Module 3 Flashcards
Food nourishes the body by supplying necessary nutrients and calories to function in:
- to provide energy for necessary activities
- to build and maintain body tissues
- To regulate body processes
Nutrients necessary to the body
- macronutrients
- micronutrients
- water
stimulates the pituitary to release growth hormone
Growth hormone-releasing hormone (GHRH)
Other name for growth hormone–inhibiting hormone (GHIBH)
Somatostatin
inhibits the secretion of both GHRH and thyroid- stimulating hormone (TSH)
Somatostatin or growth hormone-inhibiting hormone (GHIBH)
_________ hormone is secreted in pulses
Growth
70% of this hormone secretion occurs during deep sleep
Growth Hormone
regulates carbohydrate, protein, and lipid metabolism
Growth hormone
Stimulates growth hormone secretion
Thyroid hormone
Thyroid hormone stimulates production of
insulin-like growth factor 1 (IGF-1) and interleukins 6 and 8 (IL-6 and IL-8)
T or F: growth hormone also affects the growth and maturation of other body tissues.
F; the thyroid hormone does that
is a type of growth hormone produced by the liver and in peripheral tissues, like bone
IGF-1
________ releases growth hormone releasing hormone (GHRH)
Hypothalamus
GHRH stimulates _________ to release growth hormone
anterior pituitary
_______ exerts a negative feedback effect on growth hormone secretion and mediates the effect of growth hormone on bone, muscle, nervous system, and immune system cells
IGF-1
What is Ghrelin
A peptide
Known as the Hunger hormone
Ghrelin
helps control growth hormone release and influences food intake and obesity development
Ghrelin
has a key role in regulating body fat mass, and its concentration is thought to be a trigger for puberty by informing the central nervous system that adequate nutritional status and body fat mass are present to support pubertal changes and growth
Leptin
During puberty, with an increase in leptin, a relative _________ in fat percentage develops in males and an ____________ occurs in female
Decrease; increase
What do the gonads secrete during puberty
Testosterone and estrogen
Rising levels of testosterone and estrogen release what
Gonadotropins (lutenizing hormone (LH) and follicle-stimulating hormone (FSH)
Where do luteinizing hormone and follicle stimulating hormone release from
Hypothalamus
_________________ enhances muscular development and sexual maturation and promotes bone maturation and epiphyseal closure
Testosterone
stimulates the development of female secondary sexual characteristics, regulating the timing of the growth spurt and the acceleration of skeletal maturation and epiphyseal fusion.
Estrogen
Androgens are secreted by
Adrenal glands
promote masculinization manifested by secondary sex characteristics and skeletal maturation.
Androgens
Growth at puberty is dependent on the interaction of which hormones
- Growth hormone
- IGF-1
- Leptin
- Androgens (sex steroids)
What leads to adolescent growth spurt
The sex steroids stimulate an increased secretion of growth hormone, which in turn mediates the dramatic increase in IGF-1
Skeletal growth is considered complete when
epiphyses of long bones have completely fused during late puberty
More than ___% of the skeletal mass is present by 18 years of age
90
Examples of lymphatic tissues
- adenoids
- blood lymphocytes
- lymph nodes
- spleen
- tonsils
T or F: Lymphatic tissues are well developed at birth
True
Lymphatic tissues reach adult size at about ______ years old
6
What happens to lymphatic tissues between ages 6 and 20
Adult size by 6
Age 10-12 about double the adult size
During adolescence they decrease to adult size
… complete physical development more quickly than other body parts
Brain, skull , eyes, ears
Time period of most rapid and critical brain growth
Conception and 3 years of age
By 34 weeks’ gestation, ____% of the weight of a newborn’s brain is present
65
Gray matter and myelinated white matter increase dramatically between the _____ and ______ weeks of gestation
34th and 40th
In the nervous system, _______, ______, and _______ continue to develop after birth
Glial cells, dendrites, and myelin
Why does the head size increase in adolescents
Development of air sinuses and the thickening of the scalp and skull
is influenced by genetic predisposition, gestational age, the mother’s prepregnancy weight, weight gain during pregnancy, environmental exposures like secondhand smoke, overall maternal health, and intercurrent disease or complications in pregnancy such as gestational diabetes.
Birth weight
Fastest growing body part in infancy
Trunk
Fastest growing body part during childhood
Legs
During adolescence, about _____% of the individual’s ideal weight is gained, and the skeletal mass and organ systems_______ in size.
50; double
Most weight is lost postpartum in first _______ months after delivery
3
Preschool aged children should engage in about _____ hours of activity a day
3
Children 6-17 years of age should engage in _______ minutes of activity a day
60
People 18-64 should engage in ________ of activity a week
150 minutes of moderate intensity or 75 minutes of vigorous activity
Method for obtaining a food intake history
24-hour recall
Five nutrients may be deficient in a vegetarian diet
- Protein
- Calcium (lacto-ovo and vegan)
- Iron
- Vitamin B12 (vegan)
- Vitamin D
Healthy BMI range
18.5-24.9
BMI of greater than _______ is indicative of obesity
30
are indicators of visceral fat or abdominal obesity
Waist circumference and waist-height ratio
At birth, healthy term newborns have length variations between _____________ inches
18-22 (45-55 cm)
Infant body length increases by ________ in the first year of life
50%
After losing up to 10% of their birth weight, newborns regain that weight within 2 weeks and then gain weight at a rate of approximately _________ per day
30 g (1 oz)
Infants lose about _______% of their birthweight
10
Expected head circumferences for term newborns range between ____________
32.5 and 37.5 cm
By what age should a child’s head circumference be 2/3 its adult size
2 years old
evaluates six physical and six neuromuscular newborn characteristics within 36 hours of birth to establish or confirm the newborn’s gestational age
The Ballard Gestational Age Assessment Tool
The gestational ages of _______through _____ weeks are considered term and are associated with the best health outcomes
37 through 42
In a child, arm span that exceeds height is associated with
Marfan syndrome
A higher upper-to-lower body segment ratio than expected may be associated with
dwarfism or bone disorders
Approximately _______% of women are obese
42.4-43.3%
A rare disease of excessive growth and distorted proportions caused by hypersecretion of growth hormone and insulin-like growth factor after closure of the epiphyses
Acromegaly
Most commonly caused by the use of medically prescribed corticosteroids.
Cushing syndrome
causes include adrenal gland oversecretion leading to excessive production of cortisol or a pituitary tumor leading to excessive secretion of adrenocorticotropic hormone (ACTH)
Cushing syndrome
A genetic disorder in which there is partial or complete absence of a second X chromosome
Turner syndrome
Phenotype results from a reduced complement of genes that are typically expressed from both X chromosomes in females.
Turner syndrome
Turner syndrome incidence is 1 per______ live birth
2500–3000
May be caused by an infection or obstruction in the subarachnoid space that interferes with the reabsorption of CSF, or from an infection or injury that obstructs the flow of CSF to the subarachnoid space where it can be reabsorbed.
Hydrocephalus
An excess volume of cerebrospinal fluid (CSF) in the brain leading to an enlarged head circumference or increased intracranial pressure
Hydrocephalus
Often occurs in association with meningomyelocele
Hydrocephalus
Growth in an infant or child below the third to fifth percentiles on a growth chart, or a slower than expected rate of growth or crossing down two percentile lines in a short period of time (e.g., from the 50th percentile to below the 10th percentile on the growth chart)
Failure to thrive
Failure of the anterior pituitary to secrete adequate growth hormone to support growth in stature
Growth hormone deficeincy
May be congenital or develop from a pituitary tumor, radiation therapy for a tumor, or brain trauma
Growth hormone deficiency
The onset of secondary sexual characteristics before 7 years of age in white females, 6 years in Black females, and 9 years of age in males with progressive sexual maturation
Precocious puberty
A brain tumor or lesion (e.g., hypothalamic hamartoma) may activate the hypothalamic- pituitary-gonadal axis with gonadotropins triggering the growth of the gonads, secretion of the sex hormones, and progressive sexual maturation.
Precocious Puberty
May also be related to McCune-Albright syndrome
Precocious puberty
Excessive proportion of total body fat
Obesity
Eating disorder classified by the Diagnostic and Statistical Manual of Mental Disorders (fifth edition; DSM-V) as a psychiatric disease, characterized by low body weight and body image distortion
Anorexia nerovosa
Two types of anorexia
Purging and restricting
Eating disorder with two types: purging and nonpurging type episodes followed by fasting or excessive exercising
Bulimia nervosa
T or F: anatomy of the skin remains the same from one part of the body to another
False: anatomy varies from one part to the other
The outermost portion of the skin that is composed of several cellular layers
Epidermis
The top most layer of the epidermis
Stratum corneum (cornified layer)
Composed of closely packed, dead, keratin-filled squamous cells
Stratum corneum of the epidermis
Chief mechanical barrier protecting the body against environmental exposures, pathogens, and restricting water loss
Stratum corneum
Where are the keratins of the stratum corneum synthesized
Beginning at the stratum basale (basal layer)
The lower layers contain _________, which allow for the regenerative properties of the skin to manifest
Stem cells
As keratinocytes mature, they pass from the ________ layer through the _________ layer to the cornified layer
Basal, granular
As keratinocytes mature, they pass from the basal layer through the granular layer to the cornified layer— how long does this process take?
28 days
The thick skin of the palms and soles contains an additional layer compared with other parts of the body called the ________________
stratum lucidum
Where is the stratum lucidem (of thick skin on palms and soles of feet) beneath
The stratum corneum
Mucosal skin lacks:
Stratum corneum
Where are melanocytes located
Stratum basale
richly vascular connective tissue layer of the skin that supports and separates the epidermis from adipose tissue
Dermis
secure the epidermis to the dermis and provide nourishment to the epidermal cells
Interdigitating papillae
provide resilience, strength, and stability in the dermis
- elastin
- collagen
- reticular fibers
Sensory nerve fibers located in the _________ form a complex network that provides sensations of pain, touch, and temperature.
Dermis
contains autonomic motor nerves that innervate blood vessels, glands, and the arrector pili muscles
Dermis
The dermis is connected to underlying tissues by the
Hypodermis
a subcutaneous layer that consists of loose connective tissue filled with adipose
Hypodermis
Generates heat, provides insulation, shock absorption, and calorie reserve
Adipose layer of the hypodermis
are outgrowths of the skin and include eccrine sweat glands, apocrine sweat glands, sebaceous glands, hair, and nails
Cutaneous appendages
open directly onto the surface of the skin and help regulate body temperature through sweat secretion.
Eccrine sweat glands
These glands are distributed throughout the body except at the lip margins, eardrums, nail beds, inner surface of the prepuce, and glans penis
Eccrine sweat glands
Type of glands found only in the axillae, nipples, areolae, anogenital area, eyelids, and external ears
Apocrine glands
secrete an oily fluid containing protein, carbohydrate, and other substances that are odorless
Apocrine glands
How is body odor produced
By bacterial decomposition of apocrine sweat
a lipid-rich substance that acts as a lubricant and moisturizer for skin and hair
Sebum
__________ secretes sebum
Sebaceous glands
Secretory activity of sebum is stimulated by
Sex hormones, primarily testosterone
A strand of hair consists of a root and a shaft which sit in a _________
Follicle
What supplies nourishment and growth to a hair follicle
Papilla contains loop of capillaries
What gives hair its color
Melanocytes in the follicle synthesize pigment
Adults have both ________ and ________ hair.
Vellus; terminal
hair that is short, fine, soft, and nonpigmented
Vellus
Hair that is coarser, longer, thicker, and usually pigmented
Terminal hair
Cycles of Hair growth
Anagen (growth)
Catagen (atrophy)
Telogen (rest)
Exogen (Hair is shed)
Infants and children lack which type of hair
Terminal hair
a mixture of sebum and cornified epidermis, covers the infant’s body at birth
Vernix Caseosa
The newborn’s body, particularly the shoulders and back, can be covered with fine, silky hair called
Lanugo
Lanugo in neonates is typically shed in how many days
10-14 days
T or F: lanugo is more commonly seen in preterm infants
True
When do eccrine sweat glands develop
First month of life
When do apocrine glands form in children
Puberty
T or F: Children lack offensive perspiration
True because they do not have apocrine function until puberty
Hair production is one response to changing ________levels
Androgen
Processes that assists in dissipating the excess heat caused by increased metabolism in pregnancy
Acceleration of sweat/sebaceous gland activity and increased blood flow to skin (from peripheral dilation and increased number of capillaries)
In pregnancy, the skin thickens and fat is deposited in the ______ layers
Subdermal
T or F: sweat activity increases in older adults
F it decreases
What causes the skin to wrinkle in older adults
The dermis shrinks causing epidermis to fold
They are most commonly seen on the arms, legs, chest, and back and have been reported most often in Black and Japanese populations
Pigmentary demarcation lines
There is a strong association between sun exposure and the number of ______
Nevi
Spider Angiomas are
A. Arterial
B. Venous
Arterial
permanently dilated blood vessels consisting of venules or arterioles.
Telangiectasias: spider angioma
is a handheld magnifying lens that is useful in evaluating the subtle details of a lesion by providing polarized light to allow for visualization of deeper skin structures and non-polarized light for the assessment of superficial skin lesions.
Dermatoscope
Dryness and brittleness of scalp hair could indicate
Systemic or genetic disorder
Hirsutism in women, growth of terminal hair in a male distribution pattern on face, body and pubic are, could signify an _________
Endocrine disorder
A flat, circumscribed area that is a change in the color of the skin; less than 1 cm in diameter
Macule
An elevated, firm, circumscribed area; less than 1 cm in diameter
Papule
A flat, nonpalpable, irregularly shaped macule greater than 1 cm in diameter
Patch
Freckles, flat nevi, petechiae are examples of …
Macule
Warts (verruca), and lichen planus are examples of
Papule
Vitiligo, port-wine stains, cafe au lair patch are examples of
Patch
Psoriases, atopic dermatitis are examples of
Plaques
Elevated, firm, and rough
lesion with flat top surface greater than 1 cm in diameter
Plaques
Elevated, irregular- shaped area of cutaneous edema; solid, transient, variable diameter
Wheal
Elevated, firm, circumscribed lesion; deeper in dermis than a papule; 1–2 cm in diameter
Nodule
Insect bites, urticaria, and allergic reactions are examples of
Wheal
Elevated and solid lesion; may or may
not be clearly demarcated; deeper in dermis; greater than 2 cm in diameter
Tumor
Neoplasms, benign tumor, lipoma are examples of
Tumors
Elevated, circumscribed, superficial, not into dermis; filled with serous fluid; less than 1 cm in diameter
Vesicles
Varicella (chickenpox), herpes zoster (shingles) are what type of skin lesion
Vesicles
Vesicle greater than 1 cm in diameter
Bulla
Bullous pemphigus, pemphigus vulgaris are examples of what kind of skin abnormality
Bulla
Elevated, superficial lesion; similar to a vesicle but filled with purulent fluid
Pustule
Impetigo and acne are examples of what kind of skin abnormality
Pustules
Elevated, circumscribed, encapsulated lesion; in dermis or subcutaneous layer; filled with liquid or semisolid material
Cyst
Fine, irregular, red lines produced by capillary dilation
Telangiectasia
What kind of skin abnormality would you see Telangiectasia
Rosacea
Heaped-up, keratinized cells; flaky skin; irregular; thick or thin; dry or oily; variation in size
Scale
Rough, thickened epidermis secondary to persistent rubbing, itching, or skin irritation; often involves flexor surface of extremity
Lichenification
Chronic atopic dermatitis is an example of what skin abnormality
Lichenification
Irregularly shaped, elevated, progressively enlarging scar; grows beyond the boundaries of the wound; caused by excessive collagen formation during healing
Keloid
Thin to thick fibrous tissue that replaces normal skin after injury or laceration to the dermis
Scar
Loss of the epidermis; linear hollowed- out, crusted area
Excoriation
Linear crack or break from the epidermis to the dermis; may be moist or dry
Fissure
Example of a fissure
Athletes foot
Loss of part of the epidermis; depressed, moist, glistening; follows rupture of a vesicle or bulla
Erosion
Loss of epidermis and dermis; concave; varies in size
Ulcer
Thinning of skin surface and loss of skin markings; skin translucent and paper- like
Atrophy
Ragged cuticles are also a classic sign of
Dermatomyositis
Peeling nails (from the plate splitting into layers) usually found in
- hands repeated water immersion
- have underlying psoriasis
Causes of yellow discoloration of nails
- psoriasis
- fungal infections
- chronic respiratory diseases
Proximal subungual fungal infection is associated with
HIV infection
A complete absence of a nail
Anonychia
The ___________ method is when a patient places together the nail (dorsal) surfaces of the thumbs from both the right and left hands and is used to assess for clubbing
Schamroth
Expected skin finding in newborn: Cyanosis of hands and feet
Acrocyanosis
Expected skin finding in newborn: Transient mottling when infant is exposed to decreased temperature
Cutis marmorata
Expected skin finding the newborn: Pink papular rash with vesicles superimposed on thorax, back, buttocks, and abdomen; may appear in 24-48 hr and resolve after several days
Erythema toxicum
Expected skins change in a newborn: Irregular areas of deep blue pigmentation, usually in the sacral and gluteal regions; seen predominantly in newborns of African, Native American/American Indian, Asian, or Latin descent
Congenital dermal melanocytosis
Expected skin changes in a newborn: Flat, deep pink localized areas usually seen on the midforehead, eyelids, upper lip, and back of neck
Nevis simplex
Tuft of hair overlying the spinal column at birth, usually in the lumbosacral area; may be associated with spina bifida occulta
Faun tail nevus
Flat, evenly pigmented spots varying in color from light brown to dark brown or black in darker skin; larger than 5 mm in diameter; present at birth or shortly thereafter; may be associated with neurofibromatosis or miscellaneous other conditions including pulmonary stenosis, temporal lobe dysrhythmia, and tuberous sclerosis.
Cafe au lait Macules
Congenital accessory nipples with or without glandular tissue, located along the mammary ridge; may be associated with renal abnormalities, especially in the presence of other minor anomalies
Supernumerary nipples
A ring of long, dark, coarse hair surrounding a midline scalp nodule in infants is usually an isolated cutaneous anomaly that may indicate neural tube closure defects of the scalp
“Hair collar” sign
small whitish, discrete papules on the face commonly found during the first 2 to 3 months of life. The sebaceous glands function in an immature fashion at this age and are easily clogged by sebum
Milia
produces numerous tiny yellow macules and papules in the newborn, probably the result of androgen stimulation from the parent
Sebaceous hyperplasia
The increased hair shedding 2-6 months postpartum
Telogen effluvium
are tiny, bright ruby-red to dark blue/black, round papules that may become brown with time. They occur in virtually everyone older than 30 years and increase numerically with age
Cherry angiomas
are pigmented, raised, warty lesions, usually appearing on the trunk. These must be distinguished from other growths such as nevi or actinic keratoses, which may have malignant potential. Because the lesions may look similar, seek the assistance of an experienced practitioner for evaluation
Seborrheic keratoses
presents as a yellowish, flattened papule with a central depression that is often difficult to discern from a basal cell carcinoma
Sebaceous hyperplasia
are small, soft, skin-colored, pedunculated (narrow stalk) papules of skin, usually appearing on the neck and upper chest
Cutaneous tags (acrochordon)
are small, hard projections of the epidermis, usually occurring on the forehead and face and can be the manifestation of an underlying squamous cell carcinoma or a wart
Cutaneous horns
are irregular, gray-brown macules that occur in sun-exposed areas that can range in size from a few millimeters to over a centimeter
Solar lentigines
Most common inflammatory skin disorder; several forms, including irritant contact dermatitis, allergic contact dermatitis, and atopic dermatitis
Eczematous Dermatitis
Inflammation and infection of the hair follicle and surrounding dermis
Folliculitis
A deep-seated infection of the pilosebaceous unit.
Furuncle (boil)
Diffuse, acute, infection of the skin and subcutaneous tissue
Cellulitis
Group of noncandidal fungal infections that involve the stratum corneum, nails, or hair
Tinea (Dermatophytosis)
Self-limiting inflammation of unknown cause
Pityriasis rosea
Chronic and recurrent disease of keratinocyte proliferation
Psoriasis
Characterized by increased epidermal cell turnover, increased numbers of epidermal stem cells, and abnormal differentiation of keratin expression leading to thickened skin with copious scale
Psoriasis
Chronic inflammatory skin disorder
Rosacea
A tick-borne disease that can lead to multisystemic infection.
Lyme disease
A nonspecific reaction pattern associated with obesity, certain endocrine syndromes, or malignancies or as an inherited disorder
Acanthosis Nigricans
The most common form of skin cancer.
Basal cell carcinoma
Second most common form of skin cancer
Squamous cell carcinoma
Lethal form of skin cancer that develops from melanocytes
Malignant melanoma
Sudden, rapid, coin-shaped loss of hair, usually from the scalp or face
Alopecia Areata
Replacement of hair follicles with scar tissue
Scarring alopecia
A common cause of alopecia or hair loss in Black women
Central Centrifugal Cicatricial Alopecia (CCCA)
Growth of terminal hair in women in the male distribution pattern on the face, body, and pubs areas
Hirsutism
Invasion of bacteria or yeast between the nail fold and the nail plate; can be acute or chronic
Paronychia
Fungal infection of the nail
Onychomycosis
Nail pierces the lateral nail fold and grows into the dermis
Ingrown nails
Trauma to the nail plate severe enough to cause immediate bleeding and pain
Subungual hematoma
Loosening of the nail plate with separation from the nail bed that begins at the distal groove
Onycholysis
Central depression of the nail with lateral elevation of the nail plate that is associated with iron deficiency anemia, syphilis, fungal dermatoses, hemochromatosis, and hypothyroidism
Koilonychia (Spoon Nails
Transverse depression in the nail bed caused by temporary interruption of nail formation due to systemic disorders and can be associated with coronary occlusion, hypercalcemia, and skin disease
Beau lines
Whitening of the proximal half to three-quarters of the nail bed
White banding (terry nails)
Chronic and recurrent disease of keratinocyte proliferation
Psoriasis
Epidermal neoplasms caused by human papilloma virus
Warts
Cyst-like structures contain a clear, jelly-like substance
Digital mucous cysts
Cysts located on the dorsal-lateral finger at the distal interphalangeal (DIP) joint are probably caused by _________ of tendon sheaths or joint linings and are related to ganglion and synovial cysts
Herniation
A benign dermatosis that usually arises late in the third trimester of a first pregnancy
Polymorphic Eruption of pregnancy
Chronic, recurrent, erythematous scaling eruption localized in areas where sebaceous glands are concentrated
Seborrheic Dermatitis
Caused by sweat retention from occlusion of sweat ducts during periods of heat and high humidity; Overdressed babies are susceptible to this condition in the summer
Militaries rubric (Prickly heat)
Common, contagious superficial skin infection caused mostly by staphylococcal or streptococcal infection of the epidermis
Impetigo
Common condition due to plugging of hair follicles
Acne vulgaris
Acute, highly communicable disease common in children and young adults caused by varicella zoster virus
Chickenpox (varicella)
infects by invasion of the respiratory epithelium
Measles (Rubeola)
Mild, febrile, highly communicable viral disease; Spread in droplets that are shed from respiratory secretions of infected persons
German measles (Rubella)
Incubation period of Rubella
14-23 days
Hair is twisted around the finger and pulled or rubbed until it breaks off; the act of manipulation is usually an unconscious habit
Hair-pulling (Trichotillomania)
Skin inflammation resulting from chronic edema
Stasis dermatitis
Atypical squamous cells confined to the upper layers of epidermis; occurs secondary to chronic sun damage; Most lesions remain superficial; lesions can progress into squamous cell carcinoma over time
Actinic keratosis
consists of lymph fluid, the collecting lymphatic ducts, and various tissues including the lymph nodes, spleen, thymus, tonsils, adenoids, and Peyer patches in the small intestine
Lymphatic system
Functions (3) of lymphatic system
- conserving fluid and plasma that leak from capillaries
- fight disease as part of immune system
- Absorbing lipids from intestinal tract
an unwelcome manifestation of immunocompetence
Tissue rejection of transplanted organs
Every tissue supplied by blood vessels has lymphatic vessels EXCEPT
Placenta and brain
the lymphatic system plays an undesirable role in providing at least one pathway for the spread of _________
malignancy
Lymph contains
White and red blood cells
The majority of the white blood cells that make up lymph
Lymphocytes
The drainage point for the right upper body is a lymphatic trunk that empties into the
Right subclavian vein
The major vessel of the lymphatic system
Thoracic duct
drains lymph from the rest of the body into the left subclavian vein
The thoracic duct
Superficial nodes are located in ____________, and deeper nodes lie beneath the _______________ and within the various body cavities.
subcutaneous connective tissues; fascia of muscles
Lymph nodes defend against the invasion of microorganisms and other particles by what 2 processes
filtration and phagocytosis
Lymph nodes aid in the maturation of __________ and____________
lymphocytes: monocytes
are the gateway to assessing the health of the entire lymphatic system.
The superficial lymph nodes
a palpable ________ node should be suspected as a probable sign of malignancy
supraclavicular
Lymphocytes are primarily produced in
Bone marrow
involved in the humoral immune response
Lymphocytes
Marrow-derived cells that mature in the thymus
T lymphocytes
Unique ability of the T cells
Ability to differentiate between healthy and abnormal cells
T lymphocytes also have role in controlling immune responses of __________, which produce antibodies
B lymphocytes
Life span of B cells
3-4 days
Life span of T cells
100-200 days
Where is the thymus located
Superior mediastinum
the cells responsible for cell-mediated immunity reactions
T lymphocytes
It is the site for production of T lymphocytes and the controlling agent for the humoral immune responses generated by B lymphocytes.
Thymus
The Thymus is largest and most active during the ___________ and ______________ periods and atrophies after ______________.
Neonatal; preadolescent; puberty
Where is the spleen located
left upper quadrant of the abdominal cavity between the stomach and the diaphragm
Spleen is highly vascularized and is made up of two systems:
White pulp and red pulp
made up of lymphatic nodules and diffuse lymphatic tissue
The white pulp system of the spleen
The system of the spleen that is made up of venous sinusoids
Red pulp
has several functions including destroying old red blood cells, producing antibodies, storing red blood cells, and filtering microorganisms from the blood
The spleen
The ________ tonsils are commonly referred to as “the tonsils”
Palantine
Location of the palantine tonsils
set between the palatine arches on either side of the pharynx just beyond the base of the tongue
The tonsils are comprised mainly of ….
Lymphoid tissue
T or F: the palantine tonisls are covered in mucous membranes
True
Tonsils located at the nasopharyngeal border
pharyngeal tonsils aka adenoids
The tonsils located near the base of the tongue
lingual tonsils
What is the other name for the pharyngeal tonsils
Adenoids
are small, raised areas of lymph tissue on the mucosa of the small intestine and consist of many clustered lymphoid nodules
Peyer patches
facilitate an immune response when pathogenic microorganisms are detected in the intestinal tract
Peyer Patches
At what stage in gestation do the immune system and lymphoid system begin developing
20 weeks
Delayed umbilical cord separation is associated with__________________, an autosomal recessive disorder that causes recurrent infections
leukocyte adhesion deficiency
T of F: Lymph node distribution is different between children and adults
F its the same
T or F: immune changes in pregnancy can lead to temporary remission of autoimmune/inflammatory diseases
True
a contributing factor to impaired ability to resist infection in older adults
The nodes of older patients are more likely to be fibrotic and fatty than those of the young
T of F: A node fixed to surrounding tissues is cause for concern
True
enlarged lymph node(s)
Lymphadenopathy (adenopathy)
inflamed and enlarged lymph node(s)
Lymphadenitis
inflammation of the lymphatics that drain an area of infection; tender erythematous streaks extend from site to heart; regional nodes may also be tender
Lymphangitis
small non-tender nodes that feel like BBs under the skin
Shotty
wavelike motion that is felt when the node is palpated
Fluctuant
group of nodes that feel connected and seem to move as a unit
Matted
In the presence of a ___________________, nodes may become warm or tender to the touch, matted, and much less discrete
Bacterial infection
infections of the _____ usually drain to the preauricular, retropharyngeal, and deep cervical nodes
Ear
Nodes that feel like they contain fluid; suggest suppuration from infection
Fluctuant nodes
in ___________ the lymph nodes, often felt in the cervical chains, are usually body temperature, soft, matted, and not tender or painful
TB
Lymphadenopathy that is widespread, involving several lymph node regions, indicate:
systemic disease or disorder
T or F: certain drugs can cause nodal enlargement
True
T or F: Young adults and children with localized supraclavicular lymphadenopathy require further investigation
True
Infection and inflammation of a lymph node; may affect a single or localized group of nodes
Acute Suppurative Lymphadenitis
Lymphatic abnormality: Most commonly caused by group A beta-hemolytic streptococci and coagulase-positive staphylococcal infection
Acute Suppurative Lymphadenitis
Where is Acute Suppurative Lymphadenitis most commonly examined
in the cervical region-
due to microbial drainage from infections of the teeth or tonsils and in the axillary or inguinal regions secondary to infections in the extremities
Edematous swelling due to excess accumulation of lymph fluid in tissues caused by inadequate lymph drainage
Lymphedema
Congenital malformation of dilated lymphatics
Lymphangioma/Cystic Hygroma
Results from a failure of complete development and subsequent obstruction of the lymphatic system; commonly found in the neck
Lymphangioma/Cystic Hygroma
Massive accumulation of lymphedema throughout the body; the most common cause of secondary lymphedema worldwide
Lymphatic Filariasis (Elephantiasis)
Malignant neoplasm of the lymphatic system and the reticuloendothelial tissues
Non-Hodgkin Lymphoma
occur most often in lymph nodes in the chest, neck, abdomen, tonsils, and skin; they may also develop in sites other than lymph nodes such as the digestive tract, central nervous system, and around the tonsils; most arise in B cells; the rest occur in T cells
Non-Hodgkin lymphomas
Malignant lymphoma
Hodgkin lymphoma
Starts in a single node or chain and spreads to contiguous
lymph nodes, spleen, liver, and bone marrow; Neoplastic giant cells release factors that induce the accumulation of reactive lymphocytes, macrophages, and granulocytes
Hodgkin Lymphoma
Initially infects oral epithelial cells; after intracellular viral replication and cell lysis with release of new virions, virus spreads to contiguous structures such as the salivary glands, with eventual viremia and infection of the entire lymphoreticular system, including the liver and spleen
Epstein-Barr Virus Mononucleosis
Zoonosis, caused by the parasite Toxoplasma gondii
Toxoplasmosis
Ingestion or inhalation of oocysts in soil/fomites, undercooked meat, or raw eggs; cat feces or litter; infection persists for life without signs of disease
Toxoplasmosis
May cause serious congenital infection if exposed during pregnancy, particularly in the first trimester; transmitted directly from pregnant mother to fetus
Toxoplasmosis
Infection by human herpes virus 6
Roseola Infantum (HHV-6)
Infection by human herpes virus 1 (HSV-1) or human herpes virus 2 (HSV-2)
Herpes Simplex (HSV)
A common cause of subacute or chronic lymphadenitis in children
Cat Scratch Disease
Caused mainly by Bartonella henselae and Bartonella clarridgeiae; usually follows a bite, scratch, or other penetrating injury from a kitten or cat; the organisms, however, rarely cause illness in the cat
Cat scratch disease
Viral infection that attacks the body’s immune system
Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS)
An immune complex disease
Serum Sickness (Type III Hypersensitivity Reaction)
Delayed hypersensitivity reaction
Latex Allergy Type IV Dermatitis
T cell–mediated, delayed response; allergic contact dermatitis that involves the immune system and is caused by the chemicals used in latex products
Latex Allergy Type IV Dermatitis
True allergic reaction caused by protein antibodies
Latex Allergy Type I Reaction
a parameter of growth calculated by charting changes in height over a time interval
Velocity
nutrients required by the body in large amounts (carbohydrates, fats, and proteins)
Macronutrients
nonnutritive eating
PICA
a marker used to determine a child’s pubertal development
Sexual maturity rating
an assessment tool that evaluates six physical and six neuromuscular characteristics within 36 hours of birth to establish or confirm the newborn’s gestational age.
Ballard gestational age assessment
a measurement that should be obtained on each visit until a child reaches 2–3 years of age
Head circumference
a measure of fat distribution by body type
Waist to height ratio
the most common method used to assess nutritional status and total body fat
Body mass index
vitamins, minerals, and electrolytes required and stored by the body in small amount
Micronutrients
an indicator of a newborn’s maturity
Gestational age
length of an infant from birth to 24 months of age measured in the supine position on the measuring device
Recumbent length
falling one or more standard deviations off growth curve pattern; below the fifth percentile for weight and height
Failure to thrive
excessive proportion of total body fat
Obesity
method for obtaining a food intake history in which the patient is asked to list all foods, beverages, and snacks ingested during the past 24 hours
24 hour recall
Hormone deficiency: A 16-year-old female with absence of sexual development; also has short stature and increased carrying angle of the elbows.
Turner Syndrome
Hormone deficiency: Woman with a round face, reddish purple striae, and fat accumulation in the lower posterior cervical area
Cushing syndrome
Hormone Disorder: A 5-year-old girl with pubertal changes
Precocious puberty
Hormone Disorder: Child with pronounced head enlargement and increased intracranial pressure
Hydrocephalus
Hormone disorder: A 60-year-old man with exaggerated facial features and massive hands
Acromegaly
A 38-year-old woman is 5 feet 7 inches tall and weighs 163 pounds. Based on these measurements, the examiner assesses total body fat using the
a. upper-to-lower body segment ratio.
b. arm span.
c. waist-to-hip circumference ratio.
d. body mass index.
D
The body mass index of a patient who is 5 feet 3 inches tall and weighs 142 pounds would be
a. 21
b. 25.2
c. 27
d. 29.5.
B
With a BMI of 22.6, you would consider a patient to be
a. underweight.
b. of normal weight
c. overweight
d. obese
B
The majority of brain growth is completed by
a. 1 year of age.
b. 2 years of age
c. 3 years of age
d. 7 years of age.
C
A child has an arm span that measures greater than his height. This finding is consistent with what condition?
a. Turner syndrome
b. Marfan syndrome
c. Acromegaly
d. Failure to thrive
B
Which assessment data do you need to calculate a Sexual Maturity Rating (SMR) for a 13-year-old female patient?
A. Height, weight, and age of menarche
b. Ages at which breast stage 4 and pubic hair stage 5 were
reached
c. Age of peak height velocity and average stage of breast
and pubic hair development
d. Stage of breast development and stage of pubic hair
development
D
To accurately assess height velocity, the examiner must measure a child’s height at a. 6-month intervals. b. 12-month intervals. c. 18-month intervals. d. 24-month intervals.
B
A pregnant patient has a prepregnancy body mass index of
- The examiner expects this patient’s weight gain during pregnancy to fall into which weight range?
a. Less than 20 pounds
b. 20 to 26 pounds
c. 25 to 35 pounds
d. 40 to 50 pounds
- The examiner expects this patient’s weight gain during pregnancy to fall into which weight range?
C
You ask an 82-year-old patient to keep a food diary to aid in assessing the adequacy of her diet. Which is an appropriate instruction to provide?
a. Keep the diary for 3 days. Start tomorrow morning at breakfast and end before breakfast on Friday.
b. Make a list of what and how much you eat or drink at each meal for the next week.
c. Keep a record of everything you eat and drink over the weekend. Be sure to include snacks and alcohol.
d. Write down what/how much of everything you eat and drink for four days, at least one of which is a weekend day.
D
To assess and monitor growth, the examiner makes routine measurements of an infant’s weight, length, and which of the following?
a. Head circumference
b. Hip-to-toe length
c. Forearm length
d. Chest circumference
A
A 4-month-old infant is brought to the clinic. At birth, the baby weighed 6 pounds, 8 ounces. If the baby is gaining weight at the desired rate, the examiner should expect the baby to now weigh
a. 9 pounds.
b. 11 pounds
c. 13 pounds
d. 15 pounds.
D
Which hormone has a key role in regulating body fat mass and is thought to be a trigger for puberty?
a. Leptin
b. Androgen
c. Estrogen
d. Growth hormone
A
A dietary assessment is performed by:
a. comparing established eating habits with the
recommended dietary allowances.
b. asking the patient to fill out a food pyramid.
c. comparing the recommended dietary allowances to the
U.S. Department of Agriculture MyPlate.
d. asking the patient to do a 24-hour dietary recall
D
Which position would you ask a 14-year-old male patient to assume in order for you to assess his pubertal development? a. Sitting B. Standing C. Lying supine D. Knee-chest
B
A 22-year-old patient presents for a routine physical examination. As part of her history, she states that she has been on a vegan diet for 14 months. Based on this information, you would be most concerned about a possible deficiency in which two nutrients?
a. Calcium and vitamin B12
b. Protein and iron
c. Vitamin D and phosphorus
d. Fat and vitamin A
A
round, active margins with central clearing
Annular
referring to lesions that run together
Confluent
widely distributed or present in several areas simultaneously
Generalized
a mole that varies in size and degree of pigmentation
Nevus
a fluid- filled and elevated, but superficial, skin lesion
Vesicles
a bluish discoloration of the hands and feet that may be present at birth and may persist for several days or longer if the newborn is kept in cool ambient temperatures
Acrocyanosis
fine, silky hair of newborns found on the shoulders and back
Lanugo
tiny, flat, purple, or red spots on the skin surface resulting from minute hemorrhages within the dermal layer smaller than 0.5 cm in diameter
Petechiae
refers to maculopapular lesions that become confluent on the face and body (often drug induced)
Morbilliform
Hair loss
Alopecia
permanently dilated, small blood vessels consisting of venules or arterioles
Telangiectasis
hyperpigmentation that occurs in pregnant women and is found on the forehead, cheeks, bridge of the nose, and chin; it is blotchy and symmetric
Chloasma
flat, deep- pink, localized areas usually seen on the mid-forehead, eyelids, upper lip, and back of the neck in a newborn.
Salmon patches (stork bite)
a discoloration produced by injury
Ecchyomosis
a lipid substance that keeps skin and hair from drying out.
Sebum
a type of skin lesion common in patients with psoriasis.
Plaque
referring to a lesion that follows a nerve or segment of the body.
Dermatomal
irregularly shaped, elevated, progressively enlarging, and hypertrophied scar.
Keloid
referring to a star-shaped lesion
Stellate
synthesized in the stratum germinativum by melanocytes and is the pigment that gives skin its color.
Melanin
a mixture of sebum and cornified epidermis that covers the infant’s body at birth
Vernix caseosa
referring to a lesion with a netlike or lacy appearance
Reticulate
referring to lesions that appear to occur in a wavy line
Serpiginous
Type of lesion in: chickenpox
Vesicles
Type of lesion in insect bite
Wheal
Type of lesion in impetigo
Pustule
Type of lesion in chronic atopic dermatitis
Lichenification
Type of lesion in lipoma
Tumor
Type of lesion in blister
Bulla
Type of lesion in wart
Papule
Type of lesion in port-wine stain
Patch
Type of lesion in petechiae
Macule
Stratum corneum is found in the
Epidermis
Autonomic motor nerves are found in the
Dermis
Cellular stratum is found in the
Epidermis
Keratin cells are found in the
Epidermis
Reticulum fibers is found in the
Dermis
Subcutaneous layer is found in the
Hypodermis
Stratum germinativum is found in the
Epidermis
Skin layer that generates heat
Hypodermis
Milia are an expected finding in which age group?
a. Newborns
b. Young children
c. Adolescents
d. Older adults
A
An older patient asks the examiner, “Is this spot on my chin a cancer?” Which of the following would indicate a need for further medical investigation?
a. Reddish-brown color of the lesion
b. Presence on his chin for 20 years
c. Bleeds easily when it is touched
d. Slightly raised and circumscribed
C
A 6-year-old girl has freckles over her nose and cheeks. Freckles are a type of a. macule. b. papule. c. nodule. d. petechiae
A
What grade should be assigned to a pressure ulcer over the coccyx that is open and shallow, showing a red-pink wound bed?
a. Stage I
b. Stage II
c. Stage III
d. Stage IV
B
Why do some infants develop a yellowish skin tone on the third or fourth day of life?
a. Increased formation of subcutaneous tissue causes a yellow hue.
b. Capillaries broken during the birth process turn the skin yellow as bruises heal.
c. Yellowish color results from increased fat metabolism and heat production.
d. Red blood cells that hemolyze after birth may cause a yellow skin hue.
D
An adolescent pt asks the examiner why teens have more problems with acne than children. Which of the following would be an appropriate response?
a. “Children have better hygiene habits than adolescents because of parental guidance.”
b. “Adolescents have reduced blood flow to the epidermal layer of the skin, making them more susceptible to infections.”
c. “At puberty, adolescents begin to secrete more oil from their sebaceous glands
d. “Children have very little skin mass, which prevents development of acne”
C
Chloasma is an expected finding in which of the following?
a. Newborns
b. Adolescents
c. Pregnant women
d. Older adults
C
While examining the skin of an 87-year-old woman, the examiner observes significant tenting. Which of the following age-associated changes best explains this finding?
a. Small skin tags form on the neck and back.
b. The skin becomes thin and takes on a parchment-like
appearance.
c. The skin becomes dry, with significant flaking.
d. There is loss of adipose tissue and loss of elasticity.
D
When assessing for the presence of clubbing, the examiner specifically examines the
a. width of the nail base.
b. angle of the nail base.
c. thickness of the nail.
d. color of the nail.
B
Which type of lesion sometimes grows out of an already- present nevus?
a. Malignant melanoma
b. Squamous cell carcinoma
c. Basal cell carcinoma
d. Kaposi sarcom
A
A skin lesion is described as sessile by the examiner. This means that the lesion a. does not have a stalk. b. is freely moveable. c. bleeds easily D. Has a spongy consistency
A
The examiner notes a large blue-black spot on the buttock of a 4-week-old black neonate. The mother states that the infant was born with it. The examiner should recognize that this
a. is a common finding.
b. may indicate child abuse.
c. is related to birth trauma.
d. suggests a congenital defect.
A
Which of the following may be associated with neurofibromatosis or pulmonary stenosis?
a. Café au lait patches
b. Nevus vasculosus
c. Port-wine limb stain
d. Spider angioma
A
Which lesion is an expected finding on the skin of healthy older adults?
a. Acne vulgaris
b. Cherry angioma
c. Miliaria
d. Trichotillomania
B
When palpating skin surfaces for temperature, the examiner should use the
a. palmar aspect of the hand.
b. fingertips of the dominant hand.
c. dorsal aspect of the hands or fingers.
d. ulnar surface of the hand.
C
Hyperkeratosis is noted on a patient’s palms and soles. The examiner recognizes that this
a. may be a sign of a systemic disorder.
b. may be an indication of a congenital heart defect.
c. is common among individuals with Down syndrome.
d. is considered a normal finding.
D
A patient with diabetes presents to the clinic complaining of an infected foot. Upon removing the patient’s sock, the examiner notes an odor that resembles rotting apples. This finding is consistent with which type of infection? A. Pseudomonas aeruginosa B. Proteus C. Viridans streptococci D. Clostridium
D
Which finding is consistent with a physical abuse injury in a toddler?
a. Burn to the skin with a splash pattern
B. Bruising of the skin over soft tissue
C. Bruising of the skin over a bony prominence
D. Cafe au lait patches
B
Which of the following techniques helps the examiner determine whether a palpable skin mass is filled with fluid?
a. Using a Wood’s lamp
b. Palpating
c. Transilluminating
d. Noting the odor of the lesion
C
Which of the following findings suggests that a patient has a fungal infection of the nail beds?
a. The nail bed is wide and thick.
b. The nail plate has a central depression, causing a spoon
appearance.
c. Superficial white spots are present in the nail plate.
d. The nail plate is yellow and crumbling
D
small nontender nodes that feel like BBs or buckshot under the skin
Shotty nodes
clear, sometimes milky-colored or yellow-tinged fluid containing a variety of white blood cells, most of which are lymphocytes, and an occasional red blood cell
Lymph
a congenital malformation of dilated lymphatics
Lymphangioedema
enlarged lymph nodes
Lymphadenopathy
wavelike motion that is felt when the node is palpated
Fluctuant
group of nodes that feel connected and seem to move as a unit
Matted
inflamed and enlarged lymph node(s)
Lymphadenitis
What lymph node is in this location: Above and in front of the ear
Preauricular
What lymph node is in this location: Superficial to the mastoid process
Postauricular
What lymph node is in this location: Base of the skull
Occipital
What lymph node is in this location: Behind the tip of the mandible
Submental
What lymph node is in this location: halfway between the angle and tip of the mandible
Submandibular
What lymph node is in this location: Overlying the sternomastoid muscle
Superficial cervicle
What lymph node is in this location: Deep under the sternomastoid muscle
Deep cervicle
What lymph node is in this location: posterior triangle along the edge of the trapezius muscle
Posterior cervicle
What lymph node is in this location: above and behind the clavicle
Supraclavicular
During an examination, which of the following questions would be most appropriate for the examiner to ask a patient to elicit information about the lymph system?
a. “Are you aware of any lumps?”
b. “Have you had a change in appetite?”
c. “Do your lymph nodes hurt?”
d. “Where are your largest lymph nodes?
A
While palpating lymph nodes on an adult, the examiner should remember that
a. tubercular nodes are hot and firm to the touch.
b. nodes that are fixed and palpable are a normal finding.
c. heavy pressure is required to locate and identify nodes.
d. easily palpable nodes are generally not found in healthy adults.
D
In comparison with those of a young adult, the lymph nodes of an older adult will be a. large and soft. b. small and fatty C. Hard and irregular D. Large and hard
B
A 19-year-old man has a severe infection involving the fifth digit of his right hand. Where should the examiner expect to palpate enlarged and tender lymph nodes?
a. Radial aspect of the right wrist
b. Palmar aspect of the right hand
c. Lateral aspect of the right forearm
d. Medial aspect of the right elbow
D
Which of the following examination findings in an adult is a major cause for concern?
a. A palpable fluctuant lymph node movable under the examiner’s fingers.
b. A palpable hard lymph node fixed in its setting
C. A palpable soft lymph node approximately 2 mm in size
D. Absence of any palpable lymph nodes
B
The most common causes of acute suppurative lymphadenitis are which organisms?
a. Pseudomonas and Clostridium spp.
b. Streptococcus and Staphylococcus spp.
c. Candida and Chlamydia spp.
d. Aspergillus and Escherichia spp
B
The examiner typically assesses the lymph system using which of the following methods?
a. Assesses the entire lymph system as a unit, exploring all accessible nodes.
b. Assesses both the superficial and deep nodes using palpation and a Doppler study.
c. Assesses the lymph system region by region as each body system is assessed.
d. Assesses the lymph nodes only when the patient’s history suggests a need to do so.
C
A 2-month-old infant is brought to the clinic for immunizations. The examiner palpates enlarged inguinal nodes. What additional finding might explain the enlarged nodes?
a. The mother reports that the infant has colic.
b. The infant’s length and weight are above the 85th
percentile.
c. The infant has a severe diaper rash.
d. A port-wine stain is present on the infant’s left thigh.
C
As the examiner palpates an enlarged lymph node, the patient complains of pain. This is suggestive of
a. an inflammatory process.
b. Hodgkin disease.
c. immature lymph node development.
d. toxoplasmosis.
A
Which examination method is used to differentiate an enlarged lymph node from a cyst?
a. Palpation
b. Auscultation
c. Biopsy
d. Transillumination
D
Which of the following methods best describes how to assess supraclavicular lymph nodes?
a. Have the patient assume a supine position and then hold his or her breath.
b. Place the patient in the Trendelenburg position and illuminate the lymph nodes with a bright light.
c. Palpate deeply behind the clavicles as the patient takes a deep breath.
d. Hook fingers over the clavicles with the patient in a sitting position, with head flexed
D
The examiner notes enlarged tonsils in a young child. The examiner should recognize that this
a. is an indication of a retropharyngeal abscess.
b. may be an early indication of Epstein-Barr virus.
c. is an indication that the child has lymphoma
d. may be a normal finding.
D
In addition to the head, neck, axillae, and inguinal area, the
examiner may also assess lymph nodes in which location?
a. On the palmar aspect of the hands
b. In the popliteal region
c. In the patellar region
d. On the dorsum of the foot
B
Which of the following is an assessment technique that can
differentiate mumps from cervical adenitis?
a. Palpating for the angle of the jaw
b. Palpating enlarged lymph nodes
c. Noting painful lymph nodes
d. Noting swelling of the face
A
On examining a patient, you find matted occipital lymph nodes. What do you do to facilitate subsequent assessment for change in the matted nodes?
a. Outline the mass with a skin pen.
b. Tattoo the center of the mass
C. Mark 12, 3, 6, and 9 o’clock positions on the periphery of
the mass with a skin pencil.
d. Use calipers to obtain the diameter of the mass
C
A patient presents to the office with a complaint of a lump in the neck. What would you expect to feel if the problem involved a cancer that had spread through the lymph system?
a. A soft lymph node less than 0.5 cm in size
b. Multiple small, hard, nontender nodes
c. A single, firm node affixed to underlying tissue
d. Solitary, tender, matted node of variable size
C
Normal cervical lymph nodes typically are a. matted B. Tender to palpation C. Rubbery D smaller than 1 cm
D
On examination of a patient, you palpate enlarged preauricular and submandibular lymph nodes. Which term can be used to describe the finding?
a. Lymphadenopathy
b. Lymphadenitis
c. Lymphangitis
d. Lymphedema
A
How should the patient be positioned when you palpate for
left inguinal lymph nodes?
a. Standing, with weight on the right leg
b. Sitting, with legs dangling
c. Supine, with knees slightly bent
d. Supine, with the left leg externally rotated
C
Which finding is the most concerning?
a. 3-mm occipital lymph node in a neonate
b. 6-mm postauricular lymph node in a 1 year old
c. 0.5-cm cervical lymph node in a 3 year old
d. 0.8-cm supraclavicular lymph node in a 5 year old
D
Which is the function of the thymus in early life and young children?
A. Protective immune function
B. Drain lymph from the chest
C. Destroying old white blood cells
D. Filtering mechanism from white blood cells
B
Which organ does NOT have lymphatic vessels? A. Brain B. Intestine C. Bone Marrow D. Lungs
A
Small, clustered lymphoid nodules that are raised areas of lymph tissue of the small intestine are called: A. adenoids B. Thymus C. Peyer patches D. Spleen
C
Enlarged, painful lymph nodes, firm and tender, with mild edema, caused by group A beta-hemolytic streptococci is: A. Acute suppurative lymphadenitis B. Lymphatic filariasis C. Lymphangioma D. Lymphedema
A
Which is a chronic autoimmune disorder? A. Microcephaly B. Hashimoto disease C. Salivary gland tumor D. Down syndrome
B
Mrs. Wagner is a 45 year old patient. You are examining her thyroid and note a course and gritty sensation. This is indicative of: A. Cancer B. Nodules C. Goiter D. Inflammatory process
D
Palpable supraclavicular node on left indicative of a thoracic or abdominal malignancy
Virchow Node
The lymph system is considered a _________ and _________ circulation system
Closed; porous
Produce antibodies
B lymphocytes
Site for T cell production
Thymus
