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Stack #663075
Health Assessment Test #3
Question | Answer |
---|---|
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 |