dmrn106l

• Aortic
• Pulmonary

Normal jugular venous pulsation is 2cm or less above sternal angle

• Age 20-60 years systolic BP increases by about 20 mmHg
• Age 60-80yrs another 20 mmHg
• No chane in resting heart rate diastole

• Difficulty breathing when supine
• State # of pillows needed to achieve comfort
• the need to assume a more upright position to breathe.

A blowing swooshing sound that occurs with turbulent blood flow in the heart or great vessels

• M itral
• S tenosis
• A trial
• R egurgitation
• D iastole

• M itral
• R egurgitation
• P hysiologic
• A trial
• S tenosis
• S ystolic

• Systole - the midsystolic click(which is associated with mitral valve prolapse) is the most common sound)
• Diastole - the third and fourth heart sound occurs

• Sysytolic
• May occur with normal heart or heart disease
• Diastole
• Always indicates heart disease

• Rate
• Rhythm
• Force
• Elasticity

• Force-shows the strength of the heart stroke volume
• +3=full, bounding
• +2=normal
• +1=weak/thready
• 0=absent

moving body parts (joint) right. left. forward, backward, circular motion depends on what is being tested

• Limited
• Pain with
• Limited rotation
• Limited abduction

• Change of color in response to cold, vibration, or stress
• 1-white(pallor)
• 2-blue(cyanosis)
• 3-red (rubor)

• No wave felt = Competent valve
• Wave felt = Incompetent valve

Loud high-pitched, rushing tinkling sound that signals increased motility

Absent sound followed by abdominal sugery or with inflammation of the peritoneum

• Illiopsoas Muscle Test
• Rebound Tenderness (blumberg's Sign)
• Obturator Test

• A site away from painful area
• Hold hand 90^o or perpendicular to the abdomen
• Push down slowly and deeply then lift up quickly

• Person supine, lift the right leg straight up flexing at the hip
• Push down over the right thigh as the person tries to hold his leg up
• Person should feel no pain

• With the person supine
• lift right leg, flexing the hip 90^o at the knee hold the ankle and rotate the leg internally and externally

• Murphy's sign
• Hold fingers under the liver border.
• Ask person to take a deep breath
• If normal no pain is felt when deep breathing

• Place one hand over the 12^th rib at the costovertebral angle on the clients back thump that hard with your fist
• Normally client feel thud no pain
• sharp pain occurs with inflammation

• Normal value from 5-30 min
• Listen 5 min by your watch before deciding bowel sounds are absent completely

• Audible and palpable crunching or grating that accompanies movement
• Occurs when the articular surfaces in the joints are roughened as w/rhematoid arthritis

• Epiphysis - lenghtning growth plate
• Shaft - increases diameter of bone

Concerned with motor coordination

• Contains many motor neurons and tracts
• Merges into thalamus and hypothalamus

Enlarged area containing ascending and descending fiber tract

Connects the brain and spinal cord

• Controls:
• Temperature
• HR
• BP
• Sleep center
• Pituitary gland regulation

• Vibration
• Position (kinesthesia)
• Tactile Discrimination (fine touch)
• Caused by Diabetes Mellitus

As opposed to a specific nerve lesion, which has a clear zone of deficit for its dermatome

• Using a tuning fork on the big toe
• If no vibration felt go to ulnar process, ankles, patellae, illiac crests

Tests a persons ability to recognize objects by feeling their form, shape, size

• Ability to read a number by having it traced on skin.
• With persons eyes clsoed
• Use blunt object to trace a number or letter in palm of hand

• Upper extremeties stiffly extended,
• Adducted internal rotation
• Indicates lesion in brain stem at midbrain or upper pons

• Upper extremity flexion of arms, wrist, fingers.
• Adduction of arms
• Indicates hemispheric lesion of cerebral cortex

• Eye opening (1-4)
• Motor response (1-5)
• Verbal response (1-6)

• Each area is rated separately
• # given for persons best response
• # added up
• The total reflects person functional status

• 15 - normal
• 7 > coma

• Painful swelling of the tibial tubercle, just below the knee
• Occurs during puberty
• More in males
• Symptoms resolve with rest

• Lymphedema
• Is unilateral swelling, nonpitting brawny edema, with overlaying skin indurated

• Intermittent claudication
• Cramps
• Numbness
• Tingling
• cold

• Brownish color variation
• Aching
• Tiredness
• Fullness

Snellen Eye Chart

You can read at 20 feet what the normal eye could read at 30 feet

• Whispered voice test
• Tunning fork test
• Weber test
• Rinne test
• *Audiometer*

• CN VIII
• Acoustic

• CN III
• Oculomotor

4^th to 8^th day after menses

• Oh
• Oh
• Oh
• To
• Touch
• And
• Feel
• A
• Good
• Vein
• Ah
• Heaven

• Position client at 30 to 45 degree angle
• Remove pillow
• To avoid flexing neck as person is raised to sitting position external jugulars flatten and disappear
• Unilateral distetion of vein is due to local cause(kinking and aneurysm)
• Full distention signify increased CVP as with heart failure