REGIS NU650/NU 650 Final Exam SG(100% Graded)

Order of Assessment ans: Inspection, Palpation, Percussion and Auscultation. EXCEPT with abdomen Comprehensive Health History ans: chief complaint, reason for visit, ROS, past medical and surgical history, social history and family history Pediatric Body measurements ans: length, height, weight, head circumference fro birth to 36 months Normal/Hypertension cut off ans: 130 normal 140+ hypertension Fontanel Closure ans: posterior 1-2 months, anterior 9mo-2years otoscope ans: adult-up and back, peds- down and back, using largest speculum that will fit comforably tympanic membrane ans: Cone of light R-5 l-7 EOM testing ans: CN III, IV, VI AP diameter of chest ans: 1:2 (AP less than transverse) barrel chest ans: COPD Flat or Dull percussion ans: effusion or pneumonia normal resonant percussion ans: healthy lung Hyperressonance (percussion) ans: trapped air crackles/rales ans: high pitched, discontinuous Wheezes ans: high-pitched whistling or squeaking sounds during inspiration or expiration Rhonchi ans: snoring, rumbling sounds heard upon auscultation of the chest during respiration-low pitched tactile fremitus ans: • INCREASED FREMITUS - Means there is liquid or solid inside the lungs (consolidation such as with pneumonia) - Remember Liquid or solid transmits vibrations better than air • DECREASED FREMITUS Means air trapping such as with emphysema or bronchial obstruction. Bronchophony ans: the spoken voice sound heard through the stethoscope, which sounds soft, muffled, and indistinct over normal lung tissue, clearer over disease Egophony ans: abnormal change in tone of voice that is heard when auscultating the lungs EE--AA UE Arteries ans: radial-thumb side, ulnar pinky side Pulse grading ans: 0 absent 1+ weak 2+ normal 3+ increased 4+ bounding palpate bilaterally PMI ans: point of maximal impulse mid-clavicular and 5th ICS S1 ans: normal, closure of AV, Start of systole, loudest at Apex, contraction of ventricles S2 ans: normal, closure of semilunar, end of systole, loudest at base, filling of ventricles S3 ans: third heart sound (normal in pregnant young adults, and children), gallop S4 ans: extra heart sound, end of diastole, indicative of disease-AFIB murmur grading scale ans: I-Barely Audible II-Quiet, Clearly Audible III-moderately Loud IV-loud, thrill V-Very loud, can palpate thrill VI-Very loud, thrill palpable and visible clubbing ans: bulbous enlargement of distal phalanges of fingers and toes that occurs with chronic cyanotic heart and lung conditions edema scale ans: 1+ = disappears rapidly. 2+ = last 10-15 seconds. 3+ = lasts more than one minute. 4+ = lasts 2-5 minutes. These are signs used in what scale? normal/abnormal findings spleen ans: normal=tympanic, dullness could be enlargement not normally felt on exam Blumberg Sign: Rebound Test ans: peritoneal inflammation, hurts more when release from palpation shifting dullness ans: a sign of free peritoneal fluid wherein the dullness of percussion shifts, generally from one side to the other, as the patient is turned from side to side. Psoas sign ans: RLQ pain with extension of right thigh indicative of appendicitis Obturator sign ans: RLQ on internal rotation of right thigh indicative of appendicitis