HA Vocab Exam II
Terms
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- Abduction
- Abduction: Moving the limb away from the midline of the body.
- Adduction
- Adduction: Moving the limb towards the midline of the body.
- Adventitious
- Adventitious: Used to describe sounds NOT usually heard in the lungs. Crackles, pleural friction rub, wheezing and stridor.
- Allen test
- Allen test: to evaluate the adequacy of circulation in the hand prior to inserting an IV.
- Amplitude
- Amplitude: Intensity. Loud or soft. Loud=greater amplitude
- What is the most common site for an aneurysm?
- The most common site for an aneurysm is the aorta.
- What is the most common cause of an aneurysm?
- The most common cause of an aneurysm is atherosclerosis.
- Anteroposterior
- Anteroposterior: Relating to front and back.
- Aortic
- Aortic: of or relating to the aorta. Carries blood from the left side of the heart to the arteries of all limbs and organs except the lungs.
- Where are most aortic aneurysms located?
- Most aortic aneurysms are located below the renal arteries and extend to the umbilicus. Most are palpable during routine physical exam. Feels like a pulsating mass in the upper abdomen just to the left of midline.
- Where is the apex of the heart?
- The apex of the heart is between the 4th and 5th intercostal space in the mid clavicular line on the LEFT side of the body. The apex is the lowest part of the heart.
- Where is the apex of the lung?
- The apex of the lung is 3-4 cm above the inner third of the clavicles. The apex is the highest part of the lung.
- Apices
- The narrow or pointed end of a structure. Apex of the heart points down and to the left. The apex of the lung is the highest point, which is located 3-4 cm above the inner third of the clavicles.
- Apnea
- Apnea: transient stop of breath. Assess rate depth and pattern
- Arrhythmia
- Arrythmia: alteration in rhythm of the heartbeat. Need elictrical info to verify.
- Sinus arrhythmia
- Sinus arrhythmia: Increases with inspirations and decreases with expirations.
- Ascites
- Ascites: Free fluid in the peritoneal cavity. Indications-distended abdomen, bulging flanks.
- Ataxia
- Ataxia: inability to coordinate voluntary muscular movements. Symptomatic of some nervous disorders. Parkinsonian, scissors, foot drop, waddling, short leg.
- Axillary
- Axillary: Armpit
- Borborygmi
- Borborygmi: hyperactive bowel sound. Fairly common. Stomach growling.
- How long do you need to listen to a perfectly abdomen to diagnose as having a silent abdomen?
- Five full minutes
- Bradycardia
-
Bradycardia:
Infants HR<90 BPM
Adults HR<60 BPM - Bradypnea
-
Bradypnea: Slowed breathing.
Normal Resp: 12-18 - Bronchophony
- Bronchophony: Technique used to evaluate voice sounds. Repeat "99".
- Bronchovesicular
- Bronchovesicular: One of three types of breath sounds you EXPECT to hear in an adult. Located over major bronchi. Pitch is moderate, amplitude is moderate.
- Bruit
- Bruit: Have patient hold breath and use the bell. Jugular is a common place to listen for turbulence. No obstruction=no sound
- Bulge sign
- Bulge sign: confirms presence of small amounts of fluid as you try to move fluid from one side of a joint to another. Normally no fluid is present.
- Bursa
- Bursa: Enclosed sac filled with fluid much like a joint. Located in areas of potential friction shoulder, knee. Helps muscles and tendons glide smoothly over a bone.
- Carboxyhemoglobin
- Carboxyhemoglobin is a compound formed by carbon monoxide and hemoglobin in carbon monoxide poisioning. Note changes in skin appearances. Light skin would present as bright cherry red in the face and upper torso. Dark skin would present as cherry red color in nail beds.
- Cartilage
- cartilage: dense connective tissue consisting of cells embedded in a ground substance or matrix. Tough firm consistency, yet flexible. Cushions the bones and gives a smooth surface to facilitate movement.
- Circumduction
- Circumduction: to revolve around an axis in such a way that the proximal end of a limb or organ is fixed and the distal end traces a circle. For example, moving the arm in a circle around the shoulder.
- Costovertebral angle
- Costovertebral angle:Fist percussion causses tissues to vibrate instead of producing a sound. Used to assess the kidney.l Normally the person hears a thud but feels no pain.
- Crackles
- Crackls are an adventitious lung sound also known as rales. Caused by moving air colliding with secretions in the passageways or by popping open previously deflated airways.
- What are some clinical examples of coarse crackles?
- Clinical indications of coarse crackles are: pulmonary edema, pneumonia, pulmonary fibrosis.
- Crackles: Fine
- Formally called rales. Discontinuous crackles are discrete crackling sounds. Discontinuous, high pitched, short crackling, popping sounds. Not cleared by coughing. Simulate sound by rolling strand of hair between fingers near ears.
- Fine Crackles: Late inspiratory crackles
- Late inspiratory crackles occur with restrictive diseases such as pnemonia, heart failure, interstitial fibrosis.
- Fine Crackles: Early inspiration crackles
- Early inspiration crackles occur with obstructive diseases such as chronic bronchitis, asthma and emphysema.
- Fine Crackles: Posturally induced crackles (PICS)
- PICS are fine crackles that appear with a change of position.
- Coarse Crackles
- Co8urse crackles are loud, low pitched, bubbling and burgling sounds that start in early inspiration and may be present in expiration.
- Will course crackles dissapear after coughing?
- Course crackles may decrease somewhat by suctioning or coughing but will reappear shortly.
- What causes Coarse crackles?
- Course crackles happens when inhaled air collides with secretions in the trachea and large bronchi.
- Atelectatic crackles.
- Atelectatic crackles aren't pathologic and generally dissappear after he irst few breaths or after a cough.
- Pleural friction rub
- Pleural friction rub: Low pitched and sounds a lot like crackles. When inflamed, the two layers of the pleural membrane in the affected side of your chest rub against each other, producing pain when you inhale and exhale. Between breaths, you feel almost no pain.
- Crepitation
- Crepitation: a crackeling sound heard in certain diseases. Grating sound heard on movement of ends of a broken bone. Clicking or cracking sound in movements of joints. Audible and palpable. Usually no tenderness or pain. TMJ.
- Cyanosis
- Cyanosis: Blue discoloration of the skin or mucus membranes caused by deoxygenated or reduced hemoglobin in the blood.
- Diastole
- Diastol: The period of cardiac muscle relaxation. Heart's filling phase. Normal range >40-50
- Dorsalis pedis artery and pulse
-
Dorsalis pedis
Artery: Supplies blood to the foot. Travels down the front of the leg.
Pulse: Felt over the dorsalis pedis artery of the foot. Very light touch. Lateral to and parallel with tendon of the big toe. - Dorsiflexion
- Dorseiflexion: Dorsum is the upper surface of the foot. Dorsiflexion is bending the foot towards the dorsum. Expected range is 20 degrees.
- Dysphagia
- Dysphagia: difficulty swallowing.
- Dyspnea
- Dyspnea: difficulty breathing.
- Describe the four point scale for Edema
-
Edema
1+ Mild pitting, slight indentation, no perceptible swelling of the leg
2+ Moderate pitting, indentation subsides rapidly
3+ Deep pitting, indentation remains for a short time, leg is very swollen
4+ Very deep pitting, indentation lasts a long time, let is very swollen - Where is the epigastric region?
- The epigastric region is the upper middle region of the abdomen.
- Epitrochlear
- Elbow.
- Eversion
- Eversion: moving the sole of the foot outward at the ankle.
- Fremitus
- Fremitus: Palpable vibration felt by the hand placed on the chest during coughing or speaking. Use palmar base (the ball) or the fingers or the ulnar edge of one hand. Use wordslike "99"
- What causes decreased fremitus?
- Decreased fremitus occurs when anything obstructs transmission of vibrations.
- What causes increased fremitus?
- Increased fremitus occurs with compression of consolidation of lung tissue such as pnemonia.
- Gonimeter
- An instrument that measures the joins range of motion.
- Hemodynamic
- Pertaining to the movement of blood circulation
- Hepatomegaly
- Hepatomegaly is the abnormal enlargement of the liver. Mean span is 10.5 for males and 7 cm for females.
- Hypertrophy
- Hypertrophy: increased size of muscles occuring from isometric excercise.
- Hypoxemia
- Hypoxemia: decrease of oxygen in the blood.
- Does hypoxemia increase or decrease respirations?
- ypoxemia increases respirations.
- Ischemia
- Ischemia: deficient supply of oxygenated blood to a tissue caused by obstruction of a blood vessel. complete blockage leads to death of the distal tissue.
- What are the signs of ischemia?
- Signs of ischemia: pale, cold skin with sharp pain and tingeling.
- Iliac
- Related to the ilium. Pelvis/hip.
- Iliopsoas
- Iliopsoas: flexor muscle of the hip joint. Muscle test-leg lift pain related to apendicitis.
- Inguinal
- Inguinal: groin area.
- Inversion of the foot
- When the soole (plantar) of the foot turns inward towards the inside of the legs. Performed when doing ROM of the foot.
- Kyphosis
- Kyphosis: humpback with head looking straight like the picture prof. draws.
- Ligaments
- Ligaments connect bones to bones. Fibrous bands. Strengthen joint and help prevent movement in undesirable directions.
- Mediastinu8m
- Mediastinum: middle section of the thoracic cavity containing the esophagus, trachea, heart, lungs, etc.
- Mitral Valve
- The mitral valve opens during the heart's filling phase (diastole) to allow the left ventricle to fill with blood. The mitral valve closes during the pumping phase so blood doesn't get back up into the left atrium.
- What BMI is considered obese?
- 30+
- Ortalani maneuver
- Ortalani maneuver is to check for the presence of congenital dislocation of the hips.
- For how long should the ortalani maneuver be done?
- The ortalani maneuver should be done at every professional visit until the child is 1 yo
- Who do you perform the ortalani maneuver?
- Place baby in supine with legs pointed towards you. Flex legs to form right angles at hips and knees.
- Orthopnea
- Orthopnea is difficult breathing when in the supine position so one must sit more upright to breath. (ask how many pillows a pt. sleeps on) ex: 2 pillow orthopnea
- Pericardial friction rub
- pericardial friction rub: inflammation of the precordium gives rise to a friction rub. Common during first week following an MI and may last only a few hours.
- What does a pericardial friction rub sound like?
- High pitched and scratchy. Like sand paper being rubbed. Best heard with the diaphragm with the person sitting up and leaning forward and breath held in expiration.
- Where si the pericardial friction rub best heard?
- can be heard any place on the precordium, but usually its best heard at the apex adn left lower sternal boarder.
- What organ does the pericardium protect?
-
The pericardium protects the heart.
It is anchored to the diaphram - Peritonitis
- Inflammation of the peritoneum.
- What is the peritoneum?
- The peritoneum is a membrane that lines the wall of the abdomen and covers the internal organs.
- What is the Phalen's Test used to diagnose?
-
The phalen's test is used to diagnose Carpel tunnel syndrome.
+numbness and burning - How is the Phalen's test performed?
- Hold both hands back to back while flexing the wrists 90 degrees. Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand.
- How is pigeon toes cured?
- Pigeon toes usally corrects spontaneously by three years of age as long as the foot is flexible.
- Plantar flexion
- Toes pointed towards the floor. Expected ROM is 45 degrees.
- Popliteal
- At the lower thigh, the femoral artery is termed the popliteal artery. Rarely palpable.
- Posterolateral
- Posterolateral: directional term-behind and to one side, specifically to the outer side.
- Precordium
- Precordium: external surface of the body overlying the heart and stomach.Part of the cardiovascular assessment, visual or palpation for PMI.
- Pronation
- Pronation: turning the forearm so the palm is down.
- Pronator drift
- Pronator drift indicator of upper motor neuron weakness. Extend arms and keep them in place for ten seconds with eyes closed. Normally arms will remain in place unless pronator drift, where the arm will pronate and fall.
- What are the causes for a protuberant belly?
- excessive subcutaneous fat, poor muscle tone or an increase in contents of the abdomen.
- what heart sound is the pulmonic valve associated with?
- the closing of the pulmonic valve is associated with s2 sounds.
- when do you assess rebound tenderness?
-
you assess rebound tenderness when a patient reports abdominal pain or when you elicit tenderness during palpation.
perform at end of exam b/c it can cause pain or muscle rigidness - resonant
-
resonant sounds are low pitched, hollow sounds heard over normal lung tissue.
over bones or solid masses, the sound would be flat and dull - rhonchi
- abnormal dry, leathery sounds heard in the lungs. low pitched breath sounds.
- what do rhonchi indicate?
- congestion and mucus in the larger bronchial tubes (bronchi) found mostly in bronchitis
- rovsing's sign is used to diagnose what?
- rovsing's sign is used to diagnose appendicitis
- rovsing's sign
- push on the abdomen far away from the appendix, llq to see where the patient complains of pain.
- what is the hallmark symptom of appendicitis?
- severe abdominal pain
- S1
- First sound caused by closeure of the AV valves. (tricuspid and mitral)
- What are the two AV valves?
- AV Valves: Tricuspid and Mitral
- split S1
- Hearing mitral and tricuspid components seperately
- What valves do you hear with S2
- S2: closure of the semilunar valves (aortic and pulmonic)
- Semilunar valves
- Aortic and pulmonic
- S3
- Extra heart sound. ventricular filling sound. occurs in early diastole during the rapid filling phase.
- Is S3 usually abnormal in adults?
- Yes. It is also called a ventricular gallop or an S3 gallop. But it can be normal as well. It's frequently heard in children and young adults.
- S4
- Atrial gallop. very soft, low pitched, ventricular filling sound that occurs in late diastole.
- Scaphoid
- scaphoid: Concave boat shaped stomach profile. Also a boat shaped bone in the wrist.
- What problems can severe scoliosis cause?
-
reduce lung volume, cause risk for impaired cardiopulmonary function. cosmetic deformity, self image.
Severe is greater than 45 degree deviation present. - At what age is the forward bend test used to diagnose scoliosis?
- 10-12 yo
- Functional scoliosis
- Functional scoliosis is flexible. It appears with standing and dissappears with forward bending. It may be compensatory for other abnormalities such as leg length discrepancy.
- Structural scoliosis.
- Fixed. curvature shows both standing and when bending forward.
- Scoliosis
- S shaped curvature of the thoracic and lumbar spine. mild deformities are asymptomatic.
- Spider Angioma (Nevi)
- like on my cheek
- Split 1
- normal but occurs rarely. It's a sound of the mitral and tricuspid closing seperately. Audible in the lower left sternal boarder.
- split 2
- phenomenon that occurs toward end of inspiration. inspiration separates timing of closure of the aortic and pulmonic valves.
- Striae
- Stretch marks. silvery white, jagged markes about 1-6 cm long. occurs when elstic fibers are broken following rapid or prolonged streching as in pregnancy or weight gain.
- supination
- supination: turning the forearm so the palm is up
- syncope
- syncope: sudden loss of strength, temporary loss of consciousness due to lack of cerebral blood flow. a FAINT
- systole
- systole: pumping phase. AV valves close to prevent regurgitation of blood back up into the atria. S1 is beginning of systole, S2 signals end of Systole.
- Tachycardia
-
tachycardia: rapid heart rate >100
anxiety, exercise. - tachypnea
- tachypnea: rapid shallow breathing. response to fever, fear or exercise. also increases ht repiratory insufficiency, pnemonia, alkalosis, pleurisy, lesions in the pons.
- tactile fremitus
- fremitus is a palpable vibration.
- what factors affect the normal intensity of fremitus?
-
relative location of the bronchi to the chest wall
thickness of the chest wall
pitch and intensity - trendelenburg's sign
- trendelenburg's sign is a gait adopted by someone with an absent or weakened hip abductor. painful hip disorder. the person is unable to keep hips aligned when a leg is lifted.
- tricuspid
- prevents blackflow of blood from the ventricle into the atrium. a valve of the heart that lies between the right atrium and the right ventricle.
- Tendons
- a tough band of fibrous connective tissue that connects muscle to bone. similar to ligaments except that ligaments join one bone to another.
- thrill
- thrill: palpable murmor; the vibration accompanying a cardiac or vascular murmur.
- tine's sign
- tinel's sign is a way to detect irritated nerves. performed by lightly percussing over the nerve to elicit a sensation of tingling or "pins and needles" for ex: carpal tunnel
- tonometer
-
tonometer is an instrument used by eye care professionals to measure the intraocular pressure of a patient's eye. Increase in pressure may signal the onset of glaucoma. Presure is measured in mm of mercury. pressure above 21 mm is high.
air puff test