Untitled Flashcards Set

Danger Signs of Skin Lesions (ABCDEF)

• A: Asymmetry – One half of the lesion does not match the other.

• B: Border – Irregular, blurred, or poorly defined edges.

• C: Color – Variations in color (multiple shades of brown, black, red, white, or blue).

• D: Diameter – Greater than 6mm (size of a pencil eraser).

• E: Evolution – Changes in size, shape, or color over time.

• F: Funny looking – Looks different from other moles/lesions ("ugly duckling" sign).

Physical Exam Findings of Diaphoresis vs. Dehydration

• Diaphoresis: Excessive sweating, often associated with fever, anxiety, or shock. Skin is moist and clammy.

• Dehydration: Dry mucous membranes, decreased skin turgor, sunken eyes, and in severe cases, confusion or dizziness.

What Important Information Can a Thorough Skin Assessment Provide?

• Clues about systemic diseases (e.g., jaundice in liver disease, pallor in anemia).

• Signs of infection, inflammation, or malignancy.

• Assessment of hydration status and circulation.

• Evidence of pressure injuries, wounds, or lesions.

Skin Color Changes in a Critical Patient

• Pallor: Shock, anemia, poor circulation.

• Cyanosis: Hypoxia or poor oxygenation.

• Jaundice: Liver dysfunction, hemolysis.

• Erythema: Infection, inflammation, or fever.

• Mottling: Poor perfusion, shock, end-of-life changes.

What is Skin Turgor and When Might You See It?

• Skin turgor tests for hydration by pinching the skin and seeing how quickly it returns to normal.

• Poor turgor (slow return) seen in dehydration.

• Normal turgor (immediate return) indicates adequate hydration.

Clubbing – What Is It and When Might You See It?

• Clubbing is a bulbous enlargement of the fingertips and loss of the normal angle between the nail and nail bed.

• Seen in chronic hypoxia, lung disease, congenital heart defects, and liver cirrhosis.

Stages of Pressure Injuries/Ulcers

1. Stage 1: Non-blanchable erythema of intact skin.

2. Stage 2: Partial-thickness loss, epidermis/dermis affected, shallow open wound or blister.

3. Stage 3: Full-thickness loss, subcutaneous tissue visible but no bone/tendon/muscle exposure.

4. Stage 4: Full-thickness loss with exposed bone, tendon, or muscle.

Lymph Node Examination

• Normal nodes: Soft, mobile, small, and non-tender.

• Abnormal nodes: Hard, fixed, tender, or enlarged.

• Examine by using gentle, circular motion with fingertips in a systemic pattern.

Snellen Chart – What Does It Measure?

• Measures visual acuity (distance vision).

• Normal vision: 20/20 (can see at 20 feet what a normal person sees at 20 feet).

Diagnostics Position Test – What Are You Looking for?

• Tests extraocular muscle function.

• Abnormal finding: Nystagmus (involuntary eye movement), strabismus, or muscle weakness.

Uvula Examination – What Are You Looking for?

• Uvula should rise symmetrically with phonation ("ahh").

• Abnormal: Deviation (suggests cranial nerve dysfunction), asymmetry, or absent movement (neurological deficit).

Accommodation Test – What Is It?

• Tests the eye’s ability to focus on near and far objects.

• Normal response: Pupils constrict and eyes converge when focusing on a near object.

Corneal Light Reflex Test – Normal/Abnormal Findings

• Normal: Reflection of light is symmetrical in both eyes.

• Abnormal: Asymmetry, indicating strabismus.

Tympanic Membrane (TM) Normal vs. Abnormal

• Normal: Pearly gray, translucent, cone of light present.

• Abnormal: Redness (infection), bulging (fluid buildup), perforation, or scarring.

Proper Otoscope Use

• Adults: Pull auricle up and back.

• Children (<3 years): Pull auricle down and back.

Acute Otitis Media vs. Otitis Externa

• Acute Otitis Media: Middle ear infection, TM appears red and bulging.

• Otitis Externa: Infection of the external ear canal, often called swimmer’s ear, with pain and swelling.

• Fluid behind TM: Yellow or air bubbles visible.

Tympanostomy Tubes and TM Scarring

• Tympanostomy tubes: Small tubes inserted into TM to drain fluid and prevent infections.

• TM scarring: Caused by recurrent infections or perforations.

External Ear Examination – Normal/Abnormal Findings

• Normal: No swelling, redness, or tenderness.

• Abnormal: Swelling, pain, drainage, lesions (e.g., carcinoma or infection).

Tonsil Grading (Normal/Abnormal)

• 0: Removed.

• 1+: Visible.

• 2+: Halfway between tonsillar pillars and uvula.

• 3+: Touching the uvula.

• 4+: Touching each other (airway obstruction risk).

Nasal Patency Exam – Normal vs. Abnormal

• Normal: Equal airflow in both nostrils.

• Abnormal: Obstruction, deviated septum, congestion.

Cover Test – What Is It For?

• Tests for strabismus (eye misalignment).

Cerumen (Earwax) – What Is It?

• Protects and lubricates the ear canal.

• Can be wet (common in Caucasians/Africans) or dry (Asians/Native Americans).

• Excessive buildup can cause hearing loss or discomfort.