test 1 overall Flashcards
what are the 4 principles of physical exam
inspection, palpation, percussion, auscultation
what principle of physical exam typically occurs first
inspection
what principle of physical exam typically occurs last
auscultation
what arteries should be auscultated prior to palpating the neck
carotid
what are some aspects that go along with inspection
general appearance, state of nutrition, body habits, gross symmetry, posture and gait, speech
what side should you general approach the patient from
right
what are some examples of airborne-infectious agents
TB, varicella
what are the required equipment items for an exam
stethoscope, otoscope, ophthalmoscope, penlight, reflex hammer, tuning fork (128hz), safety pins, tape measure, pocket acuity card
define sensitivity
frequency of a positive result of a test or technique in individuals with a disease or condition
define specificity
frequency of a negative result of a test or technique in individuals without a disease or condition
what does aniso- mean
unequal
what does idio- mean
separate, distinct
what does lith mean
stone
when does the physical exam usually begin
after the history has been documented
what type of mask is necessary with airborne precautions
N-95 or equivalent respiratory mask
what does the suffix -gnosis mean
recognition
what does the suffix -dynia mean
pain
what is the most common cancer in the world
basal cell carcinoma
what layer of the skin are keratinocytes in
epidermis
what layer of the skin are melanocytes in
epidermis
what layer of the skin are fibroblasts in
dermis
define primary lesions
first to appear and are due to disease or abnormal state
what techniques are required for the skin exam
inspection and palpation
what aspects are required for proper inspection of the skin
ensure adequate lighting, proper exposure, review appropriate draping
what are the general principles of the skin exam
color, moisture, turgor, texture
what are the A-E of assessment of pigmented lesions
asymmetry of shape, border irregularity, color variation, diameter >6mm, evolving
what should be evaluated on the seated patient for skin exam
fair, fingernails, skin of face/neck/back
what type of cancer is responsible for most skin cancer deaths
melanoma
what are the main symptoms of disease of the skin, hair and nails
rash or skin lesion, changes in skin color, itching, changes in hair, changes in nails
what i the only equipment necessary for the examination of the skin
penlight
what are mee’s bands historically associated with
chronic arsenic poisoning
what type of nails has the proximal portion of the nail bed is whitish, whereas the distal part is red or pink
lindsay’s nails
what diseases are commonly associated with lindsay’s nails
chronic renal disease and azotemia
what type of nails are white nail beds to within 1-2 mm of the distal border of the nail
terry’s nails
what type of nail is a dystrophic state in which the nail plate thins and cuplike depression develops
koilonychia
what is pitting of the nails commonly associated with
psoriasis and psoriatic arthropathy
what are the 3 specific criteria for a dermatologic diagnosis
morphologic characteristics, configuration and distribution
what are some examples of macules
freckles, moles
what are some examples of patches
vitiligo, cafe au lait spots
what type of lesion is a wart
papule
what type of lesion is a erythema nodosum
nodule
what type of lesion is psoriasis
plaque
what type of lesion is seborrheic keratosis
plaque
what type of lesion is a blister
vesicle or bulla
what type of lesion is acne
pustule
what type of lesion is a blackhead
comedo
what type of lesion is scabies
burrow
what are the characteristics of telangiectasia
fine, irregular dilated blood vessels
what type of lesion is disc-shaped without central clearing
discoiid
what type of lesion is a circle within a circle; bull-s eye lesion
iris
what type of melanoma is seen most commonly in the geriatric population
lentigo maligna melanoma
what 3 things should you always remember with eye exam
check vision, shine a light on the pupils, check ocular motility
what cranial nerve innervates the superior oblique
CN 4
what cranial nerve innervates lateral rectus
CN 6
what is the medical term for improper alignment of the eye
strabismus
how many degrees should the visual fields test go temporally
100-110 degrees
how many degrees should the visual fields test go nasal and upward as well as downward
nasal and upward is 60; downward is 70
what occurs if there is unilateral visual field loss
it is unilateral in front of the chiasm
what occurs if there is bilateral visual field loss
it occurs behind the chasm
what is the treatment for blepharitis
steroids, doxycycline, azithromycin, erythromycin, baby shampoo
what is the definition of a sty
inflamed around the hair follicle, often infections
what causes a chalazion
inflamed, clogged meibomian gland
what are the symptoms of the eye with allergic conjunctivitis
clear drainage, itch
what is the secretion of the eye with bacterial conjunctivitis
mucous
what is the secretion with viral conjunctivitis
clear
what is given at birth to prevent conjunctivitis in the newborn
erythromycin
what is inflammation of the connective tissue between the conjunctive and sclera
episcleritis
what is another name for nearsidedness
myopia
what is another name for far-sightedness
hyperopia
what type of lens is used for myopia
minus lenses
what type of lens is used for farsightedness
plus lens
what can cause unilateral painful loss of vision
angle closure glaucoma, optic neuritis, temporal arteritis, trauma
who does optic neuritis typically occur in
women under 45 years old
what condition with 50% of individuals who have optic neuritis develop
MS
when should you avoid using neosynephrine for eye dilation
pregnant, recent heart attack or stroke, shortness of breath
what can be used for reversing dilation
pilocarpine 1%
what is the red reflex used to test for
retinoblastoma
at what size are pupils considered large
greater than 5mm
at what size are pupils considered small
less than 3 mm
what is the term for pupil size inequality
anisocoria
how far away should the physician hold their finger from the patient when checking extra ocular movements
15-18 inches
define accommodation
near focusing of the eye
how far away should the examiner be from the patient when testing visual fields by confrontation
3 feet
what is the red free filter on the fundoscopic exam used for
green light that visualizes vessels and hemorrhages
what is the cobalt filter used for in the fundoycopic exam
evaluate for corneal abrasions, lesions or foreign objects after fluorescein staining
what is the action of the medial rectus
adduction
what is the action of the inferior rectus
depression, extorsion, adduction
what is the action of the superior rectus
elevation, intorsion, adduction
where do synapses of they eye occur
lateral geniculate body
when does the near reflex occur
when the subject looks at a nearby target
what are the 3 parts of the near reflex
Accommodation, convergence, and pupillary constriciton
what does diplopia result from
faulty alignment of the eyes
what causes the twitching symptom in the eye
fibrillation of orbiculares oculi
where is the blind spot of the ye located
approximately 15-20 degrees temporal to central fixation, corresponding to the optic nerve head
what is the term for a defect in both temporal fields
bitemporal hemianopsia
what is the term for deviation of an eye nasally
esotropia
what is the term for chronic inflammation of the eyelid margins
blepharitis
what is the term used to describe the inflammation of the lower lacrimal passage (usually seen in infants or older individuals)
dacrocystitis
what is the condition that is painless scleral condition characterized by the appearance of one or more dehiscences in the sclera in the absence of inflammatory changes
scleromalacia perforans
what is most likely occurring if there is a whitish ring at the perimeter of the cornea
arcus senilis
what is an acquired abnormality of the shape of the cornea
keratoconus
what is another name for pupillary enlargement
mydriasis
what instrument can be used for the quantitative assessment of intraocular pressure
schiotz tonometer
what is the position of the ear to view in adult
up and back and out
what is the position of the ear to view in kid
down, back and out
whats the cause of sensory-neural hearing loss
damage to CN VIII
what is sound conducted to CN VII via the ear canal, TM and auricular bones
air conduction
what is sound conducted to CN VII via the cranial bones
bone conduction
what does low frequency sound transmit through best
solids
what doe high frequency sound transmit through best
air
what is rinne test used for
determine if it is conductive loss
what is weber test used for
determine if it is neurosensory loss
what happens if the weber test is heard better in the bad ear
conduction loss or distraction
what happens if the weber test is heard better in the good ear
likely neurosensory loss
what can cause otitis externa
staph/strep, fungal, pseudomonas
what is another name for otitis externa
swimmers ear
what does the external ear consist of
pinna and external auditory canal
what are the parts of the tympanic membrane
pars flaccid and pars tensa
what meatus does the nasolacrimal duct empty into
inferior meatus
what openings does the middle meatus contain
frontal, maxillary and anterior ethmoid sinuses
where does the posterior ethmoid sinus drain
superior meatus
where is the local pain for the maxillary sinus
behind ear, cheek, nose, upper teeth, upper lip
where is referred pain for the maxillary sinus
teeth, retrobulbar
where is the local pain for the ethmoid sinus
periorbital, retronasal, retrobulbar
where is the referred pain for the ethmoid sinus
occipital, upper cervical
where is the local pain for the frontal sinus
supraorbital, frontal
where is the referred pain for the frontal sinus
bitemporal and occipital headache
what are the functions of the pharynx
enable swallowing, enable speech, provide an airway
what is another name for hoarseness
dysphonia
what is the condition in which the dorsum of the tongue has a smooth, localized red areas, denuded of filiform papillae, surrounded by well-defined, raised yellowish-white margins and normal filiform papillae
geographic tongue
what is the most common endocrine cancer
thyroid cancer
what does the lacrimal apparatus consist of
lacrimal gland, accessory tear glands, canaliculi, tear sac, and nasolacrimal duct
what is the most common cause of blindness
cataracts
where is sweetness detected
tip of the tongue
where is saltiness sensed
at the lateral margins of the tongue
where is sourness and bitterness perceived
posterior aspect of the tongue
what are the boundaries of the anterior triangle
SCM, mandible, midline
what are the boundaries of the posterior triangle of the neck
SCM, traps, clavicle
use the _____ to auscultate the carotid arteries
bell
what is the normal size of a lymph node
typically <1cm
how does the patient lie for a brudzinski’s sign test
supine
what is a positive brudzinski’s sign
patient has flexion of hips and knees with motion of neck
how does the patient lie for a kerning’s sign
supine
what is a positive kerning’s sign
patient has associated pain and resistance to motion
what part of your fingers do you use for palpating lymph nodes
pads of fingertips
