Unit_5[1].txt

the bulbar conjunctiva covers the exposed surface of the eyeball up to the outer edge of the cornea.

Under the bulbar conjunctiva, has the color of white porcelain in whites and light yellow in dark-skinned clients. The whites of the eye which is fibrous and protective

In the nasal corner or inner canthus of the eye, where tears flow to from the lacrimal gland

abnormal drooping of the lid over the pupil caused by edema or impairment of the 3rd cranial nerve

Extra, abnormal eye movements noticed during the six directions of gaze testing the muscles

• 1. Right and up right superior rectus and left inferior oblique
• 2. right right lateral rectus and left medial rectus
• 3. right and down right inferior rectus and left superior oblique
• 4. left and up left superior rectus and right inferior oblique
• 5. left left lateral rectus and right medial rectus
• 6. left and down left inferior rectus and right superior oblique

Eye chart to measure visual acuity

Pupils equal, round, reactive to light and accomodation

Congenital condition in which both eyes do not focus on an object simultaneously and the eyes appear crossed. Impairment of the extraocular muschles or their nerve supply cause this

Collects lymph from head, ears, nose, cheeks, and lips. Can warn you of infection. Inspect areas where nodes are distributed and compare both sides, inspect for edema, erythema or red streaks, also palpate

Intermittent outward movement of the nostrils with each inspiratory effort, indicates an increase in the work of breathing

The membrane lining passages and cavities communicating with the air, consisting of a surface layer of epithelium, a basement membrane, and underlying layer of connective tissue

cavities in the skull that usually communicate with the nostrils and contains air

• Hard palate-roof of mouth, located anteriorly, dome shaped
• Soft palate-extends posteriorly toward the pharynx, light pink and smooth

A mass of lymphoid tissue in the muscous membrane of the pharynx and base of the tongue. The free surface of each tonsil is covered with stratified squamous epithelium that forms deep indentations or crypts, extended into the substance of the the tonsil

the free edge of the soft palate that hangs at the back of the throat above the root of the tongue, it is made of muscle, connective tissue and mucous membrane

The lining of the cheeks of the oral cavity, it is characterized by the stratified squamous non-keratinized epithelium that may become keratinized in local areas due to cheek biting, it may also contain ectopic sebaceous glands

Inspect on all sides as well as the floor of the mouth, note any deviation, remor, or limit in movement, this tests the hypoglossal nerve

Equipment used for inspecting deeper structure of the external and middle ear

Advanced practice nurses use this to onspect the fundus, which includes the reina, choroid, optic nerve disc, macula, fovea centralis and retinal vessels

A hearing assessment using a tuning fork

Visual assessment using the snellen chart. The ability to see small details, tests central vision

Intolerance to light. Painful sensitiveness to strong light. An abnormal fear of light

An invountary, rhythmical oscillation of the eyes. Assessed by periodically stopping movement of the finger

Pupils normally converge and accommodate by constricting when looking at close objects. Test:gaze at a distant object and then at a test object held close

A disordered state which is associated with various disorders of the inner ear. and in which the individual seem to whirl dizzily diordered vertiginous movement as a symptom of disease

Bleeding from the nose

A large bi-lobed endocrine gland that arises as a median ventral outgrowth of the pharynx, it lies in the anerior base of the neck or anterior ventral part of the thorax and produces hormones. Inspect the lower neck overlying the gland for obvious masses, symmetry and any subtle fullness

Earwax

Part of the digestive and respiratory tracts situated between the cavity of the mouth and esophagus. It is continues above with the mouth and nasal passage, communicates through the eustachain tubes with the ears, and extends downward past the opening into the larynx to the lower border of the cricoid cartilage where it is continuous with the esophogus

The largely cartilaginous projecting portion of the external ear

Tube that passes air to and from the lungs

Skin, hair, scalp & nails

small stomachs, fewer digestive enzymes, underdeveloped neuromuscular system

acidity of gastric contents increase, stomach size increases, physiologic ability to control sphincters is present, learn control of bodily functions

decreased salivation, acid secretions, mucosal thickening, nutrient absorption, peristalsis, esophogeal emptying. Cardiovascular changes affect blood flow and absorption, less muscle tone in perineal floor and anal sphincter

Right upper, left upper, right lower, left lower

Right hypochondriac, epigastric, left hypochondriac, right lateral (lumbar), umbilical, left lateral (lumbar), right iliac (inguinal), suprapubic, left iliac (inguinal)

discoloration, inflammation, hemorrhoids, lessions

4 quadrants, check for bruits. Your can hear the renal artery in the RUQ, iliac artery in the RLQ, the aorta is above where the RUQ & LUQ meet, femoral artery is in the groin

Resonance, tymmpany (bubble stomach), dull (organs or fluid), flatness (lower edge of liver). Check in a Z pattern and for CVA tenderness

Very lightly, must be relaxed, check for distention

• Hep B-infection of liver
• Abdominal-anorexia, nausea, vomiting, enlargement of liver
• Lactose intolerance-inability to digest milk sugar, diarrhea, flatus, abdominal pain

Look for pallor in face, buccal and nail beds. Cyanosis in lips nail bed and palms. Jaundice in sclera

Excessive sweating, moisture, excessive dry skin

Palpate with dorsum of hand and document hot, warm, cold, etc

Is skin soft, smooth, even, flexible. Check palms of hands and soles of feet, they usually are thicker skinned areas

Checking for hydration and elasticity of skin. Grasp a fold of skin on back of forearm and release. Skin should snap back to normal immediately

Check circulation, variscosities, color and appearance of blood vessels

Check feet, sacral area and notice in pitting edema (accumulation of fluid under the skin) rated 1-4 depending on depth of pitting and how long it stays pitted.

Inspect for color, location, texture, size, shape, type, grouping and distribution. Measure size

Palpate head for any abnormalties. Inspect hair for distribution, quantity, thickness, texture, lubrication. Inspect scalp for lesions

• Check nail bed for color, cleanliness, length, thickness, and shape.
• Palpate nail bed to determine firmness and cap refill, should be less than 2 seconds

Elasticity of skin

bluish skin associated with hypoxia

decrease in color, reduced amount of oxyhemoglobin caused by anemia

Increased amount of bilirubin in tissues, seen in sclera of eye. Yellowing of skin caused by liver disease

build up of fluid in the tissues

test for peripheral circulation, press lightly on skin to produce blanching, color should return in less than 2 seconds

skin color, usually uniform over the body.

Body temperature exceeding normal. Results from external conditions creating more heat than the body can get rid of. Body not able to regulate temperature due to external conditions.

flat, nonpalpable, circumscribes less than 1cm. Example is a freckle.

Elevated, palpable, firm circumscribed less than 1 cm. example is a wart

Elevated, circumscribed, superficial filled with serous fluid. Less than 1cm. Example is a blister or chicken pox

Bluish, black areas of pigmentation, may appear over any part of the exterior suface of the body

Thin to thick fibrous tissue replacing injured dermis

aka stretch marks, irregular areas of skin that look like bands, stripes or lines

Loss of epidermis and dermis. concave, varies in size, exudative, red or redish blue. Example is decubitus ulcer or statis ulcer

Linear crack or break from epidermis to dermis. Small, deep, red. Athlete's foot

Freckles or age related changes such as skin tags, thickening of skin, red papules.

Elevated, firm, circumscribed, palpable, deeper in dermis than papule, 1-2 cm. Example is erythema, lipoma

Solid mass that extends deep through subcu tissue, larger than 1-2cm

Elevated, superficial, similar to vesicle but filled with purulent fluid. Example is acne, impetigo

Vesicle greater than 1cm. Example is blister

elevated, irregularly shaped area of cutaneous edema, solid, transient, changing, variable diameter. Example is an insect bite or hives

Character of the skin's surface and the feel of deeper proportions are texture

Localized red or puple discolorations caused by extravasation of blood onto dermis and subcu tissue

Hair loss, thinning of the hair related to genetic tendencies and endocrine disorders

mouth, abdomen, rectum

4 quadrants of abdomen, bowel sounds, bruits

Resonance, typmany, dull, flattness, z-patter

Very light palpation to feel for distention

Accumulation of fluid in the peritoneal cavity

Waste products eliminated by the rectum

Movement of contents through the intestines, is a normal function of the small and large intestines

audible passage of air and fluid that peristalsis creates

Opening for elimination

stores and expels feces

Used over abdominal quadrant. Lay palm of hand with fingers extended and palp lightly on the abdomen no deeper than 1/2 inch

Movement across the abdomen, men breath abdominally women breath costally. Dimished movement can be related to pain

Dark tarry stools related to GI hemmorhage

Large quantities of waste and gas eliminated by the colon

protrusion of abdominal organs through the muscle wall, causes upward protrusion of the umbilicus

flat, concave with the color the same as that of surrounding skin

Liver, transverse colon, gallbladder, head of pancreas, hepatic flexure and duodenum, right kidney

Stomach, spleen, left lobe of liver, left kidney, and adrenal gland, body of the pancreas, splenic flexure of colon, left kidney

cecum, appendix, right ureter, right ovary and fallopian tubes, ascending colon

left ovary, fallopian tube, descending colon, sigmoid colon, left ureter

Inspect, auscultate, percuss, palpate

R Upper, R Lower, L Upper, L Lower

• Right Hypochrondriac
• Epigastric
• Left Hypochrondriac
• Right lateral (lumbar)
• Umbilical
• Left lateral (lumbar)
• Right iliac (inguinal)
• Suprapubic
• Left iliac (inguinal)

• Bolus travels from the mouth to the esophagus to stomach, to small intestine, then to large intestine, then anus, defecation occurs.
• Bladder elmination occurs after 150-200 ml of urine collects in the bladder. As volume increase the bladder wall stretches sending sensory impulses to the spinal cord to void urine

Disease conditions, socioeconomic factors, psychological factors, fluid balance, surgical procedures, medications, diagnostic examination

urination

Hospital acquired illness

Urinary tract infection, caused by bacteria getting into the urethra. Pain and burning during urination.