Glossary of ICM
- Describe a macule?
- A flat primary lesion < 0.5cm
- Describe a patch?
- A flat primary lesion > 0.5cm
- Describe a papule?
- A superficial raised primary lesion < 0.5cm
- Describe a wheal?
- An edematous superficial raised primary lesion < 0.5cm (an edematous papule)
- Describe a plaque?
- A superficial raised primary lesion > 0.5cm
- Describe a nodule?
- A deep raised palpable primary lesion
- Describe a cyst?
- A deep raised palpable primary lesion with fluid in it (a nodule with fluid)
- Describe a vesicle?
- A fluid filled superficial primary lesion < 0.5cm
- Describe a pustule?
- A pus filled superficial primary lesion (a vesicle with cloudy fluid in it)
- Describe a bulla?
- A fluid filled superficial primary lesion > 0.5cm
- Describe a burrow?
- A miscellaneous lesion caused by a burrowing organism.
- Describe a comedo? Open and closed
- A pilosebaceous outlet filled with keratin.
Open comedo's are blackheads
Closed are whiteheads.
- What is a scale?
- It is visibly thickened stratum corneum (a secondary lesion)
- What is a crust?
- Basically a scab. A secondary lesion whereby fluid or blood has accumulated on the surface.
- What is lichenification?
- Visible, palpable thickened of the skin.
- List the secondary skin lesions characterized by skin thickness changes?
- Atrophy is thinning of the skin
Hypertrophic scar is a thick scar which stays in the place of the original injury.
Keloid is a thick progressively growing scar.
Stria are stretch marks caused by separation of elastic fibers.
Hyperkeratosis - prominent thickening of stratum corneum
- Describe Hyperkeratosis?
- Secondary lesion characterized by prominent thickening of stratum corneum
- Describe a hypertrophic scar?
- Secondary lesion which is a thick scar that stays in the place of the original injury
- What is a keloid?
- Keloid is a thick progressively growing scar
- What are stria?
- Stria are stretch marks caused by separation of elastic fibers
- What are the 4 types of skin breaks?
- Fissure - linear cracking of the skin.
Erosion - wider partial thickened epidermis
Ulcer - wider split goes through to dermis sometimes through to subcutaneous tissue.
Excoriation - scratch marks
- What is lesion color due to?
- Melanin, oxyhemoglobin, reduced hemoglobin and carotene
- Which way do you pull the ear in an adult in an otoscope exam? What about a small child?
- You pull the ear up, back and out if it is an adult or a child > 12 months
< 12 months, pull the ear down and back.
- What is the Weber test and how does it work?
- The Weber test is when you put the tuning fork on the middle of a patient's head or forehead.
Sound will localize to one side in the hearing impaired. If it is conductive damage then the side it localizes to is the damage side.
If it is sensorineural damage then the damage side is opposite the loudly heard side.
- What is the Rinne test and how does it work?
- The Rinne test is when you put the tuning fork on the mastoid process and then next to ear.
If that ear has conductive damage then the patient will not hear it after you take it off the mastoid.
If it is sensorineural damage then the patient won't hear it well on the mastoid but then hear it next to the ear.
- T/F The vestibule of the nasal cavity is lined with mucosa?
- False, it is lined with hair bearing skin.
- Discuss a general nose exam
- Using a penlight or otoscope and just take a general look in the nares. Look for deviation of the septum.
Then using an otoscope, place the tip into the nose trying to avoid touching the septum. Look for middle and inferior turbinates and meati.
Look for redness, blood or exudates.
Remember look straight back not up towards the brain.
- Discuss a general sinus exam
- First palpate the frontal sinus with thumbs under the eyebrows. Then palpate the maxillary sinuses with thumbs.
Use transillumination under the eyebrows to visualize the frontal sinuses.
Then tell the patient to open their mouth and transilluminate the maxillary sinuses.
- What are the alternate names for the submandibular duct and the parotid duct?
- Wharton's duct and Stenson's duct
- Name the 10 lymph nodes to check for in the neck, in order of palpation?
- On the mouth exam, how do you know hypoglossal and vagus are intact?
- Tell the patient to stick out their tongue to test hypoglossal
Tell the patient to say ahhh and watch the soft palate rise.
- How big is a normal optic disc? What about optic cup?
Optic cup should be 50% of this.
- When looking at blood vessels on the retina, what are you looking for?
- Arteries are smaller and reflect light better than veins. Veins have darker blood and are bigger.
You are also looking for arteriolar narrowing, AV nicking and copper/silver lining. These are all signs of hypertension.
- When should you not dilate a patient to do an eye exam?
What should you do if you decide to dilate a patient?
- Neurosurgery patient
Patient with narrow angle glaucoma
Patient with intraocular lens implant.
Write your name, time and type of drops you used on a piece of tape and stick it on their forehead.
- Discuss levels of muscle strength grading
- 0 - no movement
1 - muscle fasciculations
2 - movement but no gravity
3 - movement against gravity but no resistance
4 - movement against slight resistance
5 - full resistance.
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