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Flashcards in 11/6/13 Deck (79)
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1

Every system supplied by blood vessels also has lymphatic drainage. What are 2 exceptions to this rule?

The placenta & the brain.

2

The immune response to bloodborne antigens begins in what lymphatic organ?

The spleen.

3

What are the 2 tonsils that are removed? What are they commonly called?

Palatine Tonsils--called tonsils
Nasopharyngeal tonsils--called adenoids

4

The umbilical cord will fall off when? If not, what does that indicate?

1 to 2 weeks after birth.
If not, could be a congenital defect of the immune system.

5

Is this normal or abnormal? Finding small 2-3 mm discrete, palpable, mobile nodes in a neonate.

Normal

6

Finding inguinal, occipital, & postauricular nodes are common before what age? Uncommon after what age?

2 years of age.

7

Which nodes are common in older children, but uncommon in infants?

Cervical & submandibular nodes

8

Finding which nodes is always a bad sign?

Supraclavicular nodes...sign of malignancy.

9

What count goes up during pregnancy? What hormones cause this?

Leukocyte count increases. 7200-8500
Progesterone, Estrogen & Cortisol.

10

What is the shift of the immunity type when a woman becomes pregnant?

Cell-mediated-->Humoral
*here, the pregnant mom is more suspectible for infections.

11

What is one upside to being pregnant & your immune system?

This can lead to remission of autoimmune diseases.

12

What are 2 things that you might see with an HPI that relates to the lymphatic system?

Enlarged nodes
swelling of the extremity

13

What are some conditions that you want to ask about in the family history section when you are dealing with the lymphatic system?

Malignancy
Anemia
Recent infectious diseases
Tuberculosis
Immune Disorders
Hemophilia

14

What are 3 physical signs of problems with the lymph system?

Lymphadenopathy: enlarged lymph nodes
Lymphangitis: red streaks in the skin
Lymphedema: swelling

15

What are 4 weird body regions that are a part of the lymphatic system?

stomach
appendix
bone marrow
lungs

16

What are 2 weird functions of the lymphatic system?

Back up hematopoiesis
Absorption of fat soluble substances in the GI tract

17

What is one sad thing about the lymphatic system?

It is a way to spread malignancy.

18

Where does the lymphatic system ultimately drain to?

The subclavian veins

19

T/F massage decreases lymphatic flow

False. It increases lymphatic flow...
Other things that increase flow:
increased fluid volume
increased capillary pressure
increased permeability of the capillary walls
increased metabolic activity

20

T/F The lymphatic system is easily obstructed.

True. B/c of the low pressure of the system.

21

What is the approximate size of lymph nodes?

Smaller than .5--1 cm

22

Where are superficial nodes located? Deep nodes?

Superficial Nodes-->in the subcutaneous tissue
Deep Nodes-->In body cavities & under fascia & muscle

23

Viral infections do what to the lymphocyte count?

Increase it!

24

What is the approximate size of lymphocytes?

7mm--35mm

25

Humoral immunity includes what lymphocyte?
Cellular immunity?

Humoral--B lymphocyte
Cellular--T lymphocyte (thymus for maturity)

26

Where is the spleen located?

left upper quadrant

27

What are the 2 main areas of the spleen?

White Pulp-->lymphatic nodules
Red Pulp-->venous sinusoids

28

What is a function of the spleen early on in life?

for a while it can form blood cells

29

Where are Peyer's Patches located?

in the mucosa of the SI

30

How are the palatine tonsils activated?

thru inhaled & intranasal antigens

31

When does the lymphatic system begin to develop?

20 weeks of gestation

32

What is the state of the lymphatic system at birth?

it is still immature

33

You shouldn't be able to feel lymph nodes after what age?

2

34

Feeling_______ nodes is always a reason for suspicion of malignancy.

Supraclavicular

35

What happens to your lymph nodes when you get old?

Lymph nodes are lost. They become fatty & fibrotic
This leads to a decreased ability to fight infection.

36

What are some associated symptoms that you want to ask about w/ the lymphatic system?

malaise
fever
weight loss
night sweats
abdominal pain
fullness itching "pruritis"

37

What are 3 predisposing factors for lymphatic system issues?

Infection
Surgery
Trauma
Venous Insufficiency
Cardiac or Renal Disorder

38

What are 2 types of meds that you want to ask about w/ lymphatic system issues?

Chemotherapy
Antibiotics

39

What are some things that you should ask about for PMH w/ a person w/ lymphatic issues?

Tuberculosis!
Blood transfusion!
Organ Transplant!
HIV infection!
Malignancy!

40

What are some important social history factors for lymphatic issues?

HIV--sexual history & recreational drugs
Travel
Alcohol use

41

T/F you have to worry about taxoplasmosis w/ older adults.

True.

42

What are tender nodes indicative of?

Inflammation

43

What characteristics do cancerous nodes have?

large, but non-tender

44

What is lymphangioma?

congenital malformation of dilated lymphatics

45

What are shotty nodes?

Nodes that feel like there are pellets underneath.

46

What are fluctuant nodes?

Nodes that exhibit a wavelike motion when they are palpated.

47

What are matted nodes?

A group of nodes that feel connected & seem to move as a unit.

48

What are 2 additional disorders you want to ask about in family hx w/ head & neck exam?

Thyroid Disorders
Headaches

49

Moon facies w/ erythemetous skin is what disorder?

Cushing Syndrome

50

Dull, puffy, yellowed skin
Coarse sparse hair
temporal loss of eyebrows
periorbital edema
prominent tongue
What disorder?

Myxedema

51

Fine, moist skin
Fine Hair
Prominent Eyes
Lid retraction
Staring/startled expression
What disorder?

Hyperthyroid

52

Butterfly Rash
What disorder?

SLE/Lupus

53

Facial asymmetry
not able to close one eye
drooping of lower eyelid & mouth
Loss of naso labial fold
What disorder? Which cranial nerve?

Bell's Palsy
Cranial Nerve 7

54

Coarsening of Facial Features
Broad Nose
Prominent Zygomatic Arch
Which disorder?

Acromegaly

55

Depressed nasal bridge
Epicanthal folds
Low set ears
Large tongues
Which disorder?

Down's Syndrome

56

Smooth philtrum
Wide Set Eyes
Mild ptosis
Thin upper lip
Which disorder?

FAS Fetal Alcohol Syndrome

57

What are the general things that you palpate for on a head & neck exam?

fusion of suture for 6 mo old babies. Texture of hair, temporal artery, salivary glands

58

When do you percuss on a head & neck exam?

For hypocalcemia. Trousseau's Sign.

59

How is auscultation involved in the head & neck exam?

you can hear w/ the bell a bruit sometimes over the eyeball, temple, & occiput

60

What are some things that you look for upon inspection of the neck?

Jugular vein distention, carotid artery prominence, webbing, edema, thyroid enlargement

61

What do you palpate in a neck exam?

midline trachea, hyoid bone, thyroid & cricoid cartilage, tracheal rings.

62

What are the 2 signs for aortic aneurysm that can sometimes be elicited during the neck exam?

Cardarelli's Sign
Oliver's Sign

63

Molding from a vaginal delivery can be resolved usu in what time frame?

within one week.

64

When do fontanels usu close by on a baby?

24 months. should be 4-5 cm.

65

What might a bulging fontanel indicate?

hydrocephalus, intracranial mass, meningitis

66

Where do you palpate for craniotabes?

Firmly the scalp above & behind the ears

67

What can transillumination usu distinguish b/w?

Increased Fluid vs. Decreased Brain mass

68

What special head & neck things usu happen in the pregnant woman?

Hyperpigmentation of the skin---mask of pregnancy
Thyroid gland hypertrophies & may have an associated bruit

69

What is acute suppurative lymphadenitis?

inflammation & infection of a lymph node

70

What is lymphedema?

swelling from accumulation of lymph fluid.

71

What is lymphangioma aka cystic hygroma?

congenital malformation of dilated lymphatics

72

What is lymphatic filariasis? aka elephantiasis

lymphedema throughout the entire body

73

What is non-Hodgkin lymphoma?

malignant neoplasm of the lymphatic system.

74

What is Hodgkin disease?

Malignant Lymphoma

75

What is epstein barr virus mononucleosis?

Infectious mono

76

What is taxoplasmosis?

caused by a parasite

77

What is roseola infantum?

Infection by human herpes virus 6

78

What is herpes simplex?

Infection by human herpes virus 1 or 2

79

What is Cat Scratch Disease?

subacute or chronic lymphadenitis in children