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216 Cards in this Set
- Front
- Back
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Skull
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is a rigid bony ox that protects the brain and special sense organs
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Location of the cranial bones
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frontal, parietal, occipital, and temporal
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Sutures
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meshed immovable joints in the cranial bones. Allowed for the mobility and change in shape needed for the birth process
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Coronal Sutures
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separates the head lenghtwise btw two parietal bones
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lambdoid suture
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separates parietal bones crosswise from occipital bones
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14 facial bones articulates at suture except
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mandibule
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the cranium is supported by the cervical vertebra
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c1 the atlas
c2 the axis and down to c7 |
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C7 vertebrae
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has a long spinous prcess that is palpable when the head is flexes. Landmark, vertebrae prominients
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Cranial nerve VII
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facial nerve mediated the expression on muscle of the face
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facial structures are
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symmetric.
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Facial sensation of pain are mediated by
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three sensory branches of cranial nerve V (trigeminal nerve)
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Neck
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delimited by the base of the skull and inferior border of the mandible above, and by the manubrium sterni, the clavicle, the first rib, and the first thoracic vertebra below
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Neck is the
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passage of many structures. Blood vessels, nerves, lymphatics, etc
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Major neck muscles
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sternomastoid and the trapezius
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The sternomastoid muscle divides each side of the neck into two triangles
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anterior triangle: front, btw sternomastoid and midline
posterior triangle: behind sternomastoid and the trapezius |
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Thyroid gland
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endocrine gland with a rich blood supply. It located in the trachea in the middle of the neck
T4 & T3=cellular metabolism |
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Cricoid
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cartilage or upper trachial ring located just above the thyroid isthmus, within about 1cm
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Thyroid cartilage
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is above the cricoid cartilage
prominent adam's apple in males |
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Hyoid Bone
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the highest, palpated high in the neck at the level of the floor mouth
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head and neck have a rich supply of lymph nodes
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Preauricular: in front of the ear
Posterior auricular: superficial to the mastoid process Occipital: at the base of the skull Submental: midline, behin the tip of the mandible Submandibular: halfway btw the angle and the tip of the mandible Jugolodigastric: under the angle of the mandible. Superficial Cervical: overlaying the strnomastoid muscle Deep Cervical: Deep under the sternmastoid muscle Posterior cervical: posterior triangle along the edge of the trapezius Supraclavicular: bove and behind the clavicle |
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Lymphatic system
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a extensive vessel systems, which separate from the cardiovascular system and is phylogentically older. Major part of the immune system. Allow the flow of clear watery fliud from the tissues in the circulation
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Lymph Nodes
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are small, oval clusters of lymphatic tissue that are set at intervals along the lymph vessels like beads on a string
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Fontanels
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in bone of the neonatal skulls. Soft spots
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What is the reason for the fontanels/soft spots?
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The soft spots or fontanels allow for growth of the brain during the first year of life.
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What is the purpose of the immune system.
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Detect and eliminate foreign substances from the body Allow the flow of clear watery fluid from the tissue spaces into circulation. Filter the lymph and engulf pathogens, preventing
harmful substances from entering the circulation. |
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During pregnancy the thyroid gland
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enlarges slightly
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Headaches
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are subjective, history is important. Location. Mild, moderate of severe. Precipitating factors. Associated factors. Family history.
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Red flag is a severe headache
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in an adult or child who never had one before
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Head injury
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subjective. Loss of coinciousness before a fall, level of conciousness
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Dizziness
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determine what exactly the person feels.
Dizziness is a light-headed, swimming sensation, feeling of falling |
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true vertigo
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is true rotational spinning from neurologic disease
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Objective vertigo
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the person feels like the room spins
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Subjective vertigo
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the perception is that the person spins
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Neck pain
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onset, location associated symptoms, stress, coping strategies
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Acute onset of neck stiffness with headache and fever occurs
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with meningeal inflammation
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Dysphagia
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difficulty swallowing
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Tenderness in the neck suggest
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acute infection
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Smoking and chewing tobacco
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increase risk for oral and respiratory cancer
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smoking and large alcohol consumption together
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increase the risk for cancer
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Forceps
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increase the risk for caput succedaneum, cephalhematoma, and Bell's palsy
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the head. Normocephalic
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objective data. Denotes symmetric skull =related to the body size
abnormalities: microcephaly--> small macrocephalic-->large |
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To assess shape of the head
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use your fingers the the person's hair and palpate the scalp. Note lumps, depression, or abnormal protrussions
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Inspect the face
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note symmetry, facial expression, movement,mood.
Edema in the face occurs first around the eyes and cheeks |
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the Neck inspection and palpation
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Symmetry
Range of motion Ask the person to touch the chin to the chest, turn head to the right and left, try to touch ear to the shoulder, head backward. |
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Lymph nodes
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using a gentle circular motion of your fingerpads, palpate...check for tenderness, both hans symmetrically.
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If Lymph nodes are enlarged or tender
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check the area they drain for the source of the problem
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Lymphadenopathy
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enlargement of the lymph nodes >1 cm from infection, allergy and neoplasm
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trachea
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is pushed to the unaffected or healthy
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Trachea
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is pulled toward the affected side wtih large atelectasis or fibrosis
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Thyroid gland
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difficult to palpate. Glass of water inspect when the person swallows
Posterior and anterior approach |
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Caput succedaneum
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edematous swelling and acchyymosis of the presenting part of the head caused by birth trauma. Resolves during the first few days of life
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Cephalhematoma
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subperiosteal hemorrhage, birht trauma. Resolves first few days. Risk ofr jaundice as the red bloos cells are broken down and reabsorbed
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Craniosynostosis
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severe deformity caused by premature closure of the sutures
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Tonic neck reflex beyond 5 months may indicate
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brain damage
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Head lag after 4 months may indicate
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mental or motor retardation
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in infants short neck or webbing indicates
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congenital abnormality down or turner syndrome
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Supraclavicular nodes enlarge with
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Hodkins disease
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Percussion with your plexor finger against the head surface
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yield a resonant or cracked pot sound which is normal before closure of the fontanels
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Hydrocephalus
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obstruction of drainage of cerebrospinal fliud results in excessive accumulation, increase intracranial pressure and enlargement of the head
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Paget's disease of bone
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osteitis deformans. bowed long bone, frontal bossing, and enlargement of skull bones acorn shaped cranium.
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Acromegaly
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excessive secretion of growth hormone from the pituitary gland
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Torticollis
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hematoma in one sternomastoid muscle.
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Goitter
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a chronic enlargement of the thyroid gland. low in iodine
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Fetal alcohol syndrome
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growth and developmental abnormalities facial malformations at birth.
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Bells Palsy
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a lower motor neuron lesson (peripheral)complete paralysis of one half of the face
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Nose
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is the first segment of the respiratory system, Superior part: bridge, and the free corner is the tip
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Septum
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divide the nasal cavity into two slitlike air passages
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Turbinates
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lateral walls of each nasal cavity contain three parallel bony projections-superior middle and inferior
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Place of the most common site of nosebleeds
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kiesselbach plexus
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Location of the olfactory receptors
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lie at the roof of the nasal cavity and in the upper one third of the septum
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Paranasal sinuses
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are air filled pockets within the cranium. Communicate the nasal cavity and are lined with the same type of ciliated mucous membrane
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occlusion of the paranasal sinuses
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cause inflammation or sinusitis
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two pairs of sinuses are accessible to examination
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The frontal sinuses: frontal lobe above and medial to the orbirts
Maxillary sinuses: in the maxilla The other two set are smaller and deeper:the ethmoid btw the orbits and the sphenoid deep within the skull in the sphenoid bone |
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Mouth
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is the first segment of the digestive system and an airway for the respiratory system
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Hard Palate
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made up of bone and is a whitish color
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Soft palate
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posterior to the hard palate
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Frenulum
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is a midline fold of tissue that connects the tongue to the floor of the mouth
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Adults have
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32 permanent teeths-16 in each arch
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Uvula
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Free projection hanging down fro the middle of the soft palate
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Tongue
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is a mass of striated muscle arranged in a crosswise pattern so that it can change shape and position
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Salivary glands
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Three pairs:
1) parotid gland: largest 2) submandibular: walnut 3) Sublingual: Smallest |
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Throat
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or pharynx, area behind the mouth and nose
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Oropharynx
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is separated from the mouth by a fold of tissue on each side.
Behind this fold are the tonsils |
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Nasopharynx
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is continuos with the oropharynx above the oropharynx and behind the nasal cavity. Eustachian tube openinga
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Malocclusion
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tooth loss and the remain teeth drift caused malocclusion
1)tooth loss 2) muscle imbalance, headaches 3) stress on the temporomandibular join. cant open fully the mouth |
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Bifid uvula
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a condition in which the uvula split either completely or partially, occurs in 18% if some American Indian groups and in 10% of Asians
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Cleft palate and lip are most common
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in Asian-American newborns and American Indians. Less common in Caucasians, least common in African Americans.
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Torus palatinus
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a benign bony ridge runnig inn the middle of the hard palate
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Rhinorreah
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occurs with cold, allergies, sinus infections, trauma
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Leukoedema
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a milky, bluish-white, opaque appereance of the buccal mucosa
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Nose Subjective data
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Discharge
Frequent colds Sinus pain Trauma Epistaxis Allergies Altered smell |
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Mouth and throat subjective data
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Sores or lesions
Sore throat Bleeding gums Toothache Hoarseness Dysphagia Altered taste Smoking, alcohol consumption Self-care behaviors |
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Epistaxis
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occurs with trauma, vigorous nose bleeding, foreign body
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untreated strep throat
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lead to the complication of rheumatic fever
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Hoarseness
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difficulty producing sound. Causes: overuse of the voice, upper respiration infection (URI) chronic inflammation, lesions, neoplasm
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Xerostomia
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dry mouth, is a side effect of many drugs, antidepresant, anticholinergics, antispasmodics, antihypertensives
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Objective date nose
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symmetric, midline. inspect and palpate
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Absence of sniff indicates
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obstruction. explore using nasal speculum
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nasal cavity
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Holding the otoscope
avoid pressure on theNasal septum Turbinates polyps: benign growths chronic allergies |
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Rhinitis
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nasal mucosa is swollen and bright red with URI
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Palpate the sinus areas
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are tender to palpation in persons with chronic allergies and acute infection (sinusitis)
normal: feel pressure without pain Trans illumination |
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Gingivitis
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gums bleed with slightly pressure
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Excess saliva and drooling occur
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with gingivostomatitis and neurologic dysfunction
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Enlarged tongue occurs
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with mental retardation, hypothyroidism, acromegaly
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small tongue
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dehydration
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Stensen's duct
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the opening of the parotid salivary gland
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Mouth - inspect
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Lips
Teeth and gums Tongue Buccal mucosa Palate and uvula |
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Fordyce granules
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small, isolated or yellow papules on the mucosa of cheek, tongue and lips
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Oral kaposi sarcoma
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most common early lession in people with AIDS
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Dappled brown patches are present
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with Addison's disease
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With cranial nerve XII damage
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the tongue deviates toward the paralyzed side
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diabetic ketoacidosis
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has a sweet fruity breath odor
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Acetone smell
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children with malnutrition or dehydration
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Ammonia breath odor
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with uremia
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foul fetid odor with
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dental or RI
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Alcohol odor
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with alcohol ingestion or chemicals
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Mouse like smell
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with diphtheria
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Male Genitalia structures
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includes:
penis and scrotum externally; testis, epididymis an vas deferent internally |
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Penis
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composed of three cylindric columns of erectile tissue: two corporea cavernosa on the dorsal side and a corpus spongiosum ventrally
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Rugae
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thin skin lying in fold in the scrotal wall
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Cremaster muscle
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controls the size of the scrotum by responding to ambient temperature
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Testis
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produces sperm. solid oval shape
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Sperm are transported along a series of ducts
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Epididymis: main storage of sperm
vas deferens: lower part of epididymis spermatic cord: ascend along of the inguinal canal into the abdomen Ejaculatory duct: empties into the urethra |
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The lymphatic of the penis and scrotal surface drain into
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the inguinal lymph nodes, whereas those of the testes drain into the abdomen.
abdominal lymph nodes are not accesible to clinical examination |
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Inguinal area
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or groin, isn the juncture of the lower abdominal wall and the thigh. Diagonal borders are the anterior superior iliac spine and the symphysis pubis.
Btw these landmarks lies the inguinal ligament |
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Inferior to the inguinal ligament is the
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femoral canal
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Inguinal canal and femoral canal are useful because
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are potential sites for a hernia, which is a loop of bowel protruding through a weak spot in the musculature
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testes descend along the inguinal canal
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before birth to 2cm long and cm wide
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Adolescent
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puberty begins btw the ages of 9 1/2 and 13 1/2 years.
First sign enlargement of the testis, pubic hair and penis size increase |
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Nocturia
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occurs together with frequency and urgency in urinary tract disorders
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Dysuria
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burning is common with acute cystitis, prostatis, urethritis
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Hesitancy
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straining
loss of force and decreased caliber terminal dribbling sense of residual urine recurrent episodes of acute cystitis (progressive prostatic obstruction) |
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Usual urine
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clear or discolored
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Cloudy urine
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in urinary tract infection
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hematuria
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presence of blood in urine
danger sign that warrants futher workup |
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Urge incontinence
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involuntary urine loss from overeactive detrusor muscle in bladder causing urgent need to void
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Stress incontinence
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involuntary urine loss with physical strain, sneezing, or coughing to weakness of pelvis floor
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Questions about sexual activity
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communicates acceptance
Establishe a database screen sexual problems questions should be objectives |
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Nocturnal enuresis
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involuntarily passing urine at night after age 5 to 6 years
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Permission statement
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often boys your age experience..... conveys that it is normal and all right to think or feel a certain way
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Ubiquity approach
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when did you..? rather than do you...? this methiod is less threatening bc it implies that the topic is normal and unexceptional
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STI
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gonorrhea, herpes, AIDS, chlamydia, venereal warts, syphilis
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If an erection occurs during an examination
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do not leave the room and do not stop
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Phimosis
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narrowed opening of prepuce so cannot retract the foreskin
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Paraphimosis
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painful constriction of glans by retracted foreskin
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Hypospadias
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ventral location of the meatus
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Epispadias
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dorsal location of meatus
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Stricture
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narrowed opening
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abnormalities in the scrotum
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hernia, tumor, orchitis, epididymitis, hydrocele, spermatocele, varicocele
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Proteinuria
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indicates glomerular disease in the nephron
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Glycosuria
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hyperglycemia in diabetes
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Cryptorchidism
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undescended testes. common in premature infants
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Hydrocele
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is a cystic collection of serous fluid in the tunica vaginalis, surrounding the testis
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Teach testicular examination
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T = Timing
S = Shower E = Examination points |
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Peyronie disease
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hard nontenderm subcutaneous plaques palpated on dorsal or lateral surface of penis. assymetric, painful erection
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Vulva
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external genitalia (pudendum)
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mons pubis
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round firm pad of adipose tissue covering the symphysis pubis
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hymen
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thin circular crescent shaped fold that may cover part of the vaginal orifice or may be absent completely
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vestibular Batholin's glands
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secrete a clear lubricating mucus during intercourse
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health history questions
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Menstrual history
Obstetric history Menopause Self-care behaviors Urinary symptoms Vaginal discharge Additional history for preadolescents and adolescents Start of period Sex Sexually transmitted disease Sexual abuse Additional history for the aging adult Postmenopausal bleeding Atrophic vaginitis Uterine prolapse Sexual satisfaction |
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Nulliparous female cervix
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appear as a smooth doughnut shaped area with a small circular hole or os
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Parous female cervix
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slightly enlarged and irregular
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it dips down the rectum and cervix form the
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rectouterine pouch or cul-de-sac of Douglas
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First signs of puberty is females
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breast and pubic hair development ages o 8 1/2 and 13 years
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BMI is a major consideration
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when a clinician evaluates pubertal development
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Menopause
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cessation of the menses. Ovaries stop producing progesterone and estrogen. Uterus shrinks, ovaries atrophies. Vagina becomes shorter, narrower and less elastic. dyspareunia(pain during intercourse)
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menarche
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onset, initiation
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amenorrhea
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absent menses
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menorrhagia
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heavy menses
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Female examination
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lithotomy position
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Findings external genitalia
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note any pigmented nevus or lesion that woman cannot see. If biopsy
delayed puberty after 13 swelling excoriation, nodules, rash inflammation Polyp Foul smelling irritating discharge |
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Inspection of the cervix
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color
position size Os surface |
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Nabothian cysts
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bening growths that commonly appear on the cervix after childbirth
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Normal cervix
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consistency
contour mobility |
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anal canal
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outlet of the GI tract
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health questions rectal exam
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Usual bowel routine
Change in bowel habits Rectal bleeding or blood in the stool Medications (laxatives, stool softeners, iron) Rectal conditions (pruritus, hemorrhoids, fissure, fistula) Family history Self-care behaviors (diet of high-fiber foods, most recent examinations |
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dyschezia
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pain due to a local condition
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Melena
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black stools may be tarry due to occult blood
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steatorrhea
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excessive fat in the stool
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encopresis
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persistent passing of stools into clothing in a child older than 4 years
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Prostate gland examination
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Size
Shape Surface Consistency Mobility Sensitivity |
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Abdomen
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large oval cavity extending from the diaphragm to the brim of the pelvis
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linea alba
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midline by a tendinous seam
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Viscera
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all internal organs inside the abdominal cavity
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Solid viscera
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liver, pancreas, spleen, adrenal glands, kidneys, ovaries, and uterus
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hollow viscera
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stomach, gallbladder, small intestine, colon, and bladder
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aorta
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is just to the left of midline in the upper art of the abdomen
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RUQ
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Liver, gallbladder, duodenum, head of pancreas, right kidney, hepatic flexure of colon, part of ascending and transverse colon
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LUQ
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Stomach, spleen, left lobe of liver, body of pancreas, left kidney, splenic flexure of colon, part of transverse and descending colon
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RLQ
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Cecum, appendix, right ovary and tube, right ureter, right spermatic cord
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LLQ
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Part of descending colon, sigmoid colon, left ovary and tube, left ureter, left spermatic cord
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subjetive data questions to ask
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Changes in appetite?
Any difficulty swallowing? Any food intolerances? Complaints of abdominal pain? Any nausea or vomiting? Ask about bowel habits. Ask about past abdominal history. Any medications? Nutritional assessment via 24 hour recall. |
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Anorexia
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loss of appetite from GI disease
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Pyrosis
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a burning sensation in esophagus and stomach from reflux of gastric acid
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abdominal pain
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visceral:dull, general, poorly localized
Parietal: sharp, precisely |
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Black stools
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may be tarry due to occult blood (melena) from GI or nontarry from Iron medications
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gray stools
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with hepatitis
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Red blood in stools
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occurs with GI bleeding or bleeding around the anus
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Peptic ulcer disease occurs
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with frequent use of nonsteroidall antiinflammation drugs, alcohol, smoking and helicpbacter pylori infection
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anorexia nervosa
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a serious psychosocial disorder that include loss of appettite, volutnary starvation, grave weight loss
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Contour of the abdomen
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flat
rounded scaphoid protuberant |
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Hernia
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protusion of abdominal viscera through abnormal opening in muscle wall
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Dullness
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occrus over a distended bladder, adipose tissue, fluid, or a mass
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Hyperresonance
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is present with gaseous distention
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hepatomegaly
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indicates liver enlargement
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Liver
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measure height on the right misclavicular line
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Splenic dulness
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ninth to eleventh intercostal space just behind the left midaxillary line
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Kidney
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place one hand over the twelfth rib at the costovertebral angle ont he back
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Test for ascites
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fluid wave and shifting dullness
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enlarged spleen
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if you feel enlarged spleen (three times normal size) refer the person but do not continue to palpate
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Aorta
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widened with aneurysm
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kidneys
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left kidney 1cm higher that right one. Sometimes you feel the lower pole of the right kidney as a round, smooth mas slide between your fingers
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oliopsoas muscle test
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when the acute abdominal pain or appedicities is suspected.
Supine position, lift the right leg straight up, flexing at the hip; then push down over the lower part of the right thigh as the person tries to hold the leg up. negative persons feels no change. positive feel pain in the lower quadrant |
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a bruit
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indicates turbulent blood flow
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Enlarged gallbladder
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acute cholecystitis
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Enlarged kidney
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hydronephrosis, cyst, or neoplasm
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