Maryville 612 Exam 1 questions with
verified complete solutions
Claudication - ANSWER -a condition in which cramping pain in the leg is induced by
exercise, typically caused by obstruction of the arteries. May be characterized as a
dull ache with accompanying muscle fatigue and cramps. Usually appears with
sustained exercise. Site of pain is distant to narrowing.
How do you test EOM? - ANSWER -Eye movement is controlled by 6 extraocular
muscles and 3 cranial nerves, III, IV, and VI. To evaluate eye movement, use 4
techniques.
● First have the patient watch your finger move through the 6 cardinal fields of
gaze. Jerking or sustained nystagmus is abnormal. A few beats of horizontal
nystagmus may occur.
● Second have the patient follow your finger vertically from the ceiling to the
floor.The globes and the upper eyelids should move smoothly without eyelid lag or
exposure of the sclera.
● Third, test extraocular muscle balance using the corneal light reflex. WIth the
patient looking at a nearby object, shine a light on the nasal bridge. The eyes
should converge and reflect the light symmetrically.
● Fourth, if the corneal light reflex is imbalanced, perform the cover-uncover test.
As the patient stares at a fixed point nearby, cover one eye and observe the
uncovered eye. Then remove the cover and observe that eye as it focuses on the
object. Note any eye movement.
Your patient should be able to follow your finger with full, smooth extraocular
movements and without nystagmus, or "shaky" eye motion. Normal extraocular
movements indicate intact cranial nerves III, IV, and VI.
*******What is the difference between objective and subjective data? What
components of the health history are objective and subjective? *********** -
ANSWER -Seidel pg 618: objective: "direct observation, what you see, hear, and
touch". This includes vital signs and actual assessment. Subjective: "information
patients offer about their condition or feelings." This includes chief complaint, past
medical history, history or present illness, family history, and review of symptoms.
Erb's point - ANSWER -Erb's point is the auscultation location for heart sounds and
heart murmurs located at the third intercostal space and the left lower sternal
border. Erb's point, found two interspaces below the pulmonic area, does not reflect
,sound from one particular heart valve, but is a common listening post, lying halfway
between the base and the apex of the heart.
Tonsil assessment - ANSWER -• Enlargement; Acute infection, 2+, 3+, or 4+
o 1+ - visible
o 2+ halfway between tonsillar pillars
o 3+ touching uvula
o 4+ touching each other
Order physical assessment is done - ANSWER -Inspection, Palpation, Percussion,
Auscultation
Proper use of Otoscope on adult or child - ANSWER -Adult- straighten the external
auditory canal by pulling auricle up and back
Child- face child sideways with one arm around parents waist. Pull auricle either
downward and back or upward and back to gain best view of tympanic membrane.
How do you assess for sensoineural hearing loss - ANSWER -air conduction heard
longer than bone conduction with Rinne Test; lateralization to unaffected ear; loss
of high-frequency sounds
How do you assess for conductive hearing loss - ANSWER -bone conduction heard
longer than air conduction with Rinne Test; lateralization to affected ear with Weber
Test; loss of low frequency sounds; loss of 11-30 decibels on audiometry with
cerumen impaction.
Rinne Test***** - ANSWER -helps distinguish whether patient hears better by air or
bone conduction. Place the tuning fork at base of vibrating tuning fork against the
patient's mastoid bone and ask patient to tell you when the sound is no longer
heard. Time this interval of bone conduction noting number of seconds. Continue
timing the interval of sound due to by air conduction heard by the patient. Compare
# of seconds air vs. bone. Air conducted should be heard twice as long as bone
conducted sounds. (If bone conducted heard for 15 seconds, air conducted should
be heard for additional 15 seconds).
, Weber Test - ANSWER -helps assess unilateral hearing loss. Place base of fork on
mid-line of patient's head. Ask patient if sound heard equally in both ears or in one
ear (lateralization of sound). Should hear sound equally.
Presbyopia - ANSWER -Progressive weakening of accommodation (focusing power).
The major physiologic change that occurs after the age of 45 years; the lens
becomes more rigid, and the ciliary muscle becomes weaker.
Strabismus - ANSWER -a condition in which both eyes do not focus on the object
simultaneously, although either eye can focus independently; may be paralytic or
non-paralytic.
Photopsia - ANSWER -presence of perceived flashes of light. (Most commonly
associated with posterior vitreous detachment, migraine with aura, retinal break, or
detachment).
Amblyopia - ANSWER -also called lazy eye; is disorder of sight d/t eye and brain not
working well together. Results in decreased vision in an eye that otherwise typically
appears normal. Most common cause of decreased vision in a single eye among
children and younger adults.
Macular Degeneration - ANSWER -is caused when part of the retina deteriorates; dry
(atrophic) from gradual breakdown of cells in macula resulting in gradual blurring of
central vision and wet (exudative or neovascular)- new abnormal vessels grow
under the center of the retina; the blood vessels leak, bleed, and scar the retina,
distorting or destroying central vision. In contrast to dry, vision loss may be rapid. Is
leading cause of blindness in older than 55 years of age in U.S.
Xanthelasma - ANSWER -condition characterized by elevated plaque of cholesterol;
commonly found on the nasal portion of the eyelid.
Snellen Test***** - ANSWER -The optic nerve is assessed by testing for visual acuity
and peripheral vision.
Visual acuity is tested using a snellen chart, for those who are illiterate and
unfamiliar with the western alphabet, the illiterate E chart, in which the letter E
faces in different directions, maybe used. The chart has a standardized number at
verified complete solutions
Claudication - ANSWER -a condition in which cramping pain in the leg is induced by
exercise, typically caused by obstruction of the arteries. May be characterized as a
dull ache with accompanying muscle fatigue and cramps. Usually appears with
sustained exercise. Site of pain is distant to narrowing.
How do you test EOM? - ANSWER -Eye movement is controlled by 6 extraocular
muscles and 3 cranial nerves, III, IV, and VI. To evaluate eye movement, use 4
techniques.
● First have the patient watch your finger move through the 6 cardinal fields of
gaze. Jerking or sustained nystagmus is abnormal. A few beats of horizontal
nystagmus may occur.
● Second have the patient follow your finger vertically from the ceiling to the
floor.The globes and the upper eyelids should move smoothly without eyelid lag or
exposure of the sclera.
● Third, test extraocular muscle balance using the corneal light reflex. WIth the
patient looking at a nearby object, shine a light on the nasal bridge. The eyes
should converge and reflect the light symmetrically.
● Fourth, if the corneal light reflex is imbalanced, perform the cover-uncover test.
As the patient stares at a fixed point nearby, cover one eye and observe the
uncovered eye. Then remove the cover and observe that eye as it focuses on the
object. Note any eye movement.
Your patient should be able to follow your finger with full, smooth extraocular
movements and without nystagmus, or "shaky" eye motion. Normal extraocular
movements indicate intact cranial nerves III, IV, and VI.
*******What is the difference between objective and subjective data? What
components of the health history are objective and subjective? *********** -
ANSWER -Seidel pg 618: objective: "direct observation, what you see, hear, and
touch". This includes vital signs and actual assessment. Subjective: "information
patients offer about their condition or feelings." This includes chief complaint, past
medical history, history or present illness, family history, and review of symptoms.
Erb's point - ANSWER -Erb's point is the auscultation location for heart sounds and
heart murmurs located at the third intercostal space and the left lower sternal
border. Erb's point, found two interspaces below the pulmonic area, does not reflect
,sound from one particular heart valve, but is a common listening post, lying halfway
between the base and the apex of the heart.
Tonsil assessment - ANSWER -• Enlargement; Acute infection, 2+, 3+, or 4+
o 1+ - visible
o 2+ halfway between tonsillar pillars
o 3+ touching uvula
o 4+ touching each other
Order physical assessment is done - ANSWER -Inspection, Palpation, Percussion,
Auscultation
Proper use of Otoscope on adult or child - ANSWER -Adult- straighten the external
auditory canal by pulling auricle up and back
Child- face child sideways with one arm around parents waist. Pull auricle either
downward and back or upward and back to gain best view of tympanic membrane.
How do you assess for sensoineural hearing loss - ANSWER -air conduction heard
longer than bone conduction with Rinne Test; lateralization to unaffected ear; loss
of high-frequency sounds
How do you assess for conductive hearing loss - ANSWER -bone conduction heard
longer than air conduction with Rinne Test; lateralization to affected ear with Weber
Test; loss of low frequency sounds; loss of 11-30 decibels on audiometry with
cerumen impaction.
Rinne Test***** - ANSWER -helps distinguish whether patient hears better by air or
bone conduction. Place the tuning fork at base of vibrating tuning fork against the
patient's mastoid bone and ask patient to tell you when the sound is no longer
heard. Time this interval of bone conduction noting number of seconds. Continue
timing the interval of sound due to by air conduction heard by the patient. Compare
# of seconds air vs. bone. Air conducted should be heard twice as long as bone
conducted sounds. (If bone conducted heard for 15 seconds, air conducted should
be heard for additional 15 seconds).
, Weber Test - ANSWER -helps assess unilateral hearing loss. Place base of fork on
mid-line of patient's head. Ask patient if sound heard equally in both ears or in one
ear (lateralization of sound). Should hear sound equally.
Presbyopia - ANSWER -Progressive weakening of accommodation (focusing power).
The major physiologic change that occurs after the age of 45 years; the lens
becomes more rigid, and the ciliary muscle becomes weaker.
Strabismus - ANSWER -a condition in which both eyes do not focus on the object
simultaneously, although either eye can focus independently; may be paralytic or
non-paralytic.
Photopsia - ANSWER -presence of perceived flashes of light. (Most commonly
associated with posterior vitreous detachment, migraine with aura, retinal break, or
detachment).
Amblyopia - ANSWER -also called lazy eye; is disorder of sight d/t eye and brain not
working well together. Results in decreased vision in an eye that otherwise typically
appears normal. Most common cause of decreased vision in a single eye among
children and younger adults.
Macular Degeneration - ANSWER -is caused when part of the retina deteriorates; dry
(atrophic) from gradual breakdown of cells in macula resulting in gradual blurring of
central vision and wet (exudative or neovascular)- new abnormal vessels grow
under the center of the retina; the blood vessels leak, bleed, and scar the retina,
distorting or destroying central vision. In contrast to dry, vision loss may be rapid. Is
leading cause of blindness in older than 55 years of age in U.S.
Xanthelasma - ANSWER -condition characterized by elevated plaque of cholesterol;
commonly found on the nasal portion of the eyelid.
Snellen Test***** - ANSWER -The optic nerve is assessed by testing for visual acuity
and peripheral vision.
Visual acuity is tested using a snellen chart, for those who are illiterate and
unfamiliar with the western alphabet, the illiterate E chart, in which the letter E
faces in different directions, maybe used. The chart has a standardized number at
