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Exam Basics & Vital Signs
ELCS EXAM 1
15
Other
Graduate
07/27/2013

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Cards

Term
What are the basic techniques of examining?
Definition
  • Visual inspection
  • palpation-touching, is it soft/hard? painful? purulence? (puss)
  • probing-touching with instrument
  • percussion-percuss something
  • diascopy-use glass slide to put over lesion to see if it blanches (vascular)
  • auscultation-listening with stethoscope
  • aspiration-drawing out fluid
  • evaluation of function-rehab: to make them open wider
Term
What is the general appraisal of extraoral clinical examination?
Definition

Objective: obtain a general idea of the patient's physical status

stature and nutritional status

Gait and posture

Upper extremities

Vital signs

Term
What all must you do to check the vital signs?
Definition

Blood pressure

pulse rate

respiration rate

oral temperature

Usually reserved to when suspect:

  1. systemic illness
  2. systemic response secondary to dental infection
Term
How do you check the pulse? What is considered normal?
Definition

Palpate radial artery (thumb side of arm)

use fingertips

compress artery

evaluate rhythm and volume

Normal=72 beats/min

Term
What is the respiration rate? How do you check it and what is normal?
Definition

Number of inspirations/minute

Watch patient's chest rise and fall

normal rate=14-18/minute

Term
What is the definition of blood pressure? What do we use to measure it?
Definition

Force exerted by circulating blood on the walls of blood vessels

 Arterial pressure

 

Sphygmomanometer

Term
What are the 2 different types of sphygmomanometer? What does spygmomanometer mean?
Definition
  1. Aneroid sphygmomanometer
  2. digital sphygmomanometer (not as accurate)

sphygo: greek sphygmos, pulse

manometer: pressure meter

Term
What techniques does the sphygmomanometer use? What is bp measured in?
Definition

Palpated or ausculated

measured in mmHg

Term
What is the peak pressure in the arteries and occurs near the beginning of cardiac cycle?
Definition
systolic arterial pressure
Term
What is the lowest pressure and is at the resting phase of the cardiac cycle
Definition
diastolic arterial pressure
Term
Describe the technique to taking blood pressure
Definition
  • Patient seated upright and resting
  • artery positioned at heart level
  • cuff placed ~1 inch above antecubital fossa (depression in front elbow)
  • Radial (or brachial) artery palpated, cuff inflated until disappears=estimated systolic pressure
  • after 1 min. place stethoscope over the brachial artery and inflate cuff
  • deflate cuff ~3 mm/second
  • Auscultate the KOROTKOFF SOUNDS
    • 1st sound=systolic pressure
    • sound disappears=diastolic pressure
    • if an auscultatory gap is present, then record 2nd diastolic pressure
Term
What is normal? Prehypertension? What is stage 1 hypertensive? stage 2 hypertension? Stage 3?
Definition

Normal: <120/<80

Prehypertensive: 120-139/80-89

Stage 1 hypertension: 140-159/90-99

Stage 2 hypertension: > or = 160/ > or = 100

Stage 3 hypertension: >180/>110

 

 

Term
Can stage 1 hypertension patients be good candidates for all dental procedures? What would require a patient to be hospitalized? What BP would need to be referred for immediate medical evaluation?
Definition
  • Yes
  • Patients with markedly elevated BP (180-209/110-119) and acute target-organ damage (ex: prior myocardial infarction and unstable angina)
    • If marked BP elevation but not acute target -organ damage usually can be managed by immediate combination oral antihypertensive therapy
  • >210/120 mmHG
Term
What is the cutoff point for many dental clinicians for offering urgent treatment without medical consultation and referral?
Definition
Stage 3: >180/ >110 mmHg
Term
Any patient, especially an older patient who is taking multiple medications for hypertension, is at risk of developing _______ if he/she attempts to stand upright immediately after being in a reclining or supine position for a prolonged period
Definition
orthostatic hypotension
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