal amount |
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Blood urea nitrogen (BUN) |
Indirect measurement of renal function and glomerular flitration rate. it is a measure of kidney function |
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Creatinine (Cr) |
blood test that reflects renal function |
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Intravenous Pyelogram (IVP)radio |
graphic study utilizing contrast dye to visualize the kidneys, ureters, and bladder |
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Kidney, Ureter, Bladder (KUB)/Flat Plate of Abdomen |
Radiographic view of abdomen to related structures. |
Calculi (stones) can be visualized |
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Urine dip |
rapid test of urine to detect presence of abnormal cells |
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What test can be done in the ED and does not need to be sent to the laboratory |
Urine dip |
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Urinalysis (UA) |
Routine microscopic exam of urine |
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Urine culture and sensitivity (Urine C&S) |
urine culture for bacteria |
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Urine HCG |
Urine pregnancy test |
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Arterial blood gas (ABG) assesses what in the body |
Assesses the adequacy of oxygenation in the body |
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What is reflected in the ABG |
It reflects respiratory, metabolic, and renal status of the patient |
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What is measured in ABG |
pH, pCO2, HCO3, pO2, and O2 saturation |
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pH |
acid base balance |
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pCO2 |
respiratory component of the acid base balance |
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HCO3 (bicarbonate) |
measures renal/metabolic component of the acid/base balance |
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O2 saturation |
% of hemoglobin saturated with oxygen |
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Carboxyhemoglobin (COHb) |
Detects carbon monoxide poisoning |
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What is viewed using the Chest x-ray (CXR) |
chest x-rays provide picture views of the heart, lungs, and skeletal/thoracic system |
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What is commonly requested for when using CXR |
Posterior/anterior (PA), lateral, oblique, decubitus |
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posterior/anterior for cxr |
x-rays pass through the posterior of the body to the anterior |
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Lateral xr |
x-rays pass through the side |
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Oblique xr |
oblique views pass through the body at various angles |
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Decubitus xr |
views taken with patient lying on their side |
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What is a decubitus xr helpful in detecting |
Helpful in detecting any fluid levels (pleural effusion) |
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Peak flow |
Respiratory measurement of expiration acquired by patient forcibly exhaling into peak flow meter |
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Where is peak flow obtained |
asthmatics |
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Pulse oximetry |
Noninvasive method of monitoring the saturated oxygen hemoglobin expressed in a percentage |
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What must be included when reading pulse oximetry |
The reading must include oxygen delivery to patient or if the patient is on room air or via O2 device (nasal cannula, bvm, non-rebreather) and rate |
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Computed Tomography (CAT, CT scan) |
A noninvasive radiographic study that can be done with or without contrast medium (dye) to determine pathology (tumors, bleeding, inflammation, and vascular abnormalities) |
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What are common CT scans |
head, brain, chest, abdomen/pelvis, C-spine, neck, facial bones, orbits |
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How can contrast be administered for CT scans |
contrast can be administered by mouth (PO) and/or IV |
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CT angiography (CTA) |
a computed tomography technique used to visualize arterial and venous vessels throughout the body. |
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What ranges does CTA have |
Ranges from arteries serving the brain to those bringing blood to the lungs, kidneys, arms and legs |
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Ultrasound (U/S or Utz) |
High frequency sound waves are electronically converted to a picture image |
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Doppler studies |
An utz study providing information about arterial and venous patency (Blood flow) |
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What are doppler studies common for |
Common in rule out (r/o) DVT work-up |
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Magnetic resonance imaging (MRI) |
A type of radiography using electromagnetic energy |
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Why is MRI an ideal test to diagnose multiple sclerosis (MS), tumors (brain, pituitary), infections (brain, spine, joints), strokes (early stages), torn ligaments, and shoulder injuries |
It can produce images of multiple planes at various angles |
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What is MRI most effective in evaluating |
it is very effective to evaluate masses in soft tissues of the body as well as bone tumors, cysts and bulging or herniated discs in the spine |
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Ventilation perfusion scan (VQ scan) |
A nuclear scan used in determining the relationship of the patient's perfusion status and respiratory system |
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What is ordered to rule out pulmonary embolus if patient is allergic to contrast dye |
Ventilation perfusion scan (VQ scan) |
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Electroencephalography (EEG) |
The recording of electrical activity along the scalp produced by the firing of neurons within the brain |
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When are drugs sub-therapeutic, or toxic, to patients |
If a patient is non-compliant with the drug regimen or is taking an incorrect dose |
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What are commonly requested drug levels |
Depakote (valproic acid), digoxin (digitalis), dilantin (phenytoin), lithium, phenobarbital, tegretol (carbamazepine), theophyllinen |
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In the case of potential overdose or poisoning, drug levels on suspected ingestions of drug(s) will be ordered which include...
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Blood level and urine level
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What drugs/chemicals are tested for blood level overdose/poisoning |
Acetaminophen (tylenol), Blood alcohol level (BAL), Carboxyhemoglobin (COHb), Lead (Pb), salicylate (aspirin, ASA) |
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What drugs are tested for during a urine drug screening (UDS) |
Amphetamine/methamphetamine, barbiturates, benzodiazepines, cocaine (including crack), cannabinoids (marijuana), ethanol, opiates, methadone, Phencyclidine (PCP) |
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