T3 - Chapter 9 Skin, Hair, and Nails Flashcards
Skin Cancer Risk Factors
- History of cancer
- family history
- excessive exposure to ultraviolet radiation
- fair skin, blonde and red hair
- blue or green eyes
- moles
What are the structures of the head?
Skull: 6 bones -frontal -parietal x2 -temporal x2 -occipital Face 14 bones Facial Muscles -controlled by cranial nerves 5 and 7
What are the three head sizes?
Noemocephalic: -normal (symmetric and proportionate) Macrocephalic: -abnormally large Microcephalic -abnormally small
Normal head inspection findings
- symmetry in features and bones
- skull should be firm
- no lumps or lesions
- temporal artery should be smooth and non tender
Types of headaches
Cluster Migraine Tension Sinus Post Traumatic
Cluster Headache
Most painful
Last 30 min to an hour
Repeats daily for 6-12 weeks
Remission is an average of 12 months
Migraine
Starts with aura, cause by vasospasm Lasts up to 72 hours Causes: -depression -irritability -photophobia -nausea
Tension
Most common between age 20 and 40
Bilateral pain may be confined to one area (occipital, temporal..)
Gradual onset, may last several days
Post traumatic
After head injury (concussion) Symptoms -Dull pain -inability to concentrate -dizziness
Sinus
Caused by allergies or cold
Pain face
Two vision tests
Near sighted
- rosenbaum chart
- people over 40
- 14 inches away
Farsighted
- Snellen chart
- 20 feet away
Visual abnormalities
Leaning to see the chart Squinting Blinking Hesitancy Vision not 20/20
Peripheral vision or confrontation test
Face sitting 2-3 feet away
Cover one eye move an object from far to close and test when patient can see it
Eye inspection
Eyes Eyebrows Eyelashes Eyelids Look for: Symmetry, skin characteristics, and discharge
Pupils and cornea Testing
PERRLA
Pupils are equal, round and reactive to light and accommodation
Pupils should constrict when looking close
Pupils should dilate when looking far
Eye movement testing
6 Cardinal fields of gaze -star or H pattern -nerves 3, 4, and 6 Cover uncover test -should have no movement Corneal Reflex -cotton ball only on unconscious patient
What is chalazoin
Nodule of melibomian gland
covers most of the eyelid
What is conjunctivitis
Inflammation of palpebral or bulbar conjunctiva Cause by: -contacts -allergies -pink eye -chemical reaction Findings: Redness and sticky discharge
What are cataracts
Opacity of lens from denatured lens protein by age or trauma Findings: Blurry vision Cloudiness Halo around lights
What is diabetic retinopathy
Visual alteration cause by diabetes Leading cause of blindness Detachment of retina, curtain over eye Findings Decreased vision Hemorrhage or micro aneurisms Exudate Vessel formation
What is glaucoma
Group of diseases that increase intraocular pressure
Findings
Loss of vision without pain
Glaucoma risk factors
Age over 40
Genetics
Diabetes/ HTN
General ear assessment
Alignment Symmetry Color Darwin tubercle Normal conversation hearing
Hearing assessment
Tests cranial nerve 8 Whisper Test Finger rub test Weber Test -sensorineural (top of head) Rinse Test -conductive (sides)
Inner ear inspection
Some wax is normal
Tympanic membrane should be shiny/ pearl gray
Colors of tympanic membrane
Yellow/amber -fluid being the membrane Redness -infection in general Chalky White -middle ear infection Red streaks -increased blood flow (cause by allergies)
Wax (cerumen) removal
Loop Drops Wax candle Do not irrigate if perforated No odor should be present
What causes a hematoma?
Direct trauma, usually a contact sport
What is an ear carcinoma
Cancer of the skin, patch of crusty skin or waxy bump
What is cauliflower ear
Thickened disfigured auricle resulting from repeat trauma
- wrestling
- red flag if seen in kids
Ear Problem:
Foreign Body
Frequent in children
S/S:
Pain, drainage, fever
Decreased hearing
What is Otitis Media
Middle ear infection S/S Fever, pain Vomiting (infants) Decreased hearing Pulling at ears Red/ bulging TM White or yellow drainage
What is otitis media with effusion
Ear infection with fluid build up S/S Hearing/ balance problems Clicking or popping No fever or pain Retracted TM
Types of hearing loss
Conductive or Sensorineural
Conductive hearing loss
Interference if air conduction to middle ear
Mechanical problem
Wax build up
Scarring of otitis externa
Sensorineural hearing loss
90% of hearing loss Caused by prebycusis Bilateral deafness with loss of high pitch tones Nerve damage Transmission problem
Nose inspection
Palpate for tenderness Assess patency (able to breathe from both nostrils)
Mouth inspection
Inspect lips, gums, teeth, tongue, tonsils, and anterior/posterior pillars
Lips inspection
Color, moisture, and texture Pale: anemia or shock Cyanotic: blue, hypoxemia Dry: dehydration Cracks: vitamin B deficit
Teeth inspection
Findings:
If patient does drugs, tobacco, was or is a smoker
Tongue inspection
Tongue should be moist and bumpy
Able to stick tongue out (cranial nerve 12)
Smooth: Vit B deficit
Hairy tongue: antibiotics use, pipe smoker, super infection
What is tonsillitis
Bacterial infection S/S Sore throat Fever/ chills Swollen nodes Ear pain
What is candidiasis
Thrush
Common in immunocompromised and with antibiotics
S/S
Soft white plaque on tongue
Treat with swish and spit, do not peel off
What is herpes of the mouth
Type 1 herpes Highly contagious cold sore S/S Stress, allergies, extended sun exposure Burning/ tingling/ pain before outbreak Lesion on lips or around mouth White ulcers inside the mouth
What is gingivitis
Inflammation of the gums Caused by Poor dental care S/S Bleeding gums Redness/ swelling Hyperplasia
What is an aphthous ulcer
Canker sore
Appear around mouth, lips, and tongue
Round/ oval ulcer yellow white center and red halo
Last up to 2 weeks
Neck assessment
Inspect ROM
Palpate thyroid
Palpate lymph nodes
What is hyperthyroidism
Excessive production and secretion of thyroid hormone
S/S of hyperthyroidism
Intolerance to heat Bulging eyes Facial flushing Clubbing Tremors Diarrhea Edema Weight loss Tachycardia
What is hypothyroidism
Decreased production of thyroid hormone
S/S if hypothyroidism
Hair loss Cold intolerance Facial edema Extreme fatigue Slow speech Anorexia Brittle nails and hair Constipation Dry skin
