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POM > 11/6/13 > Flashcards

11/6/13 Flashcards

1
Q

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

A

The placenta & the brain.

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2
Q

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

A

The spleen.

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3
Q

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

A

Palatine Tonsils–called tonsils

Nasopharyngeal tonsils–called adenoids

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4
Q

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

A

1 to 2 weeks after birth.

If not, could be a congenital defect of the immune system.

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5
Q

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

A

Normal

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6
Q

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

A

2 years of age.

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7
Q

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

A

Cervical & submandibular nodes

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8
Q

Finding which nodes is always a bad sign?

A

Supraclavicular nodes…sign of malignancy.

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9
Q

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

A

Leukocyte count increases. 7200-8500

Progesterone, Estrogen & Cortisol.

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10
Q

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

A

Cell-mediated–>Humoral

*here, the pregnant mom is more suspectible for infections.

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11
Q

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

A

This can lead to remission of autoimmune diseases.

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12
Q

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

A

Enlarged nodes

swelling of the extremity

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13
Q

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

A 
Malignancy
Anemia
Recent infectious diseases
Tuberculosis
Immune Disorders
Hemophilia
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14
Q

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

A

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

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15
Q

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

A

stomach
appendix
bone marrow
lungs

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16
Q

What are 2 weird functions of the lymphatic system?

A

Back up hematopoiesis

Absorption of fat soluble substances in the GI tract

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17
Q

What is one sad thing about the lymphatic system?

A

It is a way to spread malignancy.

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18
Q

Where does the lymphatic system ultimately drain to?

A

The subclavian veins

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19
Q

T/F massage decreases lymphatic flow

A 
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
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20
Q

T/F The lymphatic system is easily obstructed.

A

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

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21
Q

What is the approximate size of lymph nodes?

A

Smaller than .5–1 cm

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22
Q

Where are superficial nodes located? Deep nodes?

A

Superficial Nodes–>in the subcutaneous tissue

Deep Nodes–>In body cavities & under fascia & muscle

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23
Q

Viral infections do what to the lymphocyte count?

A

Increase it!

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24
Q

What is the approximate size of lymphocytes?

A

7mm–35mm

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25
Q

Humoral immunity includes what lymphocyte?

Cellular immunity?

A

Humoral–B lymphocyte

Cellular–T lymphocyte (thymus for maturity)

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26
Q

Where is the spleen located?

A

left upper quadrant

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27
Q

What are the 2 main areas of the spleen?

A

White Pulp–>lymphatic nodules

Red Pulp–>venous sinusoids

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28
Q

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

A

for a while it can form blood cells

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29
Q

Where are Peyer’s Patches located?

A

in the mucosa of the SI

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30
Q

How are the palatine tonsils activated?

A

thru inhaled & intranasal antigens

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31
Q

When does the lymphatic system begin to develop?

A

20 weeks of gestation

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32
Q

What is the state of the lymphatic system at birth?

A

it is still immature

33
Q

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

A

2

34
Q

Feeling_______ nodes is always a reason for suspicion of malignancy.

A

Supraclavicular

35
Q

What happens to your lymph nodes when you get old?

A

Lymph nodes are lost. They become fatty & fibrotic

This leads to a decreased ability to fight infection.

36
Q

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

A 
malaise
fever
weight loss
night sweats
abdominal pain
fullness itching "pruritis"
37
Q

What are 3 predisposing factors for lymphatic system issues?

A 
Infection
Surgery 
Trauma
Venous Insufficiency
Cardiac or Renal Disorder
38
Q

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

A

Chemotherapy

Antibiotics

39
Q

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

A 
Tuberculosis!
Blood transfusion!
Organ Transplant!
HIV infection!
Malignancy!
40
Q

What are some important social history factors for lymphatic issues?

A

HIV–sexual history & recreational drugs
Travel
Alcohol use

41
Q

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

A

True.

42
Q

What are tender nodes indicative of?

A

Inflammation

43
Q

What characteristics do cancerous nodes have?

A

large, but non-tender

44
Q

What is lymphangioma?

A

congenital malformation of dilated lymphatics

45
Q

What are shotty nodes?

A

Nodes that feel like there are pellets underneath.

46
Q

What are fluctuant nodes?

A

Nodes that exhibit a wavelike motion when they are palpated.

47
Q

What are matted nodes?

A

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

48
Q

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

A

Thyroid Disorders

Headaches

49
Q

Moon facies w/ erythemetous skin is what disorder?

A

Cushing Syndrome

50
Q 
Dull, puffy, yellowed skin
Coarse sparse hair
temporal loss of eyebrows
periorbital edema
prominent tongue
What disorder?
A

Myxedema

51
Q 
Fine, moist skin
Fine Hair
Prominent Eyes
Lid retraction
Staring/startled expression
What disorder?
A

Hyperthyroid

52
Q

Butterfly Rash

What disorder?

A

SLE/Lupus

53
Q 
Facial asymmetry
not able to close one eye
drooping of lower eyelid & mouth
Loss of naso labial fold
What disorder? Which cranial nerve?
A

Bell’s Palsy

Cranial Nerve 7

54
Q

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

A

Acromegaly

55
Q 
Depressed nasal bridge
Epicanthal folds
Low set ears
Large tongues
Which disorder?
A

Down’s Syndrome

56
Q 
Smooth philtrum
Wide Set Eyes
Mild ptosis
Thin upper lip
Which disorder?
A

FAS Fetal Alcohol Syndrome

57
Q

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

A

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

58
Q

When do you percuss on a head & neck exam?

A

For hypocalcemia. Trousseau’s Sign.

59
Q

How is auscultation involved in the head & neck exam?

A

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

60
Q

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

A

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

61
Q

What do you palpate in a neck exam?

A

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

62
Q

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

A

Cardarelli’s Sign

Oliver’s Sign

63
Q

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

A

within one week.

64
Q

When do fontanels usu close by on a baby?

A

24 months. should be 4-5 cm.

65
Q

What might a bulging fontanel indicate?

A

hydrocephalus, intracranial mass, meningitis

66
Q

Where do you palpate for craniotabes?

A

Firmly the scalp above & behind the ears

67
Q

What can transillumination usu distinguish b/w?

A

Increased Fluid vs. Decreased Brain mass

68
Q

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

A

Hyperpigmentation of the skin—mask of pregnancy

Thyroid gland hypertrophies & may have an associated bruit

69
Q

What is acute suppurative lymphadenitis?

A

inflammation & infection of a lymph node

70
Q

What is lymphedema?

A

swelling from accumulation of lymph fluid.

71
Q

What is lymphangioma aka cystic hygroma?

A

congenital malformation of dilated lymphatics

72
Q

What is lymphatic filariasis? aka elephantiasis

A

lymphedema throughout the entire body

73
Q

What is non-Hodgkin lymphoma?

A

malignant neoplasm of the lymphatic system.

74
Q

What is Hodgkin disease?

A

Malignant Lymphoma

75
Q

What is epstein barr virus mononucleosis?

A

Infectious mono

76
Q

What is taxoplasmosis?

A

caused by a parasite

77
Q

What is roseola infantum?

A

Infection by human herpes virus 6

78
Q

What is herpes simplex?

A

Infection by human herpes virus 1 or 2

79
Q

What is Cat Scratch Disease?

A

subacute or chronic lymphadenitis in children

POM (4 decks)

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