Ch 2 Physical Exam Flashcards
Exaggerated IgE-mediated response triggering a histamine response
Atopy
Any exaggerated immune response to a foreign antigen regardless of mechanism
Allergy
Atopy has a ______ component
Hereditary
Only essential tools for a physical exam
Hands
Best lighting for examination
Daylight/natural light
Annular
Ring Shaped
Nummular
Round
Arcuate
Arc Shaped
Multiple different shapes located closely together
Multiform
Formed from coalescing circles, rings, or incomplete rings
Polycyclic
Target-like, with a center darker than the periphery
Targetoid
Dot-like; typically, around 1 mm
Punctate
With a central depression of the surface
Also known as “delled”
Umbilicated
Resembling a straight line
Ex: Poison Ivy or scratches
Linear
Serpentine or snake-like
Ex: Lymphadenitis
Serpiginous
Most important additional feature of a lesion other than primary morphology
Lesion Color
Borders are clearly defined and have a definitive ‘stop’ point
Well-demarcated
Tight borders on a round lesion
Clear “beginning and end”
Circumscribed
Borders are indistinct and lack a definitive start/stop point
Not well-demarcated
Protein-rich fluid containing cellular elements extruded from blood vessels secondary to inflammation or injury
Exudate
Thin, pink-colored discharge associated with normal wound healing
Serosanguinous
Mild, yellow and cloudy discharge associated with mild infections
Seropurulent
Thick, yellow to green discharge typically associated with infection
Purulent
Thin, clear discharge associated with and expected in inflammatory stage of wound healing
Serous
Thin, darker red drainage associated with capillary permeability and/or capillary injuries
Sanguineous
Dead crust =
Serum
Unilateral and lying in the distribution of a single spinal afferent nerve root
Dermatomal/Zosteriform
Lying along the distribution of a lymph vessel; implies infectious agent spreading from an acral (distal) site
Lymphangitic
Occurring in distal locations, such as on the hands, feet, wrists, ankles, ears, or penis
Distal (Acral)
Occurring on the trunk or central body
Truncal
Occurring in areas usually not covered by clothing; face, dorsal hands
Sun Exposed (AKA Photo-distributed)
Occurring in areas usually covered by clothes
Sun Protected
Occurring over the dorsal extremities (knees/elbows)
Extensor
Overlying the flexor muscles of the extremities (antecubital and popliteal fossae)
Flexor
Occurring in the skin folds, where 2 skin surfaces are in contact (axillae, inguinal folds, inner thighs, inframammary skin)
Intertriginous
Favoring the hair-bearing locations of the skin
Scalp, eyebrows, beard, central chest, axillae, genitals, nasolabial and postauricular creases
Seborrheic
Confined to a single body location
Localized
Widespread
Medical term for rash
Generalized
Lesions which develop as a direct result of the disease process
Primary lesions
Evolve from primary lesions or develop because of patient’s activities
Lesions which develop from longstanding/untreated disease
Secondary Lesions
Flat, circumscribed area of color change less than 1 cm in diameter
Macule
A flat, non-palpable, irregularly shaped macule greater than 1 cm in diameter
Patch
An elevated, firm, circumscribed area less than 1 cm in diameter
Papule
An elevated firm, rough, lesion with flat top greater than 1 cm in diameter
Plaque
Elevated, circumscribed, superficial fluid-filled. Less than 1 cm.
Vesicle
Elevated, superficial lesion. Similar to a vesicle but filled with purulent fluid
Pustule
Vesicle greater than 1 cm
Bulla
An elevated, irregularly-shaped area of cutaneous edema. Solid, transient and variable diameter
Wheal (Hive)
Elevated, firm, circumscribed lesion; deeper in the dermis than a papule
1-2 cm in diameter
Nodule
Elevated and solid lesion; may or may not be clearly demarcated; deep in the dermis
Great than 2 cm
Tumor (mass)
Encapsulated lesion in the dermis or hypodermis; filled with liquid or semi-solid material
Cyst
Fine, irregular, red line produced by capillary dilation
Telangiectasia
Loose or adherent flake composed of stratum corneum cells
Scales
Rough and thickened epidermis secondary to persistent rubbing, itching, or irritation. Accentuation of skin markings is often seen
Lichenification
Dried serum, blood, or purulent exudates; slightly elevated
Crust
Thick and fibrous tissue that replaces normal skin after injury to the dermis. Epithelial tissue is replaced with connective tissue during the healing process
Scar
Overgrowth of scar tissue that remains confined to the site of initial injury
Hypertrophic scar
Enlargement or overgrowth of an organ or part of the body due to increased size of constituent cells
Hypertrophy
Irregularly shaped, elevated scar that grows beyond the boundaries of the initial injury or wound
Keloid
Keloids are more common in ___ skin types
IV-VI
Thinning of the skin and loss of skin markings. Skin can turn translucent and paper-like
Atrophy
Side-effect of long-term topical corticosteroid use
Aging
Striae
Atrophy
Loss of part of the epidermis
Erosion
Loss of epidermis and dermis
Ulcer
Loss of epidermis
Excoriation
Linear crack in skin continuity from epidermis to dermis
Fissure
Excessive hair (female) in non-hairy areas
Hirsutism
Variable patchy & round hair loss on scalp
Alopecia Areata
Hair loss secondary to excessive/constant traction
Traction Alopecia
Hair loss secondary to scar formation and follicle loss
Scarring Alopecia
Loss of all scalp hair
Alopecia Totalis
Loss of all body hair
Alopecia Universalis
Male pattern baldness
Andropause
Normal nail angle
160 degrees
Nail angle that would indicate clubbing
> 180 degrees
Well circumscribed areas of thickened epidermal keratin that develop at locations of repeated pressure or friction
Callus
Develop similarly to calluses but have a central hyperkeratotic core that is often painful
Corn (clavus)
Human papillomavirus lesions that occur on the soles of feet
Plantar warts
Accumulation of melanocytes/nevus cells in dermis
Symmetric brown macule or papule with smooth, regular borders
Nevus (Mole)
Abnormalities of the nails are typically grouped into 3 categories:
Injury
Infection
Systemic disease
Bleeding from nail bed secondary to trauma
May lead to onycholysis
Subungual hematoma
Nail separates from distal nail bed
Secondary to trauma, hematoma, fungus
Onycholysis
Ingrowing of nail, secondary to improper trimming technique, shoe compression
Onychocryptosis
Yellow, crumbling nail plate
Hyperkeratotic debris beneath
Onycholysis
Due to fungal infection
Onychomycosis
Infection around nail
Bacteria
Paronychia