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asymmetry
border irregularity
colour
diameter
evolution/elavation
What are the ABCDE to screen for Nevi/Moles?
Discussing a DRE (digital rectal exam)
PSA test (protein specific antigen)
When it comes to screen for Prostate Cancer in Males, what are the two tests that need to be discussed?
The Snellen Chart
What is the chart called for evaluating vision?
Ask about smoking
Advise them to stop
Assist in setting a stop date
Arrange and monitor follow up (counselling and nicotine replacement)
While health teaching regarding the Thorax and Lungs, what are the Four A's in smoking cessation?
Visual Assessment
Palpation
Percussion
What physical assessment techniques are used while assessing the skin?
The skin, hair, nails and glands
What does the integumentary system consist?
Epidermis:
-Stratum Corneum
-Stratum Germinativum
Dermis
Hypodermis (Subcutaneous Tissue)
Layers of the Skin - what do they do and what are they made up of?
Stratum Corneum: the layer we see and is made up of flattened dead cells
Stratum Germinativum: bottom layer made of living cells that are flattened and stacked as they are pushed toward the outside as they grow.
What does the epidermis consist of?
internal layer of the skin just below the epidermis. Formed of connective tissues such as collagen, elastin and reticulum. These cells allows for stretching.
What does the dermis consist of?
hair follicles, sebaceous glands, sweat glands, blood vessels, lymphatic
The dermis also contains…
the foundation layer for sweat glands, hair follicles, blood supply to the dermis and a layer of fat that acts as padding and insulation.
What does the hypodermis (subcutaneous) consist of?
Protection - Protects against pathogenic microorganisms
Sensation - heat, cold, pain, pressure, touch
Communication - feelings, flushing, sweating, pallor
Thermoregulation - Convection, Evaporation, Conduction, and Radiation.
Metabolism - contributes to changes in cardiac output and blood pressure
What are the Functions of the skin?
Lesions that appear as a result of a change in the external or internal environment of the skin.
Define primary skin lesions
Result of trauma, infection or inflammation of a primary skin lesion. Example: a vesicle may rupture and cause an erosion
Define secondary skin lesions
Ulcer/ pressure injury - A hole like break in the skin that may extend into the dermis or deeper. Example: Pressure Injury
Define the abnormal lesions of the skin?
Consists of tightly packed cells of the stratum corneum that essentially are keratinized dead cells.
What are nails composed of?
It is a tough, fibrous, insoluble protein
What is keratin?
nail plate shape, angle between the nail and the nail bed, nail texture, nail bed color, and the intactness of the tissues around the nails
What are the nails assessed for?
Nail Root - the nail cells and mitosis of these cells occurs at the nail root, which extends from the proximal end of the nail back under the cuticle.
Lunula - white half-moon shape found at the proximal end of the nail
Cuticle - the layer of the epidermis that covers the nail bed
Nail Bed - the nail rests on this part of the epidermis
What are the four major parts of the nail?
Grow slower, Nail thickening, Splits, Streaks on the nail plate, white spotting, and spoon shaped
Explain the changes to nails caused by aging?
Clubbing - 180 degrees or greater and in the advanced stage, the ends of the fingers have a rounded appearance.
Spooning (koilonychia) - nail curves upward from the nail bed creating a "spoon" effect. (iron deficiency)
What are the potential abnormalities found with the shape of the nail?
The evenness of growth over the scalp, patchy hair loss, Texture - coarse, silky, dry or greasy, Thick or thin, Alopecia, Hypertrichosis,
Hair is assessed for which things? What are the abnormal findings of hair? And what are some changes to the hair caused by aging?
These glands produce sebum, an oily secretion that keeps the skin moist and soft and prevents drying and cracking.
located close to the hair follicles and usually drains into the follicle to travel to the surface of the skin.
Sebaceous Glands (oil), Sudoriferous or Sweat Glands :
Apocrine sweat glands - secrete a milky sweat into the hair follicle and give each person a unique scent. found in the axillae, pubic region, areola of the breast, external ear canals and eyelids
Merocrine glands - they are distributed throughout the body in the upper lip, forehead, back, palms and soles of the feet. They produce a secretion that is mostly water and a few salts.
Sudoriferous: These glands are located in the dermis with two distinct types:
to act as a cooling function for the body as well as aid in eliminating waste and moisturize the skin.
The main function of both the Sebaceous and Sudoriferous sweat glands is…
Occipital
2 Parietals
Frontal
2 Temporals
Sphenoidal
Ethmoidal
Eight bones of the cranium
2 Nasals
2 Maxillae
2 Lacrimals
2 Zygomatics
2 Palatines
2 Inferior conchae
Mandible
14 bones of the skeleton face
• created when the mandible meets the temporal bone of the skull, which is immediately in front of each ear.
• "ball and socket" that has a disc between it. The movement should be smooth and pain-free.
• frequently used joint in the body.
What is the TM joint?
Sore jaw muscles
Difficulty opening the mouth
Lock jaw - open or closed - medical emergency
Headaches
what are the potential abnormalities that a person may encounter when suffering with a problem in their TMJ?
Jaw rest, medication, physical theraphy
Treatment for Temporal Mandibular Joint (TMJ)
Located anterior to the tragus of the ear and has several branches. A pulse is normally felt on palpation. Abnormalities included no noted pulse, tenderness in the area of swelling
What is the definition of a Temporal Artery?
I. Olfactory
II. Optic
III. Oculomotor
IV. Trochlear
V. Trigeminal
VI. Abducens
VII. Facial
VIII. Vestibulochlear
IX. Glossopharyngeal
X. Vagus
XI. Accessory
XII. Hypoglossal
12 cranial nerves in order
Smell
Function of Olfactory nerve (CN I)
Vision
Function of Optic nerve (CN II)
Pupil-Field of Gaze
Function of oculomotor nerve (CN III)
Field of Gaze ( eye movements )
Function of trochlear nerve (CN IV)
Jaw clench / facial sensation
Function of trigeminal nerve (CN V)
Field of gaze (eye movement)
Function of abducens nerve (CN VI)
Expression / taste
Function of facial nerve (CN VII)
Hearing
Function of vestibulocochlear nerve (CN VIII)
"ah" - upward movement of the uvula
Function of glossopharyngeal nerve (CN IX)
Gag, reflex, swallowing, vocal movement
Function of Vagus nerve (CN X)
Shoulder shrug/ head movement
Function of accessory nerve (CN XI)
tongue wag
Function of hypoglossal nerve (CN XII)
Vomer and Ethmoid bone
The nasal septum is formed by which two bones?
Occurs when there is not a full fusion of the palatine bones and even possible the maxillae.
How does a cleft palate occur?
Location: Under the jaw line
Function: Drains the chin, lips, nose, cheeks, and tongue
Submandibular Nodes:
Location: Under the chin
Function: Drains lower lip, chin and the floor of the mouth
Submental Cervical nodes:
Location: Face, Cheek Region.
Function: Drains eyelids, nose and the facial skin
Buccal Nodes:
Location: Face, front of the ear
Function: Drains eyelids, nose and ears.
Parotid Nodes:
Location: Behind the ear
Function: Drains behind the ear and temples.
Posterior Auricular Nodes:
Location: Back of the head
Function: Drains the back of the scalp and the upper neck region
Occipital nodes
Location: Neck, below the ears.
Function: Drains lower part of the ear, parotid area & neck
Superficial Cervical Nodes:
Location: Neck
Function: Drains back of the scalp and neck.
Deep Cervical Nodes:
Role in growth
Role in development
Stimulates heart rate
Stimulates heart contraction
Stimulates synthesis of proteins & carbs
Degrades cholesterol and tryglyceride’s
Enhances beta
Increases vitamin requirements.
what are the functions of the Thyroid Gland?
Regulates calcium
Located behind the thyroid gland in neck
Secretes parathormone ( parathyrin )
Critical to calcium & phosphorus metabolism
Functions of Parathyroid Glands:
Fever
Fatigue
Sore throat
Swollen lymph glands
Mononucleosis causes:
Circulation, Sensation, Movements.
CSM:
C: Skin, Planning, Temp.
S: Touch, Wiggle toes.
M: Range of Motion, Plantar/ Dorsi
How do we assess CSM:
lymph nodes (lymph glands), spleen, thymus gland and bone marrow
Parts of the body that affects lymph nodes
anatomical landmark in anterior skull base surgery (olfactory nerve)
Crista Galli:
the cavity in the temporal bone that enables interaction with the mandibular condyle
mandibular fossa
Connects bone together
Sphenoid Bone