Phys assess #3

Question 1

Sensory organ for vision-

Answer 1

Eyes

Question 2

Important for functioning and ability to perform

Answer 2

Eyes

Question 3

Transparent protective cover of the eye is the ___

Answer 3

cornea

Question 4

Lacrimal apparatus-

Answer 4

irrigates the eye by producing tears

Question 5

Movement of the extraocular muscles stimulated by

Answer 5

three cranial nerves

Question 6

Cranial nerve VI (6):

Answer 6

abducens nerve, innervates lateral rectus muscle, which abducts eye

Question 7

Cranial nerve IV (4):

Answer 7

trochlear nerve, innervates superior oblique muscle

Question 8

Cranial nerve III (3):

Answer 8

oculomotor nerve, innervates all the rest: the superior, inferior, and medial rectus and the inferior oblique muscles

Question 9

There are _ muscles that move the eye and keep it straight and rotate

Answer 9

6

Question 10

Each muscle makes sure both eyes move together, known as _____ (eyes remain parallel)

Answer 10

conjugate movement

Question 11

Parallel axis is important for eye movement bc the human brain is ____ or a single image visual system

Answer 11

Binocular

Question 12

Both eyes creating one image in the brain

Answer 12

Binocular/Single image visual system

Question 13

Follow movement of pen light or object proceeding clockwise.

Answer 13

Six cardinal positions of gaze

Question 14

Assess for potential extra ocular muscle (EOM) weakness, nystagmus or lid lag.

Answer 14

Six cardinal positions of gaze

Question 15

Normal response is eyes being able to track the movement parallel

Answer 15

Six cardinal positions of gaze

Question 16

Weakness in cranial nerve or muscle dysfunction if the eyes do not move parallel

Answer 16

Six cardinal positions of gaze

Question 17

Three concentric coats of the eye

Answer 17

Outer, middle, and inner coat

Question 18

Outer coat

Answer 18

Sclera and cornea

Question 19

Middle coat

Answer 19

Choroid, pupil, and the anterior and posterior chambers of the lens

Question 20

Inner coat

Answer 20

Contains the retina

Question 21

Internal Anatomy: Outer Layer

Answer 21

Sclera, Cornea, Corneal reflex, Trigeminal nerve, Facial nerve

Question 22

Sclera:

Answer 22

tough, protective, white covering.

Question 23

Continuous anteriorly with smooth, transparent cornea, which covers iris and pupil

Answer 23

Sclera

Question 24

Cornea:

Answer 24

part of refracting media of eye, bending incoming light rays so that they will be focused on inner retina.

Question 25

Corneal reflex—

Answer 25

contact with a wisp of cotton stimulates a blink response in both eyes simultaneously.

Question 26

Trigeminal nerve-

Answer 26

cranial nerve V, sending message from corneal reflex to the brain, carries afferent sensation into brain.

Question 27

Facial nerve-

Answer 27

cranial nerve VII, causes the blink reflex, carries efferent message that stimulates blinking

Question 28

Sensitive to touch-

Answer 28

cornea and sclera

Question 29

Internal Anatomy: Middle Layer

Answer 29

Choroid, Iris, Muscle fibers, Pupil changes, Lens

Question 30

Choroid:

Answer 30

has dark pigmentation to prevent light from reflecting internally and is heavily vascularized to deliver blood to retina

Question 31

Iris:

Answer 31

Functions as a diaphragm, varying opening at its center

Question 32

The pupil changes size in order to control amount of ___ in the pupil.

Answer 32

light

Question 33

Dilates when light is dim and focus on far vision.
Constricts when light is bright and focus on near vision.

Answer 33

Pupil

Question 34

Budges to see near objects.
Flatten to focus on far objects.

Answer 34

Lens

Question 35

Muscle fibers of iris contract pupil in ____

Answer 35

bright light and to accommodate for near vision

Question 36

Pupil:

Answer 36

round and regular; size determined by balance between parasympathetic and sympathetic chains of autonomic nervous system

Question 37

Stimulation of parasympathetic branch, through ____, causes constriction of pupil.

Answer 37

cranial nerve III

Question 38

Stimulation of sympathetic branch

Answer 38

dilates pupil and elevates eyelid.

Question 39

Pupil size also reacts to amount of ___ and to accommodation, or focusing an object on retina.

Answer 39

ambient light

Question 40

The fight or flight mode is responsible for

Answer 40

constriction and dilation of the pupils

Question 41

Lens:

Answer 41

biconvex disc located just posterior to pupil

Question 42

Different pupil size can occur up to 20% of population.

Answer 42

Anisocoria

Question 43

Can indicate glaucoma, brain bleed, traumatic brain injury, cancer, or concussion.

Answer 43

Anisocoria

Question 44

Transparent; it serves as a refracting medium, keeping a viewed object in focus on retina

Answer 44

Lens

Question 45

Anterior and posterior chambers contain clear, watery aqueous humor produced continually by ciliary body.

Answer 45

Lens

Question 46

Continuous flow of fluid serves to deliver nutrients to surrounding tissues and to drain metabolic wastes.

Answer 46

Lens

Question 47

Intraocular pressure determined by balance between amount of aqueous produced and resistance to outflow

Answer 47

Lens

Question 48

Internal Anatomy: Inner Layer

Answer 48

Retina, Optic disk, Retinal vessels, Macula

Question 49

Retina:

Answer 49

the visual receptive layer of eye where light waves change into nerve impulses

Question 50

Retinal structures viewed through ophthalmoscope are

Answer 50

optic disc, retinal vessels, general background, and macula.

Question 51

Optic disc:

Answer 51

area in which fibers from retina converge to form optic nerve

Question 52

Located toward nasal side of retina, it has characteristics specific to color, shape and margins

Answer 52

Optic disc

Question 53

Retinal vessels:

Answer 53

normally include a paired artery and vein extending to each quadrant.
Receiving and transducing light from central field

Question 54

located on temporal side of fundus

Answer 54

Macula:

Question 55

Slightly darker pigmented region surrounding fovea centralis, area of sharpest and keenest vision

Answer 55

Macula:

Question 56

Receives and transduces light from center of visual field

Answer 56

Macula:

Question 57

Image that is formed on the retina is going to be

Answer 57

upside down and reversed

Question 58

normal constriction of pupils when bright light shines on retina.

Answer 58

Pupillary light reflex

Question 59

Note direct and consensual pupillary constriction.

Answer 59

Pupillary light reflex

Question 60

Subcortical reflex arc with no conscious control

Answer 60

Pupillary light reflex

Question 61

a reflex direction of eye toward an object attracting a person’s attention

Answer 61

Fixation:

Question 62

Image fixed in center of visual field, the fovea centralis

Answer 62

Fixation:

Question 63

adaptation of eye for near vision.

Answer 63

Accommodation:

Question 64

Accomplished by increasing curvature of lens through movement of ciliary muscles

Answer 64

Accommodation:

Question 65

Although lens cannot be observed directly, the following components of accommodation can be observed:

Answer 65

Convergence (motion toward) of the axes of the eyeballs
Pupillary constriction

Question 66

Responses to pupillary light reflex under the influence of alcohol, drugs, fatigued, or not paying attention can show

Answer 66

abnormal movements

Question 67

____ vision is intact in newborn infant.

Answer 67

Peripheral

Question 68

Macula, area of keenest vision, is absent at birth but mature by

Answer 68

8 months.

Question 69

By ___ months of age, infant establishes binocularity. Before that age the muscles are not that strong (cross-eyed).

Answer 69

3 to 4

Question 70

Can fixate on a single image with both eyes simultaneously

Answer 70

binocularity

Question 71

Lens is nearly spherical at birth.

Answer 71

Growing flatter throughout life

Question 72

Consistency changes from that of soft plastic at birth to rigid glass consistency in old age.

Answer 72

Lens

Question 73

Eye function is limited and movement is poorly coordinated

Answer 73

at birth

Question 74

Age-related farsightedness

Answer 74

Presbyopia

Question 75

Lens loses elasticity, becoming hard and glasslike, which decreases ability to change shape to accommodate for near vision.

Answer 75

Presbyopia

Question 76

Accommodation is lost so it effects near vision.

Answer 76

Presbyopia

Question 77

Most common causes of decreased visual functioning in older adults are the following:

Answer 77

Cataract formation, Glaucoma, Age-related macular degeneration (AMD), Diabetic retinopathy

Question 78

Clouding or lens opacity, resulting from a clumping of proteins in lens

Answer 78

Cataract

Question 79

Decreased peripheral vision and will compensate by turning their head

Answer 79

Glaucoma

Question 80

Increased intraocular pressure- Chronic open-angle glaucoma is most common type.

Answer 80

Glaucoma

Question 81

Complain of almost tunnel vision changes that are gradual.

Answer 81

Glaucoma Late stages-

Question 82

Breakdown of cells in macula of retina; loss of central vision

Answer 82

Age-related macular degeneration (AMD)

Question 83

Leading cause of blindness in adults ages 25 to 74 years of age.

Answer 83

Diabetic retinopathy

Question 84

Pupil size decrease by the age of __

Answer 84

70

Question 85

Normal transparent clean lens will begin to thicken and yellow which begins formation of

Answer 85

cataracts

Question 86

Visual acuity diminishes gradually after age __ and more after age of __

Answer 86

50, 70

Question 87

Open angle glaucoma

Answer 87

Obstructed drainage canal

Question 88

Closed angle glaucoma

Answer 88

Pressure pushes iris against cornea

Question 89

most common, no s/sx at the beginning

Answer 89

Open angle

Question 90

Glaucoma is caused by increased

Answer 90

intraocular pressure

Question 91

The iris may appear bulging because the aqueous humor cannot circulate throughout the eye and the pressure is increased

Answer 91

Glaucoma

Question 92

Peripheral vision effected

Answer 92

Glaucoma

Question 93

Affect central part of vision

Answer 93

Age-related macular degeneration (AMD)

Question 94

Most common cause of blindless characterized by the loss of central vision

Answer 94

Age-related macular degeneration (AMD)

Question 95

Its not consistent with vision that is considered normal at any age- not a common finding

Answer 95

Age-related macular degeneration (AMD)

Question 96

Culturally based variability present in color of

Answer 96

iris and retinal pigmentation

Question 97

___ are a leading cause of blindness worldwide.

Answer 97

Cataracts

Question 98

Estimated that 80% are preventable or curable with surgery

Answer 98

Cataracts

Question 99

Glaucoma incidence increases with __

Answer 99

age.

Question 100

Glaucoma: African Americans ___ times more likely to develop than Caucasian Americans.

Answer 100

3-6

Question 101

Culture and Genetics

Answer 101

Age-related macular degeneration

Question 102

Visual Impairment-

Answer 102

defined by the inability of seeing letters on eye chart at 20/50 or below

Question 103

Primary angle glaucoma- primary cause of blindness in ___

Answer 103

African Americans and Hispanics

Question 104

Risk factors for primary angle glaucoma

Answer 104

Positive family history, smoking, light iris color, hypertension, high cholesterol and being female

Question 105

Visual screenings important for school aged children for safety and address eye issues at early age, helps detect ____

Answer 105

cross eye and lazy eye in children

Question 106

Patients may complain of shadow or diminished vision in one quarter to one half of visual field.

Answer 106

Retinal detachment

Question 107

If occurs after trauma or injury it is considered an emergency.

Answer 107

Retinal detachment

Question 108

Occurs bc part of retina has pulled away from support system

Answer 108

Retinal detachment

Question 109

Eyes Objective Data

Answer 109

Preparation, Position a person standing for vision screening; then sitting up with head at your eye level.

Question 110

Snellen eye chart Equipment needed:

Answer 110

Handheld visual screener
Opaque card or occluder
Penlight
Applicator stick
Ophthalmoscope

Question 111

most commonly used and most accurate for visual acuity

Answer 111

Snellen eye chart

Question 112

normal vision

Answer 112

20/20

Question 113

visual impairment

Answer 113

20/50

Question 114

Stand person 20 ft away from chart

Answer 114

Snellen eye chart

Question 115

if pt has glasses or contacts leave on but if reading glasses take off

Answer 115

Snellen eye chart

Question 116

Read smallest line of letter possible

Answer 116

Snellen eye chart

Question 117

If unable to see the largest letters going to shorten the distance from the chart.

Answer 117

Snellen eye chart

Question 118

If the pt is 10 ft away document it was

Answer 118

10/20

Question 119

If acuity ___ you can read 20 feet but others normally can see 30

Answer 119

20/30

Question 120

considered legally blind

Answer 120

20/200

Question 121

Also known as the Hirschberg test

Answer 121

Corneal Light Reflex

Question 122

Assess parallel alignment of eye axes by shining a light toward the person’s eyes.

Answer 122

Corneal Light Reflex (Hirschberg test)

Question 123

Direct the person to stare straight ahead as you hold the light about 30 cm (12 inches) away.

Answer 123

Corneal Light Reflex (Hirschberg test)

Question 124

Note reflection of light on corneas; should be in exactly same spot on each eye.

Answer 124

Corneal Light Reflex (Hirschberg test)

Question 125

If any asymmetry can identify deviation of the eye muscles or paralysis

Answer 125

Corneal Light Reflex (Hirschberg test)

Question 126

Perform cover test is asymmetric. The covered eye must response to reflex

Answer 126

Corneal Light Reflex (Hirschberg test)

Question 127

If child has untreated strabismus can lead to

Answer 127

permanent visual damage

Question 128

Younger than ___ could see some types of abnormalities bc muscles are not strong enough yet

Answer 128

6 months

Question 129

Ask the person to look up; using thumbs, slide lower lids down along orbital rim, being careful not to push against eyeball.

Answer 129

Conjunctiva and Sclera

Question 130

Inspect exposed area; eyeball should look moist, white, and glossy.

Answer 130

Conjunctiva and Sclera

Question 131

Numerous small blood vessels normally show through

Answer 131

transparent conjunctiva.

Question 132

Otherwise, conjunctivae clear and show normal color of structure below;

Answer 132

pink over lower lids and white over sclera.

Question 133

Note any color change, swelling, or lesions.

Answer 133

Conjunctiva and Sclera

Question 134

Be aware of ethnic variations.

Answer 134

Conjunctiva and Sclera

Question 135

Ask the person to look down; with thumbs, slide outer part of upper lid up along bony orbit to expose under lid; inspect for any redness or swelling.

Answer 135

Lacrimal Apparatus

Question 136

Normally puncta drain tears into

Answer 136

lacrimal sac.

Question 137

Presence of excessive tearing may indicate blockage of

Answer 137

nasolacrimal duct.

Question 138

Check by pressing index finger against sac, just inside lower orbital rim, not against side of the nose.

Answer 138

Lacrimal Apparatus

Question 139

Pressure will slightly evert lower lid, but there should be no other response to pressure.

Answer 139

Lacrimal Apparatus

Question 140

Tear duct

Answer 140

Lacrimal Apparatus

Question 141

Shine light from side across cornea and check for

Answer 141

smoothness and clarity.

Question 142

Oblique view highlights any abnormal irregularities in corneal surface.

Answer 142

Cornea and Lens

Question 143

Should not be cloudiness or opacities

Answer 143

Cornea and Lens

Question 144

___ a common finding in geriatric pts, opacity around the cornea

Answer 144

Arcus senilis

Question 145

Note size, shape, and equality of

Answer 145

pupils

Question 146

Normally pupils appear

Answer 146

round, regular, and of equal size in both eyes

Question 147

Normal response includes

Answer 147

pupillary constriction.
convergence of axes of eyes.

Question 148

Test for accommodation by asking the person to focus on a

Answer 148

distant object

Question 149

Record normal response to all these maneuvers as PERRLA, or

Answer 149

Pupils Equal, Round, React to Light, and Accommodation.

Question 150

Muscle fibers of the iris are going to contract the pupil in

Answer 150

bright light

Question 151

Accommodate for near vision, when contracts allow pupil to

Answer 151

constrict

Question 152

May have smaller pupils and slower responses-

Answer 152

older adults, constriction should be symmetric

Question 153

Poor coordinated eye movement

Answer 153

Newborns

Question 154

In newborns, ___ common; eyes appear to deviate down with white rim of sclera visible over iris

Answer 154

setting-sun sign

Question 155

Many infants have an ___, an excess skinfold extending over inner corner of eye, partly or totally overlapping inner canthus.

Answer 155

epicanthal fold

Question 156

Iris normally blue or slate gray in light-skinned newborns and brown in dark-skinned infants;

Answer 156

by 6 to 9 months, permanent color differentiated

Question 157

When assessing children use appropriate assessment for

Answer 157

developmental stage

Question 158

Adults: Eyes may appear sunken from atrophy of

Answer 158

orbital fat

Question 159

Orbital fat may herniate, causing bulging at

Answer 159

lower lids and inner third of upper lids.

Question 160

____ may decrease tear production, causing eyes to look dry and lusterless and the person to report a burning sensation.

Answer 160

Lacrimal apparatus

Question 161

__ may look cloudy with age

Answer 161

Cornea

Question 162

Arcus senilis is commonly seen around cornea.

Answer 162

Can be common caused by deposits of lipid material.

Question 163

Lower eye lids droopy- muscle fiber looses elasticity and roll outward. can complain of dry and itchy.

Answer 163

Ectropion

Question 164

Hordeolum (Stye)

Answer 164

Hordeolum (Stye)

Question 165

Localized staph infection

Answer 165

Hordeolum (Stye)

Question 166

Affects hair follicle along lid margin

Answer 166

Hordeolum (Stye)

Question 167

Painful, red, swollen

Answer 167

Hordeolum (Stye)

Question 168

Contagious and rubbing eye can cause cross-contamination

Answer 168

Hordeolum (Stye)

Question 169

Recommend warm compresses, wash hands, do not rub both eyes, topical antibiotics

Answer 169

Hordeolum (Stye)

Question 170

Acute localized staph infection that occurs at hair follicles are lid margin

Answer 170

Hordeolum (Stye)

Question 171

Caused by blunt trauma.

Answer 171

HYPHEMA

Question 172

Can also results from herpes zoster infection.

Answer 172

HYPHEMA

Question 173

Can see blood in anterior chamber in the eye and gravy cause blood to settle in front of the iris.

Answer 173

HYPHEMA

Question 174

External portion of the ear-

Answer 174

Pinna or auricle

Question 175

Consists of movable cartilage and skin

Answer 175

Ear

Question 176

Auditory canal-

Answer 176

slight s curvature in the adult patient

Question 177

External Ear Called the

Answer 177

auricle or pinna

Question 178

serves as a funnel for sound waves into its opening, shape of the canal

Answer 178

External auditory canal

Question 179

2.5-3 cm in length

Answer 179

Auditory canal

Question 180

Extends to the ear drum

Answer 180

Auditory canal

Question 181

Lined with glands that secrete cerumen that lubricate and protect ear

Answer 181

Auditory canal

Question 182

Outer one third of canal is cartilage

Answer 182

Auditory canal

Question 183

inner two thirds of the tunnel is covered by

Answer 183

very thin and sensitive skin

Question 184

Also called the eardrum

Answer 184

Tympanic Membrane

Question 185

Translucent membrane with a pearly gray color

Answer 185

Tympanic Membrane

Question 186

Oval and slightly concave, pulled in at its center by one of middle ear ossicles, the malleus- parts that show through the eardrum called the umbo, manubrium, and short process.

Answer 186

Tympanic Membrane

Question 187

Separates external and middle ear-

Answer 187

tympanic membrane

Question 188

Tiny air-filled cavity inside temporal bone

Answer 188

Middle Ear

Question 189

Middle Ear contains tiny ear bones, or auditory ossicles:

Answer 189

Malleus
Incus
Stapes

Question 190

Several openings are present.

Answer 190

Middle Ear

Question 191

To the outer ear and inner ear eustachian tube:

Answer 191

opening that connects middle ear with nasopharynx and allows passage of air

Question 192

Normally closed, but opens with swallowing or yawning

Answer 192

Tubea

Question 193

Conduct sound vibrations from outer ear

Answer 193

Function of middle ear

Question 194

To central hearing apparatus that is located in the inner ear

Answer 194

Function of middle ear

Question 195

Protects inner ear by reducing amplitude of loud sounds

Answer 195

Function of middle ear

Question 196

Allows equalization of air pressure on each side of the tympanic membrane to prevent rupturing

Answer 196

Function of middle ear

Question 197

Contains the bony labyrinth, which holds sensory organs for equilibrium and hearing.

Answer 197

Inner Ear

Question 198

Cochlea contains central hearing apparatus.

Answer 198

Inner Ear

Question 199

Not assessable for direct examination can still assess function of it

Answer 199

Inner Ear

Question 200

Auditory system can be divided into three levels

Answer 200

Peripheral, Brain Stem, Cerebral Cortex

Question 201

Amplitude:

Answer 201

loudness

Question 202

Frequency:

Answer 202

pitch or number of cycles per second

Question 203

Sound waves produce vibrations on __

Answer 203

Tympanic membrane

Question 204

Ear transmits sounds and convert sounds into

Answer 204

vibrations.

Question 205

Then turns them into electrical impulses that the brain analyzes-

Answer 205

Peripheral

Question 206

Sensory organ of hearing, Numerous fibers on membrane.

Answer 206

Organ of corti

Question 207

Hair cells bend and mediate vibrations into the

Answer 207

electrical impulses.

Question 208

The electrical impulses conducted by the auditory portion of

Answer 208

cranial nerve 8 to the brain stem

Question 209

Function at brainstem level is

Answer 209

binaural interaction

Question 210

Locates direction of a sound in space, as well as identifying the sound

Answer 210

binaural interaction

Question 211

___ from each ear sends signals to both sides of brainstem, which are sensitive to differences in intensity and timing of messages from two ears, depending on way head is turned

Answer 211

Cranial nerve VIII

Question 212

Normal pathway of hearing is _____ described previously; it is the most efficient.

Answer 212

Air conduction (AC)

Question 213

Alternate pathway of hearing is by

Answer 213

Bone conduction (BC)

Question 214

Bones of the skull vibrate and are transmitted directly to inner ear and to cranial nerve VIII.

Answer 214

Bone conduction (BC).

Question 215

___ is to interpret the meaning of that sound and begin appropriate response.

Answer 215

Function of cortex

Question 216

Hearing loss is anything that

Answer 216

obstructs transmission of sound and effects hearing

Question 217

Types of hearing loss

Answer 217

Conductive, Sensorineural/Perceptive, Mixed hearing loss

Question 218

Mechanical dysfunction of external or middle ear.

Answer 218

Conductive hearing loss

Question 219

Known as partial loss bc if the sound amplitude is increased high enough then the pt will be able to hear it

Answer 219

Conductive hearing loss

Question 220

Can be caused by impacted cerumen, foreign bodies in the ear canal, perforated tympanic membrane, or any other puss or serum located within the middle ear.

Answer 220

Conductive hearing loss

Question 221

Can be caused by otosclerosis

Answer 221

Conductive hearing loss

Question 222

Indicate pathology of the inner ear, Cranial nerve 8, or the auditory areas of the cerebral cortex.

Answer 222

Sensorineural/Perceptive) hearing loss

Question 223

If increasing amplitude the pt will not be able to hear it.

Answer 223

Sensorineural/Perceptive) hearing loss

Question 224

Can be caused by presbycusis or other ototoxic drugs that effect hear cells in cochlea.

Answer 224

Sensorineural/Perceptive) hearing loss

Question 225

Antibiotics, loop directs, nsaids and other cancer treatments- ototoxic

Answer 225

Sensorineural/Perceptive) hearing loss

Question 226

Mixed hearing loss: both conductive and sensoineural within same ear.

Answer 226

Mixed hearing loss

Question 227

Inner ear starts to develop early in __ of gestation.

Answer 227

5th week

Question 228

Early development ears

Answer 228

posteriorly rotated and low set

Question 229

Can effect hearing in infants-

Answer 229

rubella.

Question 230

Early during first trimester can harm organ of corti and impair hearing to the fetus.

Answer 230

rubella.

Question 231

Estuation tube is ___ position in infant.

Answer 231

shorter than, wider and more horizontal

Question 232

Increases middle ear infections

Answer 232

Estuation tube in infants/Children

Question 233

Lumen surrounded by lymphoid tissue, which increases during childhood and is

Answer 233

easily occluded.

Question 234

Infant’s and young child’s external auditory canal is __ to that of adults.

Answer 234

shorter and has a slope opposite

Question 235

Short and flat, easier for viruses to get in

Answer 235

Infant eustachian tube

Question 236

More angular, hard for viruses to get in from the nose

Answer 236

Adult eustachian tube

Question 237

Obstruction of eustachian tube or passage of nasopharyngeal secretions into middle ear

Answer 237

Otitis Media

Question 238

Common illness in children

Answer 238

Otitis Media

Question 239

Otitis media risk factors

Answer 239

Drinking bottles when sleeping, not being breastfed first month of life, 2nd hand smoke, attending day care, premature, male gender, fall and winter season.

Question 240

Increased ambulatory visits

Answer 240

Otitis Media

Question 241

Persistent effusion may lead to hearing loss.

Answer 241

Otitis Media

Question 242

Genetic variation regarding

Answer 242

cerumen development

Question 243

Caucasians and African American-

Answer 243

honey brown and dark down consistency, wet cerumen

Question 244

Asians and American Indians-

Answer 244

Dry and flakey cerumen with gray

Question 245

Ears Subjective Data

Answer 245

Earache
Infections
Discharge
Hearing loss
Environmental noise
Tinnitus
Vertigo
Patient centered are

Question 246

Hearing loss-

Answer 246

gradually or recently/quickly

Question 247

Environmental noise-

Answer 247

damage to hearing

Question 248

Tinnitus-

Answer 248

comes within the person, describe as ringing of crackling or buzzing sound. complaint of- is it louder when no other noise is present.

Question 249

Vertigo-

Answer 249

dizziness, room spinning

Question 250

Low speech pt cannot hear it.

Answer 250

If increase volume or make louder for them can be very painful for pts

Question 251

At what age was child’s first episode?

Answer 251

Infants and Children Ear infections

Question 252

Has child had any surgery, such as insertion of ear tubes or removal of tonsils?

Answer 252

Infants and Children Ear infections

Question 253

Does anyone in the home smoke cigarettes?

Answer 253

Infants and Children Ear infections

Question 254

Does child receive care outside your home?

Answer 254

Infants and Children Ear infections

Question 255

Does child seem to be hearing well?

Answer 255

Infants and Children hearing problems

Question 256

Have you noticed that infant startles with loud noise?

Answer 256

Infants and Children hearing problems

Question 257

Increased risk for developing recurrent ear infections if first episode of ear infection is before age of

Answer 257

3 months

Question 258

To determine recurrent otitis media-

Answer 258

3 episodes with in 3 months, 4 within last year, total, and how they treated

Question 259

Address problems early bc they are at grater risk for hearing loss, delayed speech, social development issues, and learn deficits.

Answer 259

Infants and Children

Question 260

Inspect and palpate external ear

Answer 260

Size and shape
Skin condition
Tenderness
External auditory meatus

Question 261

Skin color consistent with the person’s facial skin color
Skin intact, with no lumps or lesions

Answer 261

Skin condition

Question 262

Note size of opening to direct choice of speculum for otoscope; no swelling, redness, or discharge should be present.

Answer 262

External auditory meatus

Question 263

Some cerumen usually present with color and texture variation

Answer 263

External auditory meatus

Question 264

Should feel firm and produce no pain upon palpation

Answer 264

Pinna

Question 265

As you inspect external ear, note size of

Answer 265

auditory meatus.

Question 266

Choose largest ___ that will fit comfortably in ear canal.

Answer 266

speculum

Question 267

Pull pinna up and back on an adult or older child to straighten

Answer 267

S-shape of canal.

Question 268

Pull pinna down and back on an infant and a child

Answer 268

under 3.

Question 269

Hold pinna gently but firmly; do not release traction on ear until you have

Answer 269

finished examination and removed otoscope.

Question 270

Insert speculum

Answer 270

slowly and carefully

Question 271

Last, perform otoscopic examination before you

Answer 271

test hearing.

Question 272

Never touching boney section of canal wall bc its

Answer 272

very sensitive

Question 273

If impacted cerumen can give pt sense of

Answer 273

pathologic hearing loss

Question 274

Note any redness and swelling, lesions, foreign bodies, or discharge.

Answer 274

External Canal

Question 275

Frank blood or clear, watery drainage (cerebrospinal fluid [CSF]) after head injury suggests

Answer 275

basal skull fracture and warrants immediate referral.

Question 276

If any discharge is present note

Answer 276

color and odor.

Question 277

Loss of hearing esp. upper respiratory infection needs to be

Answer 277

reported and followed up immediately

Question 278

Tympanic Membrane (Ear Drum) Color and characteristics

Answer 278

Shiny pearl grey translucent

Question 279

Cone-shaped light reflex prominent in anteroinferior quadrant, a reflection of the otoscope light

Answer 279

Tympanic Membrane (Ear Drum)

Question 280

Sections of malleus are visible through translucent drum: the umbo, manubrium, and short process.

Answer 280

Tympanic Membrane (Ear Drum)

Question 281

May notice some scarring- If several ear infections

Answer 281

Tympanic Membrane (Ear Drum)

Question 282

Screening for hearing deficit begins during history;

Answer 282

how well does a person hear conversational speech?

Question 283

Measure hearing air conduction (AC) or by bone conduction (BC), in which

Answer 283

sound vibrates through cranial bones to the inner ear.

Question 284

When performing be careful to not injure the patient esp pain with increased sounds.

Answer 284

Tuning fork Tests

Question 285

Infants and young children hard to assess-

Answer 285

look at startle reflex, making loud noise to see response and if they can see toward.

Question 286

___ infant able to turn their head to localize sound and should respond to own name.

Answer 286

6-8 month

Question 287

Weber test
Rinne test

Answer 287

Tuning fork Tests

Question 288

If the child is being seen for any type of illness or fever

Answer 288

Autoscopic examination

Question 289

Should always be done in order to rule out ear infection.

Answer 289

Autoscopic examination

Question 290

Recommend to do this exam at the end of the examination bc parent may need to hold down

Answer 290

Autoscopic examination

Question 291

In addition to its place in complete examination

Answer 291

Otoscopic examination Infants and Young Children

Question 292

Positioning of child to get clear view of canal

Answer 292

Otoscopic examination Infants and Young Children

Question 293

Remember to pull pinna

Answer 293

straight down on an infant or a child younger than 3 years old; this will match slope of ear canal.

Question 294

Otoscopic examination is not performed at birth because

Answer 294

canal is filled with amniotic fluid and vernix caseosa; after a few days the TM is examined.

Question 295

Amber yellow color in tympanic membrane-

Answer 295

serum or puss with in middle ear.

Question 296

May complain of feelings of fullness or transient hearing loss or

Answer 296

popping sound when swallowing

Question 297

Young children to determine hearing loss-

Answer 297

may not pay attention to any normal conversation and react more to movement/facial expressions than they do to sound.

Question 298

Present with a speech problem and appear confused esp when talking to them.

Answer 298

Hearing problem

Question 299

May have pendulous ear lobes with linear wrinkling because of loss of elasticity of pinna (dangle)

Answer 299

Aging Adult

Question 300

High-tone frequency loss apparent for those affected with presbycusis

Answer 300

Aging Adult

Question 301

White in color, more opaque duller nad thicker than in younger adults

Answer 301

Aging Adult

Question 302

If high toned frequency loss they may complain of individuals mumbling when talking to them

Answer 302

Aging Adult

Question 303

Infection of outer ear

Answer 303

Otitis externa

Question 304

Severe pain with movement of pinna or tragus

Answer 304

Otitis externa

Question 305

S/Sx: Redness and swelling, drainage, scaling, itching, fever, enlarged regional lymph nodes

Answer 305

Otitis externa

Question 306

Can diminish hearing on affected ear

Answer 306

Otitis externa

Question 307

Dense white patches on ear drum

Answer 307

Scarred Drum

Question 308

Caused by repeated infections

Answer 308

Scarred Drum

Question 309

Do not necessarily affect hearing

Answer 309

Scarred Drum

Question 310

Repeated infections causes scars but wont affect pts ability to hear

Answer 310

Scarred Drum

Question 311

Middle ear fluid infection

Answer 311

Acute Otitis Media

Question 312

Absent light reflex- early sign of infection

Answer 312

Acute Otitis Media

Question 313

Increasing pressure in middle ear

Answer 313

Acute Otitis Media

Question 314

S/Sx: Fever, redness and bulging drum, earache (throbbing)
Hearing loss (transient)

Answer 314

Acute Otitis Media

Question 315

If bright red color of eardrum-

Answer 315

indicates acute otitis media

Question 316

Surgical intervention to treat chronic or recurrent middle ear infections. Decrease number of infection to promote drainage (aeration)

Answer 316

Tympanostomy Tubes

Question 317

Relieves middle ear pressure

Answer 317

Tympanostomy Tubes

Question 318

Promotes drainage

Answer 318

Tympanostomy Tubes

Question 319

Tubes are going to Spontaneously squeeze out 6 months to 1 year after insertion

Answer 319

Tympanostomy Tubes

Question 320

First part of the respiratory system

Answer 320

Nose

Question 321

Upper portion of the nose is made of

Answer 321

bone and the rest is cartilage

Question 322

First segment of respiratory system

Answer 322

Nose

Question 323

Upper third made up of bone; rest is cartilage

Answer 323

Nose

Question 324

Nasal cavity divided medially by septum into

Answer 324

two slit-like air passages

Question 325

Olfactory receptors, hair cells, lie at roof of

Answer 325

nasal cavity and upper third of septum.

Question 326

These receptors for smell merge into olfactory nerve, cranial nerve I, which transmits to

Answer 326

temporal lobe of brain.

Question 327

Paranasal sinuses:

Answer 327

air-filled pockets within the cranium

Question 328

Anterior part of the septum, Rich vascular network-

Answer 328

kiesselbach plexus- common site for nose bleeds

Question 329

Lateral walls contain 3 parallel boney progections called -

Answer 329

superior, middle, and the inferior turbonets

Question 330

Turbinates

Answer 330

Rich in blood vessels and purpose is to warm, filter and humidify air
Projections in the nasal cavity that increase the surface area

Question 331

Two pairs of sinuses are accessible to

Answer 331

examine.

Question 332

Frontal sinuses in frontal bone

Answer 332

above and medial to orbits

Question 333

Maxillary sinuses in

Answer 333

maxilla (cheekbone) along side walls of nasal cavity

Question 334

Other two sets are smaller and deeper.

Answer 334

Ethmoid and Sphenoid

Question 335

Ethmoid sinuses between

Answer 335

the orbits

Question 336

Sphenoid sinuses deep within skull in the

Answer 336

sphenoid bone

Question 337

Only maxillary and ethmoid sinuses are present at

Answer 337

birth.

Question 338

Adolescents the maxillary sinuses meet full size when the

Answer 338

permanent teeth are adult

Question 339

First segment of digestive system and an airway for the respiratory system

Answer 339

Mouth

Question 340

short passage bordered by lips, palate, cheeks, and tongue

Answer 340

Oral cavity:

Question 341

anterior border of oral cavity, transition zone from outer skin to inner mucous membrane lining the oral cavity

Answer 341

Lips:

Question 342

striated muscle, that is arranged in a crosswise pattern. So it can change shape and position for speaking chewing swallowing speech cleaning the teeth. Also assists in taste sensation.

Answer 342

Tongue:

Question 343

Mouth contains three pairs of

Answer 343

salivary glands.

Question 344

___ lies within cheeks in front of ear.

Answer 344

Parotid gland

Question 345

___ runs forward to open on buccal mucosa opposite second molar.

Answer 345

Stensen’s duct

Question 346

_____ lies beneath mandible at angle of jaw

Answer 346

Submandibular gland l

Question 347

____ runs up and forward to the floor of mouth and opens at either side of frenulum

Answer 347

Wharton’s duct

Question 348

____, the smallest, almond-shaped, lies within floor of mouth under tongue and has many small openings along sublingual fold under tongue.

Answer 348

Sublingual gland

Question 349

Largest of salivary glands-

Answer 349

Parotid

Question 350

located in front of the ear from the zygomatic arch and down the angle of the jaw

Answer 350

Parotid

Question 351

Glands secrete ____, the clear fluid that moistens and lubricates the food bolus, starts digestion, and cleans and protects the mucosa.

Answer 351

saliva

Question 352

Teeth-

Answer 352

32 permanent teeth adult, 16 in each arch

Question 353

(gingivae) collar the teeth.

Answer 353

Gums

Question 354

Thick fibrous tissues covered with mucous membrane

Answer 354

Gums

Question 355

Different from rest of oral mucosa because of their pale pink color and stippled surface

Answer 355

Gums

Question 356

Crown neck and root-

Answer 356

parts of teeth

Question 357

Area behind mouth and nose

Answer 357

Throat or Pharynx

Question 358

separated from mouth by a fold of tissue on each side, the anterior tonsillar pillar

Answer 358

Oropharynx:

Question 359

located behind the folds, mass of lymphoid tissue. Appear more granular in appurtenance and surface shows deep crypts (holes).

Answer 359

Tonsils:

Question 360

___ enlarges during childhood until puberty. Reaches adult length and then deteriorates

Answer 360

Tonsillar tissue

Question 361

___ starts at 3 months

Answer 361

Salivation

Question 362

Baby will drool periodically for a few months before learning to

Answer 362

swallow saliva.

Question 363

Development of teeth- begins in

Answer 363

utero.

Question 364

Children have 20 deciduous (2 1/2 years), or temporary, teeth that erupt between

Answer 364

6 months and 24 months of age.

Question 365

Deciduous teeth lost beginning at age ____; replaced by permanent, starting with central incisors

Answer 365

6 through 12

Question 366

____ develops shape during adolescence, along with other secondary sex characteristics.

Answer 366

Nose

Question 367

Nasal stuffiness and epistaxis(nose bleeds) may occur during pregnancy bc of

Answer 367

increased vascularity to the respiratory tract.

Question 368

Gums may be hyperemic and softened.

Answer 368

Pregnancy

Question 369

Bleeding gums when brushing teeth

Answer 369

Pregnancy

Question 370

Aging adult: Gradual loss of subcutaneous fat starts during later middle adult years,

Answer 370

making the nose appear more prominent in some people.

Question 371

Aging adult: Atrophic tissues ulcerate easily. Gums and nose drier and sensitive.

Answer 371

increasing risk for older people for infections, such as oral moniliasis and malignant lesions.

Question 372

Aging adult: Natural tooth loss exacerbated by inadequate dental care, poor oral hygiene, and tobacco use

Answer 372

can lead to malocclusion leading to further tooth loss and pain.

Question 373

Diminished sense of taste and smell

Answer 373

Can contribute to malnutrition in older adults

Question 374

Decreasing number of olfactory nerves related to

Answer 374

normal aging

Question 375

Protein, vitamin and mineral malnutrition occurrence due to

Answer 375

malnutrition

Question 376

Cleft lip and cleft palate-

Answer 376

congenital defect.

Question 377

Most common in Asians, intermediate in whites, and least common in blacks

Answer 377

Cleft lip and cleft palate

Question 378

A bony ridge running in middle of hard palate is seen in 20% to 35% of the US population.

Answer 378

Torus palatinus

Question 379

A benign lesion occurring on buccal mucosa is seen more often in black patients.

Answer 379

Leukoedema

Question 380

Dental caries if poor oral health (broken teeth, cavities.)- broken skin tissue within the mouth leaves greater risk for infection and dental disease.

Answer 380

Increased evidence of oral cancers by HPV and changes in sexual norms

Question 381

Subjective Data: Nose

Answer 381

Discharge-color, consistency
Frequent colds (upper respiratory infections)
Sinus pain
Trauma
Epistaxis (nosebleeds)
Allergies
Altered smell

Question 382

Altered smell Causes:

Answer 382

cigarette smoking, chronic allergies and aging

Question 383

Overuse of over-the-counter nasal medications irritates the

Answer 383

mucosa

Question 384

Causes rebound swelling- only use when needed bc can cause rebound congestion due to irritation of the lining of the nose.

Answer 384

Overuse of over-the-counter nasal medications

Question 385

EPISTAXIS (Nose bleed) Management:

Answer 385

Sit up
Head tilted forward
Pinch nose with thumb and forefinger
For 5 to 15 minutes

Question 386

Most common site- kiesselbach plexus

Answer 386

Epistaxis

Question 387

Subjective Data: Mouth and Throat

Answer 387

Sores or lesions
Sore throat
Bleeding gums
Toothache
Hoarseness
Dysphagia
Altered taste
Smoking, alcohol consumption
Patient-centered care regarding specific dental maintenance

Question 388

Patient-centered care regarding specific dental maintenance

Answer 388

Dental care pattern
Dentures or appliances

Question 389

Does child have any mouth infections or sores, such as thrush(candidiasis of the mouth) or canker sores? How frequently?

Answer 389

Infants and Children History

Question 390

Does child have frequent sore throat or tonsillitis? How often? How are these treated? Have they ever been documented as streptococcal infections?

Answer 390

Infants and Children History

Question 391

Any dryness in the mouth? (increase in Dry mouth) Are you taking any medications? (Note prescribed and over-the-counter medications.)

Answer 391

Aging adult history

Question 392

> 250 meds cause

Answer 392

dry mouth

Question 393

Are you able to care for your own teeth or dentures?

Answer 393

Aging adult history

Question 394

Have you noticed a change in your sense of taste or smell?

Answer 394

Aging adult history

Question 395

Test patency of nostrils.

Answer 395

External nose

Question 396

Sense of smell, mediated by __, is usually not tested in a routine examination.

Answer 396

cranial nerve I

Question 397

Inspect nasal mucosa, noting its normal

Answer 397

red color and smooth moist surface.

Question 398

Note any swelling, discharge, bleeding, or foreign body.

Answer 398

External nose

Question 399

Assessing for symmetry for midline and no deviations

Answer 399

External nose

Question 400

Highly vascularized, should be moist. Note any bleeding

Answer 400

External nose

Question 401

Inspect turbinates.

Answer 401

Nose

Question 402

Superior turbinate may

Answer 402

not be in view.

Question 403

___ turbinates appear the same light red color as nasal mucosa; note any swelling but do not try to push speculum past it

Answer 403

Middle and inferior

Question 404

Humidify, warm and increase surface area function of

Answer 404

Turbinates

Question 405

Never put direct pressure on the

Answer 405

nasal cavity

Question 406

Lift nose very gently to

Answer 406

avoid injury

Question 407

Never touch on tissues

Answer 407

inside of the nose

Question 408

Both hands, applying gentle pressure esp. complaining of pain bc of upper respiratory infecting

Answer 408

Inspection/Palpation of Sinus Area

Question 409

Utilize the thumbs. Press frontal sinus by up and under the eyebrows

Answer 409

Inspection/Palpation of Sinus Area

Question 410

Assess the maxillary sinus below the cheekbones

Answer 410

Inspection/Palpation of Sinus Area

Question 411

Begin with anterior structures and move posteriorly; use tongue blade to retract structures and bright light for optimal visualization. Be careful bc it can elicit gag reflex in pts.

Answer 411

Inspection of the Oral Cavity

Question 412

Inspect lips:

Answer 412

noting cracks or open areas.
Assess for moisture and remember any cultural variations depending on the pt assessing.
African Americans-bluish tint to lips

Question 413

Condition of teeth is an index of the

Answer 413

person’s general health

Question 414

Check for swelling; retraction of gingival margins; and spongy, bleeding, or discolored gums.

Answer 414

Inspection of the Oral Cavity

Question 415

Check tongue for

Answer 415

color, surface characteristics, and moisture.

Question 416

Dorsal and underneath the tongue entire

Answer 416

U shape area of the tongue located behind the teeth.

Question 417

If any lesion or pt with a lesion over 50 years old esp. alcohol and smoking use,

Answer 417

palpate area with a gloved hand.

Question 418

Any lesions that last more than

Answer 418

2 weeks requires a follow up.

Question 419

Anterior hard palate white with irregular transverse rugae

Answer 419

Palate/Uvula

Question 420

Posterior soft palate is pinker, smooth, and upwardly movable.

Answer 420

Palate/Uvula

Question 421

Uvula normally looks like a fleshy pendant hanging structure in the

Answer 421

midline of the throat.

Question 422

Have pt open mouth and say “ah” and note any movement of the soft palate and make sure uvula is moving midline (cranial nerve 10, vagus nerve)

Answer 422

Palate/Uvula

Question 423

Observe oval, rough-surfaced tonsils.

Answer 423

Color is same pink as oral mucosa, and their surface peppered with indentations, or crypts; there should be no exudate on tonsils.

Question 424

Tonsils graded in size as follows:

Answer 424

1+ - tonsils visible
2+ - half way between tonsil and pillars ad uvula
3+ - touching the uvula
4+ - tonsils touching each other

Question 425

You may normally see 1+ or 2+ tonsils in healthy people, especially in children, WHY?

Answer 425

Still growing, lymphoid tissue still enlarged

Question 426

Test hypoglossal nerve (12)-

Answer 426

open mouth and stick out tongue.
should protrude midline and note any tremor, loss of movement, or deviation to one side

Question 427

Throat culture for strep throat.-

Answer 427

untreated can lead to secondary heart issues, kidney issues, and joint infection.

Question 428

Ask patients if difficulty swallowing if they do make sure if they have hx CVA, gerd, or esophageal cancer

Answer 428

Inspection of Throat

Question 429

Because oral examination is intrusive for infant or young child, timing is best toward

Answer 429

end with ear examination.

Question 430

With a toddler, be alert for possible

Answer 430

foreign body lodged in nasal cavity.

Question 431

Normal finding in infants is sucking tubercle, a small pad in middle of upper lip from friction of breastfeeding or bottle-feeding.

Answer 431

Mouth and throat

Question 432

Be alert to any foreign body lodged in the nasal cavity- toddlers esp. if there is a

Answer 432

very strong odor and not able to breath on that side

Question 433

Be careful when using tongue blade bc

Answer 433

elicits gag reflex

Question 434

Mobility should allow tongue to extend at least as far as alveolar ridge.

Answer 434

Infants and Children

Question 435

Note any ___ on buccal mucosa or gums of infant or young child.

Answer 435

bruising or laceration

Question 436

___ on palate are normal finding in newborns and infants.- will go away

Answer 436

Epstein pearls

Question 437

___ are not visible in newborn; gradually enlarge during childhood, remaining proportionately larger until puberty. Larger if crying or gagging, wait until stop to inspect

Answer 437

Tonsils

Question 438

example of candidiasis or thrush

Answer 438

Can occur in breastfed children and if individual is taking antibiotics or long tx, steroids, or if immunocompromised

Question 439

Gum hypertrophy

Answer 439

Pregnant Woman

Question 440

Surface looks smooth and stippling disappears.

Answer 440

Pregnant Woman Gums

Question 441

May occur normally at puberty or during pregnancy (pregnancy gingivitis).

Answer 441

Pregnant Woman Gums

Question 442

Nose may appear more prominent on face from loss of subcutaneous fat.

Answer 442

Aging Adult

Question 443

In edentulous person, mouth and lips fold in, giving a “purse-string” appearance.

Answer 443

Aging Adult

Question 444

Teeth may look slightly yellowed, but color is uniform.

Answer 444

Aging Adult

Question 445

Yellowing results from dentin visible through worn enamel.

Answer 445

Aging Adult

Question 446

Teeth may look longer as gum margins recede.

Answer 446

Aging Adult

Question 447

If issues with dental work make sure

Answer 447

no malnutrition

Question 448

Complain of pressure and pain in both of the sinus locations- eyebrow level or below cheek bones

Answer 448

Suspect it after an upper respiratory infection with facial pain
Throbbing in cheeks

Question 449

Cleft lip, Herpes simplex 1, Angular cheilitis, carcinoma, retention cyst

Answer 449

Lip Abnormalities

Question 450

Herpes simplex 1 (HSV-1)-blisters rupture and crust over in about 10 days
Lasts 4-10 days
They will rupture, weep, crust, and heal over

Answer 450

Herpes simplex 1 (HSV-1)-

Question 451

Erythema, scaling, and shallow and painful fissures at corners of the mouth occur with excess salivation and candida infection.

Answer 451

Angular cheilitis- (Stomatitis, perlèche)

Question 452

Carcinoma-The initial lesion is round and indurated; it becomes crusted and ulcerated with an elevated border.

Answer 452

Carcinoma-

Question 453

A round well defiend translucent nodule that may be very small or up to 1-2 cm.

Answer 453

Retention “cyst” - Mucocele

Question 454

Teeth and Gum Abnormalities

Answer 454

Baby bottle tooth decay
Dental caries
Tooth avulsion
Epulis
Gingival hyperplasia
Gingivitis
Meth mouth

Question 455

Destruction of numerous deciduous who take a bottle of milk, juice, or sweetened drink to bed and prolong bottle feeding past the age of 1 year

Answer 455

Baby bottle tooth decay

Question 456

A traumatic injury may dislodge a primary (deciduous) or permanent tooth from alveolar socket

Answer 456

Tooth avulsion

Question 457

Progressive destruction of tooth

Answer 457

Dental caries

Question 458

A benign nontender, fibrous nodule of the gum seen emerging between teeth

Answer 458

Epulis

Question 459

Painless enlargement of gums, sometimes overreaching the teeth

Answer 459

Gingival hyperplasia

Question 460

Gym margins are red swollen and bleed easily

Answer 460

Gingivitis

Question 461

Illicit methamphetamine abuse leads to extensive dental caries, gingivitis, tooth cracking, and edentulism

Answer 461

Meth mouth

Question 462

Make sure determining if using a bottle-

Answer 462

not to use it at night, do not use for juice or soda only milk

Question 463

Prolonged bottle use –

Answer 463

increase infection and tooth decay

Question 464

Buccal Mucosa Abnormalities

Answer 464

Aphthous ulcers
Koplik spots
Leukoplakia
Candidiasis or monilial infection
Candidiasis in adult
Herpes simplex 1

Question 465

A common canker sore is a vesicle at first and then a small round punched out ulcer with a white base surrounded by a red halo

Answer 465

Aphthous ulcers

Question 466

Small blue-white spots with irregular red halo scattered over mucosa opposite the molars

Answer 466

Koplik spots

Question 467

Chalky white, thick, raised patch with well defined borders

Answer 467

Leukoplakia

Question 468

A white, cheesy, curdlike patch on the buccal mucosa and tongue
Teach to not scrape the white film off bc the tongue is going to be irritated, raw, and bleed

Answer 468

Candidiasis or monilial infection

Question 469

The candida species as normal flora is present in 60% of healthy adults. caused by steroids, hiv infection, broad spectrum antibiotics, leukemia, malnutrition, reduced immunity.

Answer 469

Candidiasis in adult

Question 470

Infection on the hard palate

Answer 470

Herpes simplex 1

Question 471

Tongue Abnormalities

Answer 471

Ankyloglossia
Geographic tongue (migratory glossitis)
Smooth, glossy tongue (atrophic glossitis)
Black hairy tongue
Carcinoma
Fissured or scrotal tongue
Enlarged tongue (macroglossia)

Question 472

A short lingual frenulum, here fixing tongue tip to the floor of the mouth and gums

Answer 472

Ankyloglossia

Question 473

Pattern of normal coating intersped with bright red shiny, circular bald areas caused by atrophy of the filiform papillae, with raised pearly borders

Answer 473

Geographic tongue (migratory glossitis)

Question 474

The surface is slick and shiny; the mucosa thins and looks red from decreased papillae.

Answer 474

Smooth, glossy tongue (atrophic glossitis)

Question 475

caused by fungal infection. Color can vary from brown to yellow. Caused by use of antibiotics which inhibits the normal bacteria which allows the fungus to grow.

Answer 475

Black hairy tongue

Question 476

An ulcer with rolled edges; indurated

Answer 476

Carcinoma

Question 477

Deep furrows divide the papillae into small irregular rows

Answer 477

Fissured or scrotal tongue

Question 478

The tongue is enlarged and may protrude from the mouth

Answer 478

Enlarged tongue (macroglossia)

Question 479

Oropharynx Abnormalities

Answer 479

Bifid uvula
Oral Kaposi’s sarcoma
Peritonsillar abscess
Acute tonsillitis and pharyngitis
Cleft palate- congenital defect

Question 480

Appears to be severed. Effect speech and development bc it prevent necessary air from passing through the airway. More common in American Indians.

Answer 480

Bifid uvula

Question 481

Bruise like dark red violet confluent macule usually on the hard palate may be on soft palate or gingival margin

Answer 481

Oral Kaposi’s sarcoma

Question 482

Untreated acute streptococcal pharyngitis may cause suppurative complications, peritonsillar abscess, or suppurative thrombophlebitis.

Answer 482

Peritonsillar abscess

Question 483

Bright red throat, swollen tonsils, white or yeellow exudate on tontils and pharynx, swollen uvula, and enlarged, tender anterior cervical and tonsillar nodes.

Answer 483

Acute tonsillitis and pharyngitis

Question 484

Congenital defect, the failure of fusion of the maxillary process

Answer 484

Cleft palate

Question 485

Breasts lie

Answer 485

Anterior to pectoralis major and serratus anterior muscles.

Question 486

Located between second and sixth ribs, extending from side of sternum to midaxillary line

Answer 486

Breasts

Question 487

Tail of Spence:

Answer 487

Superior lateral corner projects up and laterally into axilla. Located on either side of the breast located in the axilla area.

Question 488

Areola surrounds

Answer 488

nipples.

Question 489

Montgomery’s Glands: Small elevated sebaceous glands

Answer 489

Secrete protective lipid material during lactation

Question 490

Tail of Spence- location for most tumors

Answer 490

Tail of Spence-

Question 491

Cone shaped breast tissue located close to pectoral group of the axillary lymph nodes

Answer 491

Tail of Spence-

Question 492

Breast is composed of

Answer 492

glandular tissue.(mostly)
fibrous tissue, including suspensory ligaments.
adipose tissue.

Question 493

Glandular tissue (produce milk) contains 15 to 20 lobes radiating from

Answer 493

nipple, and these are composed of lobules.

Question 494

Fibrous bands extending vertically from surface to attach on chest wall muscles

Answer 494

Cooper’s Ligaments:

Question 495

Lobes are embedded in

Answer 495

adipose tissue.

Question 496

Breast may be divided into four quadrants by imaginary

Answer 496

horizontal and vertical lines intersecting at nipple.

Question 497

Upper outer quadrant is the site of most

Answer 497

breast tumors.

Question 498

Clusters alveoli produce

Answer 498

milk

Question 499

Breast has extensive

Answer 499

lymphatic drainage.

Question 500

Four groups of axillary nodes are present

Answer 500

Central axillary nodes, Pectoral (anterior), Subscapular (posterior), Lateral

Question 501

located high in the middle of the axilla

Answer 501

Central axillary nodes-

Question 502

located along the edge of the pectorallis major

Answer 502

Pectoral (anterior)-

Question 503

lateral edge of the scapula. deep in the axialiry fold

Answer 503

Subscapular (posterior)-

Question 504

along the humorous inside the upper arm

Answer 504

Lateral-

Question 505

From the central axillary nodes, drainage flows up to

Answer 505

infraclavicular and supraclavicular nodes.

Question 506

More than 75% of breast tissue is going to drain in the

Answer 506

equilateral or same side axillary nodes.

Question 507

During embryonic life, ventral epidermal ridges, or “milk lines,” are present and

Answer 507

curve down from axilla to groin bilaterally.

Question 508

Develops along ridge over thorax, and rest of the ridge usually atrophies.

Answer 508

Breasts

Question 509

Supernumerary nipple occasionally persists and is visible along track of

Answer 509

mammary ridge.

Question 510

At birth, the only breast structures present are

Answer 510

lactiferous ducts within nipple.

Question 511

If there is a third nipple presented the individual it is located along those lines,

Answer 511

ventral epidermal ridges

Question 512

At puberty, estrogen stimulates

Answer 512

breast changes.

Question 513

Temporary asymmetry:

Answer 513

Occasionally one breast may grow faster than other

Question 514

Tanner Staging:

Answer 514

Five stages of breast development are included as levels of sexual maturity. Stages 2-5 takes on average of 3 years.

Question 515

Tanner Stage 1:

Answer 515

Preadolescent: there is only a small elevated nipple

Question 516

Tanner Stage 2:

Answer 516

Breast bud stage: A small mound of breast and nipple develops; the areola widens

Question 517

Tanner Stage 3:

Answer 517

The breast and areola enlarge; the nipple is flush with breast surface

Question 518

Tanner Stage 4:

Answer 518

The areola and nipple from a secondary mound over the breast

Question 519

Tanner Stage 5:

Answer 519

Mature breast: only the nipple protrudes; the areola is flush with the breast contour

Question 520

Thelarche precedes menarche by about 2 years.

Answer 520

Breasts develop before the period starts by about 2 years.

Question 521

One breast can grow faster than the other-

Answer 521

can produce asymmetry and can cause distress and mensural issues, provide reassurance that it is still changing and is normal

Question 522

Breast changes start during the ___ of pregnancy and are an early sign for most women.

Answer 522

second month

Question 523

Thick yellow fluid is precursor for milk, containing same amount of protein and lactose, but practically no fat.

Answer 523

Colostrum

Question 524

Colostrum (first milk that comes in that has protein. Perfect nutrition for the infant) may be expressed after

Answer 524

fourth month.

Question 525

Breasts produce colostrum for first

Answer 525

few days after delivery.

Question 526

Rich in antibodies that protect newborn against infection, so breastfeeding is important.

Answer 526

Colostrum

Question 527

Lactation:

Answer 527

Milk production

Question 528

Begins 1 to 3 days postpartum

Answer 528

Milk production

Question 529

Whitish color is from emulsified fat and calcium caseinate.

Answer 529

Milk production

Question 530

Teach pregnancy women that breastfeeding is important for

Answer 530

newborn

Question 531

Breastfeeding for infant for at least ___ decreased risk for ear infections and increase bonding between baby and mother and increase relaxation

Answer 531

6 months

Question 532

After menopause, ovarian secretion of estrogen and progesterone decreases, causing

Answer 532

Breast glandular tissue to atrophy.

Question 533

Decreased breast size makes inner structures more prominent.

Answer 533

Aging woman

Question 534

A breast lump may have been present for years but is suddenly palpable.

Answer 534

Aging woman

Question 535

Around nipple, the lactiferous ducts are more palpable and feel firm and stringy because of fibrosis and calcification.

Answer 535

Aging woman

Question 536

Axillary hair decreases.

Answer 536

Aging woman

Question 537

After menopause- decreases in elasticity and have a flabby appearance and kyphosis makes it worse

Answer 537

Aging woman

Question 538

Rudimentary structure consisting of a thin disk of undeveloped tissue underlying nipple.

Answer 538

Male Breast

Question 539

Gynecomastia: during adolescence, it is common for breast tissue to temporarily enlarge.

Answer 539

Male Breast

Question 540

Increase in body hair

Answer 540

Aging woman

Question 541

Condition is usually unilateral and temporary.

Answer 541

Gynecomastia

Question 542

May reappear in aging male and may be due to testosterone deficiency.

Answer 542

Gynecomastia

Question 543

Review statistics of breast cancer morbidity, mortality, and prognosis.

Answer 543

BRCA1 and BRACA2 mutation
Cumulative risk
Survival varies by stage when diagnosed.

Question 544

Breast Cancer: Consider family history(prevalence), ethnicity, and other environmental variables

Answer 544

Racial disparity in survival
Socioeconomic conditions affecting access to health care

Question 545

Reassurance is necessary for adolescent male, whose attention is riveted on his body image.

Answer 545

Gynecomastia

Question 546

Screening mammography recommendations

Answer 546

Breast Cancer

Question 547

Breast Cancer Review lifestyle risk factors:

Answer 547

Alcohol dose-dependent effect
Postmenopausal weight gain
Decreased physical activity

Question 548

Two different tumor suppression genes- BRCA1 and BRCA 2

Answer 548

Mutation of one or both genes- risk of breast cancer is at risk significantly

Question 549

Early detection is ideal in recovery/tx. Recommend screening

Answer 549

Breast Cancer

Question 550

Pain, lump, sore areas and discharge(noting color and consistency) except with lactation other discharge is abnormal

Answer 550

Breast Subjective Data

Question 551

Rash, swelling, trauma
History of breast disease
Surgery or radiation
Medications
Patient-centered care
Perform breast self-examination/last mammogram

Answer 551

Breast Subjective Data

Question 552

Tenderness, lump, or swelling
Rash

Answer 552

Axilla Subjective Data

Question 553

Some meds can cause breast discharge-

Answer 553

Contraceptives dietetics, digitalis and steroids

Question 554

In many cultures, female breasts signify more than their primary purpose of lactation.

Answer 554

Plays a role by Affecting body image
Influenced by society and media response
Integrated with women’s self-concept

Question 555

A woman who has found a breast lump may come to you with

Answer 555

fear, anxiety, and panic.

Question 556

Although many breast lumps are benign, women initially assume worst possible outcome, including

Answer 556

cancer, disfigurement, and death.

Question 557

Be sensitive to individual’s perception of

Answer 557

female body image.

Question 558

If diagnosis with beginning breast disease or any type of lump or hx of lumps it makes

Answer 558

diagnosis breast cancer more difficult.

Question 559

If they been treated for breast cancer before or have had it in the past the risk is going to be

Answer 559

higher

Question 560

Subjective Data Questions: Pain, Any pain or tenderness in breasts(contraceptives)?

Answer 560

Onset

Question 561

Subjective Data Questions: Pain, Pain location

Answer 561

Localized or diffuse

Question 562

Is painful spot sore to touch? Do you feel a burning or pulling sensation?

Answer 562

Subjective Data Questions: Pain

Question 563

Subjective Data Questions: Pain, Appearance of pain cyclic?

Answer 563

Any relation to menstrual cycle?

Question 564

Subjective Data Questions: Pain, Precipitating factors

Answer 564

Brought on by strenuous activity?
Change in activity?
Sexual manipulation?

Question 565

If lump identified-

Answer 565

address the location, when did first noticed and has it changed/grown/moved/smaller or impact by menstrual period

Question 566

Lump location

Answer 566

Ever noticed lump or thickening in breast? Where?

Question 567

Lump onset

Answer 567

When did you first notice it? Changed at all since then?

Question 568

Lump appearance

Answer 568

Does lump have any relation to your menstrual period?

Question 569

Subjective Data Questions: Lump and Discharge

Answer 569

Lump- needs to be evaluated

Question 570

Lump- Noticed any change in overlying skin:
Redness, warmth, dimpling, swelling?

Answer 570

Redness, warmth, dimpling, swelling?

Question 571

Discharge Onset:

Answer 571

Any discharge from nipple? When did you first notice this?

Question 572

Discharge Characteristics:

Answer 572

What color is discharge?
Is consistency thick or runny? Odor?

Question 573

Meds that cause discharge

Answer 573

Contraceptives, diuretics, digitalis, phenothiazines, steroids, methyldopa, ccbs

Question 574

Rash Appearance:

Answer 574

Any rash on breast?

Question 575

Rash Onset:

Answer 575

When did you first notice this?

Question 576

Rash Location:

Answer 576

Where did it start? On the nipple, areola, or surrounding skin?

Question 577

Swelling Location:

Answer 577

Any swelling in breasts? In one spot or all over?

Question 578

Swelling Appearance:

Answer 578

r/t your menstrual period, pregnancy, or breastfeeding?
Any change in bra size

Question 579

appears flatter, broad, underlying crater- indicative of cancer

Answer 579

Dimpling-

Question 580

Starts at the nipple apex and spread outwards-

Answer 580

Paget’s disease

Question 581

Any trauma or injury to the

Answer 581

breasts?

Question 582

Trauma Presentation:

Answer 582

Did it result in any swelling, lump, or break in skin?

Question 583

History of breast disease

Answer 583

Any history of breast disease yourself?

Question 584

History of breast disease Medical management:

Answer 584

When did this occur? How is it being treated?

Question 584

History of breast disease Diagnosis:

Answer 584

What type? How was this diagnosed?

Question 585

breast disease Family history:

Answer 585

Any breast cancer in your family? Who? Sister, mother, maternal grandmother, maternal aunts, daughter?
At what age did this relative have breast cancer?

Question 586

Detect risk for breast cancers by

Answer 586

asking questions

Question 587

Surgical intervention: Biopsy with results

Answer 587

Mastectomy? Mammoplasty, augmentation, or reduction?

Question 588

Radiation as part of

Answer 588

therapy?

Question 589

Imaging studies:

Answer 589

Mammography, a screening x-ray examination of breasts? When was last x-ray?

Question 590

Medications

Answer 590

Have you taken oral contraceptives ? How long?
Have you been on Hormone Replacement Therapy? How long?
Types of medications: Rx and OTC

Question 591

Ask about self-breast exam (SBE)

Answer 591

Teaching moment to review basics of examination

Question 592

Review screening guidelines recommendations based on

Answer 592

age and patient history

Question 593

Begin at ages 40 to 44,

Answer 593

screening mammography

Question 594

Annual mammography from ages

Answer 594

45 to 54

Question 595

Biennial mammography over age

Answer 595

55 or continuation of annual

Question 596

Try to teach to stay on schedule every month.

Answer 596

BSE

Question 597

Perform right after menstrual period or the 4th through the 7th day after the menstrual cycle. – breast is the smallest and least congested

Answer 597

BSE

Question 598

Teach to pick a day on each month if no menstrual cycle

Answer 598

BSE

Question 599

Axilla Tenderness,

Answer 599

lump, or swelling

Question 600

Axilla Appearance:

Answer 600

Any tenderness or lump in the underarm area?

Question 601

Axilla Location:

Answer 601

Where? When did you first notice this?

Question 602

Axilla Rash Appearance:

Answer 602

Any axillary rash? Please describe it. (feels, looks, starts)

Question 603

Axilla Precipitating factor:

Answer 603

Does it seem to be a reaction to deodorant?

Question 604

Breasts in Preadolescent girl
Appearance:

Answer 604

Have you noticed your breasts changing?

Question 605

Breasts in Preadolescent girl Onset:

Answer 605

How long has this been happening?

Question 606

Breasts in Preadolescent girl Description:

Answer 606

What have you noticed?

Question 607

Breasts in Preadolescent girl Feelings:

Answer 607

What do you think about all this?

Question 608

Breasts in Pregnant woman
Appearance:

Answer 608

Have you noticed any enlargement or fullness in the breasts?

Question 609

Breasts in Pregnant woman Presentation:

Answer 609

Is there any tenderness or tingling?

Question 610

Breasts in Pregnant woman Medical history:

Answer 610

Do you have inverted nipples?

Question 610

Breasts in Pregnant woman Anticipatory planning:

Answer 610

Are you planning to breastfeed your baby?

Question 611

Breasts in Menopausal woman

Answer 611

Have you noticed any change in breast contour, size, or firmness?

Question 612

Should occur 2 years before first period-

Answer 612

breast development

Question 613

___ is second major cause of death from cancer in women

Answer 613

Breast cancer

Question 614

Early detection and improved treatment have increased survival rates.

Answer 614

Breast cancer

Question 615

Review factors associated with “relative risk”

Answer 615

RR above 1 indicates a higher likelihood of occurrence among exposed than unexposed persons.

Question 616

Early mammograms and screening if hx of

Answer 616

breast cancer

Question 617

Preparation
Woman sitting up facing examiner

Answer 617

An alternative draping method is to use a short gown, open at back, and lift it up to woman’s shoulders during inspection.

Question 618

During palpation when woman is supine, cover one breast with gown while examining other.

Answer 618

Be aware that many women are embarrassed to have their breasts examined; use a sensitive but matter-of-fact approach.

Question 619

After examination, be prepared to teach woman

Answer 619

breast self-examination.

Question 620

Breast examination Equipment

Answer 620

Small pillow
Ruler marked in centimeters
Pamphlet or teaching aid for breast self-examination (BSE)

Question 621

Inspection of the Breast General appearance

Answer 621

Note symmetry of size and shape.
Common to have a slight asymmetry in size

Question 622

Normally smooth and of even color

Answer 622

Inspection of the Breast Skin

Question 623

Note any localized areas of redness, bulging, or dimpling; also any skin lesions or focal vascular pattern.

Answer 623

Inspection of the Breast Skin

Question 624

Fine blue vascular network visible during pregnancy; pale linear striae, or stretch marks, follow pregnancy.

Answer 624

Inspection of the Breast Skin

Question 625

Normally no edema is present.

Answer 625

Inspection of the Breast Skin

Question 626

Inspection of the Breast Lymphatic drainage areas

Answer 626

Observe axillary and supraclavicular regions; note any bulging, discoloration, or edema.

Question 627

Should be symmetric on same plane on both breasts

Answer 627

Inspection of the Breast Nipple

Question 628

Nipples usually protrude, although some are flat and some are inverted.

Answer 628

Inspection of the Breast Nipple

Question 629

Normal nipple inversion may be unilateral or bilateral and usually can be pulled out.

Answer 629

Inspection of the Breast Nipple

Question 630

Note any dry scaling, any fissure or ulceration, and bleeding or other discharge.

Answer 630

Inspection of the Breast Nipple

Question 631

Supernumerary nipple is normal variation.

Answer 631

Inspection of the Breast Nipple

Question 632

Check the breast for skin retraction

Answer 632

Perform sequence of maneuvers to assess for this abnormality.

Question 633

Examine axillae while woman is

Answer 633

sitting.

Question 634

Inspect skin, noting any rash or infection; lift woman’s arm and support it so that her muscles are loose and relaxed;

Answer 634

use right hand to palpate left axilla.

Question 635

Reach fingers high into axilla;

Answer 635

move them firmly down in four directions.

Question 636

Move woman’s arm through range-of-motion to increase

Answer 636

surface area you can reach.

Question 637

Usually nodes are not palpable, although you may feel a small,

Answer 637

soft, nontender node in central group.

Question 638

Note any enlarged and tender lymph nodes.

Answer 638

Axillae

Question 639

If any lump or nodule note the location.

Answer 639

Cancerous breast masses are solitary unilateral and not tender.

Question 640

As cancer become more invasive become solid hard and dense.

Answer 640

Become fixed to underlining tissues.

Question 641

Cancerous borders- irregular, poorly delineated, cannot figure out the border

Answer 641

painless

Question 642

Mass with rubbery texture, regular border, and pt complain heavy pain upon palpation-

Answer 642

benign breast disease

Question 643

Vertical strip pattern is recommended to detect for any type breast masses.

Answer 643

Palpation of the Breasts

Question 644

Two other patterns are in common use:

Answer 644

From the nipple palpating out to periphery as if following spokes on a wheel
Palpating in concentric circles out to periphery

Question 645

In nulliparous women, normal breast tissue feels firm, smooth, and elastic.

Answer 645

After pregnancy, tissue feels softer and looser.

Question 646

Premenstrual engorgement is normal from

Answer 646

increasing progesterone.

Question 647

After palpating over four breast quadrants, palpate nipple; note any induration or subareolar mass.

Answer 647

With your thumb and forefinger, gently depress nipple tissue into well behind areola; tissue should move inward easily.

Question 648

If woman reports spontaneous nipple discharge

Answer 648

press areola inward with your index finger.
repeat from a few different directions; note color and consistency of any discharge.

Question 649

If woman mentions a breast lump that she has discovered herself, examine unaffected breast first to learn a

Answer 649

baseline of normal consistency for this woman.

Question 650

Characteristics of Lump or Mass

Answer 650

Location, size, shape, consistency, moveable, Distinctness, Nipple, Note skin over lump, Tenderness, Lymphadenopathy

Question 651

Location

Answer 651

As with clock face, describe distance in centimeters from nipple; or diagram breast in woman’s record and mark in location of lump.

Question 652

Size

Answer 652

Judge in centimeters in three dimensions: width, length, and thickness.

Question 653

Shape

Answer 653

State whether lump is oval, round, lobulated, or indistinct.

Question 654

Consistency

Answer 654

State whether lump is soft, firm, or hard.

Question 655

Movable

Answer 655

Is lump freely movable or fixed when you try to slide it over chest wall?

Question 656

Increased size in lymph nodes bc

Answer 656

breast cancer can spread

Question 656

Distinctness

Answer 656

Is lump solitary or multiple?

Question 657

Nipple

Answer 657

Is it displaced or retracted?

Question 658

Note skin over lump

Answer 658

Is it erythematous, dimpled, or retracted?

Question 659

Tenderness

Answer 659

Is lump tender to palpation?

Question 660

Lymphadenopathy

Answer 660

Are any regional lymph nodes palpable?

Question 661

Lie down. Press 3 middle fingers in a circular motion and use three levels of pressure.

Answer 661

Follow up and down pattern

Question 662

Sit up. Examine underarm with

Answer 662

arm slightly raised

Question 663

Note surface changes with hands pushed on hips

Answer 663

shoulders hunched

Question 664

The simpler the plan, the more likely the person is to comply.

Answer 664

BSE

Question 665

Describe correct technique and rationale and expected findings to note as woman inspects her own breasts.

Answer 665

BSE

Question 666

Teach woman to do this in front of a mirror while she is disrobed to waist.

Answer 666

BSE

Question 666

At home, she can start palpation in shower, where soap and water assist palpation.

Answer 666

BSE

Question 666

Encourage woman to palpate her own breasts while you monitor her technique.

Answer 666

BSE

Question 666

Then palpation should be performed while lying supine.

Answer 666

BSE

Question 667

Use of model for return demonstration as well as pamphlets may be helpful.

Answer 667

BSE

Question 668

Examination of male breast can be abbreviated, but do not

Answer 668

omit it.

Question 669

Normal male breast has

Answer 669

flat disk of undeveloped breast tissue beneath nipple.

Question 670

Benign growth of this breast tissue, making it distinguishable from other tissues in chest wall.

Answer 670

Gynecomastia

Question 671

Feels like a smooth, firm, movable disk

Answer 671

Gynecomastia

Question 672

Occurs normally during puberty and is temporary

Answer 672

Gynecomastia

Question 673

The adolescent is acutely aware of his body image.

Answer 673

Gynecomastia

Question 674

Reassure him that this change is normal, common, and temporary.

Answer 674

Gynecomastia

Question 675

Abnormal Breast Findings

Answer 675

Peau d’ orange, benign breast disease, Male breast cancer,

Question 676

Lymphatic obstruction produces edema
Thickens skin and exaggerates hair follicles
Suggestive of cancer

Answer 676

PEAU D’ORANGE

Question 677

Non-cancerous

Answer 677

BENIGN BREAST DISEASE

Question 678

Creates lumpy or ropelike texture

Answer 678

BENIGN BREAST DISEASE

Question 679

Hormonal changes

Answer 679

BENIGN BREAST DISEASE

Question 679

Pain, tenderness, lumpiness

Answer 679

BENIGN BREAST DISEASE

Question 680

More bothersome before period

Answer 680

BENIGN BREAST DISEASE

Question 681

If new changes need medical evaluation

Answer 681

BENIGN BREAST DISEASE

Question 682

Rare in men
Less than 1 percent (1 in every 100 diagnosed)

Answer 682

MALE BREAST CANCER

Question 682

Hard to examine breasts or identify new lump in new breast bc there is

Answer 682

always something different in the breast

Question 682

Make it hard to examine breasts as may conceal new lump

Answer 682

BENIGN BREAST DISEASE

Question 683

Same types of cancer as women
Lump/swelling in breast

Answer 683

MALE BREAST CANCER

Question 683

Red/flaky skin on the breast
Irritation or dimpling

Answer 683

MALE BREAST CANCER

Question 684

Nipple discharge
Pulling in of the nipple or pain surrounding the nipple

Answer 684

MALE BREAST CANCER

Question 685

Inspect breasts as woman sits, raises arms overhead, pushes

Answer 685

hands on hips, and leans forward.

Question 686

Inspect the

Answer 686

supraclavicular and infraclavicular areas.

Question 687

Palpate the

Answer 687

axillae and regional lymph nodes.

Question 688

With woman supine, palpate the breast tissue, including

Answer 688

tail of spence, the nipples, and areolae.