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Stack #663075

Health Assessment Test #3

Epidermis -avascular -inner basal cell layer: forms new cells -horny cell layer: basal cells migrate up, flatten, become dead kerontized cells -skin color = brown from melanin, yellow/orange from carotene, and red/purple from vascular bed
What is the dermis primarily made of? Collegen: resists tearing Elastic tissue: allows skin to stretch
What are the functions of the skin? protection, prevent penetration, perception, product. of Vit D, absorption/excretion, communication, temp regulation, would repair, identification
What is the difference between the 2 kinds of sweat glands? eccrine: open directly on skin and produces sweat appocrine: produce thick secretions and open on hair follicles, active during puberty
Sebaceous glands secretes sebum to lubricate skin and hair and retard H20 loss, everywhere except palms and soles
Possible causes of pallor? anemia, high-stress states like anxiety or shock
Possible causes of Erythema? polycythemia, venous statis, carbon-monoxide poisoning
Possible causes of cyanosis? decreased profusion, hypoxemia, heart failure, chronic bronchitis
What are some reasons for diaphoresis? thyrotoxicosis, anxiety, pain
Lentigines -"liver spots" -small flat brown macules that appear after sun exposure -usually on dorsum of hand and forearm -not malignant -normal for aging adult
Acrochordons -"skin tags" -overgrowths of normal skin that are polyp-like & appear in stalks
Sebaceous hyperplasia raised yellow papules with central depression, more common in males, commonly on forehead, cheeks, and nose
Vitiligo absence of melanin
What is the difference between primary & secondary lesions? primary: when lesion develops on previously unaltered skin secondary: when lesion changes over time or changes due to factors like infection/scratching
Senile angiomas -small, smooth slightly raised bright red dot -can ^ in size and # with age but it's not significant
What causes purpuic lesions? -caused by blood leaking out of the capillaries and into the tissues -(ie: petechiae (tiny round hemorrhages 1-3mm, ecchymosis, purpura (>3mm, extensive, flat patches of petechiae and ecchymosis)
What is a hemangioma and give examples? -benign proliferation of blood vessels in the dermis -ie: port-wine stain: large flat macular patch covering scalp & face -ie: strawberry mark: immature hemangioma -ie: cavernous: mature hemangioma, reddish-blue irregularly shaped spongy mass
Paronychia inflammation of the nail folds
Beau's Line transverse groove across nail occuring from trauma or illness that can temporarily inhibit nail growth
Splinter Hemorrages red-brown linear streaks
Pitting of the Nails often occurs w/psoriasis
Late clubbing of the nails -nail bed angle >180 -can occur w/ congenital cyanotic heart disease, neoplastic or pulmonary disease
Onycholysis -slow fungal infection of the nails -green/thick/crumbly nails
Folliculitis -superficial infection of the hair follicles -"whiteheads"
Pediculosis Capitis head lice
Hirsutism excessive body hair
Seborrheic Dermatitis yellow-white greasy scales w/erythema on scalp and forehead
Basal Cell Carcinoma -pearly papule that can become ulcerated -most common form of skin cancer
Squamos Cell Carcinoma -erythemous scaly patches -less common but grows rapidly
Trichotillomania -self-induced hair loss -can be a sign of personality disorder in adults
Traumatic Alopecia -hair loss (along hair line or scattered) due to trauma like hair rollers, braids, tight ponytails
Pallor in Dark Skin -brown skin- dull yellow-brown -black skin- dull, ashen gray -check areas w/least pigmentation such as conjunctiva & mucus membrane
Cyanosis in Dark Skin -darker, dull, lifeless -check in conjunctiva, oral mucosa, & nail beds
Erythema in Dark skin -purplish tinge -cherry color in nail beds, lips, oral mucosa
Examples of Secondary Skin Lesions -crust, scale, fissure, erosion, ulcer, excoriation, scar, keloid, lichenification
Skin/Hair/Nail Changes in Aging Adult - epidermis thins -loss of elastin/collagen/subQ fat/muscle tone = ^ risk for shear -decrease # of sweat & sebaceous glands -decrease # of melanocytes-->thin, fine, white hair -cell replacement & wound healing is slowe
Mastalgia breast pain
Galactarrhea nipple discharge
Risk Factors for Breast Cancer family history, high breast tissue density, obesity, hormonal therapy, having a child later in life (30 yrs+), recent oral contraceptives, never breastfeeding
Peau d'orange -lymphatic obstruction producing edema, thickening the skin and exaggerating hair follicles giving a pigskin or orange-peel look -suggests cancer
Breast Self Exam right after the menstrual cycle or the 4th-7th day of her cycle
Mammograms -start at age 40 -screening purpose
How do you palpate the breasts? -use the pads of your first 3 fingers -vertical stripe pattern is the recommended way -also spokes on wheel pattern or concentric circle
How does a decrease in estrogen & progesterone effect the breast tissue? -decrease estrogen = loss of firmness -decrease progesterone = shrinkage
Incidence of breast cancer among populations -whites have higher incidence of breast CA than blacks, but mortality rate is higher in black population due to insufficient use of screening measures or lack of access to healthcare
What are the 3 landmarks of the spine? -C7 and T1 = base of neck -T7 and T8 = inferior angle of scapula -L4 = iliac crest
Ankylosis stiffness or fixation of a joint
Tendinitis pain worse in the morning, but improves
Osteoarthritis pain worse later in the day
Rheumatoid pain worse in morning but movement decreases pain
Action of Temporomandidibular Joint -hinge = open-close action of jaw -gliding = protrusion/retraction of jaw and lateral movement
Tinel Sign +test = burning/tingling upon percussion of median nerve = carpal tunnel
Lasegue Test + sciatic pain = herniated nucleus pulposus
How do you measure leg length? between 2 fixed points from anterior iliac spine to medial malleolus
Epicondylitis -"tennis elbow"-commonly occurs w/excessive supination & pronation -pain on lateral epicondyle radiating down forearm
Phalen Sign - hold hands back to back w/wrists at 90 degrees + test numbness = carpal tunnel
Thomas Test -tests the hip -normally flexion flattens the lumbar spine, but a + test occurs when there is a flexion deformity in opposite hip
McMurray Test +click = torn meniscus
Osgood-Schlatter painful swelling of the tibial tubercle, during rapid growth, more common in males
Genu Varum bowlegs
Genu Valgum knock knees
Swan Neck Abnormality hyper-extension of proximal interphalangeal & flexion of distal interphalangeal due to rheumatoid
Boutonniere's Deformity flexion of proximal interphalangeal w/hyper-extension of distal interphalangeal
Heberden's Node bony overgrowths at the distal interphangeal
Musculoskeletal Changes in Aging Adult -reabsorption or loss of bone matrix after 40-->osteoporosis -decreased height due to thinning cartilage between vertebrae -loss of subQ fat = bony prominences -fat deposits in abdomen & hips -Kyphosis: backward head tilt & flexion of hips & knees
Hallux Valgus -big toe deviates away -sign of rheumatoid
Mechanically, how do rotator cuff lesions occur? -traumatic adduction while arm was held in abduction -fall on shoulder -heaving lifting
What are the functions of the musculoskeletal system? -support to stand erect -movement -encase & protect organs -produce RBC -storage of minerals (Ca+ & phosphorus)
Contracture shortening of a muscle leading to limited ROM
Callus hypertrophy of epithelium due to prolonged pressure
Corns thickening of soft tissue over bony prominences
Bunions inflamed bursa at a pressure point
Where can you feel the temporomandibular joint? depression anterior to tragus of ear
Glenohumeral Joint shoulder
Location of Prostate -in front of anterior wall of rectum -2 cm behind the symphysis pubis -surrounds the bladder neck and urethra
What are the effects of decreasing levels of testosterone? -slower, less intense sexual response -shorter & less forceful ejaculation -goes back to flaccidity more quickly
How do you palpate the testes? finger and thumb in rolling motion
Risks of Circumcision -sepsis -amputation of distal edge of gland -chance of urethrocutaneous fistula
Location of Rectum right above anus
Location of Anus outermost portion
Contraindications to contraceptive use -smoking -DVT -osteopuritis
Chadwick's sign -blue cervix -2nd month of pregnancy
Characteristics of a normal uterus -pair shaped -tilted forward -freely movable -superior to bladder
Characteristics of normal cervix -even, pink coloration -1 inch in diameter -midline
Characteristics of a normal prostate - heart shaped -2.5-4cm -smooth surface -slightly movable -elastic/rubbery -non tender
Iron meds cause what kind of stool? black & non-tarry
Steatorrhea excessive fat in stool caused by malabsorption
How do you palpate the anus? -lubricate finger -ask patient to cough and insert finger at an angle
What is the average length of menopause? 10 years
Gravida pregnancy
Para live births (for twins, it's still only considered 1 birth)
When do pap smears start? age 18 or when sexual activity begins NOT diagnostic, its a SCREENING process
reasons for red blood in stool -hemmorrhoids -anal fissures
Melena -black & tarry stools -sign of GI bleed
PSA prostate specific antigen -white men: 50 years -black men: 45 years, more likely to be diagnosed at an advanced stage and higher mortality rate
Definition of infertility not conceiving of 1 yr of unprotected sex
Clay-like stool no bile-->pancreas or liver problem
Reasons for hypothermia shock, peripheral arterial insufficiency, Raynaud's
Reasons for hyperthermia hyperthyroidism: ^ metabolic rate causing warm, moist skin
What is turgor and where do you assess for it? turgor: ability of skin to return to place which reflects its elasticity where to assess: anterior chest under clavicle
What can cause "tenting?" severe dehydration or extreme weight loss
Where do you assess for edema? Edema most evident in dependent parts of the body like feet, ankles, and sacral areas, where skin looks puffy and tight
Differentiate unilateral vs bilateral edema. unilateral: local or peripheral cause bilateral: generalized over whole body (anasarca)-consider central problem like heart or kidney failure
Describe skin texture w/hyperthyroidism and hypothyroidism. hyperthyroid--> velvet-like hypothyroid-->rough/dry/flaky
What is scleroderma? -"hard skin" -chronic connective tissue disorder associated w/decreased mobility
When using the Wood's light, what does a blue-green fluorescence indicate? fungal infection like tinea capitis
What does absent or sparse genital hair suggest? endocrine abnormalities
Are sudden appearance of brown linear streak across nail normal? NO! may indicate melanoma
What is a wheal? -primary skin lesion that is superficial, raised, transient, and erthematous -slightly irregular due to edema -ie: bug bite, allergic reaction
What is a nodule? -primary skin lesion that is solid, hard or soft, elevated, and >1cm -may extend deeper into dermis than a papule -ie: fibroma, intradermal nevi
What is a cyst? -primary skin lesion -encapsulated fluid-filled cavity in dermis or subQ -ie: sebaceous cyst
macule vs papule -macule: color change that is flat, circumscribed and less than 1 cm (freckle, petechiae) -papule: something you can feel, caused by superficial thickening of the epidermis (elevated nevus, lichen, wart)
What is a vesicle? -primary skin lesion -elevated cavity containing free fluid, up to 1 cm -ie: blister
Excoriation -secondary skin lesion -self-inflicted abrasion -ie: insect bites, scabies, dermatitis
keloid -secondary skin lesion -hypertrophic scar
What is associated w/Epididymitis? -swelling of the epididymis that causes sudden severe pain, red, and enlarged scrotum -enlarged, reddened scrotum
Varicocele -abnormality of scrotum that feel like *"a bag of worms"
Spermatocele -abnormality of the scrotum that when palpated it feels like a round, freely movable mass lying above or behind testis...and if large enough can feel like a third testis
Orchitis -swelling of 1 testis -S&S: acute moderate pain, swollen testis, feeling of weight, fever, reddened area
Scrotal hernia -non-tender swelling of the scrotum -signs: swelling, may have pain w/straining -observation: doesn't transilluminate -Palpate: soft, mushy mass
What are hemorrhoids? -painless, flabby papules due to varicose vein -result from increased portal venous pressure as it occurs with straining at stool, chronic constipation, pregnancy, obesity, chronic liver disease, and low-fiber diets
Fecal Impaction collection of hard, desiccated feces in the rectum due to decreased bowel motility whereby more H20 is removed from the stool
rectal carcinoma -asymptomatic -1/5 are malignant
What are some signs and observations of BPH? S: urinary frequency, urgency, hesitancy, straining to urinate, weak stream O: symmetric non-tender enlargement, prostate feels smooth, rubbery, or firm, with median sulcus obliterated
What are some signs and observations of Prostatitis? S: fever, chills, malaise, urinary frequency, urgency, dysuria O: w/acute inflammation = asymmetric enlargement , w/chronic inflammation = tender enlargement w/boggy feel to isolated firm areas to normal feeling
When should you start and how often should you have a pap smear/cervical screening? -begin within 3 years of first having sex or at age 21 -continue annually until age 30 and if you have 3 consecutive normal paps, then you can be screened every 2-3 years
What is urge incontinence? involuntary urine loss from overactive detrusor muscle in the bladder
What is stress incontinence? involuntary urine loss w/physical strain like sneezing, coughing, laughing, etc
Vellus hair vs terminal hair -vellus: fine hair that covers most of body -terminal: thicker & darker, on scalp, eyebrows, axilla, pubic area
Tinea pedis athlete's foot
Tinea corporis ringworm
Created by: kcstoll