Quiz 2 Flashcards by Joseph Heston

The avascular superficial layer of skin; pigment producing melanocytes in this layer provide protection from UV rays. Langerhan cells also in this layer are an important component of the immunologic barrier of the skin

Epidermis

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Contains blood vessels, nerves, and appendages (sweat glands, sebaceous glands, hair follicles, nails).

Dermis

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Why do the blood vessels in the dermis consist of two horizontal plexuses one on top of the other?

Allows shunting of blood either toward the skin to cool or away from the skin to stay warm

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Helps insulate against the cold and serves as a reserve food source

Subcutaneous tissues

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Technically a flat area of discolored skin less than a cm in diameter.

Macule

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Examples of a macule.

Examples of a large macule

Macule = freckle or cherry angioma

Large macule = patches, marks, spots, plaques, nevi, age spots, vitiligo, or port wine stains

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A solid elevation of skin less than 1 cm in diameter.

Papule

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Examples of papules

Examples of large papules

Papules = moles, warts, or skin tags

Large papules = nodules, tumors, lipomas, cysts, other masses

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Small, fluid filled elevation of the skin

Vesicle

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Examples of vesicles

Examples of large vesicles

Vesicles = herpes simplex, chicken pox, or herpes zoster

Large vesicles = Bullae (blisters)

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A small pus filled elevation of the skin

Pustule

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Examples of pustules

Examples of large pustules

Pustule = pimples

Large pustules = abscesses, furuncles, and carbuncles

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Flaky skin, keratinized cells. Ex: dandruff, seborrhea, psoriasis

Scales

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Dried serum, blood or purulent exudates. Ex: weeping eczema

Crust

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Rough, thickened epidermis with accentuated skin markings. Ex: chronic dermatitis

Lichenification

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Fine, irregular, superficial capillary dilations. Ex: Rosacea

Telangiectasis

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Linear, crusted loss of epidermis/dermis. Ex: Abrasion or scratch

Excoriation

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Loss of some epidermis. Ex: Sun damaged skin

Erosion

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Linear crack extending into the dermis. Ex: Athletes foot

Fissure

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Skin concavity involving the epidermis and dermis. Ex: Bed sores

Ulcer

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Acute skin eruption that is a new localized rash due to direct skin contact with an irritant or allergen is most likely caused by this. Ex: poison ivy, household or industrial irritants

Contact reations

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Acute skin eruption that causes an often itchy, red, maculopapular skin eruptions over a large portion of the body. May be associated with prescriptions, vitamins, supplements, etc.

Adverse drug reaction

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Condition that presents with a nonpruritic rash to the palms, soles, mouth, or genitals. May also see white mucus patches, flat-topped, moist genital warts, and spotty alopecia of the scalp

Secondary syphilis

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The primary lesion of syphilis. Painless ulceration, difficult to heal, and usually disappears prior to the rash associated with secondary syphilis

Chancre

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Skin presentations associated with tertiary syphilis

Gummas | Ulceration

Who is at the greatest risk of developing skin cancer?

Light skinned people who are outside a lot, have a family history of skin cancer, and have a history of a severe sunburn

ABCDE's of skin cancer

``` A- Asymmetry B- Border C- Color D- Diameter E- Evolution ```

Epithelial cell tumor that begins as a papule and enlarges peripherally. Metastasis is rare and therefore the least worry some

Basal cell carcinoma

A slow growing, malignant tumor of squamous epithelium. Common to the skin and lungs, but found elsewhere.

Squamous cell carcinoma

A malignant neoplasm originating in the skin. Small percentage of all skin cancers, but by far the most severe

Melanoma

A malignant multifocal neoplasm beginning as soft brown or purplish papules on the feet. Associated with AIDS, diabetes, and malignant lymphoma

Kaposi's Sarcoma

Typical balding pattern

Males begins as early as 20 starting in the frontotemporal and vertex areas and may end with a rim of hair remaining in the lateral and posterior scalp Uncommon for females until 60

Idiopathic disease resulting in atypical patches of hair loss. Self limiting.

Alopecia areata

Alopecia that is less common and results in permanent hair loss on the scalp

Alopecia totalis

Very rare alopecia causes widespread loss of all body hair

Alopecia universalis

A superficial lung infection of the scalp, often seen in children. Appears as scaly, round, sometimes pustular patches with broken-off hair that leave bald spots

Tinea capitis (ringworm)

A chronic, superficial, inflammatory skin process, especially common to the scalp, eyebrows, ears, face, axilla, breast, groin, and gluteal folds. Dandruff is a milder form of this condition

Seborrheic dermatitis

Chronic seborrheic dermatitis in infants

Cradle cap

Idiopathic condition that causes excessive growth of the epidermal keratinocytes causing inflammed cells and increased angiogenesis. Appears silvery-white scale on red patches that may itch.

Psoriasis

An infestation of the blood-sucking louse whi feeds on the scalp and neck. Seen in children with poor hygiene. Intense itching is the main symptom with the presence of eggs (nits) in the hair

Pediculosis capitis (head lice)

Results when epidermal tissue invaginates the dermis and becomes encapsulated. Appears as a subcutaneous nodule with an inner, cream-colored, pasty substance

Sebaceous cyst

Symptoms of a TMJ disorder

- Chronic pain in the jaw, teeth, face, head, neck, shoulders, or back. - Jaw clicking - Limited jaw movement - Can't but 3 fingers in your mouth

Primary source and another possible source of TMJ disorder

``` Primary = malocclusion Other = Whiplash injuries ```

What conditions can cause TMJ disorders?

Rheumatoid arthritis Osteoarthritis Displaced TMJ cartilage

Osteoarthritis produces _______ in the TMJ with joint movement

Crepitus (crackling)

How should the salivary glands feel if unaffected?

Soft, pliable, and non tender

Salivary glands of the head

Parotid Submandibular Sublingual

Unilateral swollen glands usually result from:

1) Bacterial infection (Parotitis) 2) Ductal calculus (stones) 3) Cyst or tumor (painless)

Located by the 2nd upper molar

Stenson's duct

Located on either side of the frenulum of the tongue

Wharton's duct

Bilateral swollen glands usually result from:

1) Viral infection (mumps) 2) Drug reactions 3) Lymphomas

Superficial lymph node sites to palpate

- Head and Neck - Axillary - Inguinal

Produces small, mobile, tender nodes involving one or two groups of nodes, but possible more

Acute infections

Way to differentiate between a localized acute infection and a systemic acute infection using lymph nodes

1-2 nodes = localized | 3 or more = systemic

Produces multiple, less tender and mobile nodes that are matted together

Chronic infections

Produces large rubbery lymph nodes

Hodgkin's Lymphoma

Produces stony hard, non-tender nodes of variable sizes.

Metastatic cancer

Swollen node in the left supraclavicular group that lacks a typical explanation. Red flag for thoracic or abdominal cancer.

Virchow's node

Causes of tracheal deviation

1) Head tilt/cervical rotation 2) Unilateral goiter/large lymph node 3) Pneumothorax/pleural effusion 4) Unilateral atelectasis/pulmonary fibrosis

T/F The thyroid should stay stationary during swallowing

FALSE | It should move up and down

Congenital condition associated with an iodine deficiency in children

Cretinism

#1 cause of hypothyroidism in the US

Hashimoto's disease

Severe, advanced form of adult-onset hypothyroidism

Myxedema

Most common form of hyperthyroidism. Produces exophthalmos

Grave's disease

Nerve for the muscles of mastication. Have patient clench their teeth to test for its function

C.N. V

Lightly touching the patients brow, cheek, and chin on both sides of the face tests the functionality of this nerve

C.N. V

Asking the patient to raise their eyebrows and show their teeth tests the functionality of this nerve

C.N. VII

Placing different substances on the anterior part of the tongue and asking the patient to taste it tests the functionality of this nerve

C.N. VII

Having the patient rotate their head in both directions against resistance and shrugging their shoulders against resistance tests the functionality of this nerve

C.N. XI

May be the most commonly encountered headache in chiropractic practice

Whiplash headaches

Typical patient profile and symptoms of whiplash headaches

``` Patient= anybody who sustained a flexion-extension injury Symptoms = stiff neck and a new atypical headache ```

Physical findings of a whiplash headache

Spinal and TMJ asymmetries, abnormal ranges of motion; trigger points and/or temperature discrepancies

Diagnostic studies for a whiplash headache

Flexion-extension X-rays may show soft tissue damage. MR is definitive

Symptom associated with concussion headaches

New headache

Associated symptoms of concussion headaches

Headache, amnesia, and confusion are the most common

Physical findings of concussion headaches

Anything other than a mild injury warrants a neurological exam (memory, concentration, vision, hearing, balance, reflexes, etc.)

Management of concussion headaches

Positive neurological findings = need an immediate head CT, neurological consultation or hospital referral

Symptoms of a migraine headache

Escalating, intense, throbbing, unilateral headache lasting hour to days (maybe auras, scintillating scotomas, or tingling arms or legs which precedes the headache lasting 10-30 minutes prior to the headache)

Associated symptoms of of migraine headaches

Possible nausea, vomiting light and noise sensitivity

Symptom of a dissecting vertebral artery headache

Sudden, severe (worst ever), atypical, unilateral headaches behind one ear and occipital area

Associated symptoms of a dissecting vertebral artery headache

Dizziness, Diplopia, Difficulty walking, Dysphagia, Dysarthria, Nausea, Nystagmus, and Numbness (5 D's and 3 N's)

Physical findings of a dissecting vertebral artery headache

Decreased carotid pulse and/or carotid bruit, or a + vertebrobasilar artery maneuver test raise suspicion of an ominous vascular component of the headache.

Diagnostic study of a dissecting vertebral artery headache

MRA of the head is definitive

Headache as a result of emotional or physical stress such as jaw clenching, teeth grinding, loss of sleep, missed meals, and sustained occupational head, neck, and shoulder postures

Episodic Tension Headaches

Symptoms of a episodic tension headache

Moderate feeling of persistent pressure in the neck, scalp, face, and jaw muscles and the hat band area of the head. May occur as frequently as 15 times a month and last from hours to days

Tension headaches that occur more than 15 times in a month

Chronic Tension Headaches

Pressure over the affected sinuses.

Sinusitis

Physical exam findings of sinusitis

Sensitive to digital pressure of the sinuses

Quiz 2 Flashcards

(88 cards)