Health Assessment-Module B

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Health Assessment-Module B
2011-03-22 17:04:49
HA Module

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  1. What are the functions of the lymphatic system?
    • Provides immunity
    • Phagocytizes foreign and abnormal cells
    • Collects interstitial fluid and returnsit to the blood stream
  2. What's the name of the cells that are marrow derived and are produced in the thymus?
    Hint: they control the immune responses.
    • t-cells
    • they sense the difference in cells of the body that have been invaded by any foreign substance ( a living virus, bacteria, parasite ect.)
  3. What is humoral immunity?
    involves the antibodies produced by B-cells
  4. What is cellular immunity?
    Involves attacks on "invaders" by the cells themselves.
  5. What are Peyer Patches?
    • Small, raised areas of lymph tissure on the mucosa of the small intestine.
    • They consist of many clusteredlyphoid nodules, and they serve the intestinal tract.

  6. Name the Lymph Nodes.
    • 1. Submental
    • 2. Submandibular
    • 3. Retropharyngeal (tonsilar)
    • 4. Preauricular
    • 5.Postauricular
    • 6. Occipital
    • 7. Deep Cervical
    • 8. Supraclavicular/Infraclavicular
    • 9. Anterior Cervical/ Posterior Cervical
  7. Where do the following lymphatics drain:
    Cervial nodes
    Axillary nodes
    Epitrochlear nodes
    Inguinal nodes
    • Cervial nodes: drain the head and neck
    • Axillary nodes: drain the breast and upper arm
    • Epitrochlear nodes: drain the hand and lower arm
    • Inguinal nodes: drain most of the lower extremity, the external genitalia and the anterior abdominal wall.
  8. List some changes in the lymphatic system as the client ages.
    • The number of lymph nodes may diminish
    • Node size may decrease
    • Nodes are more likely to be fibrotic and fatty ( a contributing factor in an impaired abilityto resist infection)
  9. What are some characteristics of a lymph node?
    • Usually occur in groups
    • Nodes are numerous and tiny
    • They defend against the invasion of microorganisms
    • Nodes aid in the maturation of lymphocytes and monocytes
    • Superficial nodes are located in subcutaneous connective tissue and are readily accesible to inspection and palpation.provide earliest clues to presence of infection and malignancy
    • Deeper nodes lie beneath the fascia of muscles and within various body cavities
  10. What are the 7 bones of the head?
    • 2 Frontal
    • 2 Parietal
    • 2 Temporal
    • Occupital
  11. What are the 8 facial bones?
    • Nasal
    • Frontal
    • Lacrimal
    • Sphenoid
    • Ethmoid
    • Zygomatic
    • Maxillary
    • Mandible
  12. What are 2 physical changes in the head that generally occur with older adults?
    • Hypo-pigmintation (gray hair)
    • Hair shaft becomes thinner (hair loss)
  13. In the neck what is formed by the medial border of the sternocleidomastoid muscles, the mandible, and the midline?
    Anterior triangle
  14. In the neck, what is formed by the trapezius and sternocleidomastoid muscles and the clavicle?
    Posterior triangle
  15. What are some of nasal functions?
    • Air passageway
    • Humidifier
    • Smell
    • Filter
    • Resonance of laryngeal sound
  16. Know Nasal Anatomy

    • Note that:
    • -the floor of the nose is formed by hard and soft palate
    • -the internal nose is divided by the septum into 2 anterior cavities (the vestibules)
    • -the lateral walls of the nose are formed by turbinates (curved bony structured covered by vascular mucous membrane) thatrun horizontally and protude into the nasal cavity.
    • Frontal Sinuses
    • Ethmoidal Cells
    • Superior Nasal Concha
    • Maxillary Sinus
    • Nasal Septum
    • Inferior Nasal Concha
    • Nasolacrimal Duct (on right side)
  17. What are some of the changes of the nose that can occur with aging?
    • Nose elongates
    • Muscus membranes may dry
    • Decreased olfactory functions and ability to distinguish specific odors
  18. What are the functions of the mouth and oropharynx?
    • Emission of air for vocalization and non-nasal expiration
    • Passageway for food, liquid, and saliva, either swallowed or vomites
    • Initiation of digestion by masticating solid foods and by salivary secretions
    • Identification of taste
  19. How many teeth should an adult generally have?
    32 permanent teeth
  20. What structures are included in the anatomy of the mouth and oropharynx?
    • mouth:
    • -teeth
    • -hard palate
    • -tongue ( dorsal{taste buds} and ventral)
    • -3 pairs of salivary glands ( submandibular, sublingual, and parotid{stenson's duct})
    • oropharynx:
    • -soft palate (uvula)
    • -anterior pillar
    • -posterior pillar
    • -tonsils
    • -posterior pharyngeal wall
    • -epiglottis
  21. What separates the mouth and the oropharynx?
    • the anterior and posterior tonsillar pillars on each side.
    • the tonsils, lying in the cavity between these pillars, have crypts that collect cell debris and particles.
  22. What are some changes in the mouth that can occur with age?
    • Decreased elasticity in lips ("pursed lips")
    • Gums/mucosa paler
    • Decrease in saliva production
    • Gums recede slightly
    • Tooth color more yellow
    • Decrease in taste sensation
    • Not able to chew as well
  23. An S shaped pathway in the ear composed of cartilage covered with skin
    • external ear
    • 2.5 cm long
  24. An air-filled cavity in the temporal bone in the ear.
    Middle ear.
  25. In ear, A membranous, curved cavity inside a bony labyrinth consisting of the vestibule, semicircular canals, and cochlea.
    Functions: Hearing and balance transmits sound impulses via CN VIII
    Inner Ear
  26. A coiled structure in the ear containing the organ of Corti.
  27. What are the 3 levels of hearing?
    • Peripheral- Sound waves enter ear canal and strike membrane.
    • Brain Stem- Vibration stimulates hair cells of the organ of Corti. As hair cells bend turn vibrations into electric impulse. Electric impulse travels to brain via CN 8. Locates sound's directions: R or L.
    • Cerebral Cortex- Interprets sound's meaning. Begins to make appropriate response
  28. Vibrations of TM to inner ear structures?
    Air conduction
  29. Vibration of bone directly to inner ear structures.
    • Bone Conduction
    • Hint: both air and bone conductions activate cochlea which transmits to CN VIII.
  30. What hearing test tests bone conduction?
    • Weber
    • normal is equal bilaterally
  31. What hearing test compares AC to BC?
    • Rinne
    • AC greater than BC= normal
  32. What is the mechanical dysfunction in the external ear of middle ear?
    • Conductive loss
    • -also if foreign object in canal, perforated TM, or otosclerosis and can still hear if sound is loud enough.
  33. What is Sensorineural Loss?
    • Damage to cochlear, CN VII or auditory area of cerebral cortex
    • -can have sensorineural loss if there is an inner ear disease, ototoxic drugs
  34. What is the loss of high frequency sound due to aging?
  35. What is the Romberg Test?
    • Tests for CN VIII
    • Have patient stand with arms at sides and eyes open then closed. watch for exaggerated swaying.
  36. What are some changes that are common in the ear as aging occurs?
    • Pinna increases in width and length
    • Hair growth may increase
    • Skin may become dry and less elastic
    • Cerumen becomes drier
    • TM more rigid
    • Decreased discrimination of pitch and acuity
  37. Inflammation in the middle ear, associated with middle ear effusion(fluid) that becomes infected by bacteria organisms
    Otitis Media
  38. A disorder of progressive hearing loss.
    Meniere Disease
  39. The illusion of rotational movement by a client, often due to a disorder of the inner ear.
    • On Left:
    • Upper eyelid
    • Palpebral fissure
    • Lateral canthus
    • Lower eyelid
    • On Right:
    • Pupil
    • Iris
    • Sclera
    • Medial Canthus
    • Caruncle
    • Limbus
  40. Trochlear
    • CN IV
    • eyes down and towards nose
  41. Abducens
    • CN VI
    • eyes lateral and toward ear
  42. Oculomotor
    CN III
  43. Tough protective outer layer. Part of the refracting media of the eye. Bends incoming light rays so they will be focused.
  44. Transparent front part of the eye that covers the iris, pupil and anterior chamber and provides most of an eye's optical power.
    • Cornea
    • Hint: together with the lens, the cornea helps refract light and consequently helps the eye to focus.
  45. What is the space between the cornea and iris filled with Agueous Humor which delivers nutrients to surrounding tissue.
    Anterior Chamber
  46. What is the layer of blood vessels between the retina and sclera
  47. When vision shift from far object to near object, pupils constrict to bring object into focus. What cranial nerve controls this?
    CN III
  48. Nearsighted
    • Myopia
    • Can't see things far away
  49. Farsighted
    • Hperopia
    • Can't see things that are close
  50. Decreased accomodation with aging
    • Presbyopia
    • Needs to move objects farther away to see it
  51. Confrontation test?
    • pt. covers one eye and you cover yours.
    • move hand foward from behind to front in four directions.
    • pt. tells you when they can see your hand. each time.
    • repeart for other eye.
  52. What are some changes that may occur in the eye with age?
    • Lids may droop
    • Dry eyes due to decreased tearing
    • Cornea may cloud
    • Loss of peripheral vision
    • Lipid accumulation causes white-ray circle around eye
    • decrease in ability to distinguish between pastels and like colors.
  53. What is the large opening where brain and spinal cord become continuous?
  54. What is the name of the entrance/exit of the spinal neres and blood vessels?
  55. Outer fibrous layer, supports occipital and temporal lobes and separates cerebral hemispheres from brain stem
    Dura mater
  56. Fibrous, elastic membrane that covers folds and fissures of brain
  57. Inner layer which contains lots of blood vessels which supply the brain.
    Pia mater
  58. What is Cerebral Spinal Fluid (CSF)?
    • Colorless, odorless fluid which contains glucose, electrolytes, O2 and H2O
    • Provides cushion for the brain and spinal cord
    • Removes waste products
    • Provides nutrition to the brain
    • Maintains normal intracranial
  59. What are some characteristics of the brain?
    • Composed of cerebral cortex,cerebellum, diencephalon and brain stem
    • Made of grey and white matter
    • Blood supply by crotid, vertebral and basilar arteries.
  60. Found at the base of brain to provide back up for arterial blood flow
    Cirlce of Willis
  61. What are some characteristics of the cerebral cortex?
    • Center for human's highest functions
    • Governs thought, memory,reasoning, sensationand voluntary movement
    • 2 hemispheres with 4 lobes
    • Lobes control function for the opposite side of the body
  62. Contains primary voluntary motor cortex and is concerned with personality, behavior, emotions and higher intellectual functions.
    • Frontal lobes
    • Hint: Broca's area (for motor speech) if damaged can get expressive aphasia.
  63. Primary center for sensation.
    Processes sensory input: touch, position, sense shape and consistency of objects.
    Parietal Lobe
  64. Primary visial receptor center.
    Responsible for recieving and interpreting visual information
    Occipital Lobe
  65. Primary auditory reception are in the brain.
    Contains interpretive area where auditory, visual and somatic input are integrated into thought and memory.
    Temporal Lobe
  66. Wernicke's Area
    • Associated with language comprehension
    • Damage to this area get a receptive aphasia. Hears sound but has no meaning.
  67. Main relay station for the nervous system
  68. Major control for many vital functions- heart rate, BP, sleep center, pituitarygland regulation, coordinator of autonomic nervous system and emotional status.
  69. Contains pineal gland for growth and sexual development.
  70. Pain of extrapyramidal system of ANS & basal ganglia.
  71. Bands of gray matter buried deep in teh cerebral hemispheres
    Basal Ganglia
  72. Coiled structure located under the occipital lobe.
    Concerned with motor coordination of voluntary movements equilibrium and muscle tone.
    • Cerebellum
    • Hint: does not initiate movement, but coordinates and smoothes it. Assess for balance. Romberg Test CN VII
  73. Cranial nerves 3 and 4 originate here
    • Midbrain
    • Hint: anterior part of the brain.
  74. Cranial nerves 5-8 start here
    • Pons
    • Hint: contains ascending and descending fiber tracts.
  75. Cranial nerves 9-12 originate here
    • Medulla
    • Hint: continuation of spinal cord. contains ascending and descending tracts and vital autonomic centers for respirations, heart and GI function.
  76. What system is involves in short term memory and helps to mediate visceral and behavioral responses to emotions such as fear, affection, and aggression.
    • Limbic System
    • Hint: on medial surface of each cerebral hemisphere.
  77. What do sensory pathways do?
    Monitors conscious sensations, internal organ functions, body positions reflexes.
  78. Contains sensory fibers that transmit sensations, pain, temperature and light touch.
    Spinothalmic Tract.
  79. Posterior Columns
    • Conduct sensations of position, vibrations
    • -Stereogenesis: tactile recognition of object
    • -Proprioception: you know without looking where your body parts are in relation to space.
  80. What are the 2 motor pathways?
    • Corticospinal Tracts: originate inmotor cortexand travel to brain stem. Mediate voluntary movement
    • Extrapyramidal Tract: maintainmuscle tone and control gross automatic body movements such as walking
  81. What diseases are related with Uppper Motor Neurons?
    • CVA, MS, Cerebral Palsy
    • Hint: Located completely within CNS
  82. What diseases are related to Lower Motor Neurons?
    • Polio, ALS
    • Hint: located mostly in PNS
  83. What makes up Spinal Nerves?
    • Consists of 31 pairs
    • -8 cervical
    • -12 thoracic
    • -5 lumbar
    • -5 sacral
    • -1 coccygeal
  84. Relfex Arc
    • Sensory impulse which synapses immediatly with a motor neuron within the spinal column.
    • Basic defense mechanism of nervouse system
    • Involuntary
  85. Fight or Flight response
    • Sympathetic
    • Hint: increases heart rate, BP, vasoconstricts peripheral blood vessels.
  86. Controls "Vegatative function" that conserves energy
    • Parasympathetic
    • Hint: decreases BP, respiration, heart rate.
  87. CN I
    • Olfactory
    • Test: Sniff test
  88. CN II
    • Optic
    • Test: Snellen, Jager(confrontation)
  89. CN III
    • Oculomotor
    • Test: Pupil's constriction, convergence/accomodations( finger to nose), PERL
  90. CN IV
    • Trochlear
    • Test: EOM( extraocular movements) or 6 cardinal fields of gaze.
  91. CN V
    • Trigeminal
    • Test: Cottom wisp(sensory) and feel masseter muscles(motor)( clench jaw)
  92. CN VI
    • Abducens
    • Test: EOM and 6 cardinal fields of gaze
  93. CN VII
    • Facial
    • Test: facial expressions(motor). discriminate taste(sensory)
  94. CN VIII
    • Acoustic (vestibulocochlear)
    • Test: compare air to bone conduction, Weber and Rinne
  95. CN IX
    • Glossopharyngeal
    • Test: "ah" and gag reflex
  96. CN X
    • Vagus
    • Test: "ah" and gag reflex
  97. CN XI
    • Spinal Accessory
    • Test: Shrug and with resistance, turning of head and with resistance
  98. CN XII
    • Hypoglossal
    • Test: stick out tongue,push tongue against cheek. check for strength.
  99. What is the degree of balance between nutrient intakeand nutrient requirements?
  100. How is Optimal Nutritional Status achieved?
    when the sufficient nutrients are consumed to support day to day body needs and any increased metabolic demands due to growth.
  101. Process by which the digest proteins, fats, carbohydrates, vitamins, minerals and water are actively and passively transported through the intestinal mucosa into the blood or lymphatic circulation.
  102. A complex chemical process that occurs in the cells to allow for energy use & cellular growth and repair.
  103. Builds tissue, produces antibodies, replaces blood cells, and repairs tissue.
    Building blocks for every living cell. Regulates fluid balance and regulates acid-base balance.
    • Proteins
    • Hint: 4 kilocalories per gram
  104. Nutrient that provides energy.
    2 types: Simple and complex.
    • Carbohydrates
    • Hint: 4 kilocalories per gram.
  105. Negative Nitrogen Balance
    • More nitrogen is excreted than what is taken in.
    • Hint: Nitrogen is excreted when amino acids are broken down.
  106. Fats
    • Function:
    • - cellular transport
    • -Insulation and protection of vital organs
    • -Energy storage in adipose tissue
    • -Vitamin absorption and transport of fat-soluble vitamins
    • Hint: 9 kilocalories per gram
  107. Difference between saturated fats and unsaturated fats?
    • saturated fats: all points on chain have a hydrgen atom
    • unsaturated fats: at least one point not filled with a hydrogen atom
  108. What are Lipoproteins?
    • Lipids containing protein
    • produces in the liver
    • HDL vs. LDL(remember HDL is good or "happy :)")
  109. What is emulsification?
    Breaking down fats into smaller droplets and placing these droplets in solution.
  110. What is the function of vitamins?
    • Organic compounds that are essential to the body in small amounts for growth, development, maintenance and reproduction.
    • They do not supply energy but assist in the use of energy nutrients.
  111. Inorganic substances found in nearly all body tissues and fluids.
    • Minerals
    • Hint: they help to build body tissue,regulate enzyme metabolism, and transmission of nerve impulses & contractility of muscles.
  112. What can happen if you have a calcium deficiency and why is calcium important?
    • Fragile bones, cardiac& neurological irregularities.
    • Calcium: nervous stimulation, muscle contractions, blood clotting.99% in bone and teeth.
    • Hint: macro mineral
  113. What can happen is you have phosphorus deficiency and why is phosphorus important?
    • Electrolyte abnormalities, osteromalacia
    • Phosphorus: transport of fats, protein synthesis-need vitamin D to absorb and use.
    • Hint: macro mineral
  114. What can happen if you have magnesium deficiency and why is magnesium important?
    • Can affect virtually every organ system of the body.
    • Affects smooth and skeletal muscle
    • Magnesium: transmits nerve impulses, muscle contraction, 60% in bone and teeth.
    • Hint: macro mineral
  115. What can happen if you have iron deficiency and why is iron important?
    • Anemia, Cheilosis, pallor.
    • Iron: found mostly in hemoglobin, needed for energy, and RBC production.
    • Hint: Micromineral
  116. What can happen if you have iodine deficiency and why is iodine important?
    • Goiter
    • Iodine: forms thyroxinefor energy metabolism
    • Hint: Micromineral
  117. What can happen if you have zinc deficiency and why is zinc important?
    • growth retardation and altered taste
    • Zinc: taste, protein synthesis, transfer of CO2
    • Hint: Micromineral
  118. What provides turgor to body tissue and is a medium for all chemical reactions?
    • Water
    • Hint: maintains stable body temperature. drinking 2.5 L is recommended per day
  119. Arthropometrics
    • skinfold measurement.
    • measures SQ tissue not muscle
  120. Biochemical Test
    Tests for: CBC, Glucose, Cholesterol & Triglycerides, Albumin and Iron.