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EC Health Assessment > Exam 1 Material > Flashcards

Exam 1 Material Flashcards

1
Q

What is a SOAP note and what parts are the assessment?

A

S = subjective (what patient says)

O = Objective (what is observed)

A = assessment/diagnosis

P = plan

S&O are the assessment

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2
Q

What is OLDCARTS?

A

O = onset

L = location

D = duration

C = characteristics

A = aggravating/alleviating factors

R = Region/Radiation

T = timing

S = severity

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3
Q

What are the layers of the skin

A

Epidermis

Dermis

Subcutaneous

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4
Q

What layers make up the epidermis?

A

Horny cell layer

Basal cell layer

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5
Q

What does the dermis consist of?

A

Connective tissue

Elastic tissue

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6
Q

What is the subcutaneous layer?

A

Adipose tissue

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7
Q

What are epidermal appendages?

A

Hair

Sebaceous glands

Sweat glands (apocrine, eccrine)

Nails

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8
Q

Functions of the skin

A

Protection

Prevents penetration

Perception

Temperature regulation

Identification

Communication

Wound repair

Absorption and excretion

Production of vitamin D

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9
Q

What are the steps of wound healing?

A

Division of stratum basale cells and migration across wound

Thickening of epidermis

Inflammatory phase

Maturation phase

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10
Q

Pallor

A

Pale

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11
Q

Jaundice

A

Yellow

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12
Q

Cyanosis

A

Blue

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13
Q

Erythema

A

Red

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14
Q

Mottled

A

Blotchy red and purple

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15
Q

Necrosis

A

Black

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16
Q

Ecchymosis

A

Bruising (purple)

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17
Q

What are the ABCDE’s when assessing skin?

A

A = asymmetry

B = border

C = color

D = diameter

E = evolution

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18
Q

What are types of primary lesions?

A

Macule

Patch

Papule

Plaque

Nodule

Tumor

Wheal

Urticaria

Vesicle

Bulla

Cyst

Pustule

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19
Q

What is a macule

A

Flat primary lesion

Color change

Flat and circumscribed Less than 1 cm

(Freckles)

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20
Q

What is a patch

A

Flat primary lesion

Macules larger than 1 cm

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21
Q

What is a papule?

A

Elevated primary lesion

Less than 1 cm

Superficial thickening in epidermis

(Elevated nevus [mole])

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22
Q

What is a plaque?

A

Elevated primary lesion

Papules coalesce to form surface elevation wider than 1 cm

(psoriasis)

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23
Q

What is a nodule?

A

Elevated primary lesion

Solid, elevated, hard or soft, larger than 1 cm

May extend deeper into dermis

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24
Q

What is a tumor?

A

Elevated primary lesion

Larger than a few cm in diameter

Deeper into dermis

Can be benign or malignant

(lipoma)

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25
Q

What is a wheal?

A

Elevated primary lesion

Superficial, raise, transient, and erythematous; slightly irregular shape from edema

(mosquito bites)

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26
Q

What is urticaria?

A

Elevated primary lesion

Hives

Wheals coalesce to form an extensive reaction

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27
Q

What is a vesicle?

A

Elevated, fluid-filled primary lesion

Elevated cavity containing free fluid Less than 1 cm

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28
Q

What is a bulla?

A

Elevated, fluid-filled primary lesion

Larger than 1 cm Blister

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29
Q

What is a cyst?

A

Elevated, fluid-filled primary lesion

Encapsulated fluid-filled cavity in dermis or SQ

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30
Q

What is a pustule?

A

Elevated, fluid-filled primary lesion T

urbud fluid (pus) in cavity

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31
Q

What is crust?

A

Secondary lesion

Thickened, dried-out exudate

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32
Q

What is a scale?

A

Secondary lesion

Compact, desiccated flakes of skin, dry or greasy

From dead excess keratin cells

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33
Q

What is a fissure?

A

Secondary lesion

Linear crack with abrupt ends

Extends into dermis

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34
Q

What is erosion?

A

Secondary lesion

Scooped out, but shallow depression

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35
Q

What is an ulcer?

A

Secondary lesion

Deeper depression extending into the dermis

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36
Q

What is excoriation?

A

Secondary lesion

Self-inflicted

Superficial

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37
Q

Scar

A

Secondary lesion

After a skin lesion is repaired, normal tissue is lost and replaced with connective tissue.

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38
Q

Atrophic scar

A

Secondary lesion

Skin level is depressed with loss of tissue and thinning of epidermis

(Striae)

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39
Q

Lichenification

A

Secondary lesion

Thickened skin

Produces tightly packed sets of papules

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40
Q

Keloid

A

Secondary lesion

Benign excess of scar tissue

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41
Q

Stage I Pressure ulcer

A

Non-blanchable erythema Intact skin

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42
Q

Stage 2 pressure ulcer

A

Partial thickness skin loss

Shallow abrasion

No visible fat or deeper tissue

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43
Q

Stage 3 pressure ulcer

A

Full-thickness skin loss

Extends into subcutaneous tissue

Resembles a crater

See fat but not deeper tissues

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44
Q

Stage 4 pressure ulcer

A

Full-thickness skin loss and tissue loss

Exposed muscle, tendons, or bone

May have necrotic tissue

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45
Q

Deep tissue pressure injury

A

Localized, non-blanchable Intact or nonintact skin

Pain

Temperature change

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46
Q

Hemangioma

A

Benign proliferation of blood vessels in the dermis

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47
Q

Port-wine stain (Nevus Flammeus)

A

Large, flat, macular patch

Hemangioma

Red, purple/bluish Intensifies with heat or cold or emotions

Typically on face or scalp

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48
Q

Strawberry mark (immature hemangioma)

A

Raised, bright-red area with defined borders

Nonblanchable

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49
Q

Cavernous hemangioma (mature)

A

reddish-blue Irregularly shaped

Solid and spongy mass of blood vessels

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50
Q

Telangiectasia

A

Vascular dilation seen on skin surface

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51
Q

Spider or star angioma

A

Fiery red, star-shaped marking with solid circular center

Central pulsating body and blanching of extended legs

Associated with pregnancy, liver disease

52
Q

Venous lake

A

Blue-purple dilation of venules and capillaries

53
Q

Purpuric lesions

A

Caused by blood flowing out of breaks in the vessels

54
Q

Petechiae

A

Tiny punctate hemorrhages

Bleeding of superficial capillaries

Will not blanch

Broken blood vessels

55
Q

Purpura

A

Confluent and extensive patch of petechiae and eccyhmoses

56
Q

Annular

57
Q

Grouped

58
Q

Linear

59
Q

Confluent

A

All over the place but connected

60
Q

Gyrate

61
Q

Polycyclic

A

Several different circles

62
Q

Discrete

A

Distinct forms

63
Q

Target

A

Circle with bullseye

64
Q

Zosteriform

A

Shingles along a dermatome

65
Q

Clubbing

A

Nail curves

Lack of oxygen

Schamroth sign

66
Q

Nail pitting

A

Little dents

67
Q

Spoon nails/kolionychia

A

Rounded like a spoon

68
Q

Habit tic nails

A

Repetitive trauma

69
Q

Omycholysis

A

Coming off the nailbed

70
Q

Paronychia

A

Entire nail is coming off the nailbed

71
Q

Onychomycosis

A

Nail fungus

72
Q

Onychogryphosis

A

Overgrown toenails

73
Q

What cranial nerves cause facial expression

A

Facial nerve (CNVII)

74
Q

Can you feel salivary glands? Where are they located?

A

Typically no

Parotid glands are in cheeks over mandible, anterior to and blow ear

75
Q

What cranial nerves innervate the major neck muscles?

76
Q

Thyroid gland

A

Important part of endocrine system

Straddles the trachea in the middle of the neck

Should not be able to see (goiter)

Can palpate it

Synthesizes and secretes thyroxine (T4 and triiodothyronine (T3) - hormones that stimulate metabolism

77
Q

Lymphatic system

A

Extensive vessel system that is a major part of the immune system

Passive

78
Q

Related lymphatic organs

A

Spleen

Tonsils

Thymus

79
Q

Spleen functions

A

Destroys old rbcs

Produces antibodies

Stores rbcs

Filters microorganisms

80
Q

Tonsils function

A

Respond to local inflammation

Located in entrance to respiratory and gastrointestinal tracts

81
Q

Thymus function

A

Gland located in superior mediastinum behind the sternum and in front of aorta

Atrophies after puberty

Develops T lymphocytes

No function in adult

82
Q

Parts of thorax

A

12 pairs of ribs

12 thoracic vertebra

Diaphragm

Sternum

83
Q

What ribs attach to costal cartilages?

84
Q

What ribs attach costal cartilage above?

85
Q

What rips are floating and have palpable tips?

A

Ribs 11 and 12

86
Q

What are the parts of sternum

A

Manubrium

Body

Xiphoid process

87
Q

What is the Manubriusternal angle?

A

Angle of Louis

Bifurcation of the bronchus

88
Q

What is the costal ange?

A

Trigangle shaped anle at Ziphoid process

90 degrees or less

89
Q

What are the posterior thoracic landmarks?

A
  • Vertebral prominence (C7)
  • Spinous processes (T3)
  • Inferior border of scapula (7th or 8th rib)
  • 12th rib
90
Q

What are the pleuae?

A
  • Lining
  • A potential space (problem if there is)
  • Contains lubricating fluid
  • Visceral: outside the lungs
  • Parietal: inside chest wall and diaphragm
91
Q

What is the location of the R and L upper lobes and lower lobes?

A

Posteriorly, Upper lobes go to T3

Lower lobes go to T10/T12 on inspiration

92
Q

What are the anterior lung lobe locations?

A
  • Right lobes:
    • Right upper: 4th rib costally and 5th rib laterally
    • Right middle: 6th rib midclavicular with right upper superior
    • Right lower: 5th midaxillary rib and 6th rib midclavicular
  • Left lobes:
    • Left upper: 6th rib midclavicular, 5th rib midaxillary
93
Q

Functions of respiratory system

A
  • Supply oxygen
  • Remove Co2
  • Maintain homeostasis - pH
  • Maintain heat exchange
94
Q

What controls respirations?

95
Q

Tachypnea

A

Breathing to fast

96
Q

Badypnea

A

Beathing too slow

97
Q

What controls breathing?

98
Q

What is pectus excavatum?

A

When sternum is sunken into chest

99
Q

What is a barrel chest?

A

1:1 ration of chest and side

Should be 1:2

100
Q

Pectus carinatum

A

Breatbone pushes outward

Pigeon chest or keel chest

101
Q

Kyphosis

A

Abnormal rounding of upper back

Hunchback

102
Q

Normal breath rate

A

12-20 breaths/minute

103
Q

What are Cheyne Strokes?

A

End of life breathing

104
Q

Characteristic of chronic obstructive breathing

A

Deep breath in, slowly out

105
Q

Biot’s respiration

A

Period of hyperventilation followed by persiod of hypoventillation

106
Q

Tactile fremitus

A
  • Air should move throughout your lungs
  • Assess with pals on thorax - patient should say 99 (creates vibration)
  • Normal is symmetrical vibration
  • Palpate the entire chest wall (front and back)
107
Q

What sound will you get when you percus a lung?

A

Should be resonance; symmetric bilaterally

108
Q

What do normal breath sounds sound like? What are the different types? Where are they located?

A
  • Bronchial
    • High pitch loud sounds
    • Inspiration < expriation
    • Trachea and larynx
  • Bronchovesicular
    • Moderate pitch moderate sounds
    • Inspiration = expiration
    • Over majority of bronchi where there are fewer alveoli
  • Vesicular
    • Low pitch soft sounds
    • Inspiration > expiration
    • Over peripheral lung field where air flows through smaller alveoli
109
Q

What are advantitious lung sounds?

A

Wheezing, crackles, ronchi

110
Q

Atelectasis

A

Part of lung is not being aerated

Bronchial obstruction

Tactile fremetis decreased

Absent breath sounds in the area or decreased

Percussion may result in dullness

111
Q

Bronchitis

A

Inflammation of larger airways

Causes obstructions through congestion

Cough is productive or nonproductive

Sore throat

No advantitious sounds

Increased mucus production

112
Q

Pneumonia

A

General inflammation of entire lung

Proliferation of mucus glands

Productive cough

Tactile fremitus normal

Crackles, many have wheeze

113
Q

Ventricles

A

Larger chambers of the heart that contact to move blood through the body

114
Q

Atriums

A

Smaller chambers of the hert that fill passively and moves blood into the ventricles; no valves

115
Q

Layers of the heart wall

A
  • Pericardium: touch, fibrous, double-walled sact that surrounds and protects the heart
  • Myocardium: muscular wall of heart; it does the pumping
  • Endocardium: thin layer of endothelial tissue that lines the inner surface of the heart chambers and valves
116
Q

Endocarditis

A

Inflammation of the endocardium

117
Q

What do atroventricular valves do?

A

Separate the chambers; atrioventricular valves

Tricuspid separates the right atrium and ventricle

Mital separates the left atrium and ventricle

118
Q

What do the semilunar valves do?

A

Separate the ventricles from the great vessels

Names for the vessels

Pulmonic: separates the right ventricle from the pulonary artery

Aortic: separates the left ventricle from the aorta

119
Q

What side of the heart is deoxygenated?

A

Right side is deoxygenated - gets blood from the body to send to the lungs

Left side is oxygenated - gets blood from the lungs to send to the body

120
Q

Heart sounds

A

Sound waves from interruption of blood flow; sounds travel in the direction of the blood flow

121
Q

First heart sound

A

Closing of mitral and tricuspid valve

122
Q

Second heart sound

A

Closing of aortic and pulmonic valve

123
Q

Murmurs

A

Valve not closing all the way and allowing blood to continue to flow

124
Q

What side of the heart do the events occur first?

A

Left

M1T1A2P2

125
Q

Systole

A

Heart’s contraction (engaging)

Blood is pumped from the ventricles to the arteries

From S1 to S2

126
Q

Diastole

A

Ventricles relax and fill with blood

2/3 of cardiac cycle

From S2 to S1

EC Health Assessment (14 decks)

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