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Test 3 reviewed notes
Phys Assessment (NSG 305)
Misericordia University
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Exam Blue Print # 3
Lung disease risk factors (modifiable) = 2%
Tri-pod position = 2%
Normal chest findings upon inspection = 2%
Medical conditions associated with increased chest AP diameter = 2%
Lung sounds adventitious and normal = 12%
Tracheal obstruction = 2%
Clubbing of fingers = 2%
Vocal resonance/tactile fremitus = 4%
A&P of respiratory system = 8%
Prioritization = 4%
Dyspnea = 2%
Pulse Oximetry = 2%
Costal Angle = 2%
Problem based history for heartburn= 2%
ABD assessment findings = 10%
A&P GI tract = 8%
Appendicitis = 2%
Scoliosis = 2%
Poliomyelitis = 2%
Osteoarthritis = 4%
Range of Motion (ROM) (ex. Knee, shoulder, neck) = 6%
Grading of muscle strength = 4%
Assessment of leg length= 2%
Osteoporosis = 2%
Dosage Calculations= 6%
Assessment of pack years = 4%
Additional Terms to Review
o Vocal resonance and consolidation (Pg 205-206) o Repeat 1, 2, 3 or 99 o Bronchophony Should hear a muffled sound and should not be able to understand clearly o Whispered pectoriloquy Whisper 1, 2, 3 o Egophony Say “eee”. The intensity of the spoken word should be muffled. o Should not be clear. Should be muffled, soft sounds.
o Vocal (tactile) fremitus assessment o Using hands to feel vibrations o Repeat 1, 2, 3, or “99” Feeling for vibrations. They should be symmetric on both sides o NORMAL FINDINGS: More prominent in men. It is normal not to hear the sounds with high pitched or soft voiced people (frequently women). o ABNORMAL FINDINGS: Fluid or air can collapse a lung due to pneumothorax, PE, or tumor.
o Functions of upper airways o Conduct air to the lower air way o Protect the lower airway from foreign matters o Warms, filters, and humidifies air
o Focused Respiratory health history questions (Pg 193) o Cough? o SOB? o Breathing related issues? o Ask direct questions
o Primary muscles of inspiration (Pg 190) o Diaphragm contracts and pushes the abdominal content down o Thennnn intercoastal muscles push the chest wall outward o Decreases the intrathoracic pressure, which creates the negative pressure compared to the pressure outside of the lungs o The pressure differences causes the lungs to fill with air o The muscles relax upon expiration o Accessory muscles contribute to resp. effort
Causes or associated conditions with
Percussion of costovertebral angle
o To assess the inflammation of gallbladder o Direct percussion o Ulnar surface of the dominant fist o Alternative approach (indirect approach) o Palmar surface of the nondominant hand over the CVA and tap the dorsum of that hand with the dominant fist o The patient should report a thud but no pain o Crystals from kidneys o Kidney stones from uric acid
Assessing the neck (ex. hyperextension, turning, bending)
o Neck supported by cervical vertebrae, ligaments, and sternocleidomastoid and trapezius muscles. o Greatest mobility at level of C4 to 5 or C5 to 6. o Movements permitted include... o Flexion: chin to chest. 45 degrees o Extension: Return head to position o Hyperflexion: Bend head back as far as possible. 55 degrees. o lateral flexion: Tilt head side to side. 40 degrees. o Rotation: Turn head as far as possible to the right and left. 70 degrees. o Can be impaired by o Myositis Pain upon palpitation may indicate Inflammation of the muscles o Disc herniation o Degeneration o Osteoarthritis (OA)
ROM (example: which joints do flexion and/ or extension, abduction, adduction, circumduction)
Risk factors of OA
Test 3 reviewed notes
Course: Phys Assessment (NSG 305)
University: Misericordia University
