final exam Flashcards by Michelle Anderson

breast, age 15-25, single round firm well deleanted very mobile nontender

Fibroadenoma

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breast, age 35-50 single or multiple, soft to firm, elastic, well delinated, round, mobile tender

cyst

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breast, age 30-90 single irregular not dileanted fixed non tender retraction may be present

cancer

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scaly nipple that weeps

pagents disease

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best time to do self breast exam

5-7 days after menses

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recommendations for breast screening

mammography annual beginning age 40. clinical breast exam every 3 years age 20-39 annually after age 40

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best breast exam technique for breast mass detection

vertical strip

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most palpable nodes, normal one or more soft small <1cm nontender

central nodes

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joint capsule, cartilage, the synovial fluid, synovium, intra articular ligaments

articular structures

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periarticular ligaments, tendons, bursae muscle, fascia bone nerve and skin

extra articular structures

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tendons connect:

muscle to bone

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ligaments connect:

bone to bone

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Pouches of synovial fluid that cushion the movement of tendons and muscles over bone or other joint structures.

Bursae

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For medial nerve compression by tapping on inside of wrist

tinels sign, carpal tunnel test

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hold writs back to back or flex wrists

phalens sign, capal tunnel test

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adduct pts arm across chest

if pain and tender, arthritis

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pt supine, knee slightly flexed, move thigh about 30 degrees, laterally

valgus test, for medial ligament damage of knee

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muscle strength barely flicker trace

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muscle strength active movement

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muscle strength active movement against gravity

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muscle strength active with resistance

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muscle strength active against full resistance without fatigue

5 normal

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symptoms of carpal tunnel

pulp of index finger numbness, decreased hand grip, finkelsteins test, thumb test painful, weakness in thumb adduction, tinels sign and phalens sign

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Where would is most common place to find herniated disc.

L5-S1 or L4-L5

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how to test for herniated disk

pain when raising leg when pt is supine calf wasting weak ankle dorsiflexion absent ankle jerk

lyme disease

fever flu like symptoms pain and weakness in arms an legs swelling and pain like arthritis. loss of control of facial muscles. numbess and tingling in hand feet and back

degenerative joint disease with tenderness, seldom warm, rarely red, brief stiffness in mornings or being sedentary, limitation in motion, heberdens nodes

Osteoarthritis

back pain, fx

osteoporosis

aching pain in lumbosachral area, acute, work related heavy lifting, poor conditioning, obesity

mechanical back pain

chronic, inflammation, tender warm seldom red, stiffness lasting more than an hour, weakness, fatique, weight loss, low fever

rheumatoid arthritis

cranial nerve 1

smell

cranial nerve 2

visual acuity, visual fields, ocular fundi

cranial nerve 3

pupillary reactions, use pen light

cranial nerve 4and 6

eye movement

cranial nerve 5

corneal reflexes, facial sensations, jaw movements

cranial nerve 7

facial movements, observe for tics

cranial nerve 8

Acoustic whisper test rinne test weber test

cranial nerve 9 and 10

Glassophalyngeal and vagus, voice and palate gag reflex

cranial nerve 11

spinal accessary, shoulder and neck movements

cranial nerve 12

tongue

function of cerbrum

thought and action

function of diencephalon, forebrain

hypothalamus, thalamus endocrine function, homeostasis, hearing, smell and vision, touch perception

function on brain stem

basic vital life functions: breathing, heartbeat, and blood pressure

cerbellum

movement and balance

reflexes 4+

brisk hyperactive clonus

reflexes 3+

brisker than average

reflexes 2+

average, normal

reflexes 1+

somewhat diminished , low normal

reflexes 0

no response

alert

responds fully

lethargy

drowsy but opens eyes and responds and falls back to sleep

obtuded

opens eyes respond slowly confused

stupor

only after painful stimuli they respond

coma

no response

tremors, resting (static) tremors

most prominent at rest. may decrease or disappear with voluntary movement

tremors, posturant

while maintaining a posture, hyperthyroidism, anxiety, and fatigue

tremors, intention

absent at rest, appear with movement, often gets worse as target gets closer. disorders of cerebellar path ways, ms

spastic hemoisparesis gait,

corticospinal tract lesion in stroke, poor control of flexor muscles during swing phase

cerebellar ataxia

gait is staggering, unsteady

parkinsonian gait

ganglia defects posture is stooped with flexion of head arms hips and knees. pts are slow getting started. shuffling turn all in one piece

scissors gait

spinal cord disease bilateral extremity spasticity. cerebral palsy appear to be walking through water

steppage

foot drop

liver, gallbladder location

right upper quadrant

spleen stomach aorta pancreas

left upper quadrant

ascending colon apendex

right lower quadrant

descending colon

left lower quadrant

pt supine place hand on pts right leg ask pt to raise leg or put on left side extend right leg at hip painful means appendix

psoas sign

referred rebound tenderness right lower quadrant during left sided pressure

rovsings sign

hook thumb around gall bladder or liver

murphys sign

obturator

flex thigh at hip knee bent rotate painful in appendix

gray turner sign

pancreatic blue tone of skin

protuberant abdomen, with bulging flanks, dull on percussion

ascites

scrotum red, vas deferens inflammation, common with chlamydia

acute epididymitis

nodule or ulcer on penis, non tender common in uncircumcised men

carcinoma of the penis

nontender fluid filled mass within the tunica vaginalis transliluminates, fingers can get above mass

hydrocele

painless moveable cystic mass just above testes, transilluminates, contains sperm

spermatocele

varicose veins of the spermatic cord, usually found on left feels like bag of worms separate from testes, slowly collapse when scrotum is elevated

varicocele

most common hernia, often into scrotum, hernia comes down the inguinal canal and touches finger tip

indirect hernia

less common, usually men over 40, Rarely into scrotum. Hernia bulges anteriorly and pushes the side of finger forward

Direct hernia

least common, more common in women

femora

Gray or white vaginal discharge, unpleasant odor

Bacterial vaginosis

yeast white curdy no smell itchy

candidiasis

trichomonas

yellowish green or gray may smell itchy pain

cervical cancer screening guidlines

begin at age 21 every 3 years | age 30-65 every 3 years unless 3 neg than every 5 years

normal prostate gland

round heart shaped

benign hyperplasia

smooth firm symmetrical prostate

cancer of prostate

hard, irregular

cancer of the rectum

firm, nodular, rolled edge of ulcerated cancre