Term
|
Definition
| A slightly but uniformly pigmented macule or patch with a somewhat irregular border, usually 0.5 to 1.5 cm in diameter; benign. Six or more such spots, each with a diameter 1.5 cm of greater, however, suggest neurofibromatosis. |
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Term
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Definition
| Common superficial fungal infection of the skin, causing hypopigmented, slightly scaly macules on the trunk, neck and upper arms (Short-sleeved shirt distribution) They are easier to see in darker skin and in some are more obvious after tanning. In lighter skin, macules may look reddish or tan instead of pale. |
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Term
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Definition
| Depigmented macules appear on the face, hands, feet, extensor surfaces, and other regions and may coalesce into extensive areas that lack melanin. The brown pigment is normal skin color. the condition may be hereditary. These changes may be distressing to the patient. |
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Term
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Definition
| Somewhat blusish color that is visible in toenails and toes. Compare this color with the normally pink fingernails and fingers of the same pt. Impaired venous return in teh leg can cause this. When it is slight, it may be hard to distinguish it from normal skin color. |
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Term
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Definition
| Makes the skin diffusely yellow. Most easily seen in the sclera. Also can be visible in mucous membranes. Causes include liver disease and hemolysis of red blood cells. |
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Term
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Definition
| The yellowish palm is compared with a normal pink palm, it can sometimes be a subtle finding. Unlike Jaundice this does not affect the sclera, which remains white. The cause is a diet high in carrots and other yellow vegetables or fruits It is not harmful but indicates the need for assessing dietary intake. |
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Term
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Definition
| Red hue, increased blood flow, seen here as the "slapped cheeks" (fifth disease) |
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Term
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Definition
| Violaceous eruption over the eyelids in the collagen vascular disease dermtaomyositis. |
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Term
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Definition
| The respiratory rate is about 14-20 per min in normal adults and up to 44 per min in infants |
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Term
| Slow Breathing (Bradypnea) |
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Definition
| Slow breathing may be secondary to such causes as diabetic coma, drug-induced respiratory depression, and increased intracranial pressure. |
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Term
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Definition
| Breathing punctuated by frequent signs should alert you to the possibility of hyperventilation syndrome- a common cause of dyspnea and dizziness. Occasional sighs are normal. |
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Term
| Rapid shallow breathing (Tachypnea) |
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Definition
| Rapid shallow breathing has a number of causes, including restrictive lung disease, pleuritic chest pain, and elevated diaphragm. |
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Term
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Definition
| Periods of deep breathing alternate with periods of apnea (no breathing). Children and aging people normally may show this pattern in sleep. Other causes include heart failure, uremia, drug-induced respiratory depression and brain damage (typically on both sides of the cerebral hemispheres or diencephalon.) |
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Term
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Definition
| In obstructive lung disease, expiration is prolonged because narrowed airways increase the resistance to air flow. Causes include asthma, chronic bronchitis and COPD. |
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Term
| Rapid deep breathing (Hyperpnea, Hyperventilation) |
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Definition
| Rapid deep breathing has several cause, including exercise, anxiety, and metabolic acidosis. In the comatose pt, consider infarction, hypoxia or hypoglycemia affecting the midbrain or pons. Kussmaul breathing is deep breathing due to metabolic acidosis. In may be fast, normal in rate or slow. |
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Term
| Ataxic breathing (Biot's breathing) |
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Definition
| Ataxic breathing is characterized by unpredictable irregularity. Breaths may be shallow or deep, and stop for short periods. Causes include respiratory depression and brain damage, typically at the medullary level. |
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Term
| Cardiac or respiratory distress |
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Definition
| Clutching the chest, pallor, diaphoresis (excessive sweating), labored breathing, wheezing, cough |
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Term
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Definition
| Wincing, sweating, protectiveness of painful area; facial grimacing; unusual posture favoring one limb or body area |
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Term
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Definition
| Anxious face, fidgety movements; cold and moist palms; inexpressive or flat affect, poor eye contact, psychomotor slowing. |
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Term
| Skin color and obvious lesions |
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Definition
| Pallor, cyanosis, jaundice, rashes and bruises |
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Term
| Dress, grooming and personal hygiene |
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Definition
| Excess clothing may reflect the cold intolerance of hypothyroidism, hide skin rash or needle marks or signal personal lifestyle preferences. |
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Term
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Definition
| Cut out holes or slippers may indicate gout, bunions, or other painful foot conditions. United laces or slippers also suggest edema. |
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Term
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Definition
| Copper bracelets are sometimes worn for arthritis. Piercing may appear on any part of the body. |
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Term
| hair, finger nails and cosmetics |
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Definition
| "Grown-out" hair and nail polish can help you estimate the length of an illness if the patient cannot give a history. Fingernails chewed to the quick may reflect stress. |
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Term
| Personal hygiene and grooming |
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Definition
| Unkempt appearance may be seen in depression and dementia, but this appearance must be compared with the pt's probably norm. |
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Term
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Definition
| The stare of hyperthyroidism; the immobile face of parkinsonism; the flat or sad affect of depression. Decreased eye contact may be cultural, or may suggest anxiety, fear or sadness. |
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Term
| Odors of the Body and Breath |
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Definition
| Breath odors of alcohol, acetone (diabetes) pulmonary infections, uremia or liver failure. |
|
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Term
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Definition
| people with alcoholism may have other serious and potentially correctable problems such as hypoglycemia, subdural hematoma or postictal state. |
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Term
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Definition
| Preference for sitting up in left-sided heart failure, and for leaning forward with arms braced in chronic obstructive pulmonary disease |
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Term
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Definition
| Fast frequent movements of hyperthyroidism; slowed activity of hypothyroidism |
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Term
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Definition
| Tremors or other involuntary movements; paralyses |
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Term
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Definition
| Very short stature in Tuner's syndrome, childhood renal failure, and achondroplastic and hypopituitary dwarfism; long limbs in proportion to the trunk in hypogonadism and Marfan's syndrome; height loss in osteoporosis and vertebral compression fractures. |
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Term
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Definition
| Generalized fat in simple obesity; truncal fat with relatively thin limbs in Cushing's syndrome and metabolic syndrome. |
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Term
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Definition
| Causes of weight loss include malignancy, DM, hyperthyroidism, chronic infection, depression, diuresis and successful dieting. |
|
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Term
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Definition
| Measure the pt's waist circumference. measure the waist just above the hip bones. The pt may have excess body fat if the waist measure: greater or equal to 35 inches in women and greater or equal to 40 inches in men |
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Term
|
Definition
1)Body mass Index chart
2) (Weight (lbs) * 700/ Height (inches))/Height (inches)
3) Weight (kg)/ Height (m2)
4) BMI calculator website |
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Term
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Definition
| Often self limiting in younger adults; also seen in RA and SLe |
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Term
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Definition
| movement of the auricle and tragus is painful in acute otitis externa (inflammation of the ear canal) but not in otitis media (inflammation of the middle ear). Tenderness behind the ear may be present in otitis media. |
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Term
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Definition
| Nontender nodular swellings covered by normal skin deep in the ear canals. These are nonmalignant overgrowths, which may obscure the drum. |
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Term
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Definition
| The canal is often swollen, narrowed, maoist, pale and tender. It may be reddened. In chronic otitis externa, the skin of the canal is often thickened, red and itchy. |
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Term
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Definition
| Test for lateralization. Place the base of the light vibrating tuning fork firmly on top of the pt's head or on the mid-forehead. Ask where the pt hears it: On one or both sides? Normally the sound is heard in the midline or equally in both ears. If nothing is heard try again, pressing the fork more firmly on the head. Because patients with normal hearing may lateralize, this test should be restricted to those with hearing loss. |
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Term
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Definition
| Compare air conduction (AC) and bone conduction (BC)Normally the sound is heard longer through air than through bone AC>BC. |
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Term
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Definition
| Sound is heard through bone as long as or longer than through the air. |
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Term
| Sensorineural hearing loss |
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Definition
| Sound is heard longer than through air (AC>BC) |
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Term
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Definition
| Used to estimate hearing. Tests cranial nerve VIII. |
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Term
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Definition
| could signify otitis media |
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Term
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Definition
| Should be able to see the pars flaccida, Incus, Pars tensa, Short process of malleus, Handle of malleus, Umbo and cone of light. |
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Term
| Red Reflex of the eardrum |
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Definition
| Normal if the patient coughed or sneezed |
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Term
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Definition
| Occulsion of a branch of the central retinal artery may cause a horizontal defect. Ischemia of the optic nerve also can produce a similar defect. |
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Term
| Blind right eye (Right optic nerve) |
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Definition
| A lesion of the optic nerve, and of course of the eye itself, produces unilateral blindness |
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Term
| Bitemporal hemianopsia (Optic chiasm) |
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Definition
| A lesion at the optic chiasm may involve only fibers crossing over to the opposite side. Since these fibers originate in the nasal half of each retina, visual loss involves the temporal half of each field. |
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Term
| Left homonymous hemianopsia (Right optic tract) |
|
Definition
| A lesion of the optic tract interupts fibers originating on the same side of both eyes. Visual loss in the eyes is therefore similar and involves half of each field. |
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Term
| Homonymous left superior quadratic defect (right optic radiation, partial) |
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Definition
| A partial lesion of the optic radiation in the temporal lobe may involve only a portion of the nerve fibers, producing, for example, a homonymous quadratic defect. |
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Term
| Left homonymous Hemianopsia (right optic variation) |
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Definition
| A complete interruption of fibers in the optic radiation produces a visual defect similar to that produced by a lesion of the optic tract. |
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Term
|
Definition
| Respiratory rate, Temp, Blood pressure, Heart rate, and pain |
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Term
| Width of the inflatable bladder of the cuf |
|
Definition
| Should be 40% of the upper arm circumference (about 12-14 cm) |
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Term
| Length of the inflatable bladder |
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Definition
| Should be about 80% of upper arm circumference. Almost long enough to encircle the arm) |
|
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Term
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Definition
| 12x23 cm which is appropriate for arm circumferences up to 28 cm. |
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Term
| What happens to bp if the cuff is too small? |
|
Definition
| The blood pressure will read high |
|
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Term
| What happens to bp is the cuff is too large or a small or large arm? |
|
Definition
Small arm: The bp will read low
Large arm: The bp will read high |
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Term
| What happens if the brachial artery is 7-8cm below heart level? |
|
Definition
| The blood pressure will read approx. 6 cm higher. |
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|
Term
| What happens if the brachial artery is 6-7 cm higher |
|
Definition
| The blood pressure willl read 5 cm lower. |
|
|
Term
| What does a loose cuff or bladder that ballons outside the cuff lead to? |
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Definition
|
|
Term
| Where should the lower border of the cuff be? |
|
Definition
| 2.5 cm above the antecubital crease |
|
|
Term
| What is the auscultatory gap? |
|
Definition
| A silent interval that may be present between the systolic and the diastolic pressures. |
|
|
Term
| What may an unrecognized ausculatory gap lead to? |
|
Definition
| Serious underestimation of systolic pressure or overestimation of diastolic pressure |
|
|
Term
| What are the sounds heard with the bell of a stethoscope called? Are they high or low pitch? |
|
Definition
| Korotkoff sounds and they are generally low in pitch. |
|
|
Term
| how many mmHg per second should the cuff the deflated? |
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Definition
|
|
Term
| What provides the best estimate of true diastolic pressure in adults? |
|
Definition
| The disappearance point, which is usually only a few mmHg below the muffling point |
|
|
Term
| If the first two readings differ by more than how many mmHG what should you do? |
|
Definition
| 5mmHG, you should take additional readings |
|
|
Term
| Venous congestion when taking BP |
|
Definition
| By making the sounds less audible, venous congestion may produce artificially low systolic and high diastolic pressures. Venous congestion ccan be due to slow or repetitive inflation of the cuff. |
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Term
| Blood pressure should be taken at least how many times and on which arm? What is a normal difference in pressure? Subsequent reading should be made on which arm? |
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Definition
| Should be taken on each arm at least once. Normally there is a difference in pressure of 5mmHg and sometimes up to 10 mmHg. Subsequent readings should be made on the arm with the higher pressure. |
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Term
| What does a pressure difference of more than 10-15 mmHG suggest? |
|
Definition
| A subclavian steal syndrome or aortic dissection. |
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Term
| How should hypertension be diagnosed? |
|
Definition
| By taking the mean of two or more properly measured seated blood pressure readings, taken on two or more office visits. BP should be verified in the contralateral arm. |
|
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Term
|
Definition
| Systolic: less than 120. Diastolic: Less than 80 |
|
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Term
|
Definition
Systolic: 120-139
Diastolic: 80-89 |
|
|
Term
|
Definition
Systolic: 140-159
Diastolic: 90-99 |
|
|
Term
|
Definition
Systolic: Greater than 160
Diastolic: Greater than 100 |
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|
Term
| What should assessment of hypertension include? |
|
Definition
| Its effects on target "end organs"- the eyes, heart, brain and kidneys. Look for hypertensive retinopathy, left ventricular hypertrophy, and neurologic deficits suggesting stroke. Renal assessment requires urinalysis and blood tests of renal function. |
|
|
Term
| When the systolic and diastolic levels fall in different categories what should you use? |
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Definition
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|
Term
| To detect coarcation of the aorta what should be done? |
|
Definition
| Make two further blood pressure measurements at least once on every hypertensive patient. Compare bp in the arms and legs and compare the volume and timing of the radial and femoral pulses. Normally, volume is equal and the pulses occur simultaneously. |
|
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Term
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Definition
| Arises from narrowing of the thoacic aorta, usually proximal but sometimes distal to the left subclavian artery. |
|
|
Term
| how are coarctation of the aorta and occlusive aortic disease distinguished? |
|
Definition
| They are distinguished by hypertension in the upper extremities and low bp in the legs and by diminished or delayed femoral pulses. |
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Term
| to determine bp in the leg |
|
Definition
| Use a wide, long thigh cuff that has a bladder size of 18*42 cm and apply it to the midthigh. Center the bladder over the posterior surface and listen over the popliteal artery. Pt should be prone. BP should be equal in the arm and leg. The usual arm cuff improperly used on the leg, gives a falsely high reading. |
|
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Term
|
Definition
| Take it from the radial artey. The range of normal is 50-90 bpm. |
|
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Term
|
Definition
1) Do early beats appear in a basically regular rhythm
2) Does the irregularity vary consistently with respiration
3) Is the rhythm totally irregular? |
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Term
| Orhtostatic blood pressure |
|
Definition
| Measure the blood pressure and heart rate in two positions- supine and standing. Normally as a pt rises from the horizontal to the standing postition, systolic pressure drops slightly or remains unchanged, while diastolic pressure rises slightly. |
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Term
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Definition
| A drop in systolic bp of greater or equal to 20 mmHg or in diastolic bp of greater or equal of 10 mmHg withing 3 minutes of standing. Causes include drugs, moderate or severe blood loss, prolonged bed rest, and diseases of the autonomic nervous system. |
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Term
| Prolonged expiration occurs in what disease? |
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Definition
|
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Term
|
Definition
| Usually 37 degrees celcius or 98.6 degrees F. In the early morning hours it may fall as low as 35.8 C and 96.4 F and in the late afternoon may rise as high as 37.3 C and 99.1 F. |
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Term
|
Definition
| Higher than oral temp by an avg of .4 to.5 C (.7to .9 F) |
|
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Term
|
Definition
| Lower than oral temp by approx. 1 degree but may take 5 to 10 mins to register and are considered less accurate than other measurements. |
|
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Term
| Fever (pyrexia) and Hyperpyrexia/Hypothermia. |
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Definition
| Refers to an elevated boody temp. Hyperpyrexia refers to extreme elevation in temp above 41.1 or 106 F while hypothermia refers to an abnormally low temp below 35C or 95F rectally. |
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Term
| Rapid respiratory rates tend to increase the discrepancy between what two types of tem? Which is more reliable in this situation? |
|
Definition
| Between oral and rectal. Rectal temps are more accurate. |
|
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Term
|
Definition
| Infection, trauma such as surgery or crush injuries, malignancy, blood disorders such as acute hemolytic anemia, drug reactions, and immune disorders such as collagen vascular disease. |
|
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Term
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Definition
| Shakes the thermometer down to 35C or 96F or below, insert it under the tongue and instruct the pt to close both lips and wait 3-5 mins. Then read the thermometer, reinsert it for a minute, and read it again. |
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Term
|
Definition
| Place the disposable cover over the probe and insert the thermometer carefully under the tongue. Ann accurate temp recording usually takes about 10 secs. |
|
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Term
|
Definition
| Insert it about 3 to 4 cm into the anal canal. Remove it after 3 mins. |
|
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Term
|
Definition
| Exposure to cold, paralysis, interference with vasoconstriction as from sepsis or excess alcohol, starvation, hypothyroidism, and hypoglycemia. Elderly people are especially susceptible to hypothermia and less likely to develop fever. |
|
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Term
|
Definition
| make sure canal is free of cerumen which lowers temp readings. Wait 2 to 3 seconds. This mehtod measures core body temp, which is higher than the normal oral temp by approx. .8 C More variable than oral and rectal. |
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Term
| Weak or inaudible Korotkoff sounds |
|
Definition
Consider technical problems and shock. May be able to estimate by palpatiion or doppler techniques or direct arterial pressure tracings.
To intensify the sounds raise the pt's arm before and while you inflate the cuff. Then lower the arm and determine the bp. Or, inflate the cuff and ask pt to make a fist several times. |
|
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Term
|
Definition
| Verify your findings with an ECG. Palpation of an irregularly irregular rhythm reliably indicates atrial fibrillation. |
|
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Term
|
Definition
People whose bp measurements are higher in the office than at home or in more relaxed settings, usually >140/90. Occurs in 10 to 25% of patients especially women.
Home or ambulatory HTN signals increased risk of cardiovascular disease. |
|
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Term
|
Definition
Obese arm: Use a wide cuff 15 cm and if the arm circumference exceed 41 cm use a thigh cuff of 18 cm. Using a small cuff overestimates systolic bp in obese pts
Thin arm: Use a pediatric cuff. |
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|
Term
| Cardinal techniques of examination |
|
Definition
| Inspection, Palpation, Percussion, and auscultation |
|
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Term
|
Definition
| Hair, nails, and sebaceous and sweat glands |
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Term
|
Definition
Heaviest single organ of the body, approx. 16% of body weight.
Contains 3 layers: epidermis, dermis and the subcutaneous tissues. |
|
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Term
|
Definition
two layers
Superficial: thin, devoid of blood vessels and divided into two layers an outer horny layer of dead keratinzied cells and an inner cellular layer where both melanin and keratin are formed.
migration from the inner layer to the top layer takes approx. 1 month.
The epidermis depends on the underlying dermis for its nutiriton. |
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Term
|
Definition
| The dermis is well supplied with blood. Contains connective tissue, sebaceous glands, sweat glands, and hair follicles. It merges below with subcutaneous or adipose tissue also known as fat. |
|
|
Term
| Color of normal skin depends on which four primary pigments? |
|
Definition
melanin, carotene, oxyhemoglobin, and deoxyhemoglobin. Carotene is a golden yellow pigment that exists in subcutaneous fat and in heavily keratinized areas such as the palms and soles.
Oxyhemoglobin is bright red and deoxyhemoglobin is darker and somewhat blue. |
|
|
Term
| Vellus hair vs. terminal hair |
|
Definition
Vellus: Short, find, inconspicuous and relatively unpigmented.
Terminal: Coarser, thicker, more conspicuous and usually pigmented. Ex. scalp and eyebrows. |
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|
Term
|
Definition
oPattern of Redness: conjunctival infection: diffuse dilation of conjunctival vessels with redness that tends to be maximal peripherally
oPain: mild discomfort
oVision: Not affected except for temporary mild blurring due to discharge
oOccular Discharge: watery, mucoid or mucopurulent
Pupil: Not affected
oCornea: Clear
oSignificance: Bacterial, viral and other infections; allergy, irritation |
|
|
Term
| Subconjunctival Hemorrhage: |
|
Definition
oPattern of Redness: Leakage of blood outside of the vessels, producing a homogeneous, sharply demarcated, red area that fades over days to yellow then disappears
oPain: absent
oVision: not affected
oOcular Discharge: Absent
oCornea: Clear
oSignificance: from trauma, bleeding disorders or a sudden increase in venous pressure (from coughing) |
|
|
Term
| Corneal Injury of Infection: |
|
Definition
oPattern of Redness: ciliary injection: dilation of deeper vessels that are visible as radiating vessels or a reddish violet flush around the lumbus- ciliary injection is an important sign of these three conditions but may not be apparent- the eye may be diffusely red instead- other cluse are pain, decreased vision, unequal pupils and a less than perfectly clear cornea
oPain: Moderate to severe, superficial
oVision: usually decreased
oOcular Discharge: watery or purulent
oPupil: not affected unless iritis develops
oCornea: changes depending on cause
oSignificance: abrasions and other injuries, viral and bacterial infections |
|
|
Term
|
Definition
oPattern of Redness: ciliary injection: dilation of deeper vessels that are visible as radiating vessels or a reddish violet flush around the lumbus- ciliary injection is an important sign of these three conditions but may not be apparent- the eye may be diffusely red instead- other cluse are pain, decreased vision, unequal pupils and a less than perfectly clear cornea
oPain: Moderate, aching, deep
oVision: decreased
oOcular Discharge: absent
oPupil: may be small and irregular
oCornea: Clear or slightly clouded
oSignificance: Associated with many ocular and systemic disorders |
|
|
Term
|
Definition
oPattern of Redness: ciliary injection: dilation of deeper vessels that are visible as radiating vessels or a reddish violet flush around the lumbus- ciliary injection is an important sign of these three conditions but may not be apparent- the eye may be diffusely red instead- other cluse are pain, decreased vision, unequal pupils and a less than perfectly clear cornea
oPain: Severe, aching, deep
oVision: Decreased
oOcular Discharge: Absent
oPupil: Dilated, fixed
oCornea: Steamy, cloudy
oSignificance: Acute increase in intraocular pressure- an emergency
oPattern of Redness: ciliary injection: dilation of deeper vessels that are visible as radiating vessels or a reddish violet flush around the lumbus- ciliary injection is an important sign of these three conditions but may not be apparent- the eye may be diffusely red instead- other cluse are pain, decreased vision, unequal pupils and a less than perfectly clear cornea
oPain: Severe, aching, deep
oVision: Decreased
oOcular Discharge: Absent
oPupil: Dilated, fixed
oCornea: Steamy, cloudy
oSignificance: Acute increase in intraocular pressure- an emergency |
|
|
Term
|
Definition
| Refers to drainage from the nose and is often associated with nasal congestion, a sense of stuffiness or obstruction. Frequently accompanied by sneezing, watery eyes and throat discomfort and also by itching in the eyes and throat. Causes include viral infections, allergic rhinitis and vasomotor rhinitis. Itching favors an allergic cause. Can be caused by hay fever. |
|
|
Term
|
Definition
| Bleeding from the nose. Usually originates from the nose itself, may come from a paranasal sinus or the nasopharynx. Carefully differentiate epistaxis from hemoptysis or hematemesis. Local causes include trauma, inflammation, drying and crusting of the nasal mucosa, tumors and foreign bodies. |
|
|
Term
|
Definition
| a word describing the symptoms of a head cold.[1] It describes the inflammation of the mucous membranes lining the nasal cavity which usually gives rise to the symptoms of nasal congestion and loss of smell, among other symptoms. Coryza may not always have an infectious or allergenic etiology and can be due to something as innocuous as a cold wind, spicy food or tender points in the muscles of the neck such as the sternocleidomastoid. It is also a symptom of narcotic withdrawal. Coryza is classically used in association with the "four Cs" of measles infection: cough, conjunctivitis, Koplik's spots, and coryza.[2] |
|
|
Term
|
Definition
Nasal congestion refers to a stuffy nose.
Considerations
Many people think that a nose gets congested (stuffy) from too much thick mucus. However, in most cases, the nose becomes congested when the tissues lining it become swollen. The swelling is due to inflamed blood vessels. |
|
|
Term
|
Definition
Heat/cold intolerance
Polyphagia
Polyuria
Polydipsia
Excessive sweating
Change in glove/shoe size
Weight changes |
|
|
Term
|
Definition
| Passage of fresh blood in the stool |
|
|
Term
|
Definition
| Refers to dark black stool which is associated with gastrointestinal hemorrage. |
|
|
Term
|
Definition
| Jaundice is a yellow color of the skin, mucus membranes, or eyes. The yellow coloring comes from bilirubin, a byproduct of old red blood cells. Jaundice can be a symptom of other health problems. |
|
|
Term
|
Definition
| Heartburn is usually associated with regurgitation of gastric acid (gastric reflux) which is the major symptom of gastroesophageal reflux disease (GERD).[5] Also known as pyrosis[1] or acid indigestion[2] is a burning sensation[3] in the chest, just behind the breastbone or in the epigastrium |
|
|
Term
|
Definition
| Tenesmus is a term used to describe the feeling that you constantly need to pass stools, even though your bowels are already empty. It can involve pain, straining, and cramping. |
|
|
Term
|
Definition
| Steatorrhea (or steatorrhoea) is the presence of excess fat in feces. Stools may also float due to excess lipid, have an oily appearance and be especially foul-smelling.[ |
|
|
Term
|
Definition
| Increased pressure within the eye leads to increased cupping (backward depression of the disc and atrophy. The base of the enlarged cup is pale. The physiologic cup is enlarged, occupying more than half of the disc’s diamter, at times extending to the edge of the disc. The retinal vessels sink in and under it and may be displaced nasally. |
|
|
Term
|
Definition
Swelling of the optic disc and anterior bulging of the physiologic cup. The absence of spontaneous venous pulsations (SVP) can be used when determining papilledema.
Causes:
Meningitis, subarachnoid hemorrhage, trauma, mass lesions |
|
|
Term
|
Definition
| vein stops abruptly on either side of the artery |
|
|
Term
|
Definition
| vein tapers down on either side of the artery |
|
|
Term
|
Definition
| Vein is twisted on distal side of artery and forms a dark wide knuckle; caused by diabetic and HTN retinopathy, retinal and choroidal detachment |
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Definition
| covers most of the anterior eyeball, adhering loosely to the underlying tissue |
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Definition
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Definition
Color and shape: Fiery red! From very small to 2 cm.
Shape: Central body, sometimes raised, surrounded by erythema and radiating legs.
Pulsatility and pressure: Pressure on the body causes blanching of the spider.
Distribution: Face, neck, arms and upper trunk. Never below the waist!
Significance: Liver disease, Pregnancy, Vit B deficiency, also occurs in normal people |
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Definition
Color and size- Bluish, variable size
Shape- Variable, may resemble a spider or be linear, irregular, cascading
Pulsatility and effect of pressure- Absent. Pressure over the center does not cause blanching, but diffuse pressure blanches the veins
Distribution: Often on the legs, near veins; also on the anterior chest
Significance: Often accompanies increased pressure in the superficial veins, as in varicose veins. |
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Term
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Definition
Color and size: Bright or ruby red, may become brownish with age
Shape- Roud, flat or sometimes raised, may be surrounded by a pale halo.
Pulsatility and effect of pressure: Absent. May show partial blanching, especially if pressure applied with edge of a pinpoint
Distribution: Trunk, also extremities.
Significance: None, increases in size and numbers with aginst. |
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Definition
color/size: deep red or reddish purple, fading away over time. Petechia 1-3 mm; purpura larger
Shape: Rounded, sometimes irregular; flat
Pulsality and effect of pressure: Absent. No effect from pressure.
Distribution: Variable
Significance: Blood outside the vessels; may suggest a bleeding disorder or, if petechiae, emboli to skin; palpable purpura in vasculitis |
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Definition
Color/size: Purple or purplish blue, fading to green, yellow, and brown with time. Variable size, larger than petechiae >3mm.
Shape: rounded, oval or irregular; may have a central subcutaneous flat nodule (a hematoma)
Pulsality: Absent. No effect from pressure
Distribution: variable
Significance: Blood outside the vessels; often secondary to bruising or trauma; also seen in bleeding disorders |
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Definition
Stress/Safety
Afraid/Abused
Friends/Family
Emergency Plan |
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| Clues to possible physical abuse: |
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Definition
Unexplained injury and inconsistent story
Delayed getting treatment for trauma
Past history of “accidents”
History of alcohol or drug abuse in the patient or partner
Partner dominates the interview, will not leave the room or seems unusually anxious. |
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Definition
| Can be large without infection |
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Definition
| White exudate on the tonsils. Together with fever and enlarged cervical nodes. Anterior CN (Group A streptococcal infection) Posterior (Infectious mononucleosis) |
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Term
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Definition
| Reddened throats without exudate. Probably will complain of sore or scratchy throat. Possible causes include viruses and bacteria. If the pt has no fever exudate or enlargement of CN then the chances of infection are small |
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Definition
| Midline bony growth in the hard palate. Fairly common in adults and is harmless |
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Definition
| Occurs with AIDS. Deep purple color of these lesions. May be flat or raised. Palate is a common site for this tumor. |
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Term
| Thrush on the Palate (Candidiasis) |
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Definition
| Yeast infection due to Candida. Thick white plaques that are somewhat adherent to the underlying mucosa. Risk factors include prolonged treatment with Ab or corticosteroids and AIDS. |
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Definition
| Caused by Corynebacterium diphteriae. Rare. Throat is dull red with gray exudate present on the uvula, pharynx and tongue. Airway may become obstructed. |
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Definition
| Early sign of measles. Small white specks usually on the mucosa near the first and second molars. Measles appear within a day |
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Definition
Typically in one individual or individuals in same sibship/generation
Males and females equally affected
Parents of an affected individual are obligate carriers of a mutation
AR conditions are seen in children of consanguineous couples
The chance two carrier parents will have an (another) affected child is 1/4 (25%) |
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Term
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Definition
Affected individuals in every generation
Every affected individual has an affected parent (with the exception of a new mutation)
Any child of an affected individual has a 50% chance of inheriting the trait; unaffected family members do not pass it to their children
Males and females equally likely to be affected (although there may be sex-limited expression, such as with ovarian cancer) |
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Term
| Mitochondrial Inheritance |
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Definition
Ovum (not sperm) is the source for a large proportion of mitochondria in a newly fertilized zygote
A mother carrying a mitochondrial mutation will pass it on to ALL her offspring
A father carrying a mitochondrial mutation does not pass it on to any of his offspring |
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Definition
| Accurate name for bp cuff |
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Definition
| vigilantly attentive and keen |
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Definition
| dull, sluggish and appears half asleep |
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Definition
| opens their eyes, responds slowly to questions, is somewhat confused, and has a decreased interest in their environment |
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Definition
| near unconscious with apparent mental inactivity and reduced ability to respond to stimulation. sternal rub, tendon pinch, roll pencil across nail bed |
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Term
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Definition
| are unconscious and unresponsive |
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Term
| Cardiac/Respiratory Distress |
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Definition
| clutching chest, pallor, diaphoresis (excessive sweating); labored breathing, wheezing, cough |
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Term
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Definition
| Wincing, sweating, protectiveness of painful area; facial grimacing, unusual posture favoring one limb or body area |
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Definition
| anxious face, fidgety movements, cold and moist palms; inexpressive or flat affect, poor eye contact, psychomotor slowing |
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Definition
| fine rhythmic oscillation of the eyes. A few beats on lateral stare are normal but if it is sustained it may be a neurological problem. |
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Definition
| In hyperthyroidism there is proptosis , a rim of sclera is visible above the iris with downward gaze. |
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Definition
| the eyes are conjugate in right lateral gaze but not in left lateral gaze! |
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Term
| Poor convergence occurs in |
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Definition
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Term
| Contraindications of mydriatic drops |
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Definition
| include head injury and coma and suspicion of narrow-angle glaucoma |
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Term
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Definition
| The light rays focus anterior to it |
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Term
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Definition
| Light rays focus posterior to it. |
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Term
| An enlarged cup suggests ... |
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Definition
| chronic open-angle glaucoma |
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Term
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Definition
| SVP is used when trying to determine if a pt has papilledema. SVP is a common occurrence in normal eyes and indicates that the intracranial pressure is probably normal. May be absent in some normal pts. Loss of venous pulsations in pathologic conditions like head trauma, meningitis, or mass lesions may be an early sign of elevated intracranial pressure. |
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Term
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Definition
Color:Light red
Size: Smaller
Light reflex: Bright |
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Definition
Color: Dark red
Size: Larger
Light reflex: Inconspicuous or absent |
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Term
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Definition
| when a person shifts gaze from a far object to a near one, the pupils constrict. This response, like the light reaction, is mediated by the oculomotor nerve CNIII. and the impulse goes to the constrictor muscles of the iris of each eye. |
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Term
| The interchangeable response |
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Definition
| is a restatement, in your own words of what the pt is trying to describe and is used to communicate that you understand. |
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Term
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Definition
| Simply feeds back to the pt exactly what is said using the same words. |
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Term
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Definition
| Conveys the same meaning as the pt’s statement but uses different words. |
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Term
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Definition
| You recognize not only what the pt expresses openly but also what he or she feels but does not express. |
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Term
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Definition
| No identifiable underlying cause |
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Term
| Secondary headache causes |
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Definition
| Arise from other conditions- some of these may endanger the pt's life |
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Term
| What do you consider is the headache is severe and of suden onset? |
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Definition
| Subarachnoid hemorrhage or meningitis |
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Term
| Which type of headaches are episodic and tend to peak over several hours? |
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Definition
| Migraine and tension headaches. |
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Term
| New and persisting progressively severe headaches raise what concerns? |
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Definition
| Tumor, abscess, or mass lesion. |
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Term
| Unilateral headaches include... |
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Definition
| Migraine and cluster headaches. |
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Term
| Where do tension and cluster headaches arise from? |
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Definition
Tension: Temporal areas
Cluster: Retro-orbital |
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Term
| Nausea and vomiting are common with what? |
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Definition
| Migraine, brain tumors and subarachnoid hemorrhage |
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Term
| What is the percent of patients with migraine that have a prodrome prior to onset? What percentage experience an aura, photophobia, scintillatin scotomate, or reversible visual and sensory symptoms |
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Definition
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Term
| Coughing, sneezing or changing the position of the head can do what? |
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Definition
| May increase pain from brain tumor and acute sinusitis. |
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Term
| With chronic daily headache what should you consider? |
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Definition
| Medication overuse with patients taking symptomatic meds more than 2 days a week. |
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Term
| Is family history positive or negative in patients with migrains? |
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Definition
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Term
| Farsightedness, Aging vision, nearsightedness |
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Definition
| Hyperopia, presbyopia, myopia |
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Term
| If sudden unilateral visual loss is painless what do you consider? |
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Definition
| Vitreous hemorrhage from diabetes or trauma, macular degeneration, retinal detachment, retinal vein occlusion, or central retinal artery occlusion. |
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Term
| If painful unilateral visual loss consider? |
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Definition
| problems in cornea and anterior chamber as in corneal ulcer, uveitis, traumatic hyphema and acute glaucoma. Optic neuritis can occur from multiple sclerosis may be painful. Immediately refer patient!!! |
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Term
Sudden bilateral vision loss (painless)..
If bilateral and painful consider... |
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Definition
1)Medications that change refraction such as cholinergics, anticholinergics and steroids.
2) Chemical or radiation exposures |
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Term
| Gradual loss of bilateral visiion |
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Definition
| Cataracts or macular degeneration. |
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Term
| Slow central loss, peripheral loss, and one sided loss |
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Definition
1)Macular degeneration or nuclear cataract
2) Open-angle glaucoma
3) Hemianopsia and quadrantic defects |
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Term
Moving specks or strands suggest?
Fixed defects suggest? |
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Definition
1) vitreous floaters
2) Lesions in the retina or visual pathways |
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Term
| Flashing lights or new vitreous floaters suggest? |
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Definition
| Detachment of vitreous from retina. Prompt eye consultation is indicated. |
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Term
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Definition
| A lesion in the brainstem or cerebellum, or from weakness or paralysis of one or mmore extraocular muscles, as in horizontal diplopia from palsy of CN III or VI, or vertical diplopia from palsy of CN III or IV. Diplopia in one eye, with the other closed, suggests a problem in the cornea or lens. |
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Term
| What can hearing loss be caused by? |
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Definition
| Congenital from single gene mutations. |
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Term
| What do people with sensorineural loss have trouble with? |
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Definition
| Trouble understanding speech, often complaining that others mumble; noisy environments make hearing worse. In conductive loss, noisy environments may help. |
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Term
| Medication that affect hearing? |
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Definition
| Aminoglycosides, aspirin, NSAIDs, quinine, furosemide and others. |
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Term
Pain suggest a problem in the external air?
Associated with symptoms of respiratory infection, in the inner ear? |
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Definition
Otitis externa
Otitis media. |
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Term
| Soft wax, debris from inflammation or rash in the ear canal, or discharge through a perforated eardrum maybe secondary to? |
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Definition
| Acute or chronic otitis media |
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Term
Tinnitus
When associated with hearing loss and vertigo what does it suggest? |
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Definition
Common symptom, increasing in frequency with age.
It suggests Meniere's disease |
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