Health Assesment Exam 2 prep

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Questions and Answers

What should be evaluated during the inspection of the head, face, and neck?

Size and shape of skull, facial symmetry, and neck alignment (correct)

Blood pressure and respiratory rate

Lung sounds and heart rhythm

Skin color and temperature of the arms

Which of the following describes the correct method to assess the trachea?

Check for pulsations in the carotid region

Instruct the patient to breathe deeply and observe for deviation

Palpate for tenderness on either side of the trachea

Have the client swallow and observe for midline trachea movement (correct)

Which neck range of motion movement involves tilting the head to one side?

Rotation

Flexion

Lateral bending (correct)

Extension

What is an expected finding when assessing the strength of neck muscles?

Smooth and controlled range of motion without pain Signup and view all the answers

Which lymph nodes are located in the neck region for inspection during an assessment?

Occipital, preauricular, and submandibular Signup and view all the answers

Which respiratory condition is characterized by a rate of less than 10 breaths per minute?

Bradypnea Signup and view all the answers

What thoracic cage shape is described as an exaggerated posterior curvature of the thoracic spine?

Kyphosis Signup and view all the answers

What type of breath sound is described as having a louder inspiration compared to expiration and is typically heard in peripheral lung fields?

Vesicular Signup and view all the answers

Which percussion note is expected over healthy lung tissue?

Resonance Signup and view all the answers

What technique is recommended to promote accurate auscultation of breath sounds?

Positioning the patient sitting upright Signup and view all the answers

What is the characteristic sound described as a coarse and low-pitched, grating quality that can be heard during both inspiration and expiration?

Pleural Friction Rub Signup and view all the answers

In which condition is an irregular shallow breathing pattern observed?

Hypoventilation Signup and view all the answers

Which of the following best describes bronchial breath sounds?

Longer expiration than inspiration Signup and view all the answers

Which of the following is a non-modifiable risk factor for breast cancer?

Age Signup and view all the answers

What type of wheezing is characterized by high-pitched sounds and is primarily observed in expiration?

Wheezing associated with acute asthma Signup and view all the answers

What is a recommended preparation tip before a mammogram?

Avoid caffeine intake Signup and view all the answers

Where is the heart and great vessels located in the thoracic cage?

Between the lungs in the middle third of the thoracic cage Signup and view all the answers

Which symptom is NOT typically associated with subjective data for breast health?

Weight loss Signup and view all the answers

Which of the following observations should be noted during the initial inspection of breasts?

Symmetry of breast movement Signup and view all the answers

During which phase of the cardiac cycle do the atrioventricular valves remain open and the ventricles are passively filled with blood?

Protodiastolic phase Signup and view all the answers

What is the primary function of breast exams?

To screen and determine survival chances Signup and view all the answers

Which event marks the beginning of systole in the cardiac cycle?

The closing of the AV valves Signup and view all the answers

What sound is created when the semilunar valves close?

S2 Signup and view all the answers

During a clinical breast exam, which position is recommended for the client first?

Sitting or standing with arms at their side Signup and view all the answers

What occurs during the ventricular isovolumetric contraction phase?

All four heart valves are closed Signup and view all the answers

What is an important factor to consider in the preparation for a clinical breast exam (CBE)?

The client's menstrual cycle Signup and view all the answers

Which of the following could indicate an abnormal finding during a breast exam?

Both B and C Signup and view all the answers

Which of the following describes the blood flow starting from the body to the right atrium?

Body - to inferior vena cava - to right atrium Signup and view all the answers

What is the main action occurring during the pre systole phase of the cardiac cycle?

Atria contract to fill the ventricles Signup and view all the answers

What is the primary benefit of the bimanual palpation technique?

It provides additional support for the breast during examination. Signup and view all the answers

Which strategy is recommended for effective education on self-breast exams?

Choose a specific day each month for regular examinations. Signup and view all the answers

What characteristic should be observed in a lump or mass during breast examination?

Distinctness of the mass. Signup and view all the answers

Which of the following is NOT a recommended health promotion strategy for optimal breast health?

Participate in vigorous exercise daily. Signup and view all the answers

For which condition is the concentric circles pattern of palpation primarily recommended?

To thoroughly examine the entire breast area. Signup and view all the answers

What position should a client be in for effective bimanual palpation?

Seated and leaning forward. Signup and view all the answers

What should a woman do during a self-breast exam while in the shower?

Palpate using soap and water to assist. Signup and view all the answers

Which question is pertinent to assess a patient's head, face, and neck health history?

Are your headaches accompanied by nausea or vomiting? Signup and view all the answers

Study Notes

Respiratory Assessment

Bradypnea: Respiratory rate less than 10 breaths per minute.
Hyperventilation: Increased rate and depth of breaths.
Hypoventilation: Irregular, shallow breathing.
Cheyne-Stokes: Increasing rate and depth followed by decreasing, alternating cycle.
Chronic Obstructive Breathing: Normal inspiration and prolonged expiration.

Thoracic Cage Shapes

Normal Adult Thorax: Elliptical shape with an anteroposterior to transverse diameter ratio of 1:2.
Kyphosis: Exaggerated posterior curvature of the thoracic spine, resulting in a humpback.
Scoliosis: Lateral S-shaped curvature of the thoracic and lumbar spine, leading to unequal shoulder and scapular height, and unequal hip levels.

Percussion Notes

Resonance: Low-pitched, clear, hollow sound indicating healthy lung tissue.
Flat: Sound over muscles or bones.
Dullness: Sound over organs.

Auscultation Strategies

Ensure the patient is relaxed, leaning forward slightly in a sitting position, or lying on their side.
Listen to at least one full respiration (inhalation and exhalation) in each location.
Perform side-to-side comparisons, moving the stethoscope from side to side and then down.
Begin auscultation over large airways in the anterior chest.

Breath Sounds

Bronchial: Heard over the trachea and larynx. Expiration is longer than inspiration and is not heard posteriorly.
Bronchovesicular: Heard over the main bronchi. Inspiration and expiration are approximately equal.
Vesicular: Heard over peripheral lung fields. Inspiration is louder and longer than expiration.

Adventitious Breath Sounds

Crackles: Discontinuous popping sounds heard during inspiration due to fluid in the lungs.
Pleural Friction Rub: Coarse and low-pitched, grating quality sound on inspiration and expiration, indicating roughened pleural surfaces.
Wheezing: High-pitched wheezing prominent during exhalation (airway obstruction, like acute asthma or chronic emphysema). Low-pitched wheezing prominent during exhalation (bronchitis).
Stridor: High-pitched inspiratory crowing sound louder in the neck than over the chest wall (airway obstruction).

Heart and Great Vessels

Location: The heart and great vessels are situated between the lungs in the middle third of the thoracic cage, known as the mediastinum.

Blood Flow

Systemic Circulation: Body --> Superior and Inferior Vena Cava --> Right Atrium --> Tricuspid Valve --> Right Ventricle --> Pulmonic Valve --> Pulmonary Arteries --> Lungs --> Pulmonary Veins --> Left Atrium --> Mitral Valve --> Left Ventricle --> Aortic Valve --> Aorta --> Body

Cardiac Cycle

Protodiastolic Phase: All chambers are relaxed. Blood passively fills ventricles. AV valves are open, semilunar valves are closed.
Presystole Phase: Atria contract, actively filling ventricles. AV valves are open, semilunar valves are closed.
Systole: Ventricular pressure exceeds atrial pressure, closing AV valves (S1 sound).
Ventricular Isovolumetric Contraction: All four valves are closed. Ventricle contracts and pressure rises.
Ejection: Semilunar valves open. Blood ejected from ventricles (aortic or pulmonary).
Semilunar Valve Closure: Semilunar valves close (S2 sound), marking the end of systole.
Diastole: All four valves are closed. Ventricular relaxation, isometric relaxation. Atria fill with blood. AV valves open, restarting the cycle.

Breast Assessment

Subjective Data:
- Pain
- Lump
- Discharge
- Rash
- Swelling
- Trauma
- History of breast disease
- Surgery or radiation
- Medications
- Client-centered concerns

Breast Cancer Risk Factors

Non-modifiable: Age, biopsy-confirmed atypical cell growth, certain genetic mutations, mammographically dense breasts, personal history of early onset breast cancer, two or more first-degree relatives with breast cancer, high endogenous estrogen or testosterone levels, high-dose radiation to the chest, Ashkenazi Jewish heritage, early menarche, height, no full-term pregnancies.
Modifiable: Alcohol consumption, late age at first full-term pregnancy, late menopause, personal history of endometrial, ovarian, or colon cancer, never breastfed a child, obesity, recent and long-term use of menopausal hormone therapy, recent oral contraceptive use.

Mammograms

Importance: Reveal cancers too small for physical examination, potentially enabling curable early detection.
Preparation:
- No deodorant, cream, lotions, or powders on underarms or breasts.
- Schedule during the time of month when breasts are not tender.
- Bring past mammogram films.
- Avoid excessive caffeine.
- Provide family breast health history.
- Inform providers of any problems.
- Bring a list of breast treatment dates and locations.

Clinical Breast Exam (CBE)

Preparation: Have necessary equipment, including a small pillow, ruler (centimeters), short gown, teaching aid or pamphlet.

Inspection

Positions:
- Arms at sides, turn side-to-side (symmetry).
- Arms lifted slowly overhead (symmetrical movement).
- Hands on hips, palms together (slight breast uplift).
Key Observations:
- Symmetry
- Skin changes (color, dimpling, discoloration)
- Nipple appearance (inversion, discharge, size, direction)

Palpation

Techniques:
- Vertical Strip Pattern: Axillary area to bra line, medially in overlapping vertical lines.
- Wedge Technique: Nipple to axillary area, like spokes on a wheel.
- Concentric Circles Pattern: Nipple to axillary area, circular pattern.
- Bimanual Technique: One hand supporting the breast, the other palpating against it.
Bimanual Palpation: Effective for pendulous breasts, with client seated and leaning forward.

Lump/Mass Characteristics

Documentation:
- Location
- Size
- Shape
- Consistency
- Mobility
- Distinctness
- Skin over lump
- Tenderness
- Lymphadenopathy

Self-Breast Exam (SBE)

Best timing: Right after menstrual period (days 4-7).
Non-menstruating: Choose a familiar date as a reminder.
Mirror Inspection: Look for size, shape, dimpling, discharge, and contour.
Shower Palpation: Soap and water assist with palpation.

Male Breast Exam

Inspection: Examine chest wall for skin changes, lumps, and swelling.
Palpation: Palpate nipple area for lumps, enlargement, or tissue changes.
Normal: Smooth, even tissue with no nodules.
Discharge: Rare.

Breast Health Promotion

Maintain a healthy weight.
Take vitamin D supplements.
Limit alcohol intake.
Moderate exercise (30 minutes, 5 times weekly).
Avoid tobacco and secondhand smoke.
Manage stress and prioritize adequate sleep.

Head, Face, and Neck Assessment

Health History

Questions:
- Unusually frequent or severe headaches (location, duration, associated symptoms, precipitating factors, medications, family history).
- Head injuries (recent or past, details of event, dizziness).
- Neck pain (onset, location, numbness or tingling in arms/shoulders/hands).
- Recent infections.
- Lumps or swelling changes.
- Smoking or chewing tobacco.
- Alcohol consumption.
- Diagnoses of thyroid issues.
- Neck or head surgery history.

Inspection and Palpation Observations

Head: Skull size and shape (normocephalic, microcephaly, macrocephaly).
Face: Facial expression, symmetry, abnormalities.
Neck: Head centered midline, symmetric accessory neck muscles.

Neck Assessments

Trachea: Observe for midline movement during swallowing.
Range of Motion (ROM): Smooth, controlled flexion, extension, rotation, and lateral bending.
Muscle Strength: Shrug shoulders and perform ROM against resistance.

Regional Lymph Nodes

Location:
- Preauricular
- Posterior auricular
- Occipital
- Submental
- Submandibular
- Jugulogastric
- Superficial cervical
- Deep cervical
- Posterior cervical
- Supraclavicular

Carotid Pulse, Trachea, and Lymph Node Assessment

Carotid Pulse: Assess with gentle palpation, one side at a time.
Trachea: Palpate for location, deviation, and mobility during swallowing.
Lymph Nodes: Palpate gently using a circular motion in each region. Note size, shape, consistency, mobility, tenderness, and any signs of inflammation.

Expected Findings

Healthy Head, Face, and Neck:
Normocephalic head, symmetric facial features, and a midline, non-deviating trachea.
Smooth, controlled ROM in the neck.
Palpable, non-tender lymph nodes (less than 0.5 cm in diameter).

Head and Neck Health Promotion

Encourage regular dental check-ups and oral hygiene practices to prevent infections and maintain oral health.
Advise against smoking and excessive alcohol consumption as risk factors for oral cancer.
Emphasize the importance of wearing helmets during activities with a risk of head injury.
Encourage early intervention for any unusual symptoms or concerns.

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Description

Test your knowledge on respiratory assessment techniques, including definitions of bradypnea, hyperventilation, and thoracic cage shapes. This quiz will also evaluate your understanding of percussion notes and auscultation strategies. Perfect for medical students and health professionals!