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Health Assessment > Exam 2- Module 4 > Flashcards

Exam 2- Module 4 Flashcards

1
Q

Skin structure

A

Epidermis: outer layer

Dermis: inner supportive layer

Beneath these layers is subcutaneous adipose tissue

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2
Q

Epidermal appendages

A

Formed by tubular invagination of epidermis down into underlying dermis

Sebaceous glands

Sweat glands : eccrine and apocrine

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3
Q

Newborn: lanugo

A

Fine downy hair

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4
Q

Newborn: vernix caseosa

A

Thick, cheesy substance

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5
Q

Newborn: sebum

A

Holding water in skin producing milia

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6
Q

What happens to children epidermis?

A

Thickens, darkens, becomes lubricated

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7
Q

Adolescent developmental competence

A

Apocrine gland secretions increase

Fat deposits increase

Secondary sex characteristics

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8
Q

Pregnant: Linea nigra

A

Increased pigmentation midline of abdomen

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9
Q

Pregnant: chloasma

A

Discoloration changes of face

“Mask of pregnancy”

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10
Q

Pregnant: striae gravidarum

A

Stretch marks

Develop over abdomen, breast, thighs

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11
Q

Aging adult: elasticity

A

Skin folds and sags

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12
Q

Aging adult: sweat and sebaceous glands

A

Decrease in number and function

Dry skin

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13
Q

Aging adult: senile purpura

A

Discoloration due to increasing capillary fragility

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14
Q

Aging adult: skin breakdown

A

Cell replacement is slower and wound healing delayed

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15
Q

Aging adult: hair matrix

A

Melanocytes decrease

Gray fine hair

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16
Q

Skin pigmentation

A

Pallor: pale

Jaundice: yellow

Erythema: red

Cyanosis: blue

Color change transient or due to pathology?

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17
Q

Inspecting lesions

A

Color

Elevation

Pattern or shape

Size

Location

Any exudate: color or odor

Woods light: UV detects fluorescing lesions

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18
Q

Hair inspection

A

Color- melanin

Texture -hair care products

Distribution

Lesions -divide hair in sections

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19
Q

Inspection nails

A

Shape and contour: angle nail base 160 degrees

Consistency

Capillary refill 1-2 seconds

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20
Q

*ABCDE skin assessment

A 
A- Asymmetry
B- border
C- color
D- diameter
E - elevation and enlargement
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21
Q

Shapes and configurations of lesions

A 
Annular or circular
Confluent- all over
Discrete- small
Grouped
Gyrate- looks like worm
Target or iris - spot in middle
Linear
Polycyclic -irregular shape but clustered 
Zosteriform- radiates to specific area and is grouped
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22
Q

Sternomastoid

A

Enables head rotation and flexion

Divided neck into two triangles: anterior and posterior

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23
Q

Trapezius muscles

A

Move shoulders

Extend and turn head

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24
Q

Thyroid gland

A

Straddles trachea in middle of neck

Synthesizes and secretes T4 and T3 that stimulate cellular metabolism

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25
Q

Lymphatic system

A

Extensive vessel system

Major part of immune system

Detects and eliminates foreign substances from body

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26
Q

Inspection and palpation of skull

A

Size and shape

Should feel symmetric and smooth

Cranial normal protrusions: forehead, lateral edge of parietal bones, occipital bone, mastoid process behind ears

Palpate zygomatic bone

Palpate temporomandibular joint when person opens mouth note movement without limitation and tenderness

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27
Q

Inspection of face

A

Facial expression and appropriateness to behavior and mood

Facial structures symmetric

Symmetry in eyebrows, palpebral fissures, nasolabial folds, sides of mouth

Abnormalities: coarse facial features, explothalmos, skin pigmentation, any swelling

Involuntary movements?

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28
Q

Inspection and palpation of neck

A

Symmetry

Range of motion

Lymph nodes

Trachea

Thyroid gland -posterior, anterior, bruit (if enlarged)

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29
Q

Infant and children: skull

A

Measure head each visit 2 years- 6 years

Infants head and posture control

Infant: turn head side to side 2 weeks

Tonic head reflex when supine

Head control: 4 months

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30
Q

Capital succedaneum

A

Swelling from birth trauma

Resolves in first few days

No treatment

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31
Q

Cephalhematoma

A

Subperiosteal hemorrhage

Birth trauma

Appears several hours after birth and increases in size

Reabsorbed during first few weeks of life without treatment

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32
Q

Craniotabes

A

Softening of skulls outer layer

Do not palpate unless suspected, because other abnormal findings

Can be normal especially in premature

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33
Q

Infant and children: percussion

A

Directly percuss plexor finger against head surface

“Cracked pot” sound

Normal before closer of fontanels

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34
Q

Infant and children: auscultation

A

Bruits are common in skull 4-5 yrs or w/ anemia

Systolic or continuous; heard over temporal area

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35
Q

Infant and children: transillumination

A

Suspect abnormal head size of intracranial lesion

Rubber-collared flashlight firmly on infant skull

Explore regions of head

A small ring around flashlight is normal

Should not see large halo around rubber collar

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36
Q

Chloasma

A

2nd trimester

Blotchy, hyperpigmented area over cheeks and forehead fades after delivery

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37
Q

Hydrocephalus

A

Obstruction of drainage of cerebrospinal fluid

Excessive accumulation

Increasing intracranial pressure

Enlargement of head

Dilated scalp veins, frontal bossing, “setting sun” downcast eyes

Thin cranial bones, separate sutures, percussion “cracked pot” sound

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38
Q

Pager disease of bone (osteitis deformans)

A

Bone disease

Softens, thickens, deforms bone

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39
Q

Acromegaly

A

Excessive secretion of growth hormone from pituitary after puberty

Enlarged skull and thick cranial bones

Elongated head, massive face, prominent nose and lower jaw, heavy eyebrow ridge, coarse facial features

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40
Q

Torticollis (wryneck)

A

Hematoma in sternomastoid muscle

Injured by intrauterine malposition

Head tilt to one side and limited ROM to opposite side

Headache, limited ROM, stiffness in neck

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41
Q

Thyroid, multiple nodules

A

Indication of inflammation or multinodular goiter

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42
Q

Thyroid, single nodule

A

Solitary: benign greater risk of malignancy

Cancerous: hard and have surrounding structure

43
Q

Pilar cyst (wen)

A

Smooth, firm, flucuant swelling on scalp

Pressure causes overlying skin to be shiny and taut

Benign growth

44
Q

Parotid gland enlargement

A

Rapid painful inflammation

Swelling occurs with blockage of duct, abscess, tumor

Note selling anterior to lower ear lobe

45
Q

Stenson duct obstruction

A

Aging adults dehydrated from diuretics or anticholinergics

46
Q

Pediatric facial abnormalities

A

Fetal alcohol syndrome

Congenital hypothyroidism

Down syndrome

Atopic ( allergic)

Allergic salute and crease

47
Q

Hyperthyroidism

A

Increased heart rate

Weight loss

48
Q

Hypothyroidism

A

Decrease heart rate

Weight gain

49
Q

Eyes: inspection

A

Fundus

Retina and vessels

Macula

Fovea centrailis

50
Q

*Visual reflex: pupillary light reflex

A

Normal construction of pupils when bright light shines on retina

51
Q

Visual reflex: fixation

A

Reflex direction of eye toward an object attracting attention

52
Q

Visual reflex: accommodation

A

Adaption of eye for near vision

53
Q

Developmental competence: again adults

A

Pupil size decreases

Lens loses elasticity becomes hard and glasslike (decrease ability to change shape for near vision) PRESBYOPIA

Age 70: transparent fibers of lens begin to thicken and yellow- beginning of cataracts

54
Q

*Aging: cataracts

A

Lens opacity

Clumping of proteins in lens

55
Q

Aging/eyes: glaucoma

A

Increase intraocular pressure

Chronic open-angled glaucoma is most common type

56
Q

Aging/eyes: muscular degeneration

A

Breakdown of cells in masculine of retina

57
Q

Aging: loss of central vision

A

Most common cause of blindness

Unable to read fine print, sew, do fine work

Can cause distress

58
Q

Ishihara chart

A

Color vision

59
Q

Equipment for eye vision test

A

Snellen eye chart

Hand held visual screener

Opaque card and occluder

Penlight

60
Q

Snellen eye chart

A

Lines of letters decreasing in size

Eye level, 20 ft

Glasses and contact lenses should stay on, remove only reading glasses

61
Q

*Test near vision

A

Handheld vision screener with various sizes of print

62
Q

Confrontation test: vision

A

Peripheral vision

Persons vs yours

Come at different angles with one eye covered

63
Q

Corneal light reflex

A

Hirshberg test

Assess parallel alignment of eye exes by shining a light toward persons eyes

12 in away

Cornea reflection same on both eyes

64
Q

Cover test

A

Stare at nose

Opaque card cover one eye

If weakness exists: covered eye will drift into relaxed position

Uncovered eye should stare straight ahead

65
Q

Iris and pupil

A

Iris is usually flat and round

Note size, shape, equality of pupils

Pupillary light reflex: darken room and ask person to gaze in distance

66
Q

*PERRLA

A

Pupils

Equal

Round

React

Light

Accommodation

67
Q

Eyes: optic disc

A

Color: creamy yellow- orange to pink

Shape: round or oval

Margins: distinct or sharply

Cup-disc ratio: physiologic cup is brighter yellow-white than rest of disc, width no more than half disc diameter

68
Q

Aging/eyes: xanthelasma

A

Soft, raised yellow plaques occurring on lids at inner canthus

Mainly in women

69
Q

*Tympanic membrane

A

Eardrum

Translucent membrane with pearly grey color

70
Q

Middle ear

A

Tiny air-filled cavity inside temporal bone

Contains tiny ear bones (auditory ossicles) malleus, incus, stapes

71
Q

Ear: Eustachian tube

A

Opening that connects middle ear with nasopharynx

Allows passage of air

Closed but opens with swallowing or yawning

72
Q

3 functions of ear

A

Sound vibrations from outer to inner

Protects ear by reducing amplitude of loud sounds

Eustachian tube allows equalization of air pressure on each side of TM so it doesn’t rupture

73
Q

Inner ear

A

Holds bony labyrinth

Sensory organs for equilibrium and hearing

Coachella: central hearing apparatus

Functions can be assessed

74
Q

Hearing

A

3 levels

Peripheral- ear transmits sounds and coverts to vibrations to electrical impulses to be analyzed by brain

Brain stem

Cerebral cortex

75
Q

Hearing: amplitude

A

Loudness

76
Q

Hearing: frequency

A

Pitch or number of cycles per second

77
Q

Conductive hearing loss

A

Mechanical dysfunction of external or middle ear

Partial loss, bales to hear if sound amplitude is increased

Cause can be impact of cerumen, foreign bodies, perforated TM, pus in serum in middle ear, otoscelerosis (decreased mobility of ossicles)

78
Q

Sensorineural hearing loss

A

Aka Perceptive

Inner ear, cranial nerve VIII, or auditory areas of cerebral cortex

May not be able to understand words

Can be caused by presbycusis

79
Q

Presbycusis

A

Gradual nerve degeneration

Occurs with aging

Ototoxic drugs- affect hair cells in cochlea

80
Q

Mixed hearing loss

A

Combination of conductive and sensorineural types in same ear

81
Q

Otoscelerosis

A

Conductive hearing loss

20-40 yrs

Gradual hardening impedes transmission of sound

Progressive deafness

82
Q

Aging: ears

A

Cilia lining ear canal becomes coarse and stiff

Cerumen is drier because of atrophy of apocrine glands

Pendulous earlobe with linear wrinkling because of loss of elasticity of pinna

83
Q

Aging/ears: presbycusis

A

Hearing loss occurs with aging

Even in ppl in quiet environment

Gradual sensorineural loss by nerve degeneration in inner ear or auditory nerve

High-frequency tone loss

84
Q

Tittinus

A

Ringing, crackling, buzzing in ear

85
Q

Vertigo

A

Dizzy

86
Q

Ear examination equipment

A

Otoscope with bright light

Pneumatic bulb attachment -with infant or young child

Tuning forks 512 and 1024 Hz

87
Q

*Romberg test

A

Ability of vestibular apparatus in inner ear to help maintain standing balance

Intactness of cerebellum

Proprioception as part of neurological system

88
Q

Nose, mouth, throat: pregnant women

A

Nasal stuffiness & Epistaxis from increased vascularity in upper respiratory tract

Gums maybe be hyperemic and softened and may bleed with normal tooth brushing

89
Q

Nose, mouth, throat: aging adult

A

Loss of subcutaneous fat

Atrophic tissues ulcerated easily: leads to infection

Tooth loss

Diminished taste and smell

Mastication issues

90
Q

Bifid uvula

A

Uvula split completely or partially

10% American Indian groups

91
Q

Cleft lip and cleft palate

A

Most common in asians

Intermediate in white

Least common in blacks

92
Q

*strambismus

A

Cross eyed vision

Person cannot align both eyes

One of eyes is turn in, out, up or down

93
Q

Diplopia

A

Double vision

94
Q

*Whispered voice test

A

One ear at a time

Hearing in other ear by placing finger on Travis and rapidly pushing it in and out of auditory meatus

Shield lips- person cannot lip read

Head 30-60 cm (1-2ft) from person ear

two-syllable words

95
Q

*tuning fork test

A

Measures air conduction (AC)

Or bone conduction (BC) sound vibrates through cranial bones in inner ear

Hold tuning fork at stem and string me softy on back of hand

96
Q

Jugular vein

A

JVD sign or central venous pressure (CVP)

Pressure in vena cava

How much blood flow into heart and how well heart can move blood to lungs and body

97
Q

Jugular being assessment

A

Head at 45 degrees on side

Measure highest point pulsations can be detected in vein

Normal 6-8cm

If too high: heart failure, or high pressure in lungs backing up to R side heart

98
Q

Palpebral fissure

A

Open space between eyelids

99
Q

Othalmoscope looks at

A

Optic disc

Retinal vessels

General background

Macula

100
Q

Snellen eye chart

A

Visual acuity

101
Q

Cover test

A

Muscle weakness

102
Q

Conjuctivitis

A

Reddened conjunctiva

103
Q

Conjunctiva

A

Mucous membrane that covers front of eye PINK

Sclera: white

Health Assessment (11 decks)

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