Exam 2 Concepts

Question 1

organ system issues that manifest in skin, hair, and nail problems

Answer 1

respiratory
cardiac
dehydration

Question 2

signs of respiratory dysfunction

Answer 2

C ap refill slow
R ounded nails “clubbing”
A zul skin “cyanosis”
P allor

Question 3

cyanosis

Answer 3

LATE sign of respiratory distress that does not always occur

some pts constantly cyanotic d/t large number of deoxygenated RBCs

Question 4

clubbing

Answer 4

REVERSIBLE bulging of distal fingers and nail beds unless pt suffers from chronic dz (irreversible)

associated w/respiratory and cardiac dysfunction, neoplasms (cancer)

Question 5

capillary refill

Answer 5

color should return in 1-2sec

slow indicates respiratory or cardiac dysfunction

Question 6

signs of cardiac dysfunction

Answer 6

T emperature cool
E dema
R espiratory signs
D iaphoresis “cold sweat”

Question 7

edema scale

Answer 7

1+ mild pitting
2+ moderate pitting
3+ deep pitting
4+ very deep pitting

Question 8

signs of dehydration

Answer 8

dry mucous membranes

poor skin turgor

Question 9

jaundice

Answer 9

yellowing of the hard/soft palate, sclera

indicates liver dysfunction, blood disorders (ex. sickle cell dz)

Question 10

malignant skin lesions

Answer 10

A  symmetry
B  order irregularity
C  olor variation
D  iameter > 6mm
E  levation or evolution

“spot ugly duckling”

Question 11

annular skin lesion

Answer 11

ring-shaped

Question 12

confluent skin lesion

Answer 12

merging together

Question 13

discreet skin lesion

Answer 13

distinct, separate

Question 14

gyrate skin lesion

Answer 14

coiled, snakelike

Question 15

grouped skin lesion

Answer 15

clustered

Question 16

linear skin lesion

Answer 16

line, stripe

Question 17

target skin lesion

Answer 17

resembles eye iris, concentric rings

Question 18

zosteriform skin lesion

Answer 18

linear along nerve route

Question 19

polycyclic skin lesion

Answer 19

annular grown together

Question 20

pressure ulcer stages

Answer 20

1 intact skin erythematous; does not turn white w/pressure
2 loss of epidermis or dermis; red-pink shallow wound
3 subcutaneous tissue visible’ resembles crater
4 exposed muscle, tendon, or bone

Question 21

assessing head size

Answer 21

normocephalic
microcephalic
macrocephalic

Question 22

fontanels

Answer 22

soft spots

1. posterior closes by 2 months
2. anterior closes by 2 yrs

if sunken = dehydration
if bulging = bleeding d/t trauma

“2,2,2”

Question 23

faces of fetal alcohol syndrome

Answer 23

smooth upper lip
thin upper lip
short eye openings

Question 24

assymetrical facial drooping

Answer 24

may be sign of a stroke

Question 25

trachea assessment

Answer 25

normally midline deviation may be d/t neoplasm, goiter, or TN pnuemothorax from lung puncture/collapse

Question 26

thyroid assessment

Answer 26

note size, consistency, symmetry, presence of nodules

Question 27

lymph node assessment

Answer 27

if palpable, normally moveable, discreet, soft, and nontender enlarged or tender LNs may signify infection or cancer

Question 28

lymphadenopathy

Answer 28

infection: bilateral enlarged, warm, tender, freely moveable LNs cancer: unilateral >3cm enlarged, nontender, matted, fixed

Question 29

eye assessment

Answer 29

``` inspect: sclera, conjunctivae, pupil sz/shape pupillary light reflex confrontation test (#s) extraocular muscles corneal light reflex red reflex ```

Question 30

assessment of ear

Answer 30

inspect whisper test otoscopic exam: tympanic membrane pearly/translucent, cone of light towards chin

Question 31

sinuses

Answer 31

frontal maxillary ethmoid sphenoid

Question 32

tonsil scale

Answer 32

4+ "kiss" each other 3+ touch uvula 2+ halfway to uvula 1+ normal should be pink

Question 33

assessment of sinuses

Answer 33

palpate for tenderness indication of sinus infection

Question 34

(GAS) group A strep

Answer 34

``` sore throat fever over 100.4F no cough tonsillar exudate cervical lymphadenopathy ``` untreated may cause rheumatic fever or neuropsych syndromes

Question 35

oral kaposi sarcoma

Answer 35

oral cancer which typically those w/decreased immune systems;elderly and those w/AIDS most common

Question 36

sydenham's chorea

Answer 36

form of REVERSIBLE jerky involuntary movements associated w/untreate rheumatic fever/GAS

Question 37

normal breast assessment findings

Answer 37

``` cyclic pain slight size assymetry bilateral network of veins non-recent nipple inversion firm transverse ride of tissue in lower quadrants ```

Question 38

breast findings associated w/cancer

Answer 38

dimpling fixation peau d'orange "orange peel" recent nipple inversion

Question 39

lung anatomy

Answer 39

R lung has two main bronchi; L has one R has three lobes; L has two

Question 40

lung assessment

Answer 40

anterior mostly upper lobes posterior mostly lower lobes inspection tactile fremitus "99" chest percussion ascultation side to side

Question 41

abnormal trunk inspection

Answer 41

``` barrel chest pectus escavatum pectus carinatum scoliosis kyphosis ```

Question 42

abnormal respiratory patterns

Answer 42

hyperventilation cheyne-stokes biot tachypnea

Question 43

signs of respiratory distress

Answer 43

``` accessory muscles grunting head bobbing nasal flaring retractions tachypnea tripod positions (forward, hand on knees) ```

Question 44

heart assessment

Answer 44

point of maximal impulse cardiac thrills and heaves auscultation

Question 45

heart auscultation areas

Answer 45

2nd intercostal L aortic, R pulmonic 3rd intercostal Erb's point 5th intercostal L tricuspid, R (midclavicular) mitral S1___systole___S2___diastole___

Question 46

heart murmurs

Answer 46

valves trouble opening = stenosis | valves trouble closing = regurgitation/insufficiency

Question 47

abnormal heart sounds

Answer 47

S4(before S1) "stiff as a board"; lub lub dub | S3 (after S3) "need to pee" d/t fluid overload

Question 48

signs of heart failure

Answer 48

``` dilated pupils pale, grey, or cyanotic skin cool, moist skin jugular vein distention low BP ascites decreased urine output ```

Question 49

potential blood vessel problems

Answer 49

arterial insufficiency venous insufficiency - venous valves bust; blood goes back down instead of toward heart deep vein thrombosis

Question 50

signs of arterial insufficiency

Answer 50

``` diminished pulses cool, pale skin thin, shiny skin loss of hair on lower legs thick-ridged nails ```

Question 51

signs of venous insufficiency

Answer 51

palpable pulses edematous (chronic) or swollen (acute) warm, brown (chronic) or red (acute) skin thickened skin

Question 52

abdomen assessment

Answer 52

inspection auscultation percussion palpation

Question 53

abdomen auscultation

Answer 53

listen w/diaphragm for 15-20sec in one quadrant; 5mins if no sounds heard listen w/bell for bruits "whooshing"; renal stenosis common

Question 54

RUQ organs

Answer 54

``` liver right kidney gallbladder pancreas colon ```

Question 55

LUQ organs

Answer 55

``` spleen left kidney stomach pancreas colon ```

Question 56

RLQ organs

Answer 56

appendix colon small intestine

Question 57

LLQ organs

Answer 57

colon | small intestine