240 terms
Victoria050

Health Assessment abnormalities

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neoplasm
New abnormal growth; benign or malignant tumors
seborrhea
excessive discharge of sebum - oily
xerosos
inadequate discharge of sebum - dry
Alopecia
significant hair loss
Hirsutism
excessive distribution of body hair, especially in womenc due to endocrine abnormalities
intertriginous areas
skin folds (ex. under breast)
Junctional nevi
macular only nevi, and occurs in children and adolescents
Compound nevi
macular and papular nevi in young adults
diaphoresis
excessive or profuse sweating
callus
an area of skin that is thick or hard from continual pressure or friction (as the sole of the foot)
peau d'orange
"orange peel" appearance caused by edema suggests cancer
scleroderma
a disease characterized by chronic hardening (induration) of the connective tissue of the skin and other body organs. shiny skin, thin lips, muscle atrophy, no facial expressions
Cherry (senile) angioma
small, smooth, slightly raised bright red dots common on the trunk in adults over 30; increase in size and number with age
Fungal infection
Tinea - under Wood's light blue-green fluoresance
Clubbing nails
-occurs with congenital chronic cyanotic heart disease --Emphysema
-chronic bronchitis
-early clubbing: angle straightens out to 180º and nail base feels spongy to palpation
Mongolian spots
A bluish-black pigmented area on the newborn's buttocks or back. Seen in newborns with dark skin and typically fade over time. Can easily be confused for bruising. In Afro-Americans, American Indians, Hospanics, Asians
Cafe au lait spot
a large round or oval patch of light brown pigmentation (hence, the name "coffee with milk"), which is usually present at birth (6+ is abnormal)
Striae
a streak or a linear scar that often results from rapidly developing tension in the skin, such as seen on the abdomen after pregnancy.
Senile Lentigines
"liver spots". Small flat brown macules. Clusters of melanocytes that appear after extensive sun exposure. Appear on forearms and doras of the hands. Not malignant
Acrochordons
skin tags, overgrowths of normal skin that form a stalk, are polyp-like, occur frequently occur on eyelids, cheeks, neck, axillae and trunk.
Venous stasis
decreased blood flow from area, engorged venules
hematoma
elevated, localized collection of blood trapped under the skin that usually results from trauma. Bruise you can feel
hemangioma
benign proliferation of blood vessels in the dermis
Port Wine stains
patch along nerve V, birth mark, bright red, abnormally dense blood vessels, in dermis, face/neck, darken with age, early in fetal development
Strawberry Mark (Immature hemangioma)
raised bright red, 2-3 cm diameter, no blanch with pressure, consists of immature capillaries, present at birth or develops in 1st few months, disappears by age 5-7 yrs, no treatment
Cavernosus Hemangioma (mature)
reddish blue irrgelary shaped present at birth, may enlarge during 10-15 months and will not involute spontaneously
Telangiectasia
vascular dialation: permanently enlarged and dilated blood vessels that are visible
Star (spider) angioma
capillary radiations extend from central arterial body on face, neck, or chest
Venous lake
a blue-purple dilation of venules and capillaries in a star-shaped, linear or flaring pattern. pressure caused them to empty or disappear. located on legs near varicose veins and also on teh face, lips, ears and chest
purpuric lesions
purpura; lesions as a result of hemorrhages into the skin due to breaks in vessels
petechiae
Pinpoint lesions, not from trauma, does not blanch, round and discrete 1to3 mm due to bleeding from superficial capillaries. May indiate abnormal clottng factors
Ecchymosis
red-purple patch due to extravasion of blood into skin >3mm
Purpura
Confluent and extensive patch of patechiae and ecchymoses
Intertrigo
candidiasis infection resulting in red, moist patches usually in genital area, aggravated by urine, feces, heat and moisture
Impetigo
Bacterial skin infection characterized by thin vesicles with erythematous base that become crusted and rupture
Atopic dermatitis (eczema)
a chronic skin inflammation characterized by the appearance of inflamed, swollen papules and vesicles that crust and scale, with severe itching and burning; most outbreaks begin in infancy and are marked by exacerbations and remissions that usually clear up before adulthood; occurs in persons with atopy (a genetic hypersensitivity to environmental irritants of allergens)
Measles (rubeola)
Transmission is direct or indirect with airborne droplets. Maculopapular rash with Koplik's spots (small irregular red spots w/bluish-white center appearing on the muccal mucosa).
German Measles (rubella)
pink papular rash begins on the face, then spreads over the body; accompanied by swollen glands - lymphodenopathy; occurs mostly in children
Chicken Pox (Varicella)
contagious virus with red itchy vesicles that erupt -> pustule and become encrusted centrally. Ertthematous base
Primary Contact Dermatitis
local inflammatory reaction to an irritant or an allergy; erythema first, swelling, urticaria, maculopapular vesicles, scales w/pruritis. ex: poison ivy
Tinea Corporis
a contagious fungal infection that forms a ringed, red pattern with elevated edges and clear centers. Also called ringworm.
Tinea Pedis
athlete's foot (ringworm of the foot), which is caused by a fungus. Chrinically moist and warm feet.
Labial Herpes Simplex
herpes simplex virs (HSV I) infectoin has a prodrome of skin tingling and sensitivity. lesion then erupts with tight vesicles followed by pustules and then produces acute gingivostomatitis with many shallow,painful ulcers. common location is upper lip, also in oral mucosa and tongue
Tinea Versicolor
Superficial fungus infection of the skin
pink, tan, or white scaly macules on the trunk, neck, and upper arms
Herpes Zoster (shingles)
an acute viral infection caused by the same virus that causes chickenpox characterized by painful, vesicular lesions or eruptions on the skin following along the nerve pathways of underlying spinal or cranial nerves. Doesn't cross midline
Psoriasis
chronic skin disease characterized by itchy, erythematous, silvery-scaled patches. Scalp, elboes, knees, low back, anogenital.
Basal cell carcinoma
a malignant tumor of the basal cell layer of the epidermis; this is the most common and least harmful type of skin cancer because it is slow growing and rarely spreads to other parts of the body. w/telangiectasia and pearly border and red ulcer. On sun exposed areas of face, ears, scalp, shoulders
Squamous cell carsinoma
start as scaly, redden lesions on the head, scalp, and lip. Develops in ulcer surrounded by erythema. Can grow rapidly and spread if not removed. surgical or radiation = removal.
Tinea Capitis
scalp ringworm , patchy hair loss on scalp - broken off hairs, pustules, and scales. shines blue-green under Wood's light= fungus
Traumatic Alopecia
Linear or oval patch of hair loss along hair line, a part, or scattered distribution; caused by trauma from hair rollers, tight braiding, tight ponytail, barrettes.
Toxic alopecia
Patchy, asymmetric balding that accompanies severe illness or use of chemotherapy where growing hairs are lost and resting hairs are spared. Regrowth occurs after illness or dis-continuation of toxin.
Alopecia Areata
the sudden falling out of hair in round patches or baldness in spots may occur on the scalp or elsewhere on the body /unknown couse
Pediculosis Capitis (head lice)
infestation with lice that causes itching and dermatitis especially on occipit
Scabies
A contagious disease caused by a parasite (mite) that invades the skin, causing an intense itch - most often found at articulation between the fingers or toes, hands and wrists
Paronychia
fungal inflammation of the tissues around the nail; pus, thickening, and brownish discoloration of the nail plate
Beau's Line
trauma or illness affecting the nail formation; linear depression develops at the base and moves distally as the nail grows
Splinter Hemorrhages
Red-brown linear streaks, embolic lesions, occur with subacute bacterial endocarditis; also may occur with minor trauma.
Onycholysis
fungal infection, change in color, loosening of the nail without shedding, usually beginning at the free edge and continuing to the lunula
Pitting
Sharply defined pitting and crumbling of the nails with distal detachment often occurs with psoriasis.
Habit-Tic Dystrophy
Depression down middle of nail or multiple horizontal ridges, caused by continuous picking of cuticle by another finger of same hand, which causes injury to nail base and nail matrix.
Vertigo
condition in which one feels that one's surroundings are turning about, spinning
Dysphagia
difficulty in swallowing
Paget's disease of Bone (Osteitis Deformance)
a skeletal bone disorder in which there is excessive bone resorption followed by replacement of normal marrow by vascular, fibrous connective tissue and new bone that is larger, disorganized, and weaker; characterized by excessive bone destruction and unorganized bone repair.
Torticollis / wryneck
hematoma in sternomastoid muscle causing stiffness and twisting of the neck that may be congenial or acquired - causes assymetry and limited ROM - visual problems, needs to be treated
Pilar Cyst (Wen)
smooth, firm, fluctuant swelling on the scalp that contains sebum and keratin. Tense pressure of the contents causes overlying skin to be shiny and taut. It is a benign growth.
Parotid gland enlargement
Rapid painful inflammation occurs with mumps. also occurs with blockage of a duct, abscess, or tumor. Note swelling anterior to lower ear lobe. Stensen duct obstruction can occur in aging adults dehydrated from diuretics or anticholinergics.
Fetal alcohol syndrome
Physical and cognitive abnormalities in children caused by a pregnant woman's heavy drinking. In severe cases, symptoms include noticeable facial misproportions: narrow palpebral fissures, midfacial hypoplasia
Congenital Hypothyrodism
by 3-6 months, low hairline, swollen eyelids, depressed nasal bridge. A and P fontanels are wide open.
Parkinson syndrome
a progressive disease that destroys brain cells and is identified by muscular tremors, slowing of movement, and partial facial paralysis, condition of slowly progressive degeneration of an area of the brainstem (substantia nigra) resulting in a decrease of dopamine ( a chemical neurotransmitter that is necessary for proper movement); characterized by tremor; rigidity of muscles, and slow movements (bradykinesia), usually occurring later in life. No facial expressions
Cushing syndrome
collection of signs and symptoms caused by an excessive level of cortisol hormone from any cause, such as a result of excessive production by the adrenal gland (often caused by a tumor), or more commonly as a side effect of treatment with glucocorticoid (steroid) hormones such as prednisone for asthma, rheumatoid arthritis, lupus or other inflammatory diseases; symptoms include upper body obesity, facial puffiness (moon-shaped appearance), hyperglycemia, weakness, thin and easily bruised skin with stria (stretch marks), hypertension, and osteoporosis
Hyperthyrodism
Grave's disease (more common) w/goiter and exopthalmos (bulging eyes), tachycardia, nevousness, insomnia, weightloss, exopthalmos (grave's only), heat intolerance
thyrotoxic crisis (thyroid storm) - extremely high thyroid hormone
Hypothyrodism / Myxedema
This is when the face is puffy and have a thick tongue. Dry skin and hair
Bell's Palsy
Facial paralysis caused by a functional disorder of CN 7 (facial nerve) and any or all or its branches. It may be unilateral, bilateral, transient, or permanent.
Cachectic appearance
Accompanies chronic wasting diseases such as cancer, dehydration, and starvation. Features include sunken eyes; hollow cheeks; and exhausted, defeated expression.
Pendlous breasts
arge breasts
nulliparous woman
female who has borne no offspring
colostrum
thin, yellow fluid, precursor of milk, secreted for a few days after birth w/protein and lactose and NO fat
Mastalgia
pain in breast
Galactorrhea
clear nipple discharge
Supernumerary nipple
extra nipple along the the embryonic "milk line" on the thorax or abdomen; a congenital finding
Dimpling
shallow, also called a skin tether, sign of skin retraction, cancer causes fibrosis, which contracts suspensory ligaments; apparent at rest, with compression, or with lifting of arms, note distortion of areola as fibrosis pulls nipple toward it , nipple is fixed
Fixation of breast
asymmetry distortion or decreased mobility with the elevated arm maneuver. As cancer becomes invasive the fibrosis fixes the breast to the underlying pectoral muscle.
Deviation in nipple pointing
underlying cancer causes fibrosis in mammary ducts which pulls nipple toward it
- this is different from someone who has always had inverted nipples
Benign Breast Disease (Fibrocystic Breast disease)
multiple tender masses. categorized based on six symptoms: swelling/tenderness, mastalgia (not always), nodularity (not always), dominant lumps, nipple discharge, and infections/inflammations. 50% of women. Bilaterally, mobile. 30-55
Breast cancer
This is/are: small, hard, fixed painless lump, change in size or shape of breast or nipple. RUQ most common. Discharge, dimpling, pulling or retraction of the skin of the breast resembling an orange peel. Lymphodenopathy. Diagnosed by BSE, mammography, biopsy. 30-80, most >50
Fibroadenoma
This is a freely movable, rounded mass with well-defined borders and a solid rubbery texture. Nontender and most common in women in their teens & early twenties. Not associated with breast cancer.
Mammary duct Ectasia
Usually 50-70 YO females with previous children. It is an inflammation of the lactiferous ducts behind the nipple; cellular debris and fluid collect in the involved duct, enlarged and from a palpable, painful mass; thick, sticky green/ brown discharge from the nipple is common, Calcification and granulomas, can be painful but not associated with cancer
Intraductal Papilloma
Small, benign, wart-like tumor in major ducts usually within 1-2 cm. of areolar edge; one or more ducts may be affected. Most commonly occurs in women 40 to 60 yrs. Clinical Findings: Is spontaneous bloody discharge from nipple; occasionally a mass is palpated. unilateral
Carcinoma of breast
Bloody nipple discharge tha is unilateral
Paget's disease (Intraductal carcinoma)
Early lesion has unilateral, clear, yellow d/c and dry scaling crusts, friable at nipple apex. Speads outward to areola with erythematous halo on aerola and crusted, eczematous, retracted nipple. Later lesion shows nipple reddedned, excoriated, ulcerated, with blood d/c when surface is eroded, and an erythematous plaque surrounding the nipple. symptoms include tingling, burning, itching.
Plugged duct
One section of the breast is tender and possible red one milk duct is clogged.(but no infection). Important to keep breasts empty, but usually resolves in one day
Mastitis
inflammation of the breast usually occurs during breast feeding and is detected by redness, heat, and tenderness or pain, this is a type of cellulitis or localized soft tissue infection which requires antibiotics for recovery.
Breast Abscess
Untreated complication of generalized infection, pocket of pus accumulates. Must temporarily discontinue nursing-manually express milk and discard. Treated with antibiotics, surgical incision, and drainage
Gynecomastia
development of mammary glands in the male, caused by altered hormone levels. Normal in newborns, adolescent, older people
Male Breast Cancer
detected by clinical symptoms. painless palpable mass, hard, irregular, fixed in area, may have retraction and discharge.1%. Early spread to axillary nodes
Dysphagia
difficulty swallowing
Pyrosis
a painful burning sensation in the chest caused by gastroesophageal reflux (backflow from the stomach irritating the esophagus)
Hematemasis
vomiting of blood which will come from the gastrointestinal tract.
Pica
an abnormal craving or appetite for nonfood substances, such as dirt, paint, or clay
Purging
engaging in behaviors such as vomiting or misusing laxatives to get rid the body of food
Borborygmus
Rumbling or gurgling noise produced by the movement of gas, fluid, or both in the gastrointestinal tract audible from distance
Obesity
Uniformly rounded. Umbilicus sunken. Normal BS. Tympany.
Air or gas in abdomen
Single round curve. Decreased BS. Tympany. May be muscle spasm of abdominal wall
Ascites of abdomen
Single curve. everted umbilicus. Recent waight gain. Normal BS, tympany on top but no BS and dullness ove fluid. Increased abdominal P
Ovarian Cyst
Curve on lower abdomen. Everted umbilicus. Normal BS over upper abdomen. Dullness over fluid. Aortic pulsation.
Feces in abdomen
localized distention with dullness. Normal BS. Tympany.
Tumor of abdomen
localized distention. Normal BS. Dull over mass. Dfine borders.
Cholecystitis
inflammation of the gall bladder
Umbilical hernia
Soft, skin-covered mass which is the protrusion of the omentum or intestine through a weakness or incomplete closure in the umbilical area in prmature infants
Epigastric hernia
location - epigastrium, anterior abdominal wall (btwn sternum and umbilicus) poking - fatty tissue ,pierced - through linea alba
Incisional Hernia
A bulge near an old operative scar that may not show when person is supine but is apparent when the person increases intra-abdominal pressure by a sit-up, by standing, or by the Valsalva maneuver.
Diastasis Recti
midline longitudinal ridge, separation of abdominal rectus muscles, ridge is revealed when intra-abdominal pressure is increased by raising head while supine, occurs congenitally and as a result of pregnancy or marked obesity in which prolonged distention or a decrease in muscle tone has occurred, not clinically significant.
Succussion splash
a very loud splash auscultated over the upper abdomen when the infant is rocked side to side. Indicates increased air and fluid in the stomach, as seen with pyloric obstruction or large hiatus hernia.
Enlarged liver
Enlarged, smooth and nontender liver occurs with fatty infiltration, portal obstruction or cirrhosis, high obstruction of inferior vena cava and lymphocytic leukemia. Liver feels enlarged and smooth but is tender to palpation with early heart failure, acute hepatits, or hepatic absess
Enlarged Nodular liver
occurs w/ late portal cirrhosis, metastatic caner, or tertiary syphilis
Enlarged Gallbladder
Suggests acute cholecystitis, felt behind the liver border as a smooth firm mass like a sausage although it may be difficult to palpate because of involuntary rigidity of abdominal muscles. If nontender, gallbladder is filled with stones or common bilr duct obstruction
Enlarged Spleen
Enlarges down and to the midline. When splenomegaly occurs, it is moderately enlarged and soft with rounded edges. If chronic, the enlargement is firm or hard. Since acute/chronic don't usually reach peritoneum, no tenderness unless pertoneum is inflamed.
Enlarged Kidney
Caused by hydronephrosis, cysts, or neoplasm. May be difficult to distinguish an enlarged kidney from an enlarged spleen because they have a similar shape. Both extend forward and down. Kidney will never have sharp edge, or palpable notch. Percussion is tympanic because of overriding bowel
Aortic Aneurysm
Located below the renal arteries and extend to the umbilicus. 80% are palpable during routine physical exam and feel like a pulsating mass in the upper abdomen just to the left of midline. Bruits are heard, but femoral pulses are weakened.
Polyuria
excessive urination
Oligouria
decreased urine production <400mL/24hr
Nocturia
urination at night; can be a symptom of renal disease or may occur in persons who drink excessive amounts of fluids before bedtime.
Dysuria
painful or difficult urination.
Hesitancy
involuntary delay in initiating urination
Urge Incontinence
Urine is lost in response to a sudden, urgent need to void; the person cannot get to a toilet in time
Stress incontinence
inability to control the voiding of urine under physical stress such as running, sneezing, laughing, or coughing
Nocturnal enuresis
involuntary discharge of urine at night; bed-wetting after 5-6 yo
Urethritis (male)
Urethral discharge and dysuria. Meatus edges are reddened, everted. 50% caused by chlamidia infection.
Renal Calculi
kidney stones, bedrest immobility, poor fluid intake, severe cramping& pain just below ribs, nausea, vomiting, fever, chills, blood in urine, person needs 2000-3000ml of fluid/day - urinary system disorders
Acute urinary retention
abrupt inability to pass urine w/bladder distention and lower abdominal pain. must catheterize to relieve acute discomfort
Urethral Stricture
pinpoint constricted opening a meatus or inside along urethra. occurs congentially or secondary to urethral injury. gradual decrease in force and caliber of urine stream is most common symptom. shaft feels indurated along ventral aspect at the site of stricture
Tinea Cruris
a fungal infection in the crural fold, not extending to scrotum, occurring in postpubertal males (jock itch) after sweating or wearing layers of occlusive clothing. it forms a red-brown half moon shape w/well defined borders
Genital herpes
inflammatory std caused by the herpes simplex virus; symptoms include vesicles with surrounding erythema. and ruptire to ulcerative lesions on the genitals 7-10 days, then dormant indefinitely
HPV Genital Warts
Soft pointed moist warty papules. In a cauliflower-like patch.
Syphilitic Chancre
O: HSV 2, Begins as a small, solitary silvery papule that erodes to a red, round or oval superficial ulcer with a yellowish serous discharge. Palpation- nontender indurated base; can be liften like a button between thumb and finger. Nontender inguinal lymphadenopathy.
Phimosis
narrowing of the opening of the foreskin so it cannot be retracted or pulled back to expose the glans penis
Paraphimosis
foreskin is retracted and fixed,, cannot return to its original position. constriction impedes circulation so glands swells- compromise arterial circulation-medical emergency!
Hypospadias
congenital deformity of the urethra in which the urethral opening is on the underside of the penis rather than at the end (ventral)
Epispadias
a congenital abnormality of the urethral opening where in the male, the urethral opening is located on the upper surface of the penis, and in the female the urethral opening is in the region of the clitoris
Priapism
an abnormally persistent erection of the penis, often accompanied by pain and tenderness; usually caused by drug overdose
Peyronie disease
disorder characterized by a buildup of hardened fibrous tissue in the corpus cavernosum, causing pain and a defective curvature of the penis, especially during erection
Pediculosis Pubis
lice that generally infect the pubic region and sometimes also hair of the axilla, eyebrows, eyelashes, beard, or other hairy body surfaces; also called crabs. Little dark spots, nits (eggs) at the roots
Red Rash/ contact dermatitis
Red, swollen vesicles -> crust, scales, excoriation. May result from feminine hygiene spray or synthetic underclothing.
Abscess of Bartholin's gland
local pain, can be severe. overlying skin red and hot. posterior part of labia swollen, palpable fluctant mass and tenderness.
Urethral Caruncle
S: Tender painful with urination, urinary frequency, hematura, dyspareunia, and asymptomatic.
O" small, deep red mass protruding from meatus; usually secondary to urethritis or skenitis; may bleed on contact.
Cystocele
hernia in which the urinary bladder protrudes through the wall of the vagina
Uterine prolapse
the condition in which the uterus slides from its normal position in the pelvic cavity and sags into the vagina
Rectocele
hernia of part of the rectum into the vagina
Atropic Vaginitis
postmenopausal thinning and dryness of the vaginal epithelium w/possible blood d/c related to decreased estrogen levels - opportunistic infection
Candidiasis (Moniliasis)
This is a yeast infection. Thick white patches (cottage cheese like) attached to the cervix, vaginal wall & vulva. Intense itching & inflammation. Use of oral contr, or antibiotics, more alkaline pH
Trichomoniasis
Can acquire it thru sexual contact, toilet seats, wet towels and wet bathing suits. Symptoms include inflammation of the vagina & cervix as well as a yellow-green, frothy odorous discharge Vagina w/ red, raised papules and petechiae.
Bacterial Vaginosis
An infection of the vagina characterized by a fishy odor and a thin white discharge. This is surface parasite - no inflammation. pH >4.5.
Chlamydia
STD the most common in developed countries. Often producing no symptoms, it can cause infertility, chronic pain. May have yellow or green d/c, dysuria
Gonorrhea
STD causes inflammation of the genital mucous membrane and d/c, dysuria. May be w/out symptoms
Ambiguous Genitalia
congenital anomaly found in newborn girls; hyperplasia of adrenal glands, clitoris may look like penis and fusion of labia resembles scrotal sac
Presbyopia
visual condition starting at late middle age in which loss of elasticity of the lens of the eye causes inability to focus sharply for near vision
Cataract
thickening,clouding of the natural lens of the eye
Glaucoma
increased intraocular pressure in the eyeball due to obstruction of the outflow of aqueous humor.Sudden loss of peripheral vision, pain, halos. Redness, dilated pupil. Emergency treatment to avoid blindness
Macular degeneration
a progressive deterioration of the portion of the macula lutea, resulting in loss of central vision. Most common cause of blindness.
Arcus senilus
gray-white circle/arc around the limbus due to deposition of vision material of the iris that is common with aging. No effect on vision.
Scotoma
a blind spot; area of depressed vision surrounded by an area of normal vision. Occurs with glaucoma & central nerve disorderes.
Photophobia
sensitivity to light; inability to tolerate light
Diplopia
an object is seen as two objects.
Exopthalmos
Condition in which the eyeballs protrude w/lid lag, such as in Grave's disease. This is generally caused by an over production of thyroid hormone.
Hyperopia/ Farsightedness
Difficulty to see close objects. Light focus behind retina. Need convex lens
Myopia/ Nearsightedness
Trouble to see things far away. Light focus in front retina. Need concave lens
Phoria
Mild weakness of muscle,apparently only with cover test.
Tropia / Strabismus/ Esotropia vs Exotropia
More severe. constant malalignment of eyes. / inward turning vs outward turning
Anisocoria
Unequal pupil size.Normal or CNS disease.
Mydriasis
dilated and fix pupils.
SNS stimulation, glaucoma, CNS damage, anesthesia.
Miosis
constricted and fix pupil.
Glaucoma treatment, drug use.
Presbycusis
Type of hearing loss. Ocurrs in older adults. Nerve degeneration in the inner ear. First, high frequency tone loss.
Otitis media
middle ear infection. Ocurrs because obstruction of eustachian tube or passage of nasopharyngeal secretions in middle ear.
Otosclerosis
Most common cause of conductive hearing loss in young adults(20 to 40 yo.) Stapes fixed to oval window.
Darwin's tubercle
Small painless nodule at the helix. Congenital variation and is not significant.
Otitis externa(Swimmer ear)
Infection in outer ear with severe painful movement of pinna and tragus.Redness and swellen of pinna and canal.Hearing normal or diminish.Common in hot or humid weather. Use rubbing alcohol or 2% acetic acid.
Tophi
Hard nodules. Small, whitish yellow, nontender.Caused by uric acid.
Rhinorrhea
discharge from the nose (as in a cold)
Epistaxis
Nosebleed. most common in Kiesselbach plexus in anterior seprum
Hoarsness
When the voice is scratchy, strained and stressed; cause=excessive screaming; laryngitis
Xerostomia
dryness of the mouth
Rhinitis
an inflammation of the mucous membrane lining the nose (usually associated with nasal discharge - appears fist - clear, watery). Acute: sneezing, swollen mucosa => nasal obstruction, dark red turbinates. When allergic - turbinates are pale , edema + itching of eyes and nose
Polyps
Tumors with stems, found in mucus membranes. Pale gray, avascular, mobile, nontender. MAy cause absence of smell
Angular Cheilitis/Stomatitis/ Perleche
inflammation and cracking of the skin of the lips at the corners. Erythema, scaling, painful fissures w/excess salivation
Malocclusion
any deviation from the normal positioning of the upper teeth against the lower teeth => risk for facial deformity, negative self-image chewing problems, speech dysfluency
Leukoplakia
whitish or grayish patches w/ well defined borders, doesn't scrape off that develop in the mouths on the lateral edges of tongue of tobacco or alcohol users and that may lead to cancer
bifid uvula
a condition in which the uvula is split either completely or partially. MAy affect speech development
Ankyloglossia
tongue-tie; a defect of the tongue characterized by a short, thick frenulum. Congenital defect
Perforated septum
A hole in the septum, usually in the cartilaginous part, may be caused by snorting cocaine, chronic infection, trauma from continual picking of crusts, or nasal surgery. It is seen directly or as a spot of light when the penlight is directed into the other naris.
Sinusitis
paranasal sinuses are continuous with the nasal cavities through apertures that open into them - infections may spread from the nasal cavities and produce swelling and pain in sinuses. When several sinuses are inflamed, swelling of mucosa my block one or more openings of the sinuses into the nasal cavities. Facial pain
Cleft lip
condition that results from failure of the upper lip to join medially; can be unilateral or bilateral
Carcinoma of lips
usually affects b/w the outer and middle thirds
may appear as scaly plaque, as an ulcer or without a crust or as a nodular lesion
Mucocele/ Retention Cyst
-rupture of salivary gland duct, round translucent nodule 1-2 cm, pocket of mucous. Benign. Usually on buccal mucosa, floor of the mouth, under the tip of the tongue
Dental Caries
abnormal destructive condition in a tooth caused by a complex interaction of food, especially starches and sugars, with bacteria that form dental plaque. First look chalky white -> brown or black -> forms cavity
Epulis
nontender fiberous nodule of gums seem between teeth. inflammatory response to injury or hemorrhage.
Gingival Hyperplasia
painless enlargement of the gums frequently seen in puberty,pregnancy, in leukemia, or after prolonged use of phenytoin (Dilantin)
Gingivitis
inflammation of the gums characterized by swelling, redness, and a tendency to bleed, may expose roots of teeth due to poor hygiene, vit C deficiency, in puberty and pregnancy
Meth mouth
methamphetamine abuse cause vasoconstriction - limited blood supply to mouth, vessels die, oral tissues decay. dry mouth- mouth acids eat away at teeth and gums. strong desire for sugary foods and drinks. Lead to many dental diseases
Aphthous ulcers
grey-white pits with a red border in the soft tissues lining the mouth; also known as canker sores or mouth ulcers. Painful. 2-3 weeks, unknown cause
Candidiasis / Monoilial Infection
white, cheesy, curdlike patch on buccal mucosa due to opportunistic infection when on antibiotics. Can scrape off and bleeds easily
Geographic tongue / Migratory Glossitis
Geographic tongue is a harmless (benign) oral condition that gives your tongue a map-like, or geographic, appearance. The distinct look of geographic tongue occurs when parts of your tongue are missing the layer of small bumps called papillae. This causes irregularly shaped smooth, red patches to form on parts of your tongue, like a rash. Not significant
Smooth, Glossy tongue
A: slick and shiny appearance of tongue due to decreased papillae, dryness of tongue, occurs with vitamin B12 , folic acid, and iron deficiency.
Black Hairy Tongue
The tongue is covered by hairlike papillae entangled with threads produced fungi. Could be caused by poor hygene or antibiotic therapy.
Fissured or scrotal tongue
deep furrows divide papillae into small irregular rows.
incidence increases with age, occurs in down syndrome. Increase with age
Carcinoma of the tongue
an ulcer with rolled edges, indurated. occurs mainly at sides, base and under tongue. heavy smoking and alcohol use increases odds
Enlarged tongue/ Macroglossia
maxydema, acromegaly and Down Synd. May impair speech, not painful
Clef Palate
the maxillary processes fail to fuse and do not properly separate the nose and the mouth, producing difficulty swallowing and speaking
Acute Tonsillitis and Pharyngitis
Bright red throat; swollen tonsils; white or yellow exudate on tonsils and pharynx; swollen uvula; and enlarged, tender anterior cervical and tonsillar nodes. Accompanied by severe sore throat, painful swallowing, fever >101° F of sudden onset.
Cryptorchidism
A condition in which one or both of the testicles fail to descend into the scrotum. Common in pre-term babies. Descent may occur in utero or by time infant is 3 months old. Risk for decreased spermatogenesis and infertility
Small testis
Small and soft testis upon palpation (<3.5 cm). Indicates atrophy as with cirrhosis, hypopituitarism, following estrogen therapy, or as a sequelae of orchitis. Small and firm occurs with klinefelter's syndrom (hypogonadism)
Testicular torsion
twisting of the spermatic cord causing decreased blood flow to the testis; occurs most often during puberty and often presents with a sudden onset of severe testicular or scrotal pain. Because of lack of blood flow to the testis, it is often considered a surgical emergency
Epididymitis
Acute infection of epididymis commonly caused by prostatitis, after prostatectomy b/c trauma of urethral instrumentation or d/t chlamydia, gonorrhea, or other infections. Causes severe pain of sudden onset in scrotum, somewhat relieved by elevation (phren's sign). Upon inspection, enlarged reddened scrotum.
Varicocele
refers to varicose veins of the spermatic cord due to incompetent valves , usually found on the left. It feels like a soft "bag of worms" separate from the testis, and slowly collapses when the scrotum is elevated in the supine patient. Infertility may be associated.
Spermatocele
Retention cyst in the epididymis, may be caused by obstruction of tubules. Usually painless. Upon inspection, does transluminate higher in the scrotum than a hydrocele, and the sperm may fluoresce. Upon palpation, round, freely movable mass lying above and behind testis, may feel like a third testis.Painless. Filled w/ thin. milky fluid w/sperm
Testicular tumor
nonpainful lumps, harder than testis - almost all are malignant. Diffuse tumor - maintains shape of testicle
Hydrocele
Scrotal swelling due to collection of serous fluid within the tunica vaginalis. Imbalance between fluid secretion and reabsorption. Causes- secondary to trauma or infection
Hernia of male reproductive system
Usually scrotal, direct and indirect inguinal (most common) and femoral hernia. Causes swelling, may have pain with straining. Soft mushy mass, palpating fingers cannot get above mass.
Orchitis
inflammation of one or both testicles usually caused by mumps, pathogens, or injury. testicular swelling, pain, tenderness, nausea, and fever, doesn't transilluminate
Scrotal edema
Accompanies marked edema in lower half of body. Causes tenderness. Upon inspection, enlarged, reddened scrotum with local irritation. Upon palpation, taut with pitting, probably unable to feel scrotal contents
Anorectal Fistula
Chronically inflammed GI tract creates an abnormal passage from inner anus or rectum, out to skin surrounding anus.
Hemorrhoids
-Dilated engorged veins in lining of rectum
-Increased venous pressure
Causes: straining, pregnancy, chronic liver disease, CHF
Pruritis Ani
intense itching at a red, raised, thickened, excoriated skin around the anus. Swollen and moist, and with fungal infection, it appears dull grayish pink. skin is dry and brittle with itching
Rectal Abscess
develop in the ischioanal fossa, submucosa, perineal, Filled w/ pus, need incisions and drainage. Persistent throbbin pain, red, hot, swollen, tender
Benign Prostatic Hypertrophy
Urinary frequency, weak stream, symmetric, nontender enlargement in male sin middle ages
Prostatitis
Fever, chills, frequency, dysuria, urthral d/c, tender enlargement, slightly asymmetric
Carcinoma of Prostate gland
Frequency, hematouria, dyuria, pain in low back, pelvis. Asymmetric. Hard and fixed
Uterine fibroids/ Myoma / Leimyoma
Benign Smooth muscle tumors. Up to 80% of women. 2-3 times more prevalent in African American women*
Hormonally responsive ~~> regress after menopause
Most are asymptomatic, but symptoms include menorrhagia, pelvic pressure/pain, GI/GU complaints, infertility
Endometrosis
painful benign disease presence of growth of endometrial tissue outside the uterus , dysmenorrhea and hypermenorrhea that begins after years of pain free menses
Acute Salpimgitis/ Pelvic Inflammatory Disease (PID)
Inflammation of the fallopian tubes, most often caused by bacteria, intense sudden pain, difficult to assess. May result in ectopic pregnancy, infertility.
Ovarian cyst
Sac that develops within the ovary. Usually asymptomatic. Smooth, mobile, nontender. Should resolve spontaneously within 60 days
Ectropion
Lower eyelid loose and rolling outward. Dry and itchy eyes. Aging, trauma
Entropion
inversion of the eyelid, causing the lashes to rub against the eye; corneal abrasion may result
Blepharitis
inflammation of eyelid, causing redness, crusting, and swelling along lid margins
Dacryocystitis
blockage, inflammation, and infection of a nasolacrimal duct and lacrimal sac, causing redness and swelling in the region between the nose and lower lid. Tearing present
Conjunctivitis
Inflammation of the conjunctiva, pink eye. Red at periphery,clear aroung iris
Subconjunctival hemorrhage
result of a strong sneeze or cough that caused a broken blood vessel underneath the clear surface of your eye (conjunctiva). usually a harmless condition that disappears within 10 to 14 days.
Iritis
inflammation of the iris, usually marked by pain, redness around iris. photophobia, irregular pupil, and discoloration of the iris
Otalgia
pain in the ear
Otorrhea
discharge from the ear
Tinnitis
ringing, buzzing, or roaring sound in one or both ears. MAy be due to medications