Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
72 Cards in this Set
- Front
- Back
general survey:
age |
appears his or her stated age
abn* - older, b/c of chronic illness, chronic alcoholism |
|
general survey:
sex |
sexaul development appropriate.
abn*- delayed or precocious puberty |
|
general survey:
level of consciousness |
alert, oriented, attends to questions -- person, place, time.
abn*- confused, drowsy, lethargic |
|
general survey:
skin color |
color tone is even, pigmentation varying w/ genetic background, intact
abn*pallor,cyanosis,jaundice,erythema, lesions |
|
general survey:
facial features |
facial features symmetric --
abn*- immobile, masklike, asymmetric, drooping |
|
gernal survey -
normal: no signs of acute distress are present |
abn* respiratory signs, SOB/wheezing. pain, indicated by grimace - holding body part
|
|
body structure:
stature |
height appears normal w/ age, genetic heritage
abn* excessively tall/short |
|
body structure:
nutrition |
weight appears normal range for height/body - body fat distribution is even
abn*- cachectic, emaciated |
|
nutrition abn*
|
centripetal obesity- concentrated in face, neck, trunk, thin extremities
(Cushing's Syndrome) hyperadrenalism |
|
body structure
symmetry |
body parts equal bilaterally
*abn - unilateral atrophy or hypertrophy assymetric location of body part |
|
body structure:
posture |
stands comfortable,erect.
*abn - rigid spine & neck, stiff, tense, slumped |
|
body structure:
posture normal for age |
older person -- kyphosis
tolddler - toddler lordosis |
|
body structure:
position |
sits comfortable in chair
abn* tripod, COPD resists lying down - CHF fetal position - abd. pain |
|
Mobility:
gait |
base is as wide as shoulders, smooth, well balanced.
*abn - wide base, staggered, stumbling, shuffling, dragging, limping |
|
Mobility:
range of motion |
full mobility for each joint, accurate, smooth, coordinated
abn*- limited, paralysis, jerky, titics, tremors, seizures |
|
Behavior:
facial expression |
eye contact - unless culture
(asians) -abn* flat, depressed, angry, sad, anxious |
|
Behavior:
Mood & Affect: |
comfortable/cooperative
*abn - hositle, distrustful, suspicious, crying |
|
Behavior:
speech |
clear, understandable
abn* - dysarthria - speech, dysphagia - swallow |
|
Behavior:
dress |
appropriate to climate, clean, fits.
*abn - too large, held by belt - wt. loss, ascites - long sleeves - drug abuse |
|
Behavior:
personal hygiene |
clean and groomed for age, occupation, socioeconomic group. -
abn* - unkept - illness |
|
weight - kg & lbs
|
balance, recommended range for height
same time a day (lasix) |
|
height -
|
headpiece on top of head, shoeless, stand straight
|
|
Temperature
|
hypothalamus as thermostat
|
|
influences temperature
|
diurnal cycle - 1 degree to 1.5 degree from early morning to later in evening
|
|
factors affecting body temperature
|
menstrual cycle, exercise, age (elders, lower)
|
|
routes
|
oral, electronic thermometer, axillary, rectal, tympanic membrane thermometer
|
|
pulse
|
with every beat, the heart pumps an amt. of blood - called Stroke Volume
|
|
rhythm "sinus arrythmias"
|
irregularity - children/young adults
|
|
force of pulse
|
strength of heart's SV
3 + full, bounding 2 + normal 1 + weak, thready 0 - absent |
|
elasticity
|
artery feels springy, straight, resilient.
|
|
respirations
|
ratio of pulse rate to respirations should be 4:1
|
|
blood pressure
systolic |
maximum pressure felt on artery during LV contraction
|
|
blood pressure
diastole |
resting, between contractions
|
|
pulse pressure
|
difference between systolic and diastolic, reflects SV
|
|
mean arterial pressure
|
pressure forcing blood into tissues
|
|
influences on BP
|
age (rise thru childhood --> adulthood)
gender (after puberty, girls lower, after menopause, higher) race - blacks higher |
|
influences on BP
|
diurnal rhythm - BP higher in late afternoon
weight - higher in obese exercise - increase, after 5 min - normal |
|
Physiological Factors controlling BP
|
CO
Peripheral Vascular Resistance Volume of Circulating Blood Viscosity Elasticity of vessel walls |
|
Korotkoff Sounds
|
1 tapping - systolic
auscultory gap -- II swooshing III knocking IV muffling V silence (diastolic) |
|
precordium
|
area on anterior chest overlying heart and great vessels
|
|
mediastinum
|
heart and great vessels located here -- between the lungs in the middle third of thoracic cage
|
|
apex & base of heart
|
apex - bottom
base - top |
|
pericardium
|
tough, fibrous, double-walled sac surrounds and protects heart
|
|
myocardium
|
muscular layer of the heart, does the pumping
|
|
endocardium
|
thin layer of endothelial tissue that lines the inner surface of the heart chambers and valves
|
|
atrioventricular valves
|
separate atria and ventricles
|
|
tricuspid
|
right AV
|
|
bicuspid, or mitral valve
|
left AV
|
|
semilunar
|
set between the ventricles and arteries
pulmonic - right side aortic - left side |
|
direction of blood flow
|
liver to RA -- inferior vena cava, superior vena cava from head and upper ext. - RA thru tricuspid to RV
RV -- to pulm. valve to pulm. artery -- to lungs -- pulm veins to LA LA thru mitralvalve, to LV -- to aorta -- body |
|
first heart sound
|
S1 - closure of AV valves -- beginning of systole
|
|
second heart sound
|
S2 -- closure of semilunar valves (end of systole)
|
|
effect of respiration
(insp. intrathoracic pressure dec.) |
volume of right and left ventricular systole is equal:
More to the right heart, less to the left |
|
extra heart sounds
|
S3 - ventricular filling creates vibration -- resistat to filling
|
|
fourth heart soudn
|
S3 - end of diastole, resistant to filling
|
|
murmurs
|
swooshing, turbulent blood flow
|
|
characteristics of sound
|
frequency (pitch) - heart sounds high or low pitched
intensity (loudness) - loud or soft duration - very short timing - systole or diastole |
|
pumping
|
Cardiac Output -
CO = SV x R |
|
preload
|
venous return that builds during diastole
|
|
afterload
|
opposing pressure the V must generate to open the aortic vavle against high aortic pressure
|
|
neck vessels
|
carotid, jugular (int. & ext)
|
|
subjective data
|
chest pain, dyspnea, orthopnea, cough, fatigue, cyanosis, or pallor
|
|
health history questions
|
edema, nocturia, cadiac history, family cardiac history, personal habits (cardiac risk factors)
|
|
preparation
|
position/drape,room prep, order of exam. - marking pen, small centimeter ruler, stehoscope
|
|
carotid ateries
|
paplate, auscultate for bruit
|
|
bruit -
|
blowing, swishing ( turbulence due to local vascular cause, atherosclerotic narrowing)
|
|
jugular veins
|
inspect, estimate, palpate (hepatojugular reflex)
|
|
precordium
|
inspect anterior chest, palpate apical impulse, & across precordium, percuss to outline cardiac borders
|
|
heart sounds -
|
note rate/rhythm, sinus arrythmia/pulse deficit
identify S1 & S2 - s1 louder extra heart sounds/murmur? |
|
abn - ejection click
|
short, high pitched sound - click quality
|
|
aortic prosthetic valve sounds
|
iatrogenically induced heart sound
|
|
midsystolic click
|
mitral valve prolapse - short, high pitch w/ click quality
|