NREMT Paramedic Exam
stridor
Harsh or high-pitched respiratory sound, swelling, fb in upper airway. Croup is an
example
Snoring
The sound of the soft tissue of the upper airway creating a partial obstruction of air flow.
The tongue blocking the airway is an example.
gurgling
indicates presence of fluid in the upper airway, need for suctioning
Decorticate
elbows and hands flexed, and legs flexed. They are internally rotated (the lets look
bowlegged) (make an O with their arms: corticate)
Decerebrate (worse)
Stiffened and internally rotated elbows and legs, teeth clenched, legs stiff and feet
extended.
Babinski's response
dorsiflexion (splaying) of toes
-abnormal plantae reflex response if over 18 months
mydriasis
dilation of the pupil. Appears in cardiac arrest, shock, cerebral hypoxia, cocaine,
epinephrine, and amphetamines.
Miosis
Constricted pupils. Narcotics, CNS disorder, glaucoma medication, bright light
anisocoria
unequal pupil size that may indicate serious neurologic dysfunction
nystagmus
involuntary rapid eye movements - often reported as horizontal, vertical, or rotary
subcutaneous emphysema
Air under the skin; crepitus sound
rales (crackles)
Fluid in small airways (aveoli). Common in CHF, pulonary edema, drowning,
pneumonia, and COPD
Rhonchi
Coarse, low-pitched breath sounds heard in patients with chronic mucus in the upper
airways. Found in Bronchitus, COPD, and pneumonia.
Wheezing
The production of whistling sounds during expiration such as occurs in asthma and
bronchiolitis.
Bronchial lung sounds
heard over trachea/upper sternum; expiratory sound predominates; is higher pitched
and louder; if heard in other locations it indicates consolidation -- a space that usually
contains air now has fluid
Bronchovesicular
Heard over scapula and 2/3rd intercostal space lateral to sternum.
Apneustic breathing
, Characterized by prolonged inspirations unrelieved by attempts to exhale, which
indicates trauma to the pons. AKA long, deep breaths that are stopped during
inspirations then periods of apnea.
Biot's (Ataxic) Respirations
Shallow, deep respirations with periods of apnea
Irregular pattern
Precipitating factors: respiratory depression, brain damage
Cheyne-Stokes respiration
pattern of breathing characterized by a gradual increase of depth and sometimes rate to
a maximum level, followed by a decrease, resulting in apnea
Hyperventilation
rapid, shallow breathing
Kussmaul respirations
very deep and rapid respirations. Example: DKA
Hyperresonant
tension pneumothorax, emphysema, asthma
resonant
echoing normal sound
right upper quadrant
Liver, gallbladder, and stomach
Right Lower Quadrant
Appendix, right ovary, and tube. Bladder if distended
Left Upper Quadrant
Spleen, stomach, liver, and pancreas
left lower quadrant
Left ovary and tube. Bladder if distended
Visceral Pain
Internal organs damaged or injured. Vague, not well organized, pressure like, or dull
aching, can't point to pain with one finger. Hollow organs stretches, ischemia,
inflammation.
somatic pain
Pain that originates from skeletal muscles, ligaments, or joints. Peritoneal linining sharp,
localized, throbbing, deep breath increases pain
Cullen's sign
ecchymosis in umbilical area, seen with pancreatitis. aka bleeding in abdominal cavity
Grey Turner's Sign (ecchymosis in flank area)
Chronic hemorrhagic from kidneys and pancreatitis
Kehr's sign
Referred pain down the left shoulder; indicative of a ruptured spleen.
Murphy's sign
Pain with palplation of gall bladder (seen with cholecystitis)
Brudzinski's sign
pain with resistance and involuntary flex of hip/knee when neck is flexed to chest when
lying supine. Seen in meingitis
Hamman's sign
stridor
Harsh or high-pitched respiratory sound, swelling, fb in upper airway. Croup is an
example
Snoring
The sound of the soft tissue of the upper airway creating a partial obstruction of air flow.
The tongue blocking the airway is an example.
gurgling
indicates presence of fluid in the upper airway, need for suctioning
Decorticate
elbows and hands flexed, and legs flexed. They are internally rotated (the lets look
bowlegged) (make an O with their arms: corticate)
Decerebrate (worse)
Stiffened and internally rotated elbows and legs, teeth clenched, legs stiff and feet
extended.
Babinski's response
dorsiflexion (splaying) of toes
-abnormal plantae reflex response if over 18 months
mydriasis
dilation of the pupil. Appears in cardiac arrest, shock, cerebral hypoxia, cocaine,
epinephrine, and amphetamines.
Miosis
Constricted pupils. Narcotics, CNS disorder, glaucoma medication, bright light
anisocoria
unequal pupil size that may indicate serious neurologic dysfunction
nystagmus
involuntary rapid eye movements - often reported as horizontal, vertical, or rotary
subcutaneous emphysema
Air under the skin; crepitus sound
rales (crackles)
Fluid in small airways (aveoli). Common in CHF, pulonary edema, drowning,
pneumonia, and COPD
Rhonchi
Coarse, low-pitched breath sounds heard in patients with chronic mucus in the upper
airways. Found in Bronchitus, COPD, and pneumonia.
Wheezing
The production of whistling sounds during expiration such as occurs in asthma and
bronchiolitis.
Bronchial lung sounds
heard over trachea/upper sternum; expiratory sound predominates; is higher pitched
and louder; if heard in other locations it indicates consolidation -- a space that usually
contains air now has fluid
Bronchovesicular
Heard over scapula and 2/3rd intercostal space lateral to sternum.
Apneustic breathing
, Characterized by prolonged inspirations unrelieved by attempts to exhale, which
indicates trauma to the pons. AKA long, deep breaths that are stopped during
inspirations then periods of apnea.
Biot's (Ataxic) Respirations
Shallow, deep respirations with periods of apnea
Irregular pattern
Precipitating factors: respiratory depression, brain damage
Cheyne-Stokes respiration
pattern of breathing characterized by a gradual increase of depth and sometimes rate to
a maximum level, followed by a decrease, resulting in apnea
Hyperventilation
rapid, shallow breathing
Kussmaul respirations
very deep and rapid respirations. Example: DKA
Hyperresonant
tension pneumothorax, emphysema, asthma
resonant
echoing normal sound
right upper quadrant
Liver, gallbladder, and stomach
Right Lower Quadrant
Appendix, right ovary, and tube. Bladder if distended
Left Upper Quadrant
Spleen, stomach, liver, and pancreas
left lower quadrant
Left ovary and tube. Bladder if distended
Visceral Pain
Internal organs damaged or injured. Vague, not well organized, pressure like, or dull
aching, can't point to pain with one finger. Hollow organs stretches, ischemia,
inflammation.
somatic pain
Pain that originates from skeletal muscles, ligaments, or joints. Peritoneal linining sharp,
localized, throbbing, deep breath increases pain
Cullen's sign
ecchymosis in umbilical area, seen with pancreatitis. aka bleeding in abdominal cavity
Grey Turner's Sign (ecchymosis in flank area)
Chronic hemorrhagic from kidneys and pancreatitis
Kehr's sign
Referred pain down the left shoulder; indicative of a ruptured spleen.
Murphy's sign
Pain with palplation of gall bladder (seen with cholecystitis)
Brudzinski's sign
pain with resistance and involuntary flex of hip/knee when neck is flexed to chest when
lying supine. Seen in meingitis
Hamman's sign
