Etp Pa Exam I

Front 1

Why learn basic clinical skills?

Back 1

70% of diagnoses can be made based on history alone. 90% of diagnoses can be made when the physical exam is added.

Front 2

What are the four types of data collection?

Back 2

1/ complete/classic (traditional history and physical)
2/ episodic
3/ follow-up
4/ emergency

Front 3

"classic" history and physical

Back 3

introductory Information
CC- chief complain
HPI- history present of illness
PMH- past medical history
current health
social, occupational, family history
functional assessment (ADLs, IADLs)
ROS- review of systems
PE- physical exam

Front 4

analysis of a symptom

Back 4

OPQRSTU- onset, provocation/palliative, quality/quantity, radiation/relief, severity, time, understanding

Front 5

PMH

Back 5

general health, childhood illnesses, adult illnesses, obestetric/contraceptive history, psych, accidents/injuries

Front 6

gravida

Back 6

number of pregnancies, regardless of whether they were carried to term

Front 7

para

Back 7

number of live births

Front 8

abortus

Back 8

number of pregnancies that were lost for any reasons, i.e. miscarriages and abortions

Front 9

current health

Back 9

medications, allergies, habits, screening tests, sleep patterns, exercise/leisure, diet, environmental, use of safety measures

Front 10

How many generations should a family history include?

Back 10

3!

Front 11

palpation

Back 11

purpose is to confirm points you noticed during inspection; assess texture, moisture, temperature, organ location and size, masses, pulsations, crepitus, tenderness

Front 12

Which parts of the hands should you use for fine discriminations, temperature, and vibrations?

Back 12

tips, dorsal, palmar aspects of mcp joints or ulnar surface

Front 13

What are the four assessment techniques? List in the order of performance.

Back 13

1/ inspection
2/ palpation
3/ percussion
4/ auscultation

Front 14

What is the special case for abdominal exams?

Back 14

Inspect and listen before you touch!

Front 15

percussion

Back 15

gently tap part of body w/ finger or instrument

Front 16

When would you directly percuss? When would you indirectly percuss?

Back 16

The only time you directly percuss is when assessing the thorax of a child's sinuses. Indirect percussion for everything else.

Front 17

sounds via percussion

Back 17

tympani- found in abdomen
resonance- air-filled lung/organ, is normal
dullness- dense organs (e.g. liver, spleen)
flatness- bone, tumor

Front 18

Which method yields the most physical signs?

Back 18

Inspection: although the least mechanical, it provides an enormous amount of information.

Front 19

auscultation

Back 19

listening to internal organs of the body

Front 20

diaphragm v. bell

Back 20

diaphragm- higher pitch sounds v. bell- lower pitch sounds

Front 21

vital signs

Back 21

-height/weight measurement; head circumference for peds
-temperature
-pulse
-respiration
-BP
-pain

Front 22

body mass index (BMI): adults v. peds

Back 22

weight (kg) / height (m)2
*always check if patient has weight problem or CHF

peds use percentiles (obese > 95)

Front 23

pulse

Back 23

measures stroke volume
60-100; <60 is bradycardia; >100 is tachycardia
assess for rate, rhythm, quality (force), elasticity

listen to heart if rhythm is irregular

Front 24

How to rate quality of pulse?

Back 24

1+ thready, e.g. shock
2+ normal pulse
3+ bounding, e.g. s/p exercise

Front 25

influences on temperature

Back 25

1/ diurnal cycle- lowest @ AM, highest @ PM
2/ menstrual cycle- 0.5 increase during ovulation
3/ exercise
4/ age- geriatric is usually one degree > adult

Front 26

respiration

Back 26

infants: 30-40
adults: 10-20

*usually 1/4 of pulse

Front 27

temperature

Back 27

average oral: 37 C or 98.6 F
rectal: 0.5 C or 1F > oral
axillary: 0.5 C or 1F < oral
tympanic: 0.8 C or 1.4 F > oral

Front 28

BP

Back 28

"pressure of blood against the wall"

systolic pressure- max pressure felt on wall during ventricular systole (when heart contracts)

diastolic pressure- elastic recoil/resting pressure during diastole

Front 29

influences on blood pressure

Back 29

age- BP rises as we get older (thickening of artery)
gender- women < men after puberty until menopause
race- blacks are 2x HTN than white
diurnal- higher in PM
higher in obese, during stress, exercise

peripheral vascular resistance & elasticity
volume/viscosity or circulating blood
cardiac output

Front 30

auscultatory gap

Back 30

silent interval that may be present b/w systolic and diastolic pressures

Front 31

orthostatic hypotension

Back 31

drop in systolic pressure > 20 mmHg
pulse increase >20 bpm

*usually occurs when patient is bleeding; should take vitals in supine, sitting, and standing

Front 32

What is the approach for pediatric physicals?

Back 32

QUIET TO ACTIVE

Front 33

T/F. Adolescents can consent to pregnancy and drug testing.

Back 33

True

Front 34

What is the approach for adolescents?

Back 34

HEADSSS- home, education, activities, drugs, sexuality, safety, suicide

Front 35

peds growth curve v. preemies growth curve

Back 35

measure height/weight for every well visit
>dropping off curve is bad; starting out on lower end, but following the curve is not as concerning

v. preemie growth charts which corrects for age through age 2

Front 36

When do you start a new growth chart?

Back 36

after age 2

< 2, measure length- patient is lying down
> 2, measure height- patient is standing up

measure head circumference until age 2

Front 37

peds temperature routes/variations

Back 37

*rectal is most accurate
temporal- not accurate under 3 mos
tympanic- not accurate under 6 mos

Front 38

peds heart rate

Back 38

apical pulse is the most accurate for children younger than 2

Front 39

peds BP

Back 39

*start measuring @ age 3
BP will get higher as child gets older

HTN if child is >95% in height, weight, age, or gender group

Front 40

bones of face and cranium

Back 40

bones unite @ sutures (immovable joints)
cranium is supported by C1-C7

Front 41

facial muscles

Back 41

Front 42

acromegaly

Back 42

brow prominent, soft tissues of nose, ears, and lips are enlarged, prominent jaw

*anterior pituitary gland problem

Front 43

fetal alcohol syndrome

Back 43

nose: widen bridge, flat, upturned

Front 44

bell's palsy

Back 44

*damage to facial nerve- lose movement @ top and bottom of face (e.g. close eyes, raise eyebrows)

patients who are unable to close eyes w/ long term bell's palsy have weight placed so they don't get too dry

stroke patients can close/open eyes; raise eyebrows

Front 45

temporomandibular joint

Back 45

below temporal artery, anterior to tragus
*most active joint in body; decrease ROM- arthritis; click- miniscus tear, poor occlusion or synovial swelling

Front 46

When palpating the temporal artery, what are you assessing for?

Back 46

should not feel indurated (hard) or tortuous (wavy)

Front 47

external eye structures

Back 47

palpebral fissure- opening of upper and lower eye lid
pupil- where light enters
iris
limbus- border b/w cornea and sclera
medial & lateral canthus
caruncle- crease of eye

Front 48

anatomy of eye

Back 48

tarsal plate- in lids to give structure/shape

meibomian glands- secrete oily substance to clear dust

*conjunctiva-
>bulbar- goes over sclera, clear but appears white
>palpebral- lines the lids, clear but appears pink

Front 49

What does it mean when you see white on top of the eye when it is open?

Back 49

Eye is protruding! The upper eye lid is more mobile than lower and should be able to cover the iris.

Front 50

lacrimal apparatus

Back 50

*provides constant irrigation

secretes tears >> puncta >> nasolacrimal sac >> nose

Front 51

What are the three layers of the eye?

Back 51

1/ sclera- outer layer; white; covers iris & pupil

2/ choroid- middle layer; darkly pigmented; extremely vascular- delivers blood to retina

3/ retina- inner layer; visual center

Front 52

ciliary body

Back 52

*controls thickness of lens, produces aqueous humor

bulges out for near objects
flattens for far objects

Front 53

compartments of the eye

Back 53

anterior- aqueous humor, how eye gets nutrients and gets rid of waste

posterior- vitreous humor is "gel-like" substance which can clog together to form "floaters"

Front 54

What are the extraocular muscles?

Back 54

straight muscles: superior rectus, inferior rectus, lateral rectus, medial rectus

rotary muscles: superior oblique, inferior oblique

*conjugate movement of eye prevents double vision

Front 55

CN VI

Back 55

abducens

innervates lateral rectus (look out to side)

Front 56

CN IV

Back 56

trochlear

innervates superior oblique (look down and in)

Front 57

CN III

Back 57

oculomotor

innervates the rest: superior, medial, and inferior rectus & inferior oblique

Front 58

visual field

Back 58

entire area seen by eye while looking at central point

when using both eyes- binocular, overlap
when using one eye- monocular vision

Front 59

visual pathway

Back 59

for image to be seen, light has to hit pupil and be perceived by sensory neurons @ retina

*images are projected upside down and reversed from right to left

Front 60

visual reflexes

Back 60

pupillary light reflex- direct and consensual
light travel through CN II, splits at optic chiasm, sends message to both side of the brain, and response via CN III

fixation- when looking straight ahead, fovea/macula is fixated

accommodation

Front 61

snellen chart

Back 61

20/50; can read at 20 feet what normal eye can read at 50 feet

20/200; legal blindness

Front 62

myopia v. hyperopia

Back 62

myopia- nearsighted, eye too long

hyperopia- farsighted, eye too short

Front 63

strabismus

Back 63

asymmetrical corneal light reflex

weakness/paralysis of one or more of the extraocular muscles, does not have conjugate vision

Front 64

ptosis

Back 64

one eye drooping more than the other; could be CN or congenital problem

Front 65

aniscia

Back 65

unequal pupils

Front 66

optic nerve cut prior to optic chiasm

Back 66

unable to see; cannot get to occipital cortex

Front 67

optic chiasm cut

Back 67

bitemporal hemianopsia- lose vision in both temporal area

Front 68

R optic tract cut

Back 68

left homonymous hemianopsia- can see temporal w/ R eye and nasal w/ L eye

Front 69

papilledema

Back 69

inflammation of optic disk (becomes blurry and puffy) due to intracranial pressure

Front 70

glaucoma

Back 70

increased intraoccular pressure in anterior chamber of eye, cornea will be cloudy

Front 71

structure of skin

Back 71

epidermis, dermis, subcutaneous layer

Front 72

epidermis

Back 72

thin, outermost layer, avascular (nourished by dermis)

> stratum corneum- outer most horny cell layer- dead keratin cells
> stratum germinativum- inner basal cell layer- living cells: keratin and melanocytes

Front 73

dermis

Back 73

dense connective tissue layer forming the bulk of the skin

>chiefly collagen (resistant to tearing), elastin, hair follicles, glands, vascular

Front 74

subcutaneous layer

Back 74

chiefly adipose tissue- thermal regulation

Front 75

sweat glands

Back 75

apocrine- active after adolescence, closely associated w/ hair follicles, coarse air, milky secretions, only active during sexual/emotional situations

eccrine- matures by 2 months, transparent secretion, goes directly to epidermis

Front 76

psoriasis

Back 76

skin redness and irritation; most people with psoriasis have thick, red skin with flaky, silver-white patches called scales

Front 77

pallor

Back 77

loss of color; fear, cold

>anemia?

Front 78

erythema

Back 78

redness of skin; excitement, embarrassment, hot

>localized infection
>s/p exercise
>poisoning
>emotional event

Front 79

raynaud's disease

Back 79

cold temperatures or strong emotions cause blood vessel spasms that block blood flow to the fingers, toes, ears, and nose

Front 80

jaundice

Back 80

yellowish pigmentation of skin; usually seen in mouth/eye before skin

>liver disease
>hepatitis- sclera turns yellow
>sickle cell

Front 81

cyanosis

Back 81

decreased perfusion of tissue w/ oxygenated blood: blue

>shock
>heart failure
>chronic bronchitis

Front 82

vitiligo

Back 82

melanocytes are devoid of color (MJ)

Front 83

acanthosis nigricans

Back 83

increased pigmentation; seen in adolescent/older adults who are insulin resistant

Front 84

mongolian spots

Back 84

hyper-pigmentation (blue, black, purple), starts to fade after year 1

common in Black, Asians, Native Americans

Front 85

acne

Back 85

1/ comedonal- black or white heads

2/ pustular

Front 86

Explain the changes in skin in older adults.

Back 86

They have less fat, vessels break easily, less elastin, and longer wound repair

>more wrinkling
>senile purpura- easy bruising
>xerosis- dry skin
>senile lentigines- "liver spots" melanocytes clump together from sun exposure; not cancerous, no treatments

Front 87

edema

Back 87

overaccumulation of interstitial fluid

possible affected system
>circulatory
>cardiovascular
>kidney
>lymphatic

Front 88

primary skin lesions

Back 88

macula, patch
papule, plaque
nodule, tumor
wheal, urticaria
vesicle, bulla
cyst
pustule

Front 89

macule v. patch

Back 89

macule- flat, non palpable change in skin color, up to 1 cm

patch- macule larger than 1 cm

Front 90

papule v. plaque

Back 90

papule- palpable, elevated, solid mass caussed by superficial thickening of epidermis, up to 0.5 cm

plaque- coalescence of papules, larger than 0.5 cm

Front 91

nodule v. tumor

Back 91

nodule- solid, elevated, soft or firm mass less than 1-2 cm

tumor- larger than 1-2 cm, may extend deeper into dermis

Front 92

wheal v. urticaria

Back 92

wheal- superficial, raised, erythematous, transient lesion w/ irregular borders due to localized edema; fluid is held diffusely in the tissues

v. urticaria- wheals coalescing, pruritic

Front 93

vesicles v. bullae

Back 93

vesicle- cirumscribed, superficial elevated cavity; contains free fluid, up to 1 cm

bullae- larger than 1 cm; usually single chambered, thin wall, easily ruptured

Front 94

cyst

Back 94

encapsulated fluid or pus-filled cavity in dermis or subcutaneous layer, larger than 1 cm

Front 95

pustules

Back 95

circumscribed, superficial, elevated cavity, contains turbid fluid (pus), up to 1 cm

Front 96

secondary skin lesions

Back 96

crust
scale
fissure
erosion
ulcer
excoriation
scar
atrophic scar
lichenification
keloid

Front 97

crust

Back 97

thickened dried residue of burst vesicles, pustules or blood; red-brow, honey-colored, or yellow

Front 98

scaling

Back 98

compact desiccated flakes of skin; visible exfoliation of the dermis; shedding of dead excess keratin cells

Front 99

fissures

Back 99

linear crack w/ abrupt edges, extends into dermis; dry or moist

Front 100

erosion v. ulcer

Back 100

erosion- superficial circumscribed loss of epidermis; moist but no bleeding; heals w/o a scar; "stage 2 pressure sore"

ulcer- circumscribed depression extending into dermis; irregular shape; may bleed; scar

Front 101

excoriation

Back 101

scratch mark, superficial

Front 102

scar

Back 102

replacement of destroyed normal skin tissue by fibrous connective tissue

Front 103

atrophy

Back 103

depressed skin level >> loss of tissue; thinning of epidermis w/ loss of normal skin resulting in shiny translucent skin

*like a scar, but depressed

Front 104

lichenification

Back 104

thickening/roughening of skin (usually from scratching); results from tightly packed papules

Front 105

keloid scar

Back 105

hypertrophic; skin level is elevated by excess scar tissue, which is invasive beyond site of original injury

Front 106

common shapes/configurations of lesions

Back 106

confluent- coalescing (edges overlap)
grouped- multiple lesions (edges don't overlap)
gyrate- angled, tunneling (not straight)
polycyclic- multiple round lesions
zosteriform- following a dermatome

Front 107

vascular lesions

Back 107

petechiae, purpura
ecchymosis
cherry angioma
spider angioma
telangiestasia
nevus flammeus "port wine stain"

Front 108

petechiae v. purpura

Back 108

petechiae- red, pin sized macules of blood; < 3 mm

purpura- 0.3 to 1 cm

*blood filled lesions do not blanch

Front 109

ecchymosis

Back 109

escape of blood into tissues from ruptured blood vessels; small hemorrhagic spot in skin; non-elevated, blue/purplish patch; > 1 cm

*larger bruise

Front 110

cherry angioma

Back 110

aka Campbell de Morgan spots

bright red papules; benign; common on trunks of middle-aged and elderly

Front 111

spider angioma

Back 111

*if many on trunk, check liver function- possible deficiency; may be normal in children and pregnant women

stellate telangiectases radiating from central palpable feeding vessel

Front 112

telangiectasia

Back 112

permanently dilated and visible vessels in the skin

*can be caused by nifedipine

Front 113

nevus flammeus

Back 113

aka port wine stain, stork bite

present at birth, caused by dilated dermal capillaries; pale pink to purple macules; mostly on face or trunk

Front 114

skin warning signs

Back 114

"ABCDE"

asymmetry
border- irregular
color- mottled
diameter- unusually large (> 6 mm)
elevation
*enlargement

Front 115

basal cell carcinoma

Back 115

most common malignancy
locally invasive and destructive
slow growing, rarely metastasized
translucent, dome-shaped papule with overlying telangiectasias

Front 116

actinic keratosis

Back 116

yellowish; can progress into squamous cells

Front 117

squamous cell carcinoma

Back 117

invasive malignancy; common on head, neck, hands
"sore- heals and opens continuously"

Front 118

melanoma

Back 118

superficial spreading or nodular; can be benign or malignant; usually dark from the pigments produced by melanocytes

Front 119

What are the two types of hairs?

Back 119

1/ vellus- fine faint hair covers most of body
2/ terminal- eyebrows, scalp, pubic, face, chest

Front 120

What happens to the hair as we get older?

Back 120

Melanin gets replaced by colorless air bubbles, resulting in gray or white hair.

Front 121

alopecia areata v. alopecia totalis

Back 121

alopecia areata- non-scarring hair loss; usually an immunological phenomenon

alopecia totalis- total hair loss

Front 122

hirsutism

Back 122

excessive hairiness @ sites where terminal hair does not normally occur (hair, face, thigh, abdomen); in women; check for hormones

Front 123

What happens to nails as we age?

Back 123

Nails are thickened, ridged and split in older adults.

Front 124

measurement of nail angle

Back 124

check for clubbing; associated w/ cystic fibrosis, cancer, lung disease

Front 125

external ear structures

Back 125

most skin cancer findings are in helix
tragus gets tender during infection

Front 126

anatomy of ear

Back 126

1/ external ear- funnels sound waves to TM

2/ middle ear (MIS)- conducts sound vibrations, reduces amplitude of sound, equalization of air pressure

3/ inner ear- vestibular fx, bony, cochlear

Front 127

Where is the cone of light on the R and L ear on the TM?

Back 127

R 5:00
L 7:00

Front 128

What is the anatomic/developmental difference in the ears of infants?

Back 128

Their eustachian tubes are shorter, wider, and more horizontal, making them more prone to infection.

Front 129

otosclerosis

Back 129

abnormal spongy bone growth in middle ear that causes hearing loss; more common in females than males

Front 130

presbycusis

Back 130

age-related hearing loss; tiny hairs get lost w/ age

Front 131

What is the most efficient hearing pathway?

Back 131

Air conduction is more efficient than bone conduction.

Front 132

tinnitus

Back 132

"ear ringing"

Front 133

weber test

Back 133

place 512 fork in midline of head; ask if sound is louder in one ear than other

Front 134

rinne test

Back 134

bone conduction- place on mastoid process
air conduction- outer ear

Front 135

Person with normal hearing ...

Back 135

Weber- hear vibration equal bilaterally
Rinne- AC > BC (last longer)

Front 136

Person with conductive hearing lost ...

Back 136

Weber- will lateralize to bad ear
Rinne- BC = AC; BC > AC

common causes- fluid, ear wax, damage to ear drum

Front 137

Person with sensorineural loss ...

Back 137

Weber- will lateralize to good ear
Rinne- AC > BC (decreased amount of time, same ratio) or they may not hear at all

Front 138

If pain when palpating mastoid process, what should you consider?

Back 138

otitis media, mastoiditis

Front 139

If pain when palpating tragus, what should you consider?

Back 139

otitis externa

Front 140

kiesselbach region

Back 140

anteroinferior part of nasal septum; where four arteries anastomoses

*common site for nose bleeds

Front 141

structures of nasal cavity

Back 141

anterior edge is lined w/ coarse nasal hairs- filters air; remainder is lined w/ ciliated mucous membranes to filter dust and bacteria

Front 142

T/F. Nasal mucosa is redder than oral mucosa.

Back 142

True; it has a larger blood supply

Front 143

lateral wall turbinates

Back 143

superior meatus- ethmoid cells
middle meatus- sinuses
inferior meatus- tears

Front 144

sinuses

Back 144

air-filled pockets within cranium to lighten weight of skull; we have for pairs of paranasal sinuses

Front 145

epistaxis

Back 145

nosebleeds

Front 146

polyps

Back 146

smooth gray nodules; overgrowth of mucosa; result of chronic allergies; non-tender; often removed b/c of breathing/snoring problems

Front 147

perforated septum

Back 147

cocaine use, excessive use of nasal spray

Front 148

rhinitis

Back 148

allergic or acute; pale inside; usually clear fluid, if pusy- possible sinus infection

Front 149

palpate sinuses

Back 149

get underneath sinus and push up

Front 150

transillumination

Back 150

shoot light through sinus >> red light if sinus is clear

Front 151

oral cavity structure

Back 151

tonsils are b/w posterior and anterior pillar

adult- 32 teeth; children- 20 teeth

Front 152

salivary glands

Back 152

*moistens food

parotid, submandibular, sublingual

Front 153

stenson's duct

Back 153

opening of parotid salivary gland; opposite upper second molar

Front 154

wharton's duct

Back 154

opening of submandibular salivary glands

Front 155

normal findings of the mouth

Back 155

fordyce spots- yellow inside cheeks
torus palatinus- roof of mouth
scrotal tongue- multiple fissures
geographic tongue- areas devoid of papillae

Front 156

CN XII

Back 156

hypoglossal

tongue should protrude midline w/o tremors or deviation; if it does deviate >> will go towards paralyzed side

Front 157

CN X

Back 157

vagus

"AHH" >> soft palate rises up and uvula stays midline

Front 158

grading tonsils

Back 158

1+ visible
2+ halfway b/w pillars and uvula
3+ touching uvula
4+ touching each other

Front 159

viral pharyngitis

Back 159

redness and vascularity of pillars and uvula; pt c/o of sore throat or scratchy throat

Front 160

bacterial pharyngitis

Back 160

red throat w/ exudate (pus) on tonsil; fever and enlarged cervical nodes; could be streptococcal infection

Front 161

thyroid gland

Back 161

endocrine gland w/ rich blood supply

thyroid cartilage (Adam's apple)
cricoid cartilage
isthmus lies over trachea at 2nd or 3rd tracheal ring

Front 162

lymph nodes

Back 162

*removes impurities; @ interstitial tissue; all over body but can only assess them at neck, under the arm, and groin

palpate w/ tip of finger, soft circular motion

swollen, tender- infection, inflammation, < 1 cm
hard, unmovable- cancer, > 1 cm

Front 163

CN XI

Back 163

spinal accessory; innervates sternomastoid and trapezius muscles (lift up shoulder against pressure)

Front 164

List all the lymph nodes!

Back 164

preauricular, postauricular, occipital
tonsillar, submandibular, submental
superficial cervical, posterior cervical, deep cervical
supraclavicular, infraclavicular

Front 165

If patient had the following conditions, where would you expect swollen lymph nodes? (eye infection, ear infection, hair dye, sore throat)

Back 165

eye- preauricular
ear- postauricular, preauricular
dye hair- occipital
sore throat- tonsillar

*always draining towards the heart

Front 166

abnormal trachea

Back 166

if on one side >> collapse lung
if mass is pushing trachea >> bulge in neck

Front 167

When checking for carotid pulse, which parts do you check?

Back 167

Always the lower third or the upper third--there is a sinus in the middle.

Listen for bruit (turbulent blood flow, "whoosh"), can hear if person has 70% occlusion)

Front 168

goiter (enlarged thyroid)

Back 168

thickening throughout neck; could be hyperthyroidism, hypothyroidism, or uthyroidism (normal)

>> always feel for nodules; single nodule is more concerning for cancer

Front 169

T/F. Suture lines may not be palpable at birth.

Back 169

True

Front 170

fontanels

Back 170

"soft spots"

*anterior- diamond shaped, 2 cm in term infants
posterior- triangular shaped, may or may not be palpable

Front 171

Normal fontanels are soft/flat. What does it mean if it is bulging or sunken?

Back 171

swollen- hydrocephaly
sunken- dehydration

Front 172

T/F. Term infant are hyperopic (farsighted) at birth.

Back 172

True

Front 173

red light reflex (bruchner test)

Back 173

to detect disease processes preventing light from entering/exiting pupil

if cataracts >> will see black spots!

Front 174

leukokoria

Back 174

whitish opacity of pupil w/ absent/partial red reflex

Front 175

Explain the difference in ear assessment b/w peds and adults.

Back 175

For peds, pull auricle inferiorly.

Front 176

T/F. Sinuses are fully formed in children.

Back 176

False; the continue to develop throughout childhood.

Front 177

T/F. Children have larger tonsils than adults.

Back 177

True

Front 178

ankylglossia

Back 178

shortened lingual frenulum; not usually repaired b/c it doesn't affect speech/feeding