What is

SCLERODERMA?

Literally "Hard Skin"

A chronic connective tissue disorder associated with decreased mobility

Poor Turgor

is evident in?

Severe Dehydration or

Extreme Weight Loss;

The skin will "tent"

Mobility is

decreased when?

When EDEMA

is present

Define

TURGOR

Skin's ability to

return to place

Define

MOBILITY

The skin's

ease of rising

Edema

1) What is it?

2) Grades & brief description of each

1) Fluid accumulation in the intercellular spaces

2) 1+ Mild pitting, slight indentation, no swelling

          2+ Moderate pitting, indentation subsides rapidly

             3+ Deep pitting, indentation remains short time; leg looks swollen

               4+ Very Deep Pitting, indentation lasts long time; leg very swollen

What is the term for

OILY SKIN?

SEBORRHEA

PRURITUS

(Itchy skin)

STRIAE's

common name

STRETCH

MARKS

What is the term for

DRY SKIN?

XEROSIS

Possible causes of

UNILATERAL

EDEMA

Local or

peripheral causes

Possible causes of

BILATERAL OR

GENERALIZED

EDEMA

Central problems such as

HEART or KIDNEY

FAILURE

What is the physiological/medical term that cooresponds with the following skin color changes:

1) White

2) Red

3) Blue

4) Yellow

1) PALLOR

2) ERYTHEMA

3) CYANOSIS

4) JAUNDICE

With

HYPOTHYROIDISM

skin feels:

Rough,

Dry &

Flaky

Very THIN, SHINY

SKIN is called?

1. When is the mnemonic ABCDE used?

2) What does each letter stand for?

1. To assess abnormal characteristics of pigmented lesions

 (moles, etc.)

2. A) ASYMMETRY

B) BORDER IRREGULARITY

C) COLOR VARIATION

D) DIAMETER GREATER THAN 6mm

E) ELEVATION & ENLARGEMENT

3 Common, Benign

Pigmented Areas of the

Skin are:

1) Freckles

2) Moles

3) Birthmarks

Mobility &

Turgor

are indicators of

skin's ________

VITILIGO

HERPES ZOSTER

1) AKA

2) Who mainly gets it

3) Can cause

1) Shingles

2) Aging, older adults

3) Intense pain and itching

The SKIN

can give clues to someone's (3 things)

1) Body Circulation

2) Nutritional Status

3) Signs of Systemic Disease

It becomes

 DRY,

BRITTLE &

LUSTERLESS

What is

DIAPHORESIS

Profuse

PERSPIRATION

The backs

of your hands

Light-skinned (i.e. white) people &

people who had blistering sunburns as a child

  SHAGGY, EXCESSIVE

HAIR

is called?

HIRSUTISM

Significant

HAIR LOSS

is called?

ALOPECIA

What causes

ACNE?

Trick question; the cause is

UNKNOWN

It is NOT caused by: Poor diet, oily complexion or contagions

JAUNDICE

can occur with

(5 disorders/diseases)

1) Hepatitis

2) Cirrhosis

3) Sickle-cell disease

4) Transfusion reaction

5) Hemolytic disease in newborns.

Skin Indicators of

HYPERTHYROIDISM?

1) Warm, moist skin

2) Abnormally smooth or soft skin; like velvet

CYANOSIS

1) Indicates: _________

2) Occurs with: (4 diseases/disorders)

1)Hypoxemia (decreased partial pressure of  0xygen in blood)

2)

I.     SHOCK

II.   HEART FAILURE

III. CHRONIC BRONCHITIS

IV.   CONGENITAL HEART DISEASE

3 Side Effects or Changes in Skin that

MEDICATIONS

may cause:

1) Allergic skin eruptions

2) Sunlight sensitivity & increased burn response

3) Hyperpigmentation

MELASMA

1) AKA

2) What is it?

1) The "Mask of Pregnancy"

2) Patch tan to dark brown discoloration of face

What is

PSEUDOFOLLICULITIS

Razor Bumps or

Ingrown Hairs

People with DIABETES or

PERIPHERAL VASCULAR DISEASE are at greater risk for?

Skin lesions on

FEET or ANKLES

What does

ERYTHEMA

occur with?

(7)

1) Expected with FEVER

2) Local Inflammation

3) Emotional Reactions (blushing)

4) Polycythemia (increase in # of RBC's)

5) Venous Stasis (slow blood flow in veins)

6) Carbon monoxide poisoning

7) Extravascular presence of RBC's

When can

PALLOR

occur or accompany?

(5)

1) High STRESS states (Anxiety, fear, SHOCK)

2) Exposure to COLD

3) CIGARRETTE smoking

4) EDEMA

5) ANEMIA(S)

Psychological Effects of

CHRONIC SKIN DISEASE

include: (3)

1) Loss of Self-Esteem

2) Social Isolation

3) Anxiety

If someone has a

GENERALIZED RASH

what is a good possible cause?

An

ALLERGIC REACTION

to a

NEW FOOD

What is the protective function of

MELANIN

It protects the skin from

harmful

ULTRAVIOLET RAYS

10 things to assess for

RASHES

1) ONSET (when did they first notice it?)

2) LOCATION (Identify the primary site)

3) CHARACTER or QUALITY (Migration, raised, flat, crust, odor)

4) COLOR

5) DURATION (how long have they had it)

6) SETTING (Anyone else at home/work have the rash)

7) ALLEVIATING OR AGGRAVATING factors (soaps, lotions)

8) ASSOCIATED SYMPTOMS (Itchiness, fever)

9) STRESS (has it increased lately, new stressors)

10) MEDICATIONS (what they take; anything new)

4 Possible Indicators of

ABUSE

1) Multiple cuts, bruises, lesions

2) Bruises, etc. in different stages of healing

3) Linear marks

4) Cigarrette burns

Medical Term for

HIVES

Chronic Recurrent

URTICARIA

PRURITUS

often occurs with?

XEROSIS

(Dry Skin)

3 types of

SKIN GLANDS

& what they produce

1) Sebaceaus Glands - protective lipid sebum oils that lubricate the skin.

2) Eccrine (sweat) Glands - dilute saline solution to reduce body temperature

3) Apocrine (sweat) Glands - thick, milky secretions due to emotional or sexual stimulation

Blink

Corneal Reflex

TARGET SHAPED LESIONS

1) Due to:

2) AKA:

1) Erythema multiforme (hypersensitivity to infection)

2) Iris lesions

1) Trigeminal (CNV)

2) Afferent

3) Facial (CNVII)

4) Efferent

5) Blink

What Cranial Nerves

stimulate

EYE MOVEMENT

 (3)

1) CN VI - Abducens

2) CN IV - Trochlear

3) CN III - Oculomotor

GYRATE

Lesions

What do they look like?

Twisted, coiled spiral,

snakelike

GROUPED

shaped lesions

are due to?

CONTACT

DERMATITIS

CONFLUENT

shaped lesions

are due to:

URTICARIA

(Hives)

What COVERS the

SCLERA

of the eyeballs?

BULBAR

CONJUNCTIVA

ANNULAR

shaped lesions

are due to:

(3)

1) Tenia Corporis (ringworm)

2) Tinea versicolor

3) Pityriasis rosea

BELL'S PALSY

1) Caused by:

2) Effects (characteristics) of:

1) Caused by a lower motor neuron lesion (peripheral) - possibly due to HSV

2) Cranial nerve VII Paralysis, almost always unilateral

Complete paralysis of one half of face; Person cannot wrinkle forehead, raise eyebrow, close eye, or show teeth on affected side.

If the patient has

CYANOTIC NAILS or

SLUGGISH CAPILLARY REFILL

you might consider what to be the problem?

CARDIOVASCULAR or

RESPIRATORY

DYSFUNCTION

5 characteristics LYMPH NODES may have with

ACUTE INFECTIONS

1) BILATERAL signs/symptoms

2) ENLARGEMENT

3) WARM to touch

4) TENDERNESS

5) FIRM but freely movable

How should you

PALPATE LYMPH NODES?

(what part of hand, procedure)

- With the FINGERPADS of BOTH hands (so you can compare sides)

-Palpate in a circular motion using gentle pressure so as not to push nodes into the neck muscles

In a healthy individual CAPILLARY REFILL

normal occurs?

Instantaneously;

under 1 second

Name 3 conditions/diseases in which CLUBBING

 is a sign:

1) Congenital Chronic Cyanotic Heart Disease

2) COPD (emphysema)

3) Chronic Bronchitis

What are the

NAIL BED ANGLES in:

1) Normal condition

2) Early Clubbing

3) Late Clubbing

1) Normal: 160 degrees or less

2) Early Clubbing: Angle straightens out to 180 degrees, nail bed feels spongy

3) Late Clubbing: Greater than 180 degrees

How do you inspect for

CLUBBING?

Inspecting the nail angles; called the

PROFILE SIGN

Facial sensations of

TOUCH or PAIN

are controlled by which

cranial nerve?

CN V

TRIGEMINAL

NERVE

6 things to note when

examining a

LESION

C.L.E.E.P.S.

1) Color

2) Location & distribution

3) Elevation

4) Exudate

5) Pattern or shape

6) Size

Define

BRUIT:

What is a

WOOD'S LIGHT

used for?

Used during skin exam to detect fluorescing lesions

i.e. BLUE GREEN  fluorescence indicates a FUNGAL infection

TINEA

CAPITIS

1) AKA/Caused by:

2) Describe:

1) Scalp Ringworm, fungal infection

2) Rounded, patchy hair loss, leaving broken off hairs, pustules & scales on skin

What are

CHERRY

ANGIOLOMA'S

**NOT SIGNIFICANT, NOT INDICATIVE OF DISEASE**

Smooth, slightly raised bright red dots that commonly appear on the trunk in all adults over 30

PAPULE

1) Describe:

2) Caused by:

3) 4 Examples:

1) Something you can feel; solid, elevated, circumscribed, less than 1 cm in diameter.

2) Caused by superficial thickening of epidermis

3) I.  Elevated nevus (Mole)

    II. Lichen planus

    III. Molluscum

    IV. Verruca (Wart)

Name the 3 LAYERS of the

SKIN

1) Epidermis

2) Dermis

3) Subcutaneous layer

MACULE

1) Describe:

2) 6 Examples:

1) Solely a color change; flat, circumscribed, less than 1 cm.

2) I. Freckles

  II. Flat nevi

III. Hypopigmentation

  IV. Petechiae

    V. Measles

  VI. Scarlet Fever

What are the 2 Layers of the EPIDERMIS?

- Main components of each & functions

1) STRATUM CORNEUM or HORNY CELL LAYER (topmost layer)

- Dead keratinized cells that form a protective barrier

2) STRATUM GERMINATIVUM or BASAL CELL LAYER

(deeper layer)

-Keratin protein that aids in formation of new skin cells

-Melanocytes that produce melanin to give skin color

ZOSTERIFORM

shaped lesions

1) Due to?

2) Look like/Form along?

1) Herpes zoster

2) Linear arrangement along a nerve route

How do you test

CRANIAL NERVE XI?

POLYCYCLIC

shaped lesions are due to?

(2)

1) Lichen planus

2) Psoriasis

CN VII (Facial Nerve)

Bell's Palsy

What color should the

OPTIC DISC

be?

Varies from

creamy YELLOW-ORANGE to

PINK

1) CN II - Optic nerve, afferent link

2) CN III - Oculomotor nerve,

efferent link

Describe

DIRECT LIGHT REFLEX &

CONSENSUAL LIGHT REFLEX

1) Direct Light Reflex - Constriction of the pupil when one eye is exposed to bright light.

2) Consensual Light Reflex - simultaneous constriction of the other pupil (even if not also exposed to bright light)

*Both occur at the same time because the Optic Nerve carries the message to both sides of the brain.

3 common causes of DECREASED VISUAL FUNCTIONING in

Aging Adults

1) CATARACT formation - lens opacity

-from clumping of proteins on the lens

2) GLAUCOMA - or increased intraocular pressure

3) MACULAR DEGENERATION - breakdown of cells in the macula of retina **THE MOST COMMON CAUSE OF BLINDNESS**

What is the most common cause of

BLINDNESS

MACULAR

DEGENERATION

PHORIA

vs.

TROPIA

How do you test for these?

PHORIA - mild weakness noted when vision is blocked

TROPIA - more severe; a constant malalignment of the eyes

*Found/Dx'd with the COVER TEST*

Common Terms for

1) SCOTOMA

2) PHOTOPHOBIA

3) DIPLOPIA

1) Scotoma - Blind spot

2) Photophobia - Intolerance to light

3) Diplopia - Double Vision

ASYMMETRY of the CORNEAL LIGHT REFLEX

indicates?

Deviation in alignment from

EYE MUSCLE WEAKNESS or

PARALYSIS

EXOPHTHALMOS

vs.

ENOPHTHALMOS

Exophthalmos - PROTRUDING eyes

Enophthalmos - SUNKEN eyes

The CORNEA should appear _____ & _____ with

NO ______

It should be

SMOOTH & CLEAR

with

 NO OPACITIES (CLOUDINESS)

CORNEAL ABRASIONS

1) APPEARANCE?

2) MOST OFTEN CAUSED BY?

3) Patient SIGNS/SYMPTOMS?

1) Cornea has irregular ridges in reflected light, producing a shattered look to light rays

2) MOST COMMON RESULT of Blunt Eye Injury

3) Pt. feels intense pain, a foreign body sensation, lacrimation, photophobia & redness

DIAGNOSTIC POSITIONS TEST

1) Why is test performed?

2) Which cranial nerves are tested (3) ?

1) Used to elicit EYE MUSCLE WEAKNESS during MOVEMENT

2) CN's III, IV, & VI

NORMAL vs. ABNORMAL Findings of the

DIAGNOSTIC POSITIONS TEST

NORMAL - Parallel tracking of an object with both eyes

ABNORMAL

 1) Eye movement NOT PARALLEL; indicates weakness of an extraocular muscle (EOM) or dysfunction of a cranial nerve

2) NYSTAGMUS - fine movement best seen around iris; occurs with Multiple Sclerosis, Brain Lesions, Paretic Eye Muscle or Disease of the Semicircular Canals in the Ears.

3) LID LAG - occurs with hyperthyroidism

How do you test for

ACCOMODATION?

NORMAL FINDINGS should be?

Ask the person to focus on a distant object; this should DILATE the pupils. Then have person shift gaze to a near object (like your pen or finger) Normally, the response should be:

1) Pupillary Constriction &

2) Convergence of the Axes of the eyes

What does

PERRLA

stand for?

Pupils

Equal

Round

React to Light

Accomodation

Normal RESTING SIZE

for

PUPILS

What is the term

for PUPILS of two

DIFFERENT SIZES?

 (This  term is for when it naturally occurs in a small % of adults; not an indicator of disease)

The RED REFLEX is a

REFLECTION off what

EYE STRUCTURE?

The

INNER

RETINA

1) Abnormal findings when inspecting the RED REFLEX?

2) Indicative of?

1) Any opacities; dark shadows, black dots.

2) CATARACTS appear as opaque black areas against red reflex

PINGUECULAE

vs.

PTERYGIUM

PINGUECULAE - yellowish nodules due to thickening of bulbar conjuctiva from prolonged exposure to the elements (wind, dust, sun, etc). Appears at the 3 & 9 o'clock positions

PTERYGIUM - also an opacity on the bulbar conjunctiva but one that GROWS OVER THE CORNEA; may obstruct vision as it covers pupil. Occurs usu. from CHRONIC exposure to the elements; which stimulates the growth of a pinguecula INTO a pterygium

 4 characteristics of the

OPTIC DISC

to inspect:

 Normal findings for each?

1) COLOR - Creamy yellow-orange to pink

2) SHAPE - Round or Oval

3) MARGINS - Distinct & Sharply Demarcated; the nasal edge may be slightly fuzzy

4) CUP to DISC RATIO - when visible; physiologic cup is brighter yellow white than rest of disc. It's width is not more than 1/2 the disc diameter.

Medical Terms for

NEARSIGHTED

&

FARSIGHTED

Nearsighted - MYOPIA

Farsighted - HYPEROPIA

What is the medical term for

SQUINT, CROSSED

EYE(S)

ECTROPION

v.

ENTROPION

Ectropion - lower lid drooping away

Entropion - lower lid turning in

ARCUS

SENILIS

Commonly seen in older adults;

A gray white arc or circle around cornea/limbus;

Has NO EFFECT on VISION

Explain 20/30 vision in

layman's terms

The patient can read at 20 feet away what the normal eye would have read at 30 feet.

-or-

A normal eye could have read that at 30 feet away whereas the patient can only read it at 20 feet away.

Confusing, I know, sorry tried my best :)

Common name for

CONJUNCTIVITIS

1) Local infection

2) Congestive Heart Failure

3) Renal Failure

4) Allergy

5) Hypothyroidism

1) How does

ACUTE GLAUCOMA

 occur?

2) What does the eye look like?

3) Patient Signs/Symptoms

1) With sudden increase in intraocular pressure from blocked outflow from anterior chamber

2) Eye shows circumcorneal redness, dilated pupil, cornea looks steamy & anterior chamber is shallow

3) Patient signs/symptoms include:

-sudden clouding of vision

-sudden eye pain

-halos around lights

Pupils with no reaction to light, that do not constrict with accomodation, are small & irregular bilaterally are termed?

What is this indicative of?

ARGYLL ROBERTSON PUPIL

Occurs with:

-Central Nervous System Syphillis

-Brain Tumor

-Meningitis

-Chronic Alcoholism

PTOSIS

What is it?

Occurs with?

Drooping Upper Lid

Occurs with

1) Neuromuscular Weakness

2) Oculomotor cranial nerve III damage 

3) Sympathetic nerve damage (e.g., Horner's syndrome)

Medical Term for

DRY MOUTH?

Causes? (3)

Xerostomia

-Side effect of many drugs

-Dehydration

-Fever

Color/Texture/Etc.

of NORMAL

NASAL MUCOSA

Red in color

Smooth, moist surface

-Attach the short tipped speculum to otoscope. 

-Gently lift up the tip of the nose with your finger before inserting

-Insert apparatus (straighforward) into nasal vestibule, avoiding pressure on the nasal septum.

-View each nasal cavity with person's head erect & then tilted back

Which cranial nerve is responsible for

SMELL?

CN I

Olfactory Nerve

Names for Cranial Nerves

I thru XII

I.       Olfactory

II.     Optic

III.   Oculomotor

IV.    Trochlear

V.      Trigeminal

VI.    Abducens

VII.  Facial

VIII. Acoustic

IX.    Glossopharyngeal

X.      Vagus

XI.    Spinal

XII.  Hypoglossal

        A rhyme I found for remember CN Functions:      

     You have 1 nose, 2 eyes, and 3,4,6 makes my eyes do tricks! 

(see back)

Medical Term for

NOSEBLEEDS

What is

RHINORRHEA

The FRONTAL &

MAXILLARY

Sinuses

Locations for

1) Frontal sinuses

2) Maxillary Sinuses

3) Ethmoid Sinuses

4) Sphenoid Sinuses

1) Frontal - in frontal bone above & medial to the orbits (center of forehead, right above eyebrows)

2) Maxillary - in the maxilla along the side walls of the nasal cavity (on cheeks, right near each nostril)

3) Ethmoid - between the orbits, smaller and deeper (on nose sides, right above ridge)

4) Sphenoid - deep with the skull in the sphenoid bone

3 Functions of the

PARANASAL

SINUSES

1) Lighten the weight of skull bones

2) Serve as resonators for sound production

3) Provide mucus, which drains into nasal cavity

PATCH

1) Describe

2) Examples (5)

1) Skin macules that are larger than 1 cm.

2) Mongolian spot

    Vitiligo

    Cafe au lait spot

    Chloasma

    Measles Rash

What is term for the GROUP of FACIAL SINUSES?

TERM FOR EACH SET?

PARANASAL SINUSES

-Frontal sinuses

-Maxillary sinuses

-Ethmoid sinuses

-Sphenoid sinuses

PLAQUE

1) Describe

2) Examples (2)

1) Papules that have coalesced to form surface elevation. Wider than 1 cm. A plateaulike, disk shaped lesion.

2) Psoriasis

    Lichen planus

NODULE

1) Describe

2) Examples (3)

1) Solid, elevated, hard or soft, larger than 1 cm. May extend deeper into dermis than papule.

2) Xanthoma

     Fibroma

     Intradermal nevi

1) Function of NASAL TURBINATES?

2) How many? Names?

1) They increase surface area so that more blood vessels & mucous membranes are available to warm, humidify & filter the inhaled air.

2) There are 3 on the lateral wall of each nasal cavity; Names -

-Superior turbinate

-Middle turbinate

-Inferior turbinate

PUSTULE

1) Describe

2) Examples (2)

1) Turbid fluid (pus) in cavity; circumscribed & elevated

2) Impetigo

Acne

1) Hearing acuity

2) Detect high-tone loss

Locations/Positions of light reflexes on the

Left vs. Right

TYMPANIC

MEMBRANES

1) Left Tympanic Membrane - Light reflex should be at

 7 o'clock position

2) RIGHT Tympanic Membrane

Light reflex should be at

 5 o'clock  position

WHEAL

1) Describe

2) Examples (3)

1) Superficial, raised, transient & erythematous; slightly irregular in shape due to edema

2) Mosquito Bite

     Allergic reaction

     Dermographism

Adult  - Pull PINNA UP & BACK

Infant to 3 yr. old - Pull PINNA DOWN

Discharge/Drainage

from the EAR

is called?

APHTHOUS

ULCERS

1) Common Name?

2) Caused by?

1) CANKER SORE

2) Cause is UNKNOWN; associated with Stress, Fatigue & Food Allergy

1) Black Hairy Tongue

2) Candidiasis "Thrush"

URTICARIA

1) AKA

2) Describe

1) HIVES

2) Wheals that have coalesced to form an extensive reaction; intensely pruritic (itchy)

TUMOR

1) Describe

2) Examples (2)

1) Larger than a few centimeters in diameter, firm or soft, deeper into dermis; may be BENIGN or MALIGNANT

2) Lipoma

     Hemangioma

VESICLE

1) Describe

2) Examples (4)

1) Elevated cavity containing free fluid; up to 1 cm, "Blister", Clear serum flows if wall is ruptured

2) Herpes simplex

     Early varicella (chickenpox)

     Herpes zoster

     Contact Dermatitus

CYST

1) Describe

2) Examples (2)

1) Encapsulated fluid filled cavity in dermis or subcutaneous layer; tensely elevating the skin

2) Sebaceous cyst

     Wen

To test CN XII, the Hypoglossal Nerve; you should have the patient do what?

What is the "normal" result?

-Have patient stick out their tongue

- It should protrude midline

CN IX - Glossopharyngeal

&

CN X - Vagus

BULLA

1) Describe

2) Examples (4)

1) Larger than 1 cm. in diameter, usually single chambered; superficial in epidermis, thin walled & ruptures easily

2) Friction blister

    Pemphigus

    Burns

    Contact dermatitus

During Mouth Inspection

How do you test the

function of

CN X?

Have the person open mouth wide & say "ahhh"

Soft palate & uvula should rise midline

What cranial nerve is responsible for

HEARING?

CN VIII

Acoustic

(Vestibulocochlear)

 Nerve

How does the

TONGUE

appear in a

DEHYDRATED person?

It will have

 Deep, Vertical

Fissures

1) Function of the EUSTACHIAN TUBE?

2) Is it normally closed or open?

1) Allows equalization of air pressure on each side of the tympanic membrane so that the membrane does not rupture.

2) Normally closed, but opens with swallowing or yawning

TYMPANIC

MEMBRANE

1) Location within the Ear

2) Normal Color

1)  The membrane separates the external & middle ear. It is tilted obliquely to the ear canal, facing downward & somwhat forward

2) Pearly Gray in color

Medical Term for

EARWAX?

What is it's Function?

CERUMEN

-Lubricates and protects the ear; forms a sticky barrier to keep foreign bodies from reaching tympanic membrane

BENIGN BREAST DISEASE

1) What % of women will have some form?

2) Characteristics (4)

1) 50% of all women will have some form

2) I. Nodules occur bilaterally, feel firm, 

        mobile, rubbery

II.   Borders are well demarcated

III. Cysts are discrete, fluid filled sacs

IV.   Patient may feel swelling, 

        tenderness

TONGUE

CARCINOMA

1) Appearance

2) Occurs primarily on what parts of the tongue?

3) What increases risk for disease?

1) Ulcer with rolled edges; indurated (abnormally hard)

2) Sides, Base & Under the tongue

3) Heavy Smoking & Heavy Alcohol use

SMOOTH, GLOSSY TONGUE A.K.A. ATROPHIC GLOSSITIS

Occurs with? (3 deficiencies)

1) Vitamin B12 deficiency (pernicious anemia)

2) Folic acid deficiency

3) Iron deficiency anemia

What happens to the NOSE of a DEHYDRATED person?

The nasal mucosa can no longer carrry out it's functions to humidify & warm inhaled air; this results in:

-Crusts, Scabs

-Itching, Mild Burning

-Nasal Obstruction

-Deterioration of Olfaction

-If Prolonged: Epistaxis

Ringing In the Ears is

termed?

Common name for

OTITIS

EXTERNA

SWIMMER'S

EAR

A BRUIT in the

THYROID

indicates?

Hyperplasia

(Hypothyroidism)

TINEA

PEDIS

Ringworm of the FOOT

"ATHLETE'S FOOT"

TINEA

CORPORIS

FIBROADENOMA

1) Characteristics (6)

2) Most common at what age(s)

BENIGN Breast Disease that occurs frequently and has distinct characteristics.

1) I. Solitary, nontender mass

   II. Solid, firm, rubbery & elastic

   III. Round, oval or lobulated

   IV. 1 to 5 cm

   V. Freely movable, slides easily through tissue

   VI. Grows quickly & constantly

2) Most common at 15 thru 30 years of age but can occur up to 55 years.

CANCER of the BREAST

1) Characteristics (7)

2) Advanced Stage Characteristics (3)

1)  I. Solitary, unilateral mass

   II. Single focus in 1 area but may be interspersed with other 

         nodules

  III. Solid, Hard, Dense

   IV. Fixed to underlying tissue or skin as becomes invasive

    V.  Border irregular & Poorly delineated

   VI. Grows constantly

  VII. Often painless, although person may have pain

2) ADVANCED SIGNS:

    I. Firm or hard irregular axillary nodes

  II. Skin dimpling

 III. Nipple retraction, elevation and discharge

Clinical Breast Exams

Women 20-39 should be every ______ years.

Women 40 & over should have them every ______ year and a __________

20-39 Clinical Breast exam should be done every 3 years

40+ Clinical Breast exam along with a MAMMOGRAM every YEAR

When is the best time for a woman to conduct a

BSE?

Right after menstrual period, or the 4th through 7th day of menstrual cycle, when breast are smallest & least congested

-They should start in the shower and continue lying supine

Medical Term for

NIPPLE

DISCHARGE

AXILLARY

&

SUPRACLAVICULAR

COOPER'S

LIGAMENTS

Fibrous bands that

SUPPORT BREAST

TISSUE

1) Glandular Tissue - site of milk production

2) Fibrous Tissue - includes suspensory ligaments which support breast tissue

3) Adipose Tissue - provides bulk of the breast

1) Name the RESERVOIRS in the BREAST for storing MILK

2) Which tissue are they in?

1) LACTIFEROUS SINUS (or AMPULLAE)

2) Glandular Tissue

The

UPPER OUTER

Quadrant

Heart Rate

 GREATER than

100 bpm

Heart Rate

LESS than

60 bpm

ATRIAL

FIBRILLATION

is detected by the absence of

____ waves on an ECG

P WAVE

of ECG

represents

Atrial

Depolarization

(Atrial Contraction)

PR INTERVAL of

ECG

represents

Conduction through atria

at AV NODE

0.12-0.20 sec

(time necessary for atrial depolarization PLUS time for impulse to travel through AV nodes to the ventricles)

Q WAVE of

ECG

represents

Negative Deflection

of the QRS

QRS Complex of

ECG

represents

Depolarization of

VENTRICLES

(Ventricular Contraction)

0.08-0.12 sec

T WAVE of

ECG

represents

VENTRICULAR

REPOLARIZATION

QT Interval of

ECG

represents

Prolonged d/t e-/metabolic imbalance

(Digoxin toxicity)

< 0.43 sec

U WAVE of

ECG

Represents?

You really only see this when?

Repolarization of purkinje fibers; hard to see

Really only seen with

HYPERCHOLEMIA (Potassium imbalance)

What happens during

DEPOLARIZATION

What happens during

REPOLARIZATION

Life-Sustaining

Nutrients

NSR

stands for

Normal

Sinus

Rhythm

Direction of

Electrical Current Flow

in the

 HEART

1) What breast abnormality thickens the skin & exaggerates hair follicles?

2) What does this condition suggest?

1) EDEMA (PEAU d' ORANGE)

2) Suggests CANCER

Enlargement of Male Breast Tissue

-Occurs normally in puberty (Unilaterally)

-Occurs commonly in Aging Males because of changing hormone levels (Bilaterally)

-Can also occur with hormone stimulation (steroids, etc) & sometimes with medicine

Nipple Discharge Colors (which correspond with which disease/condition)?

1) Sticky, purulent; can be White, Gray, Brown, Green or Bloody

2) Clear, Yellow with Scaling Crusts

3) Bloody

4) Serous or Serosanguineous

1) Mammary Duct Ectasia

2) Paget's Disease (Intraductal Carcinoma)

3) Carcinoma

4) Intraductal Papilloma

1) Breast's rise ASSYMETRICALLY; CANCERS cause breast tissue to adhere to underlying pectoral tissue

2) RETRACTION, INFLAMMATION of NIPPLES

3) SKIN RETRACTION (Dimpling) occurs with growing Neoplasms

4) HYPERPIGMENTATION, REDNESS, INFLAMMATION of skin

5) Unilateral SUPERFICIAL VEINS

6) ASSYMETRIC Nipples or TILTED/DEVIATED pointing of one nipple

7) ANY DISCHARGE; if not pregnant/nursing DISCHARGE IS NEVER NORMAL

8) EDEMA (Peau d' Orange)

2 types of

 EYE EXAM CHARTS

1) Snellen Chart - person stands exactly 20 ft. away from chart. Normal result 20/20

2) Jaegar Card - For people over 40 years of age or someone who has difficulty reading. Card should be held about 14 inches (35 cm) from the eye. Normal result: 14/15

Important Structures

(Male vs. Female)

to Palpate during

RECTAL EXAMS?

Male - PROSTATE GLAND; should feel smooth & muscular

Female - CERVIX;

should feel like a small, round mass

8

 HIGH FIBER

FOODS

1) Beans

2) Barley

3) Broccoli

4)Carrots

5) Cabbage

6) Cereal

7) Prunes

8) Wheat Germ

PILONIDAL

CYSTS

1) Describe

2) Location

3) Type of Disorder

4) Common Ages for diagnosis

1) A cyst (acute abscess)  in a hair shaft, often foul smelling & very painful

2) Located in the middle back over coccyx (tailbone) or lower sacrum

3) Congenital Disorder

4) First diagnosed at 15-30 years

Proper POSITIONING of

MALE v. FEMALE patients for

RECTAL EXAM?

1) Male - Left Lateral Decubitus (lying on left side) or Standing position. If male stands have him point toes together to relax regional muscles (this makes it easier to spread buttocks)

2) Female - Lithotomy position (lying on back, hips & knees flexed with thighs apart) if examining genetalia as well. Left Lateral Decubitus if examining rectal area alone.

Prolonged Painful

ERECTION

without

Sexual Stimulation

HYPOSPADIAS

Male Congenital Disease

in which the URETHRAL MEATUS open on VENTRAL SIDE (Underside) of glans, shaft or at penoscrotal junction

What FEMALE STRUCTURE

cooresponds to the

PENIS

The

CLITORIS

What is at the "end" of

the VAGINA

THE

CERVIX

What do the

OVARIES stop producing

during

MENOPAUSE?

PROGESTERONE

&

ESTROGEN

Where is

SPERM

made?

In the

TESTES

What is the ideal

temperature for

sperm production?

3 degrees C

below

abdominal

temperature

Structure of

INTERNAL MALE GENITALIA

(3)

1) Testes

2) Epididymis

3) Vas deferens

Structures of

EXTERNAL MALE

GENITALIA

(2)

1) Penis

2) Scrotum

How to examine

EPITROCHLEAR

NODE

1) Location

2) How to Palpate

1) In depression above & behind the medial condyle of the humerus

2) Do this by shaking hands & reaching other hand under the patient's elbow to the groove between biceps & triceps muscle above the medial epicondyle

****NORMALLY NOT PALPABLE**

A Peripheral Artery Disease (poor circulation caused by atherosclerotic blockages). Result is TROUBLE WALKING. Most often occurs in the CALVES, but can occur in feet, thighs, buttocks and arms.

***PATIENTS ARE AT INCREASED RISK FOR HEART ATTACKS (Cardiovascular Disease)

Signs of

CHRONIC

LYMPHEDEMA

(3)

1)  Unilateral Swelling

2) Non-pitting Brawny EDEMA

3) Overlaying Skin Indurated (Hardened)

*Lymphatic Obstruction*

- A condition of localized fluid retention; due to poorly developed or missing lymph nodes

-Can be a side effect of breast cancer surgery or radiation therapy

3 main functions of

LYMPHATIC

SYSTEM

1) CONSERVE FLUID & PLASMA PROTEINS that leak out of capillaries

2) Forms a major part of the Immune System that DEFENDS THE BODY against disease

3) ABSORBS LIPIDS from Intestinal Tract

The Lymphatic System

DRAINS into

what 2 DUCTS?

1) Right Lymphatic Duct - Right side of body; empties into the Right Subclavian Vein

2) Thoracic Duct - empties into Left Subclavian Vein

A Capillary Refill Time that lasts more than 1 - 2 seconds

signifies?

Signifies VASOCONSTRICTION or DECREASED CARDIAC OUTPUT

(Hypovolemia, heart failure, shock)