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106 Cards in this Set
- Front
- Back
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what depression rating scale is patient related and which are clinician rated
becks depression inventory Hamilton Depression Scale (HAM-D) Montgomery-Asberg Depression Rating Scale (MADRS) Young Mania Rating Scale (YMRS) |
Beck Depression Inventory is patient rated rest are clinician rated
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match the following
test's ability to detect symptom or illness is PRESENT tests ability to determine that a symptom or illness is ABSENT ability of scale to measure what it was designed to measure |
SENSITIVITY - test's ability to detect symptom or illness is PRESENT
SPECIFICITY - tests ability to determine that a symptom or illness is ABSENT VALIDITY - ability of scale to measure what it was designed to measure |
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classify the following as positive or negative
hallucinations decreased facial expression delusions social withdrawal anhedonia apathy disorganized speech catatonia |
POSITVE SYMPTOMS
hallucinations delusions disorganized speech catatonia NEGATIVE SYMPTOMS anhedonia social withdrawal decreased facial expression apathy |
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how many lobes are in the right and left lung
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right - 3
left - 2 |
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what does the DISCUS scale test for
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tardive dyskinesia
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match the following
tracts ascending - carry sensory impulses to brain for processing tracts descending - carry motor impulses from brain to initiate muscles corticospinal tract or spinothalamic tract |
spinothalamic tract - tracts ascending - carry sensory impulses to brain for processing
corticospinal tract - tracts descending - carry motor impulses from brain to initiate muscles |
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what are the layers of the menenges from outer to inner
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dura
arachnoid pia |
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match the following
center for vital functions: heart rate, respiration, cough, swallowing, vomiting, blood pressure contains the hypothalamus and thalamus contains the corpora quadrigemina - relay for the eyes and ears to cerebral cortex for vision and hearing found in the 4th ventricle pons, medulla, midbrain, diencephalon |
medulla - center for vital functions: heart rate, respiration, cough, swallowing, vomiting, blood pressure
diencephalon - contains the hypothalamus and thalamus midbrain - contains the corpora quadrigemina - relay for the eyes and ears to cerebral cortex for vision and hearing pons - found in the 4th ventricle |
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what is the function of the cerebelum
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coordination of skilled voluntary movements
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match the following
divides cerebrum from R/L hemisphere divides frontal and parietal seperates temporal from frontal/parietal seperates temporal from frontal/parietal central sulcus, lateral fissure, longitudinal fissure |
longitudinal fissure - divides cerebrum from R/L hemisphere
central sulcus - divides frontal and parietal lateral fissure - seperates temporal from frontal/parietal |
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match the following (related to the cerebrum)
pass to and from cortex connect parts of same hemisphere to each other connects the two hemispheres projection tracts, commissural tracts, association tracts |
projection tracts - pass to and from cortex
association tracts - connect parts of same hemisphere to each other commissural tracts - connects the two hemispheres |
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match the functions of the various parts of the cerebrum (cerebral cortex)
vision, taste, hearing, behavior/higher intellegence, reading and speech interpretation prefrontal area, parietal area, temporal lobe, occipital lobre, postcentral gyrus |
occipital lobe - vision
temporal lobe - hearing postcentral gyrus - taste prefrontal area - behaviour, higher intelligence parietal area - reading and speech interpretation |
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which side of the brain is this
language, sequential processes, process info in fragments and analyze |
left
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which side of the brain is this
artistic, visual patter recognition, see in 3d, expression/recognition of emotions, wholistic processing of info |
right
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match this sensation and what does it innervate
pain, touch, temperature, and pressure exteroceptive or propioceptive sensation |
exteroceptive sensation
innervates the skin |
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match this sensation and what does it innervate
conveys joint position and tension of tendons and muscles exteroceptive sensation or proprioceptive sensation |
proprioceptive sensantion
innervates joint, muscle, tendons |
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what cranial nerve is dominant for innervation of viscera in the thoracic and abdominal cavities
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CN X - vagus
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what cranial nerve is responsible for motor and proprioceptive innervation for lateral rectus (EOM)
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CN VI - abducens
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what cranial nerve contains opthalmic nerve, maxillary nerve, mandibular nerve
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CN V - trigeminal
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read the following
Mandibular Nerve V3 |
sensory - chin, mandible, lower lip and sides of face
motor - muscles of mastication |
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what cranial nerve innervates the anterior 2/3 of the tongue
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CN VII - facial (intermediate nerve)
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sudden onset
worse at night - "sun downing" impaired memory, attentiveness, calculation ability delirium, dement |
delerium
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which mental disorder can be caused by
polypharmacy infections metabolic disturbances |
delirium
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which mental disorder is not reversible and can be caused by
alcoholism stroke HIV alzheimers |
dementia
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insidious onset
stable throughout day impaired abstract thinking, judgment delirium, dementia |
dementia
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what type of HA is it
non-throbbing pain tender neck and shoulder muscles |
tension
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what kind of HA is it
prodrome spreading over head throbbing associated with nausea, photophobia, sensitivity to loud sounds |
migraine
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occuring in clusters
long intermissions between clusters severe throbbing on the same side without prodrome |
vascular
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what meningeal sign is this
involuntary flexion of the hips and knees when flexing the neck nuchal rigidity, kernig's sign, brudzinski's sign |
brudzinski's sign
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what menigeal sign is this
flex the leg at the knee and hip when the patient is supine. then attempt to straighten the leg nuchal rigidity, kernig's sign, brudzinski's sign |
kernig's sign
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read the red flags of headaches
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sudden onset and rapid progression
worst headache of my life change in priopr pattern |
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sudden onset of facial drop - eye down, forhead may no be involved
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bell's palsy
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absent at rest
increases with skilled activities and age decreases with mild-mod alcohol consumption intention, resting, essential |
essential tremor
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temor of outstreched hands
enhanced by emotion states and fatigue ETOH withdrawal or thyrotoxicosis intention, resting, essential |
intention tremor
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which tremor may be due to
caffeine, beta adrenergic agonists, adrenal steroids |
intention tremors
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dissappears with movement
an example is Parkinson's disease intention, resting, essential |
resting tremor
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sudden onset of vertigo with nausea and vomiting
follows URI |
vestibular neuronitis
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labyrinthitis
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vestibular neuronitis
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what level of consciousness is this
depressed mental status but awake unresponsive and unarousable response when there is painful stimuli sleep, lethargy, stupor, coma |
lethargy - depressed mental status but awake
coma - unresponsive and unarousable stupor - response when there is painful stimuli |
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what bones does the sternum consist of
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manubrium
body xiphoid process |
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what ribs are the floating ribs
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11th-12th
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what are the false ribs
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8th-10th
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what are the true ribs
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1st-7th
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what is the function of the internal intercostals
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assist with EXPIRATION by DEPRESSING the ribs
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what is the function of the external intercostals
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assist with INSPIRATION by ELEVATING the ribs
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during expiration the ____ reaches the ____ and the ____ ascends to the _____
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during expiration the RIGHT DOME reaches the 5TH RIB and the LEFT DOME ascends to the 5TH INTERCOSTAL SPACE
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where do each of the following pierce the diaphragm
inferior vena cava esophagus aorta |
T8 - inferior vena cava
T10 - esophagus T12 - aorta |
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lung landmarks of pleural cavity
midclavicular line midaxillary line vertebral column |
midclavicular line - 8th rib
midaxillary line - 10th rib vertebral column - 12th rib/T12 |
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lung landmarks of the edges of each lung
midclavicular line midaxillary line vertebral column |
midclavicular line - 6th rib
midaxillary line - 8th rib vertebral column - 10th rib/T10 |
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how many lobes does the right and left lung have
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right lung - 3 lobes
left lung - 2 lobes |
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Manubriosternal angle (Angle of Louis) connects to
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rib 2
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Parietal pleura ends in
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midclavicular line of 8th rib
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are patients with PAD usually symptomatic or asymptomatic
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asymptomatic 50%
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risk factors of PAD increase w/ ?
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age > 50
current or past smoking DM HTN hyperlipidemia Hx of vascular ds, AMI, stroke AA are 2x likely to get it vs Caucasians |
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read on pg 3 the pats at risk for PAD
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read on pg 3 the pats at risk for PAD
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acute limb ischemia is defined by the 5 "P"'s what are they
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pain
pulselessness pallor paresthesias paralysis (&polar) |
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what are typical symptoms of PAD
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intermitten claudication (exertional claudication)
resolves w/in 10" of rest |
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read vascular review of symptoms
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read vascular review of symptoms
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what is the equation for ankle brachial index
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ankle systolic pressure/brachial systolic pressure
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on the Ankle brachial index what is normal, mild-moderate, severe
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normal >0.9
mild-moderate 0.41-.0.9 severe 0 - 0.4 |
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A patient had a shiny, hairless left leg and ulcerative right leg has?
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Arterial Deficiency (peripheral vascular disease)
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Posterior tibial pulse
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located posteriorly to the medial malleolus
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thrills
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Fine, palpable rushing vibration when palpating
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AV nicking is due to
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pulmonary HTN
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where is the Point of Maximal Impulse (Apical Pulse)
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5th intercostal space (ICS) at midclavicular line (MCL)
abnormal if it is below the 5th or lateral to MCL |
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where are thrills found
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base of heart (2nd ICS MSB)
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match these listening areas
2nd left ICS MSB 4th left ICS LSB 5th left ICS MCL 2nd left ICS MSB 3rd left ICS SB |
aortic - 2nd right ICS MSB
tricuspid - 4th left ICS LSB mitral - 5th left ICS MCL pulmonic - 2nd left ICS MSB 2nd pulmonic - 3rd left ICS SB |
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when does S1 and S2 occur
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S1 - beginning of systole
S2 - end of systole |
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this heart sound is
loudest at the apex (bottom, 5th ICS) |
S1
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this heart sound is
loudest at the base (top, 2nd ICS) |
S2
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when does the S3 heartsound occur
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early in diastole
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when does the S4 heart sound occur
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just before S1
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S4 heart sound indicates decreased ventricular compliance or overfilling and may be caused by
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hyperthyroidism
severe anemia aortic stenosis hypertension |
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heart murmurs are
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turbulent blood flow
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blood circulation
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body > right atria > right ventricle > lungs > pulmonary artery > left atria > left ventricle > pulmonary vein
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what does the cardiac tamponade do
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prevents the heart from completely filling. this significantly decreases the pumping efficacy of the heart by reducing cardiac output
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what are the branches of the arch of the aorta
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brachiocephalic trunk
-right subclavian artery left common carotid artery left subclavian artery |
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what is the order of cardiac conduction
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SA node > Atria > AV node > Atrioventricular bundle > Right/Left bundle branches > Purkinge fibers
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what do the accessory muscles do
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elevate the ribs and sternum when the depth and rate of respiration need to be increased
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what are the accessory muscles
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mastoid
scaleni trapezius |
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________contract powerfully during expiration to help force the diaphragm further against the lungs
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external intercostals muscles
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how do you perform the Tactile Fremitus
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place ulnar surfaces of hands bilaterally in intercostal spaces
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when you perform the tactile fremitus and you hear increased vibrations what does that indicate
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increased vibrations = pneumonia
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match the following:
high pitched musical sandpaper rubbing together harsher musical sound deep, musical rub hair between fingers crackles, rhonchi, wheezing, stridor, friction rub |
high pitched musical
friction rub - sandpaper rubbing together stridor - harsher musical sound rhonchi - deep, musical crackles - rub hair between fingers |
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match the following
pneumonia, pulmonary edema asthma, COPD foreign body pleursy crackles, rhonchi, wheezing, stridor, friction rub |
crackles, rhonchi - pneumonia, pulmonary edema
wheezing - asthma, COPD stridor - foreign body friction rub - pleursy |
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how do you perform the test for bronchophone
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ask the pt to repeat 99 as you auscultate in the same locations as you did for breath sounds
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largely reversible
largely irreversible asthma or COPD |
asthma - largely reversible
COPD - largely irreversible |
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what are some signs and symptoms found in both asthma and COPD
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dyspnea
cyanosis hyperinflated lungs accessory muscle use wheezes diminished breath sounds coughing |
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decreased FEV1/FVC ratio is specific for
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obstruction
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increased FEV1/FVC ratio is specefic for
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restrictive disease
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does FEV1/FVC ratio effect TLC
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no
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peak flow correlates well with
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FEV1
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decrease in FVC
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obstructive disease (asthma, COPD)
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decrease in TLC
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restrictive disease (pulmonary fibrosis, pulmonary edema)
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read
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thoracentesis can be done diagnostically and/or therapeutically
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transudates and exudates both cause
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pulmonary embolism
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match
imbalance between hydrostatic and oncotic pressures exudates, transudates |
transudates
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match
alterations in local factors influencing accumulation of pleural fluid exudates, transudates |
exudates
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Apical Pulse (PMI) – normally visible at
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MCL in 4-5th ICS
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Identifying Murmurs
1. Intensity 2. Timing 3. Shape 4. Location 5. Radiation |
Identifying Murmurs
1. Intensity 2. Timing 3. Shape 4. Location 5. Radiation |
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use bell of stethoscope
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Bruit –
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Right heart failure
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– Pedal edema
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Left heart failure h
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– Coug
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match
-ID letter or number written in patient’s hand - ID object in patient’s hand with eyes closed Graphesthesia, Stereognsosi |
Graphesthesia: ID letter or number written in patient’s hand
Stereognsosi: ID object in patient’s hand with eyes closed |
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- Have patient stand with feet close together, close eyes, observe patient for postural stability. Tap gently while spotting patient to prevent falls. Falling during the test is Romberg’s sign.
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- Have patient stand with feet close together, close eyes, observe patient for postural stability. Tap gently while spotting patient to prevent falls. Falling during the test is Romberg’s sign.
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CN VII
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– Acoustic
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