N202 Comprehensive Health Assessment: Peripheral Vascular, Breast, Abdomen, Integumentary, Cardiac, and Head & Neck Systems

Comprehensive vocabulary flashcards covering nursing physical assessment across the peripheral vascular, breast and axillary lymphatics, abdominal, integumentary, cardiovascular, and head/neck systems.

Intermittent Claudication

Muscle ischemia caused by arterial insufficiency, typically affecting the gastrocnemius muscle and presenting with calf pain during exercise that is relieved by rest.

Capillary Refill Time (CRT)

A physical assessment of peripheral arterial perfusion where pressure is applied to a nailbed; normal color return is $< 2\text{ seconds}$, whereas a delay of $≥ 2\text{ seconds}$ indicates arterial occlusion, hypothermia, or hypovolemic shock.

Ankle-Brachial Index (ABI)

The ratio of systolic blood pressure measured in the lower legs compared to the arms, where a lower blood pressure in the leg indicates arterial occlusion.

Allen Test

A bedside diagnostic procedure used to assess the collateral arterial patency of the radial and ulnar arteries by compressing both vessels and observing the rate of hand recoloration upon release.

Pitting Edema Scale

A grading scale ($1+$ to $4+$) measuring interstitial fluid accumulation by finger pressure: $1+$ denotes slight pitting, $2+$ is deeper than $1+$, $3+$ is a noticeably deep pit where the extremity looks larger, and $4+$ represents very deep pitting with gross extremity edema.

Hemosiderin Staining

Brown hyperpigmentation occurring around the ankles and lower legs in chronic venous insufficiency, caused by iron deposits from red blood cells leaking out of veins under elevated venous pressure.

Deep Vein Thrombosis (DVT)

A potentially life-threatening venous occlusion presenting with localized pain, warmth, tenderness, erythema, swelling, and asymmetric calf size that predisposes the patient to pulmonary emboli.

Tail of Spence

The superior lateral projection of breast glandular tissue extending into the axilla from the upper outer quadrant, representing the most common anatomical site of breast malignancy.

Cooper's Ligaments

Fibrous suspensory bands extending throughout breast tissue to attach it to the underlying chest wall muscles; neoplastic infiltration can cause ligament retraction, producing skin dimpling or pitting.

Gynecomastia

A palpable nub of breast tissue under the areola that feels like a large grape, occurring temporarily and unilaterally in adolescent males due to conversion of excess testosterone to estrogen, or in aging men due to hormonal imbalance.

Galactorrhea

A milky nipple discharge occurring in an individual who is not actively lactating, frequently associated with a prolactin-secreting pituitary tumor.

Peau d'Orange

An orange peel cutaneous appearance of the breast caused by localized lymphatic duct obstruction and dermal edema, which exaggerates hair follicle pores; a classic sign of breast carcinoma.

Paget's Disease of the Breast

An advanced form of ductal breast carcinoma that characteristically manifests as an erythematous, crusted lesion, scaling, or fissure starting on the nipple surface.

Supernumerary Nipple

A congenital accessory nipple located along the embryonic mammary ridge at the midclavicular line, found in approximately $1\%$ of males and females, which is usually harmless and resembles a nevus.

Linea Alba

A fibrous tendinous median seam in the anterior abdominal wall that joins the bilateral rectus abdominis and oblique muscles, running vertically from the xiphoid process to the symphysis pubis.

Melena

Black, tarry, foul-smelling stool resulting from the digestion of blood from an upper gastrointestinal bleed, such as a peptic ulcer.

Hematochezia

Maroon or dark red blood passed per rectum, typically indicating lower gastrointestinal tract hemorrhage, or rapid-transit upper gastrointestinal bleeding.

Seven Fs of Abdominal Distention

The clinical mnemonic identifying the seven major etiologies of generalized abdominal distention: fluid, feces, flatus, fat, fetus, fibroid, and fatal mass.

Borborygmi

Hyperactive, gurgling, or rumbling gastrointestinal sounds caused by the acoustic propulsion of gas and fluid through the intestines.

Paralytic Ileus

A temporary absence of gastrointestinal peristalsis and bowel sounds frequently occurring secondary to abdominal surgery, which may take up to $48\text{ hours}$ to resolve.

Costovertebral Angle Tenderness (CVAT)

Pain elicited by direct or indirect blunt percussion over the 12th rib posteriorly at the costovertebral angle, indicating acute kidney inflammation or infection.

Murphy's Sign

Inspiratory arrest elicited when the examiner performs deep palpation along the liver border in the right upper quadrant as the patient inhales, indicating acute cholecystitis.

Bristol Stool Chart

A standardized clinical diagnostic tool that stratifies human feces into seven morphological categories, ranging from Type 1 (separate hard lumps indicating severe constipation) to Type 7 (entirely liquid stool indicating severe diarrhea).

Diastasis Recti

A benign midline abdominal separation of the paired rectus abdominis muscle bellies, presenting as a visible midline bulge when intra-abdominal pressure rises.

Xerosis

Pathologic excessive dryness of the skin, frequently observed in older adults due to age-related decline in sweat and sebaceous gland activity.

Spider Angioma

A vascular skin lesion with a fiery-red, pulsating central arteriole and radiating capillary branches that blanches upon applied palpation pressure; associated with elevated estrogen levels or liver disease.

Petechiae

Pinpoint, rounded, non-blanching red or purple macules measuring $1\text{ to }3\text{ mm}$, caused by superficial intradermal capillary bleeding from thrombocytopenia, bacteremia, or sepsis.

Macule

A flat, circumscribed, non-palpable alteration in skin color measuring $< 1\text{ cm}$ in diameter, such as a freckle, petechia, or solar lentigo.

Papule

A solid, elevated, circumscribed palpable primary skin lesion measuring $< 1\text{ cm}$ in diameter, such as an elevated nevus or verruca (wart).

Vesicle

A raised primary epidermal lesion measuring $< 1\text{ cm}$ filled with clear serous fluid, characteristic of herpes simplex, varicella, and contact dermatitis.

Keloid

A hypertrophic, elevated scar resulting from excessive collagen synthesis during dermal wound repair that extends beyond the original wound margins.

Lichenification

A secondary skin lesion defined by rough, thickened epidermis with accentuated surface markings, produced by chronic rubbing, scratching, or eczema.

ABCDE Rule

A clinical assessment mnemonic for identifying malignant melanoma: Asymmetry, Border irregularity, Color variation, Diameter $> 6\text{ mm}$, and Elevation or Evolving characteristics.

Clubbing

A progressive distortion of the nail matrix where the nail bed angle straightens to $\ge 180^\circ$ and the base becomes spongy, secondary to prolonged systemic hypoxia in COPD or lung carcinoma.

Precordium

The anterior anatomical area of the chest wall immediately overlying the ventricles, atria, and great vessels of the heart.

S1 Heart Sound

The first heart sound ('lub'), heard loudest at the apex, produced by the simultaneous closure of the atrioventricular (mitral and tricuspid) valves at the onset of ventricular systole.

S2 Heart Sound

The second heart sound ('dup'), heard loudest at the base, produced by the sudden closure of the semilunar (aortic and pulmonic) valves at the beginning of ventricular diastole.

S3 Heart Sound (Ventricular Gallop)

A low-pitched extra diastolic sound occurring early in diastole immediately following S2 ('Ken-tuck-y'), reflecting ventricular compliance resistance during rapid passive filling, often an early marker of heart failure.

S4 Heart Sound (Atrial Gallop)

A low-frequency sound occurring in late diastole immediately before S1 ('Ten-ness-ee'), caused by ventricular resistance to late active filling during atrial contraction; common in systemic hypertension and the elderly.

Pulse Deficit

A hemodynamic finding detected when the auscultated apical heart rate is numerically greater than the simultaneously palpated radial pulse rate, signaling an irregular cardiac arrhythmia.

Thrill

A tactile chest wall vibration resembling the purring of a cat, palpated across the precordium and corresponding to loud, turbulent cardiac murmurs ($4+$ to $6+$ intensity).

Point of Maximal Impulse (PMI)

The brief systolic apical impulse palpable at the 4th or 5th intercostal space at the left midclavicular line; lateral displacement of the PMI suggests cardiomegaly.

Jugular Venous Distention (JVD)

Pathologic distention and elevated pulsation of the internal and external jugular veins when examined at $\ge 45^∘$ head-of-bed elevation, directly indicating elevated right atrial filling pressure.

Cranial Nerve XI (Spinal Accessory)

The motor cranial nerve innervating the sternocleidomastoid and trapezius muscles, clinically evaluated by active shoulder shrug and head turning against bilateral manual resistance.

Vertigo

A distinct sensory illusion of true environmental or rotational spinning caused by inner ear vestibular disturbance or neurological dysfunction, distinct from general lightheadedness.

Tension Pneumothorax

A life-threatening thoracic emergency where trapped intrapleural air under positive pressure shifts mediastinal structures and pushes the trachea away from the midline toward the unaffected side.

Thyromegaly (Goiter)

An enlargement of the thyroid gland presenting as visible or palpable lobular fullness at the anterior base of the neck, caused by hyperthyroidism, hypothyroidism, or iodine deficiency.

Lymphadenopathy

Palpable enlargement of one or more lymph nodes measuring $> 1\text{ cm}$ in diameter, resulting from active systemic or localized infection, allergic reaction, or neoplasm.

Supraclavicular Lymph Node

A sentinel lymph node located above and behind the clavicle and sternocleidomastoid muscle that drains thoracic and abdominal regions; painless, firm enlargement here is highly suspicious for metastatic malignancy.

Craniosynostosis

The abnormal premature ossification and fusion of one or more cranial sutures in an infant while the brain continues rapid structural growth.