Patient Assessment Ii: Midterm

Front 1

Definition: Temperature

Back 1

The balance/net between the heat produced by the body and the heat lost from the body

Front 2

Temperature regulators are located where?

Back 2

Body's core and in the hypothalamus

Front 3

If core temperature is increased?

Back 3

- Sweating is initiated
- Vasodilation occurs

Front 4

If core temperature is decreased?

Back 4

- Sweating is inhibited
- Shivering is initiated

Front 5

Normal temperature reading

Back 5

98.6° F (37°C)

Front 6

Normal range of temperature

Back 6

96.4°F - 99°1 F

Front 7

Rectal temperatures

Back 7

Average 0.7° - 0.9° higher

Front 8

Axillary temperatures

Back 8

Average 0.7° - 0.9° lower

Front 9

Tympanic temperatures

Back 9

Record measurements somewhere between oral and rectal readings

Front 10

Temperature in infants and children

Back 10

- Immature temperature control mechanism
- Increased metabolic state
- Higher readings

Front 11

Temperature in the elderly

Back 11

- Decreased efficiency of thermoregulation and decreased H20
- Decreased metabolic state
- Lower readings

Front 12

Temperature can fluctuate how much in a 24 hour period

Back 12

2•F

Front 13

Highest temperature occurs between what times?

Back 13

8pm and midnight

Front 14

Lowest temperature occurs between what times?

Back 14

4am and 6am

Front 15

Exercise can increase temperature how much?

Back 15

3°F (as heat production)

Front 16

Effect of progesterone on temperature

Back 16

(Ovulation time)
- Increase 0.5° - 1°F

Front 17

Effect of estrogen on temperature

Back 17

(Peaks before ovulation)
- Slightly decreased temperature

Front 18

What hormones can affect temperature in both sexes?

Back 18

- Thyroid
- Adrenal
- Pituitary

Front 19

Stress will increase or decrease temperature?

Back 19

Increase
(Both physiologic and psychologic stress)

Front 20

Definition: Pyrexia (Fever State)

Back 20

A body temperature above normal range

Front 21

Physiologic cause of pyrexia

Back 21

"Set point" in hypothalamus has been reset to a higher temperature due to presece of pyrogens, brain injury, viral agent, etc.

Front 22

Histologic effects of pyrexia

Back 22

- Increased temperature can destroy large numbers of pathogenic organisms
- Increase temperature can cause some organisms to bee less virulence
- Increased temperature and resultant increase in BMR supports increase production of antibodies

Front 23

Physiologic effects of pyrexia

Back 23

- Higher set point is reached by promotion of peripheral vasoconstriction
- Hypothalamus will maintain this new set point until fever cause is removed
- Once the fever is removed, the hypothalamus returns to its normal set point via marked vasodilation and diaphoresis

Front 24

"Fever Crisis"

Back 24

When the patient appears flushed and sweaty
- This occurs once the fever cause is removed and the hypothalamus returns back to normal

Front 25

Techniques to take Temperature

Back 25

- Oral temperature with glass thermometer
- Oral temperature with electronic thermometer
- Axillary temperature with glass thermometer
- Rectal temperature with glass thermometer
- Tympanic temperature with tympanic thermometer

Front 26

Definition: Pulse

Back 26

A wave of blood created in an artery synchronized with the contraction of the left ventricle

Front 27

- Tachycardia?
- Bradycardia?
- Eucardia?

Back 27

- Tachycardia: increased pulse rate
- Bradycardia: decreased pulse rate
- Eucardia: normal pulse rate

Front 28

SA node regulation of pulse

Back 28

1° sympathetic nervous system

Front 29

Ventricular regulation of pulse

Back 29

1° parasympathetic nervous system

Front 30

Pulse: Normal Range

Back 30

60 - 100 beats per minute

Front 31

Affect of age on pulse

Back 31

Increased pulse due to increase in BMR in infants and young children

Front 32

Affect of gender on pulse

Back 32

After puberty, males slightly lower than females

Front 33

Affect of exercise on pulse

Back 33

- Cardiovascularly toned individual has decreased pulse and decreased reaction to exercise
- Weekend Warrior has increased pulse and increased reaction to exercise

Front 34

Affect of fever on pulse

Back 34

For every 1° of fever, the pulse increases ten beats per minute

Front 35

Affect of hemorrhage and stress on pulse

Back 35

Increases pulse

Front 36

Affect of sitting on pulse?
Affect of lying down on pulse?

Back 36

Sitting: increases
Lying down: decreases

Front 37

Pulse Grading

Back 37

4 = bounding
3 = full, increased
2 = expected, normal
1 = diminished, barely palpable, thready
0 = absent, not palpable

Front 38

What do you do if you think the pulse rhythm is irregular?

Back 38

Count the rate for a full minute and note if the irregular rhythm is regular or irregular
- May want to do an A/R deficit if it is irregular

Front 39

- Tachypnea?
- Bradypnea?
- Eupnea?
- Dyspnea?
- Apnea?

Back 39

- Tachypnea: increase in respiratory rate, > 20
- Bradypnea: decrease in respiratory rate, < 20
- Eucardia: normal breathing
- Dyspnea: difficult breathing
- Apnea: no breathing

Front 40

What regulates respiration?

Back 40

- Medulla sets the rate
- Pons sets the depth

Front 41

Respiration: Normal Range

Back 41

12 - 20 cycles per minute

Front 42

What can increase respiratory rate?

Back 42

- Exercise
- Stress
- High altitude (2° hypoxia)
- High temperature (ambiant or core)

Front 43

Affect of age on respiratory rate

Back 43

- Infants and young children have increased rates due to increased BMR
- Elderly have decreased rates due to decreased BMR

Front 44

Define: Cheyne-Stokes Respiration

Back 44

Marked rhythmic waxing and waning of respiratory rate and depth with periods of apnea

Associated with increased intracranial pressure (trauma, tumor, toxin, infection)

Front 45

Define: Kussmaul Respirations
(Hyperventilation)

Back 45

An increase in respiratory rate and depth

Associated with metabolic [keto]acidosis, panic attakcs, pulmonary emboli, exercise

Front 46

Define: Biot's Respirations
(Ataxic Breathing)

Back 46

Irregularly shallow and deep breaths interrupted by irregular periods of apnea

Associated with respiratory depression, brain damage especially at medulla

Front 47

What should you note when assessing respiration?

Back 47

- Ease of respirations
- Depth of respirations
- Use of accessory muscles
- Presence of wheezes
- Presence of any abnormal breath patterns

Front 48

Define: Blood Pressure
- Systole
- Diastole

Back 48

A peripheral measurement of cardiovascular function
- Systole: amount of pressure in arteries during contraction
- Diastole: amount of pressure in arteries during relaxation

Front 49

Regulation of blood pressure

Back 49

- Brain (responds to baroreceptors)
- Kidneys (respond to perfusion rates)

Front 50

Normal Range: Blood Pressure

Back 50

90/60 - 140/90

Front 51

Affect of age on blood pressure

Back 51

- Infants and young children have a broader range of BP readings
- Elderly have higher normal systolic readings (up to 160) due to increased arterial compliance

Front 52

Affect of stress on blood pressure

Back 52

- Anxiety/fear/moderate pain: sympathetic stimulation, increase BP
- Severe pain: vasomotor inhibition causes vasodilation, decrease BP

Front 53

Black people have a higher or lower BP than white people?

Back 53

Higher, but they can tolerate hypertension better

Front 54

After puberty, males have a slightly higher or lower BP than females?

Back 54

Higher

Front 55

BP is lowest at what time of day?
What time of day does BP peak?

Back 55

Lowest: Morning
Peak: late afternoon or early PM

Front 56

Affect of cuff size on blood pressure

Back 56

- Too small: falsely increased BP
- Too big: falsely decreased BP

Bladder inside the cuff should be 75 - 80% of arm circumference

Front 57

Karotkoff Sounds
- K1?
- K5?

Back 57

K1: Systole; 1st- faint and clear tapping

K5: Diastole; total absence of sound

Front 58

If the sclera is not white, what might than indicate?

Back 58

Trauma, allergies, infection

Front 59

If the sclera is not of normal size, what might that indicate?

Back 59

Increased size: palpebral fissure, Dalprymple's sign of Graves' Disease

Decreased: periorbital edemaof myxedema or renal disease or amany be ptosis of neurological origin

Front 60

Redness, discharge, tearing or swelling of the eye may indicate what?

Back 60

Trauma, allergen, local inflammation or infection

Front 61

Bulging of the eye may indicate what?

Back 61

- Unilateral: tumor or trauma
- Bilateral: exophthalmus of Graves' disease

Front 62

Corneal light reflection assess what?

Back 62

Eye deviation to detect OVERT strabismus

Front 63

Cover/Uncover test assess what?

Back 63

Eye deviation to detect COVERT strabismus

Front 64

Presence of lid lag is suggestive of what?

Back 64

Hyperthyroidism

Front 65

Define: Ptosis

Back 65

Drooping of the upper lid

Causes: MG, CN III damage, Horner's syndrome, congenital
- In elderly, weakened muscles and the weight of herniated fat may lead to this

Front 66

Define: Epicanthus (Epicanthal fold)

Back 66

Vertical fold of skin that lies over the medial canthus
- Normal in asian people
- Seen in Down's and other congenital conditions

Front 67

Define: Ectropion

Back 67

The turning outward of the lower lid margin exposing the palpebral conjunctiva
- Can lead to tearing (as it interrupts the normal draining of the eye)
- Commonly seen in the elderly

Front 68

Define: Entropion

Back 68

The turning inward of the lower lid margin (sometimes causing the eyelashes to be up against the conjunctive and cornea and obliterating you view of the lashes)
- Commonly seen in elderly

Front 69

Define: Periorbital Edema

Back 69

Accumulation of edema in the tissues underlying the lids
- Causes include allergies, local inflammation, myxedema, and fluid retention states such as nephrotic syndrome

Front 70

Define: Herniated Fat (eyes)

Back 70

Bulges in the lower lids and/or the inner 1/3 of the upper lids due to weakened fascia unable to hold back the fat
- More common in the elderly

Front 71

Yellowing of Sclera indicates?

Back 71

(Scleral icterus, jaundice)
- Suggestive of bilirubin disorder
- If absent in presence of yellowing of the skin, suggestive of Vitamin A toxicity

Front 72

Injection (eye) indicates?

Back 72

Allergies, local inflammation or infection, trauma
- If localized to peri-iris area (ciliary injection), may be suggestive of corneal injury, acute iritis, or acute glaucoma

Front 73

Define: Pterygium

Back 73

A triangular thickening of the bulbar conjunctiva that grows slowly across the outer surface of the cornea, usually from the nasal side
- May interfere with vision as it encroahces upong the pupil

Front 74

Define: Pinguecula

Back 74

A yellowish, somewhat triangular nodule in the bulbar conjunctiva on either side of the iris
- A harmless growth which appears with aging, usually on the nasal side first, then on the temporal side

Front 75

Define: Episcleritis

Back 75

A local, non-infectious inflammation of the superficial tissues of the sclera
- Usually benign and self-limited
- May be nodular or simply an area of redness and/or injection

Front 76

Define: Corneal Arcus (Arcus Senilis)

Back 76

A thin grayish white arc or circle not quite at the edge of the cornea
- Considered a normal variant in blacks and others over 55
- In younger patients, may be indicative of hyperlipoproteinemia

Front 77

Define: Corneal Scar

Back 77

A superficial grayish white opacity in the cornea due to an old injury or do to inflammation
- Do not confuse with opaque lens of a cataract (which can be viewed only through the pupil)

Front 78

Define: Cataract

Back 78

An opacity of the lens that is seen through the PUPIL

Front 79

(2) Types of Cataracts

Back 79

1. Nuclear: gray opacity surrounded by a black rim (will appear black against the peripheral red reflex)

2. Peripheral: spokelike shadows that point inward (will appear black against the central red reflex)

Front 80

Define: Tonic Pupil (Adie's pupil)

Back 80

A unilaterally large and regularly shaped pupil whose reaction to light is sluggish or absent
- Accommodation and convergence are also similarly affected
- Considered a pathology of pupillary muscle

Front 81

Define: Horner's Syndrome

Back 81

Unilateral meiosis, ptosis and anhydrosis due to pathology of the cervical sympathetic chain ganglia
- Affected side will exhibit NORMAL accommodation and convergence

Front 82

Define: Argyll Robertson Pupils

Back 82

Small irregular pupils which DO NOT react to light, but do accommodate
- Commonly suggestive of CNS syphillis (3°)

Front 83

Define: Anisicoria

Back 83

General term for pupils which are unequal in size
- Causes include tonic pupil and Horner's syndrome, CN or sympathetic nerve pathology

Front 84

Define: Sty (Hordeolum)

Back 84

A painful, tender, red infection around the hair follicle of an eyelash
- It appears as a pimple or boil on the lid margin

Front 85

Define: Chalazion

Back 85

A chronic painless inflammatory lesion involving the meibomia gland
- It is a nodule that usually points inside the lid (versus on the margin)

Front 86

Define: Xanthelasma

Back 86

Slightly raise, YELLOWISH, well circumscribed plaques in the periorbital skin, usually along the nasal portions of one or both eyelids
- May be suggestive of lipid disorders

Front 87

Define: Dacrocystitis

Back 87

Inflammation of the lacrimal sac which produces tearing and expressed discharge at the site of the puncta

Front 88

Define: Copper Wire Arterioles

Back 88

Increased light reflection of the arteriole giving it a bright metallic luster
- Frequently associated with increased tortuousity
- Due to hypertension

Front 89

Define: Silver Wire Arterioles

Back 89

A narrowing of an arteriole leading to total opacity of the vessel so that no blood is visible within it
- Due to hypertension

Front 90

Define: AV nicking

Back 90

An abrupt cut off of the vein as it crosses with the artery
- Seen with hypertension

Front 91

Define: AV tapering

Back 91

A tapering down of the vein as it crosses with the artery
- Seen with hypertension

Front 92

Define: Drusen Bodies

Back 92

Light colored "debris buildup" which frequently distorts the disc margin (though may be seen in the periphery as well)
- Normally seen with aging

Front 93

Define: Myelinatied (or Medullated) Nerve Fibers

Back 93

Irregular white patches with feathered margins that can obscure disc margins
- Congenital normal variant

Front 94

Define: Rings and Crescents

Back 94

Developmental variations which give a white or black border parallel to the disc, usually on the temporal side
- Normal variant

Front 95

Define: Cotton Wool Spots (Soft Exudates)

Back 95

White or grayish ovoid lesions with irregular borders usually smaller than disc

Front 96

Define: Hard Exudates

Back 96

Creamy or yellowish lesions with well defined borders which often occur in new clusters
- Often seen with hypertension and Diabetes Mellitus

Front 97

Define: Neovascularization

Back 97

Formation of new vessels, which are more numerous, tortuous and narrower than other vessels in the area
- Seen with Diabetes Mellitus

Front 98

Define: Flame Hemorrhages

Back 98

Small, linear flame shaped red streaks on the retina
- Seen with hypertension and papilledema

Front 99

What is the physiologic blind spot of the eye?

Back 99

Optic disc

Front 100

If the optic disc is decreased in size, suggestive of what?

Back 100

Papilledema

Front 101

If the optic disc is increased in size, suggestive of what?

Back 101

Glaucoma

Front 102

Avascular area of central vision containing only cone cells (and highly photosensitive)

Back 102

Macula and fovea

Front 103

Define: Emmetropia

Back 103

Perfect/Normal vision

Front 104

Define: Ametropia

Back 104

Refractive error of myopia or hyperopia

Front 105

Define: Myopia

Back 105

Nearsightedness; image falls in FRONT of retina

Front 106

Define: Hyperopia

Back 106

Farsightedness; image falls BEHIND the retina

Front 107

Define: Astigmatism

Back 107

Irregularity in the curve of the lens or the contour of the cornea

Front 108

Define: Presbyopia

Back 108

Farsightedness due to loss of lens elasticity due to aging

Front 109

Define: Harmon Distance

Back 109

Used to read Rosenbaum Chart
- Chin on fist and the chart at the elbow
- Used to screen for hyperopia (or hypermetropia)

Front 110

Define: Amsler Grid

Back 110

With one eye covered, patient is asked to look at the dark spot in the middle of a checkerboard grid
- Positive if patient perceives a defect, distortion or blank area on the grid
- May be suggestive of glaucoma or other visual field defects

Front 111

Alignment of the Auricle

Back 111

- Draw an imaginary line from the outer canthus of the eye to the most prominent protuberance of the occiput
- Draw an imaginary line perpendicular to the line
- Should be almost vertical with no greater than a 10° lateral posterior angle

Front 112

Define: Cutaneous Cyst (Sebaceous Cyst)

Back 112

Benign, firm, mobile sac that lies in the dermis forming a dome shaped lump

Front 113

Define: Darwin's Tubercle

Back 113

A thickening along the upper ridge of the helix; benign normal variant

Front 114

Define: Pre-Auricular Pits

Back 114

Small indurations found in front of the ear where the upper auricle originates
- Benign normal varian
- More common in blacks (20%)

Front 115

Define: Cauliflower Ear

Back 115

An unusual contour of the auricle due to blunt trauma and necrosis of the underlying tissue

Front 116

Define: Tophi

Back 116

A deposit of uric acid crystals on the helix or anti-helix
- Usually due to years of sustained hyepruricemia

Front 117

Define: Rheumatoid Nodules

Back 117

Lumps on the helix or antihelix which may ulcerate (look for nodules f RA on other areas of the body to help distinguish from tophi)

Front 118

Define: Battle's Sign

Back 118

Hemorrhagic spot behind the ear suggestive of a skull base fracture
- In presence of head trauma

Front 119

Define: Mastoiditis

Back 119

An infection of the mastoid, usually secondary to otitis media
- Mastoid appears erythematous and edematous and pinna displaces anteriorly and inferiorly

Front 120

(4) Neurological Tests for Hearing

Back 120

1. Weber
2. Rinne
3. Schwabach
4. Watch-Tick Test

Front 121

(3) Neurological Tests for Vestibular Function

Back 121

1. Caloric Test (Barany-Caloric Test)
2. Rhomberg's
3. Mittelmeyer March

Front 122

Define: Transverse Nasal Crease (Allergic Salute)

Back 122

Seen at the junction of the cartilage and bone; usually due to chronic nasal itching from allergies

Front 123

Define: Rhinophyma

Back 123

Prominent hypertrophy of sebaceous glands of the nose with overgrowth of the soft tissue; most commonly seen in males

Front 124

What causes chronic mouth breathing?

Back 124

Narrowing of nares during inspiration

Front 125

Flaring of the nares is suggestive of what

Back 125

Acute respiratory distress

Front 126

Internal Nose Discharge Colors- What are they suggestive of?
Green?
White?
Clear?

Back 126

Green: bacterial infection
White: viral infection
Clear: allergic reaction

Front 127

Purpose of sinuses physiologically?

Back 127

- Makes head lighter
- Warms inspired air
- Phonates voice

Front 128

Define: Herpes Simplex (Cold Sore or Fever Blister)

Back 128

Recurrent painful vesicular eruption of the lips and the surrounding skin
- Begins as a small cluster of vesicles, which break, forming a yellow brown crust
- Usually heals within 10 - 14 days

Front 129

Define: Angular Cheilitis

Back 129

Softening of the skin followed by formation of fissures at the angles of the mouth
- Frequently due to nutritional deficiency or to overclosure of the mouth in edentulous persons

Front 130

Define: Acitinic Cheilitis

Back 130

Loss of redness and a thickening, scaling and eversion usually of the lower lip
- Usually due to excessive exposure to sunlight

Front 131

Define: Squamous Cell Carcinoma (lips)

Back 131

Scaly plaque or an ulcer with or without crust or a nodular lesion which usually forms on the lower lip
- Risk factors include fair skin and sun overexposure

Front 132

Define: Chancre of syphilis

Back 132

Firm, "button-like" lesion which ulcerates and crusts over

Front 133

Define: Angioedema

Back 133

Diffuse, tense swelling of the dermis and squamous tissue of the lip which develops rapidly and typically disappears within hours or days
- Usually as a result of allergies

Front 134

Define: Peutz-Jeghers Syndrome

Back 134

Pigmented spots on the lips more prominent than freckling of the surrounding skin with similar lesions noted the buccal mucosa and sometimes the face and hands
- Associated with multiple intestinal polyps

Front 135

Define: Gingivitis

Back 135

Inflammation of the gingiva leading to reddened and swollen gums with blunting, swelling and reddening of the interdermal papillae

Front 136

Define: Gingival Hyperplasia

Back 136

Overgrowth of the gums, sometimes accompanied by redness
- Causes include Dilantin therapy, puberty, pregnancy and leukemia

Front 137

Define: Pregnancy Tumor (Epulis, Pyogenic Granuloma)

Back 137

Localized gingival enlargement which forms a red, tumor-like mass that bleeds easily usually originating in an interdental papilla
- Occurs in about 1% of pregnancy

Front 138

Define: Kaposi's Sarcoma (in AIDS)

Back 138

Purplish to brownish discoloration and enlargement of the gums

Front 139

Define: Lead Line

Back 139

A bluish black line about 1 mm from gum margin, which follows contours of gums
- Patient may complain of metallic taste in mouth
- Seen with plumbism

Front 140

Define: Attrition of the Teeth

Back 140

Wearing down of the chewing surfaces of the teeth so that the yellow-brown dentin is exposed
- Seen in elderly

Front 141

Define: Recession of the Gums

Back 141

Gum recession which exposes the roots of the teeth
- Seen in elderly
- "Long in the tooth"

Front 142

Erosion of the Teeth

Back 142

Erosion of the enamel from the lingual surfaces of the teeth
- Seen in recurrent regurgitation

Front 143

Define: Hutchinson's Teeth

Back 143

Small, widely spaced teeth which are notched on the biting surfaces
- Sign of congenital syphilis

Front 144

Define: Thrush (Candidiasis)

Back 144

Thick, cheesy plaques which adhere somewhat to the underlying mucosa due to a yeast infection
- Risk factors also include antibiotic steroid therapy and AIDS
- May also be seen in other areas of oral mucosa

Front 145

Define: Torus Palatinus

Back 145

Common benign, midline bony growth in the hard palate

Front 146

Define: Kaposi's Sarcoma (in AIDS)

Back 146

Raised or flat lesions, frequently of deep purple color

Front 147

Define: Koplik's Spots

Back 147

Small white specks that appear on the buccal mucosa near the 1st and 2nd molars
- Seen first as a sign of measeles

Front 148

Define: Fordyce Spots

Back 148

Normal sebaceous glands which appear as small yellowish spots in the buccal mucosa

Front 149

Define: Leukoplakia

Back 149

Thick, white patch seen anywhere on the oral mucosa
- May be pre-cancerous

Front 150

Define: Fissured Tongue (Scrotal Tongue)

Back 150

Benign formation of furrows in the tongue, associated with aging

Front 151

Define: Geographic Tongue

Back 151

Benign pattern of alternating areas denuded papillae and normal papillae which remit and exacerbate

Front 152

Define: Hairy Tongue

Back 152

Yellowing to browning and elongation of the papillae
- Frequently due to antibiotic therapy, however, may occur spontaneously

Front 153

Define: Smooth Tongue (Beefy Tongue, Atrophic Glossitis)

Back 153

Tongue which has lost it's papillae
- Suggestive of Vitamin B deficiency

Front 154

Define: Apthous Ulcer (Canker Sore)

Back 154

Painful small round or oval ulcer that is white or yellowish and surrounded by a halo of reddened mucosa which usually heals in 7 - 10 days

Front 155

Define: Varicose Veins (Caviar Lesions)

Back 155

Small purplish or blue-black dilations of the lingual veins
- Benign finding

Front 156

Define: Tori Mandibulares

Back 156

Rounded bony protuberances that grow from the inner surfaces of the mandible
- Benign finding

Front 157

Define: Pharyngitis

Back 157

Reddening of the mucosa with or without exudate
- Seen as a result of several kinds of viruses and bacteria
- If accompanied by fever, lymphadenopathy and exudate, suspect strep or mono

Front 158

Define: Pseudomembrane of Diptheria

Back 158

Dull erythema and grey exudate in oropharynx
- May lead to airway obstruction
- Refer out immediately

Front 159

Eye changes of hyperthyroidism

Back 159

Dalrymple's Sign of Exophthalmus, lid lag

Front 160

Paper Test/Fine Peripheral Tremor

Back 160

Testing for hyperthyroidism
- Place a piece of paper on a patient's outstretched hand

Front 161

Pretibial Myxedema is associated with what?

Back 161

Hyperthyroidism
- Proteinaceous ground substance deposition anterior to bilateral tibia

Front 162

Loss of lateral 1/3 of eyebrow is pathognomonic for?

Back 162

Hypothyroidism

Front 163

Perioribital edema of facial puffiness is a sign of what?

Back 163

Hypothyroidism

Front 164

Macroglossia, xanthelasma, croaking or hoarseness of the voice is associated with what?

Back 164

Hypothyroidism

Front 165

Chvostek's Sign

Back 165

1. Tap facial muscles over the parotid gland
2. Positive finding is spamodic concentration of the ipsilateral facial muscles
3. Indicative of HYPOcalcemia (presence of tetany) which may or may not be due to thyroid disorder

Front 166

In regards to the thyroid, pregnancy can exhibit what?

Back 166

- Facial and/or periorbital edema
( If toxemia: pre-eclampsia or eclampsia ensue)
- Thyroid enlargement
- Thyroid bruits and/or venous hum

Front 167

Define: Superior Vena Cava Syndrome

Back 167

Swelling of the head, face and neck, usually on the right side, due to impingement by a lymph node on the SVC, thus limiting venous and/or lymph drainage)

Front 168

Define: Horner's Syndrome

Back 168

Ptosis, meoisis and anhydrosis

Front 169

Lymphedema (Non-Pitting Edema)

Back 169

Accumulation of lymph in soft tissue accompanied by swelling

Front 170

Venous Stasis Edema (Pitting Edema)

Back 170

Accumulation of fluid in soft tissue

Front 171

(7) Things to assess for lymph nodes

Back 171

1. Size
2. Shape
3. Location
4. Contour
5. Consistency
6. Mobility
7. Tenderness

Front 172

Define: Pectus Excavatum (Funnel Chest)

Back 172

Sinking or funnel-shaped depression of the lower sternum, diminished AP chest diameter
- May effect organ function if severe enough

Front 173

Define: Pectus Carinatum (Pigeon Chest, Chicken Breast)

Back 173

Projection of the sternum beyond the abdominal fontal plane

Front 174

Define: Barrel Chest

Back 174

AP dimension is greater than or equal to the lateral dimension of the thoracic cage and ribs appear more horizontal than sloped
- Normal varian after age 55, however, suggestive of COPD before that age

Front 175

Define: Gibbus Formation

Back 175

Sharp, short kyphosis due to vertebral collapse, secondary to Tuberculosis of the spine

Front 176

Define: Blue Bloater

Back 176

Patient usually with chronic obstructive bronchitis who is cyanosed from hypoxia and bloated from right side CHF

Front 177

Define: Pink Puffer

Back 177

Patient with emphysema who is thin and consistently breathless and hypercapneac; breathing is usually through pursed lips

Front 178

Define: Central Cyanosis

Back 178

Blue coloration of the mucous membranes of the mouth (especially lips and tongue); due to acute or chronic disease of either the heart or lungs causing the blood leaving the left side to the heart to be blue

Front 179

Clubbing of the fingernails occur as a result of what?

Back 179

Long-standing hypoxia

Front 180

Define: Fremitus

Back 180

Palpable vibrations transmitted through the bronchopulmonary tree to the parenchyma and then to the chest wall when the patient speaks

Front 181

Define: Crackles

Back 181

Abnormal respiratory sounds heard more often during inspiration and characterized by discrete discontinuous sounds, each lasting just a few milliseconds
- Suggestive of disease of lung parenchyma (pneumonia, fibrosis, early CHF)

Front 182

Define: Fine Crackles

Back 182

High pitched discrete discontinuous crackling sounds heard during the end of inspiration; not cleared by cough

Front 183

Define: Medium Crackles

Back 183

Lower more moist sound heard during the midstage of inspiration; not cleared by cough

Front 184

Define: Coarse Crackles

Back 184

Loud bubbly noise heard during inspiration; not cleared by cough

Front 185

Define: Rhonchi (Sonorous Wheeze)

Back 185

Loud low coarse sounds like a snore most often heard continuously during inspiration or expiration; coughing may clear sound (usually indicating mucous accumulation in trachea or large bronchi)

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Define: Wheeze (sibilant wheeze)

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Musical noise sounding like a squeak; most often heard continuously during inspiration or expiration; usually louder during expiration
- Suggestive of narrowed airways (COPD, asthma, bronchitis)

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Define: Pleural Friction Rub

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Dry rubbing or grating sound usually caused by inflammation of pleural surfaces; heard during inspiration or expiration

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Define: Scheppelman's Test

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- In patient that complains of thoracic cage pain, have patient bed away from side of pain
- If pain increases, suggestive of pleurisy