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103-Unit IV
| Question | Answer |
|---|---|
| cancer teaching | outside of skin cancers, the following cancers have the highest incidence in the US: prostate in males, breast in females, testicular in males from 15-35 yo; lung cancer is still the deadliest in males and females! |
| breasts or mammary glands | female-accessory reproductive organs-produces milk for nourishing the newborn; br ca=2nd leading cause of death in women in US; male-rudimentary |
| external anatomy of breast | lies anterior to pect major and serratus anterior muscles; located b/w 2nd & 6th ribs; tail of Spence, nipple |
| nipple and areola | more darkly pigmented; areola- surrounds nipple 1-2 cm radius; has smooth muscle fibers that cause nipple erection when stimulated. |
| montgomery's glands | small elevated sebaceous glands; secrete a protective lipid material during lactation. |
| four quadrants of breast | convenient map for describing clinical findings; UO quad-note tail of spence (also site of most breast tumors) |
| internal anatomy of breasts | breast composed of 1-glandular tissue, 2- fibrous tissue, 3-adipose tissue; glandular tissue has 15-20 lobes composed of lobules and w/i each lobule-clusters of alveoli produce milk; each lobe enters into a lactiferous duct. |
| internal anatomy of breasts continued | suspensory ligaments (cooper's ligaments)- fibrous bands that support breast tissue; become contracted in cancer of the breast producing pits or dimples in the overlying skin; lobes are embedded in adipose tissue- provides most of bulk of breast |
| breasts during pregnancy | preg stimulates expansion of ductal system!!!; breast changes start during 2nd month of preg; after 4th mo of preg, colostrum may be expressed (precursor for milk) produced by breasts 1st few days after delivery, rich in Ab (same amt of protein & lactose) |
| male breast | rudimentary consisting of thin disk of undeveloped tissue underlying nipple; has areola, in adolescence-common for gynecomastia-usually unilteral and temporary, may reappear in the aging male b/c of test deficiency (hormonal changes, meds, tx of prostatec |
| subjective data for breasts | pain, lump, discharge, rash, swelling, trauma, hx of breast dz, SBE |
| objective data for breasts | (use sensitive, but matter fact approach) gen appearance-symmetry, size; skin-smooth even color; lymph.drainage area-ax & supraclav regions-note bulging, discoloration, edema; nipple-symm, protrusion, flat, inverted, discharge; retraction |
| acs recommendations for women | clinical breast exam by HCP every 3 yrs for ages 20-39, & yearly for >40, annual mamm >40 & earlier if increased risk. |
| non-modifiable breast cancer risk factors | female >50yo personal hx of br ca mutation of BRCA1 & BRCA2 genes 1st degree relative previous breast irradiation menarche b4 12yo or menopause after 50yo |
| modifiable breast cancer risk factors | nulliparity or 1st child after 30yo, recent oral contraceptive use, postmenopausal hormone therapy, not breastfeeding, alcohol intake >1 drink daily, obesity, physical inactivity |
| paget's disease of the breasts | carcinoma of the mammary ducts |
| male breast exam | can be abbreviated but not omitted, inspect chest wall for any lumps or swelling, palpate nipple area for any lump or tissue enlargement-should feel even without nodules |
| vulva or pudendum | extends from mons pubis to anal opening |
| mons pubis | fat pad located over symphysis pubis, normally, covered with pubic hair in a triangular pattern |
| labia majora | 2 folds of skin, extend posteriorly and inferiorly from mons pubis to perineum, outer surface: covered with hair, inner surface: pink, smooth, moist |
| labia minora | located inside labia majora, folds join- anteriorly at clitoris to form prepuce, posteriorly to form frenulum, darker pink than labia majora, contains sebaceous glands for lubrication |
| clitoris | located at anterior end of labia minora, small, cylindrical mass of erectile tissue and nerve bands of fibrous tissue, similar to male penis. |
| vestible | boat-shaped area or fossa formed by the skin folds of the labia majora & labia minora; urethral meatus-urinary open located b/w the clitoris and vaginal orifice. |
| skene's glands | located on either side of urethral opening, usually not visible, referred to as lesser vestibular glands, secrete mucous to lub and maintain moist vaginal environment. |
| vaginal orifice | located below urethral meatus, external opening of vagina-slitlike if hyman intact, irregular circular structure if hymen ruptured. |
| bartholin's glands | located on either side of vaginal orifice & slightly posterior; secretes mucus that lubs the area during coitus; referred to as greater vestibular glands; not visible to naked eye. |
| internal female genitalia | fxns as female reproductive system; includes: vagina, uterus, cervix, fallopian tubes, ovaries. |
| vagina | located b/w rectum & urethra & bladder, approx. 10cm long, fxns: allows passage of menstrual flow, receives penis during intercourse, serves as lower portion of birth canal during delivery. |
| vagina continued | normal vaginal environment is acidic, environment maintained b/c normal flora is composed of Doderlein's bacilli which act on glycogen to produce lactic acid, acidic environment helps prevent vaginal infection; douching and antibiotics cause a less acidic |
| cervix | (neck of the uterus) separates upper end of vagina from isthmus of uterus; Os: opening in center of cervix (small, round opening (depression) in women having not given birth; slitlike opening in women who have given birth. |
| fxns of cervix | fxns: allows sperm into uterus, allows menstrual fluid to outflow, secretes mucus & prevents entrance of vaginal bacteria, can stretch during childbirth to allow passage of fetus, cervical cells are scraped for analysis during a pap smear. |
| uterus | pear-shaped muscular organ, usually situated in a forward position above bladder at ~45deg to the vagina when standing, normal-sized uterus is ~7.5cm long, 5cm wide, 2.5cm thick. |
| ovaries | 2 small, oval-shaped organs, ~3cm long, 2cm wide, 1cm deep, connected to uterus by ovarian ligament |
| fxns of ovary | develop and release ova, produce hormones (estrogen, progesterone, testosterone); ovum- travels to uterus thru fallopian tubes (atrophy after menopause). |
| fallopian tubes | 8-12cm long tubes, begin near ovaries, enter uterus just beneath fundus, end of tube near ovary has fringelike extensions called fimbriae (grabs ovum) |
| adnexae | latin for appendages; term used to describe ovaries, fallopian tubes, supporting oarian ligaments. |
| subjective data for female genitalia | date of last menstrual periors, symptoms before or during period-PMS, age at menarche, menstrual periods (regular, irregular, menopause), any vaginal discharge, itching, lumps, difficulty and frequency urinating, change or problem c sex perf, |
| subjective data for female genitalia continued | fertility problems, hx stds, hx pregnancy? how many? children?, could you be pregnant now? |
| lifestyle practices (female repro.) | smoking (smoking+oral contraceptives inc. risk of cv; how many sexual partners, contraceptives, wipe front to back, cotton underwear, douche frequently |
| gardasil vaccine | protects against 4 kinds of hpv which together cause 70% of cervical cancers and 90% of genital warts; indicated now for females and males ages 9-26; not recommended for pregnant women. |
| speculum examination | warm & lube speculum under warm h20, avoid gel lube (bacteriostatic=distorts cell in cyto), insert by asking woman to bear down (relaxes perineal mus & opens introitus, insert spec at 45deg angle downward toward small of women's back. |
| speculum exam cont. | the small of woman's back, after blades are fully inserted, open them by squeezing handles together, cervix should be in full view (may need rotation), try closing blades by tightening the thumbscrew. |
| scrotum | thin-walled sac suspended below pubic bone, posterior to penis, darkly pigmented, contains sweat & sebaceous glands, consists of folds of skin (rugae) & cremaster mus |
| cremaster muscle | contraction:raises scrotum & testes upward toward body for warmth (cremasteric reflex); relaxation:lowers scrotum & testes away from heat of body. |
| scrotum continued | protective covering for: testes, epididymis, vas deferens, helps maintain cooler-than-body temp necessary for production of sperm. |
| scrotal sac | divided into 2 portions each containing 1 testis |
| testis | ovoid-shaped organs, 3.7-5cm long, 2.5cm wide, 2.5cm deep, fxn: produce sperm & testosterone (testost. can cause prostate cancer to return-> may remove 1 testicle). |
| spermatic cord | suspends testes in scrotum, contains: blood vessels, lymphatic vessels, nerves, vas deferens (ductus deferens), usually longer on left side* |
| epididymis | comma-shaped, coiled tubular structure that curves up over the upper & posterior surface of the testis, site of maturation of spermatozoa, gives testicle lumpy feeling & may feel warmer. |
| vas deferens | firm, muscular tube that is continuous with lower portion of epididymis, travels up w/i spermatic cord thru inguinal canal into abdom cavity where it separates from spermatic cord & curves behind bladder. |
| prostate | surrounds neck of bladder & urethra, lies b/w bladder, urethra, & rectum, consists of 2 lobes separated by a shallow groove called median sulcus. |
| subjective data for male genitalia | any pain, discharge, lumps, or swelling, any change in your urine, any difficulty sustaining an erection, self testicular exam (1xmo in shower), multiple sex partners, stds/hiv? |
| prostate fxns | secrete thin, milky substance that promotes sperm motility & neutralizes female acidic vaginal secretions; can be palpated thru the anterior wall of rectum (chestnut or heart-shaped organ). |
| seminal vesicles | rabbit-ear-shaped structures located on either side of, & above prostate gland, produce ejaculate that nourishes and protects sperm, normally not palpable. |
| prostatic hyperplasia | enlargement of prostate gland, common in men over age 40, called Benign Prostatic Hypertrophy (BPH), causes weak urinary stream. |
| nervous system is composed of? | cns (brain & spinal cord) & pns (12 pairs of cranial nerves, 31 pairs of spinal nerves, ans-psym & sym) |
| layers of brain (out to in) | dura mater, subdural space, arachnoid mater, subaracnoid space, pia mater. |
| autonomic vs. voluntary nervous system | auto-works w/o conscious thought (glands, cardiac mus, smooth mus, digestive system, resp system, & skin); volun-governs sk.mus. |
| cns | cerebral cortex-gray matter center for highest fxns (no myelin), lt hemisphere-dominant of 95 of ppl; 4 lobes in each hemi- frontal, parietal, temporal, occipital. |
| frontal lobe | personality, behavior, emotions, intellectual fxn (damage=personality change) |
| parietal lobe | postcentral gyrus- primary center for sensation |
| occipital lobe | primary visual receptor center |
| temporal lobe | primary auditory center |
| wernicke's area | temporal lobe, language comprehension (how you receive & interpret things), receptive aphasia (stroke, foreign language) |
| broca's area | frontal lobe, motor speech/expressive (express yourself), aphasia (stroke) |
| cortical damage | potential loss of fxn: motor weakness, paralysis, loss of sensation, language comprehension; caused by: inadequate or lack of blood supply to neurologic cells. |
| cerebral cortex | cerebrum's outer layer of nerve cell bodies- gray matter, hemi-half cerebrum, most ppl are lt dominant, different lobes/areas & fxn |
| basal ganglia | gray matter deep in hemis, extrapyramidal system (EPS)-maintains mus tone & controls body movements; ex. walking and swinging arms at same time. |
| thalamus | "relay station", synapses-sites of contact b/w sensory pathways b/w sp cord & brain stem. |
| hypothalamus | major control center for temperature, ht rate, b/p control, sleep center, ant & post pituitary gland, ans activity, & emotional status. |
| cerebellum | balance; under occipital lobe, motor coordination, equilibrium, mus tone, unconscious level that adjusts voluntary movements. (unbalanced-parkinson's dz). |
| brain stem | 1.midbrain-motor neurons & tracts, 2.pons-area with ascending & descending fiber tracts, 3.medulla-vital auto centers (resp, ht, & gi fxn); herniation of brain-> fatal. |
| spinal cord | the part of the cns lodged in the sp canal, it carries sensory & motor info, the main hwy that connects the brain to the spinal nerves. (extends to L2). |
| pns | nerve-bundle of fibers outside cns, reflexes- involuntary defense mechanisms of ns, cranial nerves-12 pairs, spinal nerves- 31 pairs. |
| dermatome landmarks | thumb, middle finger, 5th finger (c6,c7,c8), nipple-t4, umbilicus-t10, groin-L1 |
| types of reflexes | deep tendon, superficial, visceral, pathologic |
| deep tendon reflex | knee jerk (patellar) |
| superficial reflex | corneal reflex, abdominal reflex |
| visceral reflex | organic, PERRLA |
| pathologic reflex | abnormal/Babinski |
| developmental considerations (neuro-infants) | not completely developed at birth, motor activity directed by primary reflexes; myelinization follows a cephalocaudal and proximodistal order so milestones can be anticipated (myelin sheaths not developed yet). |
| developmental considerations (neuro-aging) | general atrophy, steady loss of neurons, anticipate slower rxn time, dec in mus strength & agility, loss of balance with position change and some memory loss. |
| parasthesia | numbness or tingling (diabetic neuropathy) |
| dysphagia | difficulty swallowing |
| aphasia | absence of ability to communicate |
| dysphasia | problem speaking |
| expressive dysphasia | difficulty answering, but can understand (ex.-stroke pts-damaged Broca's area). |
| dysarthria | problem articulating sounds. |
| paresis | slight paralysis |
| paralysis | loss of motor fxn |
| syncope | temporary loss of consciousness |
| vertigo | rotational spinning |
| subjective data for neuro | headaches head injury dizziness/vertigo seizures tremors weakness (ADLs) altered coordination numbness or tingling difficulty swallowing (aspiration risk) difficulty speaking signif past hx envir/occup hazards. |
| complete neuro exam | mental status, cranial nerves, motor system, sensory system, reflexes |
| mental status assessment | ABCT-- appearance, behavior, cognition, thought processes |
| CN1 | olfactory, smell, S, Present object under one nare to assess wheather pt can ID object's smell |
| CN2 | optic, vision, visual accuity, S, Visual Fields- Confrontation Test; Opthalmoscope Exam |
| CN3 | oculomotor, eyelid & eyeball movement, EOM, M, EOM with cardinal positions of gaze; Pupil constriction/dilation, S, Assess for PERRLA, consensual light reaction, accomodation |
| CN4 | troclear, innervates superior oblique which turns eye downward and laterally, M, EOM with cardinal positions of gaze |
| CN5 | trigeminal, S=sensation to face, scale, corfnea, muccous membranes of math and nose, test:light touch sensation; M=Muscle of mastification |
| CN6 | abducens, turns eye laterally, M, EOM with cardinal positions of gaze |
| CN7 | facial, M=controls most facial expressions, close mouth, labial speech, & psym secretion of tears & saliva, S=Taste- sweet salty sour bitter on anterior two thirds of tongue |
| CN8 | vestibulocochlear (auditory), hearing & equilibrium sensation, S, Weber Test, Rinne Test, Whisper Test, Abilty to hear normal conversation |
| CN9 | glossopharyngeal, S=taste on posterior 1/3 of tounge, Gag Reflex, M=Phonation and swallowing, Parasymathetic- Carotid reflex, Parotid gland |
| CN10 | vagus, M=Pharynx and larynx- talking and swallowing, S=senses aortic blood pressure in carotid body, carotid sinus, pharynx, and viscera, Parasymathetic- slows heart rate with the Carotid Reflex |
| CN11 | spinal accessory, controls trapezius & sternocleidomastoid, M, Ask patient to rotate head and shrug shoulders |
| CN12 | hypoglossal, controls tongue movements, M, Inspect tounge for movement and ask pateint to say, "light, right, dynamite". You are looking for clear and distinct speech that is not impede by tounge movement |
| motor system | muscles-size, strength, tone, involuntary movements; cerbellar-gait, balance, coordination. |
| RAM | rapid alternating movements; 1.ask person to pat their knees, lift up, & turn hands over (should be done with equal turning & rhythmic pace), 2.Ask person to touch thumb to each finger on same hand starting with index finger, then reverse the direction |
| finger to finger test | ask pt to touch their index finger to their nose & then to your finger (pt's eyes are open, RN should move their finger occasionally to different location, movement should be smooth & accurate) |
| finger to nose test | ask pt to close eyes & stretch out arms & touch nose with each index finger at inc speed, assess for accuracy & smooth movement. |
| heel to shin test | tests lower extremity coordination,ask pt in supine position to place heel on opp knee & run it down the shin from the knee to the ankle (should move heel in straight line down the shin). |
| the sensory assessment | spinothalamic tract-pain, temp, light touch; posterior column tract-vibration, position (Kinesthesia), tactile discrimin, stereognosis, graphesthesia, 2pt discrim, extinction, point location. |
| vibration sensation | tuning fork over bony prominences, ask pt to id when vibration stops, move proximally if nothing is felt, (peripheral neuropathy) |
| sensitivity to position | Kinesthesia-test the person's ability to perceive passive movements; move fingers or toes up & down & ask pt to tell you which way you moved. |
| tactile discrimination | stereognosis, graphesthesia, 2pt discrimination, extinction, pt location |
| touch-tactile discrimination | -light touch (cotton wisp to skin), -vibration (tuning fork over bony proms-start on fingers & big toe), -position (kinesthesia)-ability to perceive passive movement. |
| stereognosis | ability to recognize objects by feeling their form |
| graphesthesia | ability to "read" a number by having it traced on skin. |
| procedures for testing DTRs | biceps-bicep contraction & elbow flexion, triceps-ext of elbow, brachioradialis-flexion & supination of forearm, quads/patellar-ext of lower leg, achilles- plantar flexes against your hand, ankle clonus-no rapid contractions |
| superficial reflexes | reflex of skin; plantar-plantar flexion of toes, inversion & flexion of the forefoot; abdominal-mus contract; umbilicus deviates toward stimulated side (in to out); cremasteric-scrotum elevates on stim side. |
| documentation of reflexes | grade 0-no response (dead or paralyzed), grade1+-dec, less active than normal, 2+-normal, usual response, 3+-more brisk than normal, 4+-hyperactive, very brisk, clonus (rhythmic oscillations) |
| neuro check | LOC-alert, lethargic, stupor, coma, assess for subtle changes; orientation to time, place, person; memory; extremity movement-strength (voluntary, involuntary, absent) & sensation (touch, pain); pupillary response-PERRLA, vital signs-(cushings triad) |
| grasp reflex | NOT accurate neuro response |
| GCS | glasgow coma scale: 1.best Eye opening response, 2.best Motor response,3.best Verbal response; totals-15=alert, normal, <7=coma. |
| decorticate rigidity | abnormal flexion (towards cord) |
| decerebrate rigidity | abnormal extension (away from cord) |
| Brudzinski's Sign | suggests meningitis; watch hips and knees as you flex neck, pain & flexion of hips & knees is abnormal (+Brud sign) |
| kernig's sign | flex leg at both hip & knee then extend the knee, pain & inc resistance to ext is suggestive of meningeal irritation (+Kernig's Sign) |
| rapid neuro assessment | 1.change in LOC (single most imp factor in neuro exam) 2.be aware of subtle changes 3. arousal & state of awareness (orientation)-person, place, time, reason (orientedX4) 4.PERRLA, 5.consensual & direct light reflexes. |
| musculoskeletal system fxns | 1.support & mobility for body, 2.protection for internal organs, 3.production of RBCs & mineral storage |
| components of musculoskeletal system | bone & cart-specialized forms of conn tissue |
| muscles | acct for 40-50% of body's wt, when contract-produce movement, types: sk, sm, cardiac, sk=voluntary mus composed of bundles of mus fibers (fasciculi) which attach to bone by a tendon. |
| joints | fxnal unit of musculosk. system; synovial jts=freely movable bc they have bones that are separated from each other & enclosed in cavity with syn fluid present (allows sliding), nonsyn jts=bones united by fibrous tissue or cart & are immovable. |
| flexion | forward bend to dec angle |
| extension | straightening limb to inc angle |
| abduction | move away from midline |
| adduction | move toward axis |
| internal rotation | turning part toward midline |
| external rotation | turn away from midline |
| circumduct | circular movement |
| supination | turning palm up |
| pronation | turning palm down |
| inversion | turning inward, medial raising |
| eversion | turning outward, lateral raising |
| joints def | articulation where 2 or more bones are joined |
| ligaments | fibrous bands that hold bone to bone |
| tendons | collagen at end of muscles that attach muscle to bone |
| cartilage | smooth conn tissue that forms a cap over bones |
| bursae | small sacs of conn tissue filled with synovial fluid |
| spine | vertebra-33 connecting bones stacked in a vertebral column, humans have 7C,12T,5L,5S, & 3-4coccygeal |
| surface landmarks of spine | spinous processes C7&T1, inferior angle of scapula-T7&T8, imaginary line connecting highest pt on each iliac crest (crosses L4), imag line joining 2 symm dimples overlying PSIS (crosses sacrum). |
| discs | elastic fibrocartilaginous plates that constitute 1/4 of the length of the column, each has nucleus pulposus, cushions spine & helps it move |
| as spine moves... | discs allow compression on 1 side, with compensatory expansion on the other. Sometimes compression is too great-disc can rupture & the nucleus pulposus can herniate out the vertebral column-compressing on spinal nerve & causing pain. |
| rheumatoid arthritis | abnorm of multiple jts; chronic, systemic inflammatory dz of jts & surrounding conn tissue (may be genetic, unknown cause) |
| osteoarthritis | non-inflamm, localized, progressive disorder involving deterioration of articular carts & subchondral bone, & formation of new bone (bones rub on bones) |
| osteoporosis | dec in sk bone mass, weakened bone state inc risk for stress fractures (problems with bone resorption); females exp more than males, whites more than blacks |
| aging adult (musculosk.) | loss of bone matrix (resorption) occurs more rapidly than bone growth (deposition)=loss of bone density; osteoporosis; postural changes-dec ht due to shortening of vert column, dist of subq fat changes, sedentary lifestyle hastens musculosk changes of ag |
| aging adult cont'd. | exercise inc sk mass- helps prevent or delay osteoporosis; dec in rxn time, speed of movement, agility, & endurance dec with aging |
| fractures | peak bone mass at 35-40 yrs, worldwide risk (28m Americans, 80% female), 1.5m annually, common fracture sites=distal femur, wrist, & vertebrae |
| modifiable risk factors (fractures) | activity level (exercise), Ca intake (VitD), low estrogen level, excess caffeine or alcohol intake, meds-corticosteroids. |
| transcultural (bones) | black males have densest bones resulting in the low incidence of osteoporosis, bone density in Chinese & Japanese is below that of white Americans |
| infants and children (bones) | 3mo gestation-cartilage skeleton then ossifies, single C-curve of spine (3mo-lifts head-cervical curve, walking-lumbar curve), bone growth-epiphyses, longitudinal ends around 20yo. |
| developmental considerations for the ped pop (bones) | -infant should be observed for spontaneous movements -fetal positioning may cause musculosk anomalies in newborn -newborns usually have flat feet, arches develop during the preschool period -infant should be assessed for congenital hip dislocation |
| developmental considerations for the ped pop (bones) cont'd. | -spina bifida may be indicated if tufts of hair, cysts, or masses appear on the spine -scoliosis -developmental milestones -physical activity |
| tests to check for hip dislocation | allis test and ortolani's test |
| pregnancy (musculoskeletal) | inc hormones, inc joint mobility, lordosis (low back muscle strain, anterior cervical flexion-upper extremity aching, numbness, weakness) |
| subjective data (musculoskeletal) | current health problem, pt/fam hx (bone ca?, musculo issues-joint pain, muscles, bones, menarche,menopause), lifestyle practices (meds,tobacco,alcohol,caffeine,diet,exerise,occuptation,ADLs) |
| examination (musculoskeletal) | inspection, palpation, muscle testing, ROM |
| inspection (musculosk.) | size,shape,color,swelling,masses,symmetry; movement (ROM,gait), observe demeanor |
| deformities | dislocation-1 or more bones in a jt being out of position, subluxation-partial dislocation of a jt, contracture-shortening of a mus leading to limited ROM of jt (happens with paralysis), ankylosis-stiffness or fixation of a jt. |
| palpation (musculosk.) | palpate each jt noting any temp, tenderness, swelling, or masses, palpable fluid is abnormal |
| ballottement test | to ck fluid on knee, thumb & index finger superior patella-push/tap patella on femur-feel for fluid wave |
| bulge test | stroke medial side of knee-press on lateral side-look for bulge on medial side. |
| mcmurray's test | ck for meniscus tears |
| muscle testing | -pt flexes mus as opposing force is applied -mus strength should be equal bilaterally & should fully resist your opposing force -mus status & jt status are interdependent & should be interpreted together. |
| ROM | ask for active ROM; if limitation noted-gently attempt passive ROM (normal ranges of active & passive ROM should be the same); can use goniometer to measure angles; jt motion normally causes no tenderness; crepitation-audible & palpable crunching or grati |
| genu valgum | knock knees |
| genus varum | bow legs |
| rheumatoid arthritis | chronic, systemic inflammatory dz of jts and surr conn tissue; assoc with fatigue, weakness, anorexia, wt loss, low grade fever, & lymphoadenopathy. |
| ankylosing spondylitis | chronic progressive inflamm of spine, sacroiliac, and larger jts of extremities; thoracic curve exaggerated into single kyphotic rounding. |
| osteoarthritis | noninflamm, localized, progressive disorder of deterioration of articular carts & subchondral bone & formation of new bone at jt surfaces. affected jts have stiffness, swelling with hard, bony protuberances, pain and limitation. |
| osteoporosis | dec in sk bone mass from bone resorption being greater than bone formation. inc risk for stress fractures. |
| jt effusion | swelling from excess fluid in jt capsule, fluctuant to palpation. |
| tear of rotator cuff | positive drop arm test: if arm is passively abducted at the shoulder, the person is unable to sustain the position & the arm falls to the side. |
| adhesive capsulitis | frozen shoulder; fibrous tissues form in jt capsule, causing stiffness, progressive limitation of motion, and pain; gradual onset, unknown cause (assoc with prolonged bed rest or shoulder immobility). |
| olecranon bursitis | lg soft knob (goose egg) and redness from inflammation. |
| gouty arthritis | joint effusion or synovial thickening around olecranon process. |
| subq nodules | raised, firm, nontender nodules that occur with RA. |
| epicondylitis | tennis elbow; |
| ganglion cyst | round, cystic, nontender nodule overlying a tendon sheath or jt capsule, usually on dorsum of wrist; doesn't become malignant. |
| anklyosis | wrist in extreme flexion, due to severe RA. |
| colles' fracture | nonarticular fracture of distal radius, with or without fracture of ulna at styloid process |
| dupuytren's contracture | chronic hyperplasia of the palmar fascia causes flexion contractures of the digits; occurs with diabetes, epilepsy, and alcoholic liver disease. |
| swan neck and boutonniere deformity (BD) | flexion contracture of metacarpophalangeal jt, hyperextension of proximal interphalangeal jt, & flexion of distal interphal. jt. BD=knuckle |
| ulnar deviation or drift | fingers drift to ulnar side b/c of stretching of articular capsule & mus imbalance. |
| acute RA | painful swelling & stiffness of jts |
| syndactyly | webbed fingers |
| polydactyly | extra digits |
| mild synovitis | loss of normal hallows on either side of patella; occurs with synovial thickening or effusion. |
| swelling of menisci | localized soft swelling from cyst |
| chondromalacia patellae | degeneration of articular surface of patellae; cause unknown, crepitis may be present. |
| prepatellar bursitis | localized swelling on anterior knee |
| osgood-schlatter dz | painful swelling of tibial tubercle just below the knee; condition is usually self-limited, symptoms resolve with rest. |
| achilles tenosynovitis | inflammation of tendon sheath near the ankle |
| acute gout | acute episode of gout, redness, swelling, heat, extreme tenderness |
| tophi with chronic gout | hard, painless nodule |
| scoliosis | fxnal is flexible; structural is fixed |
| herniated nucleus pulposus | nucleus ruptures into spinal canal & puts pressure on local spinal nerve root |
| talipes equinovarus | clubfoot, malposition of foot, including inversion, forefoot adduction, foot pointing downward |
| spina bifida | incomplete closure of posterior part of vertebrae |
| coxa plana | legg-calve-perthes syndrome; avascular necrosis of the femur head |
| hypospadias | urethral meatus opens on ventral side of glans |
| epispadias | urethral meatus opens on dorsal side of glans |
| priapism | prolonged painful erection of penis without sexual desire |
| peyronie's dz | hard, nontender, subq plaques; assoc with painful bending of penis during erection. |
| pilonidal cyst or sinus | hair-containing cyst or sinus; congenital |
| anorectal fistula | inflamed GI tract creates an abnormal passage from inner anus out to skin; may have indurated cord. |
| pruritis ani | intense perianal itching from pinworms or fungal infection |
Created by:
husseaj
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