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SUM '20 - Health Assessment > System Return 1 > Flashcards

Flashcards in System Return 1 Deck (33)
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1

Introduction:

Hello my name is ___

I am an SRNA and I will be performing a head to toe assessment on you today.

2

Lymph Nodes:

1. Occipital, pre and post auricular
2.) Tonsillar, Submandibular and submental
3. Superficial cervical, posterior cervical and supraclavicular

3

Lymph Node Order:

1. Pre-auricular
2. Post auricular
3. Tonsillar
4. Submandibular
5. Submental (right below chin)
6. Anterior Cervical (medial side of sternocleidomastoid)
7. Posterior Cervical (behind sternocleidosmastoid)
8. Supraclavicular (above clavicle)
9. Infraclavicular (below clavicle)
10. Occipital (behind neck)

4

Eyes Full Order:

1. Lids, lashes, conjunctiva, sclera, cornea, iris pupils
2. pupil reactivity
3. EOMS's
4. Fundoscopic exam and red reflex
5. Visual acuity

5

1. Lids, lashes, conjunctiva, sclera, cornea, iris pupils

- inspect eyebrows, lids, lashes for symmetry
- inspect sclera. It is white and moist.
- Conjuctiva pink w/o any redness.
-Shine light in eye to note any foreign objects
- Look for shape and symmetry of pupils.

6

2. pupil reactivity

1. Next, I'm going to assess your pupils. I am checking to make sure they are equally round and reactive to direct light.
2. To make sure the pupils react to consensual light, shine light in R eye and observe for pupil constriction in left eye. Repeat on other eye.
3. test accommodation: Place finger in front of patients face and have them look at your finger and then far off.

7

3. EOMS's

1. Testing 6 cardinal views of gaze.
2. have pt follow finger. Go Up, Down, Across, and diagonal on each side.
3. Next, tell pt to follow your finger as you bring it into their nose. Looking to ensure that the eyes will converge and follow your finger.

8

4. Fundoscopic exam and red reflex

1. Grab ophthalmoscope.
2. Have pt look straight at something on wall.
3. Use your R eye when looking at their R eye and vice versa.
4. Come in at an angle.
5. Note red reflex from about 12 inches away and once you see it follow it all the way in until you are very close to pt.
6. You can see optic disk is a creamy yellow to pink color and is round with distinct margins.

9

5. Visual acuity

1. Snellen Eye chart.
2. Place pt 20 ft away from chart.
3. ask pt to cover one eye and read smallest line possible. repeat on other eye.
4. A larger second number (20/40) correlates with worse vision.

10

Ears Full Order:

1. External Symmetry and placement in relation to the eyes
2. Otoscopic exam ear canal, wax, TM, color, light reflex and landmarks.
3. hearing
4. weber and rinne tests CN VIII

11

1. External symmetry and placement in relation to the eyes:

Inspect placement of ears.
Look at external canals for d/c or drainage.

12

2. Otoscopic exam:

1. with otoscope; pull ear up and back.
2. Locate TM - shoudl be a pearly white color. Also observe bony landmarks looking for light reflex.

** if TM is red/bulging it can indicate infection.

13

3. Hearing:

Whisper test:
- Put slight pressure on ear to occlude it (the side you are standing on)
- whisper common two syllable phrase.
- repeat on other side.

14

4. Weber Test:

Tests ability to hear sound bilaterally

- Strike tuning fork and place it on top of head and ask which ear they feel or hear it in.
- Should be both.

15

4. Rinne Test:

- Strike tuning fork and palce it on back of ear on the bone.
- Ask when they can no longer hear it and when they can't move it beside their ear and they should still be able to hear it.

- Air conduction should be greater than bone conduction.

16

Neck Full Order:

1. Neck symmetry and placement of the trachea
2. Thyroid gland
3. Carotid Artery bruits

17

1. Neck symmetry and placement of trachea:

1. Neck Symmetrical
2. Trachea Midline
3. Palpate trachea and move it side to side

18

2. Thyroid Gland:

1. Best to stand behind pt for this.
2. Place hands just below the cricoid cartilage
3. Have pt swallow and you will be able to feel thyroid isthmus move up.

19

3. Carotid Artery Bruits

1. List with both bell and diaphragm.

20

Heat and Face Full Order:

1. Distribution and texture of hair
2. Scalp tenderness, lesions and masses
3. Size, shape of cranium, temporal arteries
4. Facial symmetry and expression VII
5. Masseter and Temporal muscles -CN V

21

1. Distribution and texture of hair

1. inspect hair and head

22

2. Scalp tenderness, lesions and masses

1. Feel on scalp
2. Feeling for any lumps, bumps, depressions
3. Note color, lesions, or masses.

23

3. Size, shape of cranium, temporal arteries

1. Feel temporal Pulse

24

4. Facial symmetry and expression VII

1. inspect face for symmetry
2. Have pt smile to note symmetrical smile
3. This is testing CNVII (Facial)

25

5. Masseter and Temporal muscles -CN V

1. Have pt clench jaw
2. This is testing CN V (Trigeminal)

26

Nose and Sinuses Full Order:

1. External structure, deviation in shape, size, color, and discharge
2. Frontal and maxillary sinuses

27

1. External structure, deviation in shape, size, color, and discharge

1. Inspect nose for deviation and any discharge.
2. Note color, shape, and size
3. Tilt head backwards and shine light into nose.
4. Mucosa should be pink
5. Also not any deviation of the septum.

28

2. Frontal and maxillary sinuses

1. Palpate sinuses for tenderness - should not be tender
2. Frontal sinus: b/w eyes
3. maxillary: below eyes

29

Mouth Full Order:

1. Appearance, discharge pair, lips, teeth and gums, tongue mucosa and salivary ducts.
2. Movement of tongue and uvula - CN XII
3. Palate, tonsils and throat
4. Gag Reflex - CN IX, X

30

1. Appearance, discharge pair, lips, teeth and gums, tongue mucosa and salivary ducts.

1. Inspect mouth, note any sores or cracking.
2. Have pt smile to assess teeth