Midterm Review Flashcards
(133 cards)
1
Q
4 basic techniques of assessment
A
inspection
auscultation
percussion
palpation
2
Q
doppler
A
used to asses pulses when pulses cannot be palpated
3
Q
stadiometer
A
used to measure height
4
Q
wood lamp
A
used to assess fungal infections on the skin
5
Q
goniometer
A
used to measure degree of joint flexion and extension
6
Q
transilluminator
A
use to detect air, blood, fluid, or mass in body cavity
7
Q
epidermis
A
top layer of skin
8
Q
dermis
A
contains nerves, blood, and lymphatic vessels
- embedded with hair follicules, sweat glands, oil glands, and sensory nerves
9
Q
subcutaneous tissue
A
third layer of skin
10
Q
stage 1 pressure injury
A
1 layer of skin is affected
- intact, but red and non-blanchable
11
Q
stage 2 pressure injury
A
2 layers affected (epidermis and dermis)
- bleeding
12
Q
stage 3 pressure injury
A
3 layers affected (epidermis, dermis, and subcutaneous)
- see subcutaneous tissue
- skin is completely compromised
13
Q
stage 4 pressure injury
A
can see muscles and bones
14
Q
grading of skin edema
A
press around bony prominences w/ 3 finger pads
- 0: no edema
- 1+: 2mm
- 2+: 4mm
- 3+: 6mm
- 4+: 8mm
15
Q
annular vs target lesion
configuration/shape
A
both circular lesions
- annular: only 1 circle
- target: circle with concentric circles inside w/ dot at center (bullseye lesion)
16
Q
wheal
primary lesion
A
reddened, irregular borders, elevated
- cause by insect bite or hives
17
Q
macule
primary lesion
A
flat, circumcised border, change in skin color, <1cm
ie/ freckles, petichiae
18
Q
patch
primary lesion
A
irregular, >1cm
ie/ mangolian spots, port wine stain, vitiligo
type of macule
19
Q
vesicle vs bulla
primary lesion
A
fluid filled round, oval w/ translucent wall
- vesicle: <0.5cm
*ie/ chicken pox, poison ivy, small burn blister
- bulla: >0.5cm
ie/ large burn blisters
20
Q
port wine stain
vascular lesion
A
on face that is flat, deep purple/red, irregular shaped
- deepens when person cries or is highly emotional or high temperature
- typically does not fade
21
Q
spider angioma
vascular lesion
A
flat, bright red dot w/ tiny radiating blood vessels ranging from pinpoint to 2cm
22
Q
venous lake
vascular lesion
A
on the face, neck, ear, and lips; usually common in ages 50+
- soft, compressible, slightly elevated dark blue to purple
- may be due to sun exposure
23
Q
senile lentigines (liver spots)
A
usually on hands like hyperpigmented freckles
- common in elderly
24
Q
cutaneous tags
A
usually on the neck and upper chest
- common in elderly
- may increase in numbers
25
manifestations of cirrhosis of the liver
- skin variation: yellowish (jaundice) due to not getting rid of billirubin
26
tinea pedis
also known as athletes foot
27
keloid
## Footnote
secondary lesion
elevated, irregular, darkened; excess scar tissue
- the primary lesion: scar
28
ABCDE criteria
used to rule out malignant lesions
- A: asymmetry
- B: border irregularity
- C: color (varied)
- D: diameter >6mm
- E: evolving change
29
malignant melanoma
most serious type of skin cancer b/c it spreads rapidly to lymph and blood vessels
- varied colors, irregular borders, >6mm
30
kaposi's sarcoma
## Footnote
malignant lesion
painless; blue to purple; resembles keloid; common in HIV patients
31
black hairy tongue
consistent w/ fungal infection of the tongue
32
leukoplakia
whitish thickening of the mouth of HIV positive patients
- cannot be scraped off
33
risk factors of skin cancer
| predisposition
- overexposure to UV light
- genetic predisposition
34
order of occurence of herpes zoster
1) parasthesia (burning/tingling sensation)
2) redness and swelling
3) development of vesicles/blisters
4) weaping blisters
5) crusted lesions
6) posthepaticneuralgia (pain/burning sensation long after blisters disappear
35
cause of shingles (herpes zoster)
chicken pox virus
36
lanugo
## Footnote
normal variation
fine, downy hair in newborns
- prominent in the upper chest, shoulder, and back
37
mongolian spots
## Footnote
normal variation
harmless purplish/blue spots on the sacral area
- common in dark skin
- disappears at age 3
38
vernix caseosa
## Footnote
normal variation
harmless white, cheese-like mixture of sebum and epidermal cells on skin of newborn
- disappears after several bathings
39
milia
## Footnote
normal variation
pimple like whiteheads on the nose or cheeks of the newborn
- disappears after 2-3 weeks
40
vitiligo
harmless white, patchy depigmented areas over the face, neck, hands, and skinfolds of newborn
- does not disappear
41
hydrocephalus
enlarged head w/ prominent, visible scalp veins
- due to accumulation of cerebral spinal fluid in the head of the baby
42
craniosynostosis
premature closure of the coronal and saggital sutures of the head
- elongated head and altered orbital and face of baby
43
vellus hair
short, fine, pale all over the body except lips, nipples, palms, and soles of feet
44
terminal hair
longer and coarser hair
- on eyebrows, scalp, axillary, leg, pubic, and face/chest of men
45
stages of hair growth
- anagen: growth phase; 2-6 yrs
- catagen: transitional phase; 2 weeks
- telogen: shedding phase; 1-4 months
46
eccrine gland
## Footnote
sweat gland
made of water and salt
- located all over the body
47
apocrine gland
## Footnote
sweat gland
made of water, salt, protein, fatty acids
- in groin and axillary region
- when mixed with bacteria = musty
48
sebaceous glands
predominant in scalp area
49
palpating lymph nodes
gentle, circular motion
50
assessing for hearing loss
important to ask if there is family history of hearing loss
51
normal tympanic membrane
pearly gray
52
white patches on tympanic membrane
indicates previous ear infection
53
otitis externa
## Footnote
ear infection
fever, drainage, redness, itchiness in ear
- as long as tympanic membrane is pearly gray
54
otitis media
## Footnote
ear infection
infection of the middle ear
- affects the ossicles (hammer, anvil, stirrup)
55
otitis interna and S/S
| labyrinthitis
## Footnote
ear infection
infections of the semicircular canal, vestibule, and cochlea
- S/S: severe vertigo, hearing loss, ringing of ears
56
tenderness of mastoid process
indicates infection that can lead to brain infection
57
unable to visualize tympanic membrane
1) remove otoscope
2) position auricle (pull up and back)
3) reinsert otoscope
58
classic migraine
## Footnote
type of headache
preceded by aura
- floaters/flashing lights can be seen by patient
- cannot tolerate bright light
59
cluster headache
## Footnote
type of headache
several headaches over period of days or months
- lasts mins to hrs
- pain usually lasts a few mins/hrs
- onset: sudden
60
tension headache
## Footnote
type of headache
headache starts @ cervical area and radiates to top of the head; unilateral or bilateral
- onset: gradual
61
sinus headache
## Footnote
type of headache
patient with sinus headache
62
normal rinne test
air conduction 2x greater than bone conduction
63
weber test
1) activate the time
2) put base of fork at midline of skull
- normal: equal lateralization of vibration to right and left ear
64
ear impacted with cerumen
## Footnote
weber test
lateralization will go to the impacted ear
65
romberg test
test for balance
- done for 20 secs
- pt stand erect, feet together, hands to sides, with eyes closed
- support pt front and back with both hands
- normal: no swaying; swaying <2in
66
confrontation
assessing for peripheral vision
67
how to asses eyes for accomodation
move object closer to the eyes and observe for pupil constriction and convergence
68
preferred test for stabismus for children
cover/uncover test
69
normal finding for 6 cardinal fields of gaze
no nystagmus (jerking of the eyes)
70
normal consensual response
on transillumination, the pupil with direct light will constrict faster than other eye
71
snellen test grading
example: 20/30
- pt can see at 20 feet what a normal person can see at 30 feet
72
myopia vs hyperopia
- myopia: nearsighted (difficulty w/ far vison)
- hyperopia: farsighted (difficulty w/ near vision)
73
presbyopia
farsightedness for ages 45+
- difficulty w/ near vision
74
dry eyes
redness, grainy, burning
- occurs w/ aging
- advise to instill OTC eye drops (follow direction on bottle)
75
macular degeneration
central vision loss
- peripheral vison intact
76
ectropion
lower eyelids everted
- exposing conjuctiva
77
intropion
upper eyelid is inverted
- causing redness and irritation
78
midriasis
prolonged dilation of pupils w/o any change to light
- pupils ~ 7mm
79
causes of midriasis
migraine headache, marijuana, anticholinergic, adrenaline, cocaine, amphetamine, hallucinogen
80
who usually has blown pupils?
| (extensive midriasis)
clients with brain injury
81
anisocoria
unequal pupil size by 1mm
- both pupils react to light but differ in size
- harmless
82
causes of anisocoria
injury/lesions in brain
83
myosis
pinpoint pupils; unilateral or bilateral
| opposite of midriasis
84
causes of myosis
head injury, tobacco use, HTN drug, antipsychotics, galucoma drugs
85
true ribs
1-7 ribs
86
false ribs
8-10 ribs
87
floating ribs
11 & 12 ribs
88
angle of louis
articulation between manubrium and body of sternum
- inline w/ second rib
89
skin turgor in elderly
pinch bilaterally below clavicle and below wrist
90
inspecting yellowing of skin in dark skin patients
inspect lips, oral mucosa, conjuctiva, and palm of hand
91
clubbing of fingers
>160 degrees
92
phalen's test
conducted for 60 secs to asses for carpal tunnel syndrome;
- dorsal aspect of wrist brought together below the breast
- normal: no pain on wrist, forearm, upper arm, neck, and chest
93
tinel's sign
ask pt to put forearms on lap/table and feel for medial nerve
- use 3 fingertips and percuss
- ask if there is any pain
94
indirect percussion
## Footnote
lung techniques
used to percuss the lung in the intercostal spaces
- normal: resonant sound
95
auscultation is used to assess for?
## Footnote
lung techniques
bronchophony, egophony, and whispered pectoriloquy
96
palpation
## Footnote
lung techniques
used to asses for tactile fremitus
97
what causes tactile fremitus?
fluid in lungs, fibrosis, tumor, and infection
98
percussion
## Footnote
lung techniques
used to asses for diaphragmatic excursion
99
diaphragmatic excursion
- normal: 3-5cm; up to 7-8cm in well-fit/athletes
- <3-5cm: should be ruled out for pneumonia or pneumothorax (chest xray)
100
transillumation of sinuses
- normal: red glow around
- no red glow = congestion of sinuses
101
complaint of sinus headache
transillumination or direct percussion of sinuses
102
sounds of bronchophony
## Footnote
ausculation techniques of lungs
- normal: muffled sound
- abnormal: loud and clear
103
hyperresonance
## Footnote
percussion techniques of lungs
air is trapped in lungs
104
crackles
## Footnote
ausculation techniques of lungs
- expected in lobar pneumonia
105
rhonchi (sibulant)
| wheezing
## Footnote
ausculation techniques of lungs
continuous, high-pitched
- expected in asthmatic pt
106
rhonchi (sonorous)
| wheezing
## Footnote
ausculation techniques of lungs
low-pitched, continuous, snoring, rattling
- common in COPD, pneumonia, chronic bronchitis, and cystic fibrosis
107
whispered petriloguy
## Footnote
ausculation techniques of lungs
- normal: faint, muffled, indistinguishable
108
causes of atelectasis
decrease breath sounds on lower lobes of lungs
- causes: prolonged bedrest of postop pts, ineffective coughing, or HYPOventilation
109
normal chest configuration in adults
eliptical
- lateral diameter 2:1 with posterior diameter of chest
110
normal chest configuration of infants
barrel chest
- common in COPD patietns
111
scoliosis
lateral deviation of the spinal process
112
kyphosis
exaggerated curve of thoracic vertebrae
- common in elderly and osteoporosis
113
lordosis
exaggerated curve of the lumbar vertebra
- common in pregnant women
114
pectus excavatum
| (funnel chest)
congenital; depression of sternum and adjacent cartilage
- compresses the heart and lungs
- hear cardiac murmurs
- surgery is indicated
115
tachypnea vs hyperventilation
## Footnote
breathing
greater than 20 breaths/min
- tachypnea: shallow
- hyperventilation: deep
116
bradypnea vs hypoventilation
## Footnote
breathing
less than 12 breaths/min
- bradypnea: regular
- hypoventilation: irregular, shallow
117
cheyne's stokes vs biot's ataxia
## Footnote
breathing
periods of apnea
- cheyne's stokes: regular (in elderly, dying pts)
- biot's ataxia: irregular (due to brain damage)
118
pt w/ rhinitis
most important question to ask: Hx of allergies
119
most common area of breast tumor
upper, outer quadrant of breast
- close to axillary region
120
SBE
| (self breast exam)
- elderly/men: same day and time every month
- mensturating female: 3-5 days after cycle (hormones are more stable)
121
fibroadenoma
well-defined breast tumor w/ no tenderness or discharge
- most common in adolescent girls (15-35 y/o)
122
intraductal papilloma
most common cause of benign nipple discharge (bloody or liquidy)
- common in postmenopausal females
123
peau d'orange
orang peel appearance on skin of breast
- sign of breast malignancy
124
S/S of hypoxia
tachycardia, tachypnea, low O2 sat
125
monitor/action of hypoxia
- monitor: O2 sat, ABG
- actions: O2 therapy, IS, elevate HOB, breathing exercises
126
S/S and actions of retinal detachment
- S/S: floaters, sudden flashes of light, shadow in vision, diminished vision
- actions: prepare for Sx (laser sx, laser beam freezing sx)
| EMERGENCY; may lose vision withing days of diagnosis
127
10 lymph nodes
- preauricular
- postauricular
- occipital
- submental
- submandibular
- retropharyngeal
- anterior cervical cahin
- deep cervical chain
- post cervical chain
- supraclavicular
128
infected pressure injury
- elevated temp
- elevated WBC
- purulent discharge
- redness
129
S/S of COPD
- barrel chest
- decreased O2 sat
- clubbing of fingers (hypoxia)
- rhonchi (sonorous)
130
tracheal
## Footnote
breath sounds
- harsh, high-pitched
- over trachea
- I < E
131
bronchial
## Footnote
breath sounds
- loud, high-pitched
- next to trachea
- E > I
132
bronchiovesicular
## Footnote
breath sounds
- medium-pitched
- next to sternal border; between scapulae
- I = E
133
Vesicular
## Footnote
breath sounds
- soft, low-pitched
- over remainder of lungs
- I > E
