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
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
3
Q
What are the layers of the skin
A
Epidermis
Dermis
Subcutaneous
4
Q
What layers make up the epidermis?
A
Horny cell layer
Basal cell layer
5
Q
What does the dermis consist of?
A
Connective tissue
Elastic tissue
6
Q
What is the subcutaneous layer?
A
Adipose tissue
7
Q
What are epidermal appendages?
A
Hair
Sebaceous glands
Sweat glands (apocrine, eccrine)
Nails
8
Q
Functions of the skin
A
Protection
Prevents penetration
Perception
Temperature regulation
Identification
Communication
Wound repair
Absorption and excretion
Production of vitamin D
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
10
Q
Pallor
A
Pale
11
Q
Jaundice
A
Yellow
12
Q
Cyanosis
A
Blue
13
Q
Erythema
A
Red
14
Q
Mottled
A
Blotchy red and purple
15
Q
Necrosis
A
Black
16
Q
Ecchymosis
A
Bruising (purple)
17
Q
What are the ABCDE’s when assessing skin?
A
A = asymmetry
B = border
C = color
D = diameter
E = evolution
18
Q
What are types of primary lesions?
A
Macule
Patch
Papule
Plaque
Nodule
Tumor
Wheal
Urticaria
Vesicle
Bulla
Cyst
Pustule
19
Q
What is a macule
A
Flat primary lesion
Color change
Flat and circumscribed Less than 1 cm
(Freckles)
20
Q
What is a patch
A
Flat primary lesion
Macules larger than 1 cm
21
Q
What is a papule?
A
Elevated primary lesion
Less than 1 cm
Superficial thickening in epidermis
(Elevated nevus [mole])
22
Q
What is a plaque?
A
Elevated primary lesion
Papules coalesce to form surface elevation wider than 1 cm
(psoriasis)
23
Q
What is a nodule?
A
Elevated primary lesion
Solid, elevated, hard or soft, larger than 1 cm
May extend deeper into dermis
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)
25
What is a wheal?
Elevated primary lesion
Superficial, raise, transient, and erythematous; slightly irregular shape from edema
(mosquito bites)
26
What is urticaria?
Elevated primary lesion
Hives
Wheals coalesce to form an extensive reaction
27
What is a vesicle?
Elevated, fluid-filled primary lesion
Elevated cavity containing free fluid Less than 1 cm
28
What is a bulla?
Elevated, fluid-filled primary lesion
Larger than 1 cm Blister
29
What is a cyst?
Elevated, fluid-filled primary lesion
Encapsulated fluid-filled cavity in dermis or SQ
30
What is a pustule?
Elevated, fluid-filled primary lesion T
urbud fluid (pus) in cavity
31
What is crust?
Secondary lesion
Thickened, dried-out exudate
32
What is a scale?
Secondary lesion
Compact, desiccated flakes of skin, dry or greasy
From dead excess keratin cells
33
What is a fissure?
Secondary lesion
Linear crack with abrupt ends
Extends into dermis
34
What is erosion?
Secondary lesion
Scooped out, but shallow depression
35
What is an ulcer?
Secondary lesion
Deeper depression extending into the dermis
36
What is excoriation?
Secondary lesion
Self-inflicted
Superficial
37
Scar
Secondary lesion
After a skin lesion is repaired, normal tissue is lost and replaced with connective tissue.
38
Atrophic scar
Secondary lesion
Skin level is depressed with loss of tissue and thinning of epidermis
(Striae)
39
Lichenification
Secondary lesion
Thickened skin
Produces tightly packed sets of papules
40
Keloid
Secondary lesion
Benign excess of scar tissue
41
Stage I Pressure ulcer
Non-blanchable erythema Intact skin
42
Stage 2 pressure ulcer
Partial thickness skin loss
Shallow abrasion
No visible fat or deeper tissue
43
Stage 3 pressure ulcer
Full-thickness skin loss
Extends into subcutaneous tissue
Resembles a crater
See fat but not deeper tissues
44
Stage 4 pressure ulcer
Full-thickness skin loss and tissue loss
Exposed muscle, tendons, or bone
May have necrotic tissue
45
Deep tissue pressure injury
Localized, non-blanchable Intact or nonintact skin
Pain
Temperature change
46
Hemangioma
Benign proliferation of blood vessels in the dermis
47
Port-wine stain (Nevus Flammeus)
Large, flat, macular patch
Hemangioma
Red, purple/bluish Intensifies with heat or cold or emotions
Typically on face or scalp
48
Strawberry mark (immature hemangioma)
Raised, bright-red area with defined borders
Nonblanchable
49
Cavernous hemangioma (mature)
reddish-blue Irregularly shaped
Solid and spongy mass of blood vessels
50
Telangiectasia
Vascular dilation seen on skin surface
51
Spider or star angioma
Fiery red, star-shaped marking with solid circular center
Central pulsating body and blanching of extended legs
Associated with pregnancy, liver disease
52
Venous lake
Blue-purple dilation of venules and capillaries
53
Purpuric lesions
Caused by blood flowing out of breaks in the vessels
54
Petechiae
Tiny punctate hemorrhages
Bleeding of superficial capillaries
Will not blanch
Broken blood vessels
55
Purpura
Confluent and extensive patch of petechiae and eccyhmoses
56
Annular
Ring form
57
Grouped
Together
58
Linear
Stripes
59
Confluent
All over the place but connected
60
Gyrate
Twists
61
Polycyclic
Several different circles
62
Discrete
Distinct forms
63
Target
Circle with bullseye
64
Zosteriform
Shingles along a dermatome
65
Clubbing
Nail curves
Lack of oxygen
Schamroth sign
66
Nail pitting
Little dents
67
Spoon nails/kolionychia
Rounded like a spoon
68
Habit tic nails
Repetitive trauma
69
Omycholysis
Coming off the nailbed
70
Paronychia
Entire nail is coming off the nailbed
71
Onychomycosis
Nail fungus
72
Onychogryphosis
Overgrown toenails
73
What cranial nerves cause facial expression
Facial nerve (CNVII)
74
Can you feel salivary glands? Where are they located?
Typically no
Parotid glands are in cheeks over mandible, anterior to and blow ear
75
What cranial nerves innervate the major neck muscles?
XI
76
Thyroid gland
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
Lymphatic system
Extensive vessel system that is a major part of the immune system
Passive
78
Related lymphatic organs
Spleen
Tonsils
Thymus
79
Spleen functions
Destroys old rbcs
Produces antibodies
Stores rbcs
Filters microorganisms
80
Tonsils function
Respond to local inflammation
Located in entrance to respiratory and gastrointestinal tracts
81
Thymus function
Gland located in superior mediastinum behind the sternum and in front of aorta
Atrophies after puberty
Develops T lymphocytes
No function in adult
82
Parts of thorax
12 pairs of ribs
12 thoracic vertebra
Diaphragm
Sternum
83
What ribs attach to costal cartilages?
Ribs 1-7
84
What ribs attach costal cartilage above?
Ribs 8-10
85
What rips are floating and have palpable tips?
Ribs 11 and 12
86
What are the parts of sternum
Manubrium
Body
Xiphoid process
87
What is the Manubriusternal angle?
Angle of Louis
Bifurcation of the bronchus
88
What is the costal ange?
Trigangle shaped anle at Ziphoid process
90 degrees or less
89
What are the posterior thoracic landmarks?
* Vertebral prominence (C7)
* Spinous processes (T3)
* Inferior border of scapula (7th or 8th rib)
* 12th rib
90
What are the pleuae?
* Lining
* A potential space (problem if there is)
* Contains lubricating fluid
* Visceral: outside the lungs
* Parietal: inside chest wall and diaphragm
91
What is the location of the R and L upper lobes and lower lobes?
Posteriorly, Upper lobes go to T3
Lower lobes go to T10/T12 on inspiration
92
What are the anterior lung lobe locations?
* 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
Functions of respiratory system
* Supply oxygen
* Remove Co2
* Maintain homeostasis - pH
* Maintain heat exchange
94
What controls respirations?
CO2 level
95
Tachypnea
Breathing to fast
96
Badypnea
Beathing too slow
97
What controls breathing?
Brainstem
98
What is pectus excavatum?
When sternum is sunken into chest
99
What is a barrel chest?
1:1 ration of chest and side
Should be 1:2
100
Pectus carinatum
Breatbone pushes outward
Pigeon chest or keel chest
101
Kyphosis
Abnormal rounding of upper back
Hunchback
102
Normal breath rate
12-20 breaths/minute
103
What are Cheyne Strokes?
End of life breathing
104
Characteristic of chronic obstructive breathing
Deep breath in, slowly out
105
Biot's respiration
Period of hyperventilation followed by persiod of hypoventillation
106
Tactile fremitus
* 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
What sound will you get when you percus a lung?
Should be resonance; symmetric bilaterally
108
What do normal breath sounds sound like? What are the different types? Where are they located?
* 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
What are advantitious lung sounds?
Wheezing, crackles, ronchi
110
Atelectasis
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
Bronchitis
Inflammation of larger airways
Causes obstructions through congestion
Cough is productive or nonproductive
Sore throat
No advantitious sounds
Increased mucus production
112
Pneumonia
General inflammation of entire lung
Proliferation of mucus glands
Productive cough
Tactile fremitus normal
Crackles, many have wheeze
113
Ventricles
Larger chambers of the heart that contact to move blood through the body
114
Atriums
Smaller chambers of the hert that fill passively and moves blood into the ventricles; no valves
115
Layers of the heart wall
* 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
Endocarditis
Inflammation of the endocardium
117
What do atroventricular valves do?
Separate the chambers; atrioventricular valves
Tricuspid separates the right atrium and ventricle
Mital separates the left atrium and ventricle
118
What do the semilunar valves do?
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
What side of the heart is deoxygenated?
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
Heart sounds
Sound waves from interruption of blood flow; sounds travel in the direction of the blood flow
121
First heart sound
Closing of mitral and tricuspid valve
122
Second heart sound
Closing of aortic and pulmonic valve
123
Murmurs
Valve not closing all the way and allowing blood to continue to flow
124
What side of the heart do the events occur first?
Left
M1T1A2P2
125
Systole
Heart's contraction (engaging)
Blood is pumped from the ventricles to the arteries
From S1 to S2
126
Diastole
Ventricles relax and fill with blood
2/3 of cardiac cycle
From S2 to S1
127
