APA T 2

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 : 

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**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

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Functions of Parathyroid Glands:

* Fever
* Fatigue
* Sore throat
* Swollen lymph glands

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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