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health assessment

nursing 255 test 4

the breast lie anterior to the pectoralis major and serratus anterior muscles
just below the center of each breast is the nipple
the nipple surrounds the areola for a 1- to 2-centimeter radius
Montgomery’s glands secrete a protective lipid material during lactation
the superior lateral corner of the breast tissue is called the axillary tail of spence
The breast is composed of glandular, fibrous, and adipose tissue.
The glandular tissue contains 15 to 20 lobes that radiate from the nipple and are composed of lobules.
Each lobe in the breast empties into a lactiferous duct
collecting duct system converging toward the nipple lactiferous duct
lactiferous duct that carries milk to the lactiferous sinuses,
stores milk behind the nipple lactiferous sinuses
fibrous tissue includes Cooper’s ligaments that support the breast tissue
fibrous bands extending vertically from the surface to attach on chest wall muscles cooper's ligaments
Adipose tissue houses the lobes and provides most of the bulk of the breast
central axillary nodes are high in the middle of the axilla.
pectoral (or anterior) nodes lie along the lateral edge of the pectoralis major muscle.
subscapular (or posterior) nodes are found along the lateral edge of the scapula.
lateral nodes exist along the humerus, inside the upper arm
from the central axillary nodes, drainage flows up to the infraclavicular and supreaclavicular nodes
supernumerary nipple and extra nipple
five stages of breast development follow this classic description of sexual maturity rating or tanner staging
thick, yellow fluid that is a precursor for milk colostrum
begins 1-3 days postpartum milk production
mastalgia occurs with trauma, inflammation, infection and benign breast disease
a sudden increase in the size of one breast signifies inflammation or new growth
the skin is normally smooth and of even color
the nipples should be symmetrically placed on the same plane on the two breasts
lymph nodes feel small, soft, and non-tender
the vertical strip pattern currently is recommended as the best way to detect a breast mass
heat, redness and swelling in non lactating and non-postpartum breasts indicates inflammation
best time to do a self breast exam is after the menstrual period, or the 4th through 7th day of the menstrual cycle, when breasts are the smallest
gynecomastia is a benign growth of men's breast tissue
premature thelarche is early breast development with no other hormone dependent signs (pubic hair, menses)
adolescent breast development begins on an average between 8- 10 years of age
in pregnant women a delicate blue vascular pattern is visible over the breast
in a pregnant woman, colostrum can be expressed after the first trimester
colostrum changes to milk production around the 3rd postpartum day
lymphatic obstruction produces edema
edema in the breast produces and orange peel look
cyst are discrete, fluid filled sacs
breast lumps that are irregular, star-shaped, fixed, and firm to stony hard are cancerous
breast lumps that are round, lobular, mobile, firm to soft, and rubbery are benign breast disease
breast lumps that round, lobular, very mobile, usually firm and rubbery are fibroadenoma
one section of the breast is tender, may be reddened with no infection could indicate a plugged duct
area is red, swollen, tender, very hot and hard, an uncommon inflammatory mass before abscess formation mastitis
musculoskeletal system consists of the body's bones, joints and muscles
musculoskeletal system also functions to produce the red blood cells in the bone marrow
non synovial joint joints that are immovable
synovial joint joints that are freely movable
ligaments are fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions
bursa is an enclosed sac filled with viscous synovial fluid
a bursa helps muscles and tendons glide smoothly over bone
muscles account for 40-50% of the body's weight
3 types of muscles muscles, skeletal and cardiac
flexion bending limb at a joint
extension straightening a limb at a joint
abduction moving a limb away from midline
adductin moving a limb toward midline
pronation palm is down
supination palm is up
circumduction moving arm in a circle around the shoulder
inversion moving the sole of the foot inward at the ankle
eversion moving the sole of the foot outward at the ankle
rotation moving the head around a central axis
protraction moving a body part forward and parallel to the ground
retraction moving a body part backward and parallel to the ground
elevation raising the body part
depression lowering the body part
the TMJ is the articulation of the mandible and the temporal joint
humans have ___ cervical vertebrae 7
humans have ___ thoracic vertebrae 12
humans have ___ lumbar vertebrae 5
humans have ___ sacral vertebrae 5
humans have ___ coccygeal vertebrae 3-4
spinous processes of C7 and T1 are at the base of the neck,
Bone lengthening occurs at the epiphyses, or growth plates.
the vertebral column has ___ curves 4
pregnancy, the most characteristic posture change is progressive lordosis, which adjusts the center of balance as the fetus grows.
intervertebral disks are elastic fibrocartilaginous plates that constitute one fourth of the length of the column
glenohumeral joint is the articulation of the humerus with the glenoid fossa of the scapula
acromion process can be felt at the very top of the shoulder
the elbow allows for flexion and extension
palpable landmarks of the elbow are the medial and lateral epicondyles of the humerus and the large olecranon process of the ulna in between them
half of the body's bones are in the feet and hands
the radiocarpal joint is the articulation of the radius and a row of the carpal bones
the knee joint is the articulation of 3 bones femur, tibia and the patella
largest synovial membrane in the body is the knees synovial membrane
suprapatellar pouch is a sac at the superior border of the patella
gradual loss of bone density is osteoporosis
kyphosis is a hunchback, is a condition of over-curvature of the thoracic vertebrae
Rheumatoid arthritis involves symmetric joints and other musculoskeletal illnesses involve isolated or unilateral joints
RA pain is worse in the morning
osteoarthritis is worse later in the day
myalgia is usually felt as cramping or aching
a fracture causes a sharp pain that increases with movement
dislocation is a complete loss of contact between the two bones in a joint
subluxation is when two bones in a joint stay in contact but their alignment is off
contracture is the shortening of a muscle leading to limited ROM of a joint
ankylosis is the stiffness of fixation of a joint
inflammation is indicated by warmth and tenderness
active ROM is when the patient does the work
passive ROM is when you help the patient do the work
crepitation is an audible and palpable crunching or grating that accompanies movement
mcMurray test is to be performed when the person has reported a history of trauma followed by locking, giving away, or local pain in the knee
in infants the tibial torsion is a twisting of the tibia
in infants the ortolani maneuver checks the hips for congenital dislocation
allis test checks for hip dislocation by comparing leg lengths
genu varum is the lateral bowing of the legs (bow legged)
genu valgum is knees together
in adolescents kyphosis is common because of chronic poor posture
screen for scoliosis in adolescents by doing a forward bend test
osteoarthritis is located in the larger joints due to normal wear and tear
ankylosis is when the wrist is in extreme flexion due to severe RA
heberden nodes is a bone over growth of the distal interphalangeal joint toward the wrist
bouchard node is a bone over growth of the proximal interphalangeal joint towards finger tips
spina bifida is the incomplete closure of posterior part of the vertebrae resulting in a neural tube defect
The anal canal is the outlet of the GI tract
is about 3.8 cm long. the anal canal
lined with modified skin that merges with rectal mucosa at the anorectal junction The anal canal
The rectum contains only autonomic nerves but numerous somatic sensory nevers are present in the anal canal and external skin, so people can feel sharp pain.
The internal sphincter is under involuntary control by the autonomic nervous system.
The sphincters keep the anal canal tightly closed
The external sphincter surrounds the internal sphincter and is under voluntary control.
The intersphincteric groove separates the internal and external sphincter and is palpable.
The anal columns (or columns of morgagni) are folds of mucosa.
anal columns extend vertically down from the rectum and end in the anorectal junction.
The anorectal junction isn’t palpable.
The rectum is 12 cm long and is the distal portion of the large intestine
A hemorrhoid is an enlarged vein in the anal column
3 transverse folds of the interior of the rectum Valves of Houston
The peritoneum covers only the upper 2/3’s of the rectum
The prostate gland lies in front of the anterior wall of the rectum and 2 cm behind the symphysis pubis
The prostate gland has 15 to 30 ducts that open into the urethra
The prostate secretes a thin, milky, alkaline fluid that helps sperm viability.
The prostate is 2.5 cm long and 4 cm in diameter
The two lobes of the prostate are separated by a shallow groove called the median sulcus.
where are the seminal vesicles located on the prostate gland on either side
the seminal vesicles secrete fluid that is rich in fructose, which nourishes the sperm and contains prostaglandins
The bulbourethral is about the size of a pea
the bulbourethral is inferior to the prostate and secretes a clear, viscid mucus.
In a female, The uterine cervix lies in front of the anterior rectal wall and may be palpated through it.
In an adult, The combined length of the anal canal and the rectum is 16 cm.
The sigmoid colon is 40cm long and only accessible through examination.
The sigmoid colon extends from the iliac flexure of the descending colon and ends at the rectum.
The first stool in newborns is dark green in color and occurs within 24-48 hours.
Response to eating and having a stool is called the gastrocolic reflex.
Voluntary control of the anal sphincter can’t occur until the nerve supplies have become fully myelinated.
BPH is an enlarged prostate, and occurs in 1 of 10 males older than 40.
Dyschezia is pain due to a local condition, hemorrhoid, fissure or constipation.
Black tarry stool indicates upper GI bleeding with blood being partially digested.
Red blood in stools occurs with GI bleeding or local bleeding around the anus and with anal and rectal cancer.
Gray, Clay color stools indicate absent bile pigments (jaundice).
The anus normally looks moist and hairless, with coarse, folded skin that is more pigmented that the perianal skin.
A soft, slightly movable mass may be a polyp.
If a Hematest is positive it means that there is occult blood in the stool.
Meconium is the first stool that a baby passes, usually within 24-48 hours.
To assess a newborns anal reflex gently stroke the anal area and note a quick contraction of the sphincter
The external female genitalia are called the vulva, or pudendum.
The mons pubis is a round, firm pad of adipose tissue covering the symphysis pubis.
The mons pubis is covered with hair in an inverted triangle after puberty.
The labia majora are two rounded folds of adipose tissue that extend down the mons pubis around the perineum.
Inside the labia majora are two smaller, darker folds of skin called the labia minora.
labia minora join anteriorly to form the clitoris.
The clitoris is a small, pea-shaped erectile body that is sensitive to touch.
The urethral meatus appears 2.5 cm posterior to the clitoris.
The paraurethral gland (Skene’s ) are not visible but open posterior to the urethra at 5 an 7 o’clock.
The vestibular (bartholin’s) gland are on either side and posterior to the vaginal orifice and secrete a clear lubricating mucus during intercourse.
The vagina is a flattened, tubular canal extending up and backward into the pelvis.
The vagina is 9 cm long and sits between the rectum posteriorly and the bladder and urethra anteriorly.
The os is a smooth doughnut shaped area with a small circular hole
the uterus is a pear shaped, thick-walled, muscular origin
the uterus is flattened and measures 5.5 to 8 cm long by
two pliable, trumpet shaped tubes that are 10 cm in length the fallopian tubes
are located on each side of the uterus ovaries
the ovaries are oval shaped, 3 cm long by 2 cm wide
serves to develop ova (eggs) and the female hormone the ovaries
the first signs of puberty are breast and pubic hair development which begins between 8 in a half to 13 yrs old
tanner's table is on the 5 stages of pubic hair development
cervix softens is called goodell sign
goodell signs start between 4 to 6 weeks
vaginal mucosa and cervix looks cyanotic are chadwicks sign
chadwicks sign start between 8-12 weeks
isthmus of the uterus softens is known as the hegar sign
hegar sign happens between 6 to 8 weeks
during pregnancy the uterus increases its capacity by 500-1000 times
menopause is the cessation of menses
menopause usually occurs around 48-51 years old
during menopause the ovaries stop producing progesterone and estrogen
infibulation is known as a female circumcision or female genital mutilation
invasive surgical procedure done on girls before puberty infibulation
gravida is the number of pregnancies
para is the number of births
menstrual cycle is normally every 18 to 45 days
amenorrhea is the absents of menses
menstrual duration is an average of 3 to 7 days
menorrhagia is known as heavy menses
begin cervical cancer screening within 3 years after first vaginal intercourse or age 21 years, continue annually until age 30.
in women over 30, who have had 3 consecutive normal pap tests women may be screened every 2 to 3 years
urge incontinence is involuntary urine loss from overactive detrussor muscle in bladder
stress incontinence is involuntary urine loss with physical strain, sneezing, or coughing
toilet training begins normally between the ages of 2 to 2 in a half
infertility is considered after 1 year of engaging in unprotected sexual intercourse without conceiving
for pap tests a woman should be put in lithotomy position and feet in stirrups
external genitalia skin tone should be color should be even, labia minora are a darker pink
labia majora are normally symmetric, plump and well formed
to assess the bartholins glands, palpate the posterior parts of the labia majora with the index finger in the vagina and your thumb outside
normally the color of the cervix is pink and even
during the 2nd month of pregnancy the color of the cervix appears blue (chadwick's sign)
after menopause the color of the cervix is pale
the os is small and round in nulliparous woman ( haven't had a baby yet)
cervical eversion, or ectropion may occur normally after vaginal deliveries
nabothian cysts are benign growths that commonly appear on the cervix after childbirth
pap tests screen for cervical cancer and not endometrial or ovarian cancer
acetic acid wash test screens for asymptomatic human papillomavirus (HPV)
the male genital structures include the penis and scrotum externally and the testis, epididymis and vas deferens internally
the penis is composed of three cylindric columns of erectile tissue
the penis has two corpora cavernosa and one corpus spongiosum
at the distal end of the corpus spongiosum expands into a cone of erectile tissue called the glans
where the glans joins the shaft is the corona
conduit for both the genital and urinary systems urethra
over the glans the skin folds in and back on itself forming a hood known as the foreskin or prepuce
the scrotum is a loose protective sac
the cremaster muscle controls the size of the scrotum by responding to ambient temperature.
the scrotum keeps the testes 3 degrees C below abdominal temperature
produces sperm and is suspended vertically by a spermatic cord is a testis
the main storage site of sperm is known as the epididymis
the epididymis is a comma shaped structure, curved over the top and the posterior surface of the testis
the vas deferens joins with the duct of the seminal vesicle to form the ejaculatory duct
the ejaculatory duct empties into the urethra
the lymphatics of the penis and scrotal surface drain into the inguinal lymph nodes
puberty in males begins between the ages of 9 1/2 and 13 1/2 years
the first sign of puberty in males is enlargement of the testis
for male puberty, stages are defined in Tanner's sexual maturity ratings SMR
decreased kidney function or kidney damage lasting 3 months or longer is known as chronic kidney disease
chronic kidney disease can lead to end stage renal disease (ESRD)
ESRD is when the person survives only by kidney transplant or dialysis
phimosis is the narrowed opening of prepuce so cannot retract the foreskin
paraphimosis is the painful constriction of glans by retracted foreskin
hypospadias is when the urethral meatus opens on the ventral (under) side of the glans penis
epispadias is when the urethral meatus opens on the dorsal (upper) side of the glans penis
scrotal swelling may be taut and pitting, occurs with heart or renal failure or with local inflammation
the CNS includes the brain and spinal cord
the PNS includes all the nerve fibers outside the brain and spinal cord: 12 pairs of cranial nerves and 31 pairs of spinal nerves and all their branches
sensory messages are afferent and go TO the CNS from sensory receptors
motor messages are efferent and are FROM the CNS out to muscles and glands
cerebral cortex is the cerebrum's outer layer of nerve cell bodies
cerebral cortex looks grey because it lacks myelin
myelin is the white insulation on the axon that increases the conduction velocity of nerve impulses
the cerebral cortex is the center for human's highest functions, governing thought, memory, reasoning, sensation and voluntary movement
the left hemisphere is dominant in most (95%) people, including those who are left-handed
each hemisphere is divided into 4 lobes
the frontal lobe has areas concerned with personality, behavior, emotions, and intellectual function
the parietal lobe's postcentral gyrus is the primary center for sensation
the occipital lobe is the primary visual receptor center
the temporal lobe behind the ear has the primary auditory reception center with functions of hearing, taste, and smell
wernicke's area in the temporal lobe is associated with language comprehension
broca's area in the frontal lobe mediates motor speech
when the broca's area is messed up a person cannot talk, they understand language and know what they want to say but can't find the words to say
the basal ganglia are the large bands of gray matter buried deep within the two cerebral hemispheres that form the subcortical associated motor system
the thalamus is the main relay station where the sensory pathways of the spinal cord, cerebellum and brainstem form synapses
the hypothalamus is a major respiratory center with basic vital functions: temperature, appetite, sex drive, heart rate and BP
the cerebellum is a coiled structure located under the occipital love that is concerned with motor coordination of voluntary movements, equilibrium and muscle tone
the brainstem is the central core of the brain consisting of mostly nerve fibers
cranial nerves 3-12 originate from nuclei in the brainstem
the midbrain is the most anterior part of the brainstem
the pons is an enlarged area containing ascending sensory and descending motor tracts
the medulla is the continuation of the spinal cord in the brain that contains all ascending and descending fiber tracts
the spinal cord is the long, cylindric structure of nervous tissue about as big around as the little finger
the spinothalamic tract contains fibers that transmit the sensations of pain, temperature and crude or light touch
stereognosis is where a person can identify an object by touch without looking
the extrapyramidal tracts include all the motor nerve fibers originating in the motor cortex, basal ganglia, brainstem, and spinal cord that are outside the pyramidal tract.
the upper motor neurons are a complex of all the descending motor fibers that can influence or modify the lower motor neurons
upper motor neurons are located completely within the CNS
upper motor neuron diseases are cerebrovascular accident, cerebral palsy and multiple sclerosis
lower motor neurons are located mostly in the peripheral nervous system
examples of lower motor neurons diseases are spinal cord lesions, poliomyelitis, and amyotrophic lateral sclerosis
a nerve is a bundle of fibers outside the CNS
reflexes are basic defense mechanisms of the nervous system
there are four types of reflexes deep tendon, superficial, visceral, pathologic
cranial nerves enter and exit the brain rather than the spinal cord
dermal segmentation is the cutaneous distribution of the various spinal nerves
dermatome is a circumscribed skin are that is supplied mainly from one spinal cord segment through a particular spinal nerve
the thumb, middle finger and fifth finger are each in the dermatomes of C6, C7, and C8
the axilla is at the level of T1
the nipple is at the level of T4
the umbilicus is at the level of T10
the groin is in the region of L1
the knee is at the level of L4
paresis is a partial or incomplete paralysis
dysmetria is the inability of to control the distance, power and speed of a muscular action
dysarthria is the difficulty forming words
dysphasia is the difficulty with language comprehension of expression
cranial nerve 1 is the olfactory nerve
cranial nerve 2 is the optic nerve
cranial nerve 3 is the oculotmotor nerve
cranial nerve 4 is the trochlear nerve
cranial nerve 5 is the trigeminal nerve
cranial nerve 6 is the abducens nerve
cranial nerve 7 is the facial nerve
cranial nerve 8 is the acoustic nerve
cranial nerve 9 is the glossopharyngeal nerve
cranial nerve 10 is the vagus nerve
cranial nerve 11 is the spinal nerve
cranial nerve 12 is the hypoglossal nerve
positive romberg test is a loss of balance that occurs when closing the eyes
Created by: 691650210