More For Abodmen, Heart, Lungs Pt Dx And Eval

Front 1

cardiac ROS

Back 1

there are 6

Hint 1

chest pain/discomfort
heart palpitations
SOB
SOB while laying down
SOB that wakes you up at night
edema/swelling

Front 2

cardiac exam

Back 2

1)pulse and BP/ orthostatics
2)look w/ light at neck, look at precordial area with light
3)JVP
4)palpate/pmi
5) listen w/ carotids and all spaces
6) listen for s2 split

Front 3

lungs ROS

Back 3

there are 7

Hint 3

cough
sputum
hemoptysis
SOB
wheezing
chest pain
CXR

Front 4

lungs exam

Back 4

1)inspect front/back
2) all posterior resp excursion/ diapghragm excursion
3) ninety-nine
4) percuss
5)ascultate
6) all anterior: ninety-nine
7) percuss
8) auscultate

Front 5

abdomen ROS

Back 5

there are 8 billion
j/k it's 10+

Hint 5

swallowing
heartburn
appetite
nausea/vomiting
bm's (how often, straining color, pain, black tarry, blood, constipation, diarrhea)
abdominal cramping
food intolerance
belching/flatus
jaundice

Front 6

abdominal exam

Back 6

1)did you pee? do you have any pain?
2) kidney punch
3) inspect with light,diastasis recti
4) auscultate- quadrants and bruis
5) percuss- quadrants liver size (murphys sign) and spleen/palpate spleen
6) light palpate- quadrants
7) deep palpate- quadrants, kidneys, stomach, suprapubic, aorta.
8)verbalize rectal/pelvic
9) demonstrate extra testing: rebound, rovsings, psoas, obturator

Front 7

list common symptoms associated with problems referable to the abdomen;

Back 7

o acute and chronic abdominal pain
o indigestion, nausea, vomiting, including blood, loss of appetite, early satiety
o dysphagia and/or odynophagia
o change in bowel function
o diarrhea, constipation
o jaundice
o suprapubic pain
o dysuria, urgency or frequency
o hesitancy, decreased stream in males
o polyuria, nocturia
o urinary incontinence
o hematuria
o kidney or flank pain
o ureteral colic

Front 8

what abdominal organs are retroperitoneal

Back 8

kidneys, adrenal glands, part of pancreas

Front 9

RUQ has what structures

Back 9

liver, gallbladder

Front 10

LUQ has what

Back 10

spleen, pancreas, stomach

Front 11

RLQ has what

Back 11

appendix

Front 12

LLQ has what

Back 12

sigmoid colon

Front 13

cardiac cycle

Back 13

diastole, systole starts w/ s1, systole ends with s2, diastole again

Front 14

diastole

Back 14

higher pressure in atrium than ventricle causes mitral/tri to open and blood flows into ventricles (may hear s3), atrial contraction occurs (may hear s4)

Front 15

systole

Back 15

ventricle contracts and pressure rises above that of atria causing mitral/tri to close (S1), increasing pressure in ventricles causes A/P valves to open and blood rushes through, ventricular pressure decreases and a/p valves close (S2)

Front 16

expected findings of an examination of the heart

Back 16

o Palpation: no thrills, rubs, thrusts. PMI in normal anatomic location. Carotid rate and rhythm within normal limits
o Auscultation: normal rate and rhythm with no irregularities, clicks, gallops, snaps, murmurs, or friction rub.

Front 17

lower border of lung

Back 17

mid clavicular/6th rib anterior to 8th rib mid-axillary to t10 posteriorly

Front 18

oblique/major fissure

Back 18

posteriorly t3 down to 6th rib at mid-clavicular line

Front 19

horizontal/minor fissure

Back 19

only in right lung goes at about 4th rib and meets up with major fissure near the 5th rib at mid-axillary line

Front 20

perfusion

Back 20

flow of blood into tissue

Front 21

Inspection: assessing pts appearance

Back 21

• Body habitus (kyphosis, scoliosis may cause restrictive problem)
• Cyanosis? (severely hypoxic, airway management likely)
• Pallor? (sepsis, MI)
• Diaphoresis? (sepsis, MI)
• Audible wheezes/stridor? (upper airway obstruction, anaphylaxis)
• Clubbing of the nails? (chronic hypoxia, lung CA)
• Tracheal Deviation? (pneumothorax)
• Deformities or Asymmetry? (unilateral lag in pleural disease)
• Retractions? (severe asthma, COPD, other obstruction)

Front 22

respiratory rate

Back 22

• Tachypnea: >20 b/min
• Bradypnea: <12 b/min

Front 23

vesicular breath sounds

Back 23

1:0 or 1:1/4
heard low in lungs

Front 24

bronchial

Back 24

1:1
over manubrium

Front 25

brochovesicular

Back 25

1:1
over sternocostal margins and vertebral column

Front 26

normal breathing

Back 26

14-18 bpm

Front 27

hyperventilation

Back 27

fast deep breaths

Front 28

kussmauls

Back 28

deep labored

Front 29

cheyne-stokes

Back 29

very rapid breathing followed by apnea

Front 30

sighing

Back 30

depression

Front 31

tachypnea

Back 31

>20bpm

Front 32

peripheral arteries

Back 32

8:
carotid
bracheal
radial
femoral
popliteal
dorsalis pedis
posterior tibial
abdominal aorta

Front 33

lymphatics

Back 33

neck
clavicular
axillary
inguinal
epitrochlear (elbow)
popliteal

Front 34

ROS periph vasculature

Back 34

• Peripheral Vascular: intermittent claudication, leg cramps, swelling, color change of digits in cold weather, redness, tenderness, ulceration, varicose veins

Front 35

ROS lymphatic

Back 35

swollen glands (if positive, pain, heat, redness), streaking – localized inflammation and redness between beds of lymph nodes

Front 36

grading pulses

Back 36

• 4 – bounding
• 3 – full, increased
• 2 – expected
• 1 – diminished
• 0 – absent or nonpalpable

Front 37

grading edema

Back 37

• 1+ slight, disappears rapidly
• 2+ deeper than 1+, disappears in 10-15 seconds
• 3+ noticeably deep, > 1 minute, extremely swollen
• 4+ deep pit, lasts 2-5 minutes, gross swelling

Front 38

normal lymph nodes

Back 38

• vary from tiny to 1 cm. or larger and not typically palpable but typically mobile
• superficial – in the subcutaneous connective tissue
• deep – muscle, fascia or within body cavities

Front 39

lymph nodes with infection

Back 39

• moderate size
• firm
• separate
• tender

Front 40

lymph nodes with metastatic disease

Back 40

• stony hard
• nontender

Front 41

lymhpatic neoplasim

Back 41

• firm or rubbery
• matted