HA (HEALTH ASSESSMENT) Final Examinations AND ANSWERS 2022| GRADED A

HA (HEALTH ASSESSMENT) Final Examinations AND ANSWERS 2022| GRADED A Tactile fremitis is a _______ ________. Correct Answer: Palpable vibration Sounds generated from the larynx are transmitted through patent bronchi and through the lung parenchyma to the chest wall, where you feel the vibrations. Correct Answer: Tactile fremitis Use the _______ _______ of the hand to complete tactile fremitis. Correct Answer: palmar base Have the pt say "__" or "______ _____" while performing tactile fremitis. Correct Answer: 99 or blue moon Start tactile fremitis at the ____of the lung and palpate one side to the other. Correct Answer: apices _________ is most important when feeling for the vibrations in tactile fremitis although it varies from person to person. Correct Answer: symmetry R side fremitus may feel stronger than the L because the R side is closer to the ________ _______. Correct Answer: bronchial bifurcation. Avoid palpation over the ______ because _____ damps out sound transmission. Correct Answer: scapulae, bone May affect normal intensity of tactile fremitis: Correct Answer: Relative location of bronchi to chest wall Thickness of chest wall Pitch and intensity(loud, low pitched=fremitis) Occurs when anything obstructs transmission of vibration (e.g., obstructed bronchus, pleural effusion or thickening, pneumothorax, or emphysema). Any barrier that comes between the sound and palpating hand. Correct Answer: Decreased fremitus Occurs with compression or consolidation of lung tissue (e.g., lobar pneumonia)This is present only when the bronchus is patent and when consolidation extends to the lung surface. Note that only gross changes _______ fremitus. Small areas of early pneumonia do not significantly affect fremitus. Correct Answer: Increased fremitus, increase Is palpable with thick bronchial secretions Correct Answer: Rhonchal Palpable with inflammation of the pleura Correct Answer: Pleural friction fremitus Is a coarse, crackling sensation palpable over the skin surface. It occurs in subcutaneous emphysema when air escapes from the lung and enters the subcutaneous tissue, as after open thoracic injury or surgery. Correct Answer: Crepitus The first heart sound is known as Correct Answer: S1 S1 occurs with closure of the ____valves and thus signals the beginning of _______ Correct Answer: AV systole You can hear S1 over all the precordium, but usually loudest at the _____. Correct Answer: apex(mitral location) Inspiratory Arrest Correct Answer: Murphy Sign Normal murphy sign= Correct Answer: deep breath without pain when liver palpated Positive murphy sign= Correct Answer: gallbladder (cholecystitis) pain/inflammation Hold fingers under the liver boarder, take deep breath Correct Answer: How to perform murphy test/sign When murphy sign is positive, the descending liver pushes the inflamed ______ into examiners hand, the person feels sharp pain and abruptly stops inspiration midway. Correct Answer: gallbladder Pain on release of pressure confirms Correct Answer: rebound tenderness rebound tenderness is a reliable sign of ________ inflammation Correct Answer: peritoneal Peritoneal inflammation accompanies ________. Correct Answer: appendicitis ______ tenderness that is localized to a specific spot also signals peritoneal irritation. Correct Answer: Cough Refer the person with suspected appendicitis for Correct Answer: CT scanning Rebound tenderness AKA Correct Answer: Blumberg sign Rebound tenderness should be assessed when Correct Answer: person c/o abdominal pain or you elict tenderness during palpation When performing rebound tenderness you should chose a site ______ (from/to) the painful area. Correct Answer: away from Hold hand ___* to abdomen, push down slowly and deeply, then quickly lift up when performing rebound tenderness Correct Answer: 90* Normal or negative rebound tenderness response= Correct Answer: no pain on release of pressure Rebound tenderness should be performed at the _____ of examination because it can cause severe _______ and _________ __________. Correct Answer: end pain and muscle rigidity Bulge sign occurs with very small amts of _______(4-8mL) of fluid flowing across the ______. Correct Answer: effusion joints Firmly stroke up on the medial aspect of the knee two or three times to displace any fluid. Tap the lateral aspect. Watch the medial side in the hollow for a distinct bulge from a fluid wave. Normally none present. Correct Answer: bulge test This test is reliable when larger amts of fl. are present. Use your left hand to compress the suprapatellar pouch to move any fluid into the knee joint. With your R hand, push the patella sharply against the femur. If no fl. is present, the patella is already snug against the femur. Correct Answer: ballottement of the patella Perform this test when the pt has reported a hx of trauma followed by locking, giving away, or local pain in the knee. Correct Answer: McMurry Test Position the person supine as you stand on the affected side. Hold the heel and flex the knee and hip. Place your other hand on the knee with fingers on the medial side. Rotate the leg in and out to loosen the joint. Externally rotate the leg, and pus a valgus (inward) stress on the knee. Then slowly extend the knee. Normally, the leg extends smoothly with no pain. Correct Answer: McMurry Test Ask the pt to hold both hands back to back while flexing the wrists 90*. Acute flexion of the wrist for 60seconds produces no symptoms in the normal hand. Correct Answer: phalen test Reproduces numbness and burning in a person with carpal tunnel syndrome. Correct Answer: phalen test positi