Npte Study Guide

Front 1

Inspiratory reserve volume

Back 1

Men: 3.3 L
Women: 1.9 L

Front 2

Tidal volume

Back 2

0.5 L

Front 3

Expiratory reserve volume

Back 3

Men: 1.0 L
Women: 0.7 L

Front 4

Residual volume

Back 4

Men: 1.2 L
Women: 1.1 L

Front 5

Vital capacity

Back 5

Men: 4.8 L
Women: 3.1 L

IRV plus TV plus ERV

Front 6

Inspiratory capacity

Back 6

Men: 3.8 L
Women: 2.4 L

IRV plus TV

Front 7

Functional residual capacity

Back 7

Men: 2.2 L
Women: 1.8 L

ERV plus RV

Front 8

Total lung capacity

Back 8

Men: 6.0 L
Women: 4.2 L

IRV plus TV plus ERV plus RV

Front 9

RBC

Back 9

4 - 5.5 M/µL

RBC (Child)
3.5 - 5.0 M/µL

Front 10

WBC

Back 10

3.8 - 11.0 K / mm cubed

WBC (Child)
5.0 - 10.0 K / mm cubed

Front 11

Hgb

Back 11

11 - 18 g/dL

Hgb (child)
10 - 14 g/dL

Front 12

Hct

Back 12

35 - 50%

Hct (Child)
30 - 42%

Front 13

Erythrocyte Sedimentation Rate (ESR)

Back 13

15 – 20 mm/hr

Front 14

Creatinine Kinase Index (CK-Index)

Back 14

0 - 3

Front 15

Creatinine Kinase-MB (CK-MB)

Back 15

0 - 3 ng/ml

Front 16

Total Creatinine Kinase

Back 16

38 - 120 ng/ml

Front 17

Albumin

Back 17

3.5 - 5.0 gm/dL

Albumin (newborn)
2.9 - 5.5 gm/dL
Albumin (child)
3.8 - 5.4 gm/dL

Front 18

BUN

Back 18

6 - 23 mg/dL

Front 19

Calcium (total)

Back 19

8 - 11 mg/dL

Front 20

Cortisol

Back 20

Cortisol (8 AM)
5 - 25 gm/dL

Cortisol (8 PM)
2 - 9 gm/dL

Front 21

Glucose

Back 21

Glucose (fasting)
72 – 110 mg/dL OR 4 – 5.9 mmol/L

Glucose (2hr post)
Under 140 mg/dL OR 7.8 mmol/L

Front 22

Insulin

Back 22

0 - 180 pmol/L

Front 23

Rheumatoid Factor (RF)

Back 23

<80 IU/ml

Front 24

Cholesterol

Back 24

Cholesterol (total)
Less than 200 mg/dL desirable

Cholesterol (HDL)
30 - 75 mg/dL

Cholesterol (LDL)
Less than 130 mg/dL desirable

Front 25

Triglycerides

Back 25

Triglycerides (Male)
Greater than 40 - 170 mg/dL

Triglycerides (Female)
Greater than 35 - 135 mg/dL

Front 26

Platelets

Back 26

140,000 - 450,000 / ml

Front 27

PT Lab values

Back 27

10 - 14 seconds

Front 28

PTT

Back 28

32 - 45 seconds

Front 29

Thrombin time

Back 29

11 - 15 seconds

Front 30

Osmolality of CSF

Back 30

290 - 298 mOsm/L

Front 31

Pressure of CSF

Back 31

70 - 180 mm/H2O

Front 32

Cardiac Output

Back 32

4 - 8 LPM

Front 33

Ejection Fraction

Back 33

60 - 75%

Front 34

Cerebral Perfusion Pressure

Back 34

70 - 90 mm Hg

Front 35

Intracranial Pressure

Back 35

5 - 15 mm Hg or 5 - 10 cm H2O

Front 36

pH

Back 36

7.35 - 7.45

Front 37

PaCO2

Back 37

35 - 45 mm Hg

Front 38

O2 sat

Back 38

96 - 100%

Front 39

PaO2

Back 39

85 - 100 mm Hg

Front 40

Gracile fascicle:

Back 40

Ascending
· Part of Dorsal Column-Medial Lemniscal (DCML) system
· Discriminative (fine) touch, vibratory sense, position sense to lower extremities

Front 41

Cuneate Fascicle:

Back 41

Ascending
· Part of Dorsal Column-Medial Lemniscal (DCML) system
· Discriminative (fine) touch, vibratory sense, position sense to upper extremities

Front 42

Spinocerebellar tract:

Back 42

Ascending
Dorsal & Ventral:
· Proprioception from ipsilateral trunk and lower limb
· Coordination of movements of the lower limb muscles
· Posture maintenance
*Dorsal=info from muscle spindles Ventral= info from golgi

Front 43

Spinothalamic:

Back 43

Ascending
· Crude touch, pain, and temperature

Front 44

Medial Longitudinal:

Back 44

Ascending/ Descending
· Info about direction eyes should move

Front 45

Lateral Corticospinal/ Pyramidal:

Back 45

Descending
· Sensory modulation
· Fine motor control of limbs and digits

Front 46

Rubrospinal:

Back 46

Descending
· Voluntary movement of upper limb muscles
· Large muscle movement of the arms and the legs
· Fine motor control
· Facilitates flexion and inhibits extension in UEs

Front 47

Lateral reticulospinal:

Back 47

Descending
· Inhibits excitatory axial extensor muscles of movement

Front 48

Medial reticulospinal:

Back 48

Descending
· Responsible for anti-gravity, extensor muscles

Front 49

Vestibulospinal:

Back 49

Descending
· Facilitates extensor (antigravity) muscle tone and equilibrium
· Medial: Controls correct position of the head and neck
· Lateral: Maintains upright and balanced posture by stimulating extensors in the legs

Front 50

Anterior corticospinal:

Back 50

Descending
· Voluntary movement of axial and upper limb muscles

Front 51

Tectospinal:

Back 51

Descending
· Coordinates head and eye movements
· Mediates reflex postural movements of the head in response to visual and auditory stimuli

Front 52

COX-2 inhibitors

Back 52

Osteoarthritis


more selective, inhibit sysnthesis of PGs for pain and inflammation and spare beneficial PGs
· Celebrex (celecoxib)
- less gastritis
- CV - possible MI, stroke

Front 53

Glucosamine/Chondroitin

Back 53

Osteoarthritis

may provide substrates to help regenerate cartilage, synovial fluid


- upset stomach
- HA
- Drowsiness
- skin reactions
- generally well-tolerated
- may derive from shellfish

Front 54

Viscosupplementation

Back 54

helps restore viscosity of synovial fluid
· Hyaluronan (Orthovisc)
· Synvisc
- warmth, pain, stiffness, swelling, or puffiness where medicine’s injected

Front 55

DMARDs

Back 55

Rheumatoid arthritis


- inhibit production of cytokines
- inhibit cellular activation (monocytes, T and B lymphocytes)
· Methotrexate (Rheumatrex)
· Auranofin
· Hydroxychloroquine
· Cyclosporin
· Penicillamine
· Sulfasalazine
· Azathioprine
· Leflunomide
- Inhibit many aspects of immune function
- Attempt to delay or reverse progression
- If tolerated, use before excessive joint destruction

Front 56

opioids

Back 56

acute pain
chronic pain
- act on spinal cord dorsal gray matter and brain (thalamus, hypothalamus)
- bind to specific receptors on pre-synaptic neuron to inhibit release of neurotransmitter and to receptors on post-synaptic neurons to make them less excitable
· Codeine
· Fentanyl
· Hydrocodone (vicodin)
· Meperidine (Demerol)
· Oxycodone
- Sedation
- mood changes, confusion
- respiratory depression
- orthostatic hypotension
- constipation
- tolerance and dependence
- consider timing of treatment with respect to timing of medication
- PCA may help prevent overdose

Front 57

NSAIDs

Back 57

analgesic
anti-inflammatory
antipyretic
anitcoagulant
anticancer?
- inhibit synthesis of prostaglandins by inhibiting cyclooxygenase (key enzyme) - non-selective
- COX-2 inhibitors - more selective, inhibit sysnthesis of PGs for pain and inflammation and spare beneficial PGs
OTC:
· Aspirin
· Ibuprofen
· Naproxen

Front 58

Diuretics

Back 58

HTN
CHF


act on kidneys to decrease total fluid volume in vascular system
· Thiazides
· Loop diuretics (Lasix)
· Potassium sparing agents
- electrolyte imbalance
- orthostatic hypotension
- weakness/fatigue
- confusion, mood changes

Front 59

Beta Blockers

Back 59

-olol
HTN
arrhythmias
angina pectoris
heart failure
recovery from MI


- block effects of epinephrine and norepinephrine to decrease HR and contraction
- reduce sympathetic nervous system effect on cardiovascular system
Cardioselective:
· Atenolol
· Metoprolol
Nonselective
· Pindolol
· propanolol (Inderol)
- bradycardia
- bronchoconstriction
- decreased maximal exercise capacity
- orthostatic hypotension
- depression, lethargy, dec libido
- Cannot rely on vitals alone for exercise tolerance

Front 60

K+ channel blockers

Back 60

arrhythmias

prolong cardiac repolarization

· Amiodarone
· Brentlium
· Dofetilide
· Ibutilide
- initial increase in cardiac arrhythmias
- potential pulmonary/liver damage with amiodarone

Front 61

Vasodilators

Back 61

HTN
heart failure


act directly on vascular smooth muscle to inhibit contraction
· hydralazine
· minoxidil
- reflex tachycardia
- orthostatic hypotension
- dizziness. Headache
- edema, fluid retention
- avoid systemic heat

Front 62

ACE inhibitors

Back 62

-pril
HTN
heart failure


- Inhibits angiotensin converting enzyme to decrease formation of angiotensin II
- prevent acute vasoconstriction
- prevent vascular hypertrophy
· captopril (Capoten)
· enalapril (Vasotec)
· lisinopril (Prinivil, Zestril)
- allergic response/skin rash
- dry cough, nausea,
- dizziness

Front 63

Organic Nitrates

Back 63

angina pectoris
Prinzmetal angina


- venous dilation decreases cardiac preload (blood coming to heart)
- arteral dilation decreases afterload (pressure heart pumps against)
- decreased cardiac workload and O2 demand
· Nitroglycerine
- headache, dizziness
- orthostatic hypotension
- exaggerated response to
systemic heat

Front 64

Digitalis

Back 64

dig-
CHF
arrhythmias


- increases strength of cardiac contraction
- stimulates vagus (to slow HR), inhibits sympathetic to heart (which normally inc HR)


- digitalis toxicity (20-25%)
- GI distress
- Fatigue

Front 65

Anticoagulants

Back 65

venous thrombosis


increases effects of circulating protein antithrombin II to inactivate thrombin
· Heparin
- Heparin-induced thrombocytopenia (decreases platelets)

Front 66

Oral Anticoagulants

Back 66

inhibit Vitamin K function in liver to decrease synthesis of clotting factors
· Warfarin (Coumadin)
- used in tandem with heparin
- hemorrhage

Front 67

Thrombolytics

Back 67

MI
ischemic stroke


initiate clot breakdown to dissolve clots in coronary and carotid arteries
· tPA
· Eminase Retavase (bolus)
- hemorrhage

Front 68

Statins

Back 68

-statin
hyperlipidemia


inhibit HMG-CoA enzyme to decrease cholesterol biosynthesis and increase hepatic LDL breakdown
Common names
· Lipitor (atorvastatin)
· Mevacor (lovastatin)
· Pravachol (pravastatin)
· Crestor

Front 69

Antithrombotics

Back 69

MI
ischemic stroke


- inhibit platelet activity to decrease platelet induced clots
· Aspirin
· Plavix
- Hemorrhage

Front 70

Rancho Levels

Level I

Back 70

- No Response
Patient does not respond to external stimuli and appears asleep

Front 71

Rancho Levels

Level II

Back 71

- Generalized Response
Patient reacts to external stimuli in nonspecific, inconsistent, and non-purposeful manner with
stereotypic and limited responses

Front 72

Rancho Levels

Level III

Back 72

- Localized Response
Patient responds specifically and inconsistently with delays to stimuli, but may follow simple
commands for motor action

Front 73

Rancho Levels

Level IV

Back 73

- Confused, Agitated Response
Patient exhibits bizarre, non-purposeful, incoherent or inappropriate behaviors, has no short-term recall, attention is short and nonselective

Front 74

Rancho Levels

Level V

Back 74

- Confused, Inappropriate, Non-agitated Response
Patient gives random, fragmented, and non-purposeful responses to complex or unstructured stimuli - Simple commands are followed consistently, memory and selective attention are impaired, and new information is not retained

Front 75

Rancho Levels

Level VI

Back 75

- Confused, Appropriate Response
Patient gives context appropriate, goal-directed responses, dependent upon external input for direction. There is carry-over for relearned, but not for new tasks, and recent memory
problems persist

Front 76

Rancho Levels

Level VII

Back 76

- Automatic, Appropriate Response
Patient behaves appropriately in familiar settings, performs daily routines automatically, and shows carry-over for new learning at lower than normal rates. Patient initiates social interactions, but judgment remains impaired

Front 77

Rancho Levels

Level VIII

Back 77

- Purposeful, Appropriate Response
Patient oriented and responds to the environment but abstract reasoning abilities are decreased relative to premorbid levels

Front 78

Glascow Coma Scale

3 Categories & Score Interpretation

Back 78

Eye Opening
Verbal
Motor

Best Possible = 15
Worst Possible = 3

If trached
Best Possible = 10T
Worst Possible = 2T

Front 79

Glascow Coma Scale

Eye Opening

Back 79

4 = Spontaneous
3 = To speech
2 = To pain
1 = None

Front 80

Glascow Coma Scale

Verbal

Back 80

5 = Oriented
4 = Confused
3 = Inappropriate words
2 = Moans
1 = None

Modified for Infants
5 = Babbles
4 = Irritable
3 = Cries to pain
2 = Moans
1 = None

Front 81

Glascow Coma Scale

Motor

Back 81

6 = Follows commands
5 = Localizes to pain
4 = Withdraws to pain
3 = Abnormal flexion
2 = Abnormal extension
1 = None

Front 82

CN I

Back 82

Olfactory
Smell
Sensory only

Front 83

CN II

Back 83

Optic
Vision
Sensory only

Front 84

CN III

Back 84

Oculomotor
Muscles of the eye
Motor and Sensory

Front 85

CN IV

Back 85

Trochlear
Serves the superior oblique eye muscle
Motor and Sensory

Front 86

CN V

Back 86

Trigeminal
Sensory from face and mouth; Motor to muscles of mastication
Motor and Sensory

Front 87

CN VI

Back 87

Abducens
Serves the lateral rectus eye muscle
Motor and Sensory

Front 88

CN VII

Back 88

Facial
Serves the muscels of facial expression, lacrimal glands, and salivary glands
Motor and Sensory

Front 89

CN VIII

Back 89

Vestibulocochlear
Equilibrium and hearing
Sensory only

Front 90

CN IX

Back 90

Glossopharyngeal
Serves the pharynx for swallowing, posterior third of tongue, parotid salivary gland
Motor and Sensory

Front 91

CN X

Back 91

Vagus
Sensations from visceral organs, and parasympathetic motor regulation of visceral organs
Motor and Sensory

Front 92

CN XI

Back 92

Accessory
Serves muscles that move head, neck and shoulders
Motor and Sensory

Front 93

CN XII

Back 93

Hypoglossal
Serves muscles of the tongue
Motor and Sensory

Front 94

Stereognosis

Back 94

- The ability to perceive and recognize the form of an object using cues from texture, size, spatial properties, and temperature
- Inability = Astereognosis
- Mediated by the DCML pathway

Front 95

Barognosis

Back 95

- The ability of evaluating the weight of objects, or to differentiate objects of different weights by holding or lifting them
- Inability = Baragnosis
- Mediated by the DCML pathway

Front 96

Graphesthesia

Back 96

- The ability to recognize writing on the skin purely by the sensation of touch
- Mediated by the Parietal lobe opposite to the side of the hand tested & the DCML pathway

Front 97

Apraxia

Back 97

- The loss of the ability to execute or carry out learned purposeful movements, despite having the desire and the physical ability to perform the movements.
- Due to damage of typically frontal and parietal lobes

Front 98

Ideational Apraxia

Back 98

- Loss of ability to conceptualize, plan, and execute the complex sequence of motor actions involving the use of tools or objects in everyday life.
- An individual is unable to plan movement related to an object because he has lost the perception of the object's purpose
- Often due to lesions in areas of the frontal and temporal lobes

Front 99

Ideomotor Apraxia

Back 99

- Inability to correctly imitate hand gestures and voluntarily pantomime tool use, e.g. pretend to brush one's hair.
- The ability to spontaneously use tools, such as brushing one's hair in the morning without being instructed to do so, may remain intact, but is often lost.
- Due to a decrease in blood flow to the left hemisphere of the brain and particularly the parietal and premotor areas
- It is frequently seen in patients with corticobasal degeneration

Front 100

Constructional Apraxia

Back 100

- The inability or difficulty to build, assemble, or draw objects.
- Often caused by lesions of the inferior right parietal lobe

Front 101

Anosognosia

Back 101

- Deficit of self-awareness, a condition in which a person who suffers certain disability seems unaware of the existence of his or her disability.
- Due typically to the parietal lobe damage or a diffuse lesion on the fronto-temporal-parietal area in the right hemisphere

Front 102

Somatognosia

Back 102

- The awareness we have of the parts of our body
- Inability = Asomatognosia

Front 103

Visual Agnosia

Back 103

- Can see but cannot recognize or interpret visual information
- Due to a disorder in the parietal lobes.

Front 104

Dysarthria

Back 104

Difficult or unclear articulation of speech that is otherwise linguistically normal

Front 105

Neuropraxia

Back 105

- Disorder of the peripheral nervous system in which there is a temporary loss of motor and sensory function due to blockage of nerve conduction, usually lasting an average of six to eight weeks before full recovery

Front 106

Axonotmesis

Back 106

- Disruption of nerve cell axon
- The rate of outgrowth of regenerating nerve fibers is about 1 mm to 2 mm per day
- Nerve regeneration may take several months

Front 107

Neurotmesis

Back 107

- The most serious nerve injury in the scheme
- Both the nerve and the nerve sheath are disrupted
- While partial recovery may occur, complete recovery is impossible.

Front 108

Spinoreticular Tract

Back 108

Ascending
· Deep and chronic pain