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Physical Diagnosis > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

The avascular superficial layer of skin; pigment producing melanocytes in this layer provide protection from UV rays. Langerhan cells also in this layer are an important component of the immunologic barrier of the skin

A

Epidermis

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2
Q

Contains blood vessels, nerves, and appendages (sweat glands, sebaceous glands, hair follicles, nails).

A

Dermis

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3
Q

Why do the blood vessels in the dermis consist of two horizontal plexuses one on top of the other?

A

Allows shunting of blood either toward the skin to cool or away from the skin to stay warm

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4
Q

Helps insulate against the cold and serves as a reserve food source

A

Subcutaneous tissues

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5
Q

Technically a flat area of discolored skin less than a cm in diameter.

A

Macule

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6
Q

Examples of a macule.

Examples of a large macule

A

Macule = freckle or cherry angioma

Large macule = patches, marks, spots, plaques, nevi, age spots, vitiligo, or port wine stains

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7
Q

A solid elevation of skin less than 1 cm in diameter.

A

Papule

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8
Q

Examples of papules

Examples of large papules

A

Papules = moles, warts, or skin tags

Large papules = nodules, tumors, lipomas, cysts, other masses

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9
Q

Small, fluid filled elevation of the skin

A

Vesicle

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10
Q

Examples of vesicles

Examples of large vesicles

A

Vesicles = herpes simplex, chicken pox, or herpes zoster

Large vesicles = Bullae (blisters)

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11
Q

A small pus filled elevation of the skin

A

Pustule

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12
Q

Examples of pustules

Examples of large pustules

A

Pustule = pimples

Large pustules = abscesses, furuncles, and carbuncles

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13
Q

Flaky skin, keratinized cells. Ex: dandruff, seborrhea, psoriasis

A

Scales

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14
Q

Dried serum, blood or purulent exudates. Ex: weeping eczema

A

Crust

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15
Q

Rough, thickened epidermis with accentuated skin markings. Ex: chronic dermatitis

A

Lichenification

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16
Q

Fine, irregular, superficial capillary dilations. Ex: Rosacea

A

Telangiectasis

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17
Q

Linear, crusted loss of epidermis/dermis. Ex: Abrasion or scratch

A

Excoriation

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18
Q

Loss of some epidermis. Ex: Sun damaged skin

A

Erosion

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19
Q

Linear crack extending into the dermis. Ex: Athletes foot

A

Fissure

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20
Q

Skin concavity involving the epidermis and dermis. Ex: Bed sores

A

Ulcer

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21
Q

Acute skin eruption that is a new localized rash due to direct skin contact with an irritant or allergen is most likely caused by this. Ex: poison ivy, household or industrial irritants

A

Contact reations

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22
Q

Acute skin eruption that causes an often itchy, red, maculopapular skin eruptions over a large portion of the body. May be associated with prescriptions, vitamins, supplements, etc.

A

Adverse drug reaction

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23
Q

Condition that presents with a nonpruritic rash to the palms, soles, mouth, or genitals. May also see white mucus patches, flat-topped, moist genital warts, and spotty alopecia of the scalp

A

Secondary syphilis

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24
Q

The primary lesion of syphilis. Painless ulceration, difficult to heal, and usually disappears prior to the rash associated with secondary syphilis

A

Chancre

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25
Q

Skin presentations associated with tertiary syphilis

A

Gummas

Ulceration

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26
Q

Who is at the greatest risk of developing skin cancer?

A

Light skinned people who are outside a lot, have a family history of skin cancer, and have a history of a severe sunburn

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27
Q

ABCDE’s of skin cancer

A 
A- Asymmetry 
B- Border
C- Color
D- Diameter
E- Evolution
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28
Q

Epithelial cell tumor that begins as a papule and enlarges peripherally. Metastasis is rare and therefore the least worry some

A

Basal cell carcinoma

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29
Q

A slow growing, malignant tumor of squamous epithelium. Common to the skin and lungs, but found elsewhere.

A

Squamous cell carcinoma

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30
Q

A malignant neoplasm originating in the skin. Small percentage of all skin cancers, but by far the most severe

A

Melanoma

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31
Q

A malignant multifocal neoplasm beginning as soft brown or purplish papules on the feet. Associated with AIDS, diabetes, and malignant lymphoma

A

Kaposi’s Sarcoma

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32
Q

Typical balding pattern

A

Males begins as early as 20 starting in the frontotemporal and vertex areas and may end with a rim of hair remaining in the lateral and posterior scalp

Uncommon for females until 60

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33
Q

Idiopathic disease resulting in atypical patches of hair loss. Self limiting.

A

Alopecia areata

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34
Q

Alopecia that is less common and results in permanent hair loss on the scalp

A

Alopecia totalis

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35
Q

Very rare alopecia causes widespread loss of all body hair

A

Alopecia universalis

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36
Q

A superficial lung infection of the scalp, often seen in children. Appears as scaly, round, sometimes pustular patches with broken-off hair that leave bald spots

A

Tinea capitis (ringworm)

37
Q

A chronic, superficial, inflammatory skin process, especially common to the scalp, eyebrows, ears, face, axilla, breast, groin, and gluteal folds. Dandruff is a milder form of this condition

A

Seborrheic dermatitis

38
Q

Chronic seborrheic dermatitis in infants

A

Cradle cap

39
Q

Idiopathic condition that causes excessive growth of the epidermal keratinocytes causing inflammed cells and increased angiogenesis. Appears silvery-white scale on red patches that may itch.

A

Psoriasis

40
Q

An infestation of the blood-sucking louse whi feeds on the scalp and neck. Seen in children with poor hygiene. Intense itching is the main symptom with the presence of eggs (nits) in the hair

A

Pediculosis capitis (head lice)

41
Q

Results when epidermal tissue invaginates the dermis and becomes encapsulated. Appears as a subcutaneous nodule with an inner, cream-colored, pasty substance

A

Sebaceous cyst

42
Q

Symptoms of a TMJ disorder

A
  • Chronic pain in the jaw, teeth, face, head, neck, shoulders, or back.
  • Jaw clicking
  • Limited jaw movement
  • Can’t but 3 fingers in your mouth
43
Q

Primary source and another possible source of TMJ disorder

A 
Primary = malocclusion 
Other = Whiplash injuries
44
Q

What conditions can cause TMJ disorders?

A

Rheumatoid arthritis
Osteoarthritis
Displaced TMJ cartilage

45
Q

Osteoarthritis produces _______ in the TMJ with joint movement

A

Crepitus (crackling)

46
Q

How should the salivary glands feel if unaffected?

A

Soft, pliable, and non tender

47
Q

Salivary glands of the head

A

Parotid
Submandibular
Sublingual

48
Q

Unilateral swollen glands usually result from:

A

1) Bacterial infection (Parotitis)
2) Ductal calculus (stones)
3) Cyst or tumor (painless)

49
Q

Located by the 2nd upper molar

A

Stenson’s duct

50
Q

Located on either side of the frenulum of the tongue

A

Wharton’s duct

51
Q

Bilateral swollen glands usually result from:

A

1) Viral infection (mumps)
2) Drug reactions
3) Lymphomas

52
Q

Superficial lymph node sites to palpate

A
  • Head and Neck
  • Axillary
  • Inguinal
53
Q

Produces small, mobile, tender nodes involving one or two groups of nodes, but possible more

A

Acute infections

54
Q

Way to differentiate between a localized acute infection and a systemic acute infection using lymph nodes

A

1-2 nodes = localized

3 or more = systemic

55
Q

Produces multiple, less tender and mobile nodes that are matted together

A

Chronic infections

56
Q

Produces large rubbery lymph nodes

A

Hodgkin’s Lymphoma

57
Q

Produces stony hard, non-tender nodes of variable sizes.

A

Metastatic cancer

58
Q

Swollen node in the left supraclavicular group that lacks a typical explanation. Red flag for thoracic or abdominal cancer.

A

Virchow’s node

59
Q

Causes of tracheal deviation

A

1) Head tilt/cervical rotation
2) Unilateral goiter/large lymph node
3) Pneumothorax/pleural effusion
4) Unilateral atelectasis/pulmonary fibrosis

60
Q

T/F The thyroid should stay stationary during swallowing

A

FALSE

It should move up and down

61
Q

Congenital condition associated with an iodine deficiency in children

A

Cretinism

62
Q

1 cause of hypothyroidism in the US

A

Hashimoto’s disease

63
Q

Severe, advanced form of adult-onset hypothyroidism

A

Myxedema

64
Q

Most common form of hyperthyroidism. Produces exophthalmos

A

Grave’s disease

65
Q

Nerve for the muscles of mastication. Have patient clench their teeth to test for its function

A

C.N. V

66
Q

Lightly touching the patients brow, cheek, and chin on both sides of the face tests the functionality of this nerve

A

C.N. V

67
Q

Asking the patient to raise their eyebrows and show their teeth tests the functionality of this nerve

A

C.N. VII

68
Q

Placing different substances on the anterior part of the tongue and asking the patient to taste it tests the functionality of this nerve

A

C.N. VII

69
Q

Having the patient rotate their head in both directions against resistance and shrugging their shoulders against resistance tests the functionality of this nerve

A

C.N. XI

70
Q

May be the most commonly encountered headache in chiropractic practice

A

Whiplash headaches

71
Q

Typical patient profile and symptoms of whiplash headaches

A 
Patient= anybody who sustained a flexion-extension injury
Symptoms = stiff neck and a new atypical headache
72
Q

Physical findings of a whiplash headache

A

Spinal and TMJ asymmetries, abnormal ranges of motion; trigger points and/or temperature discrepancies

73
Q

Diagnostic studies for a whiplash headache

A

Flexion-extension X-rays may show soft tissue damage. MR is definitive

74
Q

Symptom associated with concussion headaches

A

New headache

75
Q

Associated symptoms of concussion headaches

A

Headache, amnesia, and confusion are the most common

76
Q

Physical findings of concussion headaches

A

Anything other than a mild injury warrants a neurological exam (memory, concentration, vision, hearing, balance, reflexes, etc.)

77
Q

Management of concussion headaches

A

Positive neurological findings = need an immediate head CT, neurological consultation or hospital referral

78
Q

Symptoms of a migraine headache

A

Escalating, intense, throbbing, unilateral headache lasting hour to days (maybe auras, scintillating scotomas, or tingling arms or legs which precedes the headache lasting 10-30 minutes prior to the headache)

79
Q

Associated symptoms of of migraine headaches

A

Possible nausea, vomiting light and noise sensitivity

80
Q

Symptom of a dissecting vertebral artery headache

A

Sudden, severe (worst ever), atypical, unilateral headaches behind one ear and occipital area

81
Q

Associated symptoms of a dissecting vertebral artery headache

A

Dizziness, Diplopia, Difficulty walking, Dysphagia, Dysarthria, Nausea, Nystagmus, and Numbness
(5 D’s and 3 N’s)

82
Q

Physical findings of a dissecting vertebral artery headache

A

Decreased carotid pulse and/or carotid bruit, or a + vertebrobasilar artery maneuver test raise suspicion of an ominous vascular component of the headache.

83
Q

Diagnostic study of a dissecting vertebral artery headache

A

MRA of the head is definitive

84
Q

Headache as a result of emotional or physical stress such as jaw clenching, teeth grinding, loss of sleep, missed meals, and sustained occupational head, neck, and shoulder postures

A

Episodic Tension Headaches

85
Q

Symptoms of a episodic tension headache

A

Moderate feeling of persistent pressure in the neck, scalp, face, and jaw muscles and the hat band area of the head. May occur as frequently as 15 times a month and last from hours to days

86
Q

Tension headaches that occur more than 15 times in a month

A

Chronic Tension Headaches

87
Q

Pressure over the affected sinuses.

A

Sinusitis

88
Q

Physical exam findings of sinusitis

A

Sensitive to digital pressure of the sinuses

Physical Diagnosis (7 decks)

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