Hair/Skin/Nails/HEENT Flashcards
(104 cards)
1
Q
Symptoms associated with Geographic Tongue
A
Peeling tongue
General discomfort or the tongue or mouth
Soreness or burning of the tongue which is worsened by spicy or acidic foods.
Insignificant finding
2
Q
Snoring can indicate
A
sleep apnea
Increased risk of cardiac event
3
Q
Epistaxis
A
nosebleeds
4
Q
Mallampati classification
A
Pre-op scoring related to intubation and visualization of larynx
5
Q
Whispered voice test detects
A
high tone loss
6
Q
Weber hearing test
A
Tuning fork on top of head
Should hear sound equally loud in both ears
7
Q
Rinne hearing test
A
Mastoid bone then air
Sound should be heard 2x as long by air conduction than by bone conduction
8
Q
Otoscopic technique
adult vs child
A
Adult- pull pinna upward and backward
Child- pull pinna down
9
Q
Tympanic membrane
A
Eardrum
Should be pearly grey and slightly concave
10
Q
Cone of Light reflux
A
7 o’clock in L ear
5 o’clock R ear
11
Q
Vertigo
A
room spinning or spinning yourself
12
Q
Tinnitus
A
ringing or buzzing sound in ear
13
Q
Sensorineural hearing loss
A
Neuro
Presbycusis- age related nerve degeneration
Ototoxicity- drugs like antibiotics or NSAIDs
14
Q
Conductive hearing loss
A
Mechanical dysfunction from cerumen impaction, FBO, perforate TM, pus, or otosclerosis
15
Q
Organ of corti
A
Hair cells that bend and turn vibrations into electrical impulses which are carried to the brain by CN VII
16
Q
Papilledema
A
Occurs w/ increaed intracranial pressure across the optic nerve
17
Q
Hypertensive retinopathy
A
-flame hemorrhages
-AV nicking
-cotton wool spots
-hard exudates
18
Q
Diabetic retinopathy
A
-dot/blot hemorrhages
-cotton wool spots
-hard exudate
-neovascularization
19
Q
Red reflux
A
red glow filling the pt’s pupils
Inspection of the ocular fundus w/ ophthalmoscope
20
Q
Corneal light reflux
A
Shine light toward the eyes. Light should be reflected at exactly the same spot in each cornea.
21
Q
Conjugate movement
A
when both eyes move, their axis remain parallel
test using H-pattern
22
Q
Pupillary light reflex tests which cranial nerves?
A
CN II and CN III
23
Q
Pupillary light reflex
A
Involves adjustments in pupil size w/ changes in light levels
The reflex is consensual. Normally light that is directed in one eye produces pupil constriction in both eyes.
Must test direct and consensual
24
Q
PERRLA
A
Pupils are equal, round, reactive to light and accomodation
25
Accomodation
Change in pupil size in response to a closer object
26
Convergence
Motor movement of the pupil
27
Conjuctivitis
bacterial, allergic, or viral
28
Pterygium
Abnormal growth of conjunctiva
Can impair vision
29
Is it normal for a pt's eyes to approximate completely?
Yes
30
Diabetic retinopathy
Leading causes of blindness in diabetic pts
Diabetic pts should have eye exam once a yr
31
What cranial nerves make the eyes do tricks?
III, IV, and VI
32
EOMI
Extraocular movement is intact
Check by performing the cardinal fields of gaze - H pattern
33
How would you test cranial nerve XI (accessory)?
What complaints may a pt present w/ if there is damage to CN XI?
shrug shoulder and hold against resistance
34
Cranial nerves
Motor vs. accessory
Some Say Marry Money But My Brother Says Big Butts Matter Most
35
Cranial Nerves
Only Owls Observe Them Traveling And Finding Voldemort Guarding Very Secret Horcruxes
I- Olfactory
II- Optic
III- Oculomotor
IV- Trochlear
V- Trigeminal
VI- Abducens
VII- Facial
VIII- Vestibulocochlear
IX- Glossopharyngeal
X- Vagus
XI- Accessory
XII- Hypoglossal
36
CN I
Olfactory
sense of smell
37
CN II
Optic
vision
38
CN III
Oculomotor
pupillary reflex
39
CN IV
Trochlear
eye muscle movement
40
CN V
Trigeminal
ophthalmic, maxillary, and mandibular branch
41
CN VI
Abducens
extrinsic muscle movement of the eye
42
CN VII
Facial
taste
facial movements- smiling, closing of eyes, frowning, production of tears, and salivary stimulation
43
CN VIII
Vestibucochlear
sense of balance/equilibrium and sense of hearing
44
CN IX
Glossopharyngeal
produces gag and swallowing reflux
taste
45
CN X
Vagus
innervates muscles of throat and mouth for swallowing and talking
46
CN XI
Accessory
movement of traps and sternocleidomastoid muscles
47
CN XII
Hypoglossal
movement of tongue
48
Lymphadenopathy
>1cm lymph node enlargement from infection, allergy, or neoplasm
49
Stroke
*Neuro*
altered LOC, seizure activity, changes in vision, unequal pupils, speech difficulty, arm drift, paralysis of other limbs, unilateral facial paralysis/droop
Stroke spares the eyes as far as motor skills
50
Bell's Palsy
*motor skills*
sudden onset of stroke like sx, unilateral facial paralysis w/loss of blink control on affected side, decreased tearing, drooping of mouth on affected side, within 48 hrs --> altered taste, slurring, speech, drooling, ear pain, sound hypersensitivity on affected side
51
What is the priority when assessing a pt w/ facial asymmetry?
Asymmetry could be an abnormal sign
--> stroke, lesion, or CN damage
52
Clubbing is common in
COPD pts
53
Where can we check cap. refill if pt has nail polish on?
Instead of nail bed, look at opposite side of finger
54
Diminished cap. refill suggests?
poor perfusion
55
Nail assessment
Inspect and palpate
shape, contour, consistency, and color
cap. refill should be <2-3 seconds
56
Hirsutism
hair growth
Ex: facial hair like beards in women
57
Alopecia
may be toxic (chemo or illness) or a result of traction (tight braids, ponytails, ,waves, or barrettes)
58
Hair assessment
Inspect and palpate
Color, texture, distribution, and lesions
59
Malignant melanoma
Malignant skin lesions
-may arise from pre-existing moles
-usually brown can be mixed pigment
-irregular and notched borders
Any growth of a mole should be of concern
60
Squamous cell carcinoma
Malignant skin lesions
-arise from actinic keratinosis
-erythematous (red) scaly patch
-usually on hands or head
-bald scalps at higher risk
-grows rapidly
61
Basal cell carcinoma
Malignant skin lesions
-most common skin cancer
-face, ears scalp, and shoulders
-small pink or red papule
-looks like a large pore
62
Other pressure injuries
Pressure injuries caused by medical devices - nasal cannula, IV hub, tubing
Common sites- heels, sacrum, butt, and coccyx
63
Pressure Injury
Unstageable
black, dead, necrotic tissue
64
Pressure Injury
Stage 4
involves all skin layers extends to bone, tendons, and muscle
65
Pressure Injury
Stage 3
crater like, fat tissue exposed, rolled edges
66
Pressure Injury
Stage 2
looks like a blister, partial thickness skin loss
67
Pressure Injury
Stage 1
non-blanchable, erythema
68
Pressure Injuries
found over bony prominences
decreased blood circulation-ischemia (cell death)
pts typically lying down
common sites- heels, ischium, sacrum, elbow, scapula, vertebra, ankle, rib, and shoulder
69
Regularly assess the incontinent pt for signs of urine and feces
Lift skin folds for moisture
diaper dermatitis
Candidiasis- fungal infection
70
Purpura
-extensive patch of petechiae and ecchymosis
-red, non-blanchable
->3mm
71
Ecchymosis
severe bruising
72
Contusion
bruises
usually due to mechanical injury
73
Petechiae
-red, purple, or brown
-bleeding from superficial capillaries
-non-blanchable
-tiny 1-3 mm
74
Zosterform
linear along unilateral nerve route
Ex: Herpes Zoster (shingles)
75
Grouped
clusters
Ex: poison ivy
76
Discrete
individual lesions, separate
Ex: wart, skin tags, acne
77
Confluent
lesions which run together
Ex: hives
78
Annular
circular
Ex: ringworm
79
Secondary skin lesions
crust- scab, impetigo
scale- psoriasis
lichenification- chronic dermatitis
erosion- scratches
ulcer- pressure injury
fissure- athlete's foot, cracks on mouth
scar- surgical healing
keloid- ear piercing
80
Keloid
Secondary
-elevated and irregular
-darkened area of excess scare tissue, benign
-fibrous tissue replacement large scar and deformity
-original injuries include surgery, acne, ear piercings, infections, and burns
81
Scar
Secondary
-fibrotic change
-irregular area of connective tissue- collagen replaces normal tissue to repair skin lesion
82
Fissure
Secondary
-linear break in skin surface
-not related to trauma
83
Ulcer
Secondary
-deeper depression, loss of skin surface
-may bleed
-irregularly shaped
-will scar
84
Erosion
Secondary
-wearing away of superficial epidermis
-moist, shallow depression w/o bleeding
-no scar when healed
85
Lichenification
Secondary
-rough and thickened
-secondary to chronic irritation (itching)
86
Scale
Secondary
-shedding flakes
-keratinized cells
-flakey
87
Crust
Secondary
-dry blood or pus
-from vesicles or pustules
-scabs
88
Primary skin lesions
macule- freckle
patch- vitiligo, Mongolian Patch
papule- molloscum contagiosum
plaque- psoriosis
pustule- acne
wheal- bug bite, TB skin test
nodule- mole
tumor- squamous cell carcinoma
vesicle- herpes
bulla- burn, large blister
89
Pustule
Primary
-similar to vesicle but w/ pus
90
Wheal
Primary
-raised
-irregular shaped
-reddish and edematous
91
Nodule & tumor
Primary
-elevated
-solid
-hard or soft mass
-deeper in dermis than papule
nodule 0.5 cm -2 cm
tumors > 2 cm
92
Vesicle & bulla
Primary
-elevated
-fluid filled
-round or oval
-on top of skin
-translucent walls
vesicle < 0.5 cm
bulla > 0.5 cm
93
Cyst
Primary
-elevated
-distinct
-walled off, encapsulated
-containing fluid or semi-solid material
-originates in subcutaneous or dermis
94
Module & patch
Primary
-flat
-nonpalpable
-discolored
-circumscribed bored
macule <1 cm
patch >1 cm
95
Papule & plaque
Primary
-elevated
-solid
-palpable
-circumscribed border
-any color
papules < 0.5 cm
plaque > 0.5 cm
96
Primary & secondary skin lesions
traumatic or pathologic changes in previously normal structures
primary- develops on unaltered or "normal" skin
secondary- when a lesion changes over time or results from scratching, infection
color, elevation, pattern/shape, size, location & distribution, bruising
97
Mobility & turgor
Both assess elasticity of the skin
*tenting*
98
Edema
swelling
Edema fluid accumulation in the interstitial spaces
pitting vs non-pitting
4 point scale
1+ mild
2+ moderate
3+ moderate to severe
4+ deep pitting
99
Skin temp
palpate skin
should be warm and equal bilaterally
100
Pallor
White
-high acute stress (anxiety or fear)
-vasoconstriction from cold to cig. smoking
-edema
-darker skin --> assess mucous membrane, lips, and nail beds
101
Erythema
Red
-intense redness from dilated superficial capillaries
-fever, inflammation, emotional reactions (blushing)
-darker skin --> palpate the skin for increased warmth or edema
102
Cyanosis
Blue
-blueish mottled color from decreased perfusion & increased levels of deoxygenated blood
-lips, nose, cheeks, ears ,and oral mucous membranes
-can be non-specific sign
-decreased oxygen to brain
-check LOC and resp. distress
-hard to observe on darker skin
103
Jaundice
Yellow
-increased levels of bilirubin in the blood
-abnormal outside newborn cases
-1st noted in the palate junction and sclera
-may be present in skin covering body as a late sign as levels rise
-darker skin --> confused with normal finding of sub-conjunctival fatty deposits
104
ABCDEF
skin assessment of a lesion
Asymmetry
Border
Color
Diameter
Elevation or evolution
Funny looking
