Patient Care and Physical Diagnosis Test 1

88 terms by Derrickcrabtree 

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What are the four paranasal sinuses?

Frontal
Maxillary
Sphenoid
Ethmoid

What is the most common site of sinusitis?

maxillary

What are salivary glands that are all over the tongue, palate, lips, and the lining of the cheek?

intrinsic

What are extrinsic salivary glands?

glands that secrete more saliva when eating

What are the extrinsic salivary glands?

Parotid
Submandibular
Sublingual

What is a sialadentis?

a salivary gland infection

What is the most common immunologic disorder associated with salivary gland disease?

Sjogren's Syndrome

What are the demographics of most Sjogren's cases?

women 50 and older

What is the difference in primary vs secondary Sjogren's syndrome

primary only involves the exocrine glands and secondary is autoimmune associated ie RA

What makes a swollen lymph node more likely to be malignant than infected?

slowly progressive
firm
multiple nodes involved
not mobile

WHat node do the throat and thyroid drain too?

ant cervical

What drains into the sub-mandibular lymph node?

floor of the mouth

What drains into the Supra-clavicular node?

thorax

What is the usual site of an emergency tracheotomy?

cricothyroid ligament

What is the chronic enlargement of the thyroid gland not due to neoplasm?

Goiter

Which of the following is not a cause of goiter nodules to form?

a. Hashimotos
b. Graves Disease
c. Iodine deficiency
d. Neoplasm

iodine deficiency

When should a suspicious thyroid lesion be re-evaluated?

2-weeks

What is the sensation of being unsteady?

dysequilibrium

Sudden onset of dizziness raises suspicious for what?

arrhythmia

If one feels lightheaded under exertion it is likely caused by__________?

aortic stenosis

A conductive hearing loss is associated with what part of the ear?

outer and middle

A sensorineural hearing loss is associated with what parts of the auditory system?

cochlea, cochlear nerve, central pathways

What is a positive Rinne test?

indicates perceptive loss; heard longer by air conduction then bone

What is a negative Rinne test?

heard longer on the bone; indicates a conductive hearing loss

If air conduction is greater than bone conduction is this always an indication of hearing loss?

no it is normal OR sensorineural

When is the Weber test useful?

in asymmetrical hearing loss

Which ear hears the sound the loudest in conductive deafness during Webber testing?

the affected ear

During Webber testing what ear hears the sound the loudest in sensorineural deafness?

the un-affected ear

What are the four vital signs?

Breathing
Pulse
Temperature
Blood Pressure

WHen should a pulse be counted for the full 60 seconds?

if the pulse is irregular

What are the two central pulse points?

Carotid and Femoral

Where is a childs pulse under 1 felt for?

Brachial

Which pulse most accurately reflects the aortic pulsation?

Carotid

What is the normal pulse rate?

60-100

Which of the following is not a way to accurately describe a pulse?

a. Bounding
b. Regular
c. Thready
d. Weak

all of the above are ways to describe the pulse

The cardiac pacemaker is the _______?

SA node

True or False the AV node conducts faster than the bundle of His?

False

What parasympathetic receptor dominates the sinus rhythm?

M2

What part of the brain controls the cardiovascular center?

medulla

The lub sound of the heart is associated with what valve?

A-V valve closure and the start of systole

The dub sound of the heart is associated with valves?

closure of the pulmonary and aortic valve and start of diastole

A cuff that is of an improper size will give what type of BP reading?

false High

What is the standard for BP monitoring?

Mercury Sphygmomanometer

What is Korotkoff sounds?

the sound of the blood in the brachial artery during bp measurment

Systolic and Diastolic pressure should be measured to the nearest ____ mm hg

2

A patient who is nervous will give what type of diastolic reading?

False high

Where is a BP taken to rule out coarctation of the aota?

the leg

True or False
It is normal to have a higher systolic pressure in the legs than the arms?

False

What are the only two conditions that cardiac arrest doesn't override?

external hemorrhage or airway obstruction

What is the primary cause of cardiac arrest?

electrical dysfunction

What is the major rhythm in pre-hospital cardiac arrest?

V-fib

Where is the AV node located?

interatrial septum

What is the purpose of the AV node slowing the conduction?

to permit completion of atrial contraction

What is the function of the bundle of His?

functional passage of the impulse from atria to ventricles

What is the p-wave caused by?

arial depolarization

What causes the QRS complex?

ventricular depolarization

Which wave is usually not seen in EKG?

U wave

What is electromechanical dissociation?

organized electrical depolarization without mechanical contractions

What muscles change the pleural pressure?

diaphragm, intercostal and abdominal walls

What are the two types of respiratory neurons?

inspiratory and expiratory

Respiratory neurons generate an efferent signal via what nerves?

phrenic to the diaphragm and the spinal nerves to the intercostal and abdominal walls

Half of the mass of the lung is made up of_______?

blood volume

What is the purpose of surfactant in the lungs?

reduces surface tension that allows the alveoli to expand

Fibromyalgia syndrome is characterized by what three things?

chronic pain
tender points
fatigue

What is a possible cause of Fibromyalgia?

abnormally high levels of substance P in the spinal fluid that can turn up the brains pain center

What is the Criteria for Fibromyalgia?

widespread pain for 3 months and pain in 11 out of 18 points

What are some treatments for fibromyalgia?

antidepressants
anti-epileptics
gabapentin

What is polymyositis?

a group of disorders that present with progressive symmetric proximal muscle weakness and inflammation of skeletal muscle

What are the demographics of a typical polymyositis patient?

40-60 yr old black woman

What is dermatomyositis?

a skin rash associated with myositis symptoms that is often associated with malignancy

What are the characteristics of osteoporosis?

low bone mass
microarchitectural deterioration of bone tissue
bone mineral density T score < 2.5

What type of osteoporosis is caused by lack of estrogen?

type 1

What is type II osteoporosis?

increased bone turnover

What is the gold standard for evaluating osteoporosis?

Dual enrgy X-Ray Absorptiometry

What is the difference in arthralgia and arthritis?

arthralgia is joint pain but may not have any inflammation

What is the most common type of arthritis in the US?

osteoarthritis

True or False
Arthritis pain most often comes from the cartilage.

False, cartilage is aneural

Where do heberdens nodes form?

distal interphlangeal joints

What nodes form at proximal interphalangeal joints?

Bouchards

What are some of the complications of juvenile rheumatoid arthritis?

leg length discrepancy
eye involvement; anterior uveitis
active arthritis in adults
radiographic joint damage

What are the treatments of JRA?

NSAIDS and steroids
ENBREL
Methotrexate

HLA-B27 has association with what diseases?

Spondyloarthropathies

What is the RF factor of Psoriatic arthritis?

RF negative

Who is more likely to get ankylosing spondylitis?

men 3x more likely

How does ankylosing spondylitis cause its problems?

chronic inflammation leads to joint remodeling and destruction

What are three diagnostic tools for ankylosing spondylitis?

Schober test
lateral spine flexion test
Chest expansion test

What is the triad of Reiter's syndrome?

seronegative asymmetric arthritis
inflammation of the urinary tract
conjunctivitis

What is Pagets disease?

excess bone destruction and unorganized bone formation and repair and osetoclasts show abnormal morphology

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