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Where is cyanosis especially evident? Lips, eyelids, nails
What causes stretch marks? Marked and relatively fast size increase
What layers of skin do superficial lacerations affect? Epidermis and maybe superficial layer of dermis
Do superficial lacerations bleed? If they extend into dermis
What layers of skin do deep lacerations affect? Deep layer of dermis, extending into subcutaneous tissue or beyond
What layers of skin are affected in a 1st degree burn? Epidermis
What are symptoms of a 1st degree burn? Erythema, pain, edema, desquamation (peeling) - no significant scarring
What layers of skin are affected in a 2nd degree burn? Epidermis and either superficial or deep dermis
What is another name for a 1st degree burn? Superficial burn
What is another name for a second degree burn? Partial thickness burn
What are symptoms of a 2nd degree burn involving superficial dermis? Blistering, pain
What are symptoms of a 2nd degree burn involving deep dermis? Loss of skin, pain
What degree of burn is considered to be the most painful and why? 2nd degree because nerve endings are being damaged
Are sweat glands and hair follicles damaged in a 2nd degree burn? Only the most superficial parts
What layers of skin are involved in a 3rd degree burn? Entire thickness of skin and perhaps underlying muscle
What is another name for a 3rd degree burn? Full-thickness burn
What are symptoms of a 3rd degree burn? Marked edema, numbness on the burned areas
Why are the burned areas in a 3rd degree burn numb? Because sensory endings are destroyed
T/F: The extent of the burn (% of total body surface affected) is generally more significant than the degree (severity in terms of depth) True
What is the Rule of Nine? Body is divided into ares that are approximately 9% or multiples of 9% of total body surface
What is another name for accessory bones? Supernumerary
When do accessory bones develop? When additional ossification centers appear and form extra bones.
What do studies show that extra bone really is? Missing part of the main bone
Where can accessory bones commonly be found? In the foot
What are small, irregular wormlike bones? Sutural bones (wormian bones)
What is reduction of a fracture? Broken ends of bone brought together, approximating their normal position
How do bones heal? Surrounding fibroblasts proliferate and secrete collagen which forms a collar of callus to hold bones together. Soon the callus calcifies and is eventually resorbed and replaced by bone
How can the age of a young person be determined? By studying the ossification centers in bones
What are the main criteria for studying ossification centers? 1. Appearance of calcified material in the diaphysis and/or epephyses 2. Disappearance of the radiolucent line representing the epiphysial plate (absence of this line indicates that epiphysial fusion has occured
How much earlier does the fusion of the epiphyses with the diaphysis occur in girls compared to boys? 1-2 years earlier in girls
What is the dense line of provisional calcification that occurs when degeneration of cartilage cells in the columns continues, called? Lines of arrested growth
What is avascular necrosis? Death of bone tissue due to loss of arterial supply to an epiphysis or other parts of a bone
What is osteochondroses? Group of clinical disorders of epiphyses in children that result from avascular necrosis of unknown etiology
What is another name for the skullcap? Calvaria
What are fontanelles? Wide areas of fibrous tissue formed from sutures at sites where an infant's cranium does not make full contact with each other
Which fontanelle is most prominent and is known as the soft spot? Anterior fontanelle
What might a depressed fontanelle indicate? Dehydration
What is another name for DJD? OA
What is DJD often accompanied by? Stiffness, discomfort, and pain
What is arthroscopy? Surgical procedure in which the synovial joint is examined by inserting a cannula and an arthroscope into it
What is often the caused of DOMS? Eccentric muscle contractions
How much can muscles lengthen before injury? Typically about 1/3 of their resting length
What are the two methods of muscle testing? 1. Person performs movements that resist those of examiner: Person keeps forearm flexed while examiner tries extending it 2. Examiner performs movements that resist those of person: Examiner asks person to flex forearm while examiner resists efforts
In compensatory hypertrophy, how does the myocardium respond to increased demands? By increasing the size of its fibers
Do cardiac muscle cells divide (do they regenerate)? No
What is the most common acquired disease of arteries? Ateriosclerosis
What is arteriosclerosis characterized by? Thickening and loss of elasticity of arterial walls
What is a common form of arteriosclerosis and what is it associated with? Atherosclerosis - buildup of fat (mainly cholesterol)
What are varicose veins? Abnormally swollen, twisted veins
How do varicose veins form? When walls of veins lose their elasticity, they become weak. These weakened veins dilate under the pressure of supporting a column of blood against gravity
What is the most common type of cancer? Carcinomas
How are carcinomas most commonly spread? Lymphogenously
Are cancerous nodes painful when compressed? No
What type of tissue do carcinomas affect? Epithelial
What is the most common route for sarcomas? Hematogenous route
Which type of cancer is more malignant? Sarcomas
What type of tissue do sarcomas affect? Connective tissue
What type of blood vessels does metastasis usually occur in and why? Veins because there are more of them and they have thinner walls
What are the most common sites of secondary sarcomas? Liver and lungs
What is lymphedema? Localized type of edema that occurs when lymph does not drain from an area of the body
What happens after a back injury as a protective mechanism? Spasm
What is a spasm? Sudden involuntary contraction
What are spasms attended by? Cramps, pain, and interference with function
How is the patient placed when trying to examine posterior segments of the lungs in the triangle of ascultation? Fold arms across chest and flex trunk
When can the axillary nerve be injured? During a humeral fracture because it wraps around the surgical neck of it
What can happen with incorrect use of crutches? Compression of axillary nerve
What is the cutaneous branch of the axillary nerve and what does it innervate? Superior lateral cutaneous nerve of the arm which innervates lateral side of proximal part of arm
What are the most commonly affected areas regarding osteoporosis? Neck of femur, bodies of vertebrae, metacarpals, and radius
What is a laminectomy? Surgical excision of one or more spinous processes and adjacent supporting vertebral laminae
Why is a laminectomy often performed? To relieve pressure on SC or nerve root
What is one of the most common injuries of cervical vertebrae? Fracture of vertebral arch of axis
What part of the vertebral arch of the axis is typically fractured? Pars interarticularis
What is a fracture to the pars interarticularis called? Traumatic spondylolysis of C2
How does traumatic spondyloysis of C2 usually occur? Whiplash
What is spina bifida occulta? Neural arches of L5 and/or S1 fail to develop normally and fuse posterior to vertebral canal
Since spina bifida occulta is usually concealed by the overlying skin, how is it indicated? By a tuft of hair
What is a more severe form of spina bifida occulta? Spina bifida cystica
What is spina bifida cystica? One or more vertebral arches may fail to develop completely
What is spinal bifida cystica associated with? Herniation of meninges
What do severe forms of spina bifida result from? Neural tube defects, such as the defective closure of the neural tube during the 4th week of embryonic development
What happens to the nuclei pulposi with age? Dehydration and loss of elastin while gaining collagen
Do intervertebral discs increase or decrease in size with age? Increase
Where do herniations of nucleus pulposus usually extend? Posterolaterally
What is the most common level for disc protrusions to occur? L4-L5 or L5-S1
What is sciatica? Pain in the lower back and hip that radiates down the back of the thigh and into the leg that is caused by a herniated lumbar IV disc that compresses and compromises the L5 or S1 component of the sciatic nerve
What is another name for bone spurs? Osteophytes
What is the general rule regarding which nerve root is compressed due to a herniated disc? When an IV disc protrudes, it usually compresses the nerve root numbered one inferior to the herniated disc; however in the cervical vertebrae it is usually the same disc and nerve
T/F: The transverse ligament of the atlas is stronger than the dens of the C2 vertebrae True
When does atlanto-axial subluxation occur? When the transverse ligament of the atlas ruptures which sets the dens free
Dislocation of the transverse ligament rupture is most likely to cause what? SC compression
What 5 categories of structures receive innervation in the back and can be sources of pain? 1. Fibroskeletal structures: periosteum, ligaments, anuli fibrosis 2. Meninges 3. Synovial joints 4. Muscles 5. Nervous tissue
What part of bone does osteoporosis affect? Trabeculae of spongy bone
What is excessive lumbar lordosis characterized by? Anterior tilting pelvis
What is functional scoliosis caused by? Difference in leg length with compensatory pelvic tilt
What is a rhizotomy? Procedure done to relieve intractable pain or spastic paralysis. Done in the nerve roots because this is the only site where M and S fibers of spinal nerves are segregated
What are the only neurons to proliferate (grow in numbers) in the adult nervous system? Olfactory epithelium
What is paresthesia? Pressure on a nerve (pins and needles)
What is a crushing nerve injury? Injury that damages or kills the axons distal to the injury site; however nerve cell bodies usually survive and the nerve's connective tissue covering remains intact; no surgical repair
What is a cutting nerve injury? One that requires surgical intervention
What is anterograde degeneration? Degeneration of axons detached from their cell bodies
What is the Saturday Night Syndrome? Intoxicated individual who passes out with a limb dangling across the arm of a chair which causes more serious and often permanent, paresthesia
Do the lumbar spinal nerves increase in size from S to I or I to S? S to I
What is a lumbar puncture? Withdrawal of CSF from the lumbar cistern
What is a lumbar puncture done? Pt is sidelying with back and hips flexed
What does a lumbar puncture go through? Dural sac
Where is spinal anesthesia injected? Subarachnoid space
What is a common symptom of receiving a lumbar puncture? HA
Where is an epidural anesthesia given? Extradural space or through the sacral hiatus (caudal epidural anesthesia)
What are important arteries in the SC? Segmental medullary arteries which supply blood to anterior and posterior spinal arteries
What is lumbar spondylosis? Group of bone and joint abnormalities (DJD)
What is colostrum? Cream white to yellowish premilk fluid that may be secreted from the nipples during the last trimester of pregnancy and during initial episodes of nursing
How is the breast divided? Into 4 quadrants
What is lymphedema? Excess fluid in subcutaneous tissue
How does a carcinoma appear on a mammogram? Large, jagged density
Where are surgical incisions usually made in breasts and why? Inferior breast quadrant because these quadrants are less vascular
What is a simple mastectomy? Breast is removed down to the retromamary space
What is a radical mastectomy? More extensive surgical procedure that involves removal of the breast, pectoral muscles, fat, fascia, and as many lymph nodes as possible in the axilla and pectoral region
What is a lumpectomy or quadrantectomy? Current practice that often only removes the tumor and surrounding tissue
What is another name for a lumpectomy or quadrantectomy? Breast-conserving surgery
What is polymastia mean? Supermumerary breasts
What does polythelia mean? Accessory nipples
What is the embryonic mammary crest? The milk line - line extending from axilla to the groin
Why is breast cancer in men typically associated with more serious consequences? Because it usually isn't detected until extensive metastases have occured
What is gynecomastia? Breast hypertrophy in males
What can be a cause of gynecomastia? Imbalance between estrogenic and androgenic hormones or from change in the metabolism of sex hormones by the liver
What is one of the most frequently fracture bones? Clavical
MOA for clavicular fx FOOSH or falling directly on shoulder
What is the weakest part of the clavicle? Junction of its middle and lateral thirds
After a clavicular fx what prevents a dislocation of the ACJ? Coracoclavicular ligament
Why does the shoulder drop after a clavicular fx? Because the trap is unable to hold the lateral fragment and weight of upper limb
Why does the medial fragment of the clavical elevate after a fracture? Because the SCM elevates it
What changes occur when there is an absence of the pectoralis major? Nipple is more inferior and anterior axillary fold is absent
What RTC tendon is most commonly ruptured? Supraspinatus
Created by: 1185240090
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