Star slides and bolded words (lymph -> musculoskeletal)

1. maintain fluid balance

2. enhance facilitate immune system

3. Facilitate absorption of fats for metabolism and storage

Functions of the lymphatic system: [3]

1-2 seconds

Normal capillary refill time:

1. radial

2. ulnar

3. brachial

Pulses in the arm: [3]

Epitrochlear lymph node

Lymph node in arm:

1. femoral

2. popliteal

3. posterior tibial (foot)

4. Dorsalis pedis (foot)

Pulses in the lower limb [4]

inguinal nodes

Lymph node near lower limb

Pretibial edema

Skin condition that causes plaques of thick, scaly skin and swelling of lower legs.

Occlusion

Closing of a passageway, complete or partial blockage of a blood vessel

Aneurysm

Localized, abnormal, permanent diation of a blood vessel, occuring when a segment of the vessel wall becomes weakened. Most common is aorta.

Chronic venous insufficiency (aka chronic venous stasis)

Condition in which veins have problems moving blood back to the heart. Most often affects veins in the legs.

Chronic arterial insufficiency

Any condition that slows or stops the flow of blood through the arteries.

Superficial varicose veins

Caused by increased blood pressure in veins. Happens in veins near the surface of the skin, blood can collect in the veins.

1. upper inner

2. upper outer

3. lower inner

4. lower outer

Four breast quadrants:

1. central

2. pectoral (anterior)

3. Subscapular (posterior)

4. Lateral

Axillary lymph node groups: [4]

Gynecomastia

Overdevelopment or enlargement of the breast tissue in males. Often uneven, usually one breast and is temprorary. Can be caused by decreased testosterone or medications.

• Dimpling

• Nipple retraction

• Edema (peau d’orange)

• Deviation in nipple pointing

• Fixation

Signs of nipple retraction and inflammation [5]

-  Benign breast disease

- cancer

- Fibroadenoma

Causes of breast lumps [3]

• Plugged duct

• Breast abscess

• Mastitis

Disorders in lactation: [3]

Mastitis

Inflammation of the breast, usually caused by an infection. Often happens while breastfeeding

Carcinoma

Cancer that begins in the skin or in tissues that line or cover internal organs. Often cause of breast cancer/type of cancer

Suprasternal notch

Visible dip in between the neck, between the clavicles, and above the manubrium of the sternum

Sternum

Breast bone

Costal angle

Meeting point of the lower border of the false ribs with the axis of the sternum

Sternal angle

Marks the point at which the costal cartilage of either second rib articulates with the sternum

Spinous process

Bony process of a vertebrae that projects posteriorly from the neural arch

Inferior border of the scapula

Lowest part of the scapula and is covered by the latissimus dorsi muscle. Moves forwards round the chest when the arm is abducted

1. right upper (anterior)

2. right lower(posterior)

3. right middle (anterior)

4. left lower (posterior)

5. left upper (anterior)

Lobes of the lungs [5]

• Anteroposterior/transverse diameter

Distance from the anterior skin to posterior skin of thoracic cage

Inspect, palpate, percuss, auscultate

Order of thoracic physical exam:

Barrel chest:

anteroposterior diameter is wider than the 1:2 ratio

Resonant. However, may be more dull or slat if a client has adipose tissue or a muscular chest.

Normal perussion notes for lungs:

Air has filled the space around the lungs and is prohibiting them from expanding fully. Air may be trapped inside small airways and alveoli

Hyperresonance percussion in lungs meaning:

Indicates denser tissue or fluid (pneumonia, pleural effusions, tumours)

Dull percussion notes in lungs meaning:

Atelectatic crackles

Crackles heard when a portion of the lung is collapsed and airless

Fine crackles

Crackles caused by mucous in larger bronchioles, as heard in COPD

Coarse crackles

Crackles heard during early inspiration and sound harsh or moist. Caused by chronic bronchitis, pneumonia, and severe pulmonary edema

Pleural friction rib

Adventitious breath sound heard on auscultation of the lung, results from movement of inflamed and roughened pleural surfaces against one another

92%, 87-100 if COPD, emphysema

Pulse oximeter should be above:

1:2

Normal anteroposterior-to-transverse ratio:

Cheyne-stokes

specific form of periodic breathing (waxing and waning amplitude of flow or tidal volume) characterized by a crescendo-decrescendo pattern of respiration between central apneas or central hypopneas.

emphysema

pathological diagnosis that affects the air spaces distal to the terminal bronchiole. It is characterized by abnormal permanent enlargement of lung air spaces with the destruction of their walls without any fibrosis and destruction of lung parenchyma with loss of elasticity.

asthma

chronic inflammatory disease of the airways, characterized by recurrent episodes of airflow obstruction resulting from edema, bronchospasm, and increased mucus production.

Pleural effusion

the accumulation of fluid in between the parietal and visceral pleura, called the pleural cavity. It can occur by itself or can be the result of surrounding parenchymal disease like infection, malignancy, or inflammatory conditions.

Pneumothorax

he collection of air in the spaces around the lungs.

Tuberculosis

is transmitted through the air when an infected person coughs, sneezes, or talks, and another person inhales the bacteria. chronic infectious disease caused by the bacterium Mycobacterium tuberculosis.

pulmonary embolism

a blockage of one or more pulmonary arteries by a blood clot. large emboli obstruct pulmonary blood flow, causing reduced oxygenation, reduced gas exchange, decreased perfusion, pulmonary tissue hypoxia, and even death.

coracoid process of the scapula

a small hook-like structure on the lateral edge of the superior anterior portion of the scapula. Pointing laterally forward, it, together with the acromion, serves to stabilize the shoulder joint

• Olecranon process of ulna

the proximal articular portion of the ulna

• Ortolani manoeuvre

• (assess for hip dislocation in babies

polydactyly

a condition in which a baby is born with one or more extra fingers

Syndactyly

webbed or conjoined fingers or toes

• Clavicle

• Acromion process

• Greater tubercle of humerus

• Coracoid process of scapula

shoulder landmarks [4]

Talipes equinovarus (club foot)

a common foot abnormality, in which the foot points downward and inward