Exam 2 blueprint questions
153 Questions
21 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What findings indicate an abnormal result during the Finger-to-Nose Test?

  • Fast and accurate tapping
  • Consistent placement on the nose
  • Overshooting or undershooting movements (correct)
  • Smooth and controlled movements

    • Which of the following describes a common mobility challenge faced by older adults?

  • Increased proprioception
  • Decreased balance and proprioception (correct)
  • Enhanced muscle strength
  • Improved reflex responses

    • During the Heel-to-Shin Test, what would indicate an abnormal finding?

  • Difficulty performing the test (correct)
  • Sliding heel smoothly down the opposite shin
  • Controlled and steady movements
  • Quickly alternating movements

    • What are the expected normal findings in Rapid Alternating Movements?

    <p>Fast and smooth alternating movements</p> Signup and view all the answers

    Which of the following is likely to affect balance and coordination in older adults?

    <p>Impaired vision or hearing</p> Signup and view all the answers

    What indication during the Romberg Test signifies an abnormal finding?

    <p>The patient sways significantly or loses balance</p> Signup and view all the answers

    What defines proprioception in relation to coordination assessment?

    <p>The ability to sense body position and movement</p> Signup and view all the answers

    What is a potential consequence of dyskinesia during coordination assessments?

    <p>Erratic and involuntary movements</p> Signup and view all the answers

    What does Passive Range of Motion (PROM) primarily assess?

    <p>Joint integrity and flexibility without muscle involvement</p> Signup and view all the answers

    Which of the following abnormalities is characterized by excessive curvature in the lumbar region?

    <p>Lordosis</p> Signup and view all the answers

    Which characteristic is NOT typically associated with normal gait?

    <p>Increased distance between the feet</p> Signup and view all the answers

    What factor might contribute to TMJ dysfunction?

    <p>Injury to the temporomandibular joint</p> Signup and view all the answers

    What common posture change may occur in older adults?

    <p>Decreased muscle strength and balance</p> Signup and view all the answers

    Which gait pattern is typically associated with balance issues?

    <p>Wide-based gait</p> Signup and view all the answers

    Which of the following is a clinical manifestation of TMJ dysfunction?

    <p>Jaw pain or discomfort</p> Signup and view all the answers

    What is an indication of antalgic gait?

    <p>A limp to avoid pain on weight-bearing</p> Signup and view all the answers

    What is the main reason for assessing older adults for changes in motor function?

    <p>To identify potential neurological issues that may lead to falls</p> Signup and view all the answers

    Which statement about recent and remote memory is accurate?

    <p>Recent memory is the ability to recall information from the past few days to weeks.</p> Signup and view all the answers

    Which approach is most important when communicating with older adults during a neurological assessment?

    <p>Speak clearly and allow extra time for responses</p> Signup and view all the answers

    What does orthostatic hypotension primarily cause in individuals?

    <p>Dizziness due to a drop in blood pressure</p> Signup and view all the answers

    Which symptom might indicate the presence of meningitis in an individual?

    <p>Altered mental status</p> Signup and view all the answers

    What type of dysfunction is indicated by involuntary twitches or contractions?

    <p>Fasciculations</p> Signup and view all the answers

    Which condition could lead to difficulty with swallowing, known as dysphagia?

    <p>Parkinson’s disease</p> Signup and view all the answers

    Which method is NOT typically utilized to assess gait patterns?

    <p>Evaluating the cognitive responses to questions</p> Signup and view all the answers

    What does the term 'borborygmus' refer to in gastrointestinal assessment?

    <p>The sound of gas movement in the intestines</p> Signup and view all the answers

    Which of the following sounds is associated with the presence of turbulent blood flow?

    <p>Bruit</p> Signup and view all the answers

    What does a finding of dullness during percussion typically indicate?

    <p>Fluid or solid masses</p> Signup and view all the answers

    What is a common cause of ascites associated with liver condition?

    <p>Liver cirrhosis</p> Signup and view all the answers

    What does the measurement of normal liver span at the mid-clavicular line typically range from?

    <p>6-12 cm</p> Signup and view all the answers

    Which of the following signs may indicate pyelonephritis during kidney assessment?

    <p>CVA tenderness</p> Signup and view all the answers

    What condition is defined as the accumulation of fluid in the peritoneal cavity?

    <p>Ascites</p> Signup and view all the answers

    Which vascular sound is characterized by a low-pitched, continuous tone over the umbilical region?

    <p>Venous hum</p> Signup and view all the answers

    What movement is defined as rotating the thigh outward away from the midline?

    <p>External Rotation</p> Signup and view all the answers

    Which movement combines all types of motion into a circular movement?

    <p>Circumduction</p> Signup and view all the answers

    What is the primary purpose of assessing range of motion (ROM) when examining the joints?

    <p>To measure the angle of joint motion accurately</p> Signup and view all the answers

    Which rating on the Muscle Strength Rating Scale indicates total paralysis?

    <p>0</p> Signup and view all the answers

    What does active range of motion (AROM) refer to?

    <p>Movement performed by the patient without assistance</p> Signup and view all the answers

    What should be noted during a physical examination regarding muscle assessment?

    <p>Muscle bulk or atrophy</p> Signup and view all the answers

    Which term describes a slight inward rotation of the tibia when the knee is flexed?

    <p>Medial Rotation</p> Signup and view all the answers

    What aspect of joint assessment involves inspecting for swelling, deformities, and symmetry?

    <p>General Appearance</p> Signup and view all the answers

    What is a potential health concern related to decreased estrogen levels in older adults?

    <p>Development of osteoporosis</p> Signup and view all the answers

    What is the correct rationale for assessing swelling or inflammation in joints?

    <p>To identify signs of possible joint disease</p> Signup and view all the answers

    What is the primary cause of encephalitis?

    <p>Viral infections</p> Signup and view all the answers

    Which of the following symptoms is NOT typically associated with stroke?

    <p>Severe headache</p> Signup and view all the answers

    What is the purpose of assessing mental status in a neurological examination?

    <p>To gauge cognitive function</p> Signup and view all the answers

    Which level of consciousness indicates a person is unresponsive to stimuli?

    <p>Coma</p> Signup and view all the answers

    Which cranial nerve function is assessed through testing visual fields?

    <p>Optic nerve</p> Signup and view all the answers

    What does the motor system evaluation primarily assess?

    <p>Strength and tone</p> Signup and view all the answers

    Which test is used to evaluate the integrity of the cerebellum?

    <p>Romberg test</p> Signup and view all the answers

    What is the goal of evaluating the sensory system in a neurological assessment?

    <p>Detecting peripheral nerve damage</p> Signup and view all the answers

    What would sudden weakness and difficulty speaking suggest in the context of a medical emergency?

    <p>Stroke</p> Signup and view all the answers

    Which function does NOT pertain to the assessment of cranial nerves?

    <p>Muscle strength</p> Signup and view all the answers

    What might diminished vibratory sensation indicate in a patient?

    <p>Peripheral neuropathy</p> Signup and view all the answers

    When assessing temperature sensation in a patient, what abnormal finding would suggest a possible issue?

    <p>Inability to sense temperature differences</p> Signup and view all the answers

    Which assessment determines a patient's ability to identify the direction of joint movement?

    <p>Sensitivity to position (proprioception)</p> Signup and view all the answers

    What does an inability to accurately perceive light touch suggest?

    <p>Sensory loss</p> Signup and view all the answers

    What equipment is typically used to assess vibratory sensation?

    <p>Low-pitched tuning fork</p> Signup and view all the answers

    What primary function does the hypoglossal nerve control?

    <p>Movement of the tongue</p> Signup and view all the answers

    Which of the following findings would indicate an abnormal result during the assessment of muscle strength and tone?

    <p>Muscle weakness in one limb</p> Signup and view all the answers

    During a gait and balance assessment, which observation would suggest an abnormal finding?

    <p>Shuffling walk</p> Signup and view all the answers

    What is a normal outcome of the Romberg test?

    <p>Maintaining balance without falling</p> Signup and view all the answers

    What does the tandem walking assessment primarily evaluate?

    <p>Proprioception and balance</p> Signup and view all the answers

    Which of the following indicates a positive finding for dysarthria during speech assessment?

    <p>Difficulty articulating words clearly</p> Signup and view all the answers

    What is the primary goal of resistance testing during the strength and tone assessment?

    <p>To identify muscle strength</p> Signup and view all the answers

    What abnormal finding may be evident during the assessment of muscle condition?

    <p>Rigidity during movement</p> Signup and view all the answers

    What does the presence of atrophy indicate during a muscle assessment?

    <p>Muscle loss or weakness</p> Signup and view all the answers

    Which of the following would be considered an abnormal finding when observing limb movements?

    <p>Tremors during activity</p> Signup and view all the answers

    What does hematemesis indicate when observed in a patient?

    <p>Potential bleeding from the gastrointestinal tract</p> Signup and view all the answers

    What condition can result from dilated veins in the esophagus due to increased portal vein pressure?

    <p>Esophageal varices</p> Signup and view all the answers

    Which factor is most likely to cause gastric ulcers?

    <p>Use of NSAIDs</p> Signup and view all the answers

    Where do ulcers form in the gastrointestinal tract?

    <p>In the stomach, small intestine, or esophagus</p> Signup and view all the answers

    What is the primary role of peristalsis in the digestive system?

    <p>To move food and waste through the gastrointestinal tract</p> Signup and view all the answers

    Which of the following symptoms would NOT be pertinent when assessing bowel elimination?

    <p>Change in appetite</p> Signup and view all the answers

    What is one common cause of constipation related to lifestyle?

    <p>Decreased physical activity</p> Signup and view all the answers

    What should be included in a patient's history during a bowel elimination assessment?

    <p>Normal bowel habits, including frequency and consistency</p> Signup and view all the answers

    What symptoms may indicate encephalitis?

    <p>Confusion and seizures</p> Signup and view all the answers

    Which type of stroke is caused by a blockage in a blood vessel supplying the brain?

    <p>Ischemic stroke</p> Signup and view all the answers

    What does assessing mental status primarily evaluate?

    <p>Cognitive function and orientation</p> Signup and view all the answers

    Which cranial nerve test evaluates visual fields?

    <p>Optic nerve test</p> Signup and view all the answers

    What is the primary purpose of evaluating the sensory system?

    <p>To detect peripheral nerve damage</p> Signup and view all the answers

    What is diastasis recti primarily characterized by?

    <p>Separation of the rectus abdominis muscles</p> Signup and view all the answers

    Which condition is defined by a bulge occurring at the site of a surgical incision?

    <p>Incisional hernia</p> Signup and view all the answers

    What is a common risk factor that cannot be modified for osteoporosis?

    <p>Age</p> Signup and view all the answers

    What role do bones play in blood cell production?

    <p>Bone marrow produces red and white blood cells.</p> Signup and view all the answers

    What aspect of bones contributes to energy storage?

    <p>Adipocytes within bones</p> Signup and view all the answers

    How does diastasis recti differ from a true hernia?

    <p>It results in muscle separation, not pouching of tissue.</p> Signup and view all the answers

    What is the primary function of the Accessory Nerve (Cranial Nerve XI)?

    <p>Controls shoulder elevation and head movement</p> Signup and view all the answers

    Which function of bones does not involve protecting vital organs?

    <p>Mineral storage</p> Signup and view all the answers

    What is the primary cause of osteoporosis?

    <p>Hormonal imbalances</p> Signup and view all the answers

    Which of the following is a common clinical manifestation associated with the Hypoglossal Nerve (Cranial Nerve XII)?

    <p>Deviation of the tongue towards the affected side</p> Signup and view all the answers

    How does the COLDSPA mnemonic assist in assessing headache symptoms?

    <p>By providing a structured approach to symptom assessment</p> Signup and view all the answers

    What might indicate a diastasis recti condition during physical examination?

    <p>Visible contraction of the abdominal muscles</p> Signup and view all the answers

    What condition is characterized by a progressive decline in cognitive function affecting daily activities?

    <p>Dementia</p> Signup and view all the answers

    Which of the following is NOT a function of bones?

    <p>Hormonal production</p> Signup and view all the answers

    What is a defining characteristic of a seizure?

    <p>Sudden burst of electrical activity in the brain</p> Signup and view all the answers

    Which condition is NOT associated with seizures?

    <p>Diabetes</p> Signup and view all the answers

    Which symptom is commonly associated with meningitis?

    <p>Stiff neck</p> Signup and view all the answers

    What symptom is commonly associated with Ménière's Disease?

    <p>Episodic vertigo</p> Signup and view all the answers

    Which term describes the ability to recall information from the distant past?

    <p>Remote Memory</p> Signup and view all the answers

    Which of the following triggers might lead to a seizure?

    <p>Exposure to bright lights</p> Signup and view all the answers

    What could be a potential indication of dysarthria?

    <p>Difficulty in articulating words</p> Signup and view all the answers

    Which of the following assessments is important when evaluating older adults for neurological issues?

    <p>Hearing and vision assessment</p> Signup and view all the answers

    Which aspect of headache assessment involves determining the temporal pattern of headaches?

    <p>Pattern</p> Signup and view all the answers

    Which neurological assessment question would help identify post-traumatic seizures?

    <p>What type of movements do you exhibit during a seizure?</p> Signup and view all the answers

    Which condition involves difficulty swallowing?

    <p>Dysphagia</p> Signup and view all the answers

    What would likely result from orthostatic hypotension?

    <p>Dizziness upon standing</p> Signup and view all the answers

    What condition is characterized by inflammation of the vestibular nerve leading to vertigo?

    <p>Vestibular Neuritis</p> Signup and view all the answers

    Which term describes sudden, brief jerking movements of a muscle or group of muscles?

    <p>Myoclonus</p> Signup and view all the answers

    What symptom may indicate acute confusion and disorientation, often reversible?

    <p>Delirium</p> Signup and view all the answers

    Which of the following describes abnormal sensations such as tingling or 'pins and needles'?

    <p>Paresthesia</p> Signup and view all the answers

    What type of abdominal pain is typically sharp and well-localized?

    <p>Parietal Pain</p> Signup and view all the answers

    Which condition is commonly associated with recurrent heartburn and acid regurgitation?

    <p>Gastroesophageal Reflux Disease (GERD)</p> Signup and view all the answers

    Which quality describes visceral pain?

    <p>Dull and crampy</p> Signup and view all the answers

    What symptom is primarily associated with heartburn?

    <p>Burning sensation in the chest</p> Signup and view all the answers

    Which factor can lead to referred pain in the body?

    <p>Shared nervous system pathways</p> Signup and view all the answers

    Which type of indigestion is characterized by feelings of fullness after eating?

    <p>Functional Dyspepsia</p> Signup and view all the answers

    Which type of pain might be experienced in the left shoulder during splenic irritation?

    <p>Referred Pain</p> Signup and view all the answers

    Which explanation best describes the cause of acid reflux?

    <p>Failure of the lower esophageal sphincter to close properly</p> Signup and view all the answers

    What is a primary difference between ischemic and hemorrhagic strokes?

    <p>Ischemic strokes result from interrupted blood flow, while hemorrhagic strokes result from bleeding.</p> Signup and view all the answers

    Which symptom is commonly associated with encephalitis?

    <p>Severe headache</p> Signup and view all the answers

    What does the assessment of a patient's level of consciousness primarily indicate?

    <p>The severity of a neurologic condition and guiding further care.</p> Signup and view all the answers

    When evaluating motor and cerebellar systems, which aspect is NOT typically assessed?

    <p>Speech and language</p> Signup and view all the answers

    Which cranial nerve function is associated with assessing facial movement?

    <p>Facial nerve</p> Signup and view all the answers

    What does a positive fluid wave test indicate?

    <p>Presence of ascites</p> Signup and view all the answers

    What commonly leads to appendicitis?

    <p>Obstruction of the appendix</p> Signup and view all the answers

    What observation is noted when performing the fluid wave test?

    <p>A wave travelling to the tapping hand</p> Signup and view all the answers

    Which symptom is most commonly associated with appendicitis?

    <p>Abdominal pain shifting to the right lower quadrant</p> Signup and view all the answers

    What does rebound tenderness during an abdominal exam suggest?

    <p>Possible infection or trauma in the peritoneum</p> Signup and view all the answers

    Which condition is characterized by fluid leakage into the peritoneal cavity?

    <p>Nephrotic syndrome</p> Signup and view all the answers

    What does the term 'peritoneal irritation' refer to?

    <p>Inflammation of the peritoneum</p> Signup and view all the answers

    How is the fluid wave test performed?

    <p>Patient lies supine while tapping on the abdomen</p> Signup and view all the answers

    Which of the following can cause peritoneal irritation?

    <p>Hemorrhage or infection</p> Signup and view all the answers

    What is true about ascites?

    <p>It can result from nephrotic syndrome</p> Signup and view all the answers

    Which group of individuals faces the highest risk of exposure to hepatitis viruses due to their profession?

    <p>Nurses</p> Signup and view all the answers

    What complication can arise from prior abdominal surgeries?

    <p>Adhesions</p> Signup and view all the answers

    Which of the following medications is known to increase the risk of developing peptic ulcers?

    <p>Corticosteroids</p> Signup and view all the answers

    Which of the following groups is NOT considered to have increased risk for exposure to hepatitis viruses?

    <p>Athletes participating in contact sports</p> Signup and view all the answers

    What is a primary risk factor for hepatitis C among individuals who inject drugs?

    <p>Sharing needles or syringes</p> Signup and view all the answers

    What gastrointestinal issue may arise due to the use of nonsteroidal anti-inflammatory drugs (NSAIDs)?

    <p>Gastric irritation</p> Signup and view all the answers

    Which complication could result from trauma to the abdomen?

    <p>Organ damage</p> Signup and view all the answers

    What potential outcome affects individuals with chronic liver disease when exposed to hepatitis viruses?

    <p>Higher susceptibility to complications</p> Signup and view all the answers

    What can be altered in the gut due to the use of antibiotics?

    <p>Gut flora</p> Signup and view all the answers

    Which type of hepatitis is primarily transmitted through sexual contact?

    <p>Hepatitis B</p> Signup and view all the answers

    What condition is characterized by a fusion of the vertebrae and may lead to reduced spinal mobility?

    <p>Ankylosing Spondylitis</p> Signup and view all the answers

    Which abnormal finding might indicate a herniated disc during a physical examination?

    <p>Localized tenderness with tingling</p> Signup and view all the answers

    What does the straight leg raise test primarily assess?

    <p>Nerve root irritation</p> Signup and view all the answers

    Which of the following is NOT commonly associated with lumbar lordosis?

    <p>Osteoporosis</p> Signup and view all the answers

    Which condition is likely to result in decreased spinal flexibility in older adults?

    <p>Degenerative disc disease</p> Signup and view all the answers

    What anatomical change is often seen with increased kyphosis in older adults?

    <p>Increased thoracic curvature</p> Signup and view all the answers

    What is a common symptom associated with lumbosacral muscle strains?

    <p>Muscle spasms</p> Signup and view all the answers

    Which curvature is characterized by a lateral deviation often presenting as an 'S' or 'C' shape?

    <p>Scoliosis</p> Signup and view all the answers

    Which of the following conditions is associated with the flattening of the lumbar curve?

    <p>Muscle strain</p> Signup and view all the answers

    What is a common presentation for compression fractures?

    <p>Localized tenderness and decreased range of motion</p> Signup and view all the answers

    Study Notes

    Assessing Coordination

    • Finger-to-Nose Test - Evaluates coordination and accuracy of movements.
      • Normal: Smooth, accurate movements.
      • Abnormal: Inaccurate or uncoordinated movements, overshooting or undershooting.
    • Rapid Alternating Movements - Assesses speed and smoothness of alternating movements.
      • Normal: Smooth and fast alternating movements.
      • Abnormal: Slow, clumsy, or uncoordinated movements.
    • Heel-to-Shin Test - Evaluates coordination and control of leg movements.
      • Normal: Smooth, controlled movements.
      • Abnormal: Difficulty performing the test or lack of coordination.

    Older Adult Considerations

    • Muscle Strength: Age-related muscle atrophy can lead to decreased strength and coordination.
    • Balance Issues: Older adults may have decreased proprioception and balance, increasing fall risk.
    • Reflexes: Diminished reflex responses may impact balance challenges.
    • Vision and Hearing: Impaired vision or hearing can affect balance and coordination.

    Key Terms

    • Proprioception: The body's ability to sense its position and movement in space.
    • Dyskinesia: Involuntary, erratic movements caused by medication effects or neurological disorders.
    • Spastic Hemiparesis: Weakness on one side of the body, often from stroke or neurological conditions, characterized by increased muscle tone.
    • Footdrop: Difficulty lifting the front part of the foot, leading to dragging or slapping of the foot during walking.

    Assessing Sensation

    • Orthostatic Hypotension: A drop in blood pressure upon standing that leads to dizziness.

    Key Terms

    • Paresthesia: Abnormal sensation such as tingling or "pins and needles."
    • Tinnitus: Ringing or noise in the ears.
    • Dysarthria: Difficulty in articulating words due to muscle weakness.
    • Dysphagia: Difficulty swallowing.
    • Fasciculations: Involuntary muscle contractions that can be observed as twitching.
    • Tremors: Involuntary shaking or rhythmic movement of a body part.
    • Myoclonus: Sudden, brief jerking movements of a muscle or group of muscles.
    • Amnesia: Loss of memory, either partially or completely.
    • Delirium: Acute confusion and disorientation, often reversible.
    • Dementia: A progressive decline in cognitive function affecting daily activities.
    • Dysphasia: Difficulty in language processing or comprehension
    • Aphasia: Complete inability to communicate effectively using speech or language.

    Older Adult Considerations

    • Sensory Perception: Assess for changes in hearing or vision, which can impact communication.
    • Cognitive Function: Be mindful of forgetfulness, confusion, or changes in alertness.
    • Motor Function: Observe for tremors, weakness, or difficulty with movements.
    • Communication: Speak clearly and allow extra time for responses, considering potential speech or language difficulties.

    Questions to Ask About Muscle Control

    • Have you noticed any weakness in your muscles?
    • Are you experiencing any difficulty with coordination or balance?
    • Have you had any recent falls or near falls?
    • Do you have a history of conditions like spinal cord injury, multiple sclerosis, or Parkinson's disease that may affect muscle control?

    Differentiating Between Recent vs. Remote Memory

    • Recent Memory: Recalling information learned or experienced within the last few days to weeks.
    • Remote Memory: Recalling information from the distant past.

    Past Health History

    • Meningitis: Inflammation of the protective membranes surrounding the brain and spinal cord. Symptoms include headache, fever, stiff neck, and altered mental status.

    Assessing Range of Motion

    • Active Range of Motion (AROM): Movements performed by the patient themselves. Evaluates strength and coordination of muscles responsible for movement.
    • Passive Range of Motion (PROM): Movements performed with assistance from the examiner. Assesses joint integrity and flexibility without muscle involvement.

    Inspection of Posture and Gait

    • Abnormal Curvatures
      • Kyphosis: Excessive curvature of the spine in the thoracic region, leading to a hunchback appearance.
      • Lordosis: Excessive curvature of the lumbar region, often seen in individuals with poor posture or obesity.
      • Scoliosis: Lateral curvature of the spine, which can be structural or functional.
    • Normal Findings for Gait
      • Rhythm: Regular and even cadence.
      • Step length: Consistent and appropriate for the individual's height.
      • Arm Swing: Natural and symmetrical movement of the arms accompanying leg motion.
      • Posture: Upright posture with head held high and shoulders back.
    • Abnormal Findings for Gait
      • Antalgic gait: A limp to avoid pain on weight-bearing.
      • Ataxic gait: Uncoordinated movements, suggesting dysfunction in the cerebellum or proprioception issues.
      • Shuffling gait: Slow, dragging steps, often associated with Parkinson's disease.
      • Steppage gait: High stepping action, commonly indicating neuropathy.
      • Wide-based gait: Increased distance between the feet while walking, which may suggest balance issues.

    Older Adult Considerations

    • Older adults may experience age-related changes in posture and gait, such as decreased muscle strength, instability, and balance challenges.
    • Postural Changes: Increased curvature of the spine or a forward stoop is common in older adults.
    • Gait Changes: Gait may become slower, shuffling, or with shorter strides. This can increase the risk of falls. Assessing the risk of osteoporosis and fall prevention strategies should be prioritized in older adults to improve mobility and safety.

    TMJ

    • TMJ Dysfunction: Conditions affecting the temporomandibular joint, which connects the jawbone to the skull. Can result from injury, arthritis, or habits such as teeth grinding or jaw clenching.

    Clinical Manifestations of TMJ Dysfunction

    • Pain: Pain in the jaw, face, neck, or head.
    • Clicking or Popping: Noises when opening or closing the mouth.
    • Limited Opening: Difficulty opening the mouth fully.
    • Locking: Jaw becoming stuck in an open or closed position.
    • Headaches: Headaches associated with jaw clenching or pain.
    • Earache: Pain in the ear that may be related to TMJ dysfunction.
    • Dizziness: Dizziness or lightheadedness that may be associated with jaw movement.
    • Tinnitus: Ringing in the ears that may be associated with TMJ dysfunction.

    Auscultation

    • Listen for bowel sounds in each quadrant for at least 5 minutes
    • Borborygmus: rumbling or gurgling sounds made by the movement of gas in the intestines, often normal
    • Use the bell of the stethoscope for vascular sounds.
    • Bruit: Turbulent blood flow sound due to narrowing of a blood vessel, often heard over arteries like the aorta, renal arteries, or carotids.
    • Venous Hum: Low-pitched, continuous sound over the umbilical region. May be a sign of increased collateral circulation due to portal hypertension.
    • Friction Rub: Grating sound associated with inflammation of the peritoneal lining; may be heard over the liver or spleen.

    Percussion Techniques

    • Tympany: Sound heard over air-filled structures like the stomach or intestines.
    • Dullness: Indicates fluid or solid masses (e.g., organ enlargement).
    • Hyperresonance: Indicates excessive gas or trapped air

    Liver Span Measurement

    • Measure at the mid-clavicular line (MCL) and midsternal line (MSL).
    • Normal Span: Approximately 6-12 cm at MCL and 4-8 cm at MSL.

    Hepatomegaly

    • Enlarged liver; it can occur due to liver disease, heart failure, or certain infections.

    Splenomegaly

    • Enlarged spleen caused by infections, liver diseases, blood disorders, or cancers.

    Blunt Percussion of the Kidneys

    • Perform CVA tenderness assessment by gently tapping the costovertebral angle with the fist.
    • Tenderness may indicate conditions like pyelonephritis.

    Ascites

    • Definition: Ascites is the accumulation of fluid in the peritoneal cavity.
    • Can lead to abdominal distension and discomfort.

    Causes of Ascites

    • Liver Cirrhosis: The most common cause, where scarring of the liver leads to increased pressure in the portal vein and fluid leakage into the abdomen.
    • Malignancy: Cancers, particularly those involving the liver, ovaries, or peritoneum, can cause fluid accumulation.
    • Heart Failure: Congestive heart failure can lead to fluid buildup in the abdomen due to poor circulation.
    • Infections: Conditions such as tuberculosis or spontaneous bacterial peritonitis can cause ascites.

    Assessment of Joints and Muscles

    • General Appearance: Look for symmetry between limbs and joints.
    • Swelling or Inflammation: Check for signs of edema, redness, or heat around joints.
    • Deformities: Observe for any abnormal shape or alignment in the joints (e.g., bowing of knees, displacement of joints).
    • Skin Changes: Note any rashes, lesions, or discoloration over joints.
    • Range of Motion (ROM): Observe any limitations or difficulties in movement.
    • Muscle bulk/atrophy: Assess for muscle wasting or hypertrophy.

    Muscle Strength Rating Scale (0-5):

    • 0: No muscle contraction (0% strength) — Total paralysis.
    • 1: Flicker or trace of contraction (1% strength) — Muscle contraction is seen but no movement.
    • 2: Active movement with gravity eliminated (10% strength) — Full ROM in a horizontal position.
    • 3: Active movement against gravity (30% strength) — Full ROM against gravity but not against resistance.
    • 4: Active movement against gravity and some resistance (70% strength) — Full ROM against moderate resistance.
    • 5: Normal strength (100% strength) — Full ROM against full resistance.

    Passive vs.Active Range of Motion:

    • Active Range of Motion (AROM): Movements performed by the patient without assistance.
    • Passive Range of Motion (PROM): Movements performed by the examiner with the patient relaxing their muscles.

    Encephalitis

    • Inflammation of the brain tissue itself, often caused by viral infections.
    • Symptoms can include headache, confusion, seizures, and changes in consciousness.

    Stroke

    • A medical emergency that occurs when there is a disruption of blood flow to the brain, resulting in tissue damage.
    • It can be classified as ischemic (due to a blockage) or hemorrhagic (due to bleeding).
    • Symptoms may include sudden weakness, difficulty speaking, facial drooping, and loss of coordination.

    Mental Status

    • Purpose: Assessment of mental status evaluates cognitive function, including orientation, memory, attention, language, and reasoning.
    • It provides insight into the patient's overall cognitive health and helps identify potential underlying neurological or psychiatric conditions.
    • Level of Consciousness: A person's awareness and responsiveness to their environment and stimuli. Levels can range from fully alert and oriented to stupor or coma.
    • It's crucial for determining the severity of a neurologic condition and directing further assessment and care.

    Cranial Nerves

    • Purpose: Evaluating cranial nerves assesses the function of the cranial nerves responsible for various sensory and motor functions (such as vision, taste, facial movement, and hearing).
    • Dysfunction can indicate specific areas of neurological impairment.

    Motor and Cerebellar Systems

    • Purpose: The motor system evaluates strength and tone, as well as movement coordination.
    • Balance: The cerebellar system assesses coordination and balance.

    Sensory System

    • Purpose: This area evaluates the sensory pathways responsible for processing sensory information, including pain, temperature, touch, vibration, and proprioception.
    • It helps in detecting peripheral nerve damage or central nervous system disorders.

    Hypoglossal Nerve (Cranial Nerve XII)

    • Function: motor; it controls the movement of the tongue, which is essential for speech and swallowing.
    • Assessment: ask patient to stick tongue out; then move with resistance by tongue depressor
    • Normal findings: symmetric, free moving, clear speech
    • Abnormal findings: deviation of tongue, weakness, atrophy, dysarthia or difficulty speaking

    Condition and Movement of Muscles

    • Assessment: Observe the patient’s ability to move limbs and assess for any involuntary movements or abnormalities in posture.
    • Normal Findings: Smooth, voluntary movements; appropriate muscle tone; no tremors or fasciculations.
    • Abnormal Findings: Difficulty in movement, rigidity, tremors, or involuntary movements like dyskinesia.

    Strength and Tone of Muscles

    • Assessment: Test muscle strength through resistance testing (e.g., bicep curls or leg lifts) and assess muscle tone by observing resistance to passive movement.
    • Normal Findings: Equal strength bilaterally; appropriate muscle tone (not too stiff or floppy).
    • Abnormal Findings: Muscle weakness (partial or complete), atrophy, or abnormal muscle tone (hypertonia or hypotonia).

    Gait and Balance

    • Assessment: Ask the patient to walk normally, then observe gait for symmetry, balance, and coordination.
    • Normal Findings: Even and balanced gait with arms swinging naturally at sides.
    • Abnormal Findings: Shuffling, limping, wide-based gait, unsteadiness, or difficulty turning.

    Tandem Walking

    • Assessment: Instruct the patient to walk in a straight line placing the heel of one foot directly in front of the toes of the other foot.
    • Normal Findings: Steady and coordinated movement without loss of balance.
    • Abnormal Findings: Loss of balance, inability to walk in a straight line, or difficulty maintaining tandem gait.

    Romberg Test

    • Assessment:
      • Have the patient stand with feet together and arms at their sides.
      • Instruct them to close their eyes and maintain the position for 20-30 seconds.
    • Normal Findings:
      • The patient should maintain balance without swaying or falling.
    • Abnormal Findings:
      • Swaying, opening eyes for balance, or falling indicates impaired proprioception or vestibular function.

    Light Touch

    • Assessment: Use a cotton ball or a soft object. Apply light touch on various areas of the skin, asking the patient to indicate when they feel it.
    • Normal Findings: The patient accurately reports feeling touch where applied.
    • Abnormal Findings: Diminished sensation or loss of touch perception (hypoesthesia or anesthesia).

    Pain

    • Assessment: Use a sharp object (e.g., pin) or a safety pin. Apply a light pinch to different areas and ask the patient to identify sharp versus dull.
    • Normal Findings: The patient can accurately differentiate between sharp and dull sensations.
    • Abnormal Findings: Inability to recognize sharpness or presence of pain when it should not be felt.

    Temperature

    • Assessment: Use test tubes filled with warm and cold water (or a thermal stimulator). Apply to various skin areas while asking the patient to identify temperature.
    • Normal Findings: The patient accurately identifies hot and cold sensations.
    • Abnormal Findings: Inability to sense temperature differences (may indicate peripheral neuropathy).

    Vibratory Sensation

    • Assessment: Use a low-pitched tuning fork (typically 128 Hz). Strike the fork and place it on bony prominences.
    • Locations to Assess:
      • Distal interphalangeal joints of the fingers (e.g., index fingers)
      • The big toe (first metatarsal)
      • Other bony areas like the wrist and ankle.
    • Normal Findings: The patient feels the vibration while the fork is placed on the bony areas.
    • Abnormal Findings: Diminished or absent vibratory sensation, which may suggest peripheral neuropathy or other neurological conditions.

    Sensitivity to Position (Proprioception)

    • Assessment: Hold the patient’s toe or finger by the sides and move it up or down. Ask the patient to identify the direction of movement.
    • Normal Findings: The patient can accurately identify the position movements.
    • Abnormal Findings: Inability to correctly identify the direction of movement may indicate a proprioceptive deficit.

    Tactile Discrimination (Fine Touch)

    • Assessment: Use a cotton swab or a two-point discriminator to assess the ability to feel light touch.
    • Normal Findings: The patient can perceive light touch accurately.
    • Abnormal Findings: Insensitivity to light touch may indicate sensory loss.

    Point Localization

    • Assessment: Touch the patient in various locations on the skin and ask them to identify where they were touched without looking.

    Hematemesis

    • Blood in vomit, can appear bright red or dark brown resembling "coffee grounds"
    • Can be a sign of serious medical conditions such as bleeding from an ulcer, esophageal varices, or gastrointestinal disorders

    Esophageal Varices

    • Dilated veins in the esophagus caused by increased pressure in the portal vein, often due to liver cirrhosis
    • Can rupture and lead to significant bleeding

    Ulcers

    • Open sores that form on the lining of the stomach, small intestine, or esophagus
    • Caused by infection with Helicobacter pylori, excessive use of NSAIDs, or excessive stomach acid production

    Peristalsis

    • Series of coordinated, wave-like muscle contractions in the gastrointestinal tract
    • Propels food, liquid, and waste through the digestive system, facilitating digestion and elimination

    Diastasis Recti

    • Separation of rectus abdominis muscles at the midline
    • Most common in pregnant women but can occur in men and women due to obesity or heavy lifting
    • Can lead to a bulge in the abdominal midline, particularly when contracting the abdominal muscles

    Incisional Hernia

    • Occurs at the site of a previous surgical incision in the abdominal wall
    • Abdominal content bulge through scar tissue
    • Common after surgeries such as appendectomies, hysterectomies, or bowel surgeries

    Bones

    • Provide support for the body
    • Protect vital organs
    • Serve as attachment points for muscles
    • Produce blood cells
    • Store minerals such as calcium and phosphorus
    • Store energy as fat

    Osteoporosis

    • Condition characterized by decreased bone density and quality
    • Increases risk of fractures and bone weakening

    Increased Risk Factors for Osteoporosis

    • Age: Increased risk with age
    • Menopause: Declining estrogen levels
    • Family history: Genetic predisposition

    Accessory Nerve (Cranial Nerve XI)

    • Controls sternocleidomastoid and trapezius muscles for head movement and shoulder elevation
    • Weakness in shoulder elevation or head rotation can indicate dysfunction

    Hypoglossal Nerve (Cranial Nerve XII)

    • Controls tongue movement
    • Difficulty in tongue movements, deviation of the tongue towards the affected side, and dysarthria can indicate dysfunction

    COLDSPA mnemonic

    • C: Character - What does the headache feel like?
    • O: Onset - When did the headache start?
    • L: Location - Where is the pain located?
    • D: Duration - How long do the headaches last?
    • S: Severity - How severe is the headache?
    • P: Pattern - What makes the headaches better or worse?

    Seizures

    • Sudden burst of electrical activity in the brain leading to behavioral, movement, feeling, or consciousness changes

    Conditions Associated with Seizures

    • Epilepsy: Chronic disorder characterized by recurrent seizures
    • Head trauma: Post-traumatic seizures
    • Stroke: Depending on the area of the brain affected
    • Infections: Meningitis, encephalitis
    • Metabolic disturbances: Hypoglycemia, electrolyte imbalances

    Ménière's Disease

    • Disorder characterized by episodic vertigo, hearing loss, tinnitus, and sensation of fullness in the ear

    Other Conditions Associated with Dizziness

    • Vestibular Neuritis: Inflammation of the vestibular nerve
    • Benign Paroxysmal Positional Vertigo (BPPV): Caused by changes in head position
    • Orthostatic Hypotension: Drop in blood pressure upon standing

    Key terms

    • Paresthesia: Abnormal sensation (e.g., tingling, "pins and needles")
    • Tinnitus: Ringing or noise in the ears
    • Dysarthria: Difficulty in articulating words due to muscle weakness
    • Dysphasia: Difficulty in language processing or comprehension
    • Aphasia: Complete inability to communicate effectively using speech or language
    • Dysphagia: Difficulty swallowing
    • Fasciculations: Involuntary muscle contractions
    • Tremors: Involuntary shaking or rhythmic movement of a body part
    • Myoclonus: Sudden, brief jerking movements of a muscle or group of muscles
    • Amnesia: Loss of memory, either partially or completely
    • Delirium: Acute confusion and disorientation, often reversible
    • Dementia: Progressive decline in cognitive function affecting daily activities

    Mental Status

    • Evaluates cognitive function including orientation, memory, attention, language, and reasoning
    • Provides insight into overall cognitive health and helps identify potential underlying neurological or psychiatric conditions

    Level of Consciousness

    • Ranges from fully alert and oriented to stupor or coma
    • Crucial for determining the severity of a neurologic condition

    Cranial Nerves

    • Assesses function of cranial nerves responsible for sensory and motor functions
    • Dysfunction can indicate specific neurological impairment

    Motor and Cerebellar Systems

    • Evaluates muscle strength and control to identify weakness or paralysis
    • Tests coordination and balance to assess the integrity of the cerebellum

    Sensory System

    • Evaluates sensory pathways responsible for processing sensory information
    • Helps in detecting peripheral nerve damage or central nervous system disorders

    Recent Memory

    • Ability to recall information learned or experienced within the last few days to weeks

    Remote Memory

    • Recalling information from the distant past

    Meningitis

    • Inflammation of the protective membranes surrounding the brain and spinal cord
    • Symptoms include headache, fever, stiff neck, and altered mental status

    Encephalitis

    • Inflammation of the brain tissue itself
    • Symptoms include headache, confusion, seizures, and changes in consciousness

    Stroke

    • Disruption of blood flow to the brain, resulting in tissue damage
    • Symptoms may include sudden weakness, difficulty speaking, facial drooping, and loss of coordination

    Abdominal Pain

    • Visceral pain arises from internal organs, often described as vague, poorly localized, or crampy.
    • Parietal pain results from irritation to the parietal peritoneum, often sharp, well-localized, and aggravated by movement.
    • Referred pain is felt in a location different from its origin due to shared pathways in the nervous system.

    Indigestion

    • Indigestion (Dyspepsia) is discomfort or pain in the upper abdomen.
    • Heartburn is a burning sensation in the chest due to stomach acid flowing back into the esophagus.
    • Acid Reflux occurs when stomach acid flows back into the esophagus due to the lower esophageal sphincter (LES) not closing properly.
    • Gastroesophageal Reflux Disease (GERD) is a chronic condition with frequent acid reflux causing persistent heartburn, regurgitation, dysphagia, and possible respiratory issues.

    Hepatitis Viruses

    • Types of hepatitis viruses include A, B, C, D, and E.

    Hepatitis Virus Exposure Risk

    • Healthcare Workers are at increased risk due to needlestick injuries or contact with infected bodily fluids.
    • People with Multiple Sexual Partners are at increased risk due to sexual transmission of hepatitis B and C.
    • People Who Inject Drugs are at increased risk due to sharing needles.
    • Travelers to Endemic Areas are at increased risk for hepatitis A or E.
    • Individuals with Chronic Liver Disease are more susceptible to complications from all forms of hepatitis.
    • Infants Born to Infected Mothers are at risk of contracting hepatitis B during childbirth.

    Prior Abdominal Surgeries or Trauma

    • Adhesions are bands of scar tissue that may cause bowel obstruction and chronic pain.
    • Infection can occur at surgical sites leading to abscesses or peritonitis.
    • Bowel Dysfunction can occur due to changes in peristalsis, potentially leading to constipation or diarrhea.
    • Organ Damage can occur directly from trauma leading to hemorrhage or organ failure.
    • Changes in Anatomy may require dietary changes or interventions.

    Medications with Adverse GI Effects

    • Nonsteroidal Anti-inflammatory Drugs (NSAIDs) can cause gastric irritation, ulcers, and gastrointestinal bleeding.
    • Corticosteroids can increase the risk of peptic ulcers and gastric bleeding.
    • Antibiotics can alter gut flora, potentially leading to diarrhea (including Clostridium difficile infections).
    • Chemotherapy Agents can cause nausea, vomiting, mucositis, and changes in bowel habits.

    Fluid Wave Test

    • The fluid wave test detects the presence of fluid in the abdominal cavity.
    • It's performed with the patient lying supine and the examiner placing one hand on the midline of the abdomen and tapping the opposite side.
    • A positive test suggests the presence of ascites, but further imaging is needed for confirmation

    Appendicitis/Peritoneal Irritation

    • Appendicitis is the inflammation of the appendix, often caused by an obstruction.
    • Peritoneal Irritation occurs when the peritoneum becomes inflamed.
    • Rebound Tenderness (Blumberg Sign) is pain upon release of pressure from the abdomen, indicating peritoneal irritation.

    Abnormal Findings

    • Herniated Disc may present with localized tenderness, decreased range of motion, and possible neurological symptoms.
    • Ankylosing Spondylitis presents with reduced spinal mobility and an increased thoracic kyphosis.
    • Pregnancy presents with increased lumbar lordosis and a protruding abdomen.
    • Obesity presents with increased lumbar lordosis and potential asymmetry.
    • Compression Fractures present with localized tenderness, decreased spinal height, and possibly kyphosis.
    • Lumbosacral Muscle Strains present with lumbosacral tenderness, possible muscle spasms, and pain upon movement.

    Spinal Curvatures

    • Thoracic Kyphosis is increased posterior curvature of the thoracic spine.
    • Lumbar Lordosis is increased anterior curvature of the lumbar spine.
    • Scoliosis is lateral curvature of the spine.

    Flattening of the Lumbar Curvature

    • Flattening of the lumbar curve results in a straightened appearance.
    • Conditions associated with flattening include muscle spasms or strain, degenerative disc disease, and post-surgical changes.

    Older Adult Considerations

    • Older Adults experience increased kyphosis, decreased spinal flexibility and muscle tone, and a higher incidence of arthritis.

    Straight Leg Raise (Lasegue Test)

    • The straight leg raise test evaluates for nerve root irritation or lumbar disc herniation.
    • A positive result indicates potential irritation of the sciatic or lumbar nerve root.

    Neurological Conditions

    • Encephalitis is inflammation of the brain tissue itself, often caused by viral infections.
    • Stroke occurs when there is a disruption of blood flow to the brain, leading to tissue damage.

    Physical Examination

    • Mental Status evaluates cognitive function, including orientation, memory, attention, language, and reasoning.
    • Level of Consciousness ranges from being fully alert to stupor or coma.
    • Cranial Nerves asses the function of cranial nerves responsible for sensory and motor functions (like vision, taste, facial movement, and hearing).
    • Motor and Cerebellar Systems evaluate strength and tone, as well as movement coordination.
    • Sensory System evaluates sensory pathways responsible for processing sensory information.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Exam 2 Blueprint Filled Out PDF

    Description

    This quiz evaluates the various coordination tests used to assess older adults, including the Finger-to-Nose, Rapid Alternating Movements, and Heel-to-Shin tests. It considers age-related factors such as muscle strength, balance issues, and reflex responses that impact coordination. Test your knowledge on how these assessments can highlight coordination challenges in older populations.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser