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112 Cards in this Set
- Front
- Back
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macule and patch?
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flat, not palpable
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papula and plaque?
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palpable
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nodule
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1-2 cm
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tumor
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larger than 2 cm
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wheal, vesicle and bulla
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fluid
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pustule
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pus filled
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scales
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peeling keratin
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crusts
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dried blood or puss
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erosions
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superficial loss of epidermis
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scars
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repaired skin
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keloids
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extend beyond original injury often from liquid burns
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ulcers
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deeper loss of epidermis or skin
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M.E.A.S.U.R.E.
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measure, exudate, appearance, suffering, undermining, re-evaluation, edge
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Lichenification
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thickened skin from scratching or rubbing, plaques of scaling. Exaggeration and widening of skin lines
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Telangectasia
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spider veins, dilated superficial capillaries
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what is nikolsky's sign
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blisters spread when you push on them
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what are the symptoms of peripheral Arterial disease?
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non-specific pain, pain in calf or thigh when walking, muscle cramps at night, cold, numb, or burning toes, occluded vessels
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what categories must you ask about when doing a vascular history?
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past medical history, surgical history, social history, family history, review of systems
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what are the common symptoms of ischemia?
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burning, numb, cramps, resting pain, dry shiny skin, hair loss, weak pulse, geographic temperature change, intermintent claudication
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what does rubor mean?
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read, flushing of the skin
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what is atherosclerosis?
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arterial blocking, causes poor circulation and can lead to gangrene in the extremities
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what is a cholesterol emboli?
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occluded vessels from a cholesterol plaque, manifested in marble skin, and is often seen after surgery
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What pulses do you search for in an arterial exam?
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dorsalis pedis, posterior tibialis, lateral tarsal, perforating fib, ant tib, popliteal, femoral
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where do you check for the lateral tarsal pulse?
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at the medial aspect of the cuboid
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what is the grading system of pulses?
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0 - absent
1 - barely palpable 2 - palpable 3 - strong 4 - bounding |
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where do you start to check for temperature change?
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tibial tuberosity
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what is the accepted amount of temp. change from proximal to distal?
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6-8 degrees
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what is a normal capillary filling time?
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less than 3 - 5 sec.
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what is petechia
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pinpoint areas of capillary bleeding from capillary rupture
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what is purpura?
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bluish black area due to platelet clotting factor defiecencies
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what are telangiectases?
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dilation of capillaires and small venules
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what are the non-invasive qualitative tests for vascular testing?
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doppler, pulse volume recordings (PVR), PPG's
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what are the quantitative tests non invasive vascular
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ankle/arm index, segmental pressure
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when is a doppler used?
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when pulses aren't palpable, or when there is a non-healing ulcer
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what are the doppler sounds called?
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mono, bi, and triphasic, tri is best. Tilt at 45 degrees towards the heart of the patient
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what is the ankle brachial index?
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highest systolic in arms/highest systolic in legs
above 1.3 = calcification below .9 = ischemia (.9, .7, .5 = mild moderate, severe). |
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dopplers: teepees or igloos?
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teepees (steeper the better)
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when doing a segmental pressure, what amount of drop in BP indicates disease at that level?
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20 mm (unreliable when calcified blood vessels)
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what is the difference between segmental pressures and pulse volume recordings?
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PVR - only inflated to 60-65 mm HG. Cuff expands with pulse, creates wave.
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what is standard BP in toes?
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30 mm HG
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What is Photoplethysmography PPG
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small infrared light measures blood flow in skin
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what is a duplex scan?
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ultrasound and doppler, used to locate blocks and access severity
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which arteries is Duplex scan not good for?
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tibial and fibular
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what is MRA?
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non-invasive use for vessel identification
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what is an arteriograom/angiogram?
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injected dye into vessel = roadmap of blocked vessels
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what is superficial thrombophlebitis?
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block in the veins in the leg. acute pain, local swelling, palpable cord over area of involvement.
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what are the symptoms of deep vein thrombosis?
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asymmetric edema of leg, pain w/ calf compression AND FOOT DORSIFLEXION (HOMAN'S SIGN)
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how do you diagnose DVT?
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vein doesn't collapsew/ compression, absent or abnormal vein pulsation on doppler scan
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what is the brodie/trendelenburg test?
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elevate extremity, apply tourniquet mid-thigh, not standing. fill time = 35 sec. more = arterial problem, less = invompetent valves, fast fill after release = bad superficial system
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What is Perthes test
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same as brodie's, except patient is walking for 3-5 minutes (superficial should collapse). no change = bad comm. valves, if engorged = blocked deep veins
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in lymphedema, what part of the foot does not swell?
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dorsal foot
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what nerve is patellar reflex?
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L4
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what nerves is the achilles reflex?
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S1
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where do the fibers of the corticospinal level cross?
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medulla (some fibers don't cross at all)
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What happens in the extrapyramidal levels?
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maintain muscle tone, controls auto. body movements (walking). refinement of voluntary movement
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what is the role fo the cerebellum?
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coordination, maintain equilibrium, helps control posture
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What is the role of the lateral spinothalamic tract?
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carries pain and temp. crosses w/in 1 or 2 spinal segments upon entering cord. protopathic sensations
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what is the role of the posterior sensory column (dorsal)?
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vibration and position , ascends in gracilis and crosses in medulla. epicritic sensations
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what is the role of the anterior spinothalamic column?
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crude touch, enters the spinal cord and crosses within one or two spinal levels
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what are the cutaneous nerves?
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saphenous, common superfical and deep fib, tibial
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when testing the motor system, what things do you want to look for?
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muscle volume, tone, strength, coordination
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what is the scale for muscle strength?
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0 - no contraction
1 - trace of contraction 2 - limb move w/ gravity 3 - move against gravity 4 - move against gravity + 5 - move against resistance |
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what is the diference between neuropathy and radiculopathy?
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rad - problem with the nerve root. neuro is peripheral
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what are examples of SMPM?
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diabetes mellitus, chronic renal, B12 def., hypothyroidism, Chorcot tooth,
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what are examples of polyradiculoneuropathy?
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lyme disease, CIPD, Barre syndrome
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what are examples of mononeuritis multiplex?
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diabetes, Lyme, leprosy, vasculitis
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what is a semmes weinstein monofiliament used for?
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protective sensation
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what are the causes of peripheral neuropathy?
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DANG THERAPIST!!!
(Diabetes, Alcohol, Nutrition, Gullian barre, Toxic, HEredity, Recurrent, Amyloidosis, Porphhyria, Infection, Systemic, Tumor |
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what are reflex recordings for the achilles reflex
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4 - hyperactive
2 - normal (plantarflexion of toes) 0 - no response |
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when is scissor knees seen?
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MS
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what problems are associated with the lower motor neuron?
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flaccid paralysis
atrophy deceased muscle tone decreased muscle strength poor coordination |
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what problems are associated with the pyramidal tract?
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spastic paralysis
clasp-knife hyperactive reflexes atrophy increased tone decreased strength poor coordination |
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what problems are associated with the extrapyramidal tract
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cog wheel, rigid muscles
resting tremor problematic tone slow coordination |
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what probelms are associated with the cerebellum
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intention tremor
lower coordination dysdiadochokinesia widened based gait |
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what happens if there is a central cord lesion?
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loss of pain and temp. in a dermatone
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what happens if there is a lesion in the posterior column?
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loss of proprioceptive sensation
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what happens if there is a half of cord transection?
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brown sequard syndrome - loss of sensation on ipsilateral, loss of pain and temp on contralateral
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L4 radiculopathy?
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anterior thigh, inner shin pain. (quads and tib. ant.)
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L5 radiculopathy?
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post lat thigh, outer calf, dorsal foot pain - foot drop
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S1 radiculopathy?
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back of thigh, calf, lat foot and lesser toes pain - test long head of biceps femoris
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what is the role of the autonomic peripheral nervous system?
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cardiac muscle, smooth muscle, perspiration, digestion
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what is electromyography used for?
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to test the electrical activity of muscles, and to help in estimation of nerve lesion chronicity and severity
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what is nerve conduction velocity used for
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distinguish between peripheral and root damage
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what are the common things seen in elderly, middle aged, young adults and children when doing a dermatologic exam?
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old - solar damage, actinic keratosis, cancer, xerosis, nail dystrophies, infection, ulcers
middle - dermatitis, mechanichal keratoses, tinea, eczemas young - verrucae, IGTN's child - tinea pedis, eczema |
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what are more commonly found in females?
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vasospastic disorders, atrophy, stasis dermatitis, diabetic dermopathies
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what are more commly found in males?
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keratoderma of Reiter's, tinea (fungal issues), onychomychosis (fungal infection of the nail)
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when is atrophy blanche commonly seen?
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women age 30 - 60 with recurrent venous leg ulcers and vein insufficiency
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why is race and ethnicity important?
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less melanin = solar damage and skin cancer risk
high melanin = longitudinal melanonychia and plantar nevi risks Celtic = xerosis risk Mediterranean = Kaposi's risk Asia - Madura foot, hepatitis, Africa - elephantitus, lymphedema Southwest US - brown recluse bites, blastomycoses Midwest - poison oak and ivy |
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why is recording leasure activities important?
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talon noir - basketball or volleyball
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what does NLDOCAT mean?
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nature, location, duration, onset, course, aggrivation, treatment
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what is usually found on the flexor and extensor surface of the arms?
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flexor - atopic dermatitis
extensor - psoriasis |
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what skin problems are commonly found on the hands?
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warts, paronychia, tinea manum, punctate keratadoma,
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what skin problems are commonly seen in the groin
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tinea cruris, discharge, ulcers
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what skin problems are commonly seen on the legs?
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extensor - psoriasis, flexor - atopic dermatitis
also telangectasias, varices, stasis dermatisis |
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what skin problems are commonly seen on the feet?
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tinea pedis, onychomycosis, pressure keratoses, warts
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what do annular, archiform, polysyclic, and serpingious mean?
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annular - circle (tinea, psoriasis, drugs)
archiform - arcs polycyclic - intersecting circles serpingious - wavy lines |
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what do iris, zosteriform, retiform grouping mean?
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iris - bull's eye pattern
zosteriform - broad band (herpes, shingles) retiform - criss cross |
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what are macules and patches?
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flat alteration in skin color, not raised or depressed. Examples are freckles or tattoos. Patches are macules bigger than 1 cm.
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what are papules and plaques?
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elevatedabove skin level, moles and goosebumps, plaques are papules larger than 1cm, plantar warts
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what are wheals and vesicles?
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localized edema, misquito bites - fluid filled are vesicles, herpes simplex
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what are bullae?
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large fluid filled vesicles, blisters
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what are scales and crusts?
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scales - exfoliation of acculumulated dead stratum, dandruff
crusts - dried blood (scab) |
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what are excoriations and fissures?
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excoriations - scratches
fissures - cracks in skin, suggests ischemia |
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what are erosions?
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base of a ruptured blister
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what are keloids?
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scar - kind seen in severe burns
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what is lichenification?
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thickened skin from rubbing, (scratched plaques)
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what is telangectasia?
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spider veins, usually harmless, can be associated with pregnancy and portal vein hypertension
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what conditions can stain the skin yellow?
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excess carotene and jaundice
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when is a mole considered suspicious?
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asymmetry, irregular border, color variation, diameter larger than 6mm, elevated
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what is nikolsky's sign
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blister that spreads in the skin when you push on it
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what is auspitz's sign of psoriasis?
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pinpoint bleeding when forcible removal of scales
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what glows in wood's light test?
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erythrasma - red
psuedomonas - white urine - pink microsporum - green yellow |
