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Test 1 HEENT, Behavior, Skin, Hair, Nails
Test 1 HEENT, Behavior, Skin, Hair, Nails
104
Medical
Graduate
01/26/2015

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Term
What are focal neurological signs
Definition
Focal neurologic signs also known as focal neurological deficits or focal CNS signs are impairments of nerve, spinal cord, or brain function that affects a specific region of the body, e.g. weakness in the left arm, the right leg, paresis, or plegia.
Term
what are the different headache classifications
Definition
Primary and Secondary. Primary accounts for all your typical headaches while secondary are a result of something pathological like a tumor, trauma, SAH
Term
The majority of migraines are unilateral or bifrontal or global
Definition
70% are unilateral
Term
Do all migraines have associated auras?
Definition
NO. Only 30%
Term
What is the physiology of a tension headache
Definition
involves pericranial muscle tenderness, normallly bilateral and back of the head or upper neck area. Also can be frontotemporal area. Unclear physiology
Term
What is the difference in sx between tension headaches and migraines
Definition
Migraines have sx of nausea while tension HA never have nausea.
Term
drooping of the eyelid is called?
Definition
ptosis
Term
another name for pupil constriction
Definition
miosis (0 - c0nstriction)
Term
Another name for dilation of pupil
Definition
myDriasis (D=dilation)
Term
what is vertigo? What causes it? What cranial nerve is involved?
Definition
there is something wrong with the labyrinth of the inner ear. The ear connects to brain via the vetibular-cochlear nerve VIII
Term
To examine ear by "tug test" what do you do for a child and what do you do for an adult
Definition
For child pull pinna down, for adult pull pina back and up. This will let you know if patient has external otitis.
Term
a thyroid becomes a goieter when
Definition
when its twice its normal size
Term
how do you do a thryoid exam
Definition
Start by finding your landmarks. Located thryoid cartilage. Then run fingers down over crico-thryoid membrane, then over cricoid cartilage. Then to the first two rings of the trachea. That's where you want to be and thats where the isthmus of the thryoid lies ( over the first two rings in the trachea cartilage). Go from behind the patient and lay your fingers of both hands horizontally over your landmark. Ask patient to swalllow. When he does the thyroid will come up and allow you to feel if both sides are equal in size and or excessively large. Then assess nodes where lie in same plane more posterior. Also assess hands for tremors with hands out and for sweating/edema.
Term
what are the five components of a mental status examination
Definition
1. appearance and behavior
2. speech and language
3. mood
4. thoughts and perceptions
5. cognitive function
Term
what is aphonia
Definition
loss of voice
Term
what nerve is involved with speech
Definition
glossopharyngeal IX
Term
What is dysphonia
Definition
less severe than aphonia but a compromise to volume of voice, quality, or pitch of voice
Term
what's the difference between broca's aphasia and wernicke's aphasia
Definition
Wernicke's area is responsible for processing meaningfulnes of words and producing meaninngful words.. damage results in receptive aphasia. Pt say words right but lack meaning. Broca's aphasia is expressive aphasia, takes time or may not say words, they can ready but can't recognize and name something.
Term
depression is a decrease in what neurotransmitters
Definition
dopamine, NE, serotonin
Term
how do tricyclic antidepressants work
Definition
they prevent the reuptake of NE and serotonin so that more is left in the synaptic cleft to bind to the post-synaptic membrane and illicit a response.
Term
what are some causes for delirium
Definition
1. delirium tremens from withdrawal
2. uremia
3. acute hepatic failure
4. acute cerebral vasculitis
5. atropine poisoning
6. drug intoxication
7. ICU Psychosis
Term
What are some causes for dementia
Definition
1. vitamin B12 def (reversible)
2. Thryoid disease (reversible)
3. alzyheimers
4. vascular dementia
5. Dementia from head trauma.
Term
what is a macule?
Definition
small flat spots, <1.0 cm
Term
what is a burrow, what can cause this skin condition
Definition
burrow are a tunnel like appearance usually associated with scabies.
Term
spider angiomas are seen in what conditions
Definition
1. liver disease
2. pregnancy
3. vitamin B deficiency
Term
what's the difference between petechia/purpura and ecchymosis
Definition
mostly the same except petechia/purpura are less <3mm and ecchymosis is >3 cm.
Term
moles should be < ? mm
Definition
<6 mm
Term
what are the ABCDEs of melanoma
Definition
A: Asymmetry
B: Borders (Irregular)
C: Color (variation - black/blue/white/red)
D: Diameter (>6mm)
E: Evolution (Changes in size, sx)
Term
what is acitinic keratosis
Definition
People who had a lot of sun can get it and they are considered pre-cancerous. 1 in 1000 develop into squamos cell carcinoma.
Term
What nerves attenuate taste for the tongue
Definition
1. facial nerve does 2/3 anterior tongue
2. glossopharyngeal does 1/3 posterior tongue
Term
what nerve does speech?
Definition
Glossopharyngeal nerve and Vagus Nerve
Term
What nerve does abduction of the eyes
Definition
CN VI: Abducen Nerve: Abduction means looking away from midline (side-to-side) This nerve is abducen nerve
Term
What nerve pulls the eyes down and in
Definition
Trochlear
Term
what motor movement does occulomotor do?
Definition
Occulomotor is Cranial Nerve III. Itpulls eyes upward via superior rectus muscle, downward via inferior rectus muscle, medial via the medial rectus and up and in via the inferior oblique.
Term
What does the hypoglossal nerve do? How do you test for it?
Definition

tongue movement

Ask patient to touch the rough of their mouth with their tongue, stick tongue out, left and right. 

Term
what cranial nerve causes miosis
Definition
occulomotor
Term
what nerve is responsible for mastication
Definition
trigeminal
Term
What nerves attenuate taste for the tongue
Definition
1. facial nerve does 2/3 anterior tongue
2. glossopharyngeal does 1/3 posterior tongue
Term
a person develops the worse headache of their life and is found to have a SAH..what class of headache is this; primary or secondary
Definition
secondary
Term
What skin condition is a precursor for squamos cell carcinoma
Definition
actinic keratosis
Term
What are the five layers of the cornea
Definition
1. epithelium
2. bowman's layer
3. stroma
4. descemet
5. endothelium
Term
what is an Anisocoria (ANNE-ICE-SO-CORE-E-Ahhh)
Definition
unequal pupil sizes. It may be normal and up to 20% of people in population have this.
Term
what are some sx of horner's syndrome
Definition
1. ptosis: droopy eyelid
2. anhidrosis: inability to sweat
3. Mydriasis: dilation of pupil.
Term
most common peripheral blocks that cause horner's syndrome
Definition
1. scalene blocks
2. cervical pelxuses blocks
Term
CN III paralysis. What would your right eye do?
Definition
Eye would deviate lateral/outward due to CN VI
Term
CN IV paralysis would do what to your right eye
Definition
Eye would not be able to look downward when turned inward. Very rare
Term
CN VI paralysis would do what to right eye
Definition
Right eye could not look lateral. It would be come disconjugate from left eye when you tried focusing your own eyes to right.
Term
what can increase ICP results in what findings when assessing the eye?
Definition
causes papilledema which is seen as intra-axonal edema along optic nerve with engorgement and swelling of the optic disc
Term
what's the difference between conductive and sensorineural hearing loss?
Definition
Sensorineural hearing loss relates to issues with the inner ear and cochlear or nerves and connection with the brain. While conductive deals with the outer and middle ear and its apparatus that delivers vibrations into the inner ear from environment
Term
what two medications are notorious for causing hearing loss
Definition
1. aminoglycosides
2. lasix
Term
If a patient felt dizzy or lightheadedness would you think vertigo?
Definition
NOOOOOOOOOOOO. Vertigo is more like the room is spinning around them or they are spinning around the room.
Term
what is otitis externa and what would you see when assessing for it?
Definition
ear infection of the external ear. You would see a swollen canal, the canal may be narrowed, pain would be illicited when tugging on the auricle. The external ear may be reddened.
Term
When examining for otitis externa how do you manipulate the pinna of an adult compared to a young child
Definition
Adult: pull pinna up and back
Child: pull pinna straight down.
Term
how do you test for auditory acuity
Definition
whispered voice. Stand 2 feet behind patient. Occlude non-test ear with finger.
Term
how do you test to see if someone has conductive or neurosensory hearing loss?
Definition
use a tuning fork
Term
What is the difference between the Rinne Test and Weber Test
Definition
You first test with the Rinne test which tests for conduction differences between air and bone conduction. Normal is Air is > than bone. If Air=Bone or Bone > Air then conductive hearing loss. IF Air is > bone but air does not last that much longer compared to when its done to you then there may be sensorineural hearing loss. Further test for sensorineural with a webers test to differentiate unilateral sensorilateral hearing loss with fork over head.
Term
what are the three tonsils in the body
Definition
1. palatine tonsil
2. lingual tonsil
3. pharyngeal tonsil (aka adenoid tonsils)
Term
asymmetric tongue protrusion (Stick your tongue out!) means what cranial nerve involvement
Definition
CN 12
Term
what are the three different types of sleep apnea. describe them
Definition
1. Obstructive Sleep Apnea: obstruction
2. Central Sleep Apnea: Brain/signal issue
3. Complex sleep apnea: combo of obstructive and central SA
Term
where are your visual inputs transformed into auditory code?
Definition
angular gyrus
Term
Auditory information is interpreted for meaning in what part of the brain
Definition
wernicke's area
Term
what area control speech via the __
Definition
brocas via the motor cortex
Term
patient words lack meaning but come out clear and fast..what area is affected? Causing what kind of aphasia
Definition
wernicke's area causing receptive aphasia
Term
patient has slow, laborous speech, words are meaningfull and concise but poorly articulated, few words, what area affected? What type of aphasia
Definition
Broca's area damaged causing expressive aphasia.
Term
what are some common sx of depression
Definition
1. muscle aches
2. headaches
3. fatigue
Term
what herbal upregulates the CYP3A4 cytochrome of the P450 system in the liver.[24]
Definition
St. John's wort
Term
what antidepressant has significant anti-cholinergic effects
Definition
tricyclic anti depresseants
Term
what antidepressant may be used for pain use
Definition
tricyclics
Term
what drugs do you avoid with tricyclics and MAOIS
Definition
Avoid indirect acting sympathomimetics and vasoactive drugs like pancorunioum, ketamine, demerol, ephedrine
Term
how do tricyclics work
Definition
block the reuptake of amines
Term
what medicaiton has a serious side effect with MAOI's and is contraindicated
Definition
demerol!!!!
Term
which antidepressant has the lease cholinergic effects and no sedation
Definition
SSRI
Term
what is circumstantiality
Definition

is a communication disorder in which the focus of a conversation drifts, but often comes back to the point.[1] In circumstantiality, unnecessary details and irrelevant remarks cause a delay in getting to the point

 

Think about circumstantial evidence in law enforcement. It helps but can also just be "fluff and puff" adding to the case but not necessarily directly related to your case or point. 

Term
Derailment is?
Definition
is a thought disorder characterized by discourse consisting of a sequence of unrelated or only remotely related ideas. The frame of reference often changes from one sentence to the next"The traffic is rumbling along the main road. They are going to the north. Why do girls always play pantomime heroes?
Term
Flight of ideas
Definition
Flight of ideas describes excessive speech at a rapid rate that involves fragmented or unrelated ideas.[8] It is common in mania.[8] It has also been described in schizophrenia and ADHD
Term
Neologisms
Definition
In psychiatry, the term neologism is used to describe the use of words that have meaning only to the person who uses them, independent of their common meaning.[8] This tendency is considered normal in children, but in adults it can be a symptom of psychopathy[9] or a thought disorder (indicative of a psychotic mental illness, such as schizophrenia).[
Term
Blocking
Definition
Thought blocking, a phenomenon that occurs in people with psychiatric illnesses (usually schizophrenia), occurs when a person's speech is suddenly interrupted by silences that may last a few seconds to a minute or longer
Term
Confabulation
Definition
In psychology, confabulation (verb: confabulate) is a memory disturbance, defined as the production of fabricated, distorted or misinterpreted memories about oneself or the world, without the conscious intention to deceive.[1] Confabulation is distinguished from lying as there is no intent to deceive and the person is unaware the information is false
Term
Echolalia
Definition
The word "echolalia" is derived from the Greek ἠχώ, meaning "echo" or "to repeat",[2] and λαλιά (laliá) meaning "speech" or "talk"[3] In Transcortical sensory aphasia, echolalia is common, with the patient incorporating another person's words or sentences into his or her own response. While these patients lack language comprehension, they are still able to read. A typical pediatric presentation of echolalia might be as follows: a child is asked "Do you want dinner?"; the child echoes back "Do you want dinner?", followed by a pause, and then a response, "Yes. What's for dinner?"[9]
Term
Clanging
Definition
In psychology and psychiatry, clanging refers to a mode of speech characterized by association of words based upon sound rather than concepts.Example: “He went in entry in trying tieing sighing dying ding-dong dangles dashing dancing ding-a-ling!”
Term
misperceptions of real external stimulus
Definition
illusions
Term
fixed, false beliefs, cannot be corrected by logic and are not consistent with culture and education of the patient
Definition
delusions
Term
What is the difference in remote and recent memory
Definition
Remote Memory

Definition
Remote memory is the ability to remember things that happened years ago.Ex: remember what dad use to do on 4th of july? This memory lost late in dementia.

Recent memory is just that. usually effected in delerius patients
Term
when is LOC affected in dementia?
Definition
LATE dementia will have change in LOC
Term
what are some reversible causees of dementia
Definition
1. vitamin B 12 (Cobalamin) def 2. thryoid disorders
Term
what are some causes of delerium
Definition
1. atropine overdose
2. drug intox
3. ICU psychosis
Term
difference between petechia/purpura and ecchymosis
Definition
both are purple, petechia/purpura <3 mm.
Term
what are the characterestics of benign nevus
Definition
a mole. Normally round or oval, sharply defined borders, uniform colors, <6mm, flat or raised slightly
Term
give some examples of secondary headache
Definition
1. SAH
2. Infections
3. analgesia rebound
Term
what common drug we give in the hospital can precipitate migraines in some people
Definition
Zofran
Term
What three things can cause ptsosis
Definition
1. myathenis gravis
2. horner's syndrome
3. cranial nerve III damage
Term
people with exophthalamos cant do what with their eyes well?
Definition
- Exophthalmos pts can’t converge well.
Term
The posterior part of the eye seen through an opthalmoscope is known as the?
Definition
fundus
Term
Lateral and slightly inferior to the disc, there is a small depression in the retinal surface that marks the point of central vision – around it is a darkened circular area known as the?
Definition
fovea
Term
causes of dysphonia
Definition
Causes? cerebellar disease or parkinsons
Term
what antidepressant can exacerbate anticholinergic sx associated with scopolamine and benadryl
Definition
tricyclics anti dep
Term
difference in sleep between dementia and delerium
Definition
dementia pts have fragmented sleep patterns while delerius patients have disrupted sleep patterns
Term
what are some risk factors for melanoma?
Definition
1. age > 50
2. multiple >50 moles
3. red or light hair
4. Actinic letingines
Term
what is Actinic letingines
Definition
is a small pigmented spot on the skin with a clearly defined edge, surrounded by normal-appearing skin. It is a harmless (benign) hyperplasia of melanocytes which is linear in its spread. A lentigo has an increased number of melanocytes. Freckles will increase in number and darkness with sunlight exposure, whereas lentigines will stay stable in their color regardless of sunlight exposure. Risk factor for melanoma.
Term
what is Seborrheic keratosis?
Definition
- seBorrheic Keratosis: B=benign. STUCK ON, black spotsgreasy/velvety/warty
Term
most common type of skin cancer? What does it look like?
Definition
basal cell carcinoma, 80%, pearly red, slow growing and doesn't often metastasizes
Term
Crusted, hyperkeratotic lesions with a rough surface or flat reddish patches with inflammed, ulcerated appearance is??
Definition
Squamos cell carcinoma. 18% of skin cancers. Can arise from aCintic Keratosis. More red and firm than basal cell. Also doesn't metastasize as often.
Term
What is the difference between:
Tinea Capitis
Trichotillomania
Alopecia Areata
Definition
Tinea Capitis: Ring work. Circular hair loss with scales and dry skin
Trichotillomania: Hair mania. Pulling or plucking hair. Psch issues.
Alopecia Areata: Hair loss in circular fashion with no other sx. Autoimmune.
Term
What does clubbing fingers indicate?
Definition
Clubbing means congenital heart disease.
Clubbing:
Loss of normal angle between nail and proximal nail fold.
Angle >180
Nail bed is spongy or floating
Seen in congenital heart disease, interstitial lung disease, Lung cancer, inflammatory bowel disease, and malignancies.
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