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health assessment chapter 12
health assessment chapter 12
82
Health Care
Graduate
02/22/2011

Additional Health Care Flashcards

 


 

Cards

Term
The ____ drains into the posterior aspect of the inferior turbinate of the nose.
Definition
Eustachian tube
Term
The ear is divided into the ____,____, and  ____.
Definition

external, middle, and inner ear

 

External-The auricle (pinna) and external auditory canal

 

Middle-An air-filled cavity in the temporal bonde containing the ossicles that transmit sound from the tympanic membrane to the oval window of the inner ear.

 

Inner ear- a membranous curved cavity inside a bony labyrinth consisting of the vestibule, semicircular canal, and cochlea.

Term
Substance secreated by the apocrine gland in te distal third of the auditory canal that provides an acidic pH environments that inhibits growth of microorganisms.
Definition
Cerumen
Term
Separates the external ear from the middle ear:
Definition
The tempanic membrane surrounded by a dense fibrous ring called the annulus.
Term
See the anatomic structure of the auricle on figure 12-3 pg 298
Definition
Term
The ____, a coiled structure containing the organ of Corti, transmits sound impulses to the eith cranial nerve.
Definition
cochlea
Term
Equilibrium receptors in the ____ and ____ of the inner ear respond to changes in direction and movement and send signals to the cerebellum for the maintenance of balance.
Definition
semicircular canal, vestibule
Term
Hair cells in the _____ detect sound vibration and send the information to the auditory division of the eighth cranial nerve.
Definition
organ of Corti
Term

T or F

Hearing is the interpretion of sound waves by the brain

Definition
True
Term

T or F

The Nose is a sensory organ that functions in the identification, localization, and interpretation of sound, and aids in the maintenance of equilibrium. 

Definition
False The ear is the correct answer
Term
The nasal floor is formed by the ___ and ___, and the roof is formed by the ___ and ___ bone.
Definition

hard and soft palate, frontal and sphenoid bone

 

The internal nose is covered by vascular mucous membrane lined with small hares and mucous secretions that collect and carry debris and bacteria from the air to the nasopharynx for swallowing or expectoration. Mucous contains immunoglobulins and enzymes that serve as a defense against infection.

 

The internal nose is divided by the septum into two anterior cavities called vestibules.

Term
The nose and nasopharanyx function to:
Definition
  1. identify odors
  2. provide passage for inspired and expired air
  3. humidify, filer, and warm inspired air
  4. provide resonance of larangeal sound

 See figure 12-6 pg 299 for anatomic structures of the nose and nasopharynx

 

The external nose is formed by skin-covered bone and cartilage.

The nares, are surrounded by the cartilaginous ala nasi and the columella.

The frontal and maxillary bones form the nasal bridge.

Term
The ______ housing the sensory ending of the olfactory nerve, lies on the roof of the nose.
Definition

Cribriform Plate

 

Receptors for smell are located in the olfactory epithelium

Term
The _____ is a convergence of small fragile arteries and veins located on the anterior superior portion of the septum.
Definition
Kisselbach Plexus
Term
The ____ lie on the posterior wall of the nasopharynx.
Definition
Adenoids
Term
The ____ (parallel curved bony structures covered by vascular mucous membranes) form the lateral walls of the nose and protrude into the nasal cavity.
Definition

Turbinates

 

A meatus below each turbinate is named for the turbinate above it.

 

The Inferior meatus drains the nasolacrimal duct.

The Medial meatus drains the paranasal sinuses.

The Superior meatus drains the posterior ethmoid sinus.

Term
The ____ sinuses are air-filled, paired extensions of te nasal cavities withing the bones of th skull. Their openings into the medial meatus of the nasal cavity are easily obstructed.
Definition

Paranasal

 

Only the maxillary sinus (along the lateral wall of the nasal cavity of the maxillary bone) and the frontal sinus (in the frontal bones superior to the nasal cavities) are accessible for physical exam.

 

The ethmoid sinus (behind the frontal sinus near the superior portion of the nasal cavity) and the sphenoid sinus (deep in the skull behind the ethmoid sinus) are difficult to access for physical exam. 

Term
The space between the buccal mucosa and the outer surface of the teeth and gums is called the :
Definition
Vestibule-this along with the mouth make up the oral cavity.
Term

T or F

The tongue is anchored to the back of hte oral cavity at its base and to the floor of the mouth by the frenulum.

Definition
True
Term

The ____ ducts are parotid gland outlets that open on the buccal mlucosa opposite the second molar on each side of the upper jaw.

 

The ____ ducts are outlets of the submandibular glands open on eac side of the frenulum under the tongue.

Definition

Stensen, Wharton

 

The sublingual glands have many ducts opening along the sublingual fold.

Term
The roots of teeth are anchored to the alveolar ridges of the ____ and ____.
Definition

maxilla and mandible

 

Adults generally have 32 permanent teeth.

Term
The oropharynx is separated from the mouth by bilateral anterior and posterior____.
Definition
tonsils-they have crypts that collect cell debris and food particles
Term
The infant's auditiory canal is ____than an adult's and has an ____ curve.
Definition

shorter, upward

 

In addition the eustacian tube is wider, shorter and more horizontal than the adult's which allows easier reflux of nasopharyngeal secretions. With growth it lengthens and the pharyngeal orifice moves inferiorly.

 

Development of the inner ear occurs during the first trimester and insult during this time can impair hearing.

Term

Children have ___ deciduous teeth that usually erupt between ___ and ____months. Permanent teeth begin forming in the jaw at ___ months, start coming it around ___ age and process is usually complete by ____ age.

Definition
  1. 20
  2. 6-24
  3. 6
  4. 6
  5. 14-15yrs
Term
ENT Changes that occur in pregnant women include:
Definition
  1. Elevated levels of estrogen cause increased vascularity of the upper respiratory tract
  2. Capillaries of nose, pharynx, eustacian tubes become engorged causing nasal stuffiness, dec. sense of smell, epistaxis, sense of fullness in the ears, and impaired hearing.
  3. increased vascularity and proliferation of connective tissue of the gums.
  4. Laryngeal changes hormonally induced causing hoarseness, deepening, or cracking voice, vocal changes, or persistent cough may occur.
Term

T or F

One half of adults older than 65 have hearing loss.

Definition

False

One third have hearing loss

 

Sensorineural loss occurs first wit high-frequency sounds and then progresses to tones of lower frequency.

 

The ability to localize sound also diminishes with age.

 

Conductive hearing loss may result form excess deposition of bone celss along the ossicle chain, causing fixation of the stapes in the oval window, cerumen impaction, or a sclerotic tempanic membrane.

Term

Sense of smell deteriotates after age:

Sense of taste deteriorates after age:

 

___ and ___ become more prominent with aging r/t continued cartilage formation.

Definition

60, 50, ears and nose

 

LIps and cheeks become more prominent gingival tissue may receed or become vulnerable to trauma, tongue becomes more fissured and there may be altered motor function of the tongue leading to problems with swallowing. Saliva production may decrease r/t disease or meds (anticholinergics and diuretics). Lost teeth may cause diet change or malocclusion and difficulty chewing.

 

Term
Ototoxic meds like aminoglycosides, gentamicin, streptomycin, asa, furosemide, or salt-retaining meds like corticosteriods can cause a false sense of motion called:
Definition
Vertigo
Term

An instant hearing loss may indicate:

A hearing loss over a few hours or days may indicate:

Definition
vascular disruption or autoimmune process, viral infection
Term
Risk factors for adult hearing loss include:
Definition
  1. exposure to industrial or recreational noise, ototoxic meds
  2. genetic disease (M'enie're disease)
  3. Neurodegenerative and autoimmune disorders
  4. syphillis

 

Term
Risk factors for hearing loss in infants and children include:
Definition
  1. prenatal factors: maternal infection, irratiation, drug abuse, syphillis
  2. birth wt less than 1500g
  3. severe hyperbilirubinemia
  4. Infection-bacterial meningitis, reccurent episodes of acute otitis media or otitis media with effusion
  5. cleft palat, craniofacial abnormalities
  6. Ototoxic med use
  7. head trauma
  8. hypoxic episode
Term

Risk factors for oral cancer include:

 

Definition
  1. older than 40
  2. gender-men twice the rate of women
  3. ethinicity-black
  4. excessive alcohol use
  5. Ill-fitting dentures, prior oral lesions
  6. Tobacco use-risk increases with freq and durating of use/smoking hx of more than 20pk-year
  7. Occupation-textile industry, leather manufacturing
  8. Systemic disease-pernicious or iron deficiency anemia, HIV Infection, lichen planus, previous malignancy, human papilloma virus.
Term
____ are small, whitish uric acid crystals along the peripheral margins of the auricles and may indicate gout.
Definition
Tophi
Term
A low set position or unusual angle of the auricle may indicate:
Definition

chromosomal aberrations or renal disorders

 

Auricular position can be checked by drawing an imaginary line between the canthus of the eye and th most prominent proturberance of the occiput. The top of the auricle should be above this line.

 

Next Draw a verticle imaginary line perpendicular to the previous line just anterior to the auricle. Position hould be almost verticle with no more than 10 degree lateral posterior angle.

Term
A bloody or serous discharge from the ears is suggestive of:
Definition

head trauma

 

 

If a purulent, fowel-smelling discharge is present this is usually associated with otitis externa, perf. acute otitis media, or a foreign body.

 

Pull gently on the lobule-if pain the external auditory canal may be inflamed. Tenderness or swelling in the mastoid area may indicate mastoiditis.

 

 

Term
Cerumen comes in two forms:
Definition
  1. wet-that is dark and  sticky found predominantly in whites and blacks.
  2. Dry- that is light brown to gray, flaky, and sparse. It can lie in the ear canal as a thin flake. Dry occurs predomintately in asians, native americans/american indians.
Term
The pneumatic attachment of the otoscope is used to provide information about:
Definition

Tympanic membrane mobility and the middle ear space, such as the presence of middle ear effusions

 

No movement with positive and negative pressure may be a sign of acute otitis media or otitis media with effusion.

Bulging with no mobility-middle ear effusion due to pus or fluid

Retracted with no mobility or mobility with negative pressure only -Obst. Eustachian tube w/wo middle ear effusion.

Excess mobility in small areas-Healed perforation atrophic tympanic membrane

 

Term
Speech with ____ and ____ may indicated hearing loss.
Definition
monotonous tone, erratic volume
Term
When performing the whisper test you are checking the function of CN ___, and use a combination of three letters and numbers at a distance of 1-2 feet.
Definition

VIII

 

The patient should be able to hear a minimum of 3 of six sounds in each ear. Have the patient place a finger in the ear of opposite the one being tested and stand out of the patient's direct line of vision when performing.

Term
The ___ test helps distinguish wheter the patient hears better by air or bone conduction.
Definition

Rinne

 

Vibrate fork and place on mastoid bone have pt tell you when the can no longer hear quickly remove and place 1-2cm from auditory canal and have them tell you when sound no longer heard. Record the time mastoid conduction and auditory conduction. Air conduction should be twice as long as bone conduction.

Term
The ___ test helps assess unilateral hearing loss.
Definition
Weber
Term
When individuals nasally "snort" cocaine, signs of recent use include:
Definition
  1. Rhinorrhea
  2. Hyperemia
  3. Edema of the nasal mucosa
  4. White powder may still be present on the nasal hairs.

Signs of chronic use:

  1. Scabs on the nasal mucosa
  2. Decreased perception of taste and smell
  3. Perforation of the nasal septum
Term
Nasal flaring is associated with respiratory distress, whereas narrowing of the nares on inspiration may be indicative of:
Definition

chronic nasal obstruction and mouth breathing.

 

 

Term
Nasal discharge characteristics include the following:
Definition
  1. allergy-bil watery discharge and associated sneezing and nasal congestion
  2. Cerebrospinal fluid leakage-unilateral watery discharge occuring after head trauma
  3. Epistaxis or trauma-bloody discharge
  4. Rhinitis or upper respiratory infection-bil mucoid or purulent discharge
  5. Foreign Body-unilateral, purulent, thick, greenish, malodorous discharge
Term
Localized redness or swelling in the vestibule of the nasal cavity is called a:
Definition
furuncle
Term
A rounded, elongated mass projecting into the nasal cavity from boggy mucosa may be a:
Definition
polyp
Term
The sense of smell-cranial nerve ___ is often tested with recognition of different odors.
Definition
CN I
Term
If frontal or maxillary sinus tenderness is present or infection is suspected which test might be performed:
Definition
Transillumination of the sinuses may be warrented.
Term
Dry cracked lips called ______ may be caused by dehydration from whind chapping, dentures, braces, or excessive lip licking.
Definition

Cheilitis

 

Deep fissures at the corners of the mouth known as cheilosis may indicated riboflavin deficiency or overclosure of the mouth, allowing saliva to macerate the tissue.

Term
circumoral pallor is associated with:
Definition

scarlet fever

 

Lip pallor-anemia

 

Cyanosis-resp. or CV problems

 

Swelling of lips-Infection or Allergy (angioedema)

 

Round, oval, or irregular bluish grey macules on the lips and buccal mucossa-Peutz-Jeghers syndrome

Term
Cranial Nerve ___ is tested by asking the patient to clench his or teeth and smile so you can observe occlusion of teeth.
Definition
CN VII
Term
______ an expected variant, are ectopic sebaceous glands that appear on the buccal mucosa and lips as numerous small, yellow-white, raised lesions.
Definition
Fordyce Spots
Term
A red spot on the buccal mucosa at the opening of the stensen duct jis associated with:
Definition
parotitis (mumps)
Term
A thickened white patch lesion that cannot be wiped away may be:
Definition
Leukoplakia-a premalignant oral lesion
Term
A diffuse filmy grayish surface with white streaks, wrinkles, or  milky alterations, and an asymptomatic benign lesion of the buccal mucosa is:
Definition
Leukoedema-is considered a normal variant found in the majority of black adults and nearly 50% of black children. Increases with age up to 40-49yrs then declines.
Term
Gingival enlargement occurs with:
Definition
pregnancy, puberty, vitamin C deficiency, meds (phenytoin, cyclosporine, calcium channel blockers), and in leukemia.
Term
Deviation of the tongue to one side indicates:
Definition

tongue atrophy or hypoglossa nerve impairment

 

 

 

 

Term
A smooth red tongue with a slick apperance may indicate:
Definition
Vitamine B12 deficiency
Term
A hairy tongue with yellow-brown to black elongated papillae on te dorsum of the tongue sometimes follows:
Definition
antibiotic therapy
Term
A high risk site for oral cancer is:
Definition
vermilion border of the lips
Term
Any ulcer, nodule, or thickened white patch on the lateral or ventral surface of the tongue may be sugestive of:
Definition
malignancy
Term
Deviation of the uvula to one side may indicate:
Definition
vagus nerve paralysis or peritonsilar abscess
Term
 A bony proturberance that occurs bilaterally on the lingual surface of the mandible, near the canine and premolar teeth.
Definition
mandibular torus-an expected variant that occurs in 7-10% of the population. may also occur form the midline of the hard palate and is an expected variant in 20-35% of the population.
Term
See table 12-4 oral manifestatons of HIV infection
Definition
Term
A bifid uvula is a benign condition and normal variant in some native american/american indian populations but it may also be a sign of  a
Definition
submucous cleft palate
Term
By moistening the tongue blade you may help reduce triggering of the:
Definition
gag reflex
Term
The tympanic membrane is usually in an extreme _____ position in newborns.
Definition
oblique
Term
A saddleshaped nose with a low bridge and broad base, a short small nose, or a large nose may suggest a:
Definition
chromosomal disorder or congenital anomaly
Term
Secretions that accumulate in the newborn's mouth requiring frequent suctioning may indicate:
Definition
esophageal atresia
Term
If the tongue does not protrude beyond the alveolar ridge (tongue tie), feeding difficulty may occur. Macroglossia is associated with:
Definition
congenital anomalies such as congenital hypothyroidism.
Term
When examining the mouth of children:
Definition
  1. Flattened edges on the teeth-bruxism, compulsive, unconcious grinding of the teeth.
  2. Multiple brown areas or caries on the upper or lower incisors-bedtime bottle or juice/milk
  3. Teeth with black or gray color-pulp decay or oral iron therapy.
  4. Mottled or pitted teeth-tetracycline tx during tooth development or enamel dysplasia.
  5. Chalky white lines or speckles on the cutting edges of permanent incisors-excess floride intake.
Term
White specks called koplik spots,  with a red base on te buccal mucosa opposite the first and second molars, occurs with:
Definition
rubeola (measles)
Term
Presbycusis is:
Definition
some degree of sensorineural hearing deterioration with advancing  age.
Term
Trapped epithelial tissue behind the tympanic membrane that is often the result of untreated or chronic recurrent otitis media:
Definition
Cholesteatoma
Term

Conductive hearing Loss is:

Sensoineural Hearing Loss is:

Meniere Disease is:

Definition

Reduced transmission of sound to the middle ear

 

A disorder of the inner ear, damage to CN VIII, genetic disorders, systemic disease, ototoxic medication, trauma, tumors, or prolonged eqposure to loud music.

 

A disorder of progressive hearing loss that in some cases has a genetic mode of transmission.

 

 

Term
Inflammation of the vestibular nerve following an acute viral upper respiratory infection
Definition
Acute Vestibular Neuronitis
Term
Otolith fragments that gravitate into the semicircular canal, and nerve sensors in the cause vertigo with head movements:
Definition
Benign Paroxysmal Positional Vertigo
Term
Infection of tonsils or posterior pharynx by microorganisms such as group A Beta Hemolytic streptococci or other streptococcal species, Neisseria gonorrhea, or mycoplasma pneumonia.
Definition
Pharyngitis
Term
A deep infection in the space between the soft palate and tonsil.
Definition

Peritonsillar Abscess

 

When Weber's glands become inflammed, the duct is obstructed leading to cellulitis of the soft palate

 

Unilateral red and swollen tonsil and adjacent soft palate as well as displacement of the uvula and tonsil may be noted. Trismus (spasm of masicator muscle) may also be seen

Term
A life-threatening infection in the lateral pharyngeal space that has the potential to occule the airway and most commonly occurs in children is:
Definition

Retropharyngeal Abscess

 

A streptococci and Staphylococcus aureus are common causative organisms.

 

Displays as an unwillingness to move neck and lateral neck movement increases pain, torticollis  may be present.

Term
If you see an ulcertive lesion (red or white) appearing as piled up edges around a core on teh lateral border of the floor of the mouth you would suspect:
Definition
Oral Cancer
Term
The most common craniofacial congenital malformation that is the result of the lip or palate failing to fuse during embryonic development prior to the 12th week of gestation is:
Definition

Cleft Lip and Palate

 

Multifactorial causes include genetic disorders, fetal exposure to teratogens, conditions present in the mother i.e..diabetes, folate dificiency, smoking.

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