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234 Cards in this Set
- Front
- Back
What are the findings of atelectasis?
|
-lag expansion on affected side
-increase resp. rate & pulse -decrease t.f. -tracheal shift to the affected side -dull area -decrease in breath sounds |
|
What are the signs and symptoms of bronchitis?
|
Hacking/rasping cough producing thick sputum
|
|
What are the findings of bronchitis?
|
-normal t.f.
-resonant -normal voice sounds -crackles(may wheeze) |
|
What are the signs and symptoms of chronic bronchitis and what is a common cause?
|
-dyspnea
-fatigue -cyanosis -clubbing -common cause=smoking |
|
What is emphysema?
|
increase in airway resistance
hyperinflated lung increase lung volume cause=smoking |
|
What are the findings of emphysema?
|
-use of accessory muscles
-tripod position -DOE -resp. distress -tachypnea (fast not deep) -decrease t.f. -decrease chest expansion -hyperresonant -decrease breath sounds |
|
What is asthma?
|
inflammation/edema in the walls of bronchioles and secretion of highly viscous mucous into airways (allergy)
|
|
What are the symptoms of asthma?
|
wheezing
dyspnea chest tightness |
|
What are the findings of asthma?
|
-increase resp. rate
-SOB w/wheeze -accessory muscles -cyanosis -apprehension -expiration prolonged -decrease t.f. -tachycardia -resonant -decrease air movement -decrease breath and voice sounds -bilateral wheezing(exp) |
|
What are the stages of TB?
|
1. inflammatory
2.scar tissue forms; lesions calcify (xray) 3. reactivation of lesions; multiply 4. lesion erodes cause destruction forming air-filled cavity APEX=MOST DAMAGE initially asymptomatic (skin test, xray) |
|
What are the findings of emphysema?
|
-use of accessory muscles
-tripod position -DOE -resp. distress -tachypnea (fast not deep) -decrease t.f. -decrease chest expansion -hyperresonant -decrease breath sounds |
|
What are the signs and symptoms of progressive TB?
|
-weight loss/anorexia
-easy fatigue -low-grade afternoon fevers -nigh sweats -pleural effusion -recurrent resp. inf. |
|
What is asthma?
|
inflammation/edema in the walls of bronchioles and secretion of highly viscous mucous into airways (allergy)
|
|
What are the symptoms of asthma?
|
wheezing
dyspnea chest tightness |
|
What are the findings of emphysema?
|
-use of accessory muscles
-tripod position -DOE -resp. distress -tachypnea (fast not deep) -decrease t.f. -decrease chest expansion -hyperresonant -decrease breath sounds |
|
What are the findings of emphysema?
|
-use of accessory muscles
-tripod position -DOE -resp. distress -tachypnea (fast not deep) -decrease t.f. -decrease chest expansion -hyperresonant -decrease breath sounds |
|
What are the characteristics of cough in TB?
|
intially non-productive; later its purulent, yellow-green, bloody
|
|
What are the findings of asthma?
|
-increase resp. rate
-SOB w/wheeze -accessory muscles -cyanosis -apprehension -expiration prolonged -decrease t.f. -tachycardia -resonant -decrease air movement -decrease breath and voice sounds -bilateral wheezing(exp) |
|
What are the findings of TB?
|
dyspnea, orthopnea, fatigue, weakness;
-resonant initially; dull over effusion -crackles of increased lobes |
|
What are the stages of TB?
|
1. inflammatory
2.scar tissue forms; lesions calcify (xray) 3. reactivation of lesions; multiply 4. lesion erodes cause destruction forming air-filled cavity APEX=MOST DAMAGE initially asymptomatic (skin test, xray) |
|
What is asthma?
|
inflammation/edema in the walls of bronchioles and secretion of highly viscous mucous into airways (allergy)
|
|
What is asthma?
|
inflammation/edema in the walls of bronchioles and secretion of highly viscous mucous into airways (allergy)
|
|
What are the signs and symptoms of progressive TB?
|
-weight loss/anorexia
-easy fatigue -low-grade afternoon fevers -nigh sweats -pleural effusion -recurrent resp. inf. |
|
What are the symptoms of asthma?
|
wheezing
dyspnea chest tightness |
|
What are the symptoms of asthma?
|
wheezing
dyspnea chest tightness |
|
What is pneumothorax?
|
free air in pleural space causing partial or complete collapsed lung; usually unilateral
|
|
What are the characteristics of cough in TB?
|
intially non-productive; later its purulent, yellow-green, bloody
|
|
What are the findings of asthma?
|
-increase resp. rate
-SOB w/wheeze -accessory muscles -cyanosis -apprehension -expiration prolonged -decrease t.f. -tachycardia -resonant -decrease air movement -decrease breath and voice sounds -bilateral wheezing(exp) |
|
What are the findings of asthma?
|
-increase resp. rate
-SOB w/wheeze -accessory muscles -cyanosis -apprehension -expiration prolonged -decrease t.f. -tachycardia -resonant -decrease air movement -decrease breath and voice sounds -bilateral wheezing(exp) |
|
What can cause pneumothrorax?
|
-spontaneous(rupture)
-traumatic(injury) -tension(trapped air) |
|
What are the findings of TB?
|
dyspnea, orthopnea, fatigue, weakness;
-resonant initially; dull over effusion -crackles of increased lobes |
|
What are the stages of TB?
|
1. inflammatory
2.scar tissue forms; lesions calcify (xray) 3. reactivation of lesions; multiply 4. lesion erodes cause destruction forming air-filled cavity APEX=MOST DAMAGE initially asymptomatic (skin test, xray) |
|
What are the stages of TB?
|
1. inflammatory
2.scar tissue forms; lesions calcify (xray) 3. reactivation of lesions; multiply 4. lesion erodes cause destruction forming air-filled cavity APEX=MOST DAMAGE initially asymptomatic (skin test, xray) |
|
What are the signs and symptoms of progressive TB?
|
-weight loss/anorexia
-easy fatigue -low-grade afternoon fevers -nigh sweats -pleural effusion -recurrent resp. inf. |
|
What are the signs and symptoms of progressive TB?
|
-weight loss/anorexia
-easy fatigue -low-grade afternoon fevers -nigh sweats -pleural effusion -recurrent resp. inf. |
|
What is pneumothorax?
|
free air in pleural space causing partial or complete collapsed lung; usually unilateral
|
|
What are the characteristics of cough in TB?
|
intially non-productive; later its purulent, yellow-green, bloody
|
|
What are the characteristics of cough in TB?
|
intially non-productive; later its purulent, yellow-green, bloody
|
|
What can cause pneumothrorax?
|
-spontaneous(rupture)
-traumatic(injury) -tension(trapped air) |
|
What are the findings of emphysema?
|
-use of accessory muscles
-tripod position -DOE -resp. distress -tachypnea (fast not deep) -decrease t.f. -decrease chest expansion -hyperresonant -decrease breath sounds |
|
What are the findings of TB?
|
dyspnea, orthopnea, fatigue, weakness;
-resonant initially; dull over effusion -crackles of increased lobes |
|
What are the findings of TB?
|
dyspnea, orthopnea, fatigue, weakness;
-resonant initially; dull over effusion -crackles of increased lobes |
|
What is asthma?
|
inflammation/edema in the walls of bronchioles and secretion of highly viscous mucous into airways (allergy)
|
|
What is pneumothorax?
|
free air in pleural space causing partial or complete collapsed lung; usually unilateral
|
|
What can cause pneumothrorax?
|
-spontaneous(rupture)
-traumatic(injury) -tension(trapped air) |
|
What is pneumothorax?
|
free air in pleural space causing partial or complete collapsed lung; usually unilateral
|
|
What are the symptoms of asthma?
|
wheezing
dyspnea chest tightness |
|
What can cause pneumothrorax?
|
-spontaneous(rupture)
-traumatic(injury) -tension(trapped air) |
|
What are the findings of asthma?
|
-increase resp. rate
-SOB w/wheeze -accessory muscles -cyanosis -apprehension -expiration prolonged -decrease t.f. -tachycardia -resonant -decrease air movement -decrease breath and voice sounds -bilateral wheezing(exp) |
|
What are the stages of TB?
|
1. inflammatory
2.scar tissue forms; lesions calcify (xray) 3. reactivation of lesions; multiply 4. lesion erodes cause destruction forming air-filled cavity APEX=MOST DAMAGE initially asymptomatic (skin test, xray) |
|
What are the signs and symptoms of progressive TB?
|
-weight loss/anorexia
-easy fatigue -low-grade afternoon fevers -nigh sweats -pleural effusion -recurrent resp. inf. |
|
What are the characteristics of cough in TB?
|
intially non-productive; later its purulent, yellow-green, bloody
|
|
What are the findings of TB?
|
dyspnea, orthopnea, fatigue, weakness;
-resonant initially; dull over effusion -crackles of increased lobes |
|
What is pneumothorax?
|
free air in pleural space causing partial or complete collapsed lung; usually unilateral
|
|
What can cause pneumothrorax?
|
-spontaneous(rupture)
-traumatic(injury) -tension(trapped air) |
|
What are the findings of pnemothorax?
|
-unequal chest expantion(affected side)
-tachypnea -cyanosis -apprehension -tachycardia -decrease BP -decrease or absent t.f. -tracheal shift (opp.) -hyperresonant -decrease or absent breath sounds |
|
What is a pulmonary embolism?
|
-undissolved material that detach and travel through venous system and lodge to occlude pulmonary vessels; 95% arise from DVT in legs
|
|
What is a result of a PE?
|
-ischemia of lung tissue
-increase in pulmonary artery pressure -decrease of cardiac output -hypoxia |
|
What are the signs and symptoms of pulmonary embolism?
|
-chest pain (worse of insp.)
-dyspnes -apprehension -restless -anxiety/mental status change -cyanosis -tachypnea -cough/hemoptysis -PaO2 less than 80(rep. alk.) -diaphoresis -hypotension -tachycardia -accentuated S2 -crackles/wheezes |
|
What happens if there is an increase of pressure in the left heart?
|
heart failure: symptoms of pulmonary congestion
|
|
What happens if there is an increase in pressure in the right heart?
|
heart failure; shows in the neck veins and abdomen
|
|
What valves are between the artia and ventricles?
|
tricuspid & mitral (AV)
|
|
What are the valves between the ventricles and the arteries?
|
aortic & pulmonic (semilunar)
|
|
Where do you hear the closure of the AV valves best?
|
5ICS5MCL(apex)
|
|
Where do you hear the closure of the semilunar valves best?
|
2nd ICS (base)
|
|
With what condition does S3 occur?
|
CHF (sloshing in)
|
|
With what condition does S4 occur?
|
HTN (a stiff wall)
|
|
What does a thrill mean?
|
turbulent blood flow
|
|
What causes a thrill?
|
velocity of blood, viscosity (anemia), or structural defects
|
|
What is normal cardiac output?
|
4-6 L/min
|
|
What is preload?
|
the length to which the ventricle muscles stretch just before contraction; amount of blood left in the left ventricle after diastole
|
|
What is afterload?
|
how much effort the heart has to pump against
|
|
What is the carotid artery associated with?
|
ventricular systole/ S1
|
|
What does the jugular vein reflect?
|
reflects volume & pressure increase in the right heart
|
|
What produces the internal jugular vein pulsation?
|
backwash
|
|
What position should a patient be in when observing the j. veins?
|
30-40
|
|
What are artery pulses like?
|
constant boom
|
|
What are vein pulses like?
|
wave-like
|
|
What are some cardiac changes of the aging adult?
|
-increase in systole
-arteriosclerosis -thickening of ventricular walls -prone to arrhythmias -ECG changes -lifestyle changes |
|
What are some CV considerations of african americans?
|
-increased rated of heart disease and stroke
-HTN |
|
What is angina?
|
heart's vascular supply cannot keep up with demand
|
|
What is paroxysmal noctural dyspnea?
|
-occurs with HF
- awakens needing fresh air b/c lying down cause increase load and weakened heart cannot accomodate |
|
What are some CAD risk factors?
|
-increase chol. & BP
-DM, obesity -smoking -decrease exercise -hormone replacement therapy |
|
What is important to remember with a female when performing the CV portion of a physical assessment?
|
keep breasts draped
|
|
What is the order of the CV exam?
|
1. pulse & BP
2. extremities 3. neck vessels 4. precordium |
|
What info can the carotid arteries yield?
|
important info in cardiac function
|
|
Where is the carotid artery located?
|
medial to sternomastoid
|
|
What should the carotid artery pulse feel like?
|
smooth w/ rapid upstroke and slower downstroke
|
|
How do you auscultate the carotids?
|
-use bell
-exhale & hold (inhale tenses) -neck in neutral position -levels: 1. angle of jaw 2. midcervical angle 3. base of neck -listen for a bruit |
|
Does a bruit of the carotid indicate?
|
anthersclerotic narrowing
|
|
What can be assessed with the jugular veins?
|
central venous pressure (CVP); and the hearts efficiency as a pump
|
|
Which j. vein is more reliable and why?
|
internal right bc it is more directly attached to the sup. vena cava; cannot see the vein but can see pulsation
|
|
How do you examine j. veins?
|
-30 to 45
- remove pillows - turn head away - look for pulse |
|
What does unilateral distention of the j.veins indicate?
|
-local cause (kinking or aneurysm)
|
|
What does the full distention of both j. veins over 45 degrees indicate?
|
heart failure
|
|
When does elevated j. vein pressure occur?
|
over 3cm; heart failure
|
|
What is the hepatojugular reflux and when is it performed?
|
pressure on abdomen; j. veins should rise for a few seconds then recede; ABN= veins remain elevated as long as you push; used with high jugular pressure or suspected HF
|
|
What creates an apical impulse?
|
L. ventricle rotates against chest wall during systole
|
|
What is a heave/lift?
|
forceful thrusting of ventricle during systole; occurs with ventricular hypertrophy as a result of increase workload
|
|
Where would you see a right ventricle heave/lift?
|
sternal border
|
|
Where would you see a heave/lift in the L. ventricle?
|
apex
|
|
How do you palpate the apical pulse?
|
-one finger pad
-"exhale and hold it" - may not be palpable in obesity or emphysema |
|
What are the normal characteristics of a palapted apical pulse?
|
-5ICSMCL
-1cm x 2 cm -short amp. -short duration |
|
When is the amplitude & duration of the apical pulse increased?
|
-high CO states
-anemia -anxiety -fever -hyperthyroidism |
|
What difference in the apical pulse indicates cardiac enlargment?
|
displaces pulse down and to the left
|
|
What happens to the apical pulse with L. ventricle hypertrophy?
|
increase in force and duration but no change in location
|
|
What does a heave/ lift @ the left sternal border indicate?
|
pulmonic valve disease
|
|
How do you auscultate heart sounds?
|
-30 degrees
-diaphragm -"Z" pattern from base to apex |
|
What are the five articulatory areas? What valves are heard at each?
|
1. 2nd R. ICS (aortic)
2. 2nd L. ICS (pulmonic) 3. 3rd L. ICS (Erb's point) 4. 4th L.ICS (tricuspid) 5. 5th ICS MCL (mitral) |
|
What is a sinus rhythm?
|
breathing rate associated with respiration; increase at peak of inspiration & slowing with expiration
|
|
What does a 15-20 point pulse deficit indicate?
|
-heart beating but not pumping efficiently to lower extremeties
-sign of weak ventricle contraction -A. Fib |
|
What is atrial fibrilation?
|
-atria quivers
-does not get rid of all blood on contraction causing clot -decrease SV & CO -can cause stroke or PE |
|
What are the characteristics of S1?
|
-start of systole
-reference point for timing -"lub" -louder @ apex -coincides w/ carotids -closure of AV valves -split= always there |
|
What are the characteristics of S2?
|
-louder @ base
-"dub" - closure of semilunar - split = only heard on insp. |
|
What is a split heartbeat?
|
valves close seperately
|
|
With what conditions are normal heart sounds accentuated or diminished?
|
-emphysema
-obesity -pericardial fluid |
|
How do you auscultate for extra heart sounds?
|
use the bell to go over ausculatory areas
|
|
What is a midsystolic click?
|
-mitral valve prolapse
-valve not only closes with contraction, but also balloons back up into left atrium & tensing creates click -occurs @ mid to late systole - best heard at apex |
|
What are the characteristics of S3?
|
-diastole
-after S2 -"distant thunder" -best heard @ apex -does not vary w/resp |
|
When is S3 a normal finding?
|
until age 40
disappears with sitting up |
|
When is S3 pathologic?
|
-after age 40
-persists when sitting up -earliest sign of HF |
|
What are the characteristics of S4?
|
-late in diastole
-immediately b4 S1 -very soft, very low pitched |
|
When is S4 normal?
|
- in adults older than 40/50 with no evidence of CV disease
|
|
When is S4 pathologic?
|
with CAD
|
|
What characteristics are needed when a murmur is heard?
|
-timing
-loudness -pitch -pattern -quality -location -radiation -posture |
|
What are the symptoms of angina in women?
|
-hot or cold burning sensation
-tender to touch -no chest pain or discomfort |
|
What are the symptoms of a heart attack in women?
|
-pain/discomfort above waist
-brealthlessness -clamy, sweating, dizziness -anxiety -dependant edema -nausea/indigestion -sleep disturbance -unusual fatigue/ weakness |
|
What causes the signs and symptoms of heart failure?
|
the hearts inablility to pump enough blood and the kidney's compesatory mechanisms
|
|
When does acute onset HF occur?
|
after MI when direct damage to the hearts contractability has occured
|
|
When does chronic onset HF occur?
|
(HTN) when ventricles must pump against chronically increased pressure
|
|
What are the symptoms of angina in women?
|
-hot or cold burning sensation
-tender to touch -no chest pain or discomfort |
|
What are the symptoms of a heart attack in women?
|
-pain/discomfort above waist
-brealthlessness -clamy, sweating, dizziness -anxiety -dependant edema -nausea/indigestion -sleep disturbance -unusual fatigue/ weakness |
|
What are the symptoms of angina in women?
|
-hot or cold burning sensation
-tender to touch -no chest pain or discomfort |
|
What causes the signs and symptoms of heart failure?
|
the hearts inablility to pump enough blood and the kidney's compesatory mechanisms
|
|
What are the symptoms of a heart attack in women?
|
-pain/discomfort above waist
-brealthlessness -clamy, sweating, dizziness -anxiety -dependant edema -nausea/indigestion -sleep disturbance -unusual fatigue/ weakness |
|
When does acute onset HF occur?
|
after MI when direct damage to the hearts contractability has occured
|
|
What causes the signs and symptoms of heart failure?
|
the hearts inablility to pump enough blood and the kidney's compesatory mechanisms
|
|
When does chronic onset HF occur?
|
(HTN) when ventricles must pump against chronically increased pressure
|
|
When does acute onset HF occur?
|
after MI when direct damage to the hearts contractability has occured
|
|
When does chronic onset HF occur?
|
(HTN) when ventricles must pump against chronically increased pressure
|
|
What causes a thrill at the 2nd and 3rd ICS?
|
-pulmonic stenosis
-pulmonic HTN |
|
What causes a lift(heave) at the left sternal border?
|
-right ventricular hypertrophy
-pulmonic valve disease -pulmonic HTN -chronic lung disease |
|
What is volume overload?
|
-cardiac enlargement (more than 1 ICS)
-displaces apical pulse -L.vent. hypertrophy and dilation |
|
When does volume overload occur?
|
mitral/aortic regurg.
left to right shunts |
|
What is pressure overload?
|
-apical pulse increases force & duration
-not necessarily displaced or enlarged -l. ventricular hypertrophy (no dilation) |
|
What is arteriosclerosis?
|
hardening of vessel walls
|
|
What is atherosclerosis?
|
build up of plaque on vessels; turbulent blood flow heard
|
|
What is indicative of heart size?
|
Apical pulse
|
|
What are the characteristics of arteries?
|
-no valves
-high pressure -stronger walls -stretch and recoil with diastole -contain muscle fibers that control amt of blood delivered to tissue -all have pulse |
|
What are characteristics of veins?
|
-valves keep blood flowing toward heart
-low pressure -thinner walls -deoxygenated blood -body has more veins |
|
What are the deep veins of the legs?
|
femoral and popliteal
|
|
What are the risks of venous disease?
|
-prolonged sitting, standing, bedrest
-hypercoaguable states -vein wall trauma -varicose veins (wide lumen and valves cannot accomadate; occurs with genes, pregnancy and obesity) |
|
What do vessels carry?
|
blood or lymph
|
|
What happens if there is a disease in the vascular system?
|
-problem with O2 delivery and nutrients
|
|
What happens w/o lymph drainage?
|
fluid would build up causing edema (breast cancer)
|
|
What are some changes of the aging adult in the peripheral vascular system?
|
-ateriosclerosis/ athrosclerosis
-progressive englargment of calf veins -prolonged sitting/bedrest & HF = increased risk of DVT/PE -fewer lymph nodes and they decrease in size |
|
What is intermittent claudication?
|
pain w/ walking
|
|
What is claudication distance?
|
distance to produce pain
|
|
What does leg pain in the form of cramping indicate?
|
ateriole disease
|
|
What does coolness of the skin indicate?
|
arterial disease
|
|
What does bilateral edema indicate?
|
systemic cause ie: HF
|
|
What does unilateral edema indicate?
|
local obs./inflammation
|
|
When do you exam a pts arms?
|
when checking VS while pt is sitting
|
|
When do you examine a pts legs?
|
- directly after abdominal exam while pt is still supine
-have them stand to evaluate veins |
|
What does the objective data of the peripheral vascular system consist of?
|
-inspection
-palpation -comparison of opposite extremity |
|
What does oral contraception cause a risk for?
|
blood clots
|
|
What does a capillary refill of more than 2 seconds indicate?
|
vasoconstriction or decrease CO; (cold, clammy, and pale)
|
|
What does oral contraception cause a risk for?
|
blood clots
|
|
What does capillary refill indicate?
|
index of peripheral perfusion and CO
|
|
What does a capillary refill of more than 2 seconds indicate?
|
vasoconstriction or decrease CO; (cold, clammy, and pale)
|
|
What causes edema of upper extremeties?
|
lymphatic drainage obstruction; ie: breast surgery
|
|
What is a normal pulse?
|
+2
|
|
What does capillary refill indicate?
|
index of peripheral perfusion and CO
|
|
What causes edema of upper extremeties?
|
lymphatic drainage obstruction; ie: breast surgery
|
|
What is a normal pulse?
|
+2
|
|
What does a +3 pulse occur with?
|
-anemia
-hyperthyroidism -hyperkinetic states |
|
What does a +1 pulse occur with?
|
-shock
-peripheral arterial disease |
|
How do you palpate the epitrochlear lymph nodes
|
-"shake hands"
-feel under elbow btwn biceps and triceps -normal= not palapble -enlargement= inf. of lower arm or hand |
|
What does the allen test determine?
|
adequate circulation to hand
|
|
What does a pallor/sluggish return during the allen test indicate?
|
occlusion of arterial flow
|
|
What does pallor legs indicate?
|
vasoconstriction
|
|
What does erythema in the legs indicate?
|
vasodilation
|
|
What does skin color reflect?
|
reflect malnutrition
|
|
How should venous pattern appear on the legs?>
|
flat & barely visible
|
|
What should you do if you suspect DVT?
|
measure calf at widest point and then measure that the same point on the other leg
|
|
What should you do if you suspect lymphadema?
|
measure thigh, distal calf, knee and ankle
|
|
What are some characteristics of a possible DVT?
|
-acute, unilateral painful edema
-asymmetry of calves more than 1cm |
|
What does brown discoloration of the skin indicate?
|
venous disease
|
|
What is a positive Homan's sign?
|
pain when calf muscle is compressed or when foot is pushed towards tibia
|
|
How do you check for pretibial edema?
|
firmly depress skin over tibia for 5 seconds and release
|
|
With what conditions does bilateral dependant pitting edema occur?
|
-HF
-Diabetic neuropathys -hepatic cirrohsis |
|
What is the manual compression test?
|
-use with varicose veins
-determines if valves are competent -compress vein & feel at lower point -no wave should occur -wave presence indicates that the valves are incompetent |
|
What is lymphedema?
|
-impedes on drainage of lymph
-promotes fluid leaking -can lead to infection, delayed wound healing,chronic inflammation, fibrosis of surrounding tissue |
|
What is chronic lymphadema?
|
unilateral swelling, non-pittting edema, threat to body image and constant reminder of cancer
|
|
What are the characteristics of arterial ulcers?
|
-edges clearly defined
-hairless -absent pulse -nail dystrophy -nocturnal pain -occurs on toes and feet |
|
What are some risk factors of arterial ulcers?
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-CAD
-Hx of stroke/TIA -Obesity and Immobility -PVD -DM |
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What are some characteristics of venous ulcers?
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-mid calf to below malleoli
-brown skin -normal pulses |
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What are the symptoms of venous insufficiency?
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-leg pain
-aching -swelling -skin breakdown -pigmentation -eczema |
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What are the risk factors of venous ulcers?
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-varicose veins
-DVT -phlebitis -fracture,trauma,surgery -family hx |
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Where is the tail of spence located?
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upper outer quadrant; common area for tumors
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What are the normal characteristics of cooper's ligament?
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-strong and intact
-w/age they get weak and sag -fibrous band that supports breast |
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What are the cancerous characteristics of cooper's ligament?
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become contracted and produces pits and dimples in skin
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Where does lymph flow?
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to the opposite breast & liver; common metastasis
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What is gynecomastia?
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-glandular enlargement
-tender & often asymmetric or unilateral -adolecents or eldery -temporary; 1 year -digoxin |
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What is the supernumerary nipple?
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normal along embryonic milk line
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What is common breast asymmetry?
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left is bigger than right
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What is retraction?
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signs of cancer
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What does bringing arms over head during breast exam do?
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both breast should move symmetrically
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What does pushing hands together or against hips during breast exam do?
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tightens p. major muscles & slight lifting of breast will occur; dimpling or puckering
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What does leaning forward do during a breast exam?
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symmetric free-forward movement; fixation to wall signals retraction
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How do you palpate axillae?
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sitting position
ROM to increase surface area |
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When do nodes of the axillae enlarge?
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-inf. of breast, arm, or hand
-breast cancer |
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What is the patients position during the breast exam?
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-supine
-raise arm over head -flattens tissue allowing lumps to feel more distinct - use pads of first 3 fingers |
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What are the different methods of palpating the breast?
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-vertical
-wedge -circular -bimanual(large breasts) |
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What are the characteristics of fibroadenoma?
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-benign
-round -firm/rubbery -clear margins -usually single -very mobile/slippery -no tenderness -grows quickly & constantly |
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What are the characteristics of benign breast disease?
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-round
-firm to soft/rubbery -multiple -mobile -tender(before menses) -no retraction |
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What are the characteristics of a cancerous lump in the breast?
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-irregular shape
-firm to hard -poorly defined -single -fixed -skin retraction -grows constantly -immediate attention |
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What is the baseline age for BSE?
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20
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When should a woman perform BSE?
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4-7 into cycle
|
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When would a pregnant or post menopausal woman perform BSE?
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a familiar date of the month; every month
|
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What is the purpose of BSE?
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to farmiliarize woman with own breast & normal variation; detect lumps
|
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What are important ways to encourage BSE?
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-emphasize the absence of lumps and to report findings
-focus on positives -use facts: majority wont get BC; most lumps are benign; early detection=high survival rate |
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How is BSE done?
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-in shower/in front of mirror
-supine position |
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What are some breast cancer risk factors?
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-FAMILY HX
-female>50 -personal hx of bc -no children/first after 30 -menstruation before 12 -menopause after 55 |
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Where is the suprasternal notch located?
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just above the sternum btwn the
|
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Where is the angle of louis located?
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2nd ribs and lower 2nd intercostal space
|
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What are the areas of the lungs?
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-base: 6th rib A & 10th P; 12th on respiration; rests on diaphragm
-Lobes: R=3 L=2 |
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How do the lungs maintain homeostasis?
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lungs adjust level of CO2, supply O2 and maintain pH
|
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What is inspiration?
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creates neg. pressure causing air to rush in; diapragm descends & flattens; ICS lift sternum and elevates ribs
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What other systems are involved in lung function?
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nervous, renal and CV
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What is ventilation?
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air movement
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What is diffusion and perfusion?
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resp. gases move through circulation and exchange CO2 and O2
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What is control of ventilation?
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maintaining adequate gas exchange according to needs
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What is the normal stimulus of respiration?
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CO2
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