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109 Cards in this Set
- Front
- Back
- 3rd side (hint)
-Lordosis is a exaggerated curve in what region of the lower spine?
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lumbar
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Lordosis or Scoliosis
common finding in adults who have abdominal obesity… |
lordosis
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Lordosis or Scoliosis
a loss of lumbar curvature |
lordosis
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Lordosis or Scoliosis
is described as “flat back” syndrome.. |
lordosis
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Lordosis or Scoliosis
– curves from side view. |
scoliosid
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Lordosis or Scoliosis
- is established when crawling as an infant and the baby begins to lift the head/trunk into extension. |
cervical lordosis
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Lordosis or Scoliosis
-when the baby begins to stand and walk about..due to gravitational exertion |
lumbar lordosis
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Lordosis or Scoliosis
a lateral curvature of the spine (S shaped) |
Scoliosis
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Lordosis or Scoliosis
it’s what you see when looking at the back of someone from behind |
Scoliosis
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Lordosis or Scoliosis
occurs when the vertebrae rotate and begin to compress |
Scoliosis
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Lordosis or Scoliosis
the spinal column begins to move into a lateral curve, most commonly in the right lateral thoracic area. as the degree of curvature increases, damage to the vertebral bodies results. the degree of the curvature increases during periods of growth, such as adolescence. |
Scoliosis
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Lordosis or Scoliosis
-3 types: |
Scoliosis
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Lordosis or Scoliosis
A) congenital - which occurs during embryonic development (ex: wedge vertebrae, fused ribs or vertebrae) |
Scoliosis
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Lordosis or Scoliosis
B) Neuromuscular which results from a neuromuscular condition in childhood or adult hood, such as cerebral palsy or spinal cord tumors (develops several months after asymmetrical paralysis of the drunk muscles from polio, cerebral palsy, or muscular dystrophy) |
Scoliosis
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Lordosis or Scoliosis
C)idiopathic is the most common form and the cause is unknown |
Scoliosis
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Lordosis or Scoliosis
-2 types of classifications: structural, which follows some deviation of the spinal column…nonstructural results from a cause outside the spine itself, such as a leg discrepancy. |
Scoliosis
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How to assess these areas (Lordosis and Scoliosis)
-observe the patient how? |
from the front and back while standing and during forward flexion from the hips
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How to assess these areas (Lordosis and Scoliosis)
Physical examination reveals |
asymmetry (uneven) hip and shoulder height,
prominence of the thoracic ribs (rib hump) and scapula on one side, and the visible curve in the spinal column. |
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How to assess these areas (Lordosis and Scoliosis)
Inspect and palpate each vertebrae of the spine in the neck down. Mark each vertebrae with a pen to assess for curve true or false |
true
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How to assess Scoliosis
Scoliosis- ask the patient to flex forward from the hips and inspect for |
a lateral curve in the spine (you should expect a straight vertical spine while standing and also while bending forward.
posterior ribs should be symmetric with equal elevation of shoulders, scapulae, and iliac crests. |
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Lordosis or Scoliosis
is just about lumbar region |
Lordosis
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Lordosis or Scoliosis
entire spinal column being affected |
Scoliosis
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herniated disc
sign and symptoms |
pain and stiffness in the neck and top of the shoulders scapula upper extremities and head.
Paresthesias (numbness and tingling) may be felt because spinal nerves have both motor and sensory fibers. |
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herniated disc
-Diagnosis: |
MRI
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herniated disc
-in a lumbar herniation a person will complain of what s/s? |
muscle weakness,
sensory loss and alteration of tendon reflexes. causes low back pain and muscle spasms with radiation of pain down 1 leg or hip. |
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herniated disc
-in a lumbar herniation pain is aggravated by? |
bending, lifting, sneezing, or coughing.
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herniated disc
-in a lumbar herniation occurs at what interspaces? |
normally occurs at L4 – L5 or L1 – S1 interspaces
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-Herniated disc is AKA:
they most often occur between which vertebrae |
herniated nucleus pulposus (HNP)
that most often occur between the 4th and 5th lumbar vertebrae (L4-L5) |
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-herniated disc: nucleus of the disk protrudes into the annulus (ring-shaped structure) causing nerve compression
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true
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-cervical disk herniation occurs where?
what s/s do they feel |
in the neck at C5-C6 or C6-C7 interspaces
pain and stiffness in neck and top of shoulders, scapula, upper extremities, and head. paraesthesis and numbness of upper extremity. |
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-herniated disk: is a bulging in the lumbosacral area that can press on the adjacent spinal nerve (usually sciatic nerve), causing what
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severe burning or stabbing pain down into the leg or foot.
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herniated disk:
-the HNP may press on the spinal cord itself, leg weakness and what other 2 organ dysfunctions? |
bowel and bladder dysfunction
(sacral spinal nerves are part of the reflex system for the bowel and bladder, they also contain parasympathetic nerve fibers, which help control bowel and bladder function) |
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herniated disk occurs when what happens?
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when all or part of the nucleus pulposus (the soft, gelatinous, central portion of an intervertebral disk) forces through the weakened or torn annulus fibrosus (outer ring) which compresses the nerve root
(p. 710 med surge nursing made incredibly easy book) |
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S/S of nerve impingement
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Pain,
sensory loss, or impairment, motor loss or impairment, sphincter disturbance (bladder before bowel) |
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S/S of nerve impingement
-The extruded disk may impinge on spinal nerve roots as they exit from the spinal canal or on the spinal cord itself, resulting in back pain and other signs of nerve root irritation. |
..
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S/S of nerve impingement
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-tingling, numbness, burning, shooting down the buttocks and legs or in the neck, shoulders, arms, and fingers
-some pain is referred. pinched nerve in lower back may be felt in calf |
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What do dermatomes represent?
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sensory input from spinal nerves to specific areas of the skin
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Dermatomes
-area controlled by what? |
Area controlled by each spinal nerve
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how do dermatomes help a nurse?
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. Allows nurse to determine which nerve is being compressed. A dermatome is the area of skin supplied by nerves originating from a single spinal nerve root. assist in finding the location of disk herniation and nerve impingement
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Surgery for back
-Laminectomy involves removal of what? |
part of the laminae and facet joints too obtain access to the disk space and decompress the nerve roots.
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Surgery for back
-when the surgeon removes one or more of the bony laminae that cover the vertebrae is called what? |
-Laminectomy
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Back surgery
-Laminectomy (2 main uses) |
torelieve pressure on the spinal cord or spinal nerve roots resulting from a herniated disk ,
and to treat compression fracture or dislocation of vertebrae or a spinal cord tumor |
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Surgery for neck
fusion of the vertebrae with a bone graft if the spine is unstable. |
cervical fusion
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Surgery for neck
-when repeated laminectomies are performed or if the spine is unstable, the surgeon may perform what to stabilize the affected area. |
a spinal fusion (arthrodesis)
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Surgery for neck
spinal fusion (arthrodesis) what happens in this procedure? |
. chips of bone are removed, typically from the iliac crest or obtained from a donor bone and are grafted between the vertebrae for support and to strengthen the back. metal implants (usually pins, screws, plates, or rods) may be required to ensure the fusion of the spine.
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Potential complications of neck and back surgery
- minor ones: |
hoarseness, temporary dysphagia (usually not serious), initiate bowel program, braces
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Potential complications of neck and back surgery
- major ones: |
CSF leakage,
fluid volume deficit, paralytic ileus, acute urinary retention, fat embolism syndrome, persistent or progressive lumbar radiculopathy (nerve root pain) , infection (wound, diskitis, hematoma) |
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Diabetes Insipidus
-specific gravitiy -osmolarity |
-low specific gravitiy 1.005
-low osmolarity between 50-200 (tissue are dehydrating, taking water intracellular volume) based on blood volume. |
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Diabetes Insipidus
encourage pt to drink fluids equal to that of urine output true or false |
true
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Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH)
What is the complication associated with this disease? |
delusion
hyponatremia, hyperkalemia (cardiac issues) increase in plasma fluid increases the glomular filtration rate, which inhibits the release of rennin and aldosterone leading to grater hyponatremia |
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Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH)
heat or cold intolerance |
heat --always hot
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Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH)
sodium level is less than |
-sodium less than 115
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Wet to dry dressings why are they done
a dressing technique used to treat a dirty wound or to prevent build-up of exudate on a wound. how do you perform this dressing? |
Apply a saline moistened (damp not soaking wet) gauze pad to the wound and then cover this with a dry gauze pad. The reason it is called a “wet to dry dressing” is that the moist gauze directly on the wound is allowed to dry out. When this bottom layer of gauze is removed, it pulls off the exudate, debris, and non-viable tissue which have become stuck to the gauze.
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continuous wet gauze:
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the wound surface is continually bathed with a wetting agent of choice, promoting dilution of viscous exudates and softening of dry eschar
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Conscious sedation
what reflexes remain intact? |
defensive reflexes remain intact (gag and swallow reflexes)
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Conscious sedation
what route?? what drugs are used?? |
IV delivery of sedative, hypnotic, and opioid drugs
• Diazepam (Valium) , midazolam (huge amnesia component), meperidine, fentanyl, alfentanil, and morphine sulfate are the most commonly used drugs. |
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Conscious sedation
-these drugs do what??? |
reduces the level of consciousness but allows the client to maintain a patent airway and to respond to verbal commands.
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Conscious sedation
what 2 monitors is the patient connected too? |
-on cardiac monitor, and oxygen, monitor, nurse never leaves them
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Conscious sedation
Nursing assessment of what?? how often???? |
of airway,
level of consciousness, oxygen saturation, electrocardiographic status, vital signs are monitored every 15 to 30 minutes. |
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furosemide
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Lasix
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loop diuretic
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Diabetes
greatest risk for hypoglycemia is when? |
peak
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Myxedema
-results from what? |
hypothyroidism
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Myxedema
Low metabolic rate causes what to happen? |
the cellular energy to be decreased and metabolites build up inside the cells,
which increases the mucous and water, forms CELLULAR edema, and changes organ texture. The edema is mucinous (called myxedema). This edema changes the pts appearance, nonpitting edema forms everywhere. |
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Myxedema
The edema is mucinous (called myxedema). This edema changes the pts appearance, what forms everywhere. |
nonpitting edema
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-Myxedema coma is a rate, but serious complication of untreated or poorly treated _____________
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hypothyroidism
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Myxedema coma
The decreased metabolism causes the heart to become what? |
flabby and the result is decreased CO, perfusion to the brain and other vital organs.
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omeprazole
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Prilosec
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proton pump inhibitor
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Primary lesions
flat lesions of less than 1 cm in diameter. their color is different from that of the surrounding skin --most often red, brown, or white |
maculues
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Primary lesions
examples are freckles, moles, or rubella |
macule
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Primary lesions
macules that are larger than 1 cm in diameter. they may or may not have some surface changes - either slight scale or fine wrinkles |
patches
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Primary lesions
examples are vitiligo of cafe au tait spots |
patch
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Primary lesions
are small, firm, elevated lesions less than 1 cm in diameter |
papules
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Primary lesions
examples are warts or elevated moles |
papules
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Primary lesions
elevated, plateau like patches more than 1 cm in diameter that do not extend into the lower skin layers |
plaques
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Primary lesions
examples are psoriasis or seborrheic keratosis |
plaques
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Primary lesions
elevated, marble like lesions more than 1 cm wide and deep |
nodules
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Primary lesions
examples are lipomas |
nodules
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Primary lesions
nodules filled with either liquid or semisolid material that can be expressed |
cysts
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Primary lesions
examples are sebaceous cyst |
cysts
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Primary lesions
-blisters filled with clear liquid. less than 1 cm in diamter |
vesicles
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Primary lesions
exampels are acute dermatitis |
vesciles
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Primary lesions
-blisters filled with clear liquid. more than 1 cm in diameter |
bullae
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Primary lesions
vesicles filled with cloudy or purulent fluid |
pustules
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Primary lesions
examples are acne and acute impetigo |
pustules
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Primary lesions
elevated irregularly shaped, transicent areas of dermal edema |
wheals
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Primary lesions
examples are uticaria and insect bites |
wheals
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Primary lesions
wider than fissures but involve only the epidermis |
erosions
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Primary lesions
they are often associated with vesicles, bullae, or pustules |
erosions
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Primary lesions
example is varicella |
erosions
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Secondary lesions
are visibily thickened stratum corneum. they appear dry and are usually whitish. they are seen moost often with papules and plaques |
scales
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Secondary lesions
example is psoriasis |
scales
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Secondary lesions
deep erosions that extend beneath the epidermis and involve the dermis and sometimes the SQ fat |
ulcers
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Secondary lesions
example is pressure sores |
ulcers
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Secondary lesions
are palpably thickened areas of epidermis with accentuated skin markings. |
lichenifications
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Secondary lesions
caused by chronic rubbing and scratching |
linchenifications
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Secondary lesions
caused by chronic rubbing and scratching |
linchenifications
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Secondary lesions
example is chronic dermatitis |
linchenifications
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Secondary lesions
are composed of dried serum or pus on the surface of the skin beneath which liquid debris may accumulate. |
crusts and oozing
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Secondary lesions
result from broken vesicles, bullae, or pustules |
crusts and oozing
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Secondary lesions
linear cracks in the epidermis, which often extend into the dermis |
fissures
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Secondary lesions
examples are eczema and late stage impetigo |
crusts and oozing
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Secondary lesions
athletes foot |
fissures
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Secondary lesions
characterized by thinning of the skin surface with loss of skin markings |
atrophy
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Secondary lesions
the skin is translucent and paper like. |
atrophy
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Secondary lesions
if involvign the dermal layer results in skin depression |
atrophy
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Secondary lesions
examples are striae and aged skin |
atrophy
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cysts
-what are they? |
flesh colored nodules that contain liquid or semisolid fluid
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cysts
-tell me about palpation? |
they can be moved and manipulated on palpation
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what is the difference between cysts and nodules
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nodules are firm
cysts are soft and can be moved |
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