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188 Cards in this Set
- Front
- Back
Definition: Temperature
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The balance/net between the heat produced by the body and the heat lost from the body
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Temperature regulators are located where?
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Body's core and in the hypothalamus
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If core temperature is increased?
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- Sweating is initiated
- Vasodilation occurs |
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If core temperature is decreased?
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- Sweating is inhibited
- Shivering is initiated |
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Normal temperature reading
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98.6° F (37°C)
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Normal range of temperature
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96.4°F - 99°1 F
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Rectal temperatures
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Average 0.7° - 0.9° higher
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Axillary temperatures
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Average 0.7° - 0.9° lower
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Tympanic temperatures
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Record measurements somewhere between oral and rectal readings
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Temperature in infants and children
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- Immature temperature control mechanism
- Increased metabolic state - Higher readings |
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Temperature in the elderly
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- Decreased efficiency of thermoregulation and decreased H20
- Decreased metabolic state - Lower readings |
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Temperature can fluctuate how much in a 24 hour period
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2•F
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Highest temperature occurs between what times?
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8pm and midnight
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Lowest temperature occurs between what times?
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4am and 6am
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Exercise can increase temperature how much?
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3°F (as heat production)
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Effect of progesterone on temperature
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(Ovulation time)
- Increase 0.5° - 1°F |
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Effect of estrogen on temperature
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(Peaks before ovulation)
- Slightly decreased temperature |
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What hormones can affect temperature in both sexes?
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- Thyroid
- Adrenal - Pituitary |
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Stress will increase or decrease temperature?
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Increase
(Both physiologic and psychologic stress) |
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Definition: Pyrexia (Fever State)
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A body temperature above normal range
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Physiologic cause of pyrexia
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"Set point" in hypothalamus has been reset to a higher temperature due to presece of pyrogens, brain injury, viral agent, etc.
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Histologic effects of pyrexia
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- 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 |
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Physiologic effects of pyrexia
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- 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 |
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"Fever Crisis"
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When the patient appears flushed and sweaty
- This occurs once the fever cause is removed and the hypothalamus returns back to normal |
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Techniques to take Temperature
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- 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 |
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Definition: Pulse
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A wave of blood created in an artery synchronized with the contraction of the left ventricle
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- Tachycardia?
- Bradycardia? - Eucardia? |
- Tachycardia: increased pulse rate
- Bradycardia: decreased pulse rate - Eucardia: normal pulse rate |
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SA node regulation of pulse
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1° sympathetic nervous system
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Ventricular regulation of pulse
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1° parasympathetic nervous system
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Pulse: Normal Range
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60 - 100 beats per minute
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Affect of age on pulse
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Increased pulse due to increase in BMR in infants and young children
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Affect of gender on pulse
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After puberty, males slightly lower than females
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Affect of exercise on pulse
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- Cardiovascularly toned individual has decreased pulse and decreased reaction to exercise
- Weekend Warrior has increased pulse and increased reaction to exercise |
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Affect of fever on pulse
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For every 1° of fever, the pulse increases ten beats per minute
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Affect of hemorrhage and stress on pulse
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Increases pulse
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Affect of sitting on pulse?
Affect of lying down on pulse? |
Sitting: increases
Lying down: decreases |
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Pulse Grading
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4 = bounding
3 = full, increased 2 = expected, normal 1 = diminished, barely palpable, thready 0 = absent, not palpable |
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What do you do if you think the pulse rhythm is irregular?
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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 |
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- Tachypnea?
- Bradypnea? - Eupnea? - Dyspnea? - Apnea? |
- Tachypnea: increase in respiratory rate, > 20
- Bradypnea: decrease in respiratory rate, < 20 - Eucardia: normal breathing - Dyspnea: difficult breathing - Apnea: no breathing |
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What regulates respiration?
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- Medulla sets the rate
- Pons sets the depth |
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Respiration: Normal Range
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12 - 20 cycles per minute
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What can increase respiratory rate?
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- Exercise
- Stress - High altitude (2° hypoxia) - High temperature (ambiant or core) |
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Affect of age on respiratory rate
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- Infants and young children have increased rates due to increased BMR
- Elderly have decreased rates due to decreased BMR |
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Define: Cheyne-Stokes Respiration
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Marked rhythmic waxing and waning of respiratory rate and depth with periods of apnea
Associated with increased intracranial pressure (trauma, tumor, toxin, infection) |
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Define: Kussmaul Respirations
(Hyperventilation) |
An increase in respiratory rate and depth
Associated with metabolic [keto]acidosis, panic attakcs, pulmonary emboli, exercise |
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Define: Biot's Respirations
(Ataxic Breathing) |
Irregularly shallow and deep breaths interrupted by irregular periods of apnea
Associated with respiratory depression, brain damage especially at medulla |
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What should you note when assessing respiration?
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- Ease of respirations
- Depth of respirations - Use of accessory muscles - Presence of wheezes - Presence of any abnormal breath patterns |
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Define: Blood Pressure
- Systole - Diastole |
A peripheral measurement of cardiovascular function
- Systole: amount of pressure in arteries during contraction - Diastole: amount of pressure in arteries during relaxation |
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Regulation of blood pressure
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- Brain (responds to baroreceptors)
- Kidneys (respond to perfusion rates) |
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Normal Range: Blood Pressure
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90/60 - 140/90
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Affect of age on blood pressure
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- 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 |
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Affect of stress on blood pressure
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- Anxiety/fear/moderate pain: sympathetic stimulation, increase BP
- Severe pain: vasomotor inhibition causes vasodilation, decrease BP |
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Black people have a higher or lower BP than white people?
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Higher, but they can tolerate hypertension better
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After puberty, males have a slightly higher or lower BP than females?
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Higher
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BP is lowest at what time of day?
What time of day does BP peak? |
Lowest: Morning
Peak: late afternoon or early PM |
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Affect of cuff size on blood pressure
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- Too small: falsely increased BP
- Too big: falsely decreased BP Bladder inside the cuff should be 75 - 80% of arm circumference |
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Karotkoff Sounds
- K1? - K5? |
K1: Systole; 1st- faint and clear tapping
K5: Diastole; total absence of sound |
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If the sclera is not white, what might than indicate?
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Trauma, allergies, infection
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If the sclera is not of normal size, what might that indicate?
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Increased size: palpebral fissure, Dalprymple's sign of Graves' Disease
Decreased: periorbital edemaof myxedema or renal disease or amany be ptosis of neurological origin |
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Redness, discharge, tearing or swelling of the eye may indicate what?
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Trauma, allergen, local inflammation or infection
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Bulging of the eye may indicate what?
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- Unilateral: tumor or trauma
- Bilateral: exophthalmus of Graves' disease |
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Corneal light reflection assess what?
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Eye deviation to detect OVERT strabismus
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Cover/Uncover test assess what?
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Eye deviation to detect COVERT strabismus
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Presence of lid lag is suggestive of what?
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Hyperthyroidism
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Define: Ptosis
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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 |
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Define: Epicanthus (Epicanthal fold)
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Vertical fold of skin that lies over the medial canthus
- Normal in asian people - Seen in Down's and other congenital conditions |
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Define: Ectropion
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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 |
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Define: Entropion
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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 |
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Define: Periorbital Edema
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Accumulation of edema in the tissues underlying the lids
- Causes include allergies, local inflammation, myxedema, and fluid retention states such as nephrotic syndrome |
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Define: Herniated Fat (eyes)
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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 |
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Yellowing of Sclera indicates?
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(Scleral icterus, jaundice)
- Suggestive of bilirubin disorder - If absent in presence of yellowing of the skin, suggestive of Vitamin A toxicity |
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Injection (eye) indicates?
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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 |
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Define: Pterygium
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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 |
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Define: Pinguecula
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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 |
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Define: Episcleritis
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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 |
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Define: Corneal Arcus (Arcus Senilis)
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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 |
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Define: Corneal Scar
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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) |
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Define: Cataract
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An opacity of the lens that is seen through the PUPIL
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(2) Types of Cataracts
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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) |
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Define: Tonic Pupil (Adie's pupil)
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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 |
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Define: Horner's Syndrome
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Unilateral meiosis, ptosis and anhydrosis due to pathology of the cervical sympathetic chain ganglia
- Affected side will exhibit NORMAL accommodation and convergence |
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Define: Argyll Robertson Pupils
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Small irregular pupils which DO NOT react to light, but do accommodate
- Commonly suggestive of CNS syphillis (3°) |
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Define: Anisicoria
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General term for pupils which are unequal in size
- Causes include tonic pupil and Horner's syndrome, CN or sympathetic nerve pathology |
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Define: Sty (Hordeolum)
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A painful, tender, red infection around the hair follicle of an eyelash
- It appears as a pimple or boil on the lid margin |
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Define: Chalazion
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A chronic painless inflammatory lesion involving the meibomia gland
- It is a nodule that usually points inside the lid (versus on the margin) |
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Define: Xanthelasma
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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 |
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Define: Dacrocystitis
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Inflammation of the lacrimal sac which produces tearing and expressed discharge at the site of the puncta
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Define: Copper Wire Arterioles
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Increased light reflection of the arteriole giving it a bright metallic luster
- Frequently associated with increased tortuousity - Due to hypertension |
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Define: Silver Wire Arterioles
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A narrowing of an arteriole leading to total opacity of the vessel so that no blood is visible within it
- Due to hypertension |
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Define: AV nicking
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An abrupt cut off of the vein as it crosses with the artery
- Seen with hypertension |
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Define: AV tapering
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A tapering down of the vein as it crosses with the artery
- Seen with hypertension |
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Define: Drusen Bodies
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Light colored "debris buildup" which frequently distorts the disc margin (though may be seen in the periphery as well)
- Normally seen with aging |
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Define: Myelinatied (or Medullated) Nerve Fibers
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Irregular white patches with feathered margins that can obscure disc margins
- Congenital normal variant |
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Define: Rings and Crescents
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Developmental variations which give a white or black border parallel to the disc, usually on the temporal side
- Normal variant |
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Define: Cotton Wool Spots (Soft Exudates)
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White or grayish ovoid lesions with irregular borders usually smaller than disc
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Define: Hard Exudates
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Creamy or yellowish lesions with well defined borders which often occur in new clusters
- Often seen with hypertension and Diabetes Mellitus |
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Define: Neovascularization
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Formation of new vessels, which are more numerous, tortuous and narrower than other vessels in the area
- Seen with Diabetes Mellitus |
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Define: Flame Hemorrhages
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Small, linear flame shaped red streaks on the retina
- Seen with hypertension and papilledema |
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What is the physiologic blind spot of the eye?
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Optic disc
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If the optic disc is decreased in size, suggestive of what?
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Papilledema
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If the optic disc is increased in size, suggestive of what?
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Glaucoma
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Avascular area of central vision containing only cone cells (and highly photosensitive)
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Macula and fovea
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Define: Emmetropia
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Perfect/Normal vision
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Define: Ametropia
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Refractive error of myopia or hyperopia
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Define: Myopia
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Nearsightedness; image falls in FRONT of retina
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Define: Hyperopia
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Farsightedness; image falls BEHIND the retina
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Define: Astigmatism
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Irregularity in the curve of the lens or the contour of the cornea
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Define: Presbyopia
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Farsightedness due to loss of lens elasticity due to aging
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Define: Harmon Distance
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Used to read Rosenbaum Chart
- Chin on fist and the chart at the elbow - Used to screen for hyperopia (or hypermetropia) |
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Define: Amsler Grid
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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 |
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Alignment of the Auricle
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- 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 |
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Define: Cutaneous Cyst (Sebaceous Cyst)
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Benign, firm, mobile sac that lies in the dermis forming a dome shaped lump
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Define: Darwin's Tubercle
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A thickening along the upper ridge of the helix; benign normal variant
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Define: Pre-Auricular Pits
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Small indurations found in front of the ear where the upper auricle originates
- Benign normal varian - More common in blacks (20%) |
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Define: Cauliflower Ear
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An unusual contour of the auricle due to blunt trauma and necrosis of the underlying tissue
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Define: Tophi
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A deposit of uric acid crystals on the helix or anti-helix
- Usually due to years of sustained hyepruricemia |
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Define: Rheumatoid Nodules
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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)
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Define: Battle's Sign
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Hemorrhagic spot behind the ear suggestive of a skull base fracture
- In presence of head trauma |
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Define: Mastoiditis
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An infection of the mastoid, usually secondary to otitis media
- Mastoid appears erythematous and edematous and pinna displaces anteriorly and inferiorly |
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(4) Neurological Tests for Hearing
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1. Weber
2. Rinne 3. Schwabach 4. Watch-Tick Test |
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(3) Neurological Tests for Vestibular Function
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1. Caloric Test (Barany-Caloric Test)
2. Rhomberg's 3. Mittelmeyer March |
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Define: Transverse Nasal Crease (Allergic Salute)
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Seen at the junction of the cartilage and bone; usually due to chronic nasal itching from allergies
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Define: Rhinophyma
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Prominent hypertrophy of sebaceous glands of the nose with overgrowth of the soft tissue; most commonly seen in males
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What causes chronic mouth breathing?
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Narrowing of nares during inspiration
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Flaring of the nares is suggestive of what
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Acute respiratory distress
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Internal Nose Discharge Colors- What are they suggestive of?
Green? White? Clear? |
Green: bacterial infection
White: viral infection Clear: allergic reaction |
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Purpose of sinuses physiologically?
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- Makes head lighter
- Warms inspired air - Phonates voice |
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Define: Herpes Simplex (Cold Sore or Fever Blister)
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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 |
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Define: Angular Cheilitis
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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 |
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Define: Acitinic Cheilitis
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Loss of redness and a thickening, scaling and eversion usually of the lower lip
- Usually due to excessive exposure to sunlight |
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Define: Squamous Cell Carcinoma (lips)
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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 |
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Define: Chancre of syphilis
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Firm, "button-like" lesion which ulcerates and crusts over
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Define: Angioedema
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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 |
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Define: Peutz-Jeghers Syndrome
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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 |
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Define: Gingivitis
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Inflammation of the gingiva leading to reddened and swollen gums with blunting, swelling and reddening of the interdermal papillae
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Define: Gingival Hyperplasia
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Overgrowth of the gums, sometimes accompanied by redness
- Causes include Dilantin therapy, puberty, pregnancy and leukemia |
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Define: Pregnancy Tumor (Epulis, Pyogenic Granuloma)
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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 |
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Define: Kaposi's Sarcoma (in AIDS)
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Purplish to brownish discoloration and enlargement of the gums
|
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Define: Lead Line
|
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 |
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Define: Attrition of the Teeth
|
Wearing down of the chewing surfaces of the teeth so that the yellow-brown dentin is exposed
- Seen in elderly |
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Define: Recession of the Gums
|
Gum recession which exposes the roots of the teeth
- Seen in elderly - "Long in the tooth" |
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Erosion of the Teeth
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Erosion of the enamel from the lingual surfaces of the teeth
- Seen in recurrent regurgitation |
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Define: Hutchinson's Teeth
|
Small, widely spaced teeth which are notched on the biting surfaces
- Sign of congenital syphilis |
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Define: Thrush (Candidiasis)
|
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 |
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Define: Torus Palatinus
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Common benign, midline bony growth in the hard palate
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Define: Kaposi's Sarcoma (in AIDS)
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Raised or flat lesions, frequently of deep purple color
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Define: Koplik's Spots
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Small white specks that appear on the buccal mucosa near the 1st and 2nd molars
- Seen first as a sign of measeles |
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Define: Fordyce Spots
|
Normal sebaceous glands which appear as small yellowish spots in the buccal mucosa
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Define: Leukoplakia
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Thick, white patch seen anywhere on the oral mucosa
- May be pre-cancerous |
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Define: Fissured Tongue (Scrotal Tongue)
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Benign formation of furrows in the tongue, associated with aging
|
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Define: Geographic Tongue
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Benign pattern of alternating areas denuded papillae and normal papillae which remit and exacerbate
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Define: Hairy Tongue
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Yellowing to browning and elongation of the papillae
- Frequently due to antibiotic therapy, however, may occur spontaneously |
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Define: Smooth Tongue (Beefy Tongue, Atrophic Glossitis)
|
Tongue which has lost it's papillae
- Suggestive of Vitamin B deficiency |
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Define: Apthous Ulcer (Canker Sore)
|
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
|
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Define: Varicose Veins (Caviar Lesions)
|
Small purplish or blue-black dilations of the lingual veins
- Benign finding |
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Define: Tori Mandibulares
|
Rounded bony protuberances that grow from the inner surfaces of the mandible
- Benign finding |
|
Define: Pharyngitis
|
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 |
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Define: Pseudomembrane of Diptheria
|
Dull erythema and grey exudate in oropharynx
- May lead to airway obstruction - Refer out immediately |
|
Eye changes of hyperthyroidism
|
Dalrymple's Sign of Exophthalmus, lid lag
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Paper Test/Fine Peripheral Tremor
|
Testing for hyperthyroidism
- Place a piece of paper on a patient's outstretched hand |
|
Pretibial Myxedema is associated with what?
|
Hyperthyroidism
- Proteinaceous ground substance deposition anterior to bilateral tibia |
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Loss of lateral 1/3 of eyebrow is pathognomonic for?
|
Hypothyroidism
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Perioribital edema of facial puffiness is a sign of what?
|
Hypothyroidism
|
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Macroglossia, xanthelasma, croaking or hoarseness of the voice is associated with what?
|
Hypothyroidism
|
|
Chvostek's Sign
|
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 |
|
In regards to the thyroid, pregnancy can exhibit what?
|
- Facial and/or periorbital edema
( If toxemia: pre-eclampsia or eclampsia ensue) - Thyroid enlargement - Thyroid bruits and/or venous hum |
|
Define: Superior Vena Cava Syndrome
|
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)
|
|
Define: Horner's Syndrome
|
Ptosis, meoisis and anhydrosis
|
|
Lymphedema (Non-Pitting Edema)
|
Accumulation of lymph in soft tissue accompanied by swelling
|
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Venous Stasis Edema (Pitting Edema)
|
Accumulation of fluid in soft tissue
|
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(7) Things to assess for lymph nodes
|
1. Size
2. Shape 3. Location 4. Contour 5. Consistency 6. Mobility 7. Tenderness |
|
Define: Pectus Excavatum (Funnel Chest)
|
Sinking or funnel-shaped depression of the lower sternum, diminished AP chest diameter
- May effect organ function if severe enough |
|
Define: Pectus Carinatum (Pigeon Chest, Chicken Breast)
|
Projection of the sternum beyond the abdominal fontal plane
|
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Define: Barrel Chest
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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 |
|
Define: Gibbus Formation
|
Sharp, short kyphosis due to vertebral collapse, secondary to Tuberculosis of the spine
|
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Define: Blue Bloater
|
Patient usually with chronic obstructive bronchitis who is cyanosed from hypoxia and bloated from right side CHF
|
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Define: Pink Puffer
|
Patient with emphysema who is thin and consistently breathless and hypercapneac; breathing is usually through pursed lips
|
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Define: Central Cyanosis
|
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
|
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Clubbing of the fingernails occur as a result of what?
|
Long-standing hypoxia
|
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Define: Fremitus
|
Palpable vibrations transmitted through the bronchopulmonary tree to the parenchyma and then to the chest wall when the patient speaks
|
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Define: Crackles
|
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) |
|
Define: Fine Crackles
|
High pitched discrete discontinuous crackling sounds heard during the end of inspiration; not cleared by cough
|
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Define: Medium Crackles
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Lower more moist sound heard during the midstage of inspiration; not cleared by cough
|
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Define: Coarse Crackles
|
Loud bubbly noise heard during inspiration; not cleared by cough
|
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Define: Rhonchi (Sonorous Wheeze)
|
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)
|
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) |
|
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 |