Incarcerated hernia tests for ascites shifting

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abdominal aneurysm and what to do if suspected, know strangulated vs. incarcerated hernia Tests for Ascites: Shifting Dullness test: 1. Percuss abdomen while lying flat on back/ air will sound tympanic/ fluid will sound dull, 2. have patient turn on side and percuss again, 3. note if fluid shifted and dullness is now located only on bottom of abdomen Fluid Wave test: 1. Have patient place their hand midline 2. You bump the right side of the abdomen and feel for a tap on the left side of abdomen 41. Romberg test-how to assess Have patient stand with eyes closed Negative: no swaying Positive: swaying, falling over, opening eyes 42. Vertigo-associated cranial nerve Acoustic (aka Vestibulocochlear) 43. Reflex arc-where it occurs Spinal Cord (motor neuron carries the message from the CNS to the effector) 44. Gag reflex-related cranial nerve and how to assess 45. Cranial nerves-be able to recall & state how to test Olfactory Optic Oculomotor Trochlear Trigeminal Abducens Facial Acoustic Glossopharyngeal
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Vagus Spinal Accessory Hypoglossal 46. LOC-alert, stupor, comatose Alert: opens eyes, answers questions, falls back asleep Lethargic: opens eyes to loud voice, responds slowly with confusion, unaware of environment Stupor: awakens to vigorous shake or painful stimuli, but returns to unresponsive sleep Comatose: remains unresponsive to all stimuli; eyes close 47. CVA & Aphasia-know signs CVA: sudden numbness or weakness of the face/arm/leg especially on one side of the body, sudden confusion/trouble speaking/understanding speech, sudden trouble seeing in one or both eyes, sudden trouble walking/dizziness/loss of balance or coordination, sudden severe headache with no known cause Aphasia: 48. Function of cerebellum & temporal lobe Cerebellum: coordination/smoothing of voluntary movements, equilibrium, muscle tone Temporal Lobe: 49. Grading reflexes-how to grade & what are normals 0 = no response 1+ = sluggish or diminished 2+ = active or expected response 3+ = slightly hyperactive; more brisk than normal 4+ = brisk, hyperactive with intermittent clonus 50. Epispadias vs. Hypospadias Epi: Hypo: 51. How to prep for pelvic exam (lithotomy position) a supine position of the body with the legs separated, flexed, and supported in raised stirrups 52. Types of discharge (yeast, trich, gonorrhea) 53. Incontinence-differentiate types Stress: sneezing, jumping, etc. Urge: weak bladder, gotta go 54. UTI & Prostate Enlargement (BPH)-know symptoms 55. Breast cancer: risk factors and symptoms of, how to document masses Risk Factors: inherited mutation of BRCA1 and BRCA2 genes, inadequate care (low income, no insurance, cultural/language barriers, racial bias, “Alcohol/Western” diet linked to risk Symptoms: 56. Normal vs. abnormal breast exam (fibrocystic disease, peau d’orange) Normal: no rash or infection, no palpable nodes
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Abnormal: retracted nipple, dimpling, retracted breast tissue, mastitis, mastectomy, benign breast disease Peau d’orange: seen in inflammatory cancer, orange color
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