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Review > Health Assessment > Flashcards

Health Assessment Flashcards

1
Q

Skin: Freckles (Ephelides)

A

Small, flat increase of brown melanin pigment

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2
Q

Skin: Nevus (mole)

A

A proliferation of melanocytes, tan to brown colour, flat or raised

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3
Q

Skin: Birthmarks

A

May be tan to brown colour

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4
Q

Skin: Danger Signs (ABCDE)

A 
A- Asymmetry of a pigmented lesion
B- Border irregularity
C- Colour variation (areas of black, grey, blue, red, white, pink) or dark black colour
D- Diameter greater than 6 mm
E- Elevation or enlargement

Additionally, an individual may report a change in a mole’s size, a new pigmented lesion, or the development of itching, burning, or bleeding in a mole. Any of these signs should raise suspicion of malignant melanoma and warrant refferal

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5
Q

Skin: Diaphoresis

A

Profuse perspiration, accompanies an increased metabolic rate, such as occurs in heavy activity or fever
Diaphoresis occurs with thyrotoxicosis and with stimulation of the nervous system with anxiety or pain

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6
Q

Skin: Texture (Hyper/hypothyroidism)

A

Hyperthyroidism - the skin feels smoother and softer, like velvet.
Hypothyroidism- the skin feels rough, dry, and flaky

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7
Q

Skin: Thickness (Atrophic)

A

Very thin, shiny skin (atrophic) occurs with arterial insufficiency

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8
Q

Skin: Edema (anasarca)

A

Bilateral edema or edema that is generalized over the whole body (anasarca) suggests a central problem, such as heart failure or kidney failure

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9
Q

Skin: Mobility and Turgor

A

Mobility is the skin’s ease of rising, and turgor is its ability to return to place promptly when released
Mobility is decreased when edema is present.
Poor turgor is evident in severe dehydration or extreme weight loss; the pinched skin recedes slowly or “tents” and stands by itself

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10
Q

Skin: Cherry (senile) angiomas

A

Small, smooth, slightly raised, bright red dots that commonly appear on the truck in adults older than 30 years of age. They normally increase in size and number with aging and are not significant

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11
Q

Nails: Shape and Contour (Paronychia)

A

Paronychia (inflammation of base of nail) occurs with trauma or infection

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12
Q

Nails: Shape and Contour (Clubbing)

A

Clubbing of nails occurs with congenital, cyanotic heart disease, and with emphysema and chronic bronchitis. In early clubbing, the angle straightens out to 180 degrees and the nail base feels spongy

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13
Q

Skin: Pregnant Women (Striae)

A

Jagged linear “stretch marks” of silver to pink that appear during the second trimester on the abdomen, breasts, and sometimes on the thighs. Occur in 1/2 of all pregnancies and fade after delivery, but do not disappear

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14
Q

Skin: Pregnant Women (Linea nigra)

A

Appears on the abdomen as a brownish black line down the midline

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15
Q

Skin: Pregnant Women (Chloasma)

A

An irregular brown pacha of hyper pigmentation on the face. It may occur with pregnancy or in women taking oral contraceptive pills. Chloasma disappears after delivery or cessation of pill use

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16
Q

Skin: Pregnant Women (Vascular Spiders)

A

Occur in two thirds of pregnancies in women of European descent but less often in women of African descent. These lesions have tiny red centres with radiating branches and occur on the face, neck, upper chest, and arms

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17
Q

Summary Checklists : Skin, Hair, and Nails

A 
1. Inspect the skin:
Colour
General Pigmentation
Areas of hypopigmentation or hyperpigmentation
2. Palpate the skin:
Temperature
Moisture
Texture
Thickness
Edema
Mobility and turgor
Vascularity or bruising
3. Note any lesions:
Colour
Shape and configuration
Size
Location and distribution on body
4. Inspect and palpate the hair:
Texture
Distribution
Any scalp lesions
5. Inspect and palpate the nails:
Shape and contour
Consistency
Colour
6. Teach skin-self examination
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18
Q

Common Shapes and Configurations of Skin Lesions: Annular

A

Circular lesions that begin in centre and spread to periphery (e.g., ringworm, tines, veriscolor, pityriases, rose)

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19
Q

Common Shapes and Configurations of Skin Lesions: Confluent

A

Lesions that run together (e.g., urticaria)

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20
Q

Common Shapes and Configurations of Skin Lesions: Discrete

A

Distinct, individual lesions that remain seperate

21
Q

Common Shapes and Configurations of Skin Lesions: Grouped

A

Clusters of lesions (e.g., vesicles of contact dermatitis)

22
Q

Common Shapes and Configurations of Skin Lesions: Gyrate

A

Twisted, coiled spiral, or snakelike lesions

23
Q

Common Shapes and Configurations of Skin Lesions: IRIS or TARGET

A

Lesions that resemble iris of eye, concentric rings of lesions

24
Q

Common Shapes and Configurations of Skin Lesions: Linear

A

Lesions take form of a scratch, streak, line, or stripe

25
Q

Common Shapes and Configurations of Skin Lesions: Polycyclic

A

Annular lesions that grow together

26
Q

Common Shapes and Configurations of Skin Lesions: Zosteriform

A

Lesions take a linear arrangement alone a nerve route (e.g., herpes zoster)

27
Q

Primary Skin Lesions: Macule + Patch

A

Macule: Solely a colour change, flat and circumscribed, less than 1 cm (e.g., freckle, flat nevus, hypopigmentation, petechia, measles, scarlet fever)
Patch: Macule larger than 1 cm (e.g., Mongolian spot, vitiligo, cafe-au-lait spot, chloasma, measles rash)

28
Q

Primary Skin Lesions: Papule + Plaque

A

Papule: Something you can palpate, i.e., solid, elevated, circumscribed lesion less than 1 cm in diameter (e.g., elevated nevus, lichen planus, molluscum, wart (verruca))
Plaque: Papules coalesce wider than 1 cm to form a plateaulike, disc-shaped lesion (e.g., psoriasis, lichen planus)

29
Q

Primary Skin Lesions: Nodule + Tumour

A

Nodule: Solid, elevated, hard or soft lesion larger than 1 cm; may extend deeper into dermis than papule (e.g., xanthoma, fibroma, intradermal nevus)
Tumour: Lesion larger than a few centimetres in diameter, firm or soft, deeper into dermis; may be benign or malignant (e.g., lipoma, hemangioma)

30
Q

Primary Skin Lesions: Vesicle + Bulla

A

Vesicle: Elevated cavity containing free clear fluid, up to 1 cm (e.g., herpes simplex, early varicella (chicken pox), herpes zoster (shingles), contact dermatitis)
Bulla: Larger than 1 cm in diameter; usually single chambered (unilocular); superficial in epidermis; it is thin walled, so it ruptures easily (e.g., friction blister, pemphigus, burns, contact dermatitis)

31
Q

Primary Skin Lesions: Postule

A

Turbid fluid (pus) in the cavity; circumscribed and elevated (e.g., impetigo, acne)

32
Q

Primary Skin Lesions: Cyst

A

Encapsulated, fluid-filled cavity in dermis or subcutaneous layer that tensely elevates skin (e.g., sebaceous cyst, wen)

33
Q

Secondary Skin Lesions: Crust

A

Thickened, dried-out exudate left when vesicles or pustules burst or dry up. Colour can be red-brown, honey,or yellow, depending on the fluid’s ingredients (blood, serum, pus) (e.g., impetigo (dry, honey coloured), weeping eczematous dermatitis, scab following abrasion)

34
Q

Secondary Skin Lesions: Scale

A

Compact, desiccated flakes of skin, dry or greasy, silvery or white, from shedding of dead excess keratin cells (e.g., following drug reaction (laminated sheets), psoriasis (silver, mica like), seborrheic dermatitis (yellow, greasy), eczema (large, adherent, laminated), dry skin

35
Q

Secondary Skin Lesions: Fissure

A

Linear crack with abrupt edges, extending into dermis, dry or moist (e.g., cheilosis at corners of mouth due to excess moisture; athlete’s foot)

36
Q

Secondary Skin Lesions: Erosion

A

Scooped-out but shallow depression. Superficial lesion, epidermis is lost, and the lesion is moist but there is no bleeding. Heals without scar because erosion does no extend into dermis

37
Q

Secondary Skin Lesions: Ulcer

A

Deeper depression, extending into dermis, irregularly shaped. It may bleed and leaves scar when heals (e.g., stasis ulcer, pressure sore, chancre)

38
Q

Secondary Skin Lesions: Excoriation

A

Self-inflicted abrasion; superficial and sometimes crusted (e.g., scratches from intense itching from insect bite, scabies, dermatitis, varicella)

39
Q

Secondary Skin Lesions: Scar

A

After a skin lesion is repaired, normal tissue is lost and replaced with connective tissue (collagen). This is a permanent fibrotic change (e.g., healed area of surgery or injury, acne)

40
Q

Secondary Skin Lesions: Atrophic Scar

A

Resulting skin level depressed with loss of tissue; a thinning of the epidermis (e.g., striae)

41
Q

Secondary Skin Lesions: Lichenification

A

Prolonged intense scratching eventually thickens the skin and produces tightly packed sets of papules: looks like the surface of moss (or lichen)

42
Q

Secondary Skin Lesions: Keloid

A

Hypertropic scar. The resulting skin level is elevated by excess scar tissue, which is invasive beyond the site of original injury. May increase long after healing occurs; looks smooth, rubbery, “claw like.” Higher incidence among individuals of African descent

43
Q

Pressure Ulcer (Decubitus Ulcer): Stage I

A

Intact skin appears red but unbroken. Localized redness in light skin will blanch (turns light with fingertip pressure). Dark skin appears darker but does not blanch

44
Q

Pressure Ulcer (Decubitus Ulcer): Stage II

A

Partial-thicness skin erosion with loss of epidermis or also the dermis. Superficial ulcer looks shallow, like an abrasion or open blister with a red-pink wound bed

45
Q

Pressure Ulcer (Decubitus Ulcer): Stage III

A

Full-thickness pressure ulcer extending into the subcutaneous tissue and resembling a crater. May see subcutaneous fat, but not muscle, bone, or tendon

46
Q

Pressure Ulcer (Decubitus Ulcer): Stage IV

A

Full-thickness pressure ulcer involves all skin layers and extends into supporting tissue. Exposes muscle, tendon, or bone, and may show slough (stringy matter attached to wound bed) or eschar (black or brown necrotic tissue)

47
Q

Head, Face, and Neck, Incl. Lymphatic System: Lymphadenopathy

A

Is a disease of the lymph nodes with enlargement to >1 cm from infection, allergy, or neoplasm.
The following are commonly associated with lymphadenopathy but are not definitive in all circumstances:
- Acute infection - nodes are bilateral, enlarged, warm, tender, and firm but freely movable
- Chronic inflammation - e.g., in tuberculosis the nodes are clumped
- Cancerous nodes are hard, unilateral, nontender, and fixed
- Nodes in patients with HIV infection are enlarged, firm, contender, and mobile. Occipital lymphadenopathy is common
- A single, enlarged, nontender, hard left supraclavicular node may indicate a neoplasm in the thorax or abdomen
- Painless, rubbery, discrete nodes that appear gradually occur with Hodgkin’s lymphoma

48
Q

Head, Face, and Neck, Incl. Lymphatic System: Hydrocephalus

A

Increased cerebrospinal fluid

49
Q

Head, Face, and Neck, Incl. Lymphatic System: Summary Checklist

A
  1. Inspect and palpate the skull:
    General size and contour
    Note any deformities, lumps, tenderness
    Palpate temporal artery and temporomandibular joint
  2. Inspect the face:
    Facial expression
    Symmetry of movement (cranial nerve VII)
    Any involuntary movements, edema, lesions
  3. Inspect and palpate the neck:
    Active range of motion
    Enlargement of lymph nodes or thyroid gland

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