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Physical Diagnosis Block 1 Objectives > Review > Flashcards

Review Flashcards

1
Q

Exam Tool: Otoscope

A

auditory canal and TM examination

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2
Q

Exam Tool: Opthalmoscope

A

interior structure of eye.

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3
Q

Exam Tool: Sphygmomanometer

A

Indirect measure of BP (w/ stethoscope)

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4
Q

Thermometers and Avg. Temps

A

Oral - 98.7F / 37C
Rectal - 99.6F / 37.6C
Axillary - 97.6F / 36.4C
Tympanic - 99.6F / 37.6C

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5
Q

Exam Tool: Stethoscope

A

Auscultation
3 Types:
Acoustic - bell is low tones, diaphragm is high tones.
Magnetic - uses Fe disk and magnet
Electronic - converts vibrations to sound via a speaker

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6
Q

Exam Tool: Snellen / Rosenbaum

A

Visual Acuity Charts
Snellen - 20’
Rosenbaum - 10-14”

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7
Q

Exam Tool: Tuning Forks

A

512 Hz - near threshold hearing

128 Hz - neuro vibratory exam

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8
Q

Exam Tool: Percussion Hammer

A

deep tendon reflexes

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9
Q

Exam Tool: Transilluminator

A

Beam of light to differentiate between media in a cavity (air vs. fluid vs. tissue)

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10
Q

Universal Precautions

A

Hand hygiene, nail care, safe injection practices, PPE (masks and goggles, gown, gloves)

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11
Q

Traditions in Medicine

A

Physical exam with clean dry bare hands. gloves for mouth, genitals, open wounds. head to toe. right sided.

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12
Q

Exam Technique: Inspection

A

observation through site and smell. color, texture, symmetry, size, shape.

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13
Q

Exam Technique: Palation

A

Process of observation through tough.

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14
Q

Exam Technique: Percussion

A

Observation through vibration.

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15
Q

Exam Technique: Auscultation

A

Observation through sound. Usually obtained with stethoscope.

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16
Q

Tympanic Sounds

A

High pitch, drum like.

ex) gastric bubble

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17
Q

Hyperresonant Sounds

A

louder than usual low-pitched sounds.

ex) emphysematous lungs

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18
Q

Resonant Sounds

A

loud, hollow, low pitched

ex) healthy lungs

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19
Q

Dull Sounds

A

Soft, thud-like.

ex) liver

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20
Q

Flat Sounds

A

very dull soft sound

ex) over muscle

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21
Q

Sounds Best Heard with Diaphragm

A

High pitched sounds

ex) S2 in heart beat

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22
Q

Sounds Best Heard with Bell

A

Low pitched sounds.

ex) Bruits

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23
Q

S1

A

systole / ventricular contraction. miral and tricuspid valve closure. duller, low frequency sound

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24
Q

S2

A

Diastole / ventricular relaxation. aortic and pulmonary valve closure. sharper, louder than S1. Listen with bell.

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25
Q

Heart Rate

A

BPM, rhythm, regularity, amplitude. 60-90.

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26
Q

Respiratory Rate

A

breaths per min, pattern, depth, signs of distress. 12-20

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27
Q

Blood Pressure

A

peripheral measure of CV function. 60, or 140/90 adults

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28
Q

Body Temperature Control

A

Balancing heat prod. w/ heat loss. Heat prod. by liver, brain, heart,skeletal muscle. heat loss @ skin

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29
Q

Heat Loss

A

how fast can heat be conducted from core to skin to surroundings. blood shunting.

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30
Q

Mechanisms of Body Heat Loss

A

conduction (touching cold ground), convection (wind chill), radiation (loss to environment), respiration and evaporation

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31
Q

Hypothermia

A

heat loss > heat production. Core temp

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32
Q

Hyperthermia

A

heat produced > heat loss. not the same as a fever.

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33
Q

Farenheit to Celsius conversion

A 
F = (9/5)C + 32
C = (5/9)(F-32)
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34
Q

Pulse Deficit

A

Difference between apical pulse and radial pulse.

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35
Q

Pulse amplitude

A

force with which a bolus of blood moves through an artery. 0-4+

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36
Q

Apical Pulse

A

Pulse heard through stethoscope at apex of heart.

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37
Q

S1 vs. S2

A

S1 is closing of tricuspid / mitral valves. S2 is closing of aortic / pulmonary valves.

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38
Q

Pulse Pressure

A

Systolic - Diastolic. 30-50 mmHg

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39
Q

Pulsus Paradoxus

A

Exaggerated decrease in amplitude of pulse and systolic pressure (>10 mmHg) during inspiration and increase in amplitude during exhalation

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40
Q

Tachycardia vs. Bradycardia

A 
Tachy = sympathetic response
Brady = parasympathetic response
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41
Q

Cheyne-Stokes Respirations

A

period breathing with periods of apnea

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42
Q

Kussmaul Breathing

A

Deep labored rapid breathing. Associated with metabolic acidosis.

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43
Q

Korotkoff Sound

A

sound produced by turbulent blood flow in arteries. Low pitched sounds.

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44
Q

Factors that Affect BP

A

stroke volume, HR, peripheral resistance, atherosclerosis, anxiety, pain, sedentary lifestyle, illicit drugs

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45
Q

Auscultatory Gap

A

period of silence 10-15 mmHg in between korotkoff sounds. palpate radial artery prior to measuring BP

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46
Q

Orthostatic BP

A

supine 5 minutes. check BP and HR. move to sitting. wait 1 minute. record BP and HR. systolic decrease of 20 or more or pulse increase of 20 or more, volume depletion.

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47
Q

Acute Pain

A

short duration, sudden onset, in association with injury, surgery, or acute illness

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48
Q

Chronic Pain

A

Several months or longer. sustained by pathological processes like joint disease, headache, or cancer

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49
Q

Subjective Nociceptive Pain

A

A type of time limited pain that resolves when tissue damage has healed. detected by specialized peripheral nerves called nociceptors.

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50
Q

Objective Nociceptive Pain

A
  • Objective: well localized
    somatic: Subtype involving joint, bone, muscles, and other soft tissues
    visceral: Subtype involving internal organs
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51
Q

Neuropathic Pain

A

Damage / disease to nerves involved in somatosensation

central - CNS damage. ex) phantom limb

peripheral - PNS damage. ex) funny bond

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52
Q

Pain Scale

A

verified, 0-10.

ask about #, location, intensity, and character.

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53
Q

Assessment of Physical Pain Behaviors

A

subjective. 0-10. OPQRST. Note non verbal cues. barriers to pain assessment in certain populations.

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54
Q

Non-Verbal Pain indicators

A

Protective, facial, vocalizations, body movements, changes in vitals, other: diaphoresis, pupil dilation, dry mouth, confusion or iritability.

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55
Q

General Appearance

A

Gender, age category, illness vs. wellness, level of toxicity, acutely ill vs chronic, appropriate affect, posture, speech

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56
Q

Tanner stage

A

Term to identify the progression through adolescence by using secondary sex characteristics

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57
Q

Body Habitus

A

Height, weight, proportionality, nutritional status

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58
Q

External Eye anatomy

A

eyelid/palpebra - includes skin, striated muscle, tarsal plate, meibomian glands.
Conjunctiva - clear mucous membrane covering eye (bulbar and palpebral)
Lacrimal Gland - produced tears, drain via canaliculi
Canaliculi and lacrimal sacs - drain tears to nose
Eye muscles

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59
Q

Eye muscles

A

inferior, superior, lateral, medial rectus
inferior and superior oblique
LR6SO4, all the rest are CNIII

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60
Q

Internal Eye

A

Sclera, cornea, uvea (iris, pupil, ciliary body, choroid), lens, retina,

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61
Q

Sclera

A

dense avascular tissue, white of the eye

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62
Q

cornea

A

anterior 1/6th of the globe. clear tissue with sensory innervation. avascular.

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63
Q

uvea

A

iris - circular, contractile, pigmented
Pupil - central iris.
Ciliary Body - produced aqueous humor
Choroid - pigmented, vascular, provides O2 to retina

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64
Q

Lens

A

Biconvex transparent. behind iris. supported by ciliary fibers.

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65
Q

Retina

A

sensory aspect of eye. transforms light into electrical impulses, travel to optic nerve to visual cortex

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66
Q

Opthalmascope Procedure

A

turn on, begin with diopter at 0, then adjust to focus. select aperture size and filter. red free, slit, grid, cobalt, or polarized

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67
Q

External Eye Exam

A

OD = right OS = Left OU = Both Also consider peripheral vision
The external eye – begin with outside and move inward
1. Inspect area around the eye (adnexa)
a. Eyebrow size and shape
b. Orbital and periorbital area – look for edema
c. Eyelids – look for tremors and flakiness or redness of skin. Not drooping or too widely open.
d. Palpate over lacrimal gland and palpate eyelids for nodules and intraocular pressure.
2. Inspect sclera and overlying conjunctiva with ambient light AND pen light
3. Conjunctiva – translucent. Free from erythema or exudate.
4. Cornea – examine with tangential lighting. Avascular.
5. Iris and Pupil - pupil shape should be regular. Pupils should be PERRLA (pupils equal, round and reactive to light and accomodation)
a. Pupillary response, check direct and consensual
b. Check Accommodation
6. Lens – transparent
7. Extraocular Movements
a. Gaze should be conjugate, meaning both eyes move together
b. Nystagmus = eye twitch
c. Move through cardinal directions (H or star shape)
d. Normal exam is EOMI(extraocular movements intact)
8. Assess for strabismus using cover / uncover or corneal light reflex
9. Assess anterior chamber depth with tangential lighting
a. If anterior chamber is “adequate” the entire iris will light up with tangential lighting
b. If the anterior chamber is abnormal the inner iris will be in shadow

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68
Q

Internal Eye Exam

A
  1. Dilated pupils are easier to work with. Dim room lights if possible
  2. Have patient look at a distant object
  3. Right Hand Right Eye Right Eye, and vice versa
  4. Ophthalmoscopy Technique
    a. Hand on patient’s head, lift brow
    b. Locate red reflex
    c. Move close to patient
    d. Focus on anything in the retina (will appear orangey)
    e. View optic disc (where retina converges with optic nerve) and cup
    i. Stand at 15* angle
    ii. Margin should be sharp, creamy yellow
    iii. cup to disc ratio of 0.5 is normal
    f. View retinal arteries and veins (can be used to help locate optic disc)
    g. View macula (fovea) – temporal to optic disc
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69
Q

Visual Impairment

A

reduction in vision that cannot be corrected to normal 20/20 with standard lenses

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70
Q

Legal Blindness

A

20/200.

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71
Q

Proptosis / Exopthalmos

A

Protrusion of the eyeball

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72
Q

Ptosis

A

drooping of the eyelids

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73
Q

Nystagmus

A

involuntary eye movement or twitching

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74
Q

strabismus

A

eye misalignment (esotropia, exotropia, hypertropia)

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75
Q

diplopia

A

double vision

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76
Q

emmetropia

A

normal vision

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77
Q

hyperopia

A

farsightedness. can’t see close up.

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78
Q

myopia

A

nearsightedness. can’t see far away.

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79
Q

astigmatism

A

blurred vision due to irregular corneal shape or curve of lens.

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80
Q

presbyopia

A

old eyes

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81
Q

mydriasis

A

dilation of pupil caused by disease drugs or trauma

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82
Q

miosis

A

constriction of pupil

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83
Q

aniscoria

A

one pupil more dilated than the other

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84
Q

Eye Exam Findings: Diabetes

A

increased vascularization near macula. vitreous hemorrhage. cotton wool spot. snowflake cataracts. cloudy shape over the lens., AV nicking

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85
Q

Eye exam findings: hypertension

A

cotton wool spot, which are yellowish areas caused by infarction on nerve layer. A/V nicking. decreased arteriole size. hemorrhage and papilledema.

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86
Q

Eye exam findings: thyroid disease

A

calcium deposit in superficial cornea, appears as horizontal grey band inferior to pupil. cataracts caused by hypoparathyroidism. vision loss, tremors, exopthalmos

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87
Q

Eye exam findings: hypercholesteremia

A

in limepia retinalis the peripheral fundus go from normal to salmon to white. abnormalities go away as serum triglycerides return to normal. grey coloring of cornea. exudates.

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88
Q

Bones of Cranium

A

Frontal, Parietal, Sphenoid, Zygomatic, Maxilla, Mandible, Temporal, Occippital

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89
Q

Facial Features (new)

A

Nasolabial Fold

Palpebral Fissure

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90
Q

External Anatomy of Nose

A

nares, ala nasi (wing)

air passes through vestibule into choanae. vestibules separated by septum. CN I senses smells.

91
Q

External Anatomy of Ear

and Ear Exam

A

External ear: auricle (or pinna) surrounds the external auditory canal which leads to the tympanic membrane
On physical exam inspect/palpate: auricle, mastoid, tragus (triangular part near opening), helix (top of the ear), and lobule (bottom of ear, common site for piercings), use the otoscope to visual the auditory canal and tympanic membrane
Function: protects the opening of canal and provides directional sensitivity
Function: ceruminous glands secrete cerumen adding protection by trapping debris and bacteria
Function: tympanic membrane converts sound waves into mechanical movements, also the TM is a barrier to the middle ear

92
Q

Cotton Wool Spot

A

ill defined yellow areas caused by infarction of nerve layer of retina

93
Q

Hard Exudate

A

Sharply defined borders, yellow, clusters near vessels, caused by lipids in capillaries

94
Q

Soft Exudate

A

Dull grey spots poorly defined margins caused by infarction of nerve layer

95
Q

Pappilledema

A

Central Vessels pushed forward, veins dilated, venous pulsations not present

96
Q

Exopthalmost

A

bulging eyes

97
Q

Lipemia Retinalis

A

blood vessels become progressively pink then white as triglycerides rise

98
Q

Arcus Cornealis

A

Accumulation of cholesterol around the edges of the cornea causing a grey ring

99
Q

Middle Ear Anatomy and Exam

A

contains auditory ossicles (malleus/hammer, incus/anvil, stapes/stirrup); the auditory tube drains to the nasopharynx
On physical exam visualize: umbo (projection on the INNER surface of the TM at the end of the manubrium of the malleus, this is the most depressed part of the TM) and lateral process of malleus, cone of light (reflection seen on anterior inferior quadrant)
Function: conduct vibrations to the internal ear (collecting the force applied to the tympanic membrane and focusing it one the oval window)

100
Q

Internal Ear Anatomy and Exam

A

bony labyrinth (continuous with the temporal bone) is made of a membranous labyrinth of fluid-filled tubes containing endolymph
On physical exam we do not visualize the inner ear, but instead test its function by the whisper test, Weber, Rinne
Function: when the stapes contacts the round window pressure waves move through the endolymph causing distortion of the basilar membrane (in the Cochlear duct), when the basilar membrane moves hair cells are triggered to release neurotransmitters and stimulate the sensory nerve
Function: cochlea provides a sense of hearing (transmitted to the 8th nerve)
Function: semicircular ducts play a role in rotational movements, utricle and saccule provide equilibrium info (moving vs. stationary)

101
Q

Examination of the Mouth

A

lips, frenulum, tongue, tonsils, uvula, hard and soft palate, gingiva, salivary glands (parotid and sumandibular), dentition, buccal mucosa, maxilla, mandible

102
Q

Examination of the Throat

A

Pharynx, larynx, epiglottis, esophagus, tonsils

103
Q

Examination of the Neck

A

cervical vertebrae, ligaments, SCM, trapezius, lymph nodes, trachea, thyroid

104
Q

Glands of the Mouth

A

Parotid Gland - stensen ducts
Submandibular Glands - wharton ducts
Sublingual

105
Q

Bones of the Skull

A

zygomatic, frontal, parietal, temporal, occipital, sphenoid, lacrimal, mastoid process, mandible, maxilla, nasal bone

106
Q

Whisper Test

A

have patient plug non test ear. exhale all air. whisper 2 syllable word.

107
Q

Weber Test

A

assesses unilateral hearing loss. 512 Hz fork. if sound lateralizes to 1 ear, EITHER conductive loss in that ear, or sensorineural loss in the other ear.

108
Q

Rinne Test

A

determines if patient hears better by bone or air conduction. vibrating fork to mastoid bone. when pt. stops hearing sound move infront of ear. in normal ears, AC>BC. If BC>AC, sensorineural loss in that ear.

109
Q

Conductive Hearing Loss

A

sound cannot pass freely into inner ear

110
Q

Sensorineural Hearing Loss

A

missing / damaged sensory hair cells in cochlea or damage to CN VIII (vestibulocochlear).

111
Q

Examination of the Head

A

upright, centered, normal size
palpate skull front to back
free moving scalp
inspect and palpate face for symmetry. TMJ.
Hair, assess color texture distribution. look in part and behind ears.

112
Q

Examination of the Ears

A

ask about hearing aids
auricles - size, shape, symmetry, color, position.
auditory canal - discharge
mastoid - not red or raised
otoscope - discharge, scaling, erythema, cerumen, foreign bodies
TM - translucent grey.
whisper, weber, and rinne
landmarks: umbo, handle of malleus, light reflex

113
Q

Examination of the Nose

A

color same as face. midlne tip. oval symmetrical nares. no d/c
nasal bridge to tip non tender. patent nares. nasoscopy - color D/C, swelling, polyps, septum

114
Q

Examination of sinuses

A

inspect palpate percuss transiluminate

115
Q

Examination of Mouth

A

lips, mouth and oropharynx, dental prosthesis, gingiva, buccal mucosa, fordyce spots, dentition. tongue. hard/soft palate. tonsils, uvula

116
Q

Examination of the Neck

A

straight, no tracheal shift, even musculature, no JVD, no visible nodes or thyroid. palpate vertebra and musculature. Thyroid exam.

117
Q

Lymph nodes

A

Occipital, post auricular, pre auricular, tonsillar, submandibular, submental, anterior cervical, posterior cervical.

118
Q

dentition

A

central incisors, lateral incisors, canines, first premolar, second premolar, first molar, second molar, third molar

119
Q

septal deviation

A

asymmetric size of nasal cavisites. nose does not appear symmetrical.

120
Q

Rhinitis

A

inflammation of the nose, purulent discharge.

121
Q

Effusion

A

loss of fluid from the blood vessels or lymphatics into the tissue or a body cavity, edema, pain and tension in area of build-up

122
Q

Otosclerosis

A

chronic progressive deafness, caused by formation of spongy bone and ankylosis of stapes, diminished sound transmission through bone, Rinne Test

123
Q

Glossitis

A

Smooth red slick tongue, Vit B12 defficiency

124
Q

Gingivitis / Gingival Hyperplasia

A

inflammation of the gums, redness, swelling, bleeding, overgrowth of gums

125
Q

frontal bossing

A

prominent, protruding forehead or eyebrow ridge, common sign of acromegaly

126
Q

geographic tongue

A

“expected variant”, tongue that appears map-like, lots of lines and circles that expose papillae

127
Q

torus palatinus

A

boney protuberance of the hard palate, “expected variant”

128
Q

hairy tongue

A

yellow-brown to black papillae that are elongated, sometimes observed after antibiotic therapy

129
Q

cauliflower ear

A

blunt trauma and necrosis of the underlying cartilage

130
Q

nasal polyps

A

soft, typically painless non-cancerous (benign) growths. Seem to coincide with long term rhinitis/allergy. Large polyps may occlude nasal canal causing congestion, anosmia and headaches.

131
Q

Otorrhea

A

ear discharge. most commonly benign. can result from eustachician tube infection/pathology or middle ear infection/pathology. can also occur following head trauma in which case would be treated as a medical emergency (perhaps leaking brain juice AKA cerebrospinal fluid).

132
Q

retraction/bulging of the tympanic membrane

A

very conical, exaggerated loss of bony landmarks and distorted light reflex

133
Q

torticollis

A

dystonia resulting from the spasmodic contraction of neck muscles causing the head to take a turned, flexed or tilted position

134
Q

pharyngitis/ tonsillitis

A

inflammation of the pharynx can be caused by a number of things. viruses, bacteria, fungi, pollutants or chemicals. Tonsillitis typically is described as inflamed tonsils with presence of white spot-like exudates with absence of cough (if streptococcal). Streptococcal bacteria and various viruses = most common.

135
Q

dental caries

A

tooth decay or cavities. caused by bacteria

136
Q

goiter

A

thyromegaly. enlarged thyroid gland typically due to lack of iodine in diet/iodine deficiency.

137
Q

strawberry tongue

A

glossitis with hyperplastic fungiform papilla (looks like the dimpling of a strawberry). Can be associated with B12 defeciency, kawasaki disease, toxic shock, scarlet fever, etc.

138
Q

atrophic tongue

A

papillae shrink and disappear leaving tongue red, thin, and shiny, patches of redness and inflammation, painful, sensitivity to spicy foods, bad breath

139
Q

presbycusis

A

Age related hearing loss. Typically bilateral sensorineural.

140
Q

thyroid exam

A

inspection: thyroid should not be visible
palpation: Displace SCM (and examine thyroid on same side) or trachea (use one hand to displace trachea, and feel thyroid on opposite side of neck). Permits visualization of gland size, symmetry, contour.
Normal exam: small, smooth, nontender, free of nodules upon palpation. Firm yet pliable.
Abnormalities: asymmetry, nodules, tenderness, enlargement (suggests goiter or thyroiditis), course tissue or gritty sensation (suggests inflammation).

141
Q

3 layers of the epidermis

A

stratum corneum
cellular stratum
basement layer

142
Q

dermis

A

contains blood vessels, lymph, hair follicles, sweat glands. pain and touch receptors. held together by collagen.

143
Q

hypodermis

A

network of collagen and fat

144
Q

apocrine glands

A

axillae, nipples, areolae, anogenital, eyelids, external ears. larger and more deep than eccrine. secrete odorless fluid. odor arises from bacteria.

145
Q

eccrine glands

A

gland open to skin surface, sweat, evaporative cooling

146
Q

nail plate

A

dead keratin, protects nail bed

147
Q

eponychium

A

cuticle.

148
Q

paronychium

A

soft tissue surrounding nail.

149
Q

sebaceous gland

A

secrete lipid rich lubricating sebum. accompanies hair follicle at isthmus.

150
Q

hair shaft

A

non growing portion of hair protruding form follicle composed of dead keratinocytes

151
Q

hair follicle

A

region from which hair can grow
bulb
isthmus
infundibulum

152
Q

anagen phase

A

active hair follicle 3-4 years 84% of hair

153
Q

catagen phase

A

atrophy of follicle 2-3 weeks

154
Q

telogen phase

A

resting period for follicle lasts 3 months 10-15% of hair

155
Q

inspecting the nails

A

pigment, length, symmetry, ridging, beading, pitting, peeling, spooning, clubbing

156
Q

Hair, Skin, Nails by Age

A

kids: skin can be red at birth. black babies get darker in a few months. smooth skin, lanugo (fine, silky hair) at birth
Adolescent: increase apocrine glands, increase androgen and sebum, coarse terminal hair
elderly: decreased sebaceous gland activity, thinning epidermis, grey hair, hair loss. slow nail growth. brittle thicker nails.

157
Q

Hair, Skin, Nails by Race

A

white- earliest onset and greatest skin wrinkling

black - blue hue of lips and gums, pigmented nail bands. palms and soles of feet are lighter.

158
Q

Hair, Skin, Nails by Gender

A

Male - more likely to have hair loss with age. pubic hair in upright triangle.
Female - accelerate sweat gland activity with pregnancy. melasma (patches of dark skin) due to hormones with age. adrenal-androgenic female alopecia in 20s-30s. coarser facial hair in old age.

159
Q

Brown Skin lesions

A 
localized = nevi, neuofibromatosis.
generalized = pituitary, adrenal, liver disease
160
Q

White Skin Lesions

A 
Localized = vitiglio
generalized = albinism
161
Q

Red (erythmatous) skin lesions

A

increased cutaneous blood blow:
localized = inflammation
generalized = fever, viral exanthem, urticaria

increased vascular RBCs
generalized = polycythemia

162
Q

Yellow Skin Lesions

A

Increased Bile - Jaundice, generalized, liver disease

Increased carotene pigment, generalized, hypothyroidism, increased carotene intake

163
Q

Blue Skin Lesions

A

Increased unsaturated hemoglobin secondary to hypoxia, mouth lips and nail beds, cardiovascular and pulmonary disease

164
Q

white lesion ex.

A

lichen planus

165
Q

yellow lesion ex.

A

lipoma

166
Q

violaceous lesion ex.

A

erysipelas

167
Q

purple lesion ex

A

purpura, kaposi sarcoma

168
Q

pearly lesion ex

A

basal cell carcinoma

169
Q

black lesion ex

A

malignant melanoma

170
Q

brown lesion ex

A

most nevi, pityriasis versicolor

171
Q

orange-pink lesion ex

A

psoriasis

172
Q

erythmatous lesion ex

A

tinea, psoriasis

173
Q

pink lesion ex

A

eczema, pityriasis rosacea

174
Q

localized lesion ex

A

impetigo, herpes simplex

175
Q

regional lesion ex

A

acne vulgaris, psoriasis

176
Q

generalized lesion ex

A

urticaria

177
Q

lesions on sun exposed areas

A

sunburn, lupus erythmateous

178
Q

lesions in clothes-covered areas

A

contact dermatitis, miliaria

179
Q

lesions on flexural aspect of extremities

A

atopic dermatitis (inner elbow, back of knee)

180
Q

lesions on extensor aspect of extremities

A

psoriasis

181
Q

lesions in stocking and glove pattern

A

atopic dermatitis

182
Q

lesions in truncal pattern

A

pityriasis, drug reaction

183
Q

lesions on face shoulders and back

A

acne vulgaris, cushings

184
Q

lesions in round / discoid patter

A

nummular excema

185
Q

lesions in oval shape

A

pityriasis rosacea

186
Q

lesions in annular shape

A

round, active margins w/ central cleaing: tinea, sarcoidosis

187
Q

lesions in zosteriform shape

A

dermatomal: herpes zoster

188
Q

lesions in polycyclic pattern

A

psoriasis

189
Q

lesions in linear pattern

A

contact dermatitis

190
Q

lesions with iris/target shape

A

erythema multiforma

191
Q

lesions with stellate shape

A

meningococcal septicemia

192
Q

lesions with serpiginous shape

A

cutanea larva migrans

193
Q

lesions with reticulate shape

A

polyarteris nodosa

194
Q

lesions with morbilliform shape

A

measles, roseola, drug erruptions

195
Q

macule

A

primary lesion. flat. circumscribed. less than 0.5cm

196
Q

patch

A

primary. flat. circumscribed, greater than 0.5cm

197
Q

papule

A

primary. elevated, firm, circumscribed, less than 0.5cm

198
Q

plaque

A

primary. elevated firm circumscribed greater than 0.5cm

199
Q

wheal

A

primary. hive. variable diameter.

200
Q

nodule

A

primary. deeper in dermis. 1-2cm

201
Q

tumor

A

primary. deeper in dermis. greater than 2 cm

202
Q

vesicle

A

primary elevated circumscribed superficial blister

203
Q

bulla

A

primary vesible > .5 cm

204
Q

pusture

A

vesicle filled with purulent discharge

205
Q

cyst

A

primary. elevated circumscribed in demis filled with fluid variable size

206
Q

telangiectasia

A

fine irregular red lines (primary)

207
Q

secondary lesions

A

scale, lichenification, keloid, scar, excoriation, fissue, erosion, ulcer

208
Q

Assessment of Turgor

A

produced by fluid content in cells. decreased when patient is dehydrated or has edema.

209
Q

spooning nails

A

concave central depression of nail

210
Q

Pallor / rubor / cyanosis

A 
pallor = unhealthy pale
rubor = skin redness
cyanosis = skin blueness
211
Q

clubbing

A

increased curvature of nail plate, bulbous swelling at terminal phalanges

212
Q

hirsutism

A

women with hair in male distribution pattern

213
Q

beau’s lines

A

transverse depression in nail bed

214
Q

variscosities

A

varicose veins

215
Q

onycholysis

A

nail plate separates from nail bed

216
Q

alopecia

A

sudden, rapid patchy hair loss

217
Q

sriae

A

pink linear bands of skin that look like stripes… stretch marks

218
Q

edema

A

swelling due to accumulation of excess fluid

219
Q

peau d’orange

A

pitted or dimpled appearance of skin, looks like orange peel

220
Q

nail pitting

A

pin prick like depressions in the nail plate, may indicate psoriasis

221
Q

koilonychia

A

spooning nails

222
Q

paronychia

A

inflammation of the paronychium

223
Q

leukonychia

A

white spots in nail plate from trauma

Physical Diagnosis Block 1 Objectives (1 decks)

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