health assmt
Terms
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- cranial nerve I
-
olfactory
smell - cranial nerve II
-
optic
vision - cranial nerve III
-
oculomotor
motor-most EOM movement, raise eyelids
parasympathetic-pupil constriction, lens shape - cranial nerve IV
-
trochlear
down and inward movement of eye - cranial nerve V
-
trigeminal
motor-muscles of mastication
sensory-sensation of face and scalp, cornea, mucous membranes of mouth and nose - cranial nerve VI
-
abducens
lateral movement of eye - cranial nerve VII
-
facial
motor-facial muscles, close eye, labial speech
sensory-taste (sweet, salty, sour, bitter) on anterior 2/3 of tongue - cranial nerve VIII
-
acoustic
hearing and equillibrium - cranial nerve IX
-
glossopharyngeal
motor-pharynx (phonation and swallowing)
sensory-taste on posterior 1/3 of tongue, pharynx (gag reflex)
parasympathetic-parotid gland, carotid reflex - cranial nerve X
-
vagus
motor-pharynx and larynx (talking and swallowing)
sensory-general sensation from carotid body, carotid sinus, pharynx, viscera
parasympathetic-carotid reflex - cranial nerve XI
-
spinal
movement of trapezius and sternomastoid muscles - cranial nerve XII
-
hypoglossal
movement of tongue - epidermis layers
-
stratum germinativum
(basal cell layer)
stratum corneum - inner layer with major ingredient of protein keratin
- stratum germinativum
- outer horny layer consists of dead keratinized cells that are interwoven and closely packed
- stratum corneum
- inner supportive layer consisting mostly of connective tissue or collagen
- dermis
- adipose tissue which is made up of lobules of fat cells
- subcutaneous layer
- ABCDE = A
- asymmetry of a pigmented lesion (one that is not regularly round or oval)
- ABCDE = B
- border irregularity (notching, scalloping, ragged edges or poorly defined margins)
- ABCDE = C
- color variation (areas of brown, tan, black, blue, red, white or combination)
- ABCDE = D
- diameter greater than 6 mm (size of a pencil eraser)
- ABCDE = E
- elevation and enlargement
- when the red-pink tones from the oxygenated hemoglobin in the blood are lost, the skin takes on the color of connective tissue (collagen), which is mostly white
- pallor
- intense redness of skin due to excess blood (hyperemia) in the dilated superficial capillaries
- erythema
- bluish mottled color that signifies decreased perfusion; tissues are not adequately perfused with oxygenated blood
- cyanosis
- exhibited by a yellow color, indicating rising amounts of bilirubin in blood
- jaundice
- skin's ability to return to place promptly when released
- turgor
- normal nail angle
-
160 degrees or less between nail base and nail
may have slight curve - normal nail color
-
linear pigmentation (dark-skinned people)
leukonychia striata-white hairline linear markings from trauma or picking at cuticle - normal capillary refill
- < 2 seconds
- circular, begins in center and spreads to periphery; tinea corporis or ringworm, tinea versicolor, pityriasis rosea
- annular
- lesions run together; urticaria (hives)
- confluent
- distinct, individual lesions that remain separate; molluscum
- discrete
- clusters of lesions; vesicles of contact dermatitis
- grouped
- twisted, coiled spiral, snakelike
- gyrate
- iris, resembles iris of eye, concentric rings of color in lesions; erythema multiforme
- target
- scratch, streak, line or stripe
- linear
- annular lesions grow together; lichen planus, psoriasis
- polycyclic
- linear arrangement along a nerve route; herpes zoster
- zosteriform
- solely a color change, flat and circumscribed, of less than 1 cm; freckles, flat nevi, hypopigmentation, petechiae, measles, scarlet fever
- macule
- something you can feel; solid, elevated, circumscribed, less than 1 cm diameter, due to superficial thickening in epidermis; elevated nevus (mole), lichen planus, molluscum, wart (verruca)
- papule
- solid, elevated, hard or soft, larger than 1 cm. may extend deeper into dermis than papule; xanthoma, fibroma, intradermal nevi
- nodule
- superficial, raised, transient and erythematous; slightly irregular shape due to edema (fluid held diffusely in tissues); mosquito bite, allergic reaction, dermographism
- wheal
- wheals coalesce to form extensive reaction, intensely pruritic
- urticaria (hives)
- elevated cavity containing free fluid, up to 1 cm. clear serum flows if wall is ruptured; herpes simplex, early varicella (chickenpox), herpes zoster (shingles), contact dermatitis
- vesicle
- turbid fluid (pus) in cavity. circumscribed and elevated; impetigo, acne
- pustule
- deeper depression extending into dermis, irregular shape; may bleed; leaves scar when heals; stasis ulcer, pressure sore, chancre
- ulcer
- tiny punctate hemorrhages, less than 2 mm, round and discrete, dark red, purple or brown in color. due to bleeding from superficial capillaries; will not blanch
- petechiae
- nodes in front of ear
- preauricular
- nodes superficial to mastoid process
- posterior auricular
- nodes at base of skull
- occipital
- nodes midline, behind tip of mandible
- submental
- nodes halfway between angle and tip of mandible
- submandibular
- nodes under angle of mandible
- jugulodigastric
- nodes overlying sternomastoid muscle
- superficial cervical
- nodes deep under sternomastoid muscle
- deep cervical
- nodes in posterior triangle along edge of trapeqius muscle
- posterior cervical
- nodes just above and behind clavicle, at sternomastoid muscle
- supraclavicular
- normal pulsations in neck
- none when sitting
- normal palpation of salivary glands
- not palpable
- normal tyroid gland palpation
- difficult to palpate except in children
- normal newborn head circumference
- 32 to 38 cm (average 34 cm)
- edematous swelling and ecchymosis of presenting part of head due to birth trauma. extends across suture lines.
- caput succedaneum
- subperiosteal hemorrhage, which is also result of birth trauma. soft, fluctuant and well defined over one cranial bone because periosteum (covering over bone) holds bleeding in place.
- cephalhematoma
- tough, protective, white covering of eye
- sclera
- very sensitive to touch; contact with wisp of cotton stimulates blink in both eyes
- cornea
- round and regular. size is determined by balance between parasympathetic and sympathetic chains of autonomic nervous system.
- pupul
- normal constriction of pupils when bright light shines on retina
- pupillary light reflex
- reflex direction of eye toward an object attracting a person's attention
- fixation
- adaptation test of eye for near vision
- accommodation test
- gross measure of peripheral vision. compares person's peripheral vision with your own (assuming yours is normal)
- confrontation test
- normal results for confrontation test
-
50 degrees = superiorly
60 degrees = nasally
70 degrees = inferiorly
90 degrees = temporally - palpebral fissures in eyes are horizontal except in ____
- Asians which have upward slant
- normal eyeballs in blacks
- slight protrusion of eyeball beyond supraorbital ridge
- normal sclera color in blacks
-
gray-blue or muddy color;
small brown macules (like freckles) on sclera; yellowish fatty deposits beneath lids away from cornea - normal resting size pupil
- 3 to 5 mm; 5% of people have anisocoria (different sized pupils)
- eye test where room is darken and person is asked to gaze into distance which dilates pupils. a light is advanced in from outer to inner side of eye and response is noted.
- pupillary light reflex
- normal results for pupillary light reflex
- constriction of same-sided pupil (direct light reflex) and simultaneous constriction of other pupil (consensual light reflex)
- eye test where person focuses on a distant object and then on a near object
- accommodation
- normal results for accommodation test
-
focus on objects
distant = dialated pupils (convergence of axes of eyes)
close = constricted pupils - PERRLA
- pupils equal, round, react to light and accommodation
- cul-de-sac canal 2.5 to 3 cm long in adult and terminates at eardrum (tympanic membrane)
- external auditory canal
- separates external and middle ear and is tilited obliquely to ear canal
- tympanic membrane or eardrum
- connects middle ear with nasopharynx and allows passage of air. tube is normally closed, but opens with swallowing or yawning.
- eustachian tube
- snail-shaped and contains central hearing apparatus
- cochlea
- sensory organ of hearing which has numerous fibers along basilar membrane
- organ of Corti
- caused when labyrinth becomes inflamed and wrong info is fed to brain; symptoms of staggering gait and strong, spinning, whirling sensation
- vertigo
- normal skin condition of external ear
- Darwin's tubercle - small painless nodule at helix
- normal cerumen
- gray-yellow to light brown and black; texture varies from moist and waxy to dry and desicicated (dry up)
- normal eardrum
-
shiny and translucent with pearl-gray color; cone-shape light reflex
five o'clock = right drum
seven o'clock = left drum - normal degrees for alignment of child's external ear
- 10 degrees
- normal results for transillumination test of sinuses
- diffuse red glow
- sinuses in chidren are too small to palpate until what age?
- > 8 years old