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Clinical Assessment Exam 1 > Exam 1b > Flashcards

Exam 1b Flashcards

1
Q

Which part of the ear is responsible for equalization of pressure on both sides of tympanic membrane?

A

Middle ear

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2
Q

type of skin lesion: solar lentigines

A

macule

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3
Q

What kind of tuning fork do you use for Rinne Test?

A

512 hz

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4
Q

photophobia

A

experience of discomfort or pain to the eyes due to light exposure

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5
Q

Secondary skin lesion that is:

  • below the skin plane
  • loss of superficial epidermis
  • no bleeding
  • surface moist
A

erosion

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6
Q

Patient is absent red reflex. Name one possible cause?

A

Retinal Detachment

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7
Q

type of skin lesion: impetigo

A

primary: pustule

Secondary: crusting

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8
Q

When internally examining the nose, which speculum should you use with the otoscope?

A

large speculum

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9
Q

cyst

A

Primary skin lesion that is:

  • palpable
  • filled with semiliquid material or fluid
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10
Q

How do you test Extra Ocular Movements?

A

“H-method”: Move finger in 6 cardinal positions

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11
Q

type of skin leasion: striae

A

atrophy

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12
Q

You perform a Rinne test on the RIGHT ear. Patient is able to hear the tuning fork when it is pressed against the mastoid bone level with the ear canal. Once they stop hearing it there, you bring it forward (shape of U). Patient cannot hear it. Interpret.

A

This means BC=AC, or BC>AC in the right ear.

  • The right ear is affected
  • The patient has conductive hearing loss (CHL)
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13
Q

Primary skin lesion that is:

  • palpable
  • elevated
  • solid
  • <1.0 cm
A

papule

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14
Q

otalgia

A

ear pain

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15
Q

Hearing pathway: what is the sensorineural phase?

A

Inner ear and cochlear functions

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16
Q

Type of skin lesion that is:

  • elevated
  • grows beyond wound boundaries
  • the result of an overgrowth of dense fibrous tissue that usually develops after healing of a skin injury.
A

keloid

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17
Q

Medial crescentic shadow

A

A test of the Iris-this is an abnormal finding

Note: Since the iris is normally fairly flat and forms a relatively open angle with the cornea, this lighting should cast no shadow.

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18
Q

tympanosclerosis

A

condition caused by calcification of tissues in the middle ear, sometimes resulting in a detrimental effect to hearing.

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19
Q

Interpret visual acuity result of 20/40

A

Patient able to read line @20 feet; person with normal eyesight able to read line @40 feet

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20
Q

type of skin lesion: hives

A

wheal

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21
Q

TM perforation

A

A hole in the tympanic membrane (the tissue that separates the ear canal from the middle ear).

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22
Q

How do you assess gross (acoustic) hearing? Which cranial nerve are you testing?

A

CN VIII (vestibulococchlear)

Whispered Voice Test

  1. Patient covers one ear
  2. Stand 1-2 feet away
  3. Whisper alpha-numeric, have patient repeat back
  4. Test both sides
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23
Q

Typanostomy tube

A

a small tube inserted into the eardrum in order to keep the middle ear aerated for a prolonged period of time, and to prevent the accumulation of fluid in the middle ear.

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24
Q

type of skin lesion: seborrhea

A

scaling

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25
Q

Primary skin lesion that is:

  • Elevated
  • Palpable
  • Fluid-filled cavity
  • <1.0 cm
  • Filled with serous fluid
A

vesicle

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26
Q

Type of skin lesion that is:

  • vascular
  • 1-3 mm
  • bright or ruby red
  • partial blanching
  • Smooth to slightly raised
A

cherry angioma

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27
Q

icterus

A

Jaundice

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28
Q

For external eye inspection, what kind of lighting should you use? What will you be able to see?

A

Use oblique lighting

(1) Cornea & (2) Lens

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29
Q

Secondary skin lesion that is:

  • Above the skin plane
  • flaky
  • exfoliated skin
  • thick or thin
  • dry or greasy
A

Scaling

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30
Q

pruritis

A

itchy skin that makes you want to scratch

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31
Q

Patient loses sensory for tases of salty, sweet, sour, and bitter on anterior 2/3 of tongue. Which cranial nerve?

A

CN VII (facial nerve)

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32
Q

Bulla

A

Primary skin lesion that is:

  • Elevated
  • Palpable
  • Fluid-filled cavity
  • 1.0 cm or greater
  • Filled with serous fluid
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33
Q

Primary skin lesion that is:

  • palpable
  • elevated
  • solid
  • 1.0 cm or greater
  • superficial
  • surface area > height
A

Plaque

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34
Q

CHL

A

conductive hearing loss

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35
Q

scaling

A

Secondary skin lesion that is:

  • Above the skin plane
  • flaky
  • exfoliated skin
  • thick or thin
  • dry or greasy
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36
Q

serous fluid

A

typically pale yellow and transparent

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37
Q

How do you test air conduction versus bone conduction?

A

Rinne Test

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38
Q

type of skin lesion: elevated nevus

A

papule

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39
Q

type of skin lesion: tinea versicolor

A

macules

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40
Q

petechiae

A

Skin lesion that is:

  • 1-3 mm
  • reddish purple
  • nonblanching
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41
Q

type of skin lesion: blackhead

A

comedone

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42
Q

Skin-inspection. How do you asses NEVI?

A

ABCDE rule

  • Asymmetry one half unlike the other?
  • Borders regular v. irregular
  • Color uniformity: tan, black, blue, red
  • Diameter >6mm
  • Evolution/Elevation
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43
Q

Branches of CN VII (facial nerve)

A

(1) Temporal
(2) zygomatic
(3) buccal
(4) mandibular
(5) cervical

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44
Q

Which part of the ear is responsible for position sense and equilibrium?

A

Inner ear

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45
Q

Where do you palpate the frontal sinuses?

A

under eyebrows, medial aspect

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46
Q

How do you assess motor function for CN V (trigeminal)?

A
  1. Patient clench teeth, palpate temporal muscle
  2. Patient clench teeth, palpate masseter muscle
  3. Patient open mouth and move side/side
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47
Q

cherry angioma

A

Type of skin lesion that is:

  • vascular
  • 1-3 mm
  • bright or ruby red
  • partial blanching
  • Smooth to slightly raised
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48
Q

Type of skin lesion expected with liver disease

A

spider angioma

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49
Q

type of skin lesion: erythema nodosum

A

nodule

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50
Q

type of skin lesion: chancre

A

ulcer

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51
Q

fissure

A

Secondary skin lesion that is:

  • below the skin plane
  • Linear crack from epidermis to dermis
  • dry or moist
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52
Q

Patient presents with:

  • On one side: Forehead not wrinkled; eyebrow not raised (when asked to raise eyebrows). Other side has raised eyebrow, wrinkles.
  • On one side: Paralysis of the lower face (same side as eyebrow issue)
A

Bell’s Palsy

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53
Q

You inspect and observe a spider angioma. What are the three possible causes?

A
  1. Liver disease
  2. pregnancy
  3. normal
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54
Q

What are the 4 characteristics of sensorineural hearing loss?

A
  1. Greater loss in higher frequencies
  2. difficulty hearing with two or more people
  3. noisy environments make hearing worse
  4. talk loudly

(Usually Irreversible–need hearing aid, cochlear implant)

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55
Q

confluence

A

an act or process of merging

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56
Q

comedone

A

Primary skin lesion that is:

  • Keratin plugged opening of a sebeceaous gland
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57
Q

Patient presents with:

  • Stare (blank stare)
  • Decreased mobility
A

Parkinson’s Disease

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58
Q

type of skin lesion: acne

A

pustule

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59
Q

How do you characterize diplopia?

A

(1) Horizontal (images side by side) (2) Vertical (images on top of one another) (3) Oblique (images tangential to one another) (4) Does it persist with one eye closed?

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60
Q

Mobility of skin

A

ease at which skin lifts up

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61
Q

diffuse hair lose

A

global hair lose

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62
Q

Oculo sinstra (OS)

A

left eye

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63
Q

Which is greater, air conduction or bone conduction?

A

air conduction

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64
Q

binocular

A

both eyes

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65
Q

How do you palpate for the thyroid?

A
  • Posterior approach
  • Place index finger JUST BELOW cricoid cartilage
  • Slide fingers laterally onto lobes
  • Gently push with left hand and displace gland to the right; palpate right lobe
  • Assess other side
  • Ask patient to swallow
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66
Q

Patient presents with:

  • Brow prominent,
  • soft tissues of nose, ears, and lips enlarged
  • Jaw prominent
A

Acromegaly

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67
Q

Describe the “accommodation response” for pupils

A

(1) Lens rounds up
(2) Pupils constrict
(3) Eyes converge

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68
Q

How do you examine the internal ear?

A
  1. Large speculum
  2. Head tilted opposite side
  3. Pull Auricle up, out, and back
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69
Q

exudate

A

inflammation

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70
Q

crusting

A

Secondary skin lesion that is:

  • Above the skin plane
  • dried blood, pus, or serum
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71
Q

pustule

A

Primary skin lesion that is:

  • Elevated
  • Palpable
  • Fluid-filled cavity
  • <1.0 cm
  • Filled with pus
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72
Q

Skin lesion that is:

  • 1-3 mm
  • reddish purple
  • nonblanching
A

petechiae

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73
Q

When performing the internal nasal exam, which turbinates are able to be seen?

A

The middle and inferior turbinates

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74
Q

3 branches of trigeminal nerve (CN V)

A

(1) Ophthalmic
(2) Maxillary
(3) mandibular

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75
Q

Landmarks of the internal ear examination

A
  1. Malleus (bony landmark)
  2. Umbo (bony landmark)
  3. Light reflex
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76
Q

Borders of anterior triangle (neck)

A
  1. mandible
  2. sternocleidomastoid muscle
  3. middle of neck
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77
Q

Parkinson’s disease

A

Patient presents with:

  1. Stare (blank stare)
  2. Decreased mobility
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78
Q

Primary skin lesion that is:

  • palpable
  • elevated
  • solid
  • superficial cutaneous edema
A

wheal

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79
Q

lid lag

A

Lid lag is the static situation in which the eyelid is higher than normal with the globe in downgaze

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80
Q

If patient is experiencing a conductive hearing loss, where in the ear would you expect the issue to be located?

A

External and/or middle ear

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81
Q

Goiter

A

abnormal enlargement of the thyroid gland

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82
Q

Raises the eyelid. Which cranial nerve?

A

CN 3 oculomotor

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83
Q

Where do you palpate the maxillary sinuses?

A
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84
Q

You are testing visual acuity. Which cranial nerve are you testing?

A

Snellen chart. CN II (two).

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85
Q

Primary skin lesion that is:

  • Elevated
  • Palpable
  • Fluid-filled cavity
  • <1.0 cm
  • Filled with pus
A

pustule

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86
Q

diplopia

A

double vision

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87
Q

Cushing’s syndrome

A

Patient presents with:

  1. Red Cheeks
  2. Hirsutism
  3. Moon Face
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88
Q

Patient presents with periorbital edema. Name the two possible pathologies?

A
  1. Nephrotic syndrome
  2. Myxedema
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89
Q

atrophic scar

A

An atrophic scar takes the form of a sunken recess in the skin

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90
Q

tinnitus

A

the perception of noise or ringing in the ears

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91
Q

Patient presents with increased number of cherry angiomas as they have aged. concern?

A

No; no significance to cherry angioma

they tend to increase with age

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92
Q

spider angioma

A

Type of skin lesion that is:

  • vascular
  • central red body with radiating arms
  • central blanching
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93
Q

Which four sinuses drain into nasal cavity?

A
  1. Frontal
  2. Ethmoid
  3. Sphenoid
  4. Maxillary
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94
Q

Where is the submandibular duct located?

A
  • Floor of mouth
  • Deep to mandible
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95
Q

10 skin cancer risk factors

A
  1. Age >50
  2. Male
  3. Personal or Family history of Melanoma
  4. Fitzpatrick skin type 1 and 2
  5. Use of tanning beds
  6. Immunosuppresion
  7. >50 benign moles, atypical moles, changing moles
  8. sever burn at an early age
  9. overexposure to frost, wind, UVB
  10. overexposure to radioisotopes, x-rays, arsenic
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96
Q

Hirsutism

A

Unwanted male-pattern hair growth on a woman’s face, chest, and back

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97
Q

How do you assess CN XII (Hypoglossal Nerve)

A

Have patient stick out tongue and move side to side

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98
Q

Type of skin lesion expected with pregnancy

A

spider angioma

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99
Q

Periocular

A

surrounding the eyeball but within the orbit

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100
Q

Strabismus

A

Developmental dyscongugate gaze (due to imbalance in ocular muscle tone). Types are:

(1) Esotropia-INWARD
(2) Exotropia-OUTWARD
(3) Hypertropia- UPWARD
(4) Hypotropia- DOWNWARD

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101
Q

Impacted cerumen

A

Cerumen=ear wax

We say that ear wax is impacted when it has built up in the ear canal to such a point that there may be signs that something is not quite right.

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102
Q

All other movements of eye, except:

  • laterally
  • moves eye down when looking toward nose
A

CN 3 (oculomotor)

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103
Q

Atopic history

A

syndrome characterized by a tendency to be “hyperallergic”. A person with atopy typically presents with one or more of the following:

  1. eczema (atopic dermatitis),
  2. allergic rhinitis (hay fever), or
  3. allergic asthma
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104
Q

Primary skin lesion that is:

  • raised tunnel
A

burrow

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105
Q

How do you stabilize the tongue in an oral cancer screen?

A

gauze

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106
Q

Rhinorrhea

A

runny nose

nasal cavity is filled with a significant amount of mucus fluid

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107
Q

erythema

A

superficial reddening of the skin

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108
Q

You perform a Rinne Test. Where do you first place the tuning fork to test for bone conduction?

A

Against the Mastoid bone level with ear canal

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109
Q

Bone or cartilage? nasal ali of nose

A

cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

When assessing the pupils, what are you looking for?

A

PERRLA

Pupils

Equal

Round

Reactive to: Light & Accommodation

111
Q

impetigo

A

bacterial skin infection

112
Q

Which part of the ear performs sound identification and localization?

A

External ear

113
Q

Myxedema

A

Patient presents with:

  1. Hair dry, coarse, sparse
  2. Lateral eyebrows thin
  3. Periorbital edema
  4. Puffy DULL FACE WITH DRY SKIN
114
Q

Primary skin lesion

A

Initial, spontaneous manifestation

115
Q

Wheal

A

Primary skin lesion that is:

  • palpable
  • elevated
  • solid
  • superficial cutaneous edema
116
Q

What is the expected contour of the tympanic membrane?

A

concave

117
Q

Patient has abnormal red reflex. Three possible causes?

A

(1) Leukocoria
(2) Cataracts (rubella)
(3) Retinoblastoma

118
Q

type of skin lesion: cafe au lait

A

patches

119
Q

Pneumatic otoscopy

A

Pneumatic otoscopy is an examination that allows determination of the mobility of a patient’s tympanic membrane (TM) in response to pressure changes

120
Q

Hearing pathway: what is the conductive phase?

A

From external ear through middle ear

121
Q

Patient presents with:

  • Hair dry, coarse, sparse
  • Lateral eyebrows thin
  • Periorbital edema
  • Puffy DULL FACE WITH DRY SKIN
A

Myxedema

122
Q

Primary skin lesion that is:

  • accumulation of purulent material, into the dermis and subcutaneous layer
A

abscess

123
Q

Right pupil has a direct light response. Where did I shine the pen light?

A

Right eye

124
Q

Bone or cartilage? Bridge of nose

A

bone

125
Q

2 branches of CN VIII (vestibulocochlear nerve)

A
  1. Vestibular-balance
  2. cochlear-hearing
126
Q

Right pupil has a consensual light response. Where did I shine the light?

A

Left eye

127
Q

type of skin lesion: psoriasis

A

primary skin lesion: plaque

secondary skin lesion: scaling

128
Q

What is the normal pathway in the conductive phase?

A

air conduction

129
Q

Nail pitting

A

little depressions in your fingernails and toenails

130
Q

purpuric

A

characterized by purple or brownish-red spots on the skin or mucous

131
Q

type of skin lesion: sebaceous cyst

A

cyst

132
Q

type of skin lesion that is: rupture of a vesicle

A

erosion

133
Q

How do you assess temperature of skin?

A

Dorsal side of hand

134
Q

SNHL

A

sensorineural hearing loss

135
Q

When doing the internal inspection of the nose, where do you insert the speculum?

A

Insert speculum into vestibule

136
Q

Psoriasis

A

an immune-mediated disease that causes raised, red, scaly patches to appear on the skin

137
Q

Nodule

A

Primary skin lesion that is:

  • palpable
  • elevated
  • solid
  • 0.5 cm or greater
  • deep
138
Q

clubbing of fingernails

A

deformity of the finger or toe nails (relevant with regard to pulmonary exam)

139
Q

erosion

A

Secondary skin lesion that is:

  • below the skin plane
  • loss of superficial epidermis
  • no bleeding
  • surface moist
140
Q

pallor

A

an unhealthy pale appearance

141
Q

Patient exhibits the below. What is the issue? What are five possible causes? treatable?

  • Impediment to air conduction such that BC=AC or BC > AC
  • Hear voices as muffled/slurred
  • Hearing loss of all frequences
  • May be overcome by increasing amplitude of sound (louder sound)
  • Typically speak softly
A

Conductive hearing loss

  1. otitis externa or media
  2. impacted cerumen
  3. tumors
  4. otosclerosis
  5. TM perforation

Usually treatable

142
Q

patch

A

Primary skin lesion that is:

  • Non-palpable
  • flat
  • circumscribed
  • 1.0 cm or greater
143
Q

Appropriate A:V ratio of retina?

A

2:3 or 4:5 A:V ratio

144
Q

What are the 5 characteristics of conductive hearing loss?

A
  1. Impediment to air conduction such that BC=AC or BC > AC
  2. Hear voices as muffled/slurred
  3. Hearing loss of all frequences
  4. May be overcome by increasing amplitude of sound (louder sound)
  5. Typically speak softly

Note: usually treatable

145
Q

Patient exhibits the below. What is the issue? What are four possible causes? treatable?

  1. Greater loss in higher frequencies
  2. difficulty hearing with two or more people
  3. noisy environments make hearing worse
  4. talk loudly
A

Sensorineural hearing loss

  1. Presbycusis
  2. noise-induced
  3. acoustic neuromas
  4. ototoxic medications

(Usually Irreversible–need hearing aid, cochlear implant)

146
Q

otorrhea

A

Ear discharge/ drainage exiting the ear

147
Q

Epistaxis

A

bleeding from the nose.

148
Q

what is tragal tenderness associated with?

A

otitis externa

149
Q

Which part of the ear performs sound interpretation

A

Inner ear

150
Q

How do I test if pupils are reactive to accommodation?

A

Have person’s eyes converge on an object coming closer to their nose

151
Q

focal hair loss

A

patchy, localized hair loss

152
Q

What are four causes of otalgia?

A
  1. inflammatory conditions
  2. infection
  3. trauma
  4. foreign body
153
Q

Oculo dextra (OD)

A

right eye

154
Q

Secondary skin lesion that is:

  • below the skin plane
  • superficial linear or “dug out”
  • traumatized area
A

excoriation

155
Q

How do you test visual acuity?

A

Snellen chart

156
Q

Patient presents with a STYE. Describe what this is. Does the patient experience pain?

A

Hordeolum=stye

Inflammation of the glands or ducts

YES PAIN; Hordoleum Hurts

157
Q

Primary skin lesion that is:

  • Elevated
  • Palpable
  • Fluid-filled cavity
  • 1.0 cm or greater
  • Filled with serous fluid
A

bulla

158
Q

What are the 3 risk factors for oral cancer?

A
  1. Sore tongue/lesions
  2. tobacco
  3. alcohol
159
Q

type of skin lesion: scratch

A

excoriation

160
Q

ecchymosis

A

Skin lesion that is:

  • variable size
  • reddish purple
  • nonblanching
161
Q

When doing the internal inspection of the nose, what hsould you avoid touching?

A

The septum

162
Q

Type of skin lesion that is:

  • vascular
  • central red body with radiating arms
  • central blanching
A

spider angioma

163
Q

ulcer

A

Secondary skin lesion that is:

  • below the skin plane
  • loss of epidermis and dermis
  • may bleed
164
Q

scotoma

A

blind spot in an otherwise normal field of vision (specks or areas where patient can’t see)

165
Q

Primary skin lesion that is:

  • palpable
  • filled with semiliquid material or fluid
A

cyst

166
Q

Secondary skin lesion that is:

  • below the skin plane
  • skin thinning
A

atrophy

167
Q

What are four causes of otorrhea?

A
  1. trauma
  2. infection
  3. foreign body
  4. cancer
168
Q

What are characteristics of terminal hair?

A
  1. coarse
  2. thick
  3. pigmented
  4. length varies
169
Q

Lesion

A

An area of abnormal tissue change

170
Q

What three structures do you examine when you examine the fundus?

A

(1) retina
(2) optic disk and cup
(3) macula and fovea

171
Q

Secondary skin lesion

A

later evoluation or result of external trauma to the primary lesion

172
Q

Ptosis

A

Drooping of the upper eye lid

173
Q

fasiculations

A

a brief, spontaneous contraction affecting a small number of muscle fibers, often causing a flicker of movement under the skin. It can be a symptom of disease of the motor neurons.

174
Q

Fitzpatrick Skin Type

A
  1. Red hair with freckles
  2. Fair skinned, fair hair caucasians
  3. Darker caucasians
  4. Mediterranean caucasians
  5. hispanic, some blacks
  6. darker blacks
175
Q

Eye moves laterally. Which cranial nerve?

A

CN VI Abducens

176
Q

How do you assess motor function for CN VII (facial)

A
  1. Raise eyebrows (look for forehead wrinkling)
  2. Close eyes tightly; instruct patient not to let you open them
  3. Frown
  4. Smile (Display upper and lower teeth simultaneously)
  5. Puff out both keeps, poke cheeks
177
Q

Keloid

A

Type of skin lesion that is:

  • elevated
  • grows beyond wound boundaries
  • the result of an overgrowth of dense fibrous tissue that usually develops after healing of a skin injury.
178
Q

Hypertropia

A

a condition of misalignment of the eyes (strabismus), whereby the visual axis of one eye is HIGHER than the fellow fixating eye.

179
Q

Bell’s Palsy

A

Patient presents with:

  1. On one side: Forehead not wrinkled; eyebrow not raised (when asked to raise eyebrows). Other side has raised eyebrow, wrinkles.
  2. On one side: Paralysis of the lower face (same side as eyebrow issue)
180
Q

What are the four skin pigments?

A
  1. Melanin
  2. Carotene
  3. Oxyhemoglobin
  4. Deoxyhemoglobin
181
Q

How do you assess CN II (olfactory)?

A
  1. Have patient close eyes/ close one nostril
  2. wave scent; identify
  3. have patient close other eye
  4. wave different scent; identify
182
Q

burrow

A

Primary skin lesion that is:

  • raised tunnel
183
Q

How do you assess sensory function for CN V (trigeminal)?

A

Cotton ball stroking bilaterally: forehead, cheekbones, and mandible

184
Q

Which type of hearing loss is tinnitus associated with?

A

Sensorineural

185
Q

Order of Eye Exam (5 steps)

A

(1) Visual acuity (2) Visual Fields (3) Inspection (4) Extra Ocular Movements (5) Ophthalmoscopic exam

186
Q

What are six medications to be aware of with regard to ears?

A
  1. Aminoglycosides
  2. Aspirin
  3. NSAIDS
  4. Furosemide
  5. Quinine
  6. Vancomycin
187
Q

Primary skin lesion that is:

  • Non-palpable
  • flat
  • circumscribed
A

<1.0 cm: Macule

1.0cm or greater: Patch

188
Q

seborrhea

A

red, itchy rash on your scalp that has flaky scales

189
Q

How do you test for patency?

A
  • block one nostril
  • have patient inhale/exhale through opposite nasi
190
Q

papule

A

Primary skin lesion that is:

  • palpable
  • elevated
  • solid
  • <1.0 cm
191
Q

type of skin lesion: vitiligo

A

patches

192
Q

type of skin lesion: athlete’s foot

A

fissure

193
Q

Secondary skin lesion that is:

  • below the skin plane
  • Linear crack from epidermis to dermis
  • dry or moist
A

fissure

194
Q

How do you assess trachea position?

A
  • Place finger along trachea
  • Note space between trachea and sternocleidomastoid
195
Q

annular

A

ring-shaped

196
Q

type of skin lesion: scab

A

crusting

197
Q

atrophy

A

Secondary skin lesion that is:

  • below the skin plane
  • skin thinning
198
Q

type of skin lesion: herpes simplex

A

vesicle

199
Q

How do you palpate a lymph node?

A

Use pads of index and middle fingers, rotary motion

200
Q

tragal tenderness

A

External ear tenderness (see picture)

201
Q

Bone or cartilage? tip of nose

A

cartilage

202
Q

Which part of IPPA is used to assess the eyes?

A

Inspection, Palpation NO PERCUSSION, NO AUSCULTATION

203
Q

What is the white reflex?

A

It assesses ocular alignment. It is the corneal light reflex in which you assess ocular alignment by comparing the position of light reflection in the corneas (look for Strabismus)

IF NOT SURE OF RESULTS: cover/uncover test

–cover one eye, then uncover –>look for drift in the previously uncovered eye

204
Q

androgenetic alopecia

A

pattern baldness (male or female)

205
Q

Primary skin lesion that is:

  • palpable
  • elevated
  • solid
  • 0.5 cm or greater
  • deep
A

Nodule

206
Q

What kind of tuning fork do you use for the weber test?

A

512 hz

207
Q

hypertrophic scar

A

characterized by erythematous, pruritic, raised fibrous lesions that typically do not expand beyond the boundaries of the initial injury and may undergo partial spontaneous resolution

208
Q

How do you assess CN IX (Glossopharyngeal) and CN X (Vagus)?

A
  1. Tongue depressor, “Ahh” (soft palate and uvula rise and fall)
  2. Gag
209
Q

You perform a Rinne test on the RIGHT ear. Patient is able to hear the tuning fork when it is pressed against the mastoid bone level with the ear canal. Once they stop hearing it there, you bring it forward (shape of U). Patient is able to hear it, but the sound disappears quickly. Interpret.

A

This means that AC>BC in the right ear

  • Right ear is affected
  • The patient has sensorineural hearing loss (SNHL)
210
Q

For internal eye examination, what are you inspecting?

A

(1) Iris
(2) Pupils
(3) Fundus

211
Q

Papilledema

A

a condition in which increased pressure in or around the brain causes the part of the optic nerve inside the eye to swell.

212
Q

type of skin lesion: abrasion

A

excoriation

213
Q

Patient presents with a HORDEOLUM. Describe what this is. Does the patient experience pain?

A

Hordeolum=stye

Inflammation of the glands or ducts

YES PAIN; Hordoleum Hurts

214
Q

Type of skin lesion expected with trauma

A

ecchymosis

215
Q

Type of skin lesion expected with intravascular defects.

A

Purpura skin lesions

216
Q

Skin lesion that is:

  • >3 mm
  • reddish purple
  • nonblanching
A

purpura

217
Q

Pupillary constriction. Which cranial nerve?

A

CN III Oculomotor

218
Q

type of skin lesion: wart

A

papule

219
Q

Patient presents with a CHALAZION. Describe what this is. Does the patient experience pain?

A

Granuloma (cyst) of the meibomen gland

PAINLESS Chalazion is Chill

220
Q

You perform a Weber test. Patient hears the sound louder in their LEFT ear. What can you conclude?

A

The patient either has:

  • SENSORINEURAL deficit in RIGHT ear
  • CONDUCTIVE deficit in LEFT ear

How do you differentiate? Rinne Test.

221
Q

What are characteristics of vellus hair?

A
  • Short
  • fine
  • soft
  • non-pigmented
222
Q

Secondary skin lesion that is:

  • below the skin plane
  • loss of epidermis and dermis
    • may bleed
A

ulcer

223
Q

Patient presents with:

  • Periorbital edema
  • Puffy PALE face
  • Lips may be swollen
A

Nephrotic syndrome

224
Q

Patient presents with:

  • Red Cheeks
  • Hirsutism
  • Moon Face
A

Cushing’s Syndrome

225
Q

Nevi

A

moles

226
Q

type of skin lesion: 2nd degree burn

A

bulla

227
Q

type of skin lesion: scabies

A

burrow

228
Q

Secondary skin lesion that is:

  • Above the skin plane
  • dried blood, pus, or serum
A

crusting

229
Q

abcess

A

Primary skin lesion that is:

  • accumulation of purulent material, into the dermis and subcutaneous layer
230
Q

cheilitis

A

is inflammation of the lips

231
Q

What does the Weber test assess?

A

Ear examination: lateralization

232
Q

Which part of the ear performs sound transmission?

A

Middle ear

233
Q

otitis

A

Ear infection

234
Q

nystagmus

A

Nystagmus is a condition where the eyes move rapidly and uncontrollably

235
Q

type of skin lesion: insect bite

A

wheal

236
Q

Name four possible pathologies associated with PTOSIS (drooping of the upper eye lid)

A

(1) Congenital
(2) Bell’s palsy
(3) Myasthenia gravis
(4) CN III (Oculomotor nerve) damage (ex. Horner’s syndrome)

237
Q

scar

A

Type of skin lesion that is:

  • fibrous tissue
  • hypertrophic v. atrophic
  • limited to wound boundaries
238
Q

turgor of skin

A

speed at which skin returns into place

239
Q

Borders of posterior triangle (neck)

A
  1. sternocleidomastoid
  2. trapezius
  3. clavicle
240
Q

monocular

A

one eye

241
Q

Appropriate cup:disk ratio?

A

Cup should be no more than 1/2 of the disk

242
Q

Where is the parotid duct located?

A
  • Bucal mucosa
  • Superficial to the mandible
243
Q

Palpebral fissure

A

the space between the margins of the eyelids

244
Q

Which two sinuses are you able to palpate in the nose and sinus exam?

A
  1. Frontal
  2. Maxillary

CANNOT PALPATE ETHMOID OR SPHENOID

245
Q

How do you test for lid lag when assessing the extra ocular movements with the “H-method”?

A

Watch the lid on the downard vertical to look for lid lag

246
Q

type of skin lesion: cheilitis

A

fissure

247
Q

Type of skin lesion that is:

  • fibrous tissue
  • hypertrophic v. atrophic
  • limited to wound boundaries
A

scar

248
Q

Exotropia

A

a form of strabismus where the eyes are deviated OUTWARD

249
Q

purpura

A

Skin lesion that is:

  • >3 mm
  • reddish purple
  • nonblanching
250
Q

Macule

A

Primary skin lesion that is:

  • Non-palpable
  • flat
  • circumscribed
  • <1.0 cm
251
Q

Plaque

A

Primary skin lesion that is:

  • palpable
  • elevated
  • solid
  • 1.0 cm or greater
  • superficial
  • surface area > height
252
Q

How do you test for NYSTAGMUS when assessing the extra ocular movements with the “H-method”?

A

Stop on the lateral portions of the H to look for nystagmus

253
Q

type of skin lesion: dry skin

A

scaling

254
Q

Nephrotic syndrome

A

Patient presents with:

  1. Periorbital edema
  2. Puffy PALE face
  3. Lips may be swollen
255
Q

excoriation

A

Secondary skin lesion that is:

  • below the skin plane
  • superficial linear or “dug out”
  • traumatized area
256
Q

Oculo uterque

A

both eyes

257
Q

Skin lesion that is:

  • variable size
  • reddish purple
  • nonblanching
A

ecchymosis (black and blue mark)

258
Q

How do you assess lateralization (with regard to hearing)?

A

Weber test

259
Q

If patient is experiencing a sensorineural hearing loss, where in the ear would you expect the issue to be located?

A

inner ear, cochlea nerve

260
Q

Periorbital edema

A

Periorbital puffiness, also known as “puffy eyes”, or swelling around the eyes

261
Q

dysconjugate

A

eyes not both fixated on the same point

262
Q

Acromegaly

A

Patient presents with:

  1. Brow prominent,
  2. soft tissues of nose, ears, and lips enlarged
  3. Jaw prominent
263
Q

xerosis

A

abnormally dry skin

264
Q

You perform a Rinne test. What ratio do you expect for AC:BC

A

AC>BC

AC:BC ~2:1

265
Q

Type of skin lesion expected with bleeding disorders

A

ecchymosis

266
Q

Anisocoria

A

condition characterized by an unequal size of the eyes’ pupils

267
Q

Primary skin lesion that is:

  • Keratin plugged opening of a sebeceaous gland
A

comedone (black head)

268
Q

Hypotropia

A

a condition of misalignment of the eyes (strabismus), whereby the visual axis of one eye is LOWER than the fellow fixating eye.

269
Q

Esotropia

A

form of strabismus in which one or both eyes turns INWARD.

270
Q

Otosclerosis

A

An inherited disorder that causes hearing loss due to the ear’s inability to amplify sound. There are three small bones that connect to the ear drum to help amplify sound waves. When someone has this condition, one of the bones is unable to vibrate freely.

271
Q

Eye moves down when looking toward nose. Which cranial nerve?

A

CN IV (Trochlear)

272
Q

vesicle

A

Primary skin lesion that is:

  • Elevated
  • Palpable
  • Fluid-filled cavity
  • <1.0 cm
  • Filled with serous fluid
273
Q

type of skin lesion: dandruff

A

scaling

Clinical Assessment Exam 1 (2 decks)

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