Midterm Flashcards
(79 cards)
1
Q
Subjective Data
A
Demographic Reliability Chief Complaint HPI PMH/FM/PSH ROS
2
Q
Objective Data
A
Physical Exam Vitals Lungs CV Labs Radiology EKG
3
Q
Macule
A
Flat, smaller than 1 cm (Freckle, measles)
4
Q
Patch
A
Flat, circumscribed, >1cm
5
Q
Papules
A
Smaller than 1 cm, firm solid. (Wart)
6
Q
Plaque
A
Papules together >1cm (eczema, psoriasis)
7
Q
Nodules
A
Solid elevations, hard or soft. >1cm (sebaceous cyst, fibromatosis)
8
Q
Wheals
A
Superficial, raised, irregular. Caused by edema in epidermis. Transient. (PPD)
9
Q
Uritcaria
A
When wheals cohilesce to form reactions to allergens.
10
Q
Vesicle
A
Elevated blister like cavities with fluid in up to 1cm (herpes, chicken pox)
11
Q
Bullae
A
Elevated, >1 cm cavities. Blister like. (Sunburn)
12
Q
Primary lesions
A
Macules Patches Papules Plauqe Nodules Wheals Uriticaria Vesicles Bullae Pustule
13
Q
Secondary Lesions
A
Cyst Scales Fissures Crusts Excoriations/abraisons Erosions Ulcers Scars Keloid Atrophy
14
Q
Vascular Lesions
A
Spider angiomas
Spider veins
Cherry angiomas
15
Q
Purpuric Lesions
A
Ecchymosis
Petechia
Blood outside the vessel
16
Q
Pustules
A
Vessicles filled with thicker fluid (acne, impetigo)
17
Q
Cyst
A
Encapsulated, fluid filled cavity in the SQ or dermis. Hard and taught.
18
Q
Scales
A
Compact, flakes of skin. Dry or greasy. Silver, white, yellow.
19
Q
Fissures
A
Linear cracks with abrupt edges that extend (corners of mouth, athletes foot cracks)
20
Q
Crusts
A
Dried serum, pus, or blood mixed with debris.
21
Q
Excoriations/abraisons
A
Punctate or linear produced by mechanical means usually only the epidermis. Rarely dermis.
22
Q
Erosions
A
Loss of all or portion of the epidermis.
23
Q
Ulcers
A
Round or irregular excavations that result in loss of dermis and epidermis.
24
Q
Scars
A
New formations in the dermis or deeper parts as a result of injury. Healing process.
25
Keloid
Firm, irregular shaped, thickened, hypertrophic, fibrous. Pink/red.
26
ABCDE
```
Asymmtery
Border
Color
Diameter (6mm or greater)
Evolving
```
27
Impetigo
Red sores that form around the nose and mouth. Bacterial infection, sores burst and develop honey-colored crusts. (pustules, erosions)
28
Wood light
Blue light that uses long wave UV light. When a scalp has ringwork, the fungus glows. A dermascope is a magnifying glass with woodlight and measuring tool.
29
Cranial Nerve XI
Sternocleidomastoid
30
Lymph nodes
```
Preauricular/Postauricular
Occipital
Cervical
Submental
Submaxillary
Submandibular
Clavicular
```
31
Lymph Node Assessment
```
Location
Size
Delineation
Surface characteristics
Shape
Tenderness
Heat
Mobility
Consistency
```
32
Clubbing
Result of low oxygen saturation in the blood. The tips of fingers enlarge and the nails curve around the fingertips.
Normal 160
Clubbing 180
33
Reasons for Hair Loss
```
Hereditary
Age
Alopecia
Childbirth
Illnesses
Hormones
Cancer treatment
Hair styles
Chemicals
Scalp infection
Medications
Psoriasis
STI
Thyroid disease
Decreased Iron, Protein, Zinc
Friction
Poison
```
34
When do patients ALWAYS need to seen by an opthamologist.
HTN, DM, Multiple Scleriosis, Arthritis (Lupus).
35
Vision Tests
Snellen, Visual Fields, Occular Movements, Fundoscopy
| Bruckner, Hirshberg, Corneal Light Reflex, Cover/Uncover
36
Snellen Chart
20/20
Visual Acuity
1st- the distance the patient reads the chart
2nd- the distance at which a person with normal vision can read the same line
37
Visual Fields
Peripheral vision
38
Occular Movements
Alignment, cardinal gaze
39
Bruckner
Color of red reflex, size of pupil, location of pinpoint of light
40
Hirschberg
Strabismus, same spot on each side
41
Cover/uncover
Strabismus (nystagmus)
42
Conjunctivitis
Bacterial/viral inflammation of the conjunctiva. Contagious, red, itchy, painful eyes.
43
Hordeolum
Sty. Red, painful lump near the edge of the eyelid. Acute, localized swelling of the eyelid, eyelash follicle, and glands. Infected hair follice, usually staph.
44
Chalazion
Non-infectious obstruction of a meibomian gland causing extravasation of irritating lipid material in the eyelid soft tissues with focal secondary granulomatous inflammation.
45
Blepharitis
Inflammation of the eyelid that affects the eyelashes or tear production. Tiny oil glands of the inner eyelid become inflammed.
46
Tear Ducts
Lubricates and protects.
| Gives shape to the eyes.
47
Inspection of the Uvula
Press tongue down and ask to say "ah". Should look like a pendent, midline, and rise along the soft palate.
48
Cranial Nerve 9 and 10
Vagus and Glossopharyngeal
49
Tongue and salivary glands.
Have pt touch tip of tonuge to roof of mouth and inspect ventral surgace. Stick out; inspect deviation, color, texture, massess.
Parotid- cheek area below and in front of the ears; secrete saliva via stensons duct.
Submandibular-located in the floor of the oral cavity; saliva into mouth.
Sublingual- found under the tonuge.
50
Tonsils
To assess the tonsils, a patient opens their mouth and a tongue blade is used to depress the tongue. A penlight is used to inspect the back of the patient's throat, looking for pink, symmetrical and normal-size tonsils. Tonsil size is graded as follows:
1+ Visible
2+ Halfway between the tonsillar pillars and the uvula
3+ Touching the uvula
4+ Touching each other
51
Ear
Balance and equilibrium
52
Ear Tests
Weber- laterilization using a tuning fork on top of head. Louder in the bad ear because its not distracted by background noise.
Rinne- AC>BC. Mastoid processess.
53
Otitis Externa vs Otitis Media
Otitis externa (swimmers ear)- infection of the outer ear canal that runs from eardrum to the outside of the head. Warmth and pain.
Otitis Media- Infection of the air filled space behind the ear drum (middle ear).
54
Ear exam and structures you would see
Otoscopy- canal and TM
Use largest speculum possible. Up and back for adult/ Down and back for kids/smaller adults
Cone of light reflex- 5 R/ 7 L
Malleous handle, short process, incus, pars flaccid
Pearly, white, shiney (normal)
55
Pneumatic Otoscopy
Introduce air to assess movement of the TM
Performation- no mobility
normal- vibrates
56
Reasons for Epistaxis
Copious and short-term- Trauma or isolated incident
Chronic-drug therapies, chemotherapies, dry environment and fragile nasal mucosa
57
Reasons for Hearing Loss
```
Cerumen impaction
Paranoia/agitation
Aging
Presbycusis- degenerating hair cells (decreased hearing high pitches)
Syphallis
Rubella
Diabetes
Meningitis
Ear infections
Ototoxic agents
Headphones
```
58
Normal Breathe Sounds
Tracheal
Bronchial
Bronchovesicular
Vesicular
59
Adventitious Breathe Sounds
```
Crackles
Wheezes
Rhonchi
Stridor
Pleural Rubs
```
60
Ribs
12 ribs posterior.
7-8 ICS landmark for thoracentesis
Chostrochondritis- inflammation of ICS
61
Tactile Fremitus
Palmer or side of hand.
Vibration, assessment of the low-frequency vibration of a patients chest. Indirect measure of the amount of air and density of tissue present within the lungs. "99"
62
Deformities of chest wall
AP diameter 2:1
Pectus excavatum "Funnel chest"
Pectus carinatum "Pidgeon" chest
Scoliosis
Kyphosis
63
Murmur Grades
```
1
2
3
4
5
6
```
64
Systolic Murmurs
Mitral Regurgitation
Physiological Murmurs
Aortic Stenosis
Mitral Valve Prolapse
65
Diastolic Murmurs
Aoritic regurg
| Mitral Stenosis
66
Cardiac Valves
Tricuspid
Pulmonic
Mitral
Aortic
67
Aortic Stenosis
Narrowing of the opening of the valve that obstructs the flow of blood out of the left ventricle.
68
Aortic Regurgitation
Leakage of blood from aorta back into the left ventricle during diastole
69
Mitral Valve Prolapse
Inappropriate closure of the MV leaflet
70
Mitral Stenosis
Narrowing of the MV, decreased blood flow into left ventricle during diastole.
71
Mitral Regurgitation
Leakage of blood during systole from the left ventircle stroke volume back into the left atrium.
72
What is listened for when assessing a murmur?
Timing, location, radiation, pitch, quality.
73
Systole
S1
The contraction of the cardiac muscle tissue in the ventricles. S1 is the mitral and tricuspid closure, loudest at the apex. Synchronous with the carotid pulse.
74
Diastole
S2
The relaxation of the cardiac muscle tissue in the ventricles. Coincides with the S2. Aortic and pulmonic closure, loudest at the base.
75
Ejection Fraction
test that determines how well your heart pumps with each beat.
76
Echocardiogram
```
Wall Motion
EF and valves
Pericardial effusion or tamponade
Aortic root
Dissection
Pulmonary artery pressure
```
77
Cardiac Palpation
PMI- 5th ICS
Massess, pain, tenderness, costocondritis
Subcutaneous emphysema
78
PVD Tests
Allen's- radial and ulnar hand circulation.
Buergers- leg circulation
Homans sign-DVT
Cap Refill- <2, 2.9 women
79
Edema
Depress pretibial area and medial malleolus for 5 seconds. Grade +1-+4.
